title: Preventing substance misuse through community-university partnerships: randomized controlled trial outcomes 4½ years past baseline.
abstract: BACKGROUND
  Substance misuse by adolescents and related health issues constitute a major public health problem. Community-based partnership models designed for sustained, quality implementation of proven preventive interventions have been recommended to address this problem. There is very limited longitudinal study of such models.
  
  
  OBJECTIVE
  To examine the long-term findings from an RCT of a community-university partnership model designed to prevent substance misuse and related problems.
  
  
  METHODS
  A cohort sequential design included 28 public school districts in rural towns and small cities in Iowa and Pennsylvania that were randomly assigned to community-university partnership or usual-programming conditions. At baseline, 11,960 students participated, across two consecutive cohorts. Data were collected from 2002 to 2008.
  
  
  METHODS
  Partnerships supported community teams that implemented universal, evidence-based interventions selected from a menu. The selected family-focused intervention was implemented with 6th-grade students and their families; school-based interventions were implemented during the 7th grade. Observations demonstrated intervention implementation fidelity.
  
  
  METHODS
  Outcome measures were lifetime, past-month, and past-year use of a range of substances, as well as indices of gateway and illicit substance use; they were administered at baseline and follow-ups, extending to 4.5 years later.
  
  
  RESULTS
  Intent-to-treat, multilevel ANCOVAs of point-in-time use at 4.5 years past baseline were conducted, with supplemental analyses of growth in use. Data were analyzed in 2009. Results showed significantly lower substance use in the intervention group for 12 of 15 point-in-time outcomes, with relative reductions of up to 51.8%. Growth trajectory analyses showed significantly slower growth in the intervention group for 14 of 15 outcomes.
  
  
  CONCLUSIONS
  Partnership-based implementation of brief universal interventions has potential for public health impact by reducing growth in substance use among youth; a multistate network of partnerships is being developed. Notably, the tested model is suitable for other types of preventive interventions.
authors.affiliation: Partnerships in Prevention Science Institute, Iowa State University, Ames, Iowa 50010, USA. rlspoth@iastate.edu
authors.forename: Richard
authors.initials: R
authors.lastname: Spoth
authors.forename: Cleve
authors.initials: C
authors.lastname: Redmond
authors.forename: Scott
authors.initials: S
authors.lastname: Clair
authors.forename: Chungyeol
authors.initials: C
authors.lastname: Shin
authors.forename: Mark
authors.initials: M
authors.lastname: Greenberg
authors.forename: Mark
authors.initials: M
authors.lastname: Feinberg
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D002648:Child; D003159:Community-Institutional Relations; D003299:Cooperative Behavior; D019317:Evidence-Based Medicine; D005500:Follow-Up Studies; D006801:Humans; D007484:Iowa; D017146:Models, Organizational; D010043:Outcome and Process Assessment, Health Care; D010414:Pennsylvania; D012424:Rural Population; D013334:Students / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D013997:Time Factors; D014495:Universities / Q000458:organization & administration*