Behavioral interventions can be effective ways to improve health outcomes by addressing factors that influence risk behaviors in specific communities. Since the 1990s the Centers for Disease Control and Prevention (CDC) and the Division of HIV/AIDS Prevention (DHAP) has partnered with agencies like the Center for Community Practice (CCP) to provide resources, trainings, and technical assistance to health departments, community-based organizations, and healthcare organizations that are funded to deliver these Evidence-Based Interventions (EBIs) to various communities through the US. Many of these interventions, now diffused and supported by the CDC and DHAP as High Impact Prevention (HIP) Interventions are part of a broader range of options that include structural interventions, public health strategies (PHS), policy and advocacy, and complimentary services like patient navigation. CDC’s Effective Interventions website
contains a wealth of information and resources related to these programs and strategies.
The CDC also compiled an extensive list--the Compendium of Evidence-Based Interventions and Best Practices—to guide the HIV prevention and care continuum workforce in behavioral change topics. The list includes topics such as PrEP uptake and adherence, HIV testing, HIV care and medication adherence, and social support for both persons living with HIV and persons at high risk of contracting HIV. Interventions that are part of the CDC’s EBI compendium have well-defined logic models and stringent process guidelines that must be adhered to (program fidelity). We recommend that agencies consult with technical experts for intervention planning and delivery—a service available through CDC’s DHAP’s capacity-building provider network (CPN), of which CCP is capacity building assistance (CBA) provider. Those who wish to implement HIP Interventions for HIV prevention may want to consider the following points:
1. Is this HIP Intervention right for us?
Selecting an appropriate HIP Intervention is a critical early step that includes:
Conducting a comprehensive assessment of community need
Expert knowledge of your intervention community including their specific risks, factors that influence risks, and behaviors
Well-established community connection and capacity to implement the intervention
Building a strong program team and soliciting
Reviewing interventions that reflect the communities you plan to work with (e.g., 3MV is designed for, and tested/proven effective in Black MSM communities)
Ensuring that the intervention aligns with your organizational goals and resources (e.g., space)
Identifying additional gaps and barriers to implementation
2. What if the HIP Intervention doesn’t quite address all of our needs?
You may be able to avoid the need to adapt a HIP Intervention if you spend enough time in careful consideration of whether the intervention is appropriate for your agency, community, and health outcome goals. If after selecting the intervention of “best fit’ you still identify gaps, and there are no available recommended strategies to address those gaps, you may need to adapt. The adaptation process can be extensive and, as in selecting an appropriate intervention, there are established guidelines and recommendations. Some of these steps include:
Identifying adaptation needs
Examining best adaptation practices
Drafting and testing adaptation materials, exercises, and activities
The CBA program also offers technical assistance in HIP Intervention adaptation for topics like updating language and tailoring your agency’s approach to implementation. This expert support is highly recommended to ensure that the adaptation does not interfere with the intervention’s core elements and internal logic.
3. How do we keep track of everything?
Intervention monitoring and evaluation (M&E) is a continuous process that begins well before program implementation. The CDC’s Effective Interventions website
also provides many M&E tools that are specific to the intervention(s) that your agency selects. M&E tools are useful to:
Identify potential barriers to implementation
Confirm that intervention delivery is aligned with CDC/DHAP standards and guidelines (fidelity)
Assess the intervention’s community-level impact on health outcomes
CCP has been funded by the CDC to provide CBA services since 2009. Contact us
or reach out to your health department CBA Tracking System (CTS) users for your capacity building and technical assistance needs.