About Getting To Outcomes® Research

“Under the hood” of GTO is the GTO Logic Model, which shows how GTO has its impacts. GTO manuals, training, and coaching build the capacity of individuals on how to do prevention well. Individuals then use that increased capacity to carry out all the tasks outlined in the GTO Steps, applied to their program—what we call Program Performance. High Program Performance across all the GTO steps leads to programs being done with quality, which in turn leads to improved outcomes among program participants. This graphic shows how we used data to establish these links over the course of multiple GTO studies.

GTO Logic Model

  1. Implementation support
  2. Individual capacity
  3. Program performance
  4. Program quality
  5. Individual outcomes
  • Implementation support is GTO! It includes manuals, templates, training, and ongoing coaching.
  • Individual capacity is the knowledge, attitudes and skills needed to run programs well.
  • Program performance is how well each task, as outlined in the 10 GTO Steps, is conducted.
  • Program quality is how well the program is run, including fidelity, attendance, and dose.
  • Individual outcomes are the changes in the people who participated in the program.

Studies

Improving the Implementation of Evidence-based Drug Prevention Programs in Schools

2020–2025

Comparing middle schools attempting to implement an evidence-based case substance abuse prevention program (Project ALERT) randomly assigned to receive GTO to similar schools that are not using GTO and a third (control) group with neither.

Key Findings

  • Teams assigned to GTO implemented the case management approach while control teams did not.

Areas studied

  1. Implementation Support
  2. Program quality
  3. Individual Outcomes

Training the Department of Defense In Getting To Outcomes® to Strengthen Sexual Assault Prevention Programs®

2018–2021

Trained 10 military installations representing all military services, plus the Coast Guard and National Guard on how to use Getting To Outcomes® to plan, implement, and evaluate sexual assault prevention programs

Key Findings

  • Most sites completed all GTO steps at least once.
  • Interviews showed that DoD participants believe GTO improved prevention understanding, planning, and evaluation capacity; strengthened confidence in chosen programs; and helped sites tailor programs to the military context.
  • Barriers to use of GTO were the complexity of GTO, DoD personnel turnover, and the disruption that the COVID pandemic caused in sexual assault prevention program delivery.
  • Many respondents were unsure if they would continue all of GTO after the coaching ended, but many believed they would continue at least some parts.

Areas studied

  1. Implementation support
  2. Individual capacity
  3. Program performance
See the research publications for this study

Getting To Outcomes® for Integrated Violence Prevention and Resilience in the Military

2018–2021

Used Getting To Outcomes®—including new tools, training, and technical assistance—to support the Air Force’s initiative to stand up high-quality resilience and integrated violence prevention programming across all its installations.

Key Findings

  • According to interviews, Air Force staff learned new prevention skills corresponding to the GTO steps of reviewing data to identify priority problems; setting desired outcomes; considering the evidence base of programs before selecting them; creating detailed workplans; and evaluating their work.
  • The quality of Air Force Community Action Plans—plans that each Air Force base must complete every two years—were enhanced via the GTO process.

Areas studied

  1. Implementation support
  2. Program performance

Building Resilient Regions: Workforce Capacity for Translation, Implementation and Evaluation of Promising PERRC Products

2016–2017

Used the Getting To Outcomes® approach to enhance the capacity of three large local health departments in southern California to translate and implement evidence-based programs in emergency preparedness.

Key Findings

  • Local health department staff reported improved capacities

Areas studied

  1. Implementation support
  2. Individual capacity
See the research publications for this study

Preparing to Run Effective Prevention (PREP)

2013–2019

Compared community organizations attempting to implement an evidence-based drug prevention program randomly assigned to receive GTO to similar organizations that were not using GTO

Key Findings

  • GTO programs had greater fidelity than control programs.
  • GTO programs saw more improvement in planning and evaluation, despite worse implementation climates.
  • GTO programs were more likely to sustain drug prevention programming 2 years after the end of formal GTO support.
  • Better Program performance was linked to greater fidelity.
  • The benefit of GTO regarding delayed alcohol and drug use more than offsets its costs.

Areas studied

  1. Program performance
  2. Program quality
  3. Individual outcomes
See the research publications for this study

MISSION-Vet HUD-VASH Implementation Study

2012–2015

Compared VA housing teams attempting to implement an evidence-based case management approach randomly assigned to receive GTO to similar teams that were not using GTO

Key Findings

  • Teams assigned to GTO implemented the case management approach while control teams did not.

Area studied

  1. Program quality
See the research publications for this study

Building System Capacity Through Continuous Quality Improvement

2012–2015

Tested a CQI intervention based upon an expansion of the original GTO's resources on CQI developed in collaboration with community based substance abuse treatment providers

Key Findings

  • Results indicated that CQI was feasible and acceptable for community-based substance abuse prevention and treatment programs; however, some notable resource challenges remain.

Area studied

  1. Implementation support
See the research publications for this study

Evaluation and Support Services for the New Mexico Federal Home Visiting Development Project

2012–2014

Provided support for using Getting To Outcomes® to build capacity and improve home visiting program implementation in New Mexico

Key Findings

  • A local team hired to facilitate GTO did not use it as designed, and no communities were trained in GTO.
  • The coalitions that were developed operated with few resources or accountability, and made little progress on plans to enhance services. Only two of the four communities started home visiting after nearly a year and a half.
  • There was no change in the continuum of services to support children and families.
  • Due to delays and lack of implementation of the proposed intervention, the evaluation was not able to assess the project's impact on child or family outcomes, nor did the project serve as a robust pilot test of the use of GTO and ECHO to improve home visiting implementation.

Areas studied

  1. Implementation support
  2. Program performance
See the research publications for this study

Enhancing Quality Interventions Promoting Healthy Sexuality (EQUIPS)

2011–2016

Compared community organizations attempting to implement an evidence-based teen pregnancy program randomly assigned to receive GTO to similar organizations that were not using GTO

Key Findings

  • GTO saw more improvement in program performance than control programs.
  • GTO programs had greater fidelity than control programs.
  • More technical assistance was linked to better program performance.
  • Better Program Performance was linked to greater fidelity.
  • Youth from GTO programs had better individual outcomes of condom attitudes and intentions.
  • GTO costs would be recovered if it prevented one more teen birth per 140 attendees.

Areas studied

  1. Program performance
  2. Program quality
  3. Individual outcomes
See the research publications for this study

VA HOMES (Homeless Outcomes: a Model for Evaluation and Success)

2009–2012

Engaged staff members from three VA homeless programs at the Pittsburgh VA to improve their quality using Getting-To-Outcomes®

Key Findings

  • With staff members averaging 33 minutes per week on GTO, each team made significant programmatic changes.
  • Staff stated GTO was helpful, and that high levels of communication, staff member commitment to the program, and technical assistance were critical.

Areas studied

  1. Implementation support
  2. Individual capacity
  3. Program performance
See the research publications for this study

Enhancing Prevention Capacity with Developmental Assets® and Getting To Outcomes® (Assets-GTO)

2008–2013

Compared coalitions implementing a variety of drug prevention strategies randomly assigned to receive GTO to similar coalitions that were not

Key Findings

  • Assets-GTO users experienced improvements in individual prevention capacity.
  • Assets-GTO programs saw more improvement in goal setting and evaluation compared to control programs.
  • Increased capacity was linked to better program performance; worse funding stability was linked to worse performance.
  • More technical assistance yielded greater gains.

Areas studied

  1. Individual Capacity
  2. Program performance
See the research publications for this study

Getting To Outcomes® and Underage Drinking (GTO-UD)

2008–2012

Compared coalitions implementing underage drinking prevention strategies randomly assigned to receive GTO to similar coalitions that were not

Key Findings

  • Performance of some GTO steps, applied to prevention strategies, improved more over time in the GTO-UD sites than in the control sites.
  • More technical assistance yielded greater gains.
  • Merchants in the GTO-UD counties improved significantly on refusing sales to minors and control merchants did not.

Areas studied

  1. Program performance
  2. Program quality
See the research publications for this study

Building Community Capacity to Conduct Effective Violence Prevention

2005–2008

Developed and piloted a continuous quality improvement process adapted for community-based violence prevention programs

Key Finding

  • The process was found to be feasible, acceptable, and helpful to the community-based prevention and treatment providers.

Areas studied

  1. Implementation support
  2. Individual capacity
See the research publications for this study

Web-Based IT Solution for Outcome Based Prevention

2005–2007

Helped develop an online version of the Getting To Outcomes® model called iGTO and compared program performance of 99 coalition-based drug prevention programs that used and did not use iGTO in Missouri and Tennessee

Key Findings

  • At one year, analyses found that iGTO programs in both states improved their performance compared with non-iGTO programs.
  • In terms of iGTO diffusion, monitoring data show that overall, iGTO was diffused by most of the iGTO-assigned coalitions.
  • Users' experience with and perceptions of the iGTO system were mixed.

Areas studied

  1. Implementation support
  2. Program performance
See the research publications for this study

Participatory Research of an Empowerment Evaluation System

2002–2005

Compared substance abuse providers and programs receiving GTO to similar providers and programs that were not

Key Findings

  • GTO helped individual program staff improve their capacity (knowledge, attitudes, skills) and their performance of prevention (how well programs were rated performing various prevention tasks) more than the comparison programs did (more GTO engagement leads to more improvement).
  • Training and technical assistance were found to be key predictors to using the GTO intervention.
  • Evaluation assistance was used and highly valued.

Areas studied

  1. Implementation Support
  2. Individual Capacity
  3. Program performance
  4. Program quality
See the research publications for this study

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