Identifying and Selecting 

Evidence-Based Interventions

Revised Guidance Document for the Strategic Prevention 

Framework State Incentive Grant Program 

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administraiton

Center for Substance Abuse Prevention

www.samhsa.gov

January 2009

Identifying and Selecting 

Evidence-Based Interventions

Revised Guidance Document for the Strategic Prevention 

Framework State Incentive Grant Program 

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administraiton

Center for Substance Abuse Prevention

www.samhsa.gov
PUBLIC DOMAIN NOTICE

All material appearing in this report is in the public domain and may be reproduced or copied 

without permission from SAMHSA/CSAP. Citation of the source is appreciated. However, 

this publication may not be reproduced or distributed for a fee without the specific, written 

authorization of the Office of Communications, SAMHSA/CSAP and HHS.

ELECTRONIC ACCESS AND COPIES OF PUBLICATION

This publication may be downloaded or ordered at www.samhsa.gov/shin. Or, please call 

SAMHSA’s Health Information Network at 1-877-SAMHSA-7 (1-877-726-4727) (English and 

Español).

RECOMMENDED CITATION

Center for Substance Abuse Prevention. Identifying and Selecting Evidence-Based Interventions 

Revised Guidance Document for the Strategic Prevention Framework State Incentive Grant 

Program. HHS Pub. No. (SMA)09-4205. Rockville, MD: Center for Substance Abuse Prevention, 

Substance Abuse and Mental Health Services Administration, 2009.

ORIGINATING OFFICE

Center for Substance Abuse Prevention, Substance Abuse and Mental Health Services 

Administration, 1 Choke Cherry Road, Rockville, MD 20857 HHS Publication No. (SMA)09-4205 

2009
Identifying and Selecting Evidence-Based Interventions V

Contents

Executive Summary........................................................................ 1

I. Introduction ................................................................................. 3

A. Background and Context ............................................................................... 3

B. Purpose of the Guidance ............................................................................... 4

II. SPF Implications for Community Planning to Identify 

and Select Evidence-Based Interventions ................................... 5

A. Local Needs and Resource Assessment: 

Key Data Tool to Guide Community Planning .............................................. 5

B. The Community Logic Model: Key Conceptual Tool 

for Community Planning................................................................................ 5

Examples of Community Logic Models ......................................................... 7

III. Using the Community Logic Model and Assessment 

Information to Identify Best Fit Interventions ............................ 9

A. Establishing Conceptual Fit: Is It Relevant? .................................................. 9

B. Establishing Practical Fit: Is It Appropriate? ................................................10

Utility and Feasibility Checks ........................................................................11

IV. Using Public Resources and Review Processes to Identify 

Evidence-Based Interventions and Determine Their 

Evidence Status ..............................................................................12

Evidence-Based Interventions and Evidence Status ...................................12

SPF Definitions of Evidence-Based ...............................................................13

A. Using Federal Registries .................................................................................14

B. Using Peer-Reviewed Journals.......................................................................16

Assessing Elements of Evidence Reported in 

Peer-Reviewed Journals .................................................................................16
VI Identifying and Selecting Evidence-Based Interventions

C. Using Other Sources for Documenting Effectiveness ................................18

SPF SIG Program Guidelines for Documented Effectiveness ......................18

V. Summary Process Description: 

Selecting Best Fit Prevention Interventions ................................20

VI. SPF SIG Program Guidance: Roles and Expectations .............22

A. Federal Role ....................................................................................................22

B. State/Jurisdiction Role ...................................................................................22

C. Community Role .............................................................................................23

Concluding Comments ..................................................................................24

GLOSSARY ......................................................................................25

Table of Figures 

Figure 1. Community Logic Model, Outcomes-Based Prevention..................... 6

Figure 1A. Community Logic Model for Preventing AlcoholInvolved Traffic Crashes, (15- to 24-year-olds) ................................................... 7

Figure 1B. Community Logic Model for Preventing Illicit Drug Use ................. 8

Figure 2. Human Environmental Framework......................................................10

Figure 3. Process Description: 

Selecting Best Fit Prevention Interventions.......................................................21
Identifying and Selecting Evidence-Based Interventions 1

Executive Summary

The purpose of this guidance is to assist State and community planners in applying the 

Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Strategic Prevention 

Framework (SPF) to identify and select evidence-based interventions that address local needs 

and reduce substance abuse problems. 

Section I. Summarizes the five steps of SAMHSA’s SPF and sets the stage for selecting 

evidence-based interventions to include in a comprehensive strategic plan. 

Section II. Focuses on two analytic tasks included under the SPF: assessing local needs, 

resources, and readiness to act; and developing a community logic model. Explains the 

importance of these tasks in community planning to identify the best evidence-based 

interventions for specific local needs. 

Section III. Details how prevention planners can apply the community logic model to 

determine the conceptual fit or relevance of prevention strategies that hold the greatest 

potential for affecting a particular substance abuse problem. Also discusses how to examine 

candidate interventions from the perspective of practical fit or appropriateness for local 

circumstances, cultural contexts, and populations. 

Section IV. Discusses the importance of strength of evidence to inform and guide intervention 

selection decisions. Presents the three definitions of “evidence-based” provided under the 

SPF SIG Program and the advantages and challenges of using each one to select prevention 

interventions. The three definitions of “evidence-based” are as follows: 

l Inclusion in Federal registries of evidence-based interventions; 

l Reported (with positive effects on the primary targeted outcome) in peer-reviewed 

journals; or

l Documented effectiveness supported by other sources of information and the 

consensus judgment of informed experts, as described in the following set of 

guidelines, all of which must be met: 

Guideline 1: The intervention is based on a theory of change that is documented in a 

clear logic or conceptual model; and 

Guideline 2: The intervention is similar in content and structure to interventions that 

appear in registries and/or the peer-reviewed literature; and 

Guideline 3: The intervention is supported by documentation that it has been 

effectively implemented in the past, and multiple times, in a manner attentive to 
2 Identifying and Selecting Evidence-Based Interventions

scientific standards of evidence and with results that show a consistent pattern of 

credible and positive effects; and 

Guideline 4: The intervention is reviewed and deemed appropriate by a panel of 

informed prevention experts that includes: well-qualified prevention researchers who 

are experienced in evaluating prevention interventions similar to those under review; 

local prevention practitioners; and key community leaders as appropriate, e.g., officials 

from law enforcement and education sectors or elders within indigenous cultures. 

Section V. Summarizes the process of working through three considerations that determine 

the best fit of interventions to include in comprehensive prevention plans: 

l Conceptual fit to the logic model: Is the candidate intervention relevant to the 

targeted problem and outcomes? 

l Practical fit to the community’s needs and resources: Is it appropriate to the 

community’s population, cultural context, and local circumstances, including 

community readiness? 

l Strength of evidence: Is there sufficient documented effectiveness to support a 

decision to select the particular intervention and include it in a comprehensive 

community prevention plan? 

Section VI. Discusses the respective roles and expectations for SAMHSA/CSAP and SPF SIG 

States and their sub-recipient communities, jurisdictions, and Federally recognized tribes 

and tribal organizations to ensure the identification and selection of best fit, evidence-based 

prevention interventions for each community. 
Identifying and Selecting Evidence-Based Interventions 3

I. Introduction 

A. Background and Context 

The Substance Abuse and Mental Health Services Administration (SAMHSA) envisions “a life 

in the community for everyone” and has as its mission “building resilience and facilitating 

recovery.” SAMHSA strives to achieve its mission through programs supported by three goals: 

accountability, capacity, and effectiveness. The Center for Substance Abuse Prevention (CSAP) 

helps to create healthy communities. SAMHSA/CSAP helps States to provide resources and 

assistance to communities so that communities, in turn, can prevent and reduce substance 

abuse and related problems. SAMHSA/CSAP also provides training, technical assistance, and 

funds to strengthen the State prevention systems that serve local communities. SAMHSA/CSAP 

works with States to identify programs, policies, and practices that are known to be effective in 

preventing and reducing substance abuse and related problems. 

All of SAMHSA’s mission and goals are driven by strategic planning to align, manage, and 

account for priority programs and issues across the three Centers. Chief among SAMHSA’s 

priorities is the Strategic Prevention Framework (SPF)—a five-step planning process to guide 

the work of States and communities in their prevention activities. 

Step 1. Assess population needs (nature of the substance abuse problem, where it occurs, 

whom it affects, how it is manifested), the resources required to address the problem, 

and the readiness to act; 

Step 2. Build capacity at State and community levels to address needs and problems identified 

in Step 1; 

Step 3. Develop a comprehensive strategic plan. At the community level, the comprehensive 

plan articulates a vision for organizing specific prevention programs, policies, and 

practices to address substance abuse problems locally; 

Step 4. Implement the evidence-based programs, practices, and policies identified in Step 3; 

and 

Step 5. Monitor implementation, evaluate effectiveness, sustain effective activities, and 

improve or replace those that fail. 

Throughout all five steps, implementers of the SPF must address issues of cultural competence 

and sustainability. Cultural competence is important for eliminating disparities in services 

and programs offered to people of diverse racial, ethnic, and linguistic backgrounds, gender 

and sexual orientations, and those with disabilities. Cultural competence will improve the 

effectiveness of programs, policies, and practices selected for targeted populations. 
4 Identifying and Selecting Evidence-Based Interventions

Sustainability of outcomes is a goal established at the outset and addressed throughout each 

step of the SPF. Prevention planners at both State and local levels need to build systems and 

institutionalize the practices that will sustain prevention outcomes over time, beyond the life 

of any specific program. 

Under the SPF State Incentive Grant (SIG) Program, prevention planners are specifically 

required to select and implement evidence-based interventions. SAMHSA/CSAP recognized 

that this requirement necessitates the availability of a broad array of evidence-based 

interventions and further must allow prevention planners the flexibility to decide which 

options best fit their local circumstances. To assist the field in meeting this requirement, 

SAMHSA/CSAP convened an Expert Workgroup during 2005 to develop recommendations and 

guidelines for selecting evidence-based interventions under the SPF SIG Program. 

The Expert Workgroup was composed of nationally recognized substance abuse prevention 

experts from a wide spectrum of academic backgrounds and theoretical research perspectives. 

The guidance presented in this revised document is grounded in the thinking and 

recommendations of the SAMHSA/CSAP Expert Workgroup and incorporates feedback from 

the field, including prevention scientists, to clarify guidelines for documented effectiveness 

and the process for applying them. 

B. Purpose of the Guidance 

This guidance is directed toward prevention planners working through SPF Steps 3 and 4 and 

to help them select and implement evidence-based interventions successfully. The guidance 

lays out an analytic process with a few key concepts to apply in selecting interventions that are 

conceptually and practically fitting and effective. 
Identifying and Selecting Evidence-Based Interventions 5

II. SPF Implications for Community Planning to 

Identify and Select Evidence-Based Interventions 

A. Local Needs and Resource Assessment: Key Data Tool to Guide Community 

Planning 

Prevention experts agree that substance abuse problems are usually best addressed locally—

at the community level—because they are manifested locally. Yet some prevention approaches 

may be most effective when implemented on a larger scale, perhaps through a statewide 

change in laws (e.g., change in the alcohol index for driving under the influence). Experts 

also agree that substance abuse problems are among the most difficult social problems to 

prevent or reduce. Substance abuse problems require comprehensive solutions—a variety of 

intervention approaches directed to multiple opportunities. 

The challenge of selecting the optimal mix of strategies is complicated by the limited 

availability of public resources on evidence-based interventions. In practice, practitioners 

seeking to reduce substance abuse problems will need to put together their own mix of 

interventions. An optimal mix of interventions will fit the particular needs of the community–

its population, cultural context, and unique local circumstances, including community 

readiness. Some interventions in the comprehensive plan may be deemed “evidence-based” 

through inclusion in Federal registries or reported findings in the peer-reviewed literature, 

while others may document effectiveness based on other sources of information and empirical 

data. An optimal mix of strategies will combine complementary and synergistic interventions. 

The needs and resource assessments in Step 1 will guide development of the comprehensive 

prevention plan, from profiling the problem/population and the underlying factors/conditions 

that contribute to the problem, to checking the appropriateness of prevention strategies to 

include in the plan. It is crucial to use local data and information to identify effective strategies 

that fit local capacity, resources, and readiness. However, finding local data is often difficult. 

Creative approaches to data sources, including the use of proxy measures and information 

gleaned through focus groups, may be necessary. 

B. The Community Logic Model: Key Conceptual Tool for Community Planning 

The community logic model reflects the planning that needs to take place to generate 

community level change. Building the logic model begins with careful identification or 

mapping of the local substance abuse problem (and associated patterns of substance use 

and consequences among the population affected) to the factors that contribute to them. 

Developing the logic model starts with defining the substance abuse problem, not choosing 

the solutions--that is, the programs, practices, or policies already decided upon by States or 

communities. 
6 Identifying and Selecting Evidence-Based Interventions

Given that comprehensive plans combine a variety of strategies, it is important to understand 

the relationships between these problems and the factors or conditions that contribute to 

them. Few substance abuse problems are amenable to change through direct influence or 

attack. Rather, they are influenced indirectly through underlying factors that contribute to the 

problem and its initiation, escalation, and adverse consequences. 

These underlying factors include the following: 

l Risk and protective factors that present themselves across the course of human 

development and make individuals and groups either more or less prone to substance 

abuse in certain social contexts. 

l Contributing conditions and environmental factors implicated in the development 

of the problems and consequences associated with substance abuse. Examples may 

include specific local policies and practices, community realities, or population shifts. 

Identifying the underlying factors that drive changes in the targeted substance abuse problem 

and outcomes is essential to determining which programs, practices, and policies will best 

address that problem and its initiation, progression, and pattern and consequences of use. 

Linking the substance abuse problem to the underlying factors, and ultimately to potentially 

effective prevention strategies, requires analysis and a conceptual tool. The logic model in 

Figure 1 serves as the conceptual tool to map the substance abuse phenomenon and the 

factors that drive it. 

Figure 1. Community Logic Model, Outcomes-Based Prevention 

Substance abuse

& related

problems

Risk and

protective

factors/conditions

Programs,

policies &

practices
Identifying and Selecting Evidence-Based Interventions 7

Logic models lay out the community substance abuse problem and the key markers leading 

to that problem. They represent systematic plans for attacking local problems within a specific 

context. The community logic model makes explicit the rationale for selecting programs, 

policies, and practices to address the community’s substance abuse problem. Used in this 

way, the logic model becomes an important conceptual tool for planning a comprehensive and 

potentially effective prevention effort. 

Examples of Community Logic Models 

The sample community-level logic models in Figures 1A and 1B illustrate the relationships 

between an identified substance abuse problem or consequence in an identified population 

and the salient risk and protective factors/conditions that contribute to the problem. Each 

risk and protective factor/condition, in turn, highlights an opportunity—or potential point of 

entry—for interventions that can lead to positive outcomes in the targeted problem. 

While different communities may show similar substance abuse problems, the underlying factors 

that contribute most to them will likely vary from community to community. Communities will 

tailor the logic model to fit their particular needs, capacities, and readiness to act. 

Figure 1A. Community Logic Model for Preventing 

Alcohol-Involved Traffic Crashes (15- to 24-year-olds) 

Risk and protective

factors/conditions

(Examples)

Strategies

(Examples)

Retailer education

Compliance checks/sobriety 

checkpoints

Youth education programs

Community education

Restrictions on advertising 

to youth

Substance 

abuse-related

consequences

(Example)

Alcohol-involved

traffic crashes

(15- to 24-year-olds)

Easy retail access to 

alcohol for youth 

Low enforcement of 

alcohol laws

Easy social access to alcohol

Low perceived risk of 

alcohol use

Social norms accepting and/or 

encouraging youth drinking

Promotion of alcohol use 

(advertising, movies, music, etc.)

Low or discount pricing

on alcohol

Other factors from the

research literature

Restrictions on 

“happy hours ” etc

Parent education/parental

 monitoring

Other evidence-based 

interventions
8 Identifying and Selecting Evidence-Based Interventions

Figure 1B. Community Logic Model for Preventing Illicit Drug Use Among Adolescents 

Risk and protective

factors/conditions

(Examples)

Positive school environment

Disrupted parent/

child relations

Alienation from 

pro-social peers

Academic failure

Other factors from the 

research literature

Strategies

(Examples)

Family/Parenting

skills training

Changing school

climate

Social skills

training

Tutoring 

Substance abuse

problem

(Example)

Illicit drug use

Other evidencebased interventions

Social competence Communication, 

decision-making

and problem solving

skills training
Identifying and Selecting Evidence-Based Interventions 9

 III. Using the Community Logic Model and 

Assessment Information to Identify Best Fit 

Interventions 

A. Establishing Conceptual Fit: Is It Relevant? 

Relevance: If the prevention intervention does not address the underlying risk and protective factors 

and conditions that drive or contribute to the targeted substance abuse problem, then it is unlikely 

to produce positive outcomes or changes in that problem. 

The community logic model can be used to guide the identification and selection of types 

of programs, practices, and policies for substance abuse prevention that are relevant for a 

particular community. Community logic models are tailored to reflect and meet the unique 

circumstances of a particular community. SAMHSA/CSAP expects SPF SIG States to develop 

an epidemiological profile and create an initial generic logic model. In turn, each community 

participating in the program will tailor the generic logic model to its needs. 

Because substance abuse problems are complex, multiple factors and conditions will be 

implicated—some more strongly than others. Communities are encouraged to identify a 

comprehensive set of interventions directed to their most significant risk and protective 

factors and conditions and targeted to multiple points of entry. Figure 2 illustrates the Human 

Environmental Framework, one tool available to guide thinking about multiple points of entry 

for interventions directed to risk and protective factors across the life span and across social 

environments as well as to defining points of entry for interventions in different life sectors. 

The community logic model can be used to check the conceptual fit of interventions considered 

for the comprehensive community plan. The logic model screens for the types of interventions 

most likely to affect positive changes in the targeted substance abuse problem in a particular 

community, population, and cultural context. 
10 Identifying and Selecting Evidence-Based Interventions

Person

School

Family Peers

Religious

Groups Work

Neighborhood

Near Environments

Broader Environment

Politic

al nI flu

ences

Econo

mic Inf ul e

nces

So

c ai l Services

Laws and Polic

ei s

Cultural Influences

Work

Media

Judicial System

Primary Environments

Time

Figure 2. Human Environmental Framework 

This figure depicts social environments or spheres of influence in concentric circles that 

flare outward, moving progressively away from direct influence on the individual toward 

increasingly indirect influence and advancing over time. A comprehensive intervention plan 

should identify a mix or layering of interventions that target salient risk and protective factors 

in multiple contexts across the life span. 

B. Establishing Practical Fit: Is It Appropriate? 

Appropriateness: If the prevention program, policy, or practice does not fit the community’s 

capacity, resources, or readiness to act, then the community is unlikely to implement the 

intervention effectively. 

A second important concept in selecting prevention interventions is practical fit with the 

capacity, resources, and readiness of the community itself and the organizations responsible 

for implementing interventions. Practical fit is assessed through a series of utility and 

feasibility checks that grow out of the needs and resource assessment and capacity-building 

activities conducted in SPF Steps 1 and 2. 

SAMHSA/CSAP encourages practitioners to use their community assessment findings to 

judge the appropriateness of specific programs, policies, and practices deemed relevant to 

Bronfenbrenner U. (1979). The ecology 

of human development: Experiments 

by nature and design. Cambridge, MA: 

Harvard University Press. 
Identifying and Selecting Evidence-Based Interventions 11

the factors and conditions specified in the community logic model. Below is a list of utility and 

feasibility checks to consider in selecting prevention strategies. 

Utility and Feasibility Checks 

Utility Checks

l Is the intervention appropriate for the population identified in the community needs 

assessment and community logic model? Has the intervention been implemented 

successfully with the same or a similar population? Are the population differences 

likely to compromise the results? 

l Is the intervention delivered in a setting similar to the one planned by the community? 

In what ways is the context different? Are the differences likely to compromise the 

intervention’s effectiveness? 

l Is the intervention culturally appropriate? Did members of the culturally identified 

group participate in developing it? Were intervention materials adapted to the 

culturally identified group? 

l Are implementation materials (e.g., manuals, procedures) available to guide 

intervention implementation? Are training and technical assistance available to 

support implementation? Are monitoring or evaluation tools available to help track 

implementation quality? 

Feasibility Checks 

l Is the intervention culturally feasible, given the values of the community? 

l	 Is the intervention politically feasible, given the local power structure and priorities of 

the implementing organization? Does the intervention match the mission, vision, and 

culture of the implementing organization? 

l	 Is the intervention administratively feasible, given the policies and procedures of the 

implementing organization? 

l	 Is the intervention technically feasible, given staff capabilities, time commitments, and 

program resources? 

l	 Is the intervention financially feasible, given the estimated costs of implementation 

(including costs for purchase of implementation materials and specialized training or 

technical assistance)? 

Each of the points in the checklist warrants thoughtful consideration among those involved 

in planning, implementing, and evaluating the prevention strategies in the comprehensive 

community plan. 
12 Identifying and Selecting Evidence-Based Interventions

IV. Using Public Resources and Review Processes to 

Identify Evidence-Based Interventions and Determine 

Their Evidence Status 

Evidence-Based Interventions and Evidence Status 

The preceding sections defined logic models and detailed their usefulness in the prevention 

planning process. This section addresses how those logic models can be translated into action 

once a problem or set of problems has been identified through the needs-assessment process. 

Our expectation is that intervention selection is grounded in a well-defined conceptual 

model (e.g., the community logic model) that includes malleable behaviors, environments, 

or other factors (referred to as underlying factors in Section II) that can be targeted over the 

course of development in a variety of contexts. This section presents guidance for selecting 

interventions from: A. Registries of evidence-based programs; B. The peer-reviewed research 

literature; and C. Other documentation supporting effectiveness (used in the absence of a 

registry listing or direct support from the peer-reviewed literature). 

The strength of evidence for tested interventions falls along a continuum from strong to weak. 

Strength of evidence is assessed using established scientific standards and criteria for applying 

those standards and comprises four major elements: 

1. Rigor of the evaluation design (e.g., use of appropriate intervention and control 

or other comparison groups, group assignment strategy, control of dosage and 

contextual factors that can provide an alternative explanation of the results or 

findings). 

2. Rigor and appropriateness of the methods used to collect and analyze the data (e.g., 

use of appropriate data collection designs, use of measures that match outcomes 

targeted by the intervention, data collection without bias, and use of appropriate 

statistical tests). 

These two elements directly affect the inferences that can be drawn about cause and 

effect—the degree to which the results obtained from an evaluation can be attributed to the 

intervention exclusively rather than to other factors. 

3. The magnitude and consistency of the effects of the intervention on targeted 

outcomes. Magnitude refers to the amount of change or impact that an intervention 

produces for a given outcome—that is, its “effect size.” Equally important is consistency 

in the pattern of positive effects reported on the targeted outcomes. 
Identifying and Selecting Evidence-Based Interventions 13

4. The extent to which findings can be generalized to similar populations and settings. 

This element refers to the likelihood that the same pattern of positive findings will 

hold for similar populations under similar conditions. 

Taking into account these four methodological elements, strong evidence means that 

the evaluation of an intervention generates consistently positive results for the outcomes 

targeted under conditions that rule out competing explanations for effects achieved (e.g., 

population and contextual differences). Experts agree that evidence for the effectiveness 

of an intervention becomes “stronger” with replication and field testing under a variety of 

circumstances. However, there is less agreement about the threshold of evidence or cut-off 

point below which evidence should be considered insufficient. Ultimately, prevention planners 

and practitioners must judge the merits of the evidence supporting the selection of one 

intervention relative to another. 

In some cases, planners may not be able to find an intervention that meets their needs in the 

Federal registries or the peer-reviewed research literature. In these instances, other sources 

of information such as articles in non-peer-reviewed journals, book chapters, or unpublished 

program evaluation reports may be available. These sources may provide weaker support for 

effectiveness; thus, they should be reviewed as specified in the guidelines. 

In general, we recommend using the following decision rules when considering these other 

sources of supporting information: 

1. Out of two similar interventions that address the targeted needs equally well, choose 

the one for which there is stronger evidence of effectiveness, both in terms of the 

consistency and strength of effects on the desired outcomes and quality or rigor of the 

evaluation methodology utilized. 

2. Reserve the option to select an intervention with little or weak evidence of 

effectiveness for circumstances in which there are no interventions with stronger 

evidence that appropriately address the needs identified for a particular population, 

culture, or local context. 

SPF Definitions of Evidence-Based 

The SPF SIG Program specifically requires implementation of evidence-based interventions. 

Evidence-based interventions are defined in the SPF SIG Program by inclusion in one or more 

of the three categories below: 

A. Included in Federal registries of evidence-based interventions; 

B. Reported (with positive effects on the primary targeted outcome) in peer-reviewed 

journals; or 
14 Identifying and Selecting Evidence-Based Interventions

C. Documented effectiveness supported by other sources of information and the 

consensus judgment of informed experts (as specified in the Guidelines that follow). 

Each of the three definitions helps identify interventions appropriate to targeted needs and 

each has its own advantages and challenges. Prevention planners and practitioners must be 

prepared to consider the relative adequacy of evidence when deciding to select a particular 

prevention intervention to include in their comprehensive community plan. 

A. Using Federal Registries 

Federal registries are readily accessible and easy-to-use public resources for identifying 

interventions that reduce substance use risk factors and consequences or increase protective 

factors thought to be associated with reduced potential for substance abuse. Many registries 

use predetermined criteria and a formalized rating process to assess the effectiveness of 

interventions reviewed. Some registries apply quality scores to the intervention. These 

quality scores are indications of the strength of evidence according to the ratings applied. 

Thus, inclusion of an intervention in a registry can be viewed as providing some evidence 

of effectiveness. However, the level of evidence required by registries varies considerably. 

When choosing among interventions that have been reviewed by registries, we generally 

recommend selecting the one with the highest average score, provided that it demonstrates 

positive effects on the outcomes targeted for the population identified. Ultimately, while 

selecting interventions from registries may seem easier in some respects, it still requires 

planners and practitioners to think critically and make reasoned judgments about intervention 

selection, taking into account the degree of congruence with the particular cultural context 

and local circumstances. 

Advantages 

Federal Registries— 

l Provide concise descriptions of the interventions. 

l Provide documented ratings of the strength of evidence measured against defined 

and accepted standards for scientific research. 

l Present a variety of practical information, formatted and categorized for easy access 

and potentially useful to implementers. 

l Offer “one-stop” convenience for those seeking quick information on the interventions 

included. 
Identifying and Selecting Evidence-Based Interventions 15

Challenges 

Federal Registries— 

l Include a limited number of interventions depending on how they are selected. 

l	 Include interventions most easily evaluated using traditional scientific methods. 

Consequently, registries include predominantly school- and family-based interventions 

and relatively few community, environmental, or policy interventions. 

l	 Are based on evidence that may be out of date if the registry does not provide a 

process for incorporating new evidence. 

l May be confusing to consumers seeking to compare the relative strength of evidence 

for similar programs included on different registries since the criteria and rating 

procedures may vary from one registry to another. 

Federal registries include: 

l SAMHSA National Registry of Evidence-Based Programs and Practices (NREPP) 

http://www.nrepp.samhsa.gov 

Provides descriptions of and rates evidence for various interventions related to 

substance use and abuse and mental health problems. 

l OJJDP Model Programs Guide 

http://www.dsgonline.com/mpg2.5/mpg_index.htm 

Provides descriptions of and rates evidence for youth-oriented interventions, many of 

which are relevant to the prevention of substance use and abuse. 

l Exemplary and Promising Safe, Disciplined and Drug-Free Schools Programs 

Sponsored by the U.S. Department of Education 

http://www.ed.gov/admins/lead/safety/exemplary01/exemplary01.pdf 

Provides descriptions of and rates evidence for educational programs related to 

substance use. 
16 Identifying and Selecting Evidence-Based Interventions

l Guide to Clinical Preventive Services 

Sponsored by the Agency for Healthcare Research and Quality [AHRQ] 

http://www.ahrq.gov/clinic/cps3dix.htm 

Provides recommendations regarding screening and counseling in clinical settings to 

prevent the use of tobacco, alcohol, and other substances. 

l Guide to Community Preventive Services 

Sponsored by the Centers for Disease Control and Prevention [CDC] 

 http://www.thecommunityguide.org

Provides recommendations regarding generic programs and policies to prevent and 

reduce tobacco use and alcohol-impaired driving. 

l A list of other registries may be found at SAMHSA’S website: 

http://www.samhsa.gov/ebpWebguide/appendixB.asp. 

B. Using Peer-Reviewed Journals 

The research literature constitutes another primary resource for identifying evidence-based 

prevention interventions, including those not listed in Federal registries. When the literature is 

used to determine strength of evidence, all articles relevant to the specific intervention should 

be considered. In other words, it is not sufficient to garner support for an intervention from 

a single document selected from a larger body of work. We recommend careful review of all 

documents that have been published on a particular intervention to ensure that the outcomes 

reported comprise a consistent pattern of positive effects on the target outcomes. 

Unfortunately, using the primary literature is not easy and can be very time consuming and 

resource intensive, particularly for practitioners without ready access to university libraries 

or electronic copies of journal articles. Additionally, a healthy degree of skepticism and 

considerable technical expertise is required to review articles and interpret results, as the 

quality of the study reported depends on many factors such as the conceptual model or 

theory on which the intervention is based, the measurement and design strategies used to 

evaluate it, and the findings that are presented. 

Assessing Elements of Evidence Reported in Peer-Reviewed Journals 

Listed below are key elements addressed in most peer-reviewed journal articles, along with 

some questions to consider. 
Identifying and Selecting Evidence-Based Interventions 17

l A defined conceptual model that includes definitions and measures of intermediate 

and long-term outcomes. Does the article describe the theory or provide a conceptual 

model of the intervention and link the theory or model to expectations about the way 

the program should work? Does the article describe the connection of the theory or 

the conceptual model to the intervention approach, activities, and expected outcomes 

in sufficient detail to guide your decision? 

l Background on the intervention evaluated. How closely does the problem targeted 

by the intervention match the identified needs of your community? Does the article 

adequately describe the proposed mechanism of change of the intervention? Are the 

structure and content of the intervention described in enough detail? Is the context 

or setting of the intervention described to an extent that allows you to make an 

informed decision concerning how well it might work in the communities targeted? 

l A well-described study population that includes baseline or “pre–intervention” 

measurement of the study population and comparison or control groups included in 

the study. Does the article describe in detail the characteristics of the study population 

and the comparison or control groups used? How well does the study population 

match your local target group? 

l Overall quality of study design and data collection methods. Does the article describe 

how the study design rules out competing explanations for the findings? Are issues 

related to missing data and attrition addressed and satisfactorily resolved? Did the 

study methodology use a combination of strategies to measure the same outcome 

using different sources (e.g., child, parent, teacher, archival)? 

l Analytical plan and presentation of the findings. Does the article specify how the 

analytical plan addresses the main questions posed in the study? Do the analyses 

take into account the key characteristics of the study’s methodology? Does the article 

report and clearly describe findings and outcomes? Are the findings consistent with 

the theory or conceptual model and the study’s hypotheses? Are findings reported for 

all outcomes specified? 

l A summary and discussion of the findings. Does the discussion draw inferences and 

conclusions that are clearly related to the data and findings reported? 

Advantages 

Peer-Reviewed Journals— 

l Typically present detailed findings and analyses that document whether or not the 

program, practice, or policy has an adequate level of evidence that the intervention 

works. 
18 Identifying and Selecting Evidence-Based Interventions

l Provide authors’ contact information that facilitates further discussion about the 

appropriateness of the intervention to the target need. 

l In some cases, report and summarize meta-analyses and other types of complex 

analyses (e.g., core components) that examine effectiveness across interventions 

or intervention components. These types of analyses are potentially very useful to 

prevention planners. 

Challenges 

Peer-Reviewed Journals— 

l Leave it to the reader to interpret results and assess the strength of the evidence 

presented and its relevance and applicability to a particular population, culture, or 

community context. 

l Describe in limited detail the activities and practical implementation issues pertinent 

to the use of the intervention. 

C. Using Other Sources for Documenting Effectiveness 

When no existing evidence-based interventions are available in registries or the research 

literature to address the problem, then empirical support for other interventions may be 

found in unpublished reports (e.g., doctoral theses) or published, non-peer-reviewed sources 

(e.g., book chapters, evaluation reports, and Federal reviews). We recommend caution when 

relying on these other sources of support because they usually have not been subjected to 

the methodological scrutiny provided by registries and peer-reviewed journals. Ultimately, 

the “burden of proof” for documented effectiveness lies with the program planners and 

practitioners making the selection decision. Under what conditions is it appropriate to select 

an intervention that is not included in an established Federal list of evidence-based programs 

or reported with positive effects in the peer-reviewed journal literature? When no appropriate 

interventions are available through these primary resources on evidence-based interventions, 

then prevention planners may need to rely on other, weaker sources of information to identify 

an intervention that is appropriate for the assessed community need, the population served, 

and the cultural and community context in which it will be implemented. 

When selecting interventions based on other sources of supporting information, all four of the 

following guidelines should be met:

l Guideline 1: The intervention is based on a theory of change that is documented in a 

clear logic or conceptual model; 

l Guideline 2: The intervention is similar in content and structure to interventions that 

appear in registries and/or the peer-reviewed literature; 
Identifying and Selecting Evidence-Based Interventions 19

l Guideline 3: The intervention is supported by documentation that it has been 

effectively implemented in the past, and multiple times, in a manner attentive to 

scientific standards of evidence and with results that show a consistent pattern of 

credible and positive effects; and 

l Guideline 4: The intervention is reviewed and deemed appropriate by a panel of 

informed prevention experts that includes: well-qualified prevention researchers who 

are experienced in evaluating prevention interventions similar to those under review, 

local prevention practitioners, and key community leaders as appropriate (e.g., officials 

from law enforcement and education sectors or elders within indigenous cultures). 

These guidelines are intended to assist prevention planners by expanding the array of 

interventions available to them. In a comprehensive prevention plan, these interventions 

should be considered supplements, not replacements, for traditional scientific standards used 

in Federal registry systems or peer-reviewed journals. 

Advantages 

Other Sources for Documenting Effectiveness — 

l Enable State and community planners to consider interventions that do not currently 

appear on a Federal list or in the peer-reviewed literature but which have the potential 

to address the problem targeted. 

l Provide opportunities for State and community planners to use locally developed or 

adapted interventions, provided they are supported by adequate documentation of 

effectiveness. 

Challenges 

Other Sources for Documenting Effectiveness — 

l Place substantial responsibility on prevention planners and practitioners for 

intervention selection decisions. 

l Require prevention planners and practitioners to develop and implement decisionmaking and documentation processes. 

l Require prevention planners and practitioners to assemble additional documentation 

and assess its adequacy to support using a particular intervention as part of the larger 

comprehensive community prevention plan. 
20 Identifying and Selecting Evidence-Based Interventions

V. Summary Process Description: Selecting Best Fit 

Prevention Interventions 

The process described here is rooted in the work conducted by local communities during SPF 

steps 1 and 2. It begins with creating a community logic model to map the local substance 

abuse picture and draws from the findings of local needs and resource assessment. Prevention 

planners apply the logic model and assessment findings in a process of thinking critically and 

systematically about three considerations that determine best fit interventions to include in a 

comprehensive community prevention plan: 

l	 Conceptual fit with the community’s logic model: Does the candidate intervention 

target the identified problem and the underlying factors that drive or contribute to 

changes in the problem or outcomes? 

l	 Practical fit with the community’s needs, resources, and readiness to act: Is the 

candidate intervention appropriate for the particular population, cultural context, and 

set of local circumstances? 

l	 Evidence of effectiveness: Is there sufficient evidence or support for documented 

effectiveness to select the intervention and include it in the comprehensive 

community prevention plan? 

Figure 3 depicts the process for thinking through these key considerations. 

Identify types of programs, practices, and strategies that: target the identified problem, address 

the relevant underlying factors, target opportunities in multiple life domains. 

Select specific programs, practices, and strategies that are: appropriate for the community’s 

population, cultural context, and feasible, given local circumstances, including resources, 

organizational resources, and readiness to act, and that demonstrate sufficient evidence or 

support for documented effectiveness. 
Identifying and Selecting Evidence-Based Interventions 21

Figure 3. Process Description: Selecting Best Fit Prevention Interventions 

Identify types of

interventions that Select specific programs,

practices, and strategies that AND • address a community’s

salient risk and

protective factors

and contributing 

conditions

• target opportunities for

intervention in multiple

life domains

• drive positive outcomes 

in one or more substance

abuse problems,

consumption patterns, or

consequences

• are feasible given a community’s

resources, capacities, and

readiness to act

• add to/reinforce other strategies

in the community–synergistic vs.

duplicative or stand-alone efforts

• are adequately

supported by theory,

empirical data, and the

consensus judgment 

of informed experts

and community

prevention leaders

Best fit

prevention interventions

to include in

comprehensive

community plan

Demonstrate

“Conceptual Fit”

Relevant?

Demonstrate

“Practical Fit”

Appropriate?

Demonstrate

“Evidence of

Effectiveness”

Effective?
22 Identifying and Selecting Evidence-Based Interventions

VI. SPF SIG Program Guidance: Roles and Expectations 

Collaboration and partnership across all levels—Federal, State, and community or local 

grantee—are essential for successful and flexible implementation of the guidance provided 

in this document. The guidance details an analytical process and a few key concepts—what 

needs to be done to think through the selection of best fit, evidence-based prevention 

interventions. How this is accomplished will be determined by States and jurisdictions, and will 

vary from one to another. SAMHSA/CSAP’s technical assistance providers are available to work 

with States and jurisdictions to apply the process and concepts detailed in the guidance. 

A. Federal Role 

SAMHSA/CSAP will provide leadership and technical assistance to States and jurisdictions 

and will work with them to strengthen prevention systems in order to improve substance use 

outcomes and achieve targeted community change. 

Expectations

l SAMHSA/CSAP will partner with States to develop and implement a plan that 

facilitates application of the guidance. 

l	 SAMHSA/CSAP has directed its Center for the Application of Prevention Technologies 

(CAPT) with its five Regional Expert Teams, to allocate substantial technical assistance 

resources for States to apply the concepts in this guidance. At the request of States, 

the CAPT will conduct workshops and activities to help States work with communities 

to identify and select suitable and effective evidence-based interventions. 

B. State/Jurisdiction Role 

The role of the States and jurisdictions is to provide capacity-building activities, tools, and 

resources to communities to foster the development of sound community prevention systems 

and prevention strategies. 

Expectations

l SAMHSA/CSAP expects States funded under the SPF SIG Program to strengthen 

their infrastructure and capacity to assist communities in identifying and selecting 

appropriate evidence-based interventions for their comprehensive plans. To assure 

accountability for this role, SAMHSA/CSAP expects States to establish a technical panel 

of informed prevention experts that includes: well-qualified prevention researchers 

who are experienced in evaluating prevention interventions similar to those under 

review, local prevention practitioners, and key community leaders as appropriate (e.g., 

officials from law enforcement and education sectors and elders within indigenous 

cultures). The responsibilities of this technical panel are to: 1) review comprehensive 
Identifying and Selecting Evidence-Based Interventions 23

community plans and the justification for interventions included in each community 

plan, 2) identify issues and problematic intervention selections to be addressed prior 

to plan approval, and 3) target technical assistance to work with communities to 

improve and strengthen their community plans. 

l As part of their work, we expect the State-level technical expert panels to assess 

whether chosen interventions included in the sub-recipient, comprehensive 

community plans meet one or more of the definitions of “evidence-based” for the SPF 

SIG Program: included in Federal registries of evidence-based interventions; reported 

(with positive effects on the primary targeted outcome) in peer-reviewed journals; 

or documented effectiveness supported by other sources of information and the 

consensus judgment of informed experts. 

In thinking about the implications of this guidance, States should consider the questions 

below: 

How might the State engage informed experts, including community 

leaders, in applying the concepts in the guidance for funding comprehensive 

community plans (programs, practices, and policies) selected by communities? 

How might the State communicate its policies regarding funding and 

implementation of evidence-based programs, practices, and policies to 

community coalitions and organizations and other key stakeholders? 

l SAMHSA/CSAP expects States, with their technical assistance providers, to work closely 

with communities in identifying and selecting evidence-based interventions. SAMHSA/

CSAP and its technical assistance providers will work directly with States on this task. 

l SAMHSA/CSAP expects States to develop capacities to assist communities on all key 

SPF topics, including: assessing needs and resources, using data to detail the substance 

abuse problem and underlying factors and conditions, building a community logic 

model, and examining intervention options for relevance and appropriateness. 

C. Community Role 

The role of SPF SIG sub recipient communities is to develop a comprehensive and strategic 

community prevention plan based on local needs and resource assessment. Following the 

steps of the SPF, communities use the findings from these activities to develop a logic model 

specific to the community and its substance abuse problem. Each community logic model 

reflects and maps the local substance abuse phenomenon. An effective logic model may serve 

as the primary tool to guide the selection of evidence-based programs, practices, and policies 

to include in a comprehensive plan. 
24 Identifying and Selecting Evidence-Based Interventions

Expectations 

l SAMHSA/CSAP expects communities to partner with the State and its technical 

assistance providers, who in turn will partner with SAMHSA/CSAP and CSAP’s technical 

assistance providers. 

Concluding Comments

As in all steps of SAMHSA’s Strategic Prevention Framework, the application of critical thinking 

skills is vital to selecting programs, practices, and policies to include in a comprehensive 

strategic plan. Those selected must be relevant, appropriate, and effective to meet community 

needs and address the community substance abuse problem. SAMHSA/CSAP and its technical 

assistance providers welcome the opportunity to partner with SPF SIG States, jurisdictions, and 

Federally recognized tribes and tribal organizations through technical assistance workshops 

and “science-to-service” learning communities to think through the selection of best fit, 

evidence-based prevention interventions. 
Identifying and Selecting Evidence-Based Interventions 25

GLOSSARY 

Best fit interventions Interventions that are relevant to the community logic 

model (i.e., directed to the risk and protective factors 

most at play in a community) and appropriate to the 

community’s needs, resources, and readiness to act. 

Community logic model A graphic depiction or map of the relationships between 

the local substance abuse problem, the risk/protective 

factors and conditions that contribute to it, and the 

interventions known to be effective in altering those 

underlying factors and conditions. 

Conceptual fit The degree to which an intervention targets the 

community’s identified substance abuse problem and the 

underlying factors that contribute to the problem. 

Documented effectiveness Defined under the SPF SIG Program by guidelines for using 

other sources of information and support to document 

intervention effectiveness. 

Epidemiological profile A summary and characterization of the consumption 

(use) patterns and consequences of the abuse of alcohol, 

tobacco, marijuana, heroin, cocaine, methamphetamines, 

inhalants, prescription drugs, or other substances. The 

epidemiological profile identifies the sources of data on 

consumption patterns as well as the indicators used to 

identify consequences (e.g., morbidity and mortality). It 

should provide a concise, clear picture of the burden of 

substance abuse in the State using tables, graphs, and 

words as appropriate to communicate this burden to a 

wide range of stakeholders. 

Evidence-based interventions Evidence-based interventions are defined in the SPF SIG

SPF SIG Program Program by inclusion in one or more of the three

categories below: 

A. Included in Federal registries of evidence-based 

interventions; 

B. Reported (with positive effects on the primary targeted 

outcome) in peer-reviewed journals; or 
26 Identifying and Selecting Evidence-Based Interventions

C. Documented effectiveness supported by other sources 

of information and the consensus judgment of 

informed experts (as specified below). 

Evidence status or strength Refers to the continuum of evidence quality, which 

ranges from weak to strong. Strong evidence means that 

the positive outcomes assessed are attributable to the 

intervention rather than to extraneous events, and that the 

intervention reliably produces the same pattern of positive 

outcomes in similar populations and contexts. 

External validity The extent to which evaluation outcomes will be achieved 

in populations, settings, and timeframes beyond those 

involved in the study; the likelihood that the same pattern 

of outcomes will be obtained when the intervention is 

implemented with similar populations and in similar 

contexts. 

Guidelines for 

Documented Effectiveness 

SPF SIG Program

Guideline 1: The intervention is based on a theory of 

change that is documented in a clear logic or conceptual 

model; and 

Guideline 2: The intervention is similar in content and 

structure to interventions that appear in registries and/or 

the peer-reviewed literature; and 

Guideline 3: The intervention is supported by 

documentation that it has been effectively implemented 

in the past, and multiple times, in a manner attentive to 

scientific standards of evidence and with results that show 

a consistent pattern of credible and positive effects; and 

Guideline 4: The intervention is reviewed and deemed 

appropriate by a panel of informed prevention experts that 

includes: well-qualified prevention researchers who are 

experienced in evaluating prevention interventions similar 

to those under review; local prevention practitioners; and 

key community leaders as appropriate, e.g., officials from 

law enforcement and education sectors or elders within 

indigenous cultures. 
Identifying and Selecting Evidence-Based Interventions 27

Internal validity The extent to which the reported outcomes can be 

unambiguously attributed to the intervention rather than 

to other competing events or extraneous factors. 

Interventions Interventions encompass programs, practices, policies, and 

strategies that affect individuals, groups of individuals, or 

entire communities. 

Outcomes-based prevention An approach to prevention planning that begins with 

a solid understanding of a substance abuse problem, 

progresses to identify and analyze factors and conditions 

that contribute to the problem, and finally matches 

intervention approaches to these factors and conditions 

that ultimately lead to changes in the identified problem 

(i.e., behavioral outcomes). 

Practical fit The degree to which an intervention is appropriate for 

the community’s population, cultural context, and local 

circumstances including its resources, capacities, and 

readiness to take action. 

Protective factors Conditions for an individual, group, or community that 

decrease the likelihood of substance abuse problems and 

buffer the risks of substance abuse. 

Risk factors Conditions for an individual, group, or community that 

increase the likelihood of a substance abuse problem. 
HHS Publication No. (SMA) 09-4205