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PROSPER: A model of delivery for evidence-based programming


Wolk, S. & Crowley, M. (2008, November). PROSPER: A model for the diffusion and support of …

Wolk, S. & Crowley, M. (2008, November). PROSPER: A model for the diffusion and support of
evidence-based prevention in rural communities. Panel presentation at the Pennsylvania Office of Rural Health’s conference on Reducing Drug use in Rural Pennsylvania. Harrisburg, PA.

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  • 1. PROSPER: A model of delivery for evidence-based programming (Promoting School-community-university Partnerships to Enhance Resilience)
  • 2. 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 Investigator Richard Spoth, Principal Investigator
  • 3. Overview The Role of Prevention The PROSPER Model PROSPER & Rural Communities Sample of PROSPER Outcomes
  • 4. Two Windows of Opportunity for Intervention with General Populations Substance Increased No Use Initiation Use Intervene to Reduce Probability of Transition
  • 5. The Promise of Prevention: Small Short-term Changes Lead to Larger Long-term Impacts Trajectory for ISFP Condition Trajectory for Control Condition 0.4 First Time Proportion 0.3 0.2 0.1 0 0 mo. 6 mo. 18 mo. 30 mo. 48 mo. 72 mo. (Pretest) (Posttest) Grade 7 Grade 8 Grade 10 Grade 12
  • 6. 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
  • 7. The PROSPER Model for the delivery and support of evidence- based programming
  • 8. PROSPER Partnership Structure Local Community Teams Extension Agent, Public School Staff, Substance Use & Mental Health Service Agency Representatives, Parent/Youth Representatives Prevention Coordinator Team– Extension & Prevention Coordinators University/State-Level Team University Researchers, Extension Program Directors
  • 9. 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
  • 10. 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…
  • 11. 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
  • 12. PROSPER and Rural Settings
  • 13. 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
  • 14. 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
  • 15. 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.
  • 16. Examples of Promising Outcomes
  • 17. 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.
  • 18. 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
  • 19. 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.
  • 20. PROSPER Success--Reducing Adolescent Substance Use • Slower Rates of Substance Initiation • Gateway Drugs • Illicit Drugs • Reduced Past-Year Substance Use • Marijuana • Inhalants
  • 21. Adolescent Problem Solving: 7th, 8th, and 9th Grades INT Int CTRL Ctrl 3.65 3.62 3.60 3.59 3.55 3.54 3.50 3.47 3.45 3.45 3.44 3.40 3.35 7th Grade 8th Grade 9th Grade All sig at p<.01
  • 22. New User Marijuana Rates: 7th, 8th, and 9th Grades INT Int CTRL Cntrl 24.60% 19.20% 13.20% 10.60% 6.00% 3.70% 7th Grade 8th Grade 9th Grade All sig at p<.05
  • 23. 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!
  • 24. Please visit our websites at… Thank you!