Source: UNIVERSITY OF FLORIDA submitted to NRP
PROSPER FLORIDA: PREVENTING YOUTH OPIOID USE IN RURAL COMMUNITIES - USDA NIFA RHSE
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
COMPLETE
Funding Source
Reporting Frequency
Annual
Accession No.
1027109
Grant No.
2021-46100-35391
Cumulative Award Amt.
$348,388.00
Proposal No.
2021-06333
Multistate No.
(N/A)
Project Start Date
Sep 1, 2021
Project End Date
Aug 31, 2024
Grant Year
2021
Program Code
[LX]- Rural Health & Safety Education
Recipient Organization
UNIVERSITY OF FLORIDA
G022 MCCARTY HALL
GAINESVILLE,FL 32611
Performing Department
(N/A)
Non Technical Summary
The purpose of this project is to implement PROSPER (PROmoting School-community-universityPartnerships to Enhance Resilience), a community-based approach to substance use preventiondesigned specifically for use within Cooperative Extension systems. PROSPER is designed toaddress the need for training and technical assistance in capacity-building in rural communities,particularly in consideration of the well-documented scarcity of school and behavioral healthresources. PROSPER links university-based prevention researchers with two established systemswithin the state--the Cooperative Extension System and the public school system, to sustainablydeliver substance abuse prevention programs across the county to youth and their families. Inaddition, this project seeks to expand the youth engagement component of PROSPER by involvingyouth at the community level using best practices for youth-adult partnerships. Implementation willoccur in two rural Florida counties and will consist of three phases over the duration of the two-year project. Phase 1 focuses on initiating and mobilizing state and county PROSPER teamscomposed of an Extension team leader, a school co-leader, key community stakeholders, andparents and youth. Phase 2 focuses on building the capacity of the county PROSPER teams andbuilding awareness for PROSPER at the county level. Phase 3 focuses on effectively delivering oneschool-based and one family-based prevention program in each county. The project will beimplemented in coordination with the state office of Substance Abuse and Mental Health and willachieve the PROSPER goals of (1) sustaining well-functioning state and local teams; and (2)sustaining high-quality delivery of evidence-based prevention programs.
Animal Health Component
100%
Research Effort Categories
Basic
(N/A)
Applied
100%
Developmental
(N/A)
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
8026020307060%
6086099307040%
Goals / Objectives
The goal of PROSPER Floridais to create and sustain a multi-tiered state support systemwhere specialists from the University of Florida/Institute ofFood and Agricultural Sciences (UF/IFAS)work collaboratively with local rural county teams led by a county extension agent to support the effective delivery of substance use prevention programming. The project will target two rural counties in the state: Madison and Taylor Counties.PROSPER Florida aims to 1) sustain well-functioning state and local collaborative teams through training and capacity-building,and 2) deliver high-quality evidence-based prevention programming to ruralyouth and their families.The objectives of thefirst aim are to:1.Mobilize and organize the state managementteam composed of faculty from UF/IFAS with expertise in prevention science and extension programming;2. Mobilize,organize, and train county-level PROSPER teams composed of a county cooperative extension team leader,local school personnel, professionals, parents, and youth with an interest in addressing substance use, including opioids.3.Build awareness of local team initiatives via youth outreach, social media, and other community activities; and4.Develop and implement a PROSPER Florida sustainability plan.The objectives of thesecond aim are to:1.Deliver one family- and one school-based prevention program with content related to opioid misuse in each rural county. The selected programs arethe Strengthening Families Program 10-14 community-based program and the Botvin Life Skills Training school-based program;2.Fundraise and solicit local resources to support evidence-based program implementation and sustainability;3.Conduct both a process and outcome evaluation(e.g., monitoring implementation, measuring outcomes/impacts) using a mixed method evaluation design.
Project Methods
PROSPER Florida will use the PROSPER system's three-tiered developmental approach to implementation. Tier 1: Statement Management Team (SMT), Tier 2: Technical Assistant Provider (TAP), and Tier 3: Community Team (CT). The SMT includes a project director and university faculty with expertise in prevention science, Extension education, and program evaluation. The TAP works closely with the SMT to monitor CT's implementation of PROSPER. CTs include a team leader (extension agent), a school co-leader, 6-8 community leaders/professionals, parents, and youth. Each tier will receive training, coaching, and technical assistance from the PROSPER Network at Iowa State University to mobilize, implement, and sustain prevention programming.Phase 1: The PROSPER Network will conduct a virtual, three-day in-depth PROSPER training for the SMT, TAP, and CT leaders who will begin planning for PROSPER implementation in the two selected counties. CT leaders will recruit 8-10 key people for the local PROSPER Team, including at least two youth. One youth will be a middle-school aged 4-H participant. Youth representing 4-H on the CT will be uniquely positioned to take action items to their peers within the 4-H club system and to their respective county council. Additionally, 4-H youth will have opportunity to convey the message across their geographical region and the state 4-H council system as representatives from their county. The other youth member will reflect the middle school population/community at large. Teacher nominations will be utilized to recruit the second youth member, emphasizing influential youth rather than high-achieving youth.Phase 2: PROSPER teams in each county will receive virtual capacity-building trainings focused on CT development, awareness building, and implementing evidence-based programs. Each CT will receive technical assistance from the TAP on a bimonthly basis. The two youth CT members will recruit youth for an awareness-building campaign. Youth will choose strategies that best fit their communities. Options may include: social media campaigns; presentations to stakeholders (e.g., school board); radio announcements; memes; infographics.Phase 3: Each CT will receive technical assistance in implementing, monitoring, and evaluating the two required prevention programs: Botvin Life Skills Training (LST) Program and the Strengthening Families Program: For Parents and Youth 10-14 (SFP 10-14). The Botvin LST program is a school-based, comprehensive evidence-based program delivered by prevention specialists and/or school/Extension agents to promote mental health and positive youth development, develop drug resistance skills, and reduce aggression. SFP 10-14 is an evidence-based program that is delivered to families (both parents and youth) in a community setting. Caregivers learn effective discipline, and youth learn communication, stress management, and peer pressure coping skills. Both programs include materials on opioid safety and misuse.Phase 3 will also include PROSPER sustainability planning to obtain long-term buy-in, define goals, and identify federal, state, and local resources for grantsmanship and fundraising (see Sustainability Plan). Youth will play a critical role in sustainability planning. Interested youth from the awareness building phase, and those nominated by teachers and word of mouth, will conduct youth participatory action research (YPAR) to assess community needs for opioid use prevention. In YPAR, youth research topics important to them, and take action based on the findings. It has been successfully used in middle-high school, after school, and school-based and community programming.Evaluation: A formative approach to assessment will provide ongoing monitoring and feedback to ensure that the teams are progressing along PROSPER's multi-phased developmental process. The formative assessment will be provided by the PROSPER Network under the consulting agreement. The evidence base for the PROSPER system is well established, which includes an ongoing progress and performance monitoring process designed to maintain fidelity to the PROSPER delivery system and the associated evidence-based programs at the local level. Embedded in the assessment and monitoring system are two interrelated types of evaluation activities that all PROSPER-affiliated states undergo: (1) PROSPER Implementation Reports and Surveys, and (2) PROSPER Prevention Program Implementation Monitoring. In addition, there will be project implementation monitoring to systematically evaluate work on project goals and applying associated performance measures on an ongoing basis.In addition to the PROSPER monitoring and evaluation system, youth will lead a formative evaluation of their involvement in the community team. The youth formative evaluation will help address the continued challenge in PROSPER implementation of engaging youth authentically and fully in the process. Though the measures and methods will ultimately be decided by youth, the youth may answer questions after every team meeting related to what went well that the team should keep doing, what did not go well that the team should stop doing, and what should be added to improve their involvement in the next meeting. The youth may also choose to complete measures related to adultism, defined as behaviors and attitudes based on the assumption that adults are better than young people and entitled to act upon young people without permission. This youth-partnered formative evaluation process will identify problems in youth engagement early, so that they can be improved before they become insurmountable.Finally, a summative evaluation will be conducted to assess whether the evidence-based programs are achieving the desired outcomes. The developers of each of the programs provide valid and reliable questionnaires that can be used to assess short-term program outcomes including anti-drug attitudes and life skills for Botvin LST program, and parenting skills and overall family functioning for the SFP 10-14 program. Using a pre-test post-test no control group design, survey data will be collected from program participants before and after program participation to assess changes in knowledge and behavior. Quantitative data will be saved in comma-delimited files for use in data analysis software such as SPSS or SAS. Analysis of formative assessment data will primarily be descriptive and include analysis of variance techniques to examine differences between target audience groups based on demographic or socio-economic indicators. Quantitative outcome and impact indicators from pre-post testing will be analyzed using general linear modeling techniques most appropriate to the data to identify changes within subjects over time as a result of the programmatic activities. The qualitative data will be saved in text files for compatibility across various software platforms. Summaries and comparisons, coding, and thematic analysis will be used to analyze the qualitative data.

Progress 09/01/21 to 08/31/24

Outputs
Target Audience:There were three primary target audiences for this project: the PROSPER Florida team, youth and parent program participants, and community residents who were targets of local awareness-building efforts. The first target audience focused on the PROSPER Florida team members across the state at three levels: State Management Team (SMT), Local PROSPER Teams, and Technical Assistance Providers. The SMT initially included the project director, Technical Assistance Providers, and a graduate research assistant and expanded in the final year of the grant to include faculty with specialist roles and a postdoctoral associate. Local PROSPER Teams in each county included the PROSPER Team Leader (4-H Extension agent), a school district liaison, and a dedicated core team of 6-8 community leaders and professionals. Project efforts with this target audience focused on capacity-building to ensure effective communication between team members and the sustainable delivery of evidence-based prevention programs in each county. The second primary target audience included the participants in the two evidence-based interventions (EBI) delivered by the Local PROSPER Teams in each county. This included 21 youth and 25 parents who participated in the Strengthening Families Program for Parents and Youth 10-14 (SFP 10-14) community-based program. Families included at least one parent/caregiver and one child between the ages of 10 and 14. In addition, approximately 360 public school 6th-grade students participated in the Botvin Life Skills Training (Botvin LST) school-based substance use prevention program. Project efforts with this target audience focused on the outcomes of the programs, such as improved drug refusal skills, personal self-management skills, family problem solving, and rules and expectations for substance use. The final target audience was residents of the local communities in each participating county. Awareness-building efforts were sustained throughout the life of the grant and included tabling events and presentations at local school and government meetings. Project efforts for this audience focused on spreading awareness of PROSPER in Florida and the efforts to reduce substance misuse and promote healthy family functioning through EBI. Changes/Problems:One unexpected challenge encountered during the program evaluations of the classroom-based Botvin LST and the family-based SFP 10-14 was the quality of the data obtained from participants. Although the assessment questionnaires were adapted from those supplied by the curriculum developer, several subscales designed to measure specific program outcomes exhibited low reliability (internal consistency). As a result, analysis of variance tests to assess changes over time could not be conducted for these specific outcomes. Modifications were made to the questionnaires to enhance reliability, and each questionnaire is currently undergoing pilot testing with a new cohort of participants. The Local PROSPER Team Leaders played a crucial role by providing valuable feedback and recommendations for the modifications, thereby contributing ongoing support to the PROSPER team in Florida. What opportunities for training and professional development has the project provided?Numerous opportunities were provided for training and professional development throughout the duration of the project. Contracted services through the Iowa State University PROSPER Network provided eight professional trainings focused on developing the Local PROSPER Team leadership. Training occurred over an 18-month period and topics included PROSPER Onboarding, PROSPER Team Operations, PROSPER Prevention Programs, Program Observations and Implementation Tracker, Awareness Building & Outreach, Evaluation Activities & Introduction to PROSPER Indicators of Success, and PROSPER Team Sustainability. In addition, training was provided to the instructors and facilitators of the two evidence-based interventions (EBI). Approximately 12 PROSPER Florida team members completed the Botvin LifeSkills Training (Botvin LST) Middle School training, and eight PROSPER Florida team members completed the training for the SFP 10-14. The Botvin LST certification training was completed online, preparing instructors to effectively deliver the program to middle school students. Those trained included Extension agents, middle school teachers, and health department employees. Some of the individuals trained also volunteered to serve as classroom observers for the program evaluation, observing and reporting on the fidelity of implementation. In addition, two members became certified in the Botvin LST Elementary School curriculum. The Strengthening Families Program for Parents and Youth 10-14 (SFP 10-14) was a much longer, three-day, in-person certification training. This intensive training required a greater commitment from instructors, and all but one of the participants completed the training. Three instructors were required to complete the training per county to facilitate the SFP 10-14 program, and one additional participant completed the training. In addition to the trainings, members of the PROSPER Florida team convened regularly to collaborate and share updates on their progress toward project objectives. The State Management Team held monthly meetings, while the Technical Assistance Providers met biweekly with Local PROSPER Team Leaders. These meetings fostered collaboration and problem-solving, contributing to the ongoing success of the program. Finally, team members have presented their evaluation results at several national and state Extension meetings, including the 2023 NAE4-HYDP Annual Conference, the Epsilon Sigma Phi (ESP) 2023 National Conference, and the 2024 Extension Professionals Association of Florida Conference. How have the results been disseminated to communities of interest?The results have been disseminated to both professional and community audiences in several different ways. PROSPER Florida team members presented the results at several professional meetings over the past year including a presentation titled "LST in schools is an opioid prevention strategy stronger than steel" at the 2023 NAE4-HYDP Annual Conference; a presentation titled "Teaching Botvin Lifeskills to enhance youths state of mind" at the Epsilon Sigma Phi (ESP) 2023 National Conference; and a presentation titled "PROSPER: A Catalyst for Stakeholder Relationships and Capacity Building in Florida Counties" at the 2024 Extension Professionals Association of Florida Conference. Participants at all three professional conferences were Extension professionals from across the U.S. and its territories specializing in 4-H youth development or family and consumer sciences. Results were shared with key leaders within the Florida Cooperative Extension System, including the Associate Dean for Extension Families, Youth, and Communities at the University of Florida. We provided a summary of both our process and outcome evaluation results, detailing how the original counties successfully secured additional funding to sustain these programs beyond the duration of the USDA-NIFA RHSE grant. Additionally, we are in the process of creating a concise report that highlights the PROSPER delivery system, its successes, and the lessons learned in Florida. This report is expected to be available in 2025. Finally, and most importantly for the sustainability of PROSPER Florida, Team Leaders from both counties presented their findings to local community leaders. Along with these presentations were proposals aimed at securing ongoing support for the Local PROSPER Teams, funded through the Florida Opioid Settlement. The success of this initiative reflects the hard work and strategic planning of our Local PROSPER Teams, as they strived to leverage their accomplishments and program outcomes to ensure sustainability. What do you plan to do during the next reporting period to accomplish the goals? Nothing Reported

Impacts
What was accomplished under these goals? Impact Statement: The aim of PROSPER (PROmoting School-community-university Partnerships to Enhance Resilience) Florida was to implement a community-based approach to substance misuse prevention tailored for use within Cooperative Extension systems. This initiative successfully established a multi-tiered state support system where specialists from the University of Florida/Institute of Food and Agricultural Sciences (UF/IFAS) worked collaboratively with rural county teams led by an Extension agent. This collaboration was leveraged to sustainably deliver substance misuse prevention programs to youth and their families. The program was executed in four distinct phases, each yielding measurable outcomes and impacts. Phase 1 mobilized state and Local PROSPER Teams who worked collaboratively on the community-based initiatives. Phase 2 saw Local Team Leaders working diligently to promote PROSPER Florida in their communitiesand the ISU PROSPER network, providing training to facilitate capacity-building andsupport the implementation and evaluation of evidence-based interventions (EBI). Phase 3 launched the implementation and evaluation of Botvin LifeSkills Training (Botvin LST) and Strengthening Families Program for Parents and Youth 10-14 (SFP 10-14). Approximately 360 6th-grade public school students participated in the Botvin LST program, with results showing significant increases in life skills knowledge and anti-vaping attitudes. Approximately 21 youth and 25 parents participated in the SFP program, which improved family problem-solving, substance use rules and expectations, and parental behavioral expectations. Finally, Phase 4 was marked by successful efforts by the Team Leaders to petition for Opioid settlement funds distributed to each county by the Florida Opioid Settlement to support EBI and treatment models. 1.1: The State Management Team (SMT) consists of university faculty, including the project director, who is a prevention specialist, an Extension 4-H specialist, a youth engagement specialist, and a curriculum/evaluation specialist for 4-H Extension. Throughout all project phases, the SMT met monthly to supervise the project. During each meeting, the team discussed progress, addressed issues, and explored solutions to better assist each county in the development, implementation, and evaluation of the PROSPER system and EBI. 1.2: A key component of this project was engaging the local community to mobilize a Local PROSPER Team. Both counties successfully formed, trained, and sustained dedicated community teams throughout the duration of the project. Annually, team members were surveyed on several topics related to team functioning. The results from the most recent year showed the significant success they achieved during this project. In one county, survey respondents 'strongly agreed' that the Team Leader excelled in all leadership responsibilities: overall team leadership, recognition at meetings, managing conflicts, facilitating member involvement, appropriate delegation, and taking initiative. All those surveyed 'strongly agreed' that Extension is committed to both the family-focused and the school-based PROSPER programs. In another county, all respondents 'agreed' or 'strongly agreed' that their Local PROSPER Team has a strong sense of unity. Furthermore, all respondents 'strongly agreed' that Extension's reputation has been enhanced due to the PROSPER effort. Results indicate that team members were positive about Extension's role as a strong supporter of the effort in the community, and according to evaluators from The PROSPER Network, these scores were considerably higher than what is typically seen from most other Local PROSPER Teams. 1.3: Team Leaders delivered presentations on PROSPER EBI at school board and county commissioner meetings while actively engaging in the community at various tabling events. Taylor Countywas very successful in leveraging social media to disseminate information about the PROSPER EBI. Weekly Facebook updates, including photos, were shared to facilitate awareness-building and community buy-in. Additional awareness-building materials were developed, including PROSPER Florida information sheets, tabling flyers, posters, myth vs. fact sheets, and back-to-school flyers. 1.4: Results from the team member survey indicated that Local PROSPER Teams were successfully garnering resources for sustaining the EBI. In both counties, all team members surveyed 'strongly agreed' that the team's resources were being used effectively. Furthermore, most 'agreed' or 'strongly agreed' that there is adequate support for sustainability in their community. This indicates that the team members generally feel that they have what they need to sustain the PROSPER effort. The effectiveness of the PROSPER Florida program is further highlighted by both Local Team Leaders successfully petitioning for Florida Opioid Settlement funds distributed to each county to support EBI and treatment models. In their proposals, both leaders praised PROSPER programming and demonstrated how PROSPER Florida can serve as a valuable resource for delivering EBIs to prevent substance misuse among youth. 2.1: Local support was leveraged to implement two EBIs in each county. Approximately 360 sixth-grade students participated in the classroom-based EBI, Botvin LST. This program promotes the development of personal self-management and general social and drug resistance skills. In addition, 21 youth and 25 parents in two rural counties participated in the family-based EBI, SFP 10-14. Through this program, parents or guardians learn parenting skills and effective discipline while youth participate in activities that promote healthy future orientation, stress management, and drug resistance skills. 2.2: Team Leaders effectively engaged in fundraising and obtained local resources to support the PROSPER initiative and the implementation of EBI. They successfully solicited approximately $9,722 in direct contributions, donations, and volunteer support. Furthermore, results from the team member survey indicated that respondents firmly believed the programs delivered by the Local PROSPER Team have the potential to positively impact the lives of youth, affirming that their investment of time, effort, and money in the team was worthwhile. 2.3: The project evaluation was a mixed-method design, including process and outcome evaluation. The process evaluation included team member surveys, fidelity observations of EBIs, and implementation/resource tracking. The outcome evaluation was conducted using a pre-and post-questionnaire of participants in the EBI programs. While the evaluation results have been summarized throughout this report, additional findings are of note. Most team members reported they "strongly agree" that the PROSPER team will make a difference in their community.One surveyed team member stated, "Our youth are in crisis, and we desperately need a team to come in and help." In another county, one team member said, "Partnering as a community to assist in changing social norms to lead a healthy lifestyle and build a strong community is a must." For the classroom-based EBI, Botvin LST, there was a significant increase from pre to post-test in life skills knowledge and anti-vaping attitudes. For the family-based EBI, SFP 10-14, there were significant improvements from pre to post-test on family problem solving, substance use rules and expectations, and parental expectations. One parent remarked that the program "helped my kids open up to us more and create a stronger family unit." Results and feedback from participants indicate that there were marked changes during program implementation that speak to preventing substance misuse in these counties. These improvements in targeted skills for both youth and their parents could have lasting impacts on their personal and family lives.

Publications

  • Type: Conference Papers and Presentations Status: Published Year Published: 2023 Citation: Moore, E., Tharpe, A., Forthun, L.F., Hensley, S., Pracht, D. (2023, Oct. 10-12). LST in schools is an opioid prevention strategy stronger than steel [Conference presentation]. 2023 NAE4-HYDP Annual Conference, Pittsburgh, PA.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2023 Citation: Tharpe, A., Moore, E., Forthun, L.F., Hensley, S., Pracht, D. (2023, Sept 25-28). Teaching Botvin Lifeskills to enhance youths state of mind [Conference presentation]. Epsilon Sigma Phi (ESP) 2023 National Conference, Billings, MT.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2024 Citation: Hensley, S.T., Tharpe, A., Moore, B., Jackson, S., Forthun, L.F, Pracht, D., Abraczinskas, M. (2024 Aug. 26-29). PROSPER A Catalyst for Stakeholder Relationships and Capacity Building in Florida Counties [conference presentation]. 2024 Extension Professionals Association of Florida, Daytona Beach, FL.


Progress 09/01/22 to 08/31/23

Outputs
Target Audience:The audience in this reporting period primarily includes the participants in the two evidence-based interventions that were implemented in the two selected rural counties in Florida. The two Florida counties selected for this project, Madison and Taylor counties, border one another in the northwestern region of the state. Both are considered nonmetro counties adjacent to a metro area (Rural-Urban Continuum Code 6). Madison County's population is 80% rural, 40% do not have a broadband internet subscription, 38% identify as Black/African American, and 32.6% of children under the age of 18 live below the poverty line. Taylor County's population is 69% rural, 31% do not have a broadband internet subscription, 20% identify as Black/African American, and 27% of children under the age of 18 live below the poverty line. Middle-school students in both counties are more likely to drink alcohol, binge drink, and use vaping instruments to intake nicotine and marijuana than middle-schoolers statewide, with early initiation placing them at greater risk of substance abuse later in life. Participants in Madison County included 102 sixth-grade students in five public school classrooms. The sixth graders completed the Botvin Life Skills Training Program, an evidence-based substance abuse prevention program, as a part of their classroom-based health education curriculum. In the 15-session program, participants learn personal self-management skills, general social skills, and drug resistance skills. In addition, six families with children between the ages of 10-14 were recruited to participate in an after-school community-based program focused on promoting healthy families, called Strengthening Families Program for Parents and Youth 10-14. Participants in Taylor County included 223 sixth-grade students in eight public school classrooms. Each participated in the Botvin Life Skills Training Program. Six families with children between the ages of 10-14 were recruited to participate in the after-school community-based program Strengthening Families Program for Parents and Youth 10-14. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided?Approximately 12 team members across both counties participated in the Botvin LifeSkills Middle School training. A 6-hour online training to certify instructors to deliver the program to middle school students. Some of those trained were program instructors while others volunteered to conduct the classroom observations for the program evaluation, observing and reporting on the fidelity of implementation. Approximately eight PROSPER team members across both counties participated in the three-day instructor training in January 2023 for the Strengthening Families Program for Parents and Youth 10-14. The intensive training required a greater commitment from instructors and all but one of the participants completed the training. The PROSPER delivery system also expects state and local teams to meet regularly to collaborate, coordinate, and update one another on progress toward meeting project objectives. At the state level, meetings with a PROSPER Network Coach (PNC) took place on four occasions, and State Management Team meetings have taken place on six occasions. How have the results been disseminated to communities of interest?Progress toward second-year goals was disseminated during the NIFA RHSE Project Directors Meeting. Information was shared on the implementation and evaluation of the two evidence-based programs, PROSPER team maintenance, and the challenges and problems that the PROSPER Florida team is addressing. A presentation was scheduled for the annual Extension Professional Associations of Florida conference. The purpose of the presentation was to introduce PROSPER to extension educators from across the state of Florida, share findings from the program evaluation, and solicit support for the project from state and county extension leaders. However, the conference was canceled and rescheduled due to weather. What do you plan to do during the next reporting period to accomplish the goals? The second administration of the SFP 10-14 program will be implemented in both counties beginning in January 2024. Given the poor conceptual reliability of some of the items on the pre-post questionnaires for both programs, the questionnaires will be psychometrically assessed and updated to improve reliability and better assess change over time in program outcomes. The local PROSPER teams in each county will participate in a two-part training offered by the PROSPER Network focused on developing a sustainability plan. It is expected that each local team will develop a sustainability plan before the next reporting cycle. Local teams will continue their awareness-building and community outreach efforts. These efforts will be coordinated with local stakeholders including schools, the Department of Health, mental health, law enforcement and justice, and the local substance use and opioid coalition. Results of the first year of program implementation will be disseminated to state and national audiences through publication in relevant sources and presentations at state and national conferences including NAE4-HYPD and Epsilon Sigma Phi, the honor society for Extension educators.

Impacts
What was accomplished under these goals? 1.1: The state management team, composed of faculty from the University including the project director who is a prevention specialist, an Extension 4-H specialist, a youth engagement specialist, and a 4-H Extension curriculum and evaluation specialist, continued to meet monthly to provide project oversight and to discuss progress, address issues, and propose solutions to assist each county in the development, implementation, and evaluation of the PROSPER system and the evidence-based interventions. 1.2: County-level PROSPER team formation and training occurred during year one of the project. In year two the teams met less regularly, about two to three times over the course of the academic year, as they were implementing the evidence-based interventions in the school and community. While team membership changed in each county, they remain composed of community members who are liaisons to two important institutions in the community: schools and the Department of Health. Additional members include prevention specialists, law enforcement, religious leaders, and concerned parents. Results from an end-of-year team member survey in each County (~50% response rate) showed that team members reported a strong sense of unity, that the team leader (County 4-H Agent) demonstrated strong leadership skills, and that the team's connection with the local schools and the community was moderately strong. 1.3: Results from an end-of-year team member survey in each County showed that while PROSPER team members feel good about their relationships with the school, community, and local organizations, their efforts to promote PROSPER and raise awareness of their initiatives have only been partially successful. With much of their energy devoted to the success of the first year of implementation of both evidence-based programs, team members in both counties believe that they are now able to devote more time and resources to raising awareness and conducting more outreach to youth. The goal for year three is to leverage the partnerships with local mental health organizations, county health departments, local school districts, and leaders in the faith community, to promote their local PROSPER efforts and to engage more youth in the process. 1.4: Nothing to report 2.1: Both Counties implemented the Botvin Life Skills training program in all public school sixth-grade classrooms beginning in Oct. 2022. In Madison County, classrooms were spread across four buildings in the county, and each classroom received all fifteen curriculum modules. Responses from a sample of students whose parents consented for them to participate in a pre-post evaluation survey showed that most were 11 or 12 years old (95%), self-reported as either white (67%) or black, non-Hispanic (21%), and lived with two parents (69%). In Taylor County, responses from a sample of students whose parents consented for them to participate in a pre-post evaluation survey showed that most were 11 or 12 years old (92%), self-reported as either white (64%) or black, non-Hispanic (28%), and lived with two parents (67%). Most students in both counties completed their participation in the Botvin Life Skills Training Program. Following the implementation of Botvin Life Skills Training in the schools, both counties implemented the Strengthening Families Program for Parents and Youth 10-14 (SFP) beginning in February 2023. Approximately 6 families in each county were recruited representing 16 parents and 15 youth. The program was offered at the local Extension offices and families were provided with a meal before every session and free childcare. Sessions lasted approximately 2 hours with parents and youth attending separate sessions for education and skill development, followed by a combined session to consolidate learning and practice communication skills. Responses from a sample of parents and youth who consented to participate in a pre-post evaluation survey of the SFP program showed that in Madison County, parent/caregivers were mothers (50%), stepfathers (25%) or grandparents (25%), and primarily white (87%). Youth were between the ages of 9 and 13, female (56%), and earned mostly A's in school (67%). On the other hand, responses from a sample of parents and youth who consented to participate in a pre-post evaluation survey showed that in Taylor County, parents/caregivers were mothers (57%) or fathers (43%), and mostly white (67%). Youth were between the ages of 10 and 14, female (67%), and earned mostly A's or B's in school (80%). 2.2: PROSPER Teams in each county solicited donations in support of both evidence-based programs. Monetary donations were collected from 12 organizations to help support meals, snacks, and incentives for Botvin LST and SFP program participants totaling $2,844. Contributions were also made by volunteers who committed 193 hours of their time to be trained and to facilitate programs, or to support program delivery efforts such as preparing family meals or providing childcare for family participants. With the current value of volunteer time estimated at $31.80/hour, the volunteer time recorded is equivalent to a monetary contribution of over $6,137 to the project. 2.3: A combined process and outcome evaluation was conducted on the implementation of each evidence-based program. The process evaluation included observations of two lessons from each of the evidence-based programs. The first observation occurred early in program implementation while the second observation occurred later in implementation. Observers completed an implementation fidelity checklist provided by the PROSPER Network. Approximately 69% of Botvin LST classes were observed, while 100% of SFP 10-14 classes were observed. Results showed that program adherence was high for the Botvin LST program (96%) and SFP 10-14 program (96%). On a scale of one (class was not interested and didn't participate) to four (class was interested and participated), participant engagement averaged 3.36 for Botvin LST, and 3.94 for SFP 10-14. For the Botvin LST program, pre-post questionnaires were distributed to students who received parental consent to participate (n=105). The questionnaire was adapted from the Life Skills Training Health Survey developed by National Health Promotion Associates, Inc. Items on the questionnaire assessed changes in knowledge, attitudes, and skills associated with participation in the program. Several of the conceptual scales did not achieve sufficient statistical reliability and were not included in the analysis. Changes in pre to post test scores were assessed using a paired t-test and results showed that there was improvement in relaxation skills (relax muscles, slow breaths), improvement in knowledge of life skills like decision-making, coping, and interpersonal skills, and an increase in anti-vaping attitudes. For the SFP 1-14 program, pre-post questionnaires were distributed to both parents/caregivers (n=15) and youth (n=16) who provided consent/assent to participate. The SFP Parent/Youth Survey was developed by the EPISCenter at Penn State University. Again, several conceptual scales did not achieve sufficient statistical reliability and were not included in the analysis. Changes in pre to post-test scores were assessed using a paired t-test and results showed that parents reported improvement in family problem solving while youth reported an increase in parent expectations for conventional/prosocial behavior.

Publications

  • Type: Other Status: Published Year Published: 2023 Citation: Kersey, E., ONeal, L. J., Michael, A., Pierre, B., Nesbit, T., & Forthun, L. (2023). Substance Use and Rural Populations: FCS3379/FY1518, 2/2023. EDIS, 2023(1). https://doi.org/10.32473/edis-fy1518-2023
  • Type: Other Status: Published Year Published: 2022 Citation: Michael, A., ONeal, L., Kersey, E., Nielsen, A., Coker, K., & Forthun, L. (2022). A Community-Based Approach to Supporting the Mental Health of Rural Youth: FCS3375/FY1514, 11/2022. EDIS, 2022(6). https://doi.org/10.32473/edis-fy1514-2022


Progress 09/01/21 to 08/31/22

Outputs
Target Audience:The target audience in this reporting period primarily includes the 20 local professionals, advocates, and parents who joined the county prevention teams (called PROSPER teams) in each county. The goal of the first year of the project was to recruit and train community leaders, youth professionals, parents, and youth to implement the PROSPER delivery systems in each county. Membership in each county team includes the PROSPER Team Leader (4-H Extension educator), a 4-H program assistant, a liaison from the local health department and a liaison from the county school district. Other members include school principals, professionals from regional substance use prevention coalitions, community advocates, and faith-based leaders. Changes/Problems:1. A member of a local leadership team (Extension program assistant) resigned in the summer of year one. A replacement has been chosen and a transition plan was initiated to avoid any delays in project implementation. 2. The school district in one county implemented a plan to move 6th grade students out of the county's single middle school and distribute classrooms throughout the county in their local elementary schools. This has complicated the delivery of the school-based prevention program. However, the county PROSPER Team worked closely with school principals and the district curriculum coordinator to resolve the implementation issues. What opportunities for training and professional development has the project provided?Opportunities for training and professional development of both state and team leadership have been provided through multiple training courses and meetings with the PROSPER Network at ISU. Trainings were provided on the following topics: PROSPER Orientation, Ground Rules & Team Member Orientation, PROSPER Prevention Programs, Awareness-building and Outreach, and Introduction to Resource Generation and the Resource Tracker. Local state and team leaders also completed all training required by the University including Responsible Conduct of Research (RCR) training, and IRB training. Approximately 12 team members across both counties participated in the Botvin LifeSkills Middle School training. A 6-hour online training to certify instructors to deliver the program to middle school students (6-8 grade). Some of those trained will be program instructors while others will participate in the program evaluation where they will observe and report on fidelity of implementation. The PROSPER delivery system also expects that state and local teams meet regularly to collaborate, coordinate, and update one another on progress towards meeting project objectives. A the state level, meetings with a PROSPER Network Coach (PNC) from ISU has taken place on 5 occasions. State Management Team meetings have taken place on 7 occasions. Bimonthly meetings between Technical Assistance Providers (state program coordinators) and local team leaders have taken place on 8 occasions in one county and 9 occasions in the other county. At the county level, county PROSPER team meetings have occurred on three occasions in each county. How have the results been disseminated to communities of interest?Progress of first year goals was disseminated to funders during the NIFA RHSE Project Directors Meeting. Information was shared around building of the teams, challenges and problems that PROSPER is addressing, the two-year project outline and how it will achieve the goals set by the team, implementation activity plans, and the partnership between state and local teams. What do you plan to do during the next reporting period to accomplish the goals?Aim 2 activities are scheduled to take place during the second year of the project, which includes the implementation of both school- and family-based prevention programs, promotion of youth engagement on the local teams, building local awareness, fundraising and resource development, and sustainability planning. These efforts will begin in the Fall of 2022. In addition, results of the initial PROSPER team surveys suggested that additional training may be needed to develop needed skills within each local team. Local team members will be provided the opportunity to attend workshops that focus on topics of interest such as family recruitment strategies, team-building strategies, and building partnerships/networking.

Impacts
What was accomplished under these goals? Impact Statement:The purpose of this project is to implement PROSPER (PROmoting School-community-university Partnerships to Enhance Resilience), a community-based approach to substance use prevention designed specifically for use within Cooperative Extension systems. PROSPER is designed to address the need for training and technical assistance in capacity-building in rural communities, particularly in consideration of the well-documented scarcity of school and behavioral health resources. In the first year of the project, PROSPER has accomplished several important aims including initiating and mobilizing state and county PROSPER teams in two rural counties composed of a 4-H Extension team leader, a school liaison, health department liaison, and key community stakeholders. Professional training has occurred in three sectors: state team leadership, local team leadership, and prevention program implementation. Surveyed team members reported that they were optimistic that the PROSPER team in their county would be beneficial to the committee and help to address the ongoing opioid epidemic through family- and school-based prevention programs. Aim 1.1.At the state level, core leadership included faculty from the University including the project director who is a prevention specialist, an Extension 4-H specialist, a youth engagement specialist, and a 4-H Extension curriculum and evaluation specialist. To assist each county in the development and implementation of the PROSPER delivery system, county 4-H Extension faculty in both counties were provided a part-time PROSPER program assistant. The 4-H educator and program assistant in each county represented the core leadership for PROSPER in each county. Both leadership teams, state and local, participated in a series of trainings contracted through the PROSPER Network at the University of Iowa. These online trainings are described in more detail below (opportunities for training and professional development). The trainings occurred over a three-month period and upon completion, the local teams began recruiting additional members to their teams. Aim 1.2. In the development phase of the PROSPER delivery system, it is recommended that the local teams include community members who are liaisons to three important institutions in the community: schools, department of health, and mental health. To assist in recruitment, members from the state leadership team, local leadership teams, and liaisons met at a central location to discuss the PROSPER delivery system and team member roles. All participants agreed to join their local PROSPER teams and assisted with the recruitment of additional members from other sectors of the community. Taylor County has recruited 5 additional members including an additional representative from the school district, an additional representative from the Department of Health, and a representative from a local substance use prevention coalition. Madison county has also recruited 5 additional members including two additional representatives from the school district, including school principals, one additional representative from the Department of Health, one community advocate, and one faith-based leader and community advocate. The local PROSPER team leadership (4-H Extension educator and program assistant) provided training on the PROSPER delivery system to new team members at their first official team meeting, which occurred in the Spring. After approximately two PROSPER team meetings, a local team member survey was distributed to all team members to better understand the strengths and needs of their emerging teams. With an approximately 60% return rate, local team members identified personal strengths and skills in fundraising, public speaking, social media, public relations, community networking, substance use prevention, and leadership. Areas in need of support included grant writing, graphic design, and family/parenting education. Most team members identified having experience in prevention science. Less than half of team members have identified having experience with community partnerships. To support team development, the PROSPER Network at ISU provided resources for team development and made them available to all PROSPER team members. For ease of transfer, all resources were placed on a secure MS Teams group. For example, both counties established team rules, which was a strategy taught to local team leaders during the Ground Rule and Team Member Orientation Community Leader Training. PROSPER provided the Ground Rules Instruction Worksheet to aid in the development. Likewise, both local PROSPER teams created drafts of a local team vision and mission statement, with resources provided by PROSPER during the leadership team trainings (see opportunities for training and professional development). Other results from the local team member survey included the following. Team members identified expected personal benefits from engaging in the PROSPER team as gaining new skills, personal fulfillment, personal goal promotion, and networking. Team members also expected that they would receive somewhat more benefits than costs from being involved in their PROSPER teams. Team members in one county indicated that the local PROSPER teams will make a difference in their communities while a few team members in another county indicated that they are unsure in these efforts. Overall, local team members identified PROSPER as being worth the time, money, and effort, because they believe PROSPER has the potential to make a difference in their communities. Aim 1.3.Counties began making steps to increase local resources for prevention programming by creating partnerships with local mental health organizations, county health departments, local school districts, and leaders in the faith community. Local team members identified in the local team member survey that they perceived that there is a strong active partnership between the schools and local PROSPER team and strong workplace support for all local partnerships. Aim 1.4.Nothing to report Aim2.1.Planning for the implementation of the Botvin Life Skills Training Program to 6th graders in all district schools has been completed. In both counties, the Botvin LifeSkills program will be implemented beginning in October, during the students' second nine-week session. School liaisons presented the plan to local school boards and received approval. Approval for the evaluation of the program was granted by the University of Florida IRB. Implementation and evaluation will be described in the next progress report. Aim2.2.Nothing to report Aim2.3.Nothing to report

Publications