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Diffusion of Intervention Effects: The Impact of a Family-Based Substance Use Prevention Program on Friends of Participants.

ABSTRACT: We tested whether effects of the Strengthening Families Program for Youth 10-14 (SFP10-14) diffused from intervention participants to their friends. We also tested which program effects on participants accounted for diffusion.Data are from 5,449 students (51% female; mean initial age = 12.3 years) in the PROmoting School-community-university Partnerships to Enhance Resilience community intervention trial (2001-2006) who did not participate in SFP10-14 (i.e., nonparticipants). At each of five waves, students identified up to seven friends and self-reported past month drunkenness and cigarette use, substance use attitudes, parenting practices, and unsupervised time spent with friends. We computed two measures of indirect exposure to SFP10-14: total number of SFP-attending friends at each wave and cumulative proportion of SFP-attending friends averaged across the current and all previous post-intervention waves.Three years post-intervention, the odds of getting drunk (odds ratio = 1.4) and using cigarettes (odds ratio = 2.7) were higher among nonparticipants with zero SFP-attending friends compared with nonparticipants with three or more SFP-attending friends. Multilevel analyses also provided evidence of diffusion: nonparticipants with a higher cumulative proportion of SFP-attending friends at a given wave were less likely than their peers to use drugs at that wave. Effects from SFP10-14 primarily diffused through friendship networks by reducing the amount of unstructured socializing (unsupervised time that nonparticipants spent with friends), changing friends' substance use attitudes, and then changing nonparticipants' own substance use attitudes.Program developers should consider and test how interventions may facilitate diffusion to extend program reach and promote program sustainability.

SUBMITTER: Rulison KL

PROVIDER: S-EPMC4583794 | biostudies-literature | 2015 Oct

REPOSITORIES: biostudies-literature

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Diffusion of Intervention Effects: The Impact of a Family-Based Substance Use Prevention Program on Friends of Participants.

Rulison Kelly L KL Feinberg Mark M Gest Scott D SD Osgood D Wayne DW

The Journal of adolescent health : official publication of the Society for Adolescent Medicine 20150723 4

<h4>Purpose</h4>We tested whether effects of the Strengthening Families Program for Youth 10-14 (SFP10-14) diffused from intervention participants to their friends. We also tested which program effects on participants accounted for diffusion.<h4>Methods</h4>Data are from 5,449 students (51% female; mean initial age = 12.3 years) in the PROmoting School-community-university Partnerships to Enhance Resilience community intervention trial (2001-2006) who did not participate in SFP10-14 (i.e., nonpa ...[more]

PMID: 26210856

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Project description:Implementation support interventions have helped organizations implement programs with quality and obtain intended outcomes. For example, a recent randomized controlled trial called Preparing to Run Effective Programs (PREP) showed that an implementation support intervention called Getting To Outcomes (GTO) improved implementation of an evidence-based substance use prevention program (CHOICE) run in community-based settings. However, more information is needed on how these interventions affect organizational barriers and facilitators of implementation. This paper aims to identify differences in implementation facilitators and barriers in sites conducting a substance use prevention program with and without GTO. PREP is a cluster-randomized controlled trial testing GTO, a two-year implementation support intervention, in Boys & Girls Clubs. The trial compares 15 Boys & Girls Club sites implementing CHOICE (control group), a five-session evidence-based alcohol and drug prevention program, with 14 Boys & Girls Club sites implementing CHOICE supported by GTO (intervention group). All sites received CHOICE training. Intervention sites also received GTO manuals, training, and onsite technical assistance to help practitioners complete implementation best practices specified by GTO (i.e., GTO steps). During the first year, technical assistance providers helped the intervention group adopt, plan, and deliver CHOICE, and then evaluate and make quality improvements to CHOICE implementation using feedback reports summarizing their data. Following the second year of CHOICE and GTO implementation, all sites participated in semi-structured interviews to identify barriers and facilitators to CHOICE implementation using the Consolidated Framework for Implementation Research (CFIR). This paper assesses the extent to which these facilitators and barriers differed between intervention and control group. Intervention sites had significantly higher average ratings than control sites for two constructs from the CFIR process domain: planning and reflecting and evaluating. At the same time, intervention sites had significantly lower ratings on the culture and available resources constructs. Findings suggest that strong planning, evaluation, and reflection-likely improved with GTO support-can facilitate implementation even in the face of perceptions of a less desirable implementation climate. These findings highlight that implementation support, such as GTO, is likely to help low-resourced community-based organizations improve program delivery through a focus on implementation processes. TRIAL REGISTRATION: This project is registered at ClinicalTrials.gov with number NCT02135991 (URL: https://clinicaltrials.gov/show/NCT02135991). The trial was first registered May 12, 2014.

Dataset Information

Diffusion of Intervention Effects: The Impact of a Family-Based Substance Use Prevention Program on Friends of Participants.

Publications

Diffusion of Intervention Effects: The Impact of a Family-Based Substance Use Prevention Program on Friends of Participants.

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