It is becoming increasingly common for community teams or coalitions to implement programming for children and families designed to promote positive youth development and prevent adolescent problem behaviors. However, there has been only limited rigorous study of the effectiveness of community teams’ programming efforts to produce positive outcomes. This study employed a community-level randomized control design to examine protective parent and youth skills outcomes of evidence-based preventive interventions selected from a menu and delivered by community teams supported by a community-university partnership model called PROSPER. Twenty-eight rural communities in two states were randomized across intervention and control conditions. Data were collected through written questionnaires that were completed by approximately 12,000 middle school students in the fall of the 6th grade, prior to intervention delivery, and again in the spring of the 7th, 8th, and 9th grades. Positive intervention effects were found for youth, parent, and family outcomes (e.g., association with antisocial peers, child management, parent-child affective quality) at each post-intervention assessment point. Improvements in these family and youth skill outcomes are expected to support long-term reductions of adolescent problem behaviors, such as substance abuse.

Objective To examine effects of a delivery system for evidence-based preventive interventions through 12th grade, 6.5 years past baseline. Method A cohort sequential design included 28 public school districts randomly assigned to the partnership delivery system or usual-programming conditions. At baseline, 11,960 students participated. Partnerships supported community teams that implemented a family-focused intervention in 6th grade and a school-based intervention in 7th grade. Outcome measures included lifetime, current misuse, and frequencies of misuse, for a range of substances. Intent-to-treat, multilevel analyses of covariance of point-in-time misuse and analyses of growth in misuse were conducted. Results Results showed significantly lower substance misuse in the intervention group at one or both time points for most outcomes, with relative reduction rates of up to 31.4%. There was significantly slower growth in misuse in the intervention group for 8 of 10 outcomes. In addition, risk moderation results indicated there were significantly greater intervention benefits for higher- versus lower-risk youth, for misuse of 6 of 10 substances at 11th grade, illicit substances at 12th grade, and growth in misuse of illicit substances. Conclusion Partnership-based delivery systems for brief universal interventions have potential for public health impact by reducing substance misuse among youth, particularly higher-risk youth.

Data from a community-based sample of 1,126 10th-and 11th-grade adolescents were analyzed using a model-based cluster analysis approach to empirically identify heterogeneous adolescent subpopulations from the person-oriented and pattern-oriented perspectives. The model-based cluster analysis is a new clustering procedure to investigate population heterogeneity utilizing finite mixture multivariate normal densities and accordingly to classify subpopulations using more rigorous statistical procedures for the comparison of alternative models. Four cluster groups were identified and labeled multiproblem high-risk, smoking high-risk, normative, and low-risk groups. The multiproblem high risk exhibited a constellation of high levels of problem behaviors, including delinquent and sexual behaviors, multiple illicit substance use, and depressive symptoms at age 16. They had risky temperamental attributes and lower academic functioning and educational expectations at age 15.5 and, subsequently, at age 24 completed fewer years of education, and reported lower levels of physical health and higher levels of continued involvement in substance use and abuse. The smoking high-risk group was also found to be at risk for poorer functioning in young adulthood, compared to the low-risk group. The normative and the low risk groups were, by and large, similar in their adolescent and young adult functioning. The continuity and comorbidity path from middle adolescence to young adulthood may be aided and abetted by chronic as well as episodic substance use by adolescents.Adolescence is a developmental period characterized by increases in risk behaviors, mood fluctuations, and conflict with parents (Arnett, 1992(Arnett, , 1999, as well as when significant brain development occurs in the frontal lobes, influencing the development of better reasoning and decision-making capabilities (Dahl, 2004;Reyna & Farley, 2006). Recent national data from the 2005 Youth Risk Behavior Survey (Eaton et al., 2006) highlight that a substantial percentage of adolescents in 9th through 12th grades in the United States are involved in a number of risk behaviors, including current cigarette smoking (23.0%), alcohol use (43.3%), heavy drinking (25.5%), marijuana use (20.2%), aggression and violence (e.g., physical fighting; 35.9%), and extreme feelings of sadness (28.5%) and suicidal ideas (16.9%). The alarmingly high rates of substance use among adolescents and college students are echoed in the most recent report from the Monitoring the Future National Survey (Johnston, O'Malley, Bachman, & Schulenberg, 2006). For most adolescents, engagement in some level of risk behavior is part of a statistically normative process that is intertwined with age-appropriate developmental tasks associated with increases in autonomy and self-regulation.Address correspondence and reprint requests to: Eun Young Mun, Rutgers Center of Alcohol Studies, Rutgers University, 607 Allison Road, Piscataway, NJ 08854; E-mail: eymun@rci.rutgers.edu.. NIH Public Access Author Manus...

Depression symptoms are associated with impairments in functioning and have substantial health and economic consequences. Universal substance misuse prevention programs have shown effects on non-targeted mental health-related symptoms, but long-term effects are understudied. This cluster randomized controlled trial examined effects of both the LifeSkills Training (LST) and Strengthening Families Program: For Parents and Youth 10–14 (SFP 10–14) interventions, delivered during seventh grade, on age 22 young adult depression symptoms. The study was conducted in US rural Midwestern communities with a randomly-selected sample from a larger study (N= 670). Experimental conditions were LST+SFP 10–14, LST-only, and a control condition. Effects on age 22 depression symptoms were hypothesized as mediated through effects on age 21 relationship problems and illicit use of substances. Structural equation modeling with manifest and latent variables was conducted to test hypotheses; the intervention conditions were combined and compared with the control condition because analyses indicated a comparable pattern of effects between intervention conditions. Significant indirect intervention effects were found on age 22 depression symptoms via effects on the mediating variables (indirect effect: β=−0.06, 95 % CI [−0.10, −0.01], p=0.011). Effect sizes for the young adult variables were between d=0.17 and 0.29, which can be considered small, but nontrivial, especially in the context of public health benefits. Results support scaled-up implementation of school-based and family-focused universal substance misuse preventive interventions.

About 10 years ago, a special issue of the journal Prevention Science reviewed the "great progress" that had occurred in the subfield of family-focused preventive intervention research. The summary of almost two decades of effort highlighted how, in particular, the scientific community was well poised to seize an opportunity for larger scale implementa tion and greater public health impact (Spoth, Kavanagh, & Dishion, 2002). Over a decade later, the field has further progressed, and the opportunity for public health impact is even greater, although many challenges remain. In part, one of the articles featured in the special issue reviewed the research to date on the Iowa Strengthening Families Program (subsequently revised and renamed the Strengthening Families Program: For Parents and Youth 10-14 [SFP 10-14]). In this chapter, we recapitulate and update this program of research. Most important, the chapter reflects the progress in the broader field of prevention science. It also illustrates critical opportunities that, when properly seized, could better achieve the public health impact through family-focused prevention. These opportunities are suggested by knowledge gaps addressed through the SFP 10-14 program of research. GAPS ADDRESSED BY THE PROGRAM OF RESEARCHThree decades ago, one of the most salient gaps in the empirical literature on family-focused interventions was the lack of research on universal interventions' effectiveness and on the viability of their sustained, quality implementation. A key reason for the development and subsequent research on the SFP 10-14 was to address these issues.