Universal, Selective and Indicated Evidence-based Substance Use Prevention Promoting Wellness

Prevention Plus Wellness (PPW) provides evidence-based programs and training that can be used as universal, selective and indicated substance use prevention strategies that also promote healthy lifestyle behaviors and wellness-based self-images among youth and young adults. 

PPW programs are more inclusive, holistic, and protective factor focused than typical prevention interventions that address only risks for substance use.

Prevention Definitions

Universal prevention refers to approaches designed for an entire population without regard to individual risk factors.  Selective prevention is when strategies are targeted at one or more subgroups of a population determined to be at risk for substance abuse.  Indicated prevention is when interventions are aimed at individuals showing signs of substance abuse or problems. 

Evidence-based programs are interventions that have been evaluated and proven to result in positive outcomes.  Evidence-based practices, on the other hand, are techniques or strategies within those programs that have been shown to be effective through research, for example, screening and brief intervention is an evidence-based practice found within all PPW programs. 

The following provides examples of evidence-based programs and practices for each of the three types of prevention.

Universal Prevention 

Prevention Plus Wellness provides several universal substance use prevention with wellness programs designed for all youth and young adult populations.  Because most PPW programs are a single-session and come with scripted protocols for implementation in both groups (e.g., classrooms, teams) and individually (i.e., one-on-one), they are feasible even in very busy school and community organizations. Plus, since PPW programs are screening and brief interventions, they use an evidence-based practices approach.   

In addition, PPW programs promote healthy lifestyle behaviors and positive, future images which youth, parents and providers find salient, interesting and motivational.  Healthy behaviors include physical activity and sports, healthy breakfast and nutrition, sleep, stress control habits and multiple health behavior goal setting known to promote mental and physical wellbeing, performance and happiness among youth people.

Two evidence-based universal prevention with wellness programs shown to prevent substance use and increase healthy behaviors lacking among nearly all American youth include: 

Seven additional universal Prevention Plus Wellness programs adapted from the above two evidence-based interventions include: 

1.   SPORT Alcohol & Cannabis Prevention Plus Wellness a single-session group and individually implemented program with versions for high school and middle school youth,

2.   Vaping (E-Cigarette) Prevention Plus Wellness a single-session group and individually implemented program with versions for high school, middle school and elementary school youth in both manual and interactive online format, 

3.   Marijuana Prevention Plus Wellness a single-session group and individually implemented program in high school, middle school and elementary school versions,

4.   Opioid Prevention Plus Wellness a single-session group and individually implemented program for adolescents,

5.   Opioid & Stimulants Prevention Plus Wellness a single-session group and individually implemented program for college students and other young adults,  

6.   SPORT 3 Prevention Plus Wellness a three-session group implemented program with versions for high school, middle school and elementary school youth, and

7.   SPORT Health Behaviors Prevention Plus Wellness a six-session group implemented program which comes with Healthy Lifestyles Workbooks in versions for high school, middle school and elementary school youth.

Selective Prevention 

While Prevention Plus Wellness programs were originally developed for implementation with all youth and young adult populations, a study evaluating SPORT PPW among older adolescents found that youth who already were using drugs and who received the program showed larger positive substance use effect sizes than those not already using drugs, even a year after intervention. 

Specifically, published results indicated that one-year after intervention, substance using youth receiving SPORT PPW showed significant: 

  • reductions in binge drinking,
  • reductions in frequency of cigarette smoking,
  • reductions in marijuana use,
  • reductions in the initiation of cigarette use,
  • reductions in initiation of marijuana use,
  • increases in vigorous exercise, and
  • increases in moderate physical activity. 

 

These findings indicate that the SPORT PPW program, and its adaptations, hold promise as selective interventions for high-risk drug using young people.  Prevention Plus Wellness interventions may produce positive effects even greater and longer lasting than those produced among general youth and young adult populations. 

For this reason, organizations across the country are using PPW programs in school and community diversion programs, particularly for youth caught using or at greater risk for using alcohol, e-cigarettes, marijuana or opioids.

Indicated Prevention 

Prevention Plus Wellness programs may also be useful in preventing further escalation of substance abuse and problems among youth and young adults because they are founded on evidence-based screening and brief intervention practice.  Screening and brief interventions are often used to identify youth at greatest risk for substance use/misuse and provide brief prevention/intervention as well as refer those at greatest risk for further services such as assessment, counseling or treatment.

In addition, all PPW programs target health-promoting behaviors recognized as critical to successful substance abuse intervention, treatment and recovery.  Lastly, Prevention Plus Wellness offers Parent Training Programs in PPW for parents and caregivers designed to help them provide positive, healthy behavior communication and goal setting to prevent and reduce youth substance use/misuse and problems.

Evaluation Resources

While PPW programs are supported as evidence-based programs and practice, they include online and paper pretest, immediate posttest and follow-up posttest surveys to evaluate their effectiveness.  The immediate posttest permits assessment of change on key risk and protective factors associated with substance use and healthy behaviors, as well as qualitative data on what participants liked best and least about the program.  The follow-up survey allows evaluation of 30-day substance use and healthy behavior change over time.   

Two other evaluation tools include an Instructor’s Survey to monitor program implementation quality and a Fidelity Checklist to assess program implementation reliability.  Together, these evaluation resources allow providers to measure and monitor program quality, fidelity and efficacy as universal, selective and indicated prevention strategies in any setting and with any youth or young adult population.

Training Options

Prevention Plus Wellness offers on-demand online training as well as live online and onsite training for prevention and health specialists who wish to implement, or train others to implement, PPW programs with fidelity and maximum effectiveness.  PPW also offers free continuing education webinars on prevention with wellness program and research topics for professionals who wish to promote the whole health of youth and young adults.  Lastly, Unlimited PPW Program & Training Licenses allow prevention and health organizations to expand their prevention footprint across a wide geographic region in a cost-effective manner.

 Conclusion 

Evidence-based Prevention Plus Wellness programs can be used as universal, selective or indicated prevention interventions for preventing and reducing substance use, misuse and related problems while also promoting healthy lifestyle behaviors among youth and young adults necessary for protecting and promoting mental and physical wellbeing, performance and happiness.

PPW screening and brief interventions, as well as training for implementers, provide a practical solution to busy schools and community organizations by allowing implementation in groups or individually and in some cases even in interactive online format. Built-in evaluation resources allow organizations to assess and monitor program implementation quality, fidelity and efficacy for promoting and improving their prevention programs over time.