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