Identifying and de-implementing low-value practices: A multi-disciplinary approach for district and school leaders

Implementation Science is “the scientific study of methods to promote the systematic uptake of research findings and other evidence-based practices into routine practice and, hence, to improve the quality and effectiveness of health services” (Eccles & Mittman, 2006, p. 1). As this definition indicates, implementation science originated primarily in health and medically-based settings, with much of the early research on the topic reflecting that origin (e.g., Douglas et al., 2022). Schools have a similar critical need to use implementation science to help secure, contextualize, and examine the ways in which evidence-based practices work for children and educators (Cook et al., 2019; Lyon et al., 2019; Lyon et al., 2024a, 2024b; Owens et al., 2014). Germane to the present article is a focus on school leaders’ role in de-implementation.

De-implementation refers to a purposeful discontinuation of practices that are identified as low-value (Dunsmore et al., 2023; McKay et al., 2020; Walsh-Bailey et al., 2021). Low-value practices are those that are “not clinically or cost effective” (Dunsmore et al., 2023, p. 2) and potentially harmful (Walsh-Bailey et al., 2021). Educators are encouraged to employ evidence-based strategies within a multi-tiered system of support (MTSS) that are determined to be effective based on scientific evidence (e.g., What Works Clearinghouse, U.S. Department of Education, nd) and equitable for all children (e.g., Truckenmiller et al., 2024). In this way, low-value practices can be considered the opposite of evidence-based practices. The idea of both implementation science and de-implementation work has been predominantly featured in medical fields (e.g., Dunsmore et al., 2023; Lilienfeld, 2007; Niven et al., 2015; Walsh-Bailey et al., 2021; Williams et al., 2021) and is much newer to education fields (Barrett et al., 2023, 2024). Two examples of low-value practices from the medical field include overprescribing medication (Dunsmore et al., 2023) and the overuse of various medical procedures or services (Brownlee et al., 2017). In education fields, there are efforts to examine how and why certain programs, curricula, and practices are used (Barrett et al., 2023, 2024; Clinkscales et al., 2024) and to identify low-value practices (Farquharson et al., 2023). Unfortunately, this body of literature suggests that even though the evidence-base should be considered or prioritized during program selection, it is often the least important factor during school administrator decision-making (Barrett et al., 2023).

In what follows, we provide an overview of de-implementation frameworks and low-value practices. We then provide specific examples from various education practitioner points of view.