Evidence-Based Interventions

The No Child Left Behind Act of 2001 articulates the value of research and scientific evidence in education. Evidence-based education is a model in which educational practices are expected to be evaluated and results disseminated, so that empirical data informs decision making and educational intervention selection. Interventions for which there [Page 635]is reliable evidence confirming their effectiveness to bring about behavior change/desired results are referred to as evidence-based interventions (EBIs). Such interventions have been evaluated and, based on strong resulting evidence, determined to be capable of achieving specific outcomes. This entry first provides a brief history of the development of EBIs, then describes the planning process, the evaluation of evidence, locating EBIs, and the role of treatment fidelity in implementation.

Historically, the concept of EBI can be traced to evidence-based medicine, a term first introduced in 1992 and later referred to more broadly as evidence-based practice (EBP). The application of EBP has grown beyond medicine to include allied health specialties, clinical and counseling psychology, education, and school psychology.

Initially, the EBP paradigm heavily emphasized research findings, with the randomized controlled trial (RCT) representing the gold standard of rigorous evaluative research. This emphasis on research was designed to move from making opinion-driven clinical decisions to those grounded in data. However, some criticized this as too narrowly focused on research to the exclusion of other factors. In 1996, David Sackett and colleagues expanded the evidence-based medicine model to include the use of clinical expertise and consideration of the characteristics, needs, and preferences of the population or individual receiving the intervention. Later EBP models also accounted for the cultural and environmental context where the intervention would be implemented.

EBIs are validated for a limited application. To be effective, EBIs need to be used to address the specific problem/desired outcomes for which they were designed and with similar populations. Changes to the intervention could impact results. It is also important to remember that EBIs are validated on large groups—they may not be effective with every single case.

EBI planning is a process generally consisting of (a) formulating a researchable question that identifies the type of client/problem, the intervention(s) of interest, and the desired outcome or behavior change; (b) searching for the best quality evidence in response to the question; (c) critically examining the evidence for its applicability, quality, and strength; (d) choosing and implementing the best intervention by integrating the best available evidence with clinical expertise and client/population-specific information; (e) evaluating its effectiveness; and (f) sharing the results and revising the practice as indicated.

The body of education intervention research is growing, but designing and conducting rigorous evaluation research takes time and resources. Thus, not all interventions in use have been tested. Outcome studies may differ in the rigor of their research designs and the strength and reliability of their results. One cannot assume that an intervention that has been published or described as research based meets the standard of an EBI.

Because EBIs in education, as in other areas, draw upon the best available evidence—whether at the program, policy, or individual level—assessing the quality of evidential support is necessary when selecting interventions. There are numerous schemas depicting levels or grades of evidence that consider factors such as the design of the study, its reliability, and the steps taken to minimize bias. Systematic reviews and meta-analyses of RCTs, as well as individual studies using an RCT design, are considered to constitute the highest level of evidence.

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