Mixed picture of readiness for adoption of evidence-based prevention programs in communities: exploratory surveys of state program delivery systems.

An emerging literature highlights the potential for broader dissemination of evidence-based prevention programs in communities through existing state systems, such as the land grant university Extension outreach system and departments of public education and health (DOE-DPH). This exploratory study entailed surveying representatives of the national Extension system and DOE-DPH, to evaluate dissemination readiness factors, as part of a larger project on an evidence-based program delivery model called PROSPER. In addition to assessing systems' readiness factors, differences among US regions and comparative levels of readiness between state systems were evaluated. The Extension web-based survey sample N was 958 and the DOE-DPH telephone survey N was 338, with response rates of 23 and 79 %, respectively. Extension survey results suggested only a moderate level of overall readiness nationally, with relatively higher perceived need for collaborative efforts and relatively lower perceived resource availability. There were significant regional differences on all factors, generally favoring the Northeast. Results from DOE-DPH surveys showed significantly higher levels for all readiness factors, compared with Extension systems. Overall, the findings present a mixed picture. Although there were clear challenges related to measuring readiness in complex systems, addressing currently limited dissemination resources, and devising strategies for optimizing readiness, all systems showed some readiness-related strengths.

Longitudinal effects of universal preventive intervention on prescription drug misuse: three randomized controlled trials with late adolescents and young adults.

OBJECTIVES: We examined long-term prescription drug misuse outcomes in 3 randomized controlled trials evaluating brief universal preventive interventions conducted during middle school. METHODS: In 3 studies, we tested the Iowa Strengthening Families Program (ISFP); evaluated a revised ISFP, the Strengthening Families Program: For Parents and Youth 10-14 plus the school-based Life Skills Training (SFP 10-14 + LST); and examined the SFP 10-14 plus 1 of 3 school-based interventions. Self-reported outcomes were prescription opioid misuse (POM) and lifetime prescription drug misuse overall (PDMO). RESULTS: In study 1, ISFP showed significant effects on POM and PDMO, relative reduction rates (RRRs; age 25 years) of 65%, and comparable benefits for higher- and lower-risk subgroups. In study 2, SFP 10-14 + LST showed significant or marginally significant effects on POM and PDMO across all ages (21, 22, and 25 years); higher-risk participants showed stronger effects (RRRs = 32%-79%). In study 3, we found significant results for POM and PDMO (12th grade RRRs = 20%-21%); higher-risk and lower-risk participants showed comparable outcomes. CONCLUSIONS: Brief universal interventions have potential for public health impact by reducing prescription drug misuse among adolescents and young adults.

Effects of parenting and deviant peers on early to mid-adolescent conduct problems.

We investigated the influence of effective parenting behaviors (father and mother reports) and deviant peer association (adolescent reports) on subsequent young adolescent conduct problems (teacher reports) during grades 7-9, using structural equation modeling. Data were from a sample of 226 rural adolescents (n = 112 boys; n = 107 girls; n = 7 gender unknown), their parents, and teachers. Both effective parenting and association with deviant peers influenced later conduct problems; however, the pattern of influence varied across time and between fathers and mothers, with complex patterns of interactions between effective parenting and peer deviance. From seventh to eighth grade, effective parenting by both mothers and fathers buffered the effect of higher levels of peer deviance on conduct problems across adolescent gender. From eighth to ninth grade (i.e., transition into high school), fathers' effective parenting buffered the effects of deviant peer association on their daughters' conduct problems, whereas both fathers' and mothers' influence was stronger for sons when deviant peer associations were lower. Analyses also evaluated bi-directional longitudinal effects among adolescents, parents, and peers. Although varying by parent and adolescent gender or adolescent age, results generally supported the protective effects of parenting on their children's conduct problems during early to mid adolescence.

Effects of parent-child affective quality during high school years on subsequent substance use.

The literature indicates that the quality of affective relationships between youth and parents is associated with lower levels of a range of problem behaviors during childhood, early and late adolescence. While the protective effect of parental monitoring on substance use in the high school and post high school years has been demonstrated, there is a knowledge gap concerning effects of parent-child affective quality (PCAQ) during the same periods. We tested a conceptual theoretical model to examine the effects of PCAQ on substance use following high school. The sample was from a RCT that assessed adolescents in rural Iowa from the seventh grade through two years after high school (N=456). We specified direct effects of PCAQ in 12th grade on drunkenness, smoking and illicit drug use during the two years immediately following high school graduation. We also specified the effects of early substance use initiation (alcohol, tobacco and marijuana use reported at baseline) on later use. The direct effect of PCAQ in 12th grade on substance use was significant for all substances during at least one of the two years past graduation (ypg). Results were: drunkenness 1 ypg, ß=-.126, p<.05; smoking 1 ypg, ß=-.119, p<.05; 2 ypg, ß=-.146, p<.05; illicit drug use 2 ypg, ß=-.165, p<.05. Some significant indirect effects of PCAQ at baseline, via PCAQ at 12th grade, were found. Results also indicated significant direct effects of early initiation on two of the three substances, albeit with a different pattern of effects over time for each substance by years post high school. Importantly, while early initiation remains the strongest predictor of long-term tobacco and illicit drug use, results show how PCAQ might reduce its harmful effects.