Speaker
Description
Authors: Damon Jones (Penn State), Patrick O'Neill (Penn State), Sarah Chilenski (Penn State), Yoon Hur (Penn State)
Background: Programming to prevent behavioral problems can effectively build youth skills and delay substance use for adolescents. Among children facing greater risks, delivery of effective prevention programming is essential. While higher implementation quality typically supports more positive outcomes, an important question is whether it differentially affects outcomes across youth. The PROSPER prevention system used a coalition approach in rural regions of Iowa and Pennsylvania (US) to support implementation of community-selected evidence-based programs. This study examined the potential differential impact of the family-focused programming on substance use outcomes based on initial risk levels.
Methods: Outcomes measured when participants were in ninth grade included lifetime, past-month, and past-year use of various substances, along with indices for gateway and illicit substance use. Three measures of family-focused program implementation quality were also assessed: (1) adherence, (2) facilitation quality, and (3) group participation. Multi-level analysis was used to examine the effect of implementation quality at the community level as a moderator in the relationship between a child's risk status at baseline and substance use at the individual level.
Results: Results showed that higher implementation quality significantly associated with lower substance use for students with high levels of initial risk. Notably, high implementation quality significantly reduced the substance initiation index for at-risk students (p < .05). Similar results were also found related to the initiation of marijuana and cigarette use, as well as with alcohol consumption in the past month.
Discussion: These results confirm the importance of implementation quality for evidence-based programs, especially for youth with multiple risk factors in sixth grade. These findings extend prior research, as our results highlight the critical role of implementation quality factors beyond adherence. Discussion will focus on the importance of implementation quality and why different factors of implementation quality may be of greater or lesser importance for higher-risk youth.
| Conflict of interest | None |
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