Advancing methods for program evaluation in substance use by strengthening the application of epidemiology, economic evaluation, and implementation science: Reflections on the opportunities for synergy

Abstract

Program evaluation is necessary to assess the success of evidence-based programs in real-world, non-trial settings. In its most basic form, it involves understanding processes that impact the health and well-being of individuals and communities. Increasingly, robust program evaluations are integrating approaches from implementation science and economic evaluation to strengthen assessment, achievement, and sustainment of the intended impacts of evidence-based programs, while traditionally employing epidemiological methods to assess outcomes. Epidemiology, economic evaluation, and implementation science operate in overlapping yet siloed arenas, which can make it challenging for program evaluators to effectively engage all three disciplines. Furthermore, given their overlap, practitioners in these disciplines must understand differences in their purpose and lexicon to foster synergies. We use the Centers for Disease Control and Prevention Evaluation Framework and an example from substance use prevention to reflect on specific concepts and terminology within each of these disciplines and how distinctions impact the ability of multidisciplinary teams to collaborate on evaluations. The implications apply to those designing, testing, implementing, and evaluating evidence-based programs—all of whom have the opportunity to consider and strengthen these elements when developing processes and measuring impact. The substance use prevention field needs to better understand how these disciplines can complement one another to enrich process, outcome, and impact evaluations, given the complexities of substance use behaviors and evidence-based programs to address them. With this synergy, clearer communication of findings from the different components can be achieved.