Prevention Science, Vol. 6, No. 3, September 2005 (
Standards of Evidence: Criteria for Efﬁcacy,
Effectiveness and Dissemination
Brian R. Flay,
Robert F. Boruch,
Felipe Gonz´alez Castro,
Eve K. Mo´scicki,
Jeffrey C. Valentine,
and Peter Ji
Published online: 16 May 2005
Ever increasing demands for accountability, together with the proliferation of lists of
evidence-based prevention programs and policies, led the Society for Prevention Research to
charge a committee with establishing standards for identifying effective prevention programs
and policies. Recognizing that interventions that are effective and ready for dissemination
are a subset of effective programs and policies, and that effective programs and policies are a
subset of efﬁcacious interventions, SPR’s Standards Committee developed overlapping sets
of standards. We designed these Standards to assist practitioners, policy makers, and admin-
istrators to determine which interventions are efﬁcacious, which are effective, and which are
ready for dissemination. Under these Standards, an efﬁcacious intervention will have been
tested in at least two rigorous trials that (1) involved deﬁned samples from deﬁned popula-
tions, (2) used psychometrically sound measures and data collection procedures; (3) analyzed
their data with rigorous statistical approaches; (4) showed consistent positive effects (without
serious iatrogenic effects); and (5) reported at least one signiﬁcant long-term follow-up. An
effective intervention under these Standards will not only meet all standards for efﬁcacious
interventions, but also will have (1) manuals, appropriate training, and technical support
available to allow third parties to adopt and implement the intervention; (2) been evaluated
under real-world conditions in studies that included sound measurement of the level of
implementation and engagement of the target audience (in both the intervention and control
conditions); (3) indicated the practical importance of intervention outcome effects; and
(4) clearly demonstrated to whom intervention ﬁndings can be generalized. An intervention
recognized as ready for broad dissemination under these Standards will not only meet all
standards for efﬁcacious and effective interventions, but will also provide (1) evidence of the
ability to “go to scale”; (2) clear cost information; and (3) monitoring and evaluation tools
so that adopting agencies can monitor or evaluate how well the intervention works in their
settings. Finally, the Standards Committee identiﬁed possible standards desirable for current
and future areas of prevention science as the ﬁeld develops. If successful, these Standards
will inform efforts in the ﬁeld to ﬁnd prevention programs and policies that are of proven
efﬁcacy, effectiveness, or readiness for adoption and will guide prevention scientists as they
seek to discover, research, and bring to the ﬁeld new prevention programs and policies.
KEY WORDS: standards; efﬁcacy; effectiveness; dissemination.
University of Illinois at Chicago, Chicago, Illinois.
Oregon Research Institute, Eugene, Oregon.
University of Pennsylvania, Philadelphia, Pennsylvania.
Arizona State University, Tempe, Arizona.
University of Maryland, College Park, Maryland.
American Institutes for Research, Washington, District of
National Institute of Mental Health (NIMH), Bethesda,
Columbia University, New York, New York.
Duke University, Durham, North Carolina.
Correspondence should be directed to Brian R. Flay, D.Phil.,
Distinguished Professor, Institute for Health Research and Pol-
icy, University of Illinois at Chicago, 1747 W. Roosevelt Road,
Suite 500, M/C 275, Chicago, Illinois 60608; e-mail bﬂay@
2005 Society for Prevention Research