Prevention science has emerged as a discipline built on the integration of life course development research, community epidemiology and preventive intervention trials (Coie et al.. ]993; Kellam & Rebok, 1992). Prevention science is based on the premise that empirically verifiable precursors predict the likelihood of undesired health outcomes including substance abuse. Prevention science postulates that negative health outcomes can be prevented by reducing levels of risk and enhancing protective factors in individuals and their environments during the course of development (Coie, et al., 1993; Institute of Medicine, 1994). This research-based prevention model provides a framework for planning and managing prevention service system activities at the community and state levels. By collecting data on risk and protective factors at the community and state level, the most prominent factors in a given area may be identified and prioritized and effective preventive interventions selected for implementation that address the prioritized factors. This epidemiological risk and protective focused prevention planning approach represents a promising innovation, yet little is known about the process of changing state and community prevention systems to implement the model, or its effectiveness in reducing risk. increasing protection, and preventing substance abuse. This services research proposal is a joint effort of the Social Development Research Group (SDRG) of the University of Washington, the Research Triangle Institute, and the State Substance Abuse agencies: Colorado, Illinois, Kansas, Maine, Oregon, Utah and Washington. These states have shown interest in using an epidemiological risk and protective focused approach to prevention planning and system management. They began implementation of this approach at different times, and have progressed at different rates in implementing the approach. This services research project has two substudies. The first substudy will be a qualitative analysis of the natural history of implementation of epidemiologically-based prevention. SDRG staff will compile a thirteen-year history of prevention practices in each state by interviewing key public officials and community prevention contractors and conducting content analysis of state and local prevention planning documents. The second substudy will examine whether higher levels of implementation of the data-based risk and protective factor approach is associated with better prevention outcomes than low levels of implementation of the model at the community level. Two communities in each state will be identified as high implementers of the model and two matched communities within the same state will be identified as low implementers. Outcomes will be measured at the state and community levels using archival indicators of risk and substance abuse-related outcomes and data from school surveys of risk, protection, and substance use.
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