1. DEVELOPMENT OF A GROUNDED
THEORY FOR TEACHER
DECISIONS TO ADAPT RESEARCH-
BASED HEALTH
EDUCATION CURRICULA
James P. Hurley Ph.D.
jamesh@rmc.org
Brent G. Wilson Ph.D.
2. Introduction to the problem
Introduction to the study
Purpose / Significance of the study
3. Fidelity
Integrity, adherence, or quality of program delivery
Refers to the degree to which teachers and other
program providers implement programs as intended by
the program developers (Dane & Schneider, 1998; Dusenbury et
al., 2003)
4. Adaptation
Adaptation is the degree to which an innovation is
changed or modified by the user in the adoption and
implementation process (Rogers, 1995).
5. Prevalence of Adaptation
A 2003 study reveled that 79.8% of teachers adapted
the curriculum based on student needs (Ringwalt et al.
2003).
Between 23% and 81% of program activities may be
omitted during implementation (Durlak, 1998).
Only 19% of schools implemented research-based
curricula with fidelity (Hallfors & Godette, 2002).
6. “Attention to BOTH fidelity
and adaptation is
essential for successful
implementation of
science-based prevention
programs.” (Backer, 2002)
8. RESEARCH QUESTIONS
1. What factors or considerations influence health
educators’ decision to adapt curriculum?
2. When do health educators make adaptations to the
curriculum?
3. What types of curricular adaptations do health
educators make to curriculum?
14. Research-Based Curriculum
Student Reflection on
INPUTS
Policy in Practice Student Needs Engagement Practice
Local Standards, Unique student Safe, Caring • Teacher
Curriculum, and population Learning Experience
Assessment Student Environment • Reflection-on-
School policies academic Active Learning Practice
ability • Teaching Skills
Teacher
Beliefs
Teacher as Sense-maker
Teacher Planning
Additions, Modifications, Omissions
OUTPUTS
Potential Threats to Fidelity
Curricular Improvement
Research Based Curriculum Enacted
15. Safe Supportive
learning Environment
TO Safe environment
Make personal
ENGAGE connections with
students
STUDENTS To engage students
through a learning
task or activity
Make it relevant for
students
To make connections
for students
To encourage student
sharing and interacting
Student learning styles
Application of concepts
and skills and practice
17. Local curriculum,
LOCAL standards, and
assessment
POLICIES IN Assessment
PRACTICE Standards
Curriculum maps or
guides
School policies
School scheduling
Class size
School-wide initiatives
19. WHEN DID ADAPTATIONS
OCCUR?
Planning
Reflection-in-practice
Reflection-on-practice
20. Discussion
Teachers aligned adaptations with sound pedagogical
practices.
Supported culturally responsive practices.
Role-play needs to be addressed.
Local policies impacted adaptations. (assessment, class
size, school wide initiatives).
Scare tactics.
21. Implications/Recommendation
s
Implementers Curriculum Developers
Planning is a key to fidelity Ensure that activities are
and adaptations interactive
Address student academic
Make a point to understand ability
the theoretical underpinnings
of the curriculum Make theory transparent at the
lesson level
Use data to drive adaptations
Consider goal focused
Ensure alignment of all implementation
lessons (outside of the
curriculum) Provide student assessment
22. Implications/Recommendation
s
Professional Development Educational Reform
Training Efforts
Build capacity to engage in Balanced approach to fidelity
interactive activities
Examine how school level
Provide role-play inputs will impact the reform
opportunities
Build teachers belief that the
Core component reform is what’s best for their
identification students.
Implementation of program Guide adaptations as
based on school level opposed to discouraging
initiatives/policies them
23. Future Research
What is the impact of cultural adaptations on student
outcomes?
How do teachers beliefs guide curricular adaptations?
How can innovative teaching techniques be infused into
prevention curriculum to improve student engagement?
How do “goal focused” curriculum compare to
predefined research-based curriculum?
24. Conclusion
The classroom is a complex system of teaching and
learning.
Adaptations will occur.
Provide guidance for adaptations based on curriculum
theory and sound teaching pedagogy.
25. THANK YOU!
Questions
Hurley, J. P. (2011). Development of a grounded theory for teacher decisions to
adapt research based health education curricula. Denver, CO: University of
Colorado Denver. Doctoral dissertation. Online: http://goo.gl/VWjbN
26. References
Backer, T. E. (2002). Finding the balance: Program fidelity and adaptation in substance abuse prevention - A state-of-the-art review, Conference Edition 2002. Rockville M. D.:
Substance Abuse and Mental Health Services Administration Center For Substance Abuse Prevention.
Dane, A., & Schneider, B. (1998). Program integrity in primary and early secondary prevention: Are implementation effects out of control? Clinical Psychology Review, 18(1), 23-45.
Durlak, J., & DuPre, E. (2008). Implementation matters: A review of research on the influence of implementation on program outcomes and the factors affecting implementation.
American Journal of Community Psychology, 41(327-350).
Dusenbury, L., Brannigan, R., Falco, M., & Hansen, W. B. (2003). A review of research on fidelity of implementation: Implications for drug abuse prevention in school settings. Health
Education Research, 18(2), 237-256.
Glaser, B., & Strauss, A. (1967). The discovery of grounded theory: Strategies for qualitative research. Chicago: Aldine Publishing Company.
Hallfors, D., & Godette, D. (2002). Will the 'Principles of Effectiveness' improve prevention practice? Early findings from a diffusion study. Health Education Research, 17(4), 461-470.
Hurley, J. P. (2011). Development of a grounded theory for teacher decisions to adapt research based health education curricula. Denver, CO: University of Colorado Denver. Doctoral
dissertation. Online: http://goo.gl/VWjbN
Rogers, E. (1995). Diffusion of innovations. New York: Free Press.
Ringwalt, C., Ennett, S., Johnson, R., Rohrbach, L., Simons-Rudolph, A., Vincus, A., & Thorne, J. (2003). Factors associated with fidelity to substance use prevention curriculum guides
in the nation's middle schools. Health Education & Behavior, 30(3), 375-391.
Notes de l'éditeur
This study came out of my interest in the implementation of research based curriculum and the struggle that I went through as a teacher to attempt to implement them with fidelity and one particular training that I went to were participants were demeaned for the adaptations that they were making the curriculumThis study has significance in that the implementation of these prevention programs can have positive long lasting impact on the health and wellbeing or students as well as health along the life course. A number of curriculum such as Botvins, Life Skills Training Curriculum as well as Sussmans Towards no Tobacco as well as a number of other programs that when implemented in schools have been shown to delay or prevent the onset of tobacco, alcohol and other drug use. These programs have been shown to be effective in random control trials. It has been supported by a number of many researchers that these curricula are implemented as the were written or with fidelity. If the intended outcomes of the curriculum are to be expected the curriculum needs to be implemented with fidelity. However, in the real world setting implementation fidelity may not be the norm.This study was developed a grounded theory to describe how teachers make decisions to adapt research based health education curriculum, types of adaptations, when teachers make adaptations to them. By examining the adaptations that teachers are making in the classroom, researchers, implementers can curriculum designers can be better positioned to ensure implementation of these programs at a greater level of fidelity.
These measures were initially developed to examine the extent that the curriculum is being implemented with fidelity during clinical trials – RC trials. They were developed to ensure that type III errors did not occur, or that the lack of results were not due to the lack of fidelity during the trails and that they were truly due to the inadequacies of the program itself. These factors of fidelity identified by Dane and Schneider examine 1) dosage, 2) adherence to the program, 3) quality of delivery (the way the teacher delivered the program, 4). The responsiveness of participants, 5) the degree that critical components can be differentiated. n a 2008 Durlak and DuPre’s (2008) meta-analysis of nearly 500 studies 59 reported measures of fidelity of those 76% reported that fidelity had a positive association with program outcomes with at least 60% of fidelity measures positive outcomes were shown
Reasons for these adaptations - One pertains to the curriculum itself including its specificity, length, complexity, and the associated training. The other is the context or system in which it is implemented.
In the last few years, controversy about fidelity versus adaptation has given way to a compromise position. The compromise position which you se on the slide, essentially agues that fidelity to the original program on the one hand must be balanced with judicious or wise adaptation on the other hand.Tom Backer is one of the strongest advocates of balancing fidelity and adaptation.This sound logical enough, the problem is knowing when to adapt and when not to. Or, put another way, how to make adaptations without jeopardizing the effectiveness of the model or original program. Baccker proposal is a very complex model of community collaboration, with identification of key components of the curriculum, contact with the researcher, to bring these programs to scale it is very difficult to see how such an extensive process can be applicable in schools.
All participants were teaching the LST curriculum at either the middle school or HS. LST levels 1,3 and HS were observed. Class sizes ranged from 5 to 28 students. Experience ranged from a 5 year teacher to a teacher who was in their last year of teaching. Obviously a broader number of participants would have improved the study. But as I went into the final participant the key themes continued to appear and I do believe that saturation did take place.
Data was was collected from observations and interviews. The curriculum was used to track additions, modifications, and omissions. Lesson plans and materials were collected for analysis. Over 16 hours of observation were analyzed and over 11 hours of interviews were conducted.
I look for themes to emerge from the data this drove additional questions in subsequent interviews.
Sense making is the attention to how individuals make sense of competing external mandates on their work context. (Corburn, 2001)In this study the idea of sense-maker is expanded to the examination of not only mandates but the wide range of inputs.Combined with their beliefs system
Teacher made adaptations to engage students. In order to do this they took a significant amount of time setting the stage for a safe classroom environment, and took the time to add activities to make personal connections with students. For example teachers revisited norms or developed norms for this specific unit due to the potential for controversial topics being discussed. Teachers also added introductory activities to allow students to interact with other students prior to the lesson (warm-up activities, some of these had noting to do with the curriculum but just encourages team building, and communication between students.Teachers also made adaptations to engage students learning tasks or activities.Adaptations to make the curriculum more relevant, to make connections for students, to encourage student sharing and interaction, focused on student learning styles specifically encouraging movement in the classroom and the application of concepts and skills. For example teachers teachers added physical activity to lessons on tobacco asking students to exercise while breathing through a straw. One activity in the curriculum asked for students to discuss the factors that influence drug use. The teacher took this and had student think about influences and write them on post it notes. Then to share with two other students. They then posted the notes on the board and categorized them by types of influence internal, external, media, peers, curiosity etc..All of the teachers moved activities or lessons within the curriculum, they all said that it didn’t make sense to do the activity when it was in the curruclum and that the reason for the moving of the activity or lesson was to make a better connections with students.
My students just don’t get this they need more background knowledge. I had to add a sharing to this lesson because if I try and have student jump right into this activity they would just shut down. Our kids just don’t know the terminology or they need to have a basic understanding of consequences. Our students need to know about steroids, or inhalants. Marijuana use is a real problem in my school and we need to spend more time talking about this. For this reason teachers added a significant number of additional lessons and activities.
Small and large class sizes tended to adapt more often this came out of observation and discussion with participates. Also school wide initiatives.
Participants will be more responsive, thus increasing attendance, active participation, practice, and student satisfaction that supports student needs which will support fidelity itself. These processes identified by Backer and other are very time consuming and involve a wide-range of school and community partners to develop the culturally adapted curriculum.Strengthening families fewer dropouts (Kumfer et al., 2002).Increased student engagement.May support sustainability of the program (Botvin, 2004; Castro et al. 2004).Supported by CDC’s Characteristics of Effective Health Education Curriculum.Berkel (2011) proposed an integrated model that supports quality of implementation.
