Project Summary The proposed study will evaluate the economic impact of a major NIDA-funded prevention delivery and support system for evidence-based preventive interventions (EBPIs) known as PROSPER (PROmoting School/community-university Partnerships to Enhance Resilience). This research will build on the existing randomized trial of PROSPER that delivered EBPIs to over 12,000 youth in rural communities 18 to 20 years ago and cultivated sustained high-quality local prevention efforts. These community prevention teams selected and implemented family-focused and school-based EBIs for middle school students in 6th and 7th grade. Initial assessments followed students from pretest (6th grade) through 12th grade (five years post-intervention). Prior funded research pointed to consistent findings for reduced substance misuse among intervention participants. These earlier findings warrant further investigation of the economic implications. Consequently, the proposed study will allow us to assess how long-term effects of the intervention will translate into economic benefits through adulthood. Beyond estimating the full economic impact of the PROSPER system, we will also assess how local program implementation and supportive systemic factors may influence the efficiency of universal prevention efforts, providing needed information around how to build efficient substance abuse prevention efforts. The specific aims of this study are to: (1) Evaluate the economic impact of the PROSPER model for preventing substance misuse; (2) Model how variation in local prevention infrastructure influences economic impact; and (3) Assess how individual risk factors impact prevention efficiency. Prior work demonstrated how the resources necessary for program delivery can be managed more efficiently within a prevention delivery system that cultivates sustainable funding streams to support long-term dissemination. The proposed research would follow this investigation by evaluating how these increased efficiencies can improve the likelihood for positive economic benefit resulting from intervention effectiveness. Importantly, this inquiry will examine the range of expected economic outcomes given variation in implementation factors for program delivery, leveraging unique detailed data assessing this. Further, investigations of how economic impact may vary due to participant characteristics will further inform policy makers of the range of outcomes that could be expected. Thus, this research provides a unique opportunity to determine the long-term economic benefit from an efficient prevention delivery system’s impact on reduced substance misuse and risky behavior among adolescents.

Project Narrative The proposed study will determine the expected economic benefit from a prevention delivery and support system for evidence‐based preventive interventions (EBPIs) known as PROSPER (PROmoting School/community‐university Partnerships to Enhance Resilience) that has been shown to increase efficiencies for intervention delivery as well as cultivate sustainable funding streams to support long-term dissemination. Economic impact will be based on administrative data and other markers of well-being measured as participants are followed into adulthood, following up on already demonstrated project effects for reduced substance misuse as well as reduced rates of conduct disorder among adolescents. Importantly, this investigation will assess the expected variation in economic impact due to study implementation factors measured in detail in prior work, enabling further information for how resources may be most efficiently expended for the sake of prevention of long-term problems related to early substance misuse.