Optimizing the Next Generation of Family Based Substance Abuse Prevention in Schools

Despite strong evidence that evidence-based family interventions (family EBIs) have far-reaching effects to prevent problems such as substance use disorders, school dropout, criminal justice involvement, transmission of HIV/AIDS and other sexually-transmitted diseases, they have not been adopted at the level necessary to fulfill their intended public health impact. Barriers to broad school dissemination include a misfit between the EBI’s structure and priorities of schools, difficulty maintaining quality implementation, and low rates of enrollment and attendance.

The Bridges to High School Program (Bridges) was designed for middle school students in low-income communities to build youth and family competencies and reduce risk for substance abuse, academic, and mental health problems. A randomized trial showed multiple long-term benefits, including reduced binge drinking, marijuana use, alcohol abuse disorder, number of sexual partners, and mental health symptoms and disorders for Mexican Americans in late adolescence and young adulthood.  Although Bridges also produced effects on outcomes such as grades, school engagement, and school dropout that fit with the academic mission of schools, some features of the original 9-session intervention do not fit with school and family constraints.     

This presentation will describe our plans to partner with Title 1 schools to streamline (shorten from 9 to 4 sessions) and adapt the Bridges intervention to advance the next generation of family substance abuse prevention in schools. These efforts are guided by 4 goals: (1) To increase feasibility for sustained school implementation; (2) To increase family attendance and completion of core intervention components; (3) To enhance intervention content and processes that strengthen youth self-regulation;(4) To broaden the program for culturally diverse families.

Our research team is in an ideal position to reengineer this family EBI by retaining its most robust features because we have identified core components of the intervention through systematic tests of mediation. Several adaptations are planned, including the use of new technologies to enhance program effects on youth self-regulation and to overcome training and supervision barriers and costs (i.e., text messages to enhance motivation, skills practice, and engagement; e-learning program to train service providers; web-based, user-friendly monitoring and implementation assessments).