(47) Implementing Substance Use Prevention Programming in Rural Utah During COVID-19

Introduction
Although a relatively healthy state (i.e., low cancer rates, low use of alcohol/tobacco), Utah ranked seventh in the nation from 2013-2015 for drug overdose deaths, the majority being opioid related. From 2000-2015, Utah saw a 400% increase in deaths resulting from the misuse and abuse of prescription drugs. Utah sought to address this issue in three rural counties, including one that in 2014 had more than twice the state average and more than 2.4 times the national rate of opioid deaths per 100,000. The strategy used to address this public health crisis mobilized the Utah State Extension system and communities, to use the PROSPER (S2S) Framework and the 4-H Thriving Model. This approach utilized family- and school-based education programs that promote resiliency and developmental strengths for middle-school aged youth and their families.

Methods
The elements of the PROSPER delivery system include delivering the Botvin LifeSkills Training program to 6th grade students, enrolling the students in 4-H programming, and inviting them to participate with their parents in the Strengthening Families 10-14 program developed by Iowa State University.

While the PROSPER system was designed to be implemented in-person, the impacts of the COVID-19 pandemic necessitated several adaptations of the program in order to adhere to public health guidelines during the pandemic. Extension faculty and staff relied heavily on partnerships with local school districts to implement the classroom-based LifeSkills Training program since school district policies prevented volunteers from entering classrooms during the pandemic. The state PROSPER team worked with State University to implement virtual and socially distant in-person Strengthening Families 10-14 sessions. During the pandemic, over 300 youth and 37 families have received prevention programming through these adaptations.

The evaluation of the PROSPER LifeSkills Program follows a pre-post and cross-sectional hybrid design to assess short-term outcomes with respect to anti-drug knowledge, life skills, and anti-drug attitudes

Results
Preliminary evaluation results indicate that after completing the classroom-based LifeSkills Training program, students demonstrated positive anti-drug (M = 4.80, SD = 0.33), anti-smoking (M = 4.82, SD = 0.32), and anti-drinking (M = 4.78, SD = 0.37) attitudes. Students also expressed strong drug refusal skills (M = 4.00, SD = 1.67).

Conclusions
Despite the challenges of delivering programs to rural communities during the pandemic, preliminary evaluation of participant surveys shows significant drug refusal skills by program participants. Qualitative data from participants also shows increased relationship skills, which are crucial to healthy youth development. By adapting the PROSPER delivery system to meet the needs of rural communities battling the COVID-19 pandemic, Utah State University Extension has been able to continue serving high-risk communities and impacting the lives of local youth.

References: Centers for Disease Control and Prevention (CDC). (2016). Drug Overdose Death Data.
Retrieved from https://www.cdc.gov/drugoverdose/data/statedeaths.html

Substance Abuse and Mental Health Services Administration (SAMHSA). (2014). Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health. Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUHFRR1-
2014/NSDUH-FRR1-2014.pdf

Violence and Injury Prevention Program (2014). Prescription Drug Overdoses. Retrieved from
https://health.utah.gov/vipp/topics/prescription-drug-overdoses/