J. Fred Springer

Risk, protection, and substance use in adolescents: a multi-site model.

This article reports findings from a national longitudinal cross-site evaluation of high-risk youth to clarify the relationships between risk and protective factors and substance use. Using structural equation modeling, baseline data on 10,473 youth between the ages of 9 and 18 in 48 high-risk communities around the nation are analyzed. Youth were assessed on substance use (cigarette, alcohol, and marijuana use), external risk factors including family, school, peer and neighborhood influences, and individual risk and protective factors including self-control, family connectedness, and school connectedness. Findings indicate strong direct relationships between peer and parental substance use norms and substance use. Individual protective factors, particularly family and school connectedness were strong mediators of individual substance use. These findings suggest that multi-dimensional prevention programming stressing the fostering of conventional anti-substance use attitudes among parents and peers, the importance of parental supervision, and development of strong connections between youth and their family, peers, and school may be most effective in preventing and reducing substance use patterns among high-risk youth.

Estimating Intervention Effectiveness: Synthetic Projection of Field Evaluation Results

In a 46-site, 5-year high-risk youth substance abuse prevention evaluation, effect sizes were adjusted using a meta-analytic regression technique to project potential effectiveness under more optimal research and implementation conditions. Adjusting effect size estimates to control for the impact of comparison group prevention exposure, service intensity, and coherent program implementation raised the mean effectiveness estimate from near zero (.02, SD = .21) to .24 (SD = .18). This finding suggests that adolescent prevention programs can have significant positive effects under optimal, yet obtainable conditions.Editors’ Strategic Implications: The authors present a meta-analytic technique that promises to be an important tool for understanding what works in multi-site community-based prevention settings. Researchers will find this to be a creative approach to model the “noise’’ in implementation that may often overshadow the potential impact of prevention programs.

Characteristics of Effective Substance Abuse Prevention Programs for High-Risk Youth

The last two decades have witnessed a rapid development of substance abuse prevention programs. Most efforts to evaluate these programs have been limited to single program studies, and nearly all studies involving multiple drug prevention programs have involved school-based programs for general youth populations. In 1995, the Center for Substance Abuse Prevention (CSAP), with the Substance Abuse and Mental Health Administration (SAMHSA), funded the CSAP National Cross-site Evaluation of High Risk Youth Programs, a five-year, multi-site evaluation study involving 46 programs and over 10,500 youth at high risk for substance use (CSAP, 2002(a)). This article reports findings from this evaluation, focusing on program characteristics that help explain reductions in 30-day substance use among program participants. Programs found to be most effective in reducing substance use were those that offered strong behavioral life skills development content, emphasized team-building and interpersonal delivery methods, emphasized introspective learning approaches focusing on self-reflection, were based upon a clearly articulated and coherent program theory, and provided intense contact with youth. Programs utilizing these positive program components produced consistent and lasting reductions in substance use. These findings provide a solid basis for the adoption of positive program characteristics in the development of future prevention programming for high-risk youth.

Quality of provider-participant relationships and enhancement of adolescent social skills.

This study adds to the limited research on the potential importance of the quality of the relationship between adult prevention service providers and youth participants in enhancing social skills and strengthening prevention outcomes. Study subjects were drawn from seven prevention programs funded under a Youth Mentoring Initiative by the Center for Substance Abuse Prevention in the Substance Abuse and Mental Health Services Administration. These programs maintain a relationship-based service focus but use a variety of one-on-one, group, volunteer, and paid staff service formats. Study results showed that youth who perceived a higher level of trust, mutuality and empathy in their relationship with providers experienced significantly greater improvements in social skills (i.e., cooperation, self-control, assertiveness, and empathy) than program participants who perceived a lower quality relationship with adult providers. These findings underscore the importance of recruitment, training and supervisory practices that promote staff and volunteer skills in achieving high quality relationships with youth participants regardless of the specific intervention strategy. Editors’ Strategic Implications: Practitioners and policymakers should review the authors’ findings about the importance of individual adult skills in building protective mentoring relationships. The impact of relationship quality, rather than setting, suggests that the scope of effective prevention practice can be broadened beyond the confines of formal prevention programming to any place in which caring and skilled adults interact with youth.

Prevention Programming for African American Youth: A Review of Strategies in CSAP’s National Cross-Site Evaluation of High-Risk Youth Programs:

The purpose of this paper is to add to the knowledge base on prevention programming by explicating the characteristics of 12 programs (out of 47) serving African American youth funded by the Center for Substance Abuse Prevention (CSAP). Findings show that African American youth exhibit lower use rates than most other ethnic and racial groups, but by the time they reach ages 16 to 18, use is prevalent. Data on correlations of risk and protective factors with substance use reveal a very similar pattern of rank order in the strength of correlations for African American youth with youth who are not African American in the CSAP sample. The African American programs integrated Africentric principles and themes into other prevention strategies: education-and-awareness, risk-andprotection, and positive-alternative-interventions. The analysis shows that Africentric programming contributes to higher rates of satisfaction and perceived program importance to youth participating in the African American programs, compared to African American youth in other programs.

Family interventions and adolescent resiliency: The Southwest Texas State High-Risk Youth Program

The emergence of social ecology as an orienting perspective in prevention has reinforced attention to the family as a critical influence on adolescent risk and protection. The Southwest Texas High-Risk Youth Program (SWTHRY) addressed the neglect of family as a prevention focus by providing in-home sessions for high-risk families that sought to strengthen family cohesion and adaptability, and thereby promote adolescent resiliency. Based on pre- and post-program administration of carefully constructed measures, the evaluation demonstrates increased family cohesion and strengthened adolescent family bonding among participants. However, participants reported less increase in family adaptability, and adolescent family members showed no statistically significant gain over pre-program scores in dimensions of resiliency other than family bonding, nor in family interaction, family supervision, or ATOD attitudes. Family bonding, the area in which there was significant change in adolescents, was not highly correlated with ATOD use. The study supports the need for comprehensive programming to strengthen adolescent resiliency, and provides further evidence that prevention interventions targeted on affective purposes (e.g., self-esteem, family cohesion) will have limited effects.

Effectiveness of Culturally Specific Approaches to Substance Abuse Prevention: Findings from CSAP's National Cross-Site Evaluation of High Risk Youth Programs

Abstract This study assesses the degree to which culturally specific interventions enhance substance abuse prevention effectiveness for targeted cultural groups. A large and diverse (African American, Hispanic, American Indian, and Asian) sample of 10,500 youth across 48 programs was obtained. Youth participating in culturally specific programming showed greater program satisfaction and felt programs were more personally meaningful than youth in non-culturally specific progra. Culturally specific programs for African American youth were also more effective in preventing substance use. This finding may be attributable to the fact that Africentric programs apply a comprehensive and structured approach to substance abuse prevention and that cultural messages are clearly linked to important protective factors.

Understanding prevention effectiveness in real-world settings: the National Cross-Site Evaluation of high risk youth programs.

The National Cross-Site Evaluation is a large multisite evaluation (MSE) of 48 substance abuse prevention programs, 5,934 youth participating in programs, and 4,539 comparison youth programs. Data included a self-report questionnaire administered at 4 points in time, detailed dosage data on over 217,000 program contacts, and detailed site visit information. In a pooled analysis, the programs did not demonstrate significant positive effects on a composite outcome measure of tobacco, alcohol, and marijuana use in the previous 30 days. However, disaggregated analyses indicated that 1) sites in which comparison groups had strong opportunity to participate in prevention programs suppressed observed effects; 2) youth who had already started using before they entered programs reduced use significantly more than comparison youth who had started using; and 3) both males and females who participated in programs significantly reduced use relative to comparisons, but in very different patterns. Combining these patterns produced an apparent null effect. Finally, programs that incorporated at least 4 out of 5 effective intervention characteristics identified in the study significantly reduced use for both males and females relative to comparison youth. The lessons produced by this study attest to the value of MSE designs as a source of applicable knowledge about prevention interventions.

Informing the next generation of prevention programs: CSAP's cross-site evaluation of the 1994–95 high-risk youth grantees

With more than 400 projects funded since its initiation, the Substance Abuse and Mental Health Services Administrations Center for Substance Abuse Prevention (CSAP) High-Risk Youth Demonstration Program (HRY) is a prime example of federally sponsored demonstrations for generating and disseminating policy and program lessons in the area of substance abuse prevention. The HRY demonstration has provided strong support for both local and cross-site evaluation, and incorporated evaluation results into demonstration policy to (a) encourage stronger local evaluation, (b) encourage more coherent program planning and management, (c) encourage use of the risk and resiliency approach(es) to designing programs, and (d) encourage more comprehensive program purposes and activities. In April 1995, the Division of Knowledge Development and Evaluation within CSAP initiated the third cross-site evaluation of HRY programs which utilizes a clear conceptual framework emphasizing the risk and resiliency approach utilized by HRY grantees funded in 1994 and 95. The study implements a common quasi-experimental design across 48 selected sites, and will involve approximately 6,000 treatment and 4,000 comparison subjects. A common questionnaire will be used in all sites, generating data that will support a flexible, regression-based analysis plan. In addition to contributing to the systematic development of substance abuse prevention knowledge, the CSAP National Cross-Site Evaluation of HRY Programs will advance understanding of the design, implementation, and utilization of large, multi-site evaluations as sources of policy learning.

Dimensions and Sources of Administrative Climate in Development Programs of Four Asian Nations

Coordinators were R. W. Gable (U.S.) and Jose V. Abueva (Philippines); team members were Dong-suh Bark (Korea), Harry J. Friedman (U.S.), Gabriel Iglesias (Philippines), Glenn D. Paige (U.S.), Amara Raksasataya (Thailand), Fred W. Riggs (U.S.), S. P. Siagian (Indonesia), and J. F. Springer (U.S.). The project was funded by the Southeast Asia Development Advisory Group of the Asia Society and by the Rockefeller Foundation. Six dimensions of administrative climate (viz., pathology, impotence, futility, flexibility, effectiveness, and responsiveness) were identified and refined empirically through factor analysis of interview items about perceptions of the work environment in programs to improve rice production in Indonesia, Korea, the Philippines, and Thailand. Analyses utilized within-nation variance in responses rather than the pooled variance across nations. Identification of the relationships between dimensions in each program provided insight into the shared perceptions of their administrative systems held by officials in the four programs. A preliminary analysis of sources of perceptions of administrative climate (viz., social backgrounds, personal attitudes, administrative careers, and administrative relations) strongly suggests that the concept of administrative climate is an amalgam of these motivational and structural elements in a perceived environment.*