Source: UTAH STATE UNIVERSITY submitted to NRP
OPIOID PREVENTION FOR RURAL UTAH YOUTH THROUGH PROSPER
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
COMPLETE
Funding Source
Reporting Frequency
Annual
Accession No.
1020725
Grant No.
2019-46100-30273
Cumulative Award Amt.
$324,841.00
Proposal No.
2019-04616
Multistate No.
(N/A)
Project Start Date
Sep 1, 2019
Project End Date
Aug 31, 2022
Grant Year
2019
Program Code
[LX]- Rural Health & Safety Education
Recipient Organization
UTAH STATE UNIVERSITY
(N/A)
LOGAN,UT 84322
Performing Department
Youth Programs
Non Technical Summary
USU Extension will address the opioid issue in 6th grade youth in three counties by implementing the PROSPER delivery system. The elements of the program include the family-based Strengthening Families Program and the school-based LifeSkills Program,The PROSPER delivery system builds a unique partnership among University Extension Systems, public schools, public health, and prevention scientists to implement school and family evidence-based programs (EBP). EBP implementation is managed by Community Teams, supported through training and technical assistance (TA) provided by experts comprising other layers of the partnership. The EBPs, and the partnership structure that supports them, are designed to prevent adolescents from engaging in behaviors that lead to substance misuse and other problem behaviors. Typically, PROSPER County Teams start with 8-10 members, which are led by county-based Extension personnel and co-led by a school staff member. Other Team members may include social- and health-service providers, school administrators, parents and youth from the community, faith-based leaders, parents, law enforcement, and the juvenile justice system. PROSPER Community Teams have the benefit of on-going support to sustain and monitor implementation quality, a system of benchmarks to guide continuous improvement, and the support of a network of teams who learn from each other's successes.
Animal Health Component
(N/A)
Research Effort Categories
Basic
(N/A)
Applied
(N/A)
Developmental
(N/A)
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
80660203020100%
Knowledge Area
806 - Youth Development;

Subject Of Investigation
6020 - The family and its members;

Field Of Science
3020 - Education;
Goals / Objectives
Objective 1: Improve County Infrastructure & Human Resource Capacity for Science-Based Opioid Prevention by Building Extension & State Partner Knowledge & SkillsObjective 2: Increase the Number of Youth & Adults Receiving Science- or Evidence-Based Prevention Programming & Educational Content Related to Opioid Misuse Objective 3: Increase personal Resilience & Strengths of Youth in Rural Counties Against Opioid Misuse Objective 4: Increase Parent Awareness, Knowledge, & Functioning Related to Opioid Misuse
Project Methods
Methodology of PROSPER is delivered via universal prevention strategies, behavioral health awareness, family skill building, and positive youth development.Strengthening Families Program: For Parents & Youth 10-14. SFP 10-14 is a seven session universal intervention that uses a family-focused, skill-building approach to prevent substance use and other problem behaviors in young adolescents. The SFP 10-14 includes parent- and youth-relevant topics and activities that are addressed in independent groups, as well as activities that are done together as a family. The program activities were designed to work with about eight families per group (Spoth, Redmond, Mason, Schainker, & Borduin, 2015).LifeSkills Program. The school-based LifeSkills program is a 13 session training to increase resilience and strengths of middle school students. Sessions are taught by school teachers and include topics such as decision making, drug/alcohol myths & realities, coping strategies, communication, resolving conflict, and resisting peer pressure.4-H Participation. Youth participants will be enrolled in the local 4-H program using grant funding to eliminate any potential financial barriers. The purpose of 4-H participation for the proposed project is to further provide opportunities to youth for leadership and learning life skills. In addition to local participation, youth will be encouraged and provided funding to attend 4-H State Junior Youth Conference where they will be able to participate in service learning activities, leadership, healthy living, and team building workshops.PROSPER History, Outcomes and Impacts: Through a 17 year-long randomized trial of approximately 11,000 youth and their families, PROSPER has shown to be an effective solution for reducing teen drug misuse--including prescription narcotics--and other problem behaviors (Spoth, Redmond, Shin, Greenberg, & Schainker, 2013). In part, this is accomplished by enhancing young adolescent life skills and competencies, along with improving family functioning. Peer-reviewed economic analyses have illustrated that PROSPER is a cost-effective approach for preventing teen drug misuse and capable of saving substantial public resources (Spoth, Greenberg, Bierman, & Redmond, 2004).Scaling The current project is not a scale-up of a current USU Extension project, but represents an expansion and partnership with Iowa State University's multi-year and multi-state program.

Progress 09/01/19 to 08/31/22

Outputs
Target Audience:The target audience for the project was 6th grade youth and their families in three rural counties in Utah- Emery, Wayne, and San Juan. All 6th grade youth at the participating schools, Canyon View Middle (Emery), Wayne Middle, and Albert R. Lyman Middle (San Juan) was included in 4-H and LifeSkills programming. Then 6-10 families of the 6th grade students at each site was recruited to participate in the Strengthening Families Program, especially Native American or other underserved populations. Changes/Problems:Two of our rural communities (Emery and Wayne) found it very difficult to recruit enough participants to hold in-person sessions of Strengthening Families 10-14. Both communities participated in the statewide pilot of virtual SFP 10-14 sessions in the spring of 2021, but were unable to implement additional sessions of the program. This is due in large part to the rurality of the communities which would require participants to travel great distances for in-person programming. A lack of adequate broadband service has made it difficult to recruit participants for additional virtual programming. The ongoing impacts of COVID-19 in rural communities has exacerbated these challenges. Despite these challenges, local grant staff members have been in discussions with state grant team members about the future of SFP 10-14 in their communities. In addition to the three communities identified in the NIFA grant, a fourth Utah community has also received sessions of Strengthening Families 10-14. Co-PI Tim Kneady was expected to travel to other counties to provide programming support. However,COVID-19 preventedtravel to other project locations. Therefore, Kneady implemented trainings in Box Elder county, his primary Extension county.The implementation of the program in the Box Elder community was supervised by Keady, and wasimplemented in partnership with the Bear River Health Department and Box Elder County School district, with support from a grant from Iowa State University. What opportunities for training and professional development has the project provided? Nothing Reported How have the results been disseminated to communities of interest?During the third year of the grant project, our findings were disseminated as poster presentations at two national and one international conference. The details of each presentation are as follows: Helping Youth and Families PROSPER in Utah: An Evidence-Based, Community Approach to Substance Abuse Prevention. Presented by Paige Wray, Stacey MacArthur, Tim Keady, Christine Jensen, Mary Sorenson, Claire Warnick, and Lendel Narine. American Society of Addiction Medicine Annual Conference. Hollywood, FL. March 31-April 1, 2022. Helping Youth and Families PROSPER in Utah: An Evidence-Based, Community Approach to Substance Abuse Prevention. Presented by Paige Wray, Stacey MacArthur, Tim Keady, Christine Jensen, Mary Sorenson, Claire Warnick, and Lendel Narine. Annual Rural Health Conference. Albuquerque, NM. May 10-13, 2022. Helping Youth and Families PROSPER in Utah: An Evidence-Based, Community Approach to Substance Abuse Prevention. Presented by Paige Wray, Stacey MacArthur, Tim Keady, Christine Jensen, Mary Sorenson, Claire Warnick, and Lendel Narine. International Narcotics Research Conference, Valencia, Spain. July 4-8, 2022. What do you plan to do during the next reporting period to accomplish the goals? Nothing Reported

Impacts
What was accomplished under these goals? During the third year of the grant, LifeSkills Training sessions were given to 7th grade students in Wayne and Emery County. In Emery County, sessions were delivered to two classes of 7th graders at Canyon View Middle School during the 2021-2022 school year. 100% of the 54 7th graders enrolled in the school completed LifeSkills Training. Despite the challenges of recruiting participants for in-person programming, Strengthening Families 10-14 programming was delivered in San Juan County. The program ran from October through December 2021. Six families enrolled in the program, the majority of whom were from Native American communities. Five of the enrolled families completed the program. Participants included eight adults and seven youth. Over the entirety of the grant cycle (2019-2022), four groups completed Strengthening Families 10-14 programming in Box Elder County. This program implementation was overseen by one of the PROSPER grant co-investigators, and demonstrates the expansion of PROSPER programming to areas of the state that were not originally included in the grant project. These Strengthening Families 10-14 groups were implemented with support from the local department of health (Bear River Health Department) and school district (Box Elder County School District). These entities provided funding and staff to help implement the program. Additional community partners, including the local Boys and Girls Club, also provided support. In total, 68 families enrolled in the Box Elder Strengthening Families 10-14 programming; 38 families attended at least one program session, and 28 families completed a full round of program sessions; 56 youth and 51 adults participated in at least one program session. Box Elder county was included in the program because the co-PI, Tim Kneady, was unable to travel to support other counties during COVID-19. As a result, Kneady conducted youth and family sessions in Box Elder, his primary county. Component 1: Life Skills Program for Youth Knowledge and Attitudes Overall, students' knowledge after Life Skills program was moderate with the average participant scoring 68% on the post-test. The average student participant scored 66% on anti-drug knowledge, and 71% on Life Skills knowledge. With respect to attitudes, student participants demonstrated strong anti-drug attitudes (M = 4.85 out of 5), anti-smoking attitudes (M = 4.88), and anti-drinking (M = 4.85). Results show the majority of youth participants (97%) strongly disagreed with the statement "Smoking cigarettes lets you have more fun," and 95% strongly disagreed with the statements "Smoking cigarettes makes you look cool," and "Drinking alcohol makes you look cool." Evaluation results show student participants demonstrated moderate to high drug refusal skills (M = 3.74) after completing the training, moderate assertiveness skills (M = 3.25) after completing the training, high relaxation skills (M = 4.01) after completing the training, and moderate to high self-control skills (M = 3.60) after completing the training. For drug refusal skills, descriptive results show the majority of youth participants strongly agreed they would say "no" if someone tried to get them to smoke marijuana or hashish (67%), use cocaine or other drugs (67%), vape or smoke an e-cigarette (65%), use a prescription drug that was prescribed for someone else (64%), smoke a cigarette (63%), and drink beer, wine, or liquor (62%). For assertiveness skills, results show the majority of students participants were neutral towards telling someone if they received less change after paying for something, saying "no" to someone who asks to borrow money, and telling someone to go to the end of a line if they cut ahead. Concerning relaxation skills, youth participants tended to agree they would relax the muscles in their body and breath slowly to cope with stress or anxiety. Lastly, for self-control skills, most participants agreed or strongly agreed they would stick to what they're doing until completing it (62%), and most disagreed or strongly disagreed they would quit if something is difficult (55%). Component 2: Strengthening Families Program for Adults and Youth Adults For the Strengthening Families Program (SFP), descriptive evaluation results indicated there were some notable changes in parents' practices after completing the SFP program; there was a 44% increase in the number of parents who "Let my youth know the reason for the rules we have," a 36% increase in "Spend special time one-on-one with my youth," a 27% increase in "Talk with my child about ways to resist peer pressure," a 26% increase in both "Talk with my child about his or her future goals without criticizing," and "Often tell my child how I feel when he or she misbehaves." When asked about the most valuable thing(s) they (adult participants) learned during the program, one parent said, "listen more to my child and spend more time with her. Give consequences and make clear rules." Another said, "I learned how to listen to my children and how to set rules and follow through with consequences even though it isn't easy." Another parent indicated the program revealed "many things I never thought of like how to parent correctly. Involve them in family meetings, learn to calm down before talking about consequences." Youth Post-evaluation results of the SFP for youth show major improvements in several areas. There was a 65% increase in the number of youth indicating "I know one step to take to reach one of my goals," a 49% increase in "We have family meetings to discuss plans, schedules, and rules," a 42% increase in "I am able to tell when my parent(s)/caregiver(s) are stressed or having a problem," and a 37% increase in "I know how to tell when I am under stress." When asked "What was the most valuable thing(s) you learned during this program?", one youth participant said, "I have learned to see things from my parents' point of view." Another youth indicated, "I learned to handle being pressured and respecting my parents and helping around the house."

Publications


    Progress 09/01/20 to 08/31/21

    Outputs
    Target Audience:The target audience for the project is 6th grade youth and their families in three rural counties in Utah--Emery, Wayne, and San Juan (Year 2). All 6th grade youth at the participating schools, Canyon View Middle (Emery), Wayne Middle, and Albert R. Lyman Middle (San Juan) will be included in 4-H and LifeSkills programming. Then 6-10 families of the 6th grade students at each site will be recruited to participate in the Strengthening Families Program, especially Native American or other underserved populations. Changes/Problems:Due to the impacts of COVID-19, including school closures and restrictions on in-person programming, in-person implementation of programming in the fall of 2020 was very limited. While the three PROSPER communities were able to deliver more in-person programming during the spring and summer of 2021, the grant team applied for a no-cost extension for the project in order to ensure that all deliverables will be met. The no-cost extension was approved by NIFA in June 2021. We also received approval from NIFA to expand delivery to 7th and 8th grade students (not just 6th grade students) in our counties in October 2020. What opportunities for training and professional development has the project provided?Team Leaders from Wayne, Emery, and San Juan Counties met with the state project implementation team in May 2021 to discuss program implementation challenges and plans for programming during 2021-2022. Team members in San Juan County received online training to enable them to facilitate the LifeSkills Training program for students during the summer of 2021. How have the results been disseminated to communities of interest?A preliminary impact report, containing evaluation of data from the first two years of the project, was published in Utah State University's Outcomes and Impacts Quarterly, Vol. 1, Issue 2,Mental Health and Economic Wellbeing.The title of the impact report is "A Substance Misuse Prevention Program to Youth in Rural Utah." Full paper (DOI): ?https://doi.org/10.26077/85d1-8d6a Shortened Impact newsletter disseminated to county officies:https://usu.app.box.com/s/z1qypxcb5rmh0dbf622ai66eeie54zt8 Summary e-Newsletter disseminated to stakeholders (e.g., county commissioners):https://myemail.constantcontact.com/USU-Extension-Outcomes---Impacts---Summer-2021.html?soid=1102379035394&aid=L2uOmqhS_As What do you plan to do during the next reporting period to accomplish the goals?During the next reporting period, Wayne and Emery Counties will implement the school-based curriculum to another group of middle school students. They will also implement at least one additional session of the family curriculum for families in their respective counties. San Juan County will implement at least one additional session of the school curriculum, and at least one session of the family curriculum.

    Impacts
    What was accomplished under these goals? Despite the ongoing challenges associated with the COVID-19 pandemic, Team Leaders in all three of the participating counties have been able to implement PROSPER programming during the past year. In Wayne County, PROSPER team members delivered the LifeSkills Training program to 40 7thgraders at Wayne Middle School during the fall of 2020. All of the 7thgrade students at the middle school received training. They also began delivering the program to all 36 6thgraders in the spring of 2021, and plan to finish delivering LifeSkills Training sessions to those students in the fall. In Emery County, all of the 7thgraders at Canyon View Middle School (a total of 80 students) received LifeSkills Training during the 2020-2021 school year. All of the 58 6thgrade students at Canyon View Middle School have also received LifeSkills Training. In both Emery and Wayne Counties, students who started receiving LifeSkills Training sessions before the pandemic in the spring of 2020 finished the sessions after school started again in the fall. The PROSPER team in San Juan County was unable to deliver sessions of LifeSkills Training to students at the local middle school during the school year, due to the severe impacts of the COVID-19 pandemic in the region and more particularly among members of the Navajo Nation. However, the team partnered with American Indian Services in San Juan County to deliver LifeSkills Training to 60 students at AIS Prep during the summer of 2021. Sessions began in late June and will finish in early August. Evaluation results from the LifeSkills participants in Wayne and Emery Counties has shown significant anti-drug attitudes. Evaluation results indicated7thgrade students demonstrated highly positive anti-drug (M = 4.80, SD = 0.33), anti-smoking (M = 4.82, SD =0.32), and anti-drinking (M = 4.78, SD = 0.37) attitudes. Students also expressed strong drug refusal skills (M = 4.00, SD = 1.67). A correlational analysis showed strong positive correlations between all anti-drug sentiments, indicating an individual was likely to exhibit anti-drug, anti-smoking, and anti-drinking attitudes simultaneously. Further, over 70% of youth participants strongly agreed that they would not smoke a cigarette, drink alcohol, smoke marijuana, use cocaine or other drugs, use prescription drugs that were prescribed to others, and vape or smoke an e-cigarette. ANOVA analysis revealed anti-drug, anti-smoking, anti-drinking, and drug refusal skills were consistent across gender, race, age range, and number of parents in the household. This suggests the program led to positive short-term outcomes for all youth participants regardless of their demographic background. While the local teams were unable to implement in-person sessions of Strengthening Families 10-14 during this grant period, due to the difficulty of recruiting participants for in-person programming amid pandemic restrictions, they worked closely with the Strengthening Families 10-14 developer at Iowa State University to implement a virtual statewide session of the program. This virtual session was the first of its kind in Utah, and the families who participated were able to join the program from Emery, Wayne, and Davis Counties. Five families enrolled in the virtual session, and four of them completed the sessions (an 80% graduation rate). Eight youth and five adults completed the sessions, and participants were very positive about their experience with the virtual programming.Due to the number of participants,qualitative feedback was collected from participants in a post-training survey. One of the youth participants commented, "One of the best things [about the program] was and is being closer to my mom." Another youth commented that the best things they learned during the program were "family values and meeting peer pressure." One of the parents who participated said that the most valuable thing they learned was "trying to see things from my child's point of view, [and] understanding how they feel." All three participating counties plan to implement additional sessions of Strengthening Families 10-14 and LifeSkills Training in the fall of 2021.

    Publications


      Progress 09/01/19 to 08/31/20

      Outputs
      Target Audience:The target audience for the project is 6th grade youth and their families in three rural counties in Utah--Emery, Wayne, and San Juan (Year 2). All 6th grade youth at the participating schools, Canyon View Middle (Emery), Wayne Middle, and Albert R. Lyman Middle (San Juan) will be included in 4-H and LifeSkills programming. Then 6-10 families of the 6th grade students at each site will be recruited to participate in the Strengthening Families Program, especially Native American or other underserved populations. Changes/Problems:Due to the impacts of COVID-19, including school closures and restrictions on in-person programming, all spring implementation of PROSPER programs have been postponed until the fall. Wayne County and Emery County, which were both mid-implementation of the LifeSkills Program, are currently determining how they will finish implementing the programs in the fall. What opportunities for training and professional development has the project provided?Team Leaders in Emery and Wayne Counties have completed the online training required to implement the LifeSkills Program in 6th grade classrooms. Wayne County has also had 3 volunteers complete the LifeSkills training. The Team Leaders from Wayne, Emery, and Box Elder Counties completed training to implement the Strengthening Families 10-14 program to 6th grade students and their families. Three volunteers from Wayne County, one from Emery County, and one from San Juan County also completed the training. How have the results been disseminated to communities of interest? Nothing Reported What do you plan to do during the next reporting period to accomplish the goals?During the next reporting period, Wayne and Emery Counties will finish implementing the school-based curriculum and will start implementing the family curriculum. San Juan County will implement both the school- and the family curricula.

      Impacts
      What was accomplished under these goals? The Team Leaders in Emery, Wayne, and San Juan Counties have all started building local implementation teams and strengthening connections with school administrations and behavioral health organizations in their areas (Objective 1). Emery County has recruited five local partners from the education sector and San Juan County has recruited two local partners from the health sector. Wayne County has recruited four local partners from the government sector, two from the education sector, one from the law enforcement sector, one from the health sector, and one from the nonprofit sector. In Wayne County, the Team Leader and volunteers began implementing the school-based curriculum. 40 6th graders at Wayne Middle School have received 11 lessons. There are 40 total 6th grade students enrolled in the school, so 100% of 6th graders have been receiving programming. In Emery County, the Team Leader and a school volunteer began implementing the school-based curriculum. 100% of the 6th grade students at Canyon View Middle School have received 3 lessons (80 students).

      Publications


        Progress 08/01/19 to 07/31/20

        Outputs
        Target Audience:The target audience for the project is 6th grade youth and their families in three rural counties in Utah--Emery, Wayne, and San Juan (Year 2). All 6th grade youth at the participating schools, Canyon View Middle (Emery), Wayne Middle, and Albert R. Lyman Middle (San Juan) will be included in 4-H and LifeSkills programming. Then 6-10 families of the 6th grade students at each site will be recruited to participate in the Strengthening Families Program, especially Native American or other underserved populations. Changes/Problems:Due to the impacts of COVID-19, including school closures and restrictions on in-person programming, all spring implementation of PROSPER programs have been postponed until the fall. Wayne County and Emery County, which were both mid-implementation of the LifeSkills Program, are currently determining how they will finish implementing the programs in the fall. What opportunities for training and professional development has the project provided?Team Leaders in Emery and Wayne Counties have completed the online training required to implement the LifeSkills Program in 6th grade classrooms. Wayne County has also had 3 volunteers complete the LifeSkills training. The Team Leaders from Wayne, Emery, and Box Elder Counties completed training to implement the Strengthening Families 10-14 program to 6th grade students and their families. Three volunteers from Wayne County, one from Emery County, and one from San Juan County also completed the training. How have the results been disseminated to communities of interest? Nothing Reported What do you plan to do during the next reporting period to accomplish the goals?During the next reporting period, Wayne and Emery Counties will finish implementing the school-based curriculum and will start implementing the family curriculum. San Juan County will implement both the school- and the family curricula.

        Impacts
        What was accomplished under these goals? The Team Leaders in Emery, Wayne, and San Juan Counties have all started building local implementation teams and strengthening connections with school administrations and behavioral health organizations in their areas (Objective 1). Emery County has recruited five local partners from the education sector and San Juan County has recruited two local partners from the health sector. Wayne County has recruited four local partners from the government sector, two from the education sector, one from the law enforcement sector, one from the health sector, and one from the nonprofit sector. In Wayne County, the Team Leader and volunteers began implementing the school-based curriculum. 40 6th graders at Wayne Middle School have received 11 lessons. There are 40 total 6th grade students enrolled in the school, so 100% of 6th graders have been receiving programming. In Emery County, the Team Leader and a school volunteer began implementing the school-based curriculum. 100% of the 6th grade students at Canyon View Middle School have received 3 lessons (80 students).

        Publications