title: Implementing a comprehensive program for the prevention of conduct problems in rural communities: the Fast Track experience. The Conduct Problems Prevention Research Group.
abstract: Childhood conduct problems are predictive of a number of serious long-term difficulties (e.g., school failure, delinquent behavior, and mental health problems), making the design of effective prevention programs a priority. The Fast Track Program is a demonstration project currently underway in four demographically diverse areas of the United States, testing the feasibility and effectiveness of a comprehensive, multicomponent prevention program targeting children at risk for conduct disorders. This paper describes some lessons learned about the implementation of this program in a rural area. Although there are many areas of commonality in terms of program needs, program design, and implementation issues in rural and urban sites, rural areas differ from urban areas along the dimensions of geographical dispersion and regionalism, and community stability and insularity. Rural programs must cover a broad geographical area and must be sensitive to the multiple, small and regional communities that constitute their service area. Small schools, homogeneous populations, traditional values, limited recreational, educational and mental health services, and politically conservative climates are all more likely to emerge as characteristics of rural rather than urban sites (Sherman, 1992). These characteristics may both pose particular challenges to the implementation of prevention programs in rural areas, as well as offer particular benefits. Three aspects of program implementation are described in detail: (a) community entry and program initiation in rural areas, (b) the adaptation of program components and service delivery to meet the needs of rural families and schools, and (c) issues in administrative organization of a broadly dispersed tricounty rural prevention program.
authors.affiliation: Pennsylvania State University, USA.
authors.forename: K L
authors.initials: KL
authors.lastname: Bierman
mesh_terms: D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology / Q000517:prevention & control*; D003156:Community Mental Health Services; D003191:Comprehensive Health Care; D005196:Family Therapy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D010348:Patient Care Team; D010414:Pennsylvania; D012307:Risk Factors; D012424:Rural Population