Criteria for Defining Evidence-Based Practices

More than thirty years ago, Archie Cochrane wrote a seminal textbook, Effectiveness and Efficiency: Random Reflections on Health Services, outlining the need to implement healthcare programs or interventions that have an evidence base and the importance of using healthcare programs or interventions that have an evidence base and the importance of randomized control trials (RCTs) to evaluate the treatment. His call launched the modern day focus on evidence-based practices (EBPs). Outlining the finer details of what constitutes an EBP has proven to be a challenge due to the difficulties of reaching a consensus across researchers, stakeholders, and states regarding the following:

• How much evidence is needed
• Accounting for the natural drawbacks of social science research (i.e., resources, ethics, real world vs. clinical trials, homogenous sample pools, etc...)
• Allowing for programs that are currently used in the field to develop an evidence base

Accounting for these issues when reviewing programs is important, as most criteria assess programs along a continuum. Terms like model program, well-established, and promising reflect the amount of evidence that supports the practice with the definitions and terminology, differing from one criteria to the next. Links to different criteria sets for evidence-based practices are provided below:

• SAMHSA's Center for Substance Abuse Prevention created the National Registry of Effective Programs which reviews and identifies effective substance abuse prevention and mental health programs.
• The Cochrane Collaboration is an international non-profit organization that systematically reviews the effects of healthcare interventions, including mental health interventions.
• The Campbell Collaboration is a sister organization to the Cochrane Collaboration. It is an international, non-profit organization that systematically prepares, maintains, and disseminates reviews of the effects of social, behavioral, and educational interventions.
• The Society for Prevention Research (SPR) is an international organization comprised of scientists, practitioners, advocates, administrators, and policy makers. Its focus is on preventing social, physical, and mental health problems, as well as the advancement of science-based programs that promote health, safety, and well-being of individuals and their respective communities. In 2003, SPR appointed a committee to determine criteria for preventive interventions that are recognized to be efficacious, tested, and effective. The committee produced the booklet, The Standards of Evidence, which compiles criteria for efficacy, effectiveness, and dissemination.
• The Center for the Study and Prevention of Violence provides information about programs demonstrated to be effective in preventing and intervening in youth violence.
• The Hawaii Department of Mental Health's Child and Adolescent Mental Health Division adapted the APA criteria for the review of interventions for youth with behavioral and emotional needs. The two categories were expanded to five levels of Evidence-Based Services, ranging from best support (highest), to known risks (lowest). The criteria are based on the methodology design, number of trials, replication, standardization, and generalizability.
• The Oregon State EBP Model has five levels of criteria, with the first three defining EBPs. Beyond the typical criteria outlined in APA and other models (including study design, replicability, generalizability, etc...). The highest level of evidence requires the treatment be shown to be effective in both scientifically controlled and routine care settings. A fidelity tool is also required.