Evidence Based Prevention Practices

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Evidence Based Prevention Practices

• Maryland Association of Youth Services Bureaus

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Youth Services Bureaus

• Youth Services Bureaus were established in the
  early 1970s to meet the needs of those troubled
  youth who display risky and/or delinquent
  behaviors and their families
• By Statue (Art 83C section 2-122) provide
  delinquency prevention services to Marylands
  Youth

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Youth Services Bureaus

• Youth Services Bureaus work from the belief that
  prevention does not require the youth and his/her
  family to further deteriorate to receive the help
  they need
• YSBs work with youth demonstrating known risk
  factors for juvenile delinquency (truancy, family
  discord, poor school performance, drug and
  alcohol use, etc)

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10 Maryland Jurisdictions

• Youth Services Bureaus established in
• Anne Arundel County
• Baltimore City
• Baltimore County
• Calvert, Charles St Marys Counties
• Carroll County
• Dorchester County
• Montgomery County
• Prince Georges County

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YSB Outcomes

• Most recent analysis of Department of Juvenile
  Services data found that 2 years after ending
  treatment, 93 of at-risk youth had NOT been
  adjudicated delinquent.

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YSB Outcomes

• First, pilot evaluation study of Youth Services
  Bureaus formal counseling services found 60 of
  clients reported attaining most or all of their
  set treatment goals.
• Second evaluation study found that at the
  conclusion of formal counseling there was a
  statistically significant reduction in the
  intensity of youth and family problems
• Research conducted in partner with Dr. Elizabeth
  M. Timberlake, et al., The Catholic University of
  America, National Research Center for Child and
  Family Services.

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What is Evidence Based Practice?

• In the health care field, evidence-based practice
  (or practices), also called EBP or EBPs,
  generally refers to approaches to prevention or
  treatment that are validated by some form of
  documented scientific evidence. What counts as
  "evidence" varies. Evidence often is defined as
  findings established through scientific research,
  such as controlled clinical studies, but other
  methods of establishing evidence are considered
  valid as well. Evidence-based practice stands in
  contrast to approaches that are based on
  tradition, convention, belief, or anecdotal
  evidence. (SAMHSA, National Registry of Evidence
  Based Practices)

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What Is SAMHSAs NREPP?

• The National Registry of Evidence-based Programs
  and Practices (NREPP) is a searchable online
  registry of mental health and substance abuse
  interventions that have been reviewed and rated
  by independent reviewers.
• The purpose of this registry is to assist the
  public in identifying approaches to preventing
  and treating mental and/or substance use
  disorders that have been scientifically tested
  and that can be readily disseminated to the
  field.
• NREPP is a voluntary, self-nominating system in
  which intervention developers elect to
  participate. There will always be some
  interventions that are not submitted to NREPP,
  and not all that are submitted are reviewed. In
  addition, new intervention summaries are
  continually being added.

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OJJDP Model Program Rating

• The MPG evidence ratings are based on the
  evaluation literature of specific prevention and
  intervention programs. The overall rating is
  derived from four summary dimensions of program
  effectiveness
• The conceptual framework of the program
• the program fidelity
• the evaluation design
• the empirical evidence demonstrating the
  prevention or reduction of problem behavior the
  reduction of risk factors related to problem
  behavior or the enhancement of protective
  factors related to problem behavior

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OJJDP Classifications

• ExemplaryIn general, when implemented with a
  high degree of fidelity these programs
  demonstrate robust empirical findings using a
  reputable conceptual framework and an evaluation
  design of the highest quality (experimental).
• EffectiveIn general, when implemented with
  sufficient fidelity these programs demonstrate
  adequate empirical findings using a sound
  conceptual framework and an evaluation design of
  the high quality (quasi-experimental).
• PromisingIn general, when implemented with
  minimal fidelity these programs demonstrate
  promising (perhaps inconsistent) empirical
  findings using a reasonable conceptual framework
  and a limited evaluation design (single group
  pre- post-test) that requires causal confirmation
  using more appropriate experimental techniques.

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EBPs and YSBs

• Youth Services Bureaus are committed to providing
  the most effective services to clients
• Youth Services Bureaus are implementing EBPs in
  Maryland

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Brief Strategic Family Therapy

• Evidence-based model program at Carroll County
  Youth Service Bureau since 2005
• Family systems approach serving ages 6-18
• Linked to violence assessment service with CC
  Schools, DSS, DJS, Family Law Court
• Certified BSFT therapists trained by the Family
  Therapy Institute of Miami
• Parenting Emphasis Practical, Planned,
  Problem-Focused
• Low recidivism rate

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Strengthening Families Program

• SFP listed as a best practice or effective
  program by
• NIDA Red Book (one of 10 programs)
• OJJDP Strengthening Americas Families (1 of 7
  replicated programs) www.strengtheningfamilies.org
  
• SAMHSA Model Programs (2000)
• DoED (one of 8 programs)
• OJJDP BluePrints (one of 10 programs) Cochrane
  Collaboration (Foxcroft, et al., 2003) as best
  substance abuse school-based program in world.

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SFP Major Objectives

• Improve Family Relations
• Increase Parenting Skills
• Increase Childrens Skills

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SFP Typical Class Session

• FAMILY STYLE MEAL
• CHILD PARENT
• GROUP GROUP
• Childcare
• 2 FAMILY
• GROUPS
• Transportation

1Hour Simultaneously 1Hour
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Outcomes

• The program was evaluated in three longitudinal
  studies.
• The first evaluated the Iowa Strengthening Family
  Program between 1986 and 1998, with a sample of
  families of sixth graders.
• At 4 years following the pre-test, the
  experimental group showed positive effects on
  parenting behaviors targeted by the intervention
  through the 8th grade follow-up
• improvement in peer resistance skills and
  reduction in affiliations with antisocial peers
  at 7th, 8th, and 10th grade follow-up
• lower probabilities of alcohol, tobacco, and
  marijuana use lower rates of alcohol initiation
  through the 10th grade follow-up
• and lower past-month cigarette use in the 10th
  grade (Molgaard, Spoth, and Redmond, 2000).

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Botvin Life Skills

• Research-validated substance abuse prevention
  program proven to reduce the risks of alcohol,
  tobacco, drug abuse, and violence by targeting
  the major social and psychological factors that
  promote the initiation of substance use and other
  risky behaviors
• Backed by over 20 scientific studies and is
  recognized as a Model or Exemplary program by an
  array of government agencies including the U.S.
  Department of Education and the Center for
  Substance Abuse Prevention

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Life Skills Components

• DRUG RESISTANCE SKILLSThrough coaching and
  practice, youth learn information and practical
  ATOD (Alcohol, Tobacco, and Other Drug use)
  resistance skills for dealing with peers and
  media pressure to engage in ATOD use.
• PERSONAL SELF-MANAGEMENT SKILLS Students learn
  how to examine their self-image and its effects
  on behavior set goals and keep track of personal
  progress problem solving skills how to reduce
  stress and anxiety
• GENERAL SOCIAL SKILLS Youth Learn positive
  communication and conflict management skills

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Life Skills Outcomes

• Cuts tobacco use by 87  
• Cuts alcohol use by 60  
• Cuts marijuana use by 75  
• Cuts methamphetamine use by 68  
• Cuts polydrug use by 66  
• Reduces Pack-a-Day Smoking by 25  
• Decreases Use of Inhalants, Narcotics and
  Hallucinogens  Reduces Violence  
• Reduces risky driving behavior  
• Demonstrates Effects on HIV Risk Behavior

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Second Step Violence Prevention

• The Second Step curriculum is a evidenced-based
  prevention program designed to reduce aggression
  and promote social competence.
• Youth with weak social and emotional skills are
  at risk for developing problems in school and
  later in the community. Such as poor performance
  in school gang involvement and involvement in
  the criminal justice system.
• Prosocial skills training is an effective
  research based strategy that decreases the
  likelihood of such negative manifestations and
  increases the likelihood of success in school,
  the community and later in the workplace.

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Second Step Violence Prevention

• Achievers is a program based on Second Step that
  helps prepare middle school adolescents for
  successful transition into high school with a
  four-pronged approach Social Skills Training
  (empathy, problem solving and emotion
  management) Leadership and Community
  Involvement (quarterly community service
  projects) Job Readiness (earn credit towards a
  Rockville Recreation and Park activity of your
  choice through participation in the program)
  Academic Encouragement (study skills training,
  homework session and career exploration)

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Outcomes

• Participants develop and demonstrate strategies
  for managing anger and problem solving.
• Participants complete two community services
  projects by completion of program.
• Participant's families receive information and
  referrals to services as needed.

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Resources

• OJJDP Model Programs
• http//www.dsgonline.com/mpg2.5/mpg_index.htm
• SAMHSA Model Programs National Registryof
  Evidence Based Programs
• http//www.modelprograms.samhsa.gov/
• http//nrepp.samhsa.gov/

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Maryland Association of Youth Services Bureau

• Chair, Dr. Liz Park lpark_at_greenbeltmd.gov
• www.maysb.com