title: PROSPER delivery of universal preventive interventions with young adolescents: long-term effects on emerging adult substance misuse and associated risk behaviors.
abstract: BACKGROUND
  Substance misuse and associated health-risking behaviors are prevalent in emerging adulthood. There is a knowledge gap concerning the post-high school effects of community-based delivery systems for universal preventive interventions implemented during young adolescence. This study reports effects of the PROSPER delivery system through age 19, 7.5 years past baseline.
  
  
  METHODS
  A cohort sequential design included 28 public school districts randomly assigned to the PROSPER partnership delivery system or usual-programming conditions. PROSPER community teams implemented a family-focused intervention in 6th grade and a school-based intervention in 7th grade. Outcomes for the age 19, post-high school report included lifetime, current, and frequency of substance misuse, as well as antisocial and health-risking sexual behaviors. Intent-to-treat, multi-level analyses of covariance of point-in-time outcomes were conducted, along with analyses of risk-related moderation of intervention effects.
  
  
  RESULTS
  Results showed emerging adults from PROSPER communities reported significantly lower substance misuse across a range of types of substances, with relative reduction rates of up to 41.0%. No significant findings were observed for associated antisocial and health-risking sexual behavior indices; or for lifetime rates of sexually transmitted infections. Risk-related moderation effects were non-significant, suggesting generally comparable outcomes across higher- and lower-risk subgroups of emerging adults.
  
  
  CONCLUSIONS
  The PROSPER delivery system for brief universal preventive interventions has potential for public health impact by reducing long-term substance misuse, with positive results extending beyond high school.
authors.affiliation: Partnerships in Prevention Science Institute,Iowa State University,Ames,Iowa,USA.
authors.forename: R
authors.initials: R
authors.lastname: Spoth
authors.affiliation: Partnerships in Prevention Science Institute,Iowa State University,Ames,Iowa,USA.
authors.forename: C
authors.initials: C
authors.lastname: Redmond
authors.affiliation: Partnerships in Prevention Science Institute,Iowa State University,Ames,Iowa,USA.
authors.forename: C
authors.initials: C
authors.lastname: Shin
authors.affiliation: Prevention Research Center,The Pennsylvania State University,University Park,Pennsylvania,USA.
authors.forename: M T
authors.initials: MT
authors.lastname: Greenberg
authors.affiliation: Prevention Research Center,The Pennsylvania State University,University Park,Pennsylvania,USA.
authors.forename: M E
authors.initials: ME
authors.lastname: Feinberg
authors.affiliation: Partnerships in Prevention Science Institute,Iowa State University,Ames,Iowa,USA.
authors.forename: L
authors.initials: L
authors.lastname: Trudeau
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D002648:Child; D005196:Family Therapy / Q000379:methods; D005260:Female; D006801:Humans; D007484:Iowa / Q000453:epidemiology; D007604:Juvenile Delinquency / Q000517:prevention & control* / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D010414:Pennsylvania / Q000453:epidemiology; D011613:Psychotherapy / Q000379:methods*; D012307:Risk Factors; D012309:Risk-Taking; D012424:Rural Population / Q000706:statistics & numerical data; D012725:Sexual Behavior; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000517:prevention & control*; D055815:Young Adult
keywords: Community-university partnership model; delivery system; emerging adult outcomes; evidence-based intervention; universal preventive intervention