An empirical test of a diffusion framework for school-based prevention : the 21 Swedish junior high school study

This is a three year, quasi-experimental trial of an intervention diffusion framework. There were 11 intervention and 10 control junior high schools located in either a large Swedish city or the Swedish countryside. Multilevel structural equation modeling was used to evaluate a two-level model (1337 students nested in 85 classrooms), outcomes: internalizing and externalizing problems, substance use, socio-emotional competence, and perception of a positive school environment. Results showed that framework-related benefits were predominately shown either for one gender or one gender living in a particular setting. Changes were also primarily of a buffering character, in which a subgroup of comparison participants showed a poorer pattern of change relative to intervention participants. Study results provide evidence for discourse about what is an optimal level of choice for intervention stakeholders to have when implementing interventions and provides an empirical test of a diffusion framework in routine practice, outside of the United States.