Prevention Programs for Youth and Families

Several federal agencies have compiled information about evidence-based substance use disorder (SUD) prevention programs in rural communities that focus on youth and families. These programs are primarily implemented in schools, and may also take place in the home or in community settings. Rural program planners should review the evaluation criteria and program content to determine if these programs can address community needs. The examples in this toolkit are not exhaustive and additional programs can be found in various registries and databases including:

Substance Abuse and Mental Health Administration's Evidence-Based Practices (EBP) Resource Center
National Institute of Justice's CrimeSolutions.gov database
Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute's County Health Rankings & Roadmaps program database
Community Preventive Services Task Force's Community Guide
The Surgeon General's Report on Alcohol, Drugs, and Health

Examples of Evidence-Based and Promising Prevention Programs for Youth

Fast Track is a comprehensive, long term prevention program for children entering kindergarten that continues through tenth grade. Intervention components change as children age and include components such as a teacher-led classroom curriculum, parent training groups, home visits, and child tutoring. One study showed that the Fast Track intervention reduced the likelihood of alcohol use and binge drinking as well as the probability of individuals developing serious SUDs. This intervention has been rated effective by the National Institute of Justice and is listed in The Surgeon General's Report on Alcohol, Drugs, and Health as an evidence-based prevention program.
The LifeSkills Training (LST) Program is a universal, classroom based prevention program implemented among middle school students. The program consists of a three-year curriculum that teaches drug resistance skills along with general social skills. An LST booster program can be offered after students enter high school. Curriculum materials are available for a fee and are available in Spanish. LST has been shown to reduce the prevalence of both alcohol and illicit drug use. LST is recommended by the National Institute on Drug Abuse (NIDA) and listed in The Surgeon General's Report on Alcohol, Drugs, and Health as an evidence-based prevention program. Learn more about the benefits and costs of the LifeSkills Training program.
All Stars is a school and community-based intervention that targets middle school students. Key components include promoting positive norms, planning a future free of risky behaviors, and positive interactions with parents and trusted adults. This intervention consists of 13 45-minute sessions delivered weekly by teachers, prevention specialists, or other community-based staff. All Stars is considered a promising program by the Substance Abuse and Mental Health Services Administration (SAMHSA) for reducing SUDs. Learn more about the benefits and costs of the All Stars program.
The Narconon Truth About Drugs Video Program is a universal prevention program targets both middle and high school students with a multimedia curriculum consisting of eight sessions. The videos provide accurate information on various drugs and first hand stories of dependence and recovery from young adults. Implementation materials are required and include an educator's manual, four DVDs, a teacher's DVD, flyers, and pre- and post-student surveys. SAMHSA has rated this program as promising for reducing substance use disorders involving alcohol, cannabis, inhalant, hallucinogen, amphetamine/stimulant, cocaine, sedative/hypnotic/anxiolytic, opioid, and other substances.

Examples of Evidence-Based Prevention Programs for Parents and Families

The Strengthening Families Program: For Parents and Youth 10–14 (SFP 10–14) is a universal, family-centered program that includes seven two-hour sessions and four optional booster sessions where youth and parents attend the first hour separately and the second hour together. Parent sessions focus on education about the risk factors for developing SUD, as well as managing family conflict and encouraging positive child involvement in family activities. Children receive education on resisting peer pressure and drug resistance skills. Curriculum materials are available for a fee, and are available in Spanish. SFP 10-14 is recommended by NIDA and SAMHSA and is listed in The Surgeon General's Report on Alcohol, Drugs, and Health as an evidence-based prevention program. Learn more about the benefits and costs of the Strengthening Families for Parents and Youth 10-14 program.
Strong African American Families (SAAF) is a seven-week program targeting rural African American families with children from 10 to 14 years old. It is a parental training program that works to strengthen attachments between parents and children, ultimately reducing alcohol and drug use. SAAF has been rated as an effective program for reducing child alcohol use and other youth risk behaviors by the National Institute of Justice.
Guiding Good Choices is a universal, parent-focused intervention (formerly Preparing for the Drug-Free Years) consisting of five two-hour sessions that teach parents about setting clear expectations, monitoring children, teaching children how to cope with peer pressure, adopting positive conflict management strategies, and enhancing family bonding. Curriculum materials are available for a fee, and are available in Spanish. Good Choices is recommended by the National Institute on Drug Abuse, SAMHSA, and the National Institute of Justice and is listed in The Surgeon General's Report on Alcohol, Drugs, and Health as an evidence-based prevention program. Learn more about the benefits and costs of the Guiding Good Choices program.
The Nurse-Family Partnership Program involves trained nurses who provide intensive, in-home visits to at-risk, first-time mothers during their pregnancy. The Surgeon General's Report on Alcohol, Drugs, and Health describes the Nurse-Family Partnership Program as an evidence-based prevention program because a study showed that children who received the intervention were less likely to use alcohol in their teens than those who did not. The Rural Services Integration Toolkit provides additional information about the Nurse-Family Partnership Program, including implementation considerations. Learn more about the benefits and costs of the Nurse-Family Partnership program.

Considerations for Implementation

Many of these prevention programs have significant implementation costs. Programs including LifeSkills, the Strengthening Families Program, and Guiding Good Choices require the purchase of a curriculum while some programs require training, either in person or via web-based training. Travel, curriculum costs, and other training related expenses may be a barrier for rural providers.

Resources to Learn More

The Community Tool Box: Chapter 2, Section 10 – The Strategic Prevention Framework
Website
This section examines a process developed by the Center for Substance Abuse Prevention (CSAP) to plan, implement, and evaluate SUD prevention programs in organizations, communities, and states.
Organization(s): Community Health and Development, University of Kansas

Preventing Prescription Drug Misuse: Selected Strategies and Associated Risk Factors
Document
Provides a table that describes seven different strategies and associated risk factors for preventing misuse of prescription drugs.
Organization(s): Prevention Solutions@EDC
Date: 3/2017

Preventing Substance Misuse in Rural Settings
Document
Describes the unique burden of SUD on rural communities and the challenges to SUD prevention.
Organization(s): Prevention Solutions@EDC
Date: 8/2018

Touchpoints for Addressing Substance Use Issues in Home Visiting: Phase 1 Final Report
Document
Summarizes an evidence-based home visiting project supporting expectant parents and families with young children to prevent, identify, and address SUD.
Author(s): Hossain, M., Akers, L., Del Grosso, P., et al.
Organization(s): U.S. Department of Health and Human Services, Administration for Children and Families (ACF), Mathematica
Date: 3/2020