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.
PROSPER: A model of delivery for evidence-based programming
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
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
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.
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!