*PROSPER Partnerships: Toward Evidence-Based Intervention for Youth, Family and Community IMPACT

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PROSPER PartnershipsToward Evidence-Based
Intervention for Youth, Family and Community
IMPACT

• Richard Spoth
• Partnerships in Prevention Science Institute
• Congressional Educational Briefing
• June 12, 2006
• Funded by the National Institute on Drug Abuse

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Map for Todays Presentation

• A Partnership Path to Positive Impact
• Challenges to Youth, Family, Community Impact
• Opportunities for Impact
• IMPACT Framework
• Illustrations of Long-term Impact
• The PROSPER Partnership Model, Successes to Date
• Proposed Multistate Network, Anticipated Benefits

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1. A Partnership Path to Youth, Family
Community Impact Challenges, Opportunities,
Illustrations
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The ChallengeImpact Requires a Larger Piece of
Sustained, Quality, Evidence-Based
Interventions (EBIs) with General Community
Populations
EBIs
Evaluated- not effective
Not Evaluated
and rigorously demonstrated, long-term EBI
impact is very rare
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Seizing an Opportunity for Impact Linking
Public Education Dissemination Systems Reaching
Every U.S. Community

• Public School System
• Universal system reaching nearly
• all children
• Increasing emphasis on
• accountability/evidence orientation
• Cooperative Extension System in Land Grant
  Universities
• Largest informal education system in the world
• Over 3,150 agents in nearly every county in the
  U.S.
• Science with practice orientation

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IMPACT FrameworkBasic Science with Practice
Tasks
Implant intervention science in stable public
education dissemination systems, linked with
other resource systems Maintain systems-level
support for science with practice Partner with
communities strategically, offering
proactive technical assistance Advance
intervention evidence-base Conduct high quality
implementation/ participant engagement Tailor
toward sustainability of

partnerships and EBIs, planned early
Source Spoth et al. (2006). Society for
Prevention Research 14th Annual Meeting.
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What is evidence-basedhow do we know what works?

• Society for Prevention Research Standards of
  Evidence
• Design allows strongest possible statement about
  intervention causing outcome (e.g., randomized,
  controlled) also
• Specific statement about what outcomes, with whom
• Specific description of intervention and outcome
  measures
• Quality, timing of measurement
• Sample clearly specified
• Sound statistical analyses, with attention to
  practical value and duration of effects
• Specific to phase of prevention research
• Applies to partnership-based interventions
• See www.preventionresearch.org

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Illustration of Long-Term ImpactReduced Meth Use
4-6 Years Past Baseline
Specific results to be announced when released by
the journal publishing them.
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Illustration of Long-Term ImpactLifetime
Marijuana Use Through 6 Years Past Baseline
See Spoth, Redmond, Shin,  Azevedo (2004). Brief
family intervention effects on adolescent
substance initiation School-level curvilinear
growth curve analyses six years following
baseline. Journal of Consulting and Clinical
Psychology, 72, 535-542.
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Other Positive Long-Term Outcomes from
Randomized, Controlled Studies

• ? Parent and Youth Skills
• ? Academic Success
• ? Tobacco/Cigarette Initiation
• ? Alcohol Initiation
• ? Drunkenness
• ? Multi-substance Use
• ? Inhalant Use
• ? Aggression/Conduct Problems
• ? Diagnosable Disorders

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Case Study of Billy or Betty Costs of Life
Trajectory of Early Substance Use and Problem
Behaviors
Resident home expenses 50,000 Medicaid
110,000 Special
education 28,000 State hospital
128,000 Legal (estimated)
20,000 Total
336,000
Increasing Costs
Level of Problem Behaviors
Trajectory of Problems/
Early Childhood
Young Adulthood
Illustrative case history and cost projections
from Dennis Embry (PAXIS Institute).
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Illustration of Potential Economic Impact
Source Spoth, Guyll, Day (2002). Universal
family-focused interventions in alcohol-use
disorder prevention Cost-effectiveness and
cost-benefit analyses of two interventions.
Journal of Studies on Alcohol, 63, 219-228.
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2. PROSPER (Promoting School-community-university
Partnerships to Enhance Resilience)Model and
Successes to Date
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PROSPER Study Aims

• Evaluate the effectiveness of partnership
  implementation of evidence-based interventions
  (EBIs) on youth and family outcomes

• Learn what factors are most important in
  partnership effectiveness, quality
• implementation and
• sustainability

Funded by the National Institute on Drug
AbuseCollaboration with Pennsylvania State
University (Mark Greenberg, PI and Karen Bierman,
Co-PI)
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PROSPER Organizational Structure
Local Community Teams Extension Agent, Public
School Staff, Social Service Agency
Representatives, Parent/Youth Representatives
Prevention Coordinator Team Extension Prevention
Coordinators
University/State-Level Team University
Researchers, Extension Program Directors
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Phases of PROSPER Implementation

• Phase 1 Organizationteam formation/planning
• Phase 2 Initial operationsprogram
  implementation
• Teams selected one of three evidence-based,
  family-focused programs for 6th graders
• Teams selected one of three evidence-based school
  programs for 7th graders
• Phase 3 Early sustainability planning/
• institutionalization within Extension
• Phase 4 Ongoing Operations and Sustainability

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PROSPER SuccessImplementation Quality

• Literature Typical implementation adherence
  ranges from 42-86
• In PROSPER, based on ratings by trained
  observers
• Average 91 adherence for family-focused EBI
• Average 90 adherence for school-based EBIs

Source Spoth, Guyll, Lillehoj, Redmond,
Greenberg (In press). PROSPER study of
evidence-based intervention implementation
quality by community-university partnerships.
Journal of Community Psychology .
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PROSPER SuccessPositive Outcomes for Families

• At 1½ Years Past Baseline
• More consistent discipline
• Less harsh discipline
• Better family cohesion
• Better mother-child relations

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PROSPER Success Substance-related Outcomes
for 7th Graders at 1½ Years Past Baseline
Source Spoth, Redmond, Shin, Greenberg, Clair,
Feinberg (2006). Substance use outcomes at 1½
years past baseline from the PROSPER
community-university partnership trail.
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Another PROSPER SuccessInitial Sustainability

• 100 of PROSPER teams obtained external funding,
  within a year of starting the early
  sustainability phase!
• Funds were obtained from a variety of sources
  state, city, business, religious and service
  organizations, and private individuals.

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3. Proposed Multistate Partnership IMPACT Network
and Benefits
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Multistate Partnership IMPACT Network

• Step-by-step expansion of partnership network
• Twofold purpose of multistate network
• To replicate the PROSPER Model for real world
  dissemination of evidence-based interventions
  (EBIs) in early-adopter states
• To conduct multisite process and outcome
  evaluations or prevention trials, to learn more
  about how to achieve large-scale community IMPACT

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Potential Benefits of Network for
Partnership-Based EBIs on a Larger Scale

• To Our Fund of Knowledge
• Expanding knowledge of interventions producing
  long-term positive outcomes and economic benefits
• Potential for learning from multistate research
  network about optimal dissemination of
  evidence-based interventions
• To Schools and Communities
• Reduced substance use problems among youth
• Reduced youth behavior problems in school and
  community settings
• To Youth and Families
• Enhanced parenting and youth life skills
• Increased family cohesion and well-being

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What Could BeScaling up Evidence-Based
Interventions Through Partnership Networks

• Consider the empirically-demonstrated return from
  one set of NIDA-funded projects
• Imagine this on a larger scale
• Improved economic benefits from federally-funded
  projects
• Prevention stock is blue chip
• Evidence-based prevention interventions
• fiscally wise
• Improved health and well-being of youth, families
  and communitiesmaking a real world difference

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Imagine
IMPACT!
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• Acknowledgement of
• Our Partners in Research
• Investigators/Collaborators
• R. Spoth (Director), C. Redmond C. Shin
  (Associate Directors),
• T. Backer, K. Bierman, G. Botvin, G. Brody, S.
  Clair,
• T. Dishion, M. Greenberg, D. Hawkins,
• K. Kavanagh, K. Kumpfer, C. Mincemoyer,
• V. Molgaard, V. Murry, D. Perkins, J. A. Stout
• Associated Faculty/Scientists
• K. Azevedo, J. Epstein, M. Feinberg, K. Griffin,
• M. Guyll, K. Haggerty, S. Huck, R. Kosterman,
• C. Lillehoj, S. Madon, A. Mason, J. Melby, M.
  Michaels,
• T. Nichols, K. Randall, L. Schainker,
• T. Tsushima, L. Trudeau, J. Welsh, S. Yoo
• Prevention Coordinators
• E. Berrena, M. Bode, B. Bumbarger, E. Hanlon
• K. James, J. Meek, A. Santiago, C. Tomaschik

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And, again, thank you for this
opportunityQuestions?

• For more information please visit our websites
  at...

www.ppsi.iastate.edu or www.prevention.psu.edu A
lso see www.preventionresearch.org for the
Society for Prevention Research Standards of
Evidence Guidelines.