Need: An approach to support sustained, quality delivery of evidence-based programs for youth and families in rural communities.
Intervention: PROSPER, a program delivery system, guides communities in implementing evidence-based programs that build youth competencies, improve family functioning, and prevent risky behaviors, particularly substance use.
Results: Youth in PROSPER communities reported delayed initiation of a variety of substances, lower levels of other behavioral problems, and improvements in family functioning and other life skills.
Partnerships to Enhance
Resilience) is an evidence-based program
delivery system that was developed to test the
feasibility of using small strategic teams to facilitate
the delivery of other evidence-based programs in rural
communities. The original randomized controlled
PROSPER evaluation study began in 2001, with
approximately 11,000 participating youth and their
parents from 28 communities in Iowa and Pennsylvania.
PROSPER was designed to address the challenges most
commonly faced by community-based program providers, such
as difficulty with participant recruitment, maintaining
high implementation fidelity, and sustaining the effort
after initial funding sources are depleted. It uses the
infrastructures of the Cooperative Extension System at
the Land Grant University and the public school system to
build local teams of 8-12 community stakeholders that
oversee all aspects of program implementation. The
PROSPER Network Organization is headquartered at the
Prevention Science Institute at Iowa State University in
The evidence-based programs on the PROSPER menu all
emphasize building youth competencies, improving family
functioning, and preventing risky behaviors, particularly
In addition to the extension specialists and public
school co-leaders, PROSPER Community Teams include
representatives from human service agencies and local
businesses, parents, and youth. These teams are supported
by a multi-tiered, proactive model that includes
technical assistance and support from PROSPER trainers
and coaches. Community Team sustainability efforts
include grant-writing, soliciting in-kind donations and
volunteer time, and other fundraising events.
This video describes how the PROSPER model works in
schools and communities
Although the programs chosen are delivered by community
teams, the PROSPER Organization provides the following
Trainings for team members within the state's
Manuals that provide a standardized process for all
phases of implementation, from team mobilization to
Ongoing, proactive technical assistance throughout
the implementation process
Online reporting systems and assistance with
monitoring implementation quality and partnership
Evaluation of outcomes
There are 3 training units for team members:
Unit 1 educates teams on their roles, organizational
structure, the PROSPER approach, and long-term
Unit 2 builds on the first training and teaches
participants about selecting and implementing a
Unit 3 focuses on the selection and implementation of
the school-based program, team development, and more
advanced sustainability planning
The PROSPER delivery system was evaluated with a
longitudinal randomized controlled trial conducted in 28
rural communities (14 intervention and 14 control) across
Iowa and Pennsylvania. Findings from this study indicated
that PROSPER has a range of positive outcomes, including
improved family functioning and parenting, delayed
initiation of a variety of substances, and reduced
conduct behaviors in youth. For instance, youth
participating in programs implemented through PROSPER
scored significantly lower on a number of negative
behavioral outcomes, including drunkenness, cigarette
use, marijuana use, use of other illicit substances, and
conduct problem behaviors. Results extended up to 6.5
years past baseline (end of 12th grade) and,
in many cases, higher-risk youth benefited more. Specific
are highlighted below:
Reduction in gateway and illicit drug misuse
Reduction in nonmedical, prescription opioid use
Improved behavioral conduct in youths' actions like
stealing, truancy, aggression
Improvements in youth's attitude toward substance
use, inductive reasoning, and overall assertiveness
Improvements in general child
management, child monitoring, harsh discipline,
parent-child quality and activities, and family
PROSPER Community Teams were also very successful with
family program recruitment and maintaining high levels of
implementation quality. For example, Community Teams
recruited 17% of all eligible 6th grade families into the
SFP 10-14 during the first 2 years of implementation,
compared to a 1 to 6% rate for most non-PROSPER programs.
Implementation quality scores exceeded 90% for both
school and family programs for the first 6 years of
implementation. In the 2004-08 periods, all 14 PROSPER
Community Teams continued to implement their programs
with self-generated funds, averaging $20,000 per year.
Only 2 teams did not reach the 10-year sustainability
Spoth et al. (2017) PROSPER delivery of universal
preventive interventions with young adolescents:
long-term effects on emerging adult substance misuse and
associated risk behaviors. Psychological Medicine.
Greenberg, M. T. et al. (2015). Factors that predict
financial sustainability of community coalitions: Five
years of findings from the PROSPER partnership project.
Prevention Science, 16(1), 158-167.
Spoth, R. L. et al. (2015). PROSPER Partnership
Delivery System: Effects on Conduct Problem Behavior
Outcomes Through 6.5 Years Past Baseline. Journal of
Adolescence, 45, 44-55.
Redmond, C., Spoth, R., Schainker, L. M., & Feinberg,
M. (2015). The Partnership-Based PROSPER Delivery System
and Implementation of the Strengthening Families Program:
For Parents and Youth 10-14. In Van Ryzin, M., Kumpfer,
K.L., Fosco, G. & Greenberg, M. (Eds.) Family-Based
Prevention Programs for Children and Adolescents: Theory,
Research, and Large-Scale Dissemination. NY.
Spoth, R., Trudeau, L., Shin, C., Ralston, E.,
Redmond, C., Greenberg, M., Feinberg, M. (2013).
Longitudinal effects of universal preventive intervention
on prescription drug misuse: Three randomized controlled
trials with late adolescents and young adults.
American Journal of Public Health, 103(4),
The following are typical barriers that community-based
programs face when starting a new program. Knowing this,
PROSPER developers took action to overcome these
difficulties and equip community teams to successfully
mobilize and sustain their efforts.
Recruitment – PROSPER technical assistance providers
encouraged Community Teams to use their existing networks
and to personally contact potential participants in order
to prevent low recruitment rates.
Program fidelity – Technical assistance was provided
to Community Teams on the relationship between fidelity
and program outcomes, and PROSPER was designed to include
continual monitoring of family and school program
Sustainability – The goals of
sustaining the team and the programming effort were
introduced as priorities during the early stages of team
development. Technical assistance focused on planning for
ongoing implementation, building relationships with
community stakeholders, and maintaining active team
Additional difficulties that have been experienced in
states implementing PROSPER:
Adaptations have been made to the implementation
process due to downsizing, restrictions, staffing
changes, and priority shifts of state extension systems.
Turnover in key roles, such as a new team leader, can
reduce the Community Team's productivity until a new team
leader is trained and acclimated to the role.
Decreases in federal and state extension funding
sources have made it challenging for states to adopt
PROSPER without outside grant funding.
The PROSPER Organization believes that providing training
and technical assistance, sustainability planning, and
offsetting initial programming costs are key to include
in an effective program-delivery system. Other important
Effective communication and engagement within the
program-delivery system, including extension agencies,
family-serving agencies, schools youth, and families.
Learning the culture of the local community and the
way in which the extension and school systems operate are
imperative to building strong relationships.
Sustainability comes from careful planning,
fundraising efforts, and follow-through from the team.
Families want to participate in programs that have a good
reputation in the community and that are offered by
Children and youth
Substance use and misuse
Wellness, health promotion, and disease prevention
Iowa, Pennsylvania, Vermont, West Virginia
Please contact the models and innovations contact directly for the most complete and current information
about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The
programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural
community should consider whether a particular project or approach is a good match for their community’s
needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep
in mind that changes to the program design may impact results.