PROSPER Community Benefit Pilot Research

This project is expected to advance adolescent behavioral health prevention service implementation science by addressing four knowledge gaps. First, there is a need to develop and test innovative and cost-effective hospital outreach practice models that apply state-of-the-science technical assistance to effectively support adoption, quality implementation, coordination, and cost-effective sustainability of chosen empirically-supported services. Second, the practice model knowledge gap is especially salient in underserved and understudied rural communities. Third, there is a need to better understand community outreach strategies and factors associated with service implementation quality and sustainability, particularly collaborative functioning and quality of technical assistance, utilizing well-integrated service implementation monitoring systems. Fourth, the literature highlights the need to comprehensively evaluate the public health impact potential of preventive services, particularly regarding prevalent and costly substance misuse.

The two aims of the project are:

(1) To prepare randomly-assigned intervention sites for the planned prevention trial by building on pilot feasibility work already conducted and gathering additional inputs from local public health departments, community hospitals, primary care and public school stakeholders, plus performing initial capacity-building for coordination with all community partners in the identified sites.

(2) To examine process and outcome measures that map onto key dimensions to test differences between a usual collaborative hospital-based community outreach that implements evidence-based programs and services (EBPSs) for adolescent behavioral health (Usual Collaborative Plus EBPS Condition) vs. the delivery of parallel EBPSs with added infrastructural supports and technical assistance (PROSPER Community Benefit Condition), including evaluation of: (a) youth and family participation in community benefit-connected services and programs (Reach); (b) targeted behavioral health outcomes (Effectiveness); (c) levels of adoption or uptake of evidence-based programs and services by participating community organizations (Adoption); (d) implementation quality of services/programs and implementation costs, as well as predictors of implementation quality (Implementation); and (e) short-term sustainability of EBPSs, along with predictors of sustainability (Maintenance)—using a randomized controlled design in 24 sites.