Getting To Outcomes®
Improving Community-Based Prevention
A Toolkit to Help Communities Implement and Evaluate Their Prevention Programs
Director, Nashville Prevention Partnership
Young people can engage in a variety of negative behaviors—such as drug use, underage drinking, and premarital sex—that exact a high toll on local communities. These activities are often the target of community-based prevention efforts. Getting To Outcomes (GTO), a collaboration between researchers at the RAND Corporation and the University of South Carolina, is a toolkit organized around a 10-step process to help communities plan, implement, and evaluate the impact of their programs that attempt to prevent these negative behaviors. GTO was developed with support from the Centers for Disease Control and Prevention (CDC) and the Substance Abuse and Mental Health Services Administration (SAMHSA).
Bridging the Gap Between Prevention Science and Prevention Practice
Estimates show that substance use prevention programs can improve the behavioral health of communities as well as save $4 to $5 for every dollar invested in drug abuse treatment and counseling. In today's economic climate, funders are increasingly demanding high-quality outcome data for the public or private resources they provide for prevention programs. At the same time, local prevention practitioners face several challenges in implementing high-quality programs, including the significant amount of knowledge and skills required, the large number of steps that need to be addressed, and the wide variety of contexts in which prevention programs need to be implemented. These challenges have resulted in a large gap between the positive outcomes often achieved by prevention science and the lack of these outcomes by prevention practice at the local level.
GTO was specifically designed to bridge this gap and help any agency, school, or community coalition interested in improving the quality of their programs aimed at preventing or reducing a range of negative activities among youth. Since publication in 2004, GTO has earned numerous awards and recognition.
How GTO Works
GTO is both a model for carrying out prevention programming with quality, and a support intervention aimed at enhancing practitioners' capacity.1 GTO does not advocate for any specific prevention program. Rather, communities should use the best program available that meets their needs, evidence-based or otherwise. GTO then provides supports to improve the quality of that program with the goal of achieving positive results.
The GTO model focuses on ten steps describing activities required to obtain positive results from any prevention program (see diagram). Each set of activities has been shown to make prevention programs successful.2 Steps 1-6 involve various planning activities (needs assessment, goal setting, choosing programs, ensuring appropriate capacity and fit, planning program details); steps 7-8 cover process and outcome evaluation; and steps 9-10 focus on the use of data to improve and sustain programs.
The GTO intervention helps practitioners to permanently incorporate newly learned capacities into routine operations, closing the gap between research and practice. This is achieved through three types of assistance: (1) the GTO manual and tools; (2) face-to-face training, and (3) onsite technical assistance (an important part of the GTO intervention, as explained by Matthew Chinman in a video on the SAMHSA website).
1 Chinman et al. (2008). The Getting To Outcomes Demonstration and Evaluation: An Illustration of the Prevention Support System, American Journal of Community Psychology, v. 41, no. 3-4, June 2008, p. 206-224
2 Livet, M., and Wandersman, A. (2005). Organizational Functioning: Facilitating Effective Interventions and Increasing the Odds of Programming Success. In D. M. Fetterman and A. Wandersman (Eds.), Empowerment Evaluation in Practice (pp. 123-154). New York, NY: Guilford
Adaptability to a Range of Prevention Efforts
The GTO model is designed to be a best practice process—prescriptive, yet flexible enough to facilitate any prevention program. Although GTO started in 2004 with drug prevention, since that time, the toolkit has been applied to a range of prevention areas, including:
CDC adapted RAND's step-by-step summary of the 2004 GTO manual to teen pregnancy prevention. In 2008, it published 10 Steps to Promoting Science-Based Approaches (PSBA) to Teen Pregnancy Prevention using Getting To Outcomes (GTO). Known as the “Little (PSBA) GTO,” this manual was used in the later stages of a five-year, multi-state teen pregnancy prevention program conducted by the CDC from 2005-2010. GTO served as the logic model that local communities were to use to structure their teen pregnancy prevention programming.
Positive Youth Development
In 2006, the Search Institute published Ten Steps to Measuring Success in Youth Programs and Communities, a manual targeting positive youth development that blends GTO with the Institute's Developmental Assets framework. The Search Institute uses this manual for training programs. RAND is currently leading a NIDA-funded study evaluating the combined Assets-Getting To Outcomes intervention in 12 sites in Maine.
In 2007, RAND published the Getting To Outcomes for Underage Drinking toolkit, sponsored by SAMHSA. Structured according to SAMHSA's Strategic Prevention Framework, this guide tailors the GTO model specifically for environmental strategies shown to be effective in tackling the problem of underage drinking. RAND is currently leading a CDC-funded study evaluating this version of the GTO intervention in six sites in South Carolina.
The trademarks “Getting To Outcomes” and “GTO” are jointly owned by the RAND Corporation and the University of South Carolina.