PROSPER: A model of delivery for evidence-based programming

(Promoting School-community-university Partnerships to Enhance Resilience)

PROSPER: A model of delivery for evidence-based programming

Reclaiming Our Communities: Reducing Drug Use in Rural Pennsylvania

November 12, 2008

Salem Wolk and Max Crowley

Mark Greenberg, Principal InvestigatorRichard Spoth, Principal Investigator

Overview

The Role of Prevention

The PROSPER Model

PROSPER & Rural Communities

Sample of PROSPER Outcomes

Two Windows of Opportunity forIntervention with General Populations

Substance

InitiationNo Use

Increased

Use

Intervene to

Reduce Probability

of Transition

The Promise of Prevention: Small Short-term Changes Lead to Larger Long-term Impacts

0

0.1

0.2

0.3

0.4

0 mo.

(Pretest)

6 mo.

(Posttest)

18 mo.

Grade 7

30 mo.

Grade 8

48 mo.

Grade 10

72 mo.

Grade 12

Fir

st

Tim

e P

rop

ort

ion

Trajectory for ISFP Condition

Trajectory for Control Condition

The Current State of Prevention Science and Practice

Considerable progress in understanding how youth problems

develop over time.

Development of a growing number of prevention programs

Advances in methodology – our ability to measure what

didn’t happen and why

More well-designed studies to test the efficacy of these

interventions

Identification of evidence based prevention programs –

creations of lists: SAMHSA, NREPP

The PROSPER Modelfor the delivery and support of evidence-

based programming

PROSPER Partnership Structure

University/State-Level Team

University Researchers, Extension Program Directors

Prevention Coordinator Team–

Extension & Prevention Coordinators

Local Community Teams

Extension Agent, Public School Staff,

Substance Use & Mental Health Service Agency Representatives, Parent/Youth

Representatives

Local PROSPER Community Team

Small and Strategic – (7 - 9 members)

• Team Leader: Extension youth/ family educator

• Co-Leader: Local public school representative

• Local mental health agency person

• Local substance abuse agency person

• Middle or high school-aged students

• Parent

As the team grows, additional representatives may be added

PROSPER Programs

PROSPER offers teams a “menu” of evidence-based

programs targeting families (e.g., Strengthening

Families Program) and schools (e.g., Life Skills

Training, Project Alert)

Teams choose one school-based and family-based

Evidence-based programs offer greater assurance

that they will work

More efficient use of resources…

What do the local PROSPER teams do?

• Choose programs to address community needs

• Actively participate in meetings

• Recruit family-based program participants

• Assist in monitoring the quality implementation of the evidence-based programs

• Promote PROSPER and evidence-based programs in the community

• Participate in sustainability planning for PROSPER programs

PROSPER and Rural Settings

The PROSPER model to address Barriers to Rural Public Health Impact

Need for more widespread adoption of evidence-based

programs in rural communities

Look to existing infrastructures on which to build

programming and reduce risk to substance abuse

Need to improve quality and fidelity, and promote

sustainability

Create and strengthen links between local

practitioners and experts in community mobilization

and prevention science

Linking Existing Systems to promote Evidence Based Programs

• Cooperative Extension System Largest science-to-practice transfer and informal education

system in the world

Over 3,150 agents in nearly every county in the U.S.

• Public School System Universal system reaching nearly all children

States have networks for programming support

Increasing emphasis on accountability/empirical orientation

Linking local PROSPER teams to university-based prevention researchers

• Teams receive technical

assistance from Prevention

Coordinators (PCs)

• PCs are university staff with

backgrounds in prevention or

Extension programming

The PROSPER model emphasizes technical

assistance between the PCs, the local teams and

the research teams.

Examples of Promising Outcomes

Implementation Quality Findings

Average over 90% adherence to both school and

family evidence-based programs

Quality maintained across five years of program

delivery!

press). PROSPER study of evidence-based intervention implementation quality by community-university partnerships. Journal of Community Psychology.

Initial Financial Sustainability

100% of PROSPER teams obtained external funding

within a year

Funds obtained from a variety of sources – state,

city, business, religious and service organizations,

and private individuals

Collectively, over $500,000 for sustained family EBI,

over last two years

PROSPER Success—Positive Outcomes for Families

• More consistent discipline

• Less harsh discipline

• Better family cohesion

• Better mother-child relations

• More frequent parent-child activities

Studies have shown that these protective factors can decrease the use of substances and other risky

behaviors.

PROSPER Success--Reducing Adolescent Substance Use

• Slower Rates of Substance Initiation

• Gateway Drugs

• Illicit Drugs

• Reduced Past-Year Substance Use

• Marijuana

• Inhalants

Adolescent Problem Solving:7th, 8th, and 9th Grades

3.62

3.59

3.54

3.47

3.453.44

3.35

3.40

3.45

3.50

3.55

3.60

3.65

7th Grade 8th Grade 9th Grade

INT CTRLInt Ctrl

All sig at p<.01

New User Marijuana Rates:7th, 8th, and 9th Grades

3.70%

10.60%

19.20%

6.00%

13.20%

24.60%

7th Grade 8th Grade 9th Grade

INT CTRLInt Cntrl

All sig at p<.05

PROSPER Take Home Message

• PROSPER utilizes evidence-based

programming to make a difference

• Prevention programs that work are being

delivered with quality and they are

producing measurable benefits in many

communities!

Please visit our websites at…

www.prosper.ppsi.iastate.edu

www.ppsi.iastate.edu

www.prevention.psu.edu

Thank you!