Prevention is often the best medicine, and that is not only true when it comes to physical health, but also public health. Case in point -- young adults reduce their overall prescription drug misuse up to 65 percent if they are part of a community-based prevention effort while still in middle school, according to researchers at Iowa State University.
The reduced substance use is significant considering the dramatic increase in prescription drug abuse, said Richard Spoth, director of the Partnerships in Prevention Science Institute at Iowa State. The research, published in the American Journal of Public Health, focused on programs designed to reduce the risk for substance abuse.
In a related study, featured in the March-April 2013 issue of Preventive Medicine, researchers found significant reduction rates for methamphetamine, marijuana, alcohol, cigarette and inhalant use. Additionally, teens and young adults had better relationships with parents, improved life skills and few problem behaviors in general.
The research is part of a partnership between Iowa State and Penn State known as PROSPER, which stands for Promoting School-Community-University Partnerships to Enhance Resilience. PROSPER administers scientifically proven prevention programs in a community-based setting with the help of the Extension system in land grant universities.
The results are based on follow-up surveys Spoth and his colleagues conducted with families and teens for six years after completing PROSPER. Researchers developed the prevention programs in the 1980s and 1990s to target specific age groups. Spoth said understanding when and why adolescents experiment with drugs is a key to PROSPER's success.
"We think the programs work well because they reduce behaviors that place youth at higher risk for substance misuse and conduct problems," Spoth said. "We time the implementation of these interventions so they're developmentally appropriate. That's not too early, not too late; about the time when they're beginning to try out these new risky behaviors that ultimately can get them in trouble."
PROSPER administers a combination of family-focused and school-based programs. The study involved 28 communities, evenly split between Iowa and Pennsylvania. The programs start with students in the sixth grade. The goal is to teach parents and children the skills they need to build better relationships and limit exposure to substance use.
"One of the skills students are taught through the school-based program is assertiveness, so that they feel comfortable refusing to do something that might lead to them getting in trouble," Spoth said. "We try to help parents be more attuned to what their children are doing, who they're with, where they're going, effectively monitoring, supervising and communicating with their children."
Parents say the program works
Michelle Woodruff will admit that being a parent is hard work.
"Absolutely, underline and capital letters -- it is hard," said Woodruff, a mother of four sons who range in age from 13-21 years old. But the lessons learned through the PROSPER program, she believes, made her and her husband better parents and also brought out the best in their children.
"It was a lot of little things that made us re-evaluate how we parented," Woodruff said. "I think it makes children more responsible not only to themselves, but their parents and the community. They want to represent their families well, their schools well, their churches; I think it just makes them want to be a better person."
Woodruff is now a member of the PROSPER team in Fort Dodge, where she encourages and supports other parents who participate in the program. Facilitators of the family-focused program use games and role-playing to help parents and children improve communication and set expectations for behavior. Woodruff would like to see more families take advantage of the opportunity.
"Do it, not only for the one-on-one time with your child, but also to meet other like-minded parents," Woodruff said. "We're just trying to come together as a community to raise the best kids that we can possibly raise so that they're successful members of society as adults."
The ongoing community partnerships are evidence of the PROSPER program's sustainability, Spoth said. The results extend beyond a reduction in prescription drug or marijuana use. Researchers know that substance abuse often leads to other problem behaviors, so prevention can have a ripple effect and cut down on problems in school and violent behaviors in general. The benefits are measured in economic terms as well as the overall health and outlook of the community.
"There are things that can only happen over time if you have sustained programming, because more and more parents are exposed to programs that help them address all of the challenges in parenting," Spoth said. "As a result, people feel like they're making connections, their community is a better place to live, and they are positive about the leadership in their community."
- Richard Spoth, Linda Trudeau, Chungyeol Shin, Ekaterina Ralston, Cleve Redmond, Mark Greenberg, Mark Feinberg. Longitudinal Effects of Universal Preventive Intervention on Prescription Drug Misuse: Three Randomized Controlled Trials With Late Adolescents and Young Adults. American Journal of Public Health, 2013; 103 (4): 665 DOI: 10.2105/AJPH.2012.301209
- Richard Spoth, Cleve Redmond, Chungyeol Shin, Mark Greenberg, Mark Feinberg, Lisa Schainker. PROSPER community–university partnership delivery system effects on substance misuse through 6 1/2years past baseline from a cluster randomized controlled intervention trial. Preventive Medicine, 2013; 56 (3-4): 190 DOI: 10.1016/j.ypmed.2012.12.013
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