NIDA-supported studies are defining ways to get scientifically tested drug abuse prevention programs applied in communities across the Nation. This complex line of research is developing new partnerships and strategies that can enable both rural and urban communities to select and sustain effective prevention programs that promote young people's well-being and deter drug use and other harmful behaviors.

Scientists have shown that programs that help parents and children function better individually and as a family can reduce substance abuse among general populations of young people. However, the potential of such research-based family and school competency-building programs has not been fully realized because such programs are not being widely used in communities across the Nation.

"Many challenges must be overcome to implement empirically supported programs on a large scale," says Dr. Richard Spoth of Iowa State University in Ames. People seeking to adopt prevention programs often don't have good information about scientifically tested programs, he says. In addition, they often lack the personnel and time required to implement such programs faithfully.

Over the last 7 years, Dr. Spoth has led a series of interrelated studies called Project Family. The project, which is funded by NIDA, the National Institute of Mental Health, and other Federal agencies, has developed some promising ways to use existing community service delivery systems to facilitate putting youth- and family-focused prevention science into community practice. For example, Project Family researchers have developed partnerships with the Iowa Cooperative State Research, Education, and Extension Service of the U.S. Department of Agriculture.

The Strengthening Families Program addresses risk and protective factors for drug abuse and other problem behaviors. In the program, parents and children work together to improve their ability to communicate and to resolve problems at home and at school.

Extension Service agents work in nearly every county in the United States and are dedicated to serving families and youth. This network of professional practitioners has a long history of disseminating the latest scientific information for the benefit of residents of both rural and urban communities. Programming and information provided to local residents cover a wide spectrum of topics ranging from child development, family relations, and consumer economics to weed science and crop management.

The Extension Service network has helped Project Family researchers engage community residents to help with the project. For example, Extension Service agents have involved schools in research evaluating family and youth competency-building programs and have recruited and helped train local residents to deliver the programs. Extension Service agents also have assisted in such tasks as assessing family needs, identifying factors affecting family engagement in prevention programs, and carrying out strategies to disseminate effective family and youth programs.

One of the programs developed and disseminated through this research-Extension-community partnership is a brief family-focused prevention program called the Iowa Strengthening Families Program (ISFP). Adapted for general populations by Dr. Virginia Molgaard of Iowa State University from a prior, more intensive program, the seven-session ISFP was designed to improve parents' family management practices and communications skills and children's personal skills, social skills, and ability to deal with peer pressure. The program was tested with 161 families of 6th graders enrolled in Iowa public schools.

Children who took part in the program when they were in sixth grade were significantly less likely to begin using drugs and alcohol or to progress to more serious substance use than their peers who did not participate in the program, according to followup studies conducted at regular intervals over the last 4 years. For example, 48 months after the initial assessment, the proportion of new marijuana users among youths who didn't participate in the ISFP was 2.4 times greater than it was among youths who did participate. Furthermore, the divergence in drug use between youths who received the program in the sixth grade and those who didn't has widened in the 4 years since the study's pre-intervention assessment, according to a recent evaluation.

Once Project Family research demonstrated the effectiveness of the Iowa Strengthening Families Program, the State Extension Service took the lead in disseminating the program through its statewide network, Dr. Spoth says. To date, the Extension Service has trained more than 600 group leaders to deliver the ISFP, and the program has been offered in 91 communities in Iowa.

"Using the Extension Service as the mechanism to replicate these programs in other communities is an exciting way to use an existing delivery system to get effective programming into the local communities," says Dr. Elizabeth Robertson of NIDA's Division of Epidemiology, Services, and Prevention Research. "Similar types of service delivery systems across the country could be tapped in the same way," she says. "We're working to identify such systems and tap them to disseminate effective drug abuse prevention programs."

In the last 2 years, Project Family has been working extensively in Iowa with another major service delivery system-the public schools-to implement its latest study, the Capable Families and Youth project. This NIDA-funded study will assess whether adding the Iowa Strengthening Families Program to a scientifically proven school-based prevention component has a greater impact on children's substance abuse and other health behaviors than the school--based program alone.

"Comprehensive prevention programs that include school, family, and community components require effective partnerships to implement and sustain them," Dr. Spoth says. "We're integrating the school system and its technical assistance infrastructure with the Extension Service as a way to implement these kinds of programs," he says. (See "The Next Step in Disseminating Proven Prevention Programs?" p. 12.)

Sources

Spoth, R. and Molgaard, V. Project Family: A partnership integrating research with the practice of promoting family and youth competencies. In: T.R. Chibucos and R.M. Lerner (eds.). Serving Children and Families Through Community-University Partnerships: Success Stories, Boston: Kluwer Academic Publishers, pp. 127-137, in press.

Spoth, R.; Reyes, M.L.; Redmond, C.; and Shin, C. Assessing a public health approach to delay onset and progression of adolescent substance use: Latent transition and loglinear analyses of longitudinal family preventive intervention outcomes. Journal of Consulting and Clinical Psychology, in press.