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Abstract
Although much is known about effective practices in preventive interventions, little is understood about factors critical to successfully implementing such interventions in real-world communities. This study examined how school-level and individual-level variables influenced the implementation of the Adolescent Transitions Program, an empirically supported program to prevent substance abuse and delinquency in middle-school students. The study investigated how such factors affected both the utilization of the intervention and its targeted outcomes. In doing so, the study attempted to contribute to the development of models for examining the implementation, and ultimately the sustainability, of evidence-based preventive interventions.
Two separate outcomes were created to measure utilization, defined here as contact with the intervention staff. Results indicated that coming from a single-parent family was the most robust predictor of a student's likelihood of making contact with intervention staff, whereas teacher-reported risk behavior was the most robust predictor of the quality/intensity of contacts with intervention staff. No school-level factors (primarily "structural" or resource variables such as student-teacher ratio) significantly predicted contact outcomes; however, there were other indications in the data that suggested the importance of school-level processes. In addition, there was little evidence to support a model in which contact variables mediated between individual predictors (e.g., family constellation or risk behavior) and targeted outcomes of the program (e.g., growth in problem behavior over three years).
These results point to several conclusions. First, it appears that the Adolescent Transitions Program reached a broad range of families, although certain families - e.g., two-parent families and those of Asian- or Native-American ethnicity - were not as well engaged, and some schools had much higher levels of engagement than others. Second, understanding utilization and engagement in prevention research remains a critical concern.
Third, increased investigation and better measurement of implementation factors - particularly school-level interpersonal processes - will significantly improve our understanding of how to successfully prevent conduct problems with a broad range of students and families.
