Source: IOWA STATE UNIVERSITY submitted to NRP
RURAL BEHAVIORAL HEALTH RESILIENCE ZONE INITIATIVE: A SCIENCE-DRIVEN COMMUNITY OUTREACH APPROACH
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
ACTIVE
Funding Source
Reporting Frequency
Annual
Accession No.
1029074
Grant No.
2022-46100-38164
Cumulative Award Amt.
$350,000.00
Proposal No.
2022-04847
Multistate No.
(N/A)
Project Start Date
Sep 1, 2022
Project End Date
Aug 31, 2025
Grant Year
2022
Program Code
[LX]- Rural Health & Safety Education
Recipient Organization
IOWA STATE UNIVERSITY
2229 Lincoln Way
AMES,IA 50011
Performing Department
(N/A)
Non Technical Summary
According to the CDC, "The COVID-19 pandemic has had a seismic effect on communities across the country, and young people have been especially impacted by the ways in which their everyday lives have been altered. The disruptions were widespread; school buildings closed, opportunities for connecting with peers were limited, communities were dealing with loss and upheaval." A U.S. representative sample of students surveyed by the CDC indicated that more than 30% reported their mental health to be most of the time or always not good in the prior 30 days." (CDC, 2022). Stressors clearly documented to affect youth (e.g., labor shortages, inflation, social justice) are substantial and expected to persist. For example, 64% of teenage students believe "...the experience of COVID-19 will have a lasting impact on their generation's mental health..." (National 4-H Council, 2020).Rural youth have been especially negatively impacted by the pandemic. Notably, 79% of rural teens surveyed "...wish there was an inclusive environment or safe space for people in school to talk about mental health." and 70% wish their school taught them more about mental health and coping mechanisms (National 4-H Council, 2020). These findings are echoed by a CDC student survey that found students who perceive a connection with an adult at school were better protected from adversity (CDC, 2022).Behavioral health service and programming gaps are larger in rural states such as Iowa, where a "perfect storm" stems from rapidly increasing levels of exposure to adversity, increased isolation, and resultant behavioral health issues, combined with increasingly inadequate access to evidence-based behavioral health. Youth living in rural communities are particularly at risk for service inequities. Rural youth are diagnosed with behavior health conditions later in their lives than are urban or suburban children; they also are more likely to experience longer waiting periods before receiving intervention services.This project will address resilience-related behavioral health and opioid/other substance misuse issues in two rural counties, potentially impacting up to 50,000 residents through the development of sustainable, community-based resilience and prevention capacity-building and training. Our planned approach will integrate PROSPER Partnership Model components into the implementation of rural Resilience Zone Initiatives (RZIs). By doing so, our approach expands the delivery of research- and evidence-based programs that address pandemic-related rural community needs through a sustainable community-driven model, guided by a proven delivery system. In turn, our approach meets a need identified through the COVID-19 Recovery initiatives supported by ISU Extension and Outreach Extension. More specifically, an assessment will be conducted to assist Extension and other key stakeholders, in order to (1) identify root causes of problems and gaps in resilience-oriented services and (2) help support planning and delivery of a unique set of locally-selected programs from a menu of options. This process will not only be responsive to current pandemic-related adversities our rural youth are confronting by addressing substance misuse and associated behavioral health issues, but also allows for a more flexible, readiness-driven approach to developing collaborations and institutionalization of efforts. This process also supplements counties' capacity for addressing behavioral health issues and, more broadly, applies a current capacity-building framework for Extension's science-based behavioral health.
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
90360203070100%
Goals / Objectives
Increase the capacity of the PROSPER Network Organization (PNO) to support two, rural, county-based, school-focused Resilience Zone Initiatives both during the funded project period, as well as sustaining and expanding beyond the project period.Build capacity to support Resilience Zone InitiativesExpand training and technical assistance capabilities and systems for Resilience Zone Initiatives NLT August 1, 2023.Assess, select, and train Resilience Champions in two rural Iowa Counties.Develop and implement site selection process and provide an orientation to pilot sitesDevelop plans for Resilience Zone Initiatives implementation in pilot sitesNLT December 31st, 2023Apply the proven PROSPER and WeCanPROSPER technical assistance/coaching system to support local Resilience Champions' efforts to implement county-based Resilience Zone InitiativesImplement the Resilience Zone Initiative plans and training/technical assistance processesUtilizing the Resilience Zone Initiative Scorecard, county-based Champions will work to implement at least one iteration of the evidence- and research-based programs NLT the end of the project, September 29th, 2024.
Project Methods
This project will address resilience-related behavioral health and opioid/other substance misuse issues in two rural counties, potentially impacting up to 50,000 residents through the development of sustainable, community-based resilience and prevention capacity-building and training. Our planned approach will integrate PROSPER Partnership Model components into the implementation of rural Resilience Zone Initiatives (RZIs). By doing so, our approach expands the delivery of research- and evidence-based programs that address pandemic-related rural community needs through a sustainable community-driven model, guided by a proven delivery system. In turn, our approach meets a need identified through the COVID-19 Recovery initiatives supported by ISU Extension and Outreach Extension, as previously described. More specifically, an assessment will be conducted to assist Extension and other key stakeholders, in order to (1) identify root causes of problems and gaps in resilience-oriented services and (2) help support planning and delivery of a unique set of locally-selected programs from a menu of options. This process will not only be responsive to current pandemic-related adversities our rural youth are confronting by addressing substance misuse and associated behavioral health issues, but also allows for a more flexible, readiness-driven approach to developing collaborations and institutionalization of efforts. This process also supplements counties' capacity for addressing behavioral health issues and, more broadly, applies a current capacity-building framework for Extension's science-based behavioral healthThe system will adopt a 3-phased approach, starting with assessing local resources for tailored implementation. This includes developing a community implementation plan for applying resilience enhancement strategies.The purpose of Phase I is to build internal capacity to support Resilience Zone Initiatives (RZIs). RZIs are operationally defined as programmatic outreach efforts with targeted K-12 students and staff in identified school districts. They are led by a Resilience Champion, Extension partners, Linking Agents, and a team of stakeholders who conduct quality, sustained implementation of research- and evidence-based programs selected from a menu. In this phase, the PROSPER Network Organization (PNO) will adapt the PROSPER Partnership Model and related materials to meet the goals of the RZIs, along with mental health initiatives through ISU's COVID-19 Recovery efforts. PNO members who already are assigned as PROSPER Technical Assistance Providers will be given additional training regarding provision of technical assistance to Resilience Champions. PNO members, university staff, and Extension professionals also will be trained in specific resilience-oriented services and programs selected from a menu, so they will be well positioned to provide technical assistance and training for the local RZIs.The purpose of Phase II is to screen, select, and train Resilience Champions. In this phase, we implement our site selection process. Initially, counties are screened for eligibility. Subsequently, eligible counties can apply for the RZI. Selection is based on criteria regarding their (1) prioritization of the ISU Extension and Outreach initiatives described previously, (2) readiness to address behavioral health and resilience needs in their targeted populations, and (3) data demonstrating gaps in services and above average rates of behavioral health and substance misuse issues. Resilience Champions can be Extension employees, or other key community members partnered with an Extension employee, who "champion" the RZI in their school district. In the selection of counties, we will look for specific qualities in the Resilience Champion who will take a lead role in selecting and implementing resilience-oriented behavioral health programming. For example, a key quality will be familiarity with the community and experience in networking with key sectors and stakeholders. Once selected, Resilience Champions will be trained to lead a group of Linking Agents in their community, as well as lead the planning and implementation process for the RZI. Dependent upon the needs addressed, the sectors will include, but are not limited to: agencies providing behavioral health and substance misuse services, primary care providers, schools, faith-based organizations, and businesses. Transition from Phase II to Phase III begins with Resilience Champions completion of a basic level of planning for the RZI facilitated during the Resilience Champion Training.The purpose of Phase III is to refine and implement the RZI plans with ongoing technical assistance. During this phase the Champions begin recruiting Linking Agents as part of the local RZI Committee. The committees complete and implement communication and RZI action plans with targeted populations. A key aspect of the plans will be the identification of the targeted local student populations and selection of resilience-oriented programs to implement with the identified populations and school staff. The development of these plans will be based on prioritization of needs from Phase II. Phase III is oriented toward institutionalizing selected RZI programs in the school and community, as is the case with all PROSPER-supported programs. Selection criteria for programs included on the menu for Phase III included a number a considerations that had a clear focus on resilience enhancement via research-and evidenced-based programs addressing targeted student populations through a multifaceted approach. In addition to being research- or evidence-based, all programs could be readily supported by PNO infrastructure, following the project-specific capacity building described above. Selection also was based on intent to allow RZIs a range of choices regarding implementation levels (community, school, family) and specific areas or domains of resilience factors addressed, including resilience-related protective/risk factors concerning (1) general mental health, (2) reduction of externalizing or problem behaviors (substance misuse/conduct problems), (3) reduction of internalizing issues or depression/suicide, and (4) stress management.The project evaluation will involve 'process monitoring' of key activities as delineated in the logic model and objectives. Much of the process monitoring will be assessed via an existing internal tracking system (TS). This system is updated, managed, and monitored on a biweekly basis by Ms. Knutson and will be used to evaluate completion of activities by the PNO and behavioral health advisory group across all three phases. Additionally, the TS will be used to document overall project performance and progress. Phase III of the project will utilize the tracking system, in addition to applying an achievement-based benchmarking "check-up" process and system (based on adaptations of the original PROSPER Model). The benchmarking "check-up" process will be used to monitor progress of local site-specific implementation of RZI action plans, as well as to guide tailored technical assistance provision offered by the PNO. Finally, for all three phases, trainings provided by the PNO will utilize an anonymous Training Quality Evaluation (TQE) form to assess quality and perceived utility of instruction received.

Progress 09/01/23 to 08/31/24

Outputs
Target Audience:RZIs are operationally defined as programmatic outreach efforts with targeted K-12 students and staff in identified school districts. For this project, the target audience will be Resilience Zone Champions and their respective RZI Teams, who will in turn, plan their own Resilience Zone Initiatives and address their targeted audience, which will be K-12 students and school staff as identified in their RZI Plans. In the reporting period (Y2), two rural counties in Iowa will continue their Resilience Zoning efforts - Jackson County and Jones County. These two county RZI teams will be supported by PPSI's technical assistance team. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided?The two Team Leaders from Jackson and Jones County attended the Resilience Zone Initiative Team Leader Training. The two Team Leaders were trained in Teen Mental Health First Aid, Lights/Camera/Prevention, Mindfulteen, WeCanPROSPER Resilience, and Question/Persuade/Refer. The Project Director attended the National Prevention Network Conference in the reporting period. One Team Leader was trained on how to become a Technical Assistance Provider in support of new counties (as a part of the 2023 RHSE award). The two RZI Teams delivered over 20 programs locally and reached more than 450 participants through programmatic efforts. How have the results been disseminated to communities of interest?The two RZI Teams delivered over 20 programs locally and reached more than 450 participants through programmatic efforts (Jackson and Jones County). The two RZI Teams participated in their first Team Member Survey process in which the data were analyzed and a summary report was developed. These reports are provided back to the Team Leaders for use in planning with their teams. Jones County Resilience Team was interviewed for an article in their local newspaper ("Jones County Brings Awareness and Understanding to Mental Health Awareness Month"). The article highlighted the teams' efforts and included information concerning the programs that the team helped implement in their community. Jones County also developed a series ofrecognition flyers and banners for awareness building and promotional efforts. What do you plan to do during the next reporting period to accomplish the goals?In the final reporting period (September - December 2024), the two RZI Teams will continue their implementation efforts and will look towards instituitionalization and sustainability of their efforts. The RZI Teams will undergo another iteration of the RZI Scorecard process by the end of the next reporting period to help inform their planning and program delivery efforts for beyond the funded period. Additionally, the Technical Assistance Provider will begin working with 3 new counties in support of the 2023 RHSE project that is intended toexpand and sustain RZI efforts in 5 total counties (3 new counties, 2 existing).

Impacts
What was accomplished under these goals? This project will address resilience-related behavioral health and opioid/other substance misuse issues in two rural Iowa counties, potentially impacting up to 50,000 residents through the development of sustainable, community-based resilience andpreventioncapacity-buildingandtraining.OurplannedapproachwillintegratePROSPERPartnershipModelcomponents into the implementation of rural Resilience Zone Initiatives (RZIs). By doing so, our approach expands the delivery of research- and evidence-based programs that address pandemic-related rural community needs through a sustainable community-driven model, guided by a proven delivery system. The project will adapt a three-phased approach to accomplishing the major goals (listed below). Theprojectaccomplishmentsforthereportingperiodonlyareasfollows. Goal 1: Increase capacity of PROSPER Network Organization (PNO) to support two, rural, county-based, school-focused Resilience Zone Initiatives both during the funding project period, as well as sustaining and expanding beyond the project period. This activity was largely completed in Year 1 of the project period. The two RZI teams are in the implementation phase of the project and have delivered over 20 local programs in their areas. Additionally, the Project Team secured another RHSE award to support sustainability efforts for the two counties, as well as onboard an additional three new rural Iowa counties. Goal 2: Assess, select, training Resilience Champions in two rural Iowa Counties. Activity completed in Year 1 of the project period. Goal 3: Apply the proven PROSPER and WeCanPROSPER technical assistance/coaching system to support local Resilience Champions' efforts to implement county-based Resilience Zone Initaitives. Following attendance at the Resilience Zone Initiative Team Leader Training in the reporting period, the Technical Assistance Provider met with the two Team Leaders on a regular, ongoing basis (~every other week). The Team Leaders recruited Linking Agents to be involved in their local Resilience Team and completed a thorough local Needs Assessment process. Following completion of the Needs Assessment, the RZI Teams then developed a Communication Plan and an Action Plan, as well as selected their target populations. Next, the RZI team membersworked together to select programs from the Resilience Zone Initiative program menu that would best serve their communitity and associated target audience (using the Needs Assessment results to inform their decision making). As result,the two RZI teams collectively delivered over 20 programs locally in the reporting period. Program offerings included: Mindful Teen; Question, Persuade, Refer (suicide prevention); Applied Suicide Intervention Skills Training (ASIST); Lights, Camera, Prevention (substance misuse public service awareness campaign competion for youth); WeCanPROSPER Resilience Training;Youth Mental Health First Aid; and Teen Mental Health First Aid. Approximately six months following the completion of their Action Plans, the two Team Leaders participated in theirRZI Scorecard process. The Scorecard is comprised of a series of questions designed to help a community-level RZI Team assess their capacity-building progress for building and sustaining community resilience. The Scorecard is used to not only assess local-level progress, but also identify areas for future improvement and growth, celebrate successes, and recognize local support. There are four function-related categories that are assessedin the Scorecard: (1) Team Development & Functioning, (2) Awareness Building & Outreach, (3) Community-level Programming and Strategies, (4) Sustainability. Each category has a set of benchmarks of progress that document a local RZI Team's efforts toward enhancing community-level resilience through planning for, and the delivery of, research- and evidence-based programs and strategies. In the reporting period, the RZI Teams participated in the RZI Scorecard process a twice. The final results of the Scorecard are tabulated and the scores fall into one of three Designation Levels: Aspiring, Striving, and Thriving. For the first round of the RZI Scorecard process, Jackson and Jones both fell in the "Striving" category (second level of achievement out of three levels) and following completion of their second round (about six months later), they were both in the "Thriving" category (highest level that can be achieved out of three levels). Finally, the two RZI teams participated in their first Annual Team Member survey in the summer of 2024 with participation rates between 67-78%. Continued monitoring of the Resilience Zone effort is necessary to ensure that the model is being implemented as designed and to make sure that the Resilience Zone Teams are progressing and meeting their goals. The Team Member Surveys are the only monitoring tool that allows county-level team members to provide structured input on how the RZI implementation efforts are going locally. The broader areas of questions included in the survey concern team member involvement, team functioning, building and maintaining partnerships with schools and community members/stakeholders, marketing and awareness-building, and resource generation and sustainability for the RZI.?

Publications


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

    Outputs
    Target Audience:RZIs are operationally defined as programmatic outreach efforts with targeted K-12 students and staff in identified schooldistricts. For this project, the target audience will be Resilience Zone Champions and their respective Linking Agents who will inturn, plan their own Resilience Zone Initiatives and address their targeted audience, which will be K-12 students and school staffas identified in their RZI Plans. In the reporting period (Y1), two rural counties in Iowa were selected to begin theirResilience Zoning efforts - Jackson County and Jones County. Changes/Problems:Initially, more time than was originally anticipated was devoted to the development and refinement of the Resilience Zone Initiative system of training and technical assistance. This has resulted in delays of theproposed project activities, including the Team Leader Training for the two Resilience Zone Initiative implementation counties. That said, delays are minimal and no changes to the approach are needed at this time. What opportunities for training and professional development has the project provided?Training - The Resilience Zone Initiative Overview & Orientation Training was delivered to two rural counties in Iowa (Jackson, Jones) in the reporting period. - The Resilience Zone Initiative Team Leader Training was deliveredto a team of internal staff members as a "pilot" prior to delivering to the two selected counties in the next reporting period. Professional Development -The Resilience Zone Advisory Committee selected a member of Iowa State University Cooperative Extension to be trained as a Master Trainer for the LivingWorks Applied Suicide Intervention Skills Training (ASIST) program. As a result, the Extension Agent will be able to offer this training to potential facilitators. *ASIST is a program listed on the Resilience Zone Program Menu. -The Training Development Manageron this project attended the Association for Talent Development (ATD) Virtual Training & Faciliation course and completedthe requirements to obtain certification. - The Training Developer/Technical Assistance Provideron this project is currently enrolled in an Instructional Design Masters program at Iowa State for Educational Technology. During the reporting period, they completed three courses - (1) Designing Effective Learning Environments, Social Media & Education, and Research Trends in Educational Technology. - The Trainer Developer/Technical Assistance Provider attended the professional development "Governors Conference on Substance Abuse" in April of 2023. - The Trainer Developer/Technical Assistance Provider participated in two ongoing professional development opportunities hosted through InMotion Consulting. Both opportunities were focused on mentoring and coaching. - The Trainer Developer/Technical Assistance Provider participated in a professional development/training opportunity titled, "Introduction to the Prevention Core Competencies". The course is designed to introduce practioners to the essential competencies, knowledge, and skills to work in substance use and misuse prevention. - The Project Director attended the National Prevention Network Conference, "Bridging Research to Practice" in August of 2023. How have the results been disseminated to communities of interest?- In the reporting period, a total of 2,133 unique visitors accessed the WeCanPROSPER website. The clearinghouse of resilience-enhancing resources can be accessed through the WeCanPROSPER website (https://wecanprosper.org/clearinghouse/). - In the reporting period, the RFA was disseminated to all eligible rural Iowa counties for solicitation of participation in the Resilience Zone project - In the reporting period, the Resilience Zone Overview & Orientation was delivered; audience included Jones and Jackson County What do you plan to do during the next reporting period to accomplish the goals?In the next reporting period, the two selected counties (Jackson, Jones) will attend the Resilience Zone Initiative Team Leader Training. Following the training, Phase III of the project will begin. The purpose of Phase III is to refine and implement the RZI plans with ongoing technical assistance. During this phase the Team Leaders (i.e., Champions) begin recruiting Linking Agents as part of the local Resilience Zone (RZ) Team. The RZ Teams complete a Needs Assessment process, and then implement communication and RZI action plans with targeted populations. A key aspect of the plans will be the identification of the targeted local student populations and selection of resilience-oriented programs to implement with the identified populations and schoolstaff. The development of these plans will be based on prioritization of needs from the assessment process. Phase III is oriented toward institutionalizing selected RZI programs in the school and community, as is the case with all PROSPER-supported programs. Selection criteria for programs included on the menu for Phase III included a number a considerations that had a clear focus onresilience enhancement via research-and evidenced-based programs addressing targeted student populations through a multifaceted approach. In addition to being research- or evidence-based, all programs could be readily supported by PNO infrastructure. Selection also was based on intent to allow RZIs a range of choices regarding implementation levels (community, school, family) and specific areas or domains of resilience factors addressed, including resilience-related protective/risk factors concerning (1) general mental health, (2) reduction of externalizing or problem behaviors (substance misuse/conduct problems), (3) reduction of internalizing issues or depression/suicide, and (4) stress management.

    Impacts
    What was accomplished under these goals? This project will address resilience-related behavioral health and opioid/other substance misuse issues in two rural Iowa counties, potentially impacting up to 50,000 residents through the development of sustainable, community-based resilience and prevention capacity-building and training. Our planned approach will integrate PROSPER Partnership Model components into the implementation of rural Resilience Zone Initiatives (RZIs). By doing so, our approach expands the delivery of research- and evidence-based programs that address pandemic-related rural community needs through a sustainable community-driven model, guided by a proven delivery system. The project will adapt a three-phased approach to accomplishing the major goals (listed below). The project accomplishments for the reporting period only are as follows. Increase the capacity of the PROSPER Network Organization (PNO) to support two, rural, county-based, school-focused Resilience Zone Initiatives both during the funded project period, as well as sustaining and expanding beyond the project period. PNO Training Development Specialist hired Behavioral Health Advisory Committee (AC) formalized and conducted ongoing meetings (representation from expert faculty and leadership at Iowa State, inc. Extension professionals) Clearinghouse of online resilience-enhancing resources updated; 2,133 unique visitors to website in reporting period Menu of resilience-enhancing programs approved by AC; 1 University Extension professional trained in program on menu (ASIST) Resilience Zone Initiative Standard Operating Procedures (SOP) developed and approved by AC Development of a Resilience Zone Initiative 'Readiness Assessment and Checklist' Development of evaluation and progress monitoring systems and tools, including Resilience Zone Initiative Scorecard (benchmarking system), Scorecard Outcomes Tracking system, Technical Assistance Provider Reporting Guidelines, Technical Assistance Provider Reporting Templates Development of Menu of Programs - Training Tracking system Development of Recognition System and document/checklist for recognition process Development of program description and selection guidance documents Development of Local Assessment and Local Plan guidance documents Development of "Virtual Overview and Orientation Training" Development and pilot delivery of "Resilience Zone Team Leader Training" Development of Team Leader curriculum manuals Assess, select, and train Resilience Champions in two rural Iowa Counties. Eiligibility criteria decided upon by AC; rural counties/school districts identified Development/distribuition of formal RFA including Resilience Zone Scope of Work Two rural counties selected based on criteria Virtual Overview & Orientation process conducted with two rural counties participating in Resilience Zoneproject Formal agreements to participate; (2) Team Leaders/Champions solicited Apply the proven PROSPER and WeCanPROSPER technical assistance/coaching system to support local Resilience Champions' efforts to implement county-based Resilience Zone Initiatives Not yet applicable

    Publications