Form IIB Description of IIB Description of IIB Description of Evidence-Based Practices

Description of Evidence-Based Practices (EBP)
EBP
Content
Court-Ordered vs. Voluntary
Target Population
Eligibility Criteria
Mode of Delivery
Dosage
Target Outcomes
Planned Adaptations
Implementing Agency
Interaction with EBP
Developer
Content: Briefly describe the topics covered/services offered by the intervention (e.g., child growth and development, effective discipline, anger
management, problem solving skills, establishing boundaries)
Court-Ordered vs. Voluntary: Indicate whether participants were court-ordered to participate in the intervention or if they enrolled voluntarily.
Target Population: Briefly describe the population to be served by the intervention (e.g., children ages 0-5 in foster care; mothers of child
welfare involved, dependent children enrolled in a residential substance abuse program)
Eligibility Criteria: Briefly describe the criteria used to determine eligibility to receive the intervention (e.g., adolescents between the age of 13
and 18 of child welfare involved families who score above [cutoff point] on [assessment name])
Mode of Delivery: Briefly describe how the intervention is delivered (e.g., home visits, group sessions, one-on-one therapy)
Dosage: Briefly describe how frequently the service will be provided, the length of each interaction, and the length of time the participant will
receive the service (e.g., children will attend 45-minute therapy sessions once a week for six weeks)
Target Outcomes: Briefly describe outcomes targeted by the intervention (e.g., decreased parental stress, increased family functioning,
decreased externalizing behavior by child)

Planned Adaptations: Describe any adaptations/enhancements planned for the intervention (e.g., the EBP was designed for children birth to five,
but will be extended to children up to age 10)
Implementing Agency: Indicate which organization will be providing the EBP
Interaction with EBP Developer: Please describe the interaction, if any, you have had with the developers of the EBPs you selected over the
past six months. For example, have you consulted with the program developer, received training or technical assistance on the EBP, been
certified to provide the EBP, been monitored by the developer, received approval for any adaptations you are making to the model, etc.? If
you were providing the EBP prior to RPG, please describe any interactions with the developer that you may have had as you began
implementing the EBP.