• By Michael Little
  • Posted on Thursday 10th July, 2008

Embedded programs

Steve Aos and David Hawkins have been in Birmingham to support the Brighter Future’s strategy. Aos encouraged a portfolio of wise program investments. Hawkins promoted a public health approach tested in Seattle schools.The presentations started in very different places and led me to ponder a different way of thinking about the future of evidence based programs.Aos is adept at compiling sensible lists of programs using data on their costs and benefits. The following table is assembled from several of such lists published by the Washington Institute.

Program Cost Benefit Cost benefit
HIPPY $1,837 $3,313 $1,476
Parent-child Home $3,890 zero -$3,890
Early Headstart $20,972 $4,768 -$16,203
NFP $9,188 $26,298 $17,180
Big Brothers Big Sisters $4,010 $4,058 $48
Scared Straight $54 -$11,002 -$11,056
LST $29 $746 $717
Good Behaviour Game $8 $204 $196
The table is illuminating in several ways. It reminds us that cheap and popular programs, such as Scared Straight, are ineffective and therefore ultimately extremely expensive. It also reminds us that although effective, the benefits of large scale programs like Early Headstart do not repay the high costs of capital investment and training of staff.Down at the bottom of the list are a couple of inexpensive programs with good cost-benefit ratios. They are programs delivered within schools. LST, for example, takes up about an hour a week on the school curriculum. That means they have the potential to benefit all students. So the $717 return on $8 invested in LST looks pretty smart when multiplied by several thousand students.Hold that thought while I recount something from David Hawkins. He told the audience that encouraging all staff to create opportunities for children’s active involvement in social activity, giving children the skills for successful involvement in a group accompanied by consistent recognition and reinforcement produced better outcomes. It is a classic public health strategy and one that Birmingham’s 50,000 plus staff group may well apply.But a few minutes after sharing these three points, Hawkins asked the 300 plus audience if they could remember what they were. Only half put their hands up, and many more arms went down when Hawkins asked for volunteers to call out the first.Lectures alone do not change behavior.Developers of proven models do know how to change behavior. It involves producing materials, training, coaching and more. But commissioners of agencies are not always good at sustaining programs.Another answer might be to embed these programs in the school curriculum. What if schools were to agree to give over one hour a week for children’s health and development? What if teachers were then trained to routinely deliver PATHS, LST, Good Behavior Game, Success for All and the other curriculum based proven models?We have talked about integration in children’s services. (It's a good thing to do but it does not by itself improve child outcomes). How about embedding programs within systems?(Embedded is a term often associated with journalists who travel with soldiers in war, filing their stories by mobile phone. In a computer, an embedded component is responsible for a single function within a larger system, and without hindering the function of that system. This is not a long way from the idea of an hour a week in school dedicated to improving children’s health and emotional responses without getting in the way of the business of learning).

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