National Registry of Evidence-Based Programs and Practices

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The National Registry of Evidence-based Programs and Practices (NREPP) was a searchable online database of interventions designed to promote mental health or to prevent or treat substance abuse and mental disorders. The registry was funded and administered by the Substance Abuse and Mental Health Services Administration (SAMHSA), part of the U.S. Department of Health and Human Services. The goal of the Registry was to encourage wider adoption of evidence-based interventions and to help those interested in implementing an evidence-based intervention to select one that best meets their needs.

Contents

The NREPP website was phased out in 2018. See the section below about the phase out for more information.

Overview

Logo: SAMHSA's National Registry of Evidence-based Programs and Practices (NREPP), www.nrepp.samhsa.gov National Registry of Evidence-Based Programs and Practices (NREPP) Logo.jpg
Logo: SAMHSA's National Registry of Evidence-based Programs and Practices (NREPP), www.nrepp.samhsa.gov

In the behavioral health field, there is an ongoing need for researchers, developers, evaluators, and practitioners to share information about what works to improve outcomes among individuals coping with, or at risk for, mental disorders and substance abuse. Discussing how this need led to the development of NREPP, Brounstein, Gardner, and Backer (2006) [1] write:

It is important to note that not all prevention programs work. Still other programs have no empirically based support regarding their effectiveness. […] Many others have empirical support, but the methods used to generate that support are suspect. This is another reason to highlight the need for and use of scientifically defensible, effective prevention programs. These are programs that clearly demonstrate that the program was well implemented, well evaluated, and produced a consistent pattern of positive results.

The focus of NREPP is on delivering an array of standardized, comparable information on interventions that are evidence based, as opposed to identifying programs that are "effective" or ranking them in effectiveness. Its peer reviewers use specific criteria to rate the quality of an intervention's evidence base as well as the intervention's suitability for broad adoption. In addition, NREPP provides contextual information about the intervention, such as the population served, implementation history, and cost data to encourage a realistic and holistic approach to selecting prevention interventions. [2]

As of 2010, the interventions reviewed by NREPP have been implemented successfully in more than 229,000 sites, in all 50 States and more than 70 countries, and with more than 107 million clients. [3] Versions of ura review process and rating criteria have been adopted by the National Cancer Institute [4] and the Administration on Aging.

The information NREPP provides is subject to certain limitations. [5] It is not an exhaustive repository of all tested mental health interventions; submission is a voluntary process, and limited resources may preclude the review of some interventions even though they meet minimum requirements for acceptance. [6] The NREPP home page prominently states that "inclusion in the registry does not constitute an endorsement."

Submission process

NREPP holds an open submission period that runs November 1 through February 1. For an intervention to be eligible for a review, it must meet four minimum criteria: [7]

  1. The intervention has produced one or more positive behavioral outcomes (p ≤ .05) in mental health, mental disorders, substance abuse, or substance use disorders use among individuals, communities, or populations.
  2. Evidence of these outcomes has been demonstrated in at least one study using an experimental or quasi-experimental design.
  3. The results of these studies have been published in a peer-reviewed journal or other professional publication, or documented in a comprehensive evaluation report.
  4. Implementation materials, training and support resources, and quality assurance procedures have been developed and are ready for use by the public.

Once reviewed and added to the Registry, interventions are invited to undergo a new review four or five years after their initial review.

Review process

The NREPP review process consists of two parallel and simultaneous review tracks, one that looks at the intervention's Quality of Research (QOR) and another that looks at the intervention's Readiness for Dissemination (RFD). The materials used in a QOR review are generally published research articles, although unpublished final evaluation reports can also be included. The materials used in an RFD review include implementation materials and process documentation, such as manuals, curricula, training materials, and written quality assurance procedures.

The reviews are conducted by expert consultants who have received training on NREPP's review process and rating criteria. Two QOR and two RFD reviewers are assigned to each review. Reviewers work independently, rating the same materials. Their ratings are averaged to generate final scores.

While the review process is ongoing, NREPP staff work with the intervention's representatives to collect descriptive information about the intervention, such as the program goals, types of populations served, and implementation history.

The QOR ratings, given on a scale of 0.0 to 4.0, indicate the strength of the evidence supporting the outcomes of the intervention. Higher scores indicate stronger, more compelling evidence. Each outcome is rated separately because interventions may target multiple outcomes (e.g., alcohol use, marijuana use, behavior problems in school), and the evidence supporting the different outcomes may vary. The QOR rating criteria are:

  1. Reliability of measures
  2. Validity of measures
  3. Intervention fidelity
  4. Missing data and attrition
  5. Potential confounding variables
  6. Appropriateness of analysis

The RFD ratings, also given on a scale of 0.0 to 4.0, indicate the amount and quality of the resources available to support the use of the intervention. Higher scores indicate that resources are readily available and of high quality. These ratings apply to the intervention as a whole. The RFD criteria are:

  1. Availability of implementation materials
  2. Availability of training and support resources
  3. Availability of quality assurance procedures

Reviewers

QOR reviewers are required to have a doctoral-level degree and a strong background and understanding of current methods of evaluating prevention and treatment interventions. RFD reviewers are selected from two categories: direct services experts (including both providers and consumers of services), or experts in the field of implementation. Direct services experts must have previous experience evaluating prevention or treatment interventions and knowledge of mental health or substance abuse prevention or treatment content areas.

Products and publications

NREPP publishes an intervention summary for each intervention it adds to the Registry. The summaries, which are accessed through the Registry's search engine, [8] contain the following standardized information:

NREPP also maintains an online Learning Center. Offerings include learning modules on implementation and preparing for NREPP submission; a research paper on evidence-based therapy relationships; and links to screening and assessment tools for mental health and substance use.

Predecessor system

The registry originated in 1997 [9] and has gone through several changes since then. The predecessor to today's NREPP was the National Registry of Effective Prevention Programs (later renamed the National Registry of Effective Programs and Practices), which was developed by SAMHSA's Center for Substance Abuse Prevention as part of the Model Programs initiative. Procedures under this earlier registry were developed to review, rate, and designate programs as Model, Effective, or Promising. [10] Based on extensive input from scientific communities, service providers, expert panels, and the public, the procedures were revised. Reviews using the new NREPP system began in 2006, and the redesigned Web site debuted in March 2007. [11]

Phase out in 2018

According to an email from SAMHSA:

"SAMHSA is committed to advancing the adoption of evidence-based interventions related to mental health and substance use. Consistent with the January 2018 announcement from the Assistant Secretary for Mental Health and Substance Use related to discontinuing the National Registry of Evidence-based Programs and Practices (NREPP), SAMHSA has now phased out the NREPP website, which has been in existence since 1997. In April 2018, SAMHSA launched the Evidence-Based Practices Resource Center (Resource Center) that aims to provide communities, clinicians, policy makers, and others in the field with the information and tools they need to incorporate evidence-based practices into their communities or clinical settings. The Resource Center contains a collection of science-based resources; however, it does not replace NREPP and does not contain all of the resources that were previously available on NREPP.

"The Resource Center is a component of SAMHSA’s new comprehensive approach to identify and disseminate clinically sound and scientifically based policy, practices, and programs. Under this new approach, we are continuing to develop and add additional resources to the Resource Center as they become available. In the meantime, please use our Resource Center as well as the SAMHSA Store to find information on evidence-based practices and other resources related to mental health and substance use. For products and resources not developed by SAMHSA, please contact the developers for more information."

Further reading

Related Research Articles

The Substance Abuse and Mental Health Services Administration is a branch of the U.S. Department of Health and Human Services. It is charged with improving the quality and availability of treatment and rehabilitative services in order to reduce illness, death, disability, and the cost to society resulting from substance abuse and mental illnesses. The Administrator of SAMHSA reports directly to the Secretary of the U.S. Department of Health and Human Services. SAMHSA's headquarters building is located outside of Rockville, Maryland.

A best practice is a method or technique that has been generally accepted as superior to any alternatives because it produces results that are superior to those achieved by other means or because it has become a standard way of doing things, e.g., a standard way of complying with legal or ethical requirements.

Suicide prevention Collective efforts to reduce the incidence of suicide

Suicide prevention is a collection of efforts to reduce the risk of suicide. These efforts may occur at the individual, relationship, community, and society level. Suicide is often preventable.

The TeenScreen National Center for Mental Health Checkups at Columbia University was a national mental health and suicide risk screening initiative for middle- and high-school age adolescents. On November 15, 2012, according to its website, the program was terminated. The organization operated as a center in the Division of Child and Adolescent Psychiatry Department at Columbia University, in New York City. The program was developed at Columbia University in 1999, and launched nationally in 2003. Screening was voluntary and offered through doctors' offices, schools, clinics, juvenile justice facilities, and other youth-serving organizations and settings. As of August 2011, the program had more than 2,000 active screening sites across 46 states in the United States, and in other countries including Australia, Brazil, India and New Zealand.

Assertive community treatment (ACT) is an intensive and highly integrated approach for community mental health service delivery. ACT teams serve individuals with the most serious forms of mental illness, predominantly but not exclusively the schizophrenia spectrum disorders. ACT service recipients may also have diagnostic profiles that include features typically found in other DSM-5 categories. Many have histories of frequent psychiatric hospitalization, substance abuse, victimization and trauma, arrests and incarceration, homelessness, and additional significant challenges. The symptoms and complications of their mental illnesses have led to serious functioning difficulties in several areas of life, often including work, social relationships, residential independence, money management, and physical health and wellness. By the time they start receiving ACT services, they are likely to have experienced failure, discrimination, and stigmatization, and their hope for the future is likely to be quite low.

The Drug Resistance Strategies Project (DRS), a program funded by the National Institute on Drug Abuse (NIDA), teaches adolescents and pre-adolescents how to make decisions and resist alcohol, tobacco, and other drugs (ATOD).

Prolonged exposure therapy (PE) is a form of behavior therapy and cognitive behavioral therapy designed to treat post-traumatic stress disorder. It is characterized by two main treatment procedures – imaginal and in vivo exposures. Imaginal exposure is repeated 'on-purpose' retelling of the trauma memory. In vivo exposure is gradually confronting situations, places, and things that are reminders of the trauma or feel dangerous. Additional procedures include processing of the trauma memory and breathing retraining.

Substance abuse prevention Measures to prevent the consumption of licit and illicit drugs

Substance abuse prevention, also known as drug abuse prevention, is a process that attempts to prevent the onset of substance use or limit the development of problems associated with using psychoactive substances. Prevention efforts may focus on the individual or their surroundings. A concept that is known as "environmental prevention" focuses on changing community conditions or policies so that the availability of substances is reduced as well as the demand. Individual Substance Abuse Prevention, also known as drug abuse prevention involves numerous amounts of different sessions depending on the individual to help cease or reduce the use of substances. The time period to help a specific individual can vary based upon many aspects of an individual. The type of Prevention efforts should be based upon the individual's necessities which can also vary.

Parent management training (PMT), also known as behavioral parent training (BPT) or simply parent training, is a family of treatment programs that aims to change parenting behaviors, teaching parents positive reinforcement methods for improving pre-school and school-age children's behavior problems.

Communities That Care

Communities That Care (CTC) is a program of the Center for Substance Abuse Prevention (CSAP) in the office of the United States Government's Substance Abuse and Mental Health Services Administration (SAMHSA). CTC is a coalition-based prevention operating system that uses a public health approach to prevent youth problem behaviors such as violence, delinquency, school drop out and substance abuse. Using strategic consultation, training, and research-based tools, CTC is designed to help community stakeholders and decision makers understand and apply information about risk and protective factors, and programs that are proven to make a difference in promoting healthy youth development, in order to most effectively address the specific issues facing their community's youth.

The Interagency Working Group on Youth Programs is a group within the executive branch of the U.S. government, and is responsible for promoting healthy outcomes for all youth, including disconnected youth and youth who are at-risk. The Working Group also engages with national, state, local and tribal agencies and organizations, schools, and faith-based and community organizations that serve youth.

Jack, Joseph and Morton Mandel School of Applied Social Sciences is a nationally and internationally recognized school of social work, one of the six professional schools within the Case Western Reserve University system, located among many educational and cultural institutions in the University Circle in Cleveland, OH. Established in 1915, it is the first school of social work in the United States to be affiliated with a university. The school is consistently ranked among the top ten schools of social work in the United States by U.S. News & World Report.

The Copeland Center for Wellness and Recovery is a non-profit mental health organization that has created and pioneered the use of the Wellness Recovery Action Plan (WRAP) and other works developed by Dr. Mary Ellen Copeland. The Center was established in 2005, and focuses their trainings and programs on persons seeking to take personal responsibility to improve their wellness. They also work with health service providers, businesses and community groups who are seeking to improve their wellness and create a healthy workplace environment.

Center for the Collaborative Classroom is a nonprofit organization headquartered in Alameda, CA that was founded in 1980 by Eric Schaps. Collaborative Classroom develops and disseminates literacy and community-building programs for use in elementary schools, and literacy, mathematics, and science enrichment programs for use in after-school environments, as well as provides professional development services tailored to each program.

Multisystemic therapy (MST) is an intense, family-focused and community-based treatment program for juveniles with serious criminal offenses who are possibly abusing substances. It is also a therapy strategy to teach their families how to foster their success in recovery.

School-based prevention programs are initiatives implemented into school settings that aim to increase children's academic success and reduce high-risk problem behaviors.

Education sector responses to substance abuse refers to the way in which the education sector strategizes, developments and implements policies and practices that address the use of tobacco, alcohol, and other drugs in educational settings.

Prevention of mental disorders are measures that try to decrease the chances of a mental disorder occurring. A 2004 WHO report stated that "prevention of these disorders is obviously one of the most effective ways to reduce the [disease] burden." The 2011 European Psychiatric Association (EPA) guidance on prevention of mental disorders states "There is considerable evidence that various psychiatric conditions can be prevented through the implementation of effective evidence-based interventions." A 2011 UK Department of Health report on the economic case for mental health promotion and mental illness prevention found that "many interventions are outstandingly good value for money, low in cost and often become self-financing over time, saving public expenditure". In 2016, the National Institute of Mental Health re-affirmed prevention as a research priority area.

Screening, Brief Intervention and Referral to Treatment (SBIRT) is a model that encourages mental health and substance use screenings as a routine preventive service in healthcare.

References

  1. ↑ Brounstein, P. J., Gardner, S. E., & Backer, T. (2006). "Research to practice: Efforts to bring effective prevention to every community". Journal of Primary Prevention, 27(1), 91-109. doi: 10.1007/s10935-005-0024-6. PMID   16421654.
  2. ↑ Sherman, D. (2010). "A paradigm shift in selecting evidence-based approaches for substance abuse prevention”. Prevention Tactics, 9(6), 1-12.
  3. ↑ National Register of Health Service Providers in Psychology. “Evidence-based practice resources” Archived 2011-09-13 at the Wayback Machine . The Register Report. Fall 2010. Retrieved 2011-12-01.
  4. ↑ “Cancer Control and Population Services: Key collaborations”. National Cancer Institute. Retrieved 2012-04-03.
  5. ↑ About NREPP” on the NREPP Web site Archived 2011-12-13 at the Wayback Machine
  6. ↑ Hennessy, K., & Green-Hennessy, S. (2011). “A review of mental health interventions in SAMHSA’s National Registry of Evidence-Based Programs and Practices”. Psychiatric Services, 62(3). doi: 10.1176/appi.ps.62.3.303. PMID   21363903.
  7. ↑ “National Registry of Evidence-Based Programs and Practices”, 76 FR 180, Sept. 16, 2011, 57742-57744
  8. ↑ "Archived copy". Archived from the original on 2010-08-02. Retrieved 2011-12-22.CS1 maint: archived copy as title (link)
  9. ↑ “National Registry of Evidence-Based Programs and Practices adds information on former model programs initiative to web site” Archived 2012-04-10 at the Wayback Machine (Press release). SAMHSA. August 21, 2007. Retrieved 2012-04-03
  10. ↑ Brounstein, P. J., Gardner, S. E., & Backer, T. (2006). “Research to practice: Efforts to bring effective prevention to every community”. Journal of Primary Prevention, 27(1), 91-109. doi: 10.1007/s10935-005-0024-6. PMID   16421654.
  11. ↑ “SAMHSA launches searchable database of evidence-based practices in prevention and treatment of mental health and substance use disorders” Archived 2007-07-13 at the Wayback Machine (Press release). SAMHSA. March 1, 2007. Retrieved 2011-12-01.
  12. ↑ Children’s Services Council of Palm Beach County. (2007). “Research review: Evidence-based programs and practices: What does it all mean?” Retrieved 2012-03-30.
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