eric evans, ma, cpp program director heather mccarthy, jd, ma, mpa vice president prevention...
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Eric Evans, MA, CPP•Program Director
Heather McCarthy, JD, MA, MPA•Vice President Prevention Services
•BOOST Conference•April 29, 2011
Learning ObjectivesAn introduction to the L.E.A.D. Initiative and
its purpose and componentsUnderstand how youth can serve as Change
AgentsUnderstand the effectiveness of Youth
LEADersRecent findings from our quasi-experimental
and multi-method evaluationIntroduction to the development of Senior
L.E.A.D.
LEAD Initiative
Strengthening Youth Leadership Across Indiana
Helping Keep Kids Drug-Free and In School
Sponsors of the LEAD InitiativeFunded by the Indiana Family and Social
Services Administration, the Division of Mental Health and Addiction
Key Partner Agencies: Indiana Youth Services Association, Indiana Youth Institute, Boys and Girls Clubs, Girls Inc., and YMCA
Administrative Agency: Geminus Corporation
LEAD InitiativeIndiana statewide program for youth
leadership development and alcohol, tobacco and other drug use preventionThe key to the creation of the initiative was
incorporating elements that had a focus from one or more of the following evidence based prevention principle areas: Peers, Families, Communities, and Schools
PurposeThe LEAD Initiative was designed to:
Develop a network of youth leaders to facilitate prevention programming to their peers
Enhance current leadership programs with more effective prevention programming to their peers
Increase the use of youth leaders in ATOD programming
Reach communities throughout Indiana by integrating youth into the Indiana prevention system
Key Objective
Prevent and ReduceAlcohol, Tobacco, and Other Drugsuse among Indiana youth through
peer-lead prevention activities
Target PopulationModerate risk youthYouth already engaged in leadership groups
at partner agenciesAge range 10-17 with primary age range
from 12-17
LEAD Initiative Continuum
Expansion
AssessmentEnhancem
entEvaluation
Assessment PhaseIdentify preliminary sites and locationsIdentify key areas for assessment dataCoordinate site visits of targeted locationsAssist with recruitment of youth for
leadership trainingCompile assessment dataProvision of necessary training in targeted
regions
Enhancement PhaseProvide Assessment Data to targeted
locationsCoordinate youth leadership trainingsImplement strategies for improved youth
leadership programmingImplement marketing, including funding
researchProvide PREV-CAMP trainings for youthCollect evaluation data
Expansion PhaseEnsure all sites have program components in
place for utilization of ATOD LEADersIncrease Marketing componentsIntegrate trained LEADers into agency ATOD
programmingIntegrate LEADers into community service,
advocacy, mentoring and philanthropy activities
Continue training initiative as neededContinue gathering data
Evaluation PhaseCollect and analyze all quarterly reports and
assessment surveys from participating sitesCompose cohort final report
PREV-CAMPPREVention: Community ServiceAdvocacyMentoringPhilanthropy
Youth can serve as change agents! The PREV-CAMP trains youth on how they can serve as a role model for their peers and engage them in healthy, positive activities while educating them on the dangers of substance abuse.
PREVention – Normative EducationNormative Education
Provide participants with an understanding of the concepts behind Normative Education Perception False Perception
Refusal & Resistance SkillsYouth leaders give participants tools on how
Refusal & Resistance skills can be used to effectively deal with pressures in their everyday lives
CAMPCommunity Service: Organized projects with
the purpose of giving back to the communityAdvocacy: Assisting with policy change on the
local, state, or federal level relating to a cause the leadership group believes in
Mentoring: Recognizing youth can be role models and mentors and act as agents of change for their peers
Philanthropy: Sharing time, talent, and treasures across domains
Adult vs. Peer ResearchNoticeable gap in the literature regarding
demonstrative effectiveness of peer-led ATOD prevention programs when compared to adult led prevention programs.
Research FindingsA meta-analysis of 143 adolescent drug
prevention programs conducted by Tobler indicated that peer education programs had positive health outcomes in 4 distinct areas:1. Knowledge2. Attitude3. Drug Use4. Skills and behavior
(Tobler, N.S. 1986 Vol. 1 6:4 537-568)
Research FindingsThere are many reasons cited in literature to
justify the use of peer based interventions:Cost effectivePeers are a credible source of informationPeer education is empowering for those involvedUtilizes an already established means of sharing
information and advicePeers are more successful than professionals in
passing on information because people identify with their peers
(Turner and Shepherd 1999 pp. 236-7)
Research FindingsPeer educators are seen as good role modelsPeer education is beneficial for those involvedEducation presented by peers may be acceptable
when other education is notPeer education can be used to educate those who
are hard to reach through conventional methodsPeers can reinforce learning through ongoing
contact
(Turner and Shepherd 1999 pp. 236-7)
Adult vs. Peer StudyIn April 2009, a peer reviewed study of the LEAD
Initiative was published in the Journal of Alcohol and Drug EducationStandardizing and Evaluating the “Presenter”
Variable in the Peer vs. Adult Debate in Youth Drug Prevention Research
The study was designed to accomplish two goals Formulate, implement, and evaluate a protocol to
standardize important elements of the “presenter” variable in drug prevention programs
Asses the comparative impact of peer vs. adult presenters of a drug prevention program on participant knowledge and perceptions
Adult vs. Peer StudyTraining Selection and Preparation
Youth Peers – Nominations solicited from 14 participating LEAD youth agencies. 7 youth were selected to attend 1 ½ day “Train-the-Trainer” workshop to sharpen presentation skills and program knowledge
Adults – Nominations solicited from 14 participating LEAD youth agencies. 7 adults were selected to attend 1 ½ day “Train-the-Trainer” workshop to sharpen presentation skills and program knowledge
Both youth and adults were trained on the Refusal and Resistance Skills training module developed by Indiana University Bloomington
Study ResultsKnowledge Acquisition
Mean scores on the 5-item knowledge post test showed peer-led superiority over adult trainers. (T-values 2.94 adult score vs. 4.59 peer score)
Perceived Trainer EffectivenessMean scores on the 5-item evaluating training
content showed peer-led superiority over adult trainers. (T-value 3.22 adult score vs. 4.21 peer score)
Statewide Program EvaluationIndiana Youth Institute and Praxis Strategies
& Solutions Inc. conducted a quasi-experimental and multi-method evaluation for academic year of 2011-2012
Sample consisted of two groups:Outer Ring Youth – those who were mentored
by their peer LEADersControl Group – youth in agencies that had no
exposure to L.E.A.D. trainings or mentoring
Statewide Program EvaluationEvaluation and Methods
Mixed method approach that consisted of both quantitative and qualitative elements
Three data collecting tools: Pre-/Post-tests Attendance records Activity reports
Focused specifically on the Outer Ring Youth because so much research has focused on the peer mentor with limited research on the mentee
Statewide Program EvaluationSample
Mainly Boys and Girls Clubs, with a few other youth agencies
12 experimental agencies and 6 control facilities
148 youth participants – 73 Outer Ring, 45 Control 48% Male, 47% Female, 5% Did not answer 59% Younger than 13, 41% between 13 and 18 55% White or Caucasian, 20% Black or African-
American, 24% other
Results Indicate That:Outer Ring Youth were more likely to make
statistically significant better decisions regarding their choice of friends than the control group. They were less likely than the control group to have friends who use tobacco, marijuana and other drugs
Outer Ring Youth were far more likely than the control group to perceive alcohol, tobacco and other drugs use negatively
Outer Ring Youth were statistically more likely to participate in community activities, social volunteerism, clubs and pro-social activities
Results Indicate That:Outer Ring Youth were significantly more likely
to perceive cigarette smoking negativelyOuter Ring Youth were statistically less likely to
perceive alcohol consumption as a mechanism for gaining social acceptance among peers
Outer Ring Youth were significantly more likely to perceive ATOD use as “stupid”
Outer Ring Youth were statistically more likely to perceive accessing smokeless tobacco as difficult
Results Indicate That:Outer Ring Youth were significantly more
likely to perceive accessing drugs as difficultOuter Ring Youth were less likely on a
statistically significant level than the control group to continue being friends with those who use tobacco, marijuana, inhalants and other drugs
Outer Ring Youth were also statistically less likely to have peers who have used tobacco in the 30 days prior to the administration of post-program survey
Statewide Program EvaluationThe analyses indicates that the L.E.A.D.
Initiative interventions with the Outer Ring Youth facilitate a statistically significant stronger long-term resistance framework for younger youth who may otherwise be vulnerable as was the case with the control group
Study LimitationsLength of evaluation
Given that the evaluation ran the course of an academic school year, the main hurdle that was faces was gathering pre/post data from the same youth
Statistical software allows to judge and compensate for any skewed distributions
Length of surveyThe survey proved to be fairly long, especially for
younger youth who had a tendency to go off course during the survey.
For future research, recommend shortening the survey substantially.
ConclusionsResults demonstrates that the L.E.A.D. Initiative
helps youth build a framework for resisting ATOD use
The Outer Ring Youth proved to make better decisions regarding their proximity to ATOD by choosing friends who do not abuse substances
The Outer Ring Youth appear to have more negative perceptions of ATOD use by youth than control group
The L.E.A.D. Initiative seems to be especially effective for young youth, ages 10-13
Senior L.E.A.D.Promotes emotional health and reduces the
likelihood of mental illness, alcohol and prescription medication abuse, and suicide in senior citizens, aged 65 and up.
Senior LEAD will serve a protective factor helping to fill the gaps and provide resources to this community
According to the 2010 Census 13% (842,894) of Indiana residents are 65 and older.
Senior LEADSeniors are prone to prescription drug abuse
and misuse resulting in prescription drug addictions
Seniors need to be aware of the differences that alcohol has on their body and the effects it has on their medications
It is essential to promote mental health awareness among seniors
Mental Health Risk FactorsMental Illness: Depression, Mood disorders,
Psychotic disordersSubstance Abuse and Misuse: Alcohol,
Prescription, OTC medicationsPhysical: Poor physical health, Functional
impairments, PainLife Circumstance: Social isolation, Family
conflict, Loss of loved ones, Financial ProblemsPersonal Characteristics: Low self-worth,
Hopelessness
Alcohol and Drug InteractionsUnfavorable reactions: excessive drowsiness,
fainting, impaired breathing, nausea and vomiting
OverdoseInterference with how well the medical
condition is controlledChange in drug effectiveness
Senior LEADCurrently conducting a statewide older adult
needs assessment to gage substance use, abuse, related problems of substance use, and gaps in mental health awareness and promotion
Goal is to implement a statewide initiative to enhance protective factors utilizing a peer-to-peer model
The initiative will integrate prevention messages and training, mental health awareness, as well as senior-youth mentoring components
Service to ScienceThe Senior LEAD was nominated by the Indiana
Division of Mental Health and Addiction to write a proposal to participate in SAMHSA’s Service to Science Initiative and was selected to participate.
Service to Science is a national initiative by the Substance Abuse and Mental Health Services Administration (SAMHSA) for locally-developed and innovative prevention programs interested in demonstrating more credible evidence of effectiveness.
Service to Science consists of a combination of training events, customized technical assistance, and financial incentives for evaluation capacity enhancement.
Questions
Contact InformationGeminus Prevention Services
8400 Louisiana St.Merrillville, IN 46410
Eric Evanseric.evans@geminus.org
219-757-1883
www.leadinitiative.org
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