Prevention Science[JOURNAL]
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200 papers
Introduction to the Special Issue on Structural Approaches to Youth Violence Prevention: Addressing Racism and Discrimination.
Mehari KR, Bradshaw CP
Prev Sci · 2026 Jul · PMID 42400722 · Publisher ↗
Youth violence is a significant public health concern, for which a number of preventive approaches have demonstrated promise in reducing the overall harm and associated effects. Yet relatively few of those approaches hav...
Youth violence is a significant public health concern, for which a number of preventive approaches have demonstrated promise in reducing the overall harm and associated effects. Yet relatively few of those approaches have explicitly addressed the role of structural racism and discrimination, which is a potential root cause of youth violence. This paper introduces a special issue of Prevention Science, "Structural Approaches to Youth Violence Prevention: Addressing Racism and Discrimination," which includes a collection of original papers from multiple disciplines that outline promising approaches for advancing prevention science in this important and timely direction. The overarching goal of the special issue is to provide insights related to youth violence prevention by directly addressing racism and discrimination at the structural level. The papers in this issue include systematic reviews, proposed approaches to policy and practice, intervention development and process, and evaluation research. After identifying common themes across the papers, we conclude with some future directions for research on structural interventions for youth violence prevention.
Tutorial: Using Random Forest Analysis to Identify Auxiliary Variables of Missing Data.
Coxe S, Baraldi AN, Hayes T
Prev Sci · 2026 Jul · PMID 42399576 · Publisher ↗
Missing data is a pervasive problem in research; prevention science is particularly vulnerable due to the study designs used and types of data collected. Recommended approaches to address missing data include full inform...
Missing data is a pervasive problem in research; prevention science is particularly vulnerable due to the study designs used and types of data collected. Recommended approaches to address missing data include full information maximum likelihood estimation and multiple imputation, both of which rely on identification of auxiliary variables related to missingness. The methodological literature recommends including as many potential auxiliary variables as possible, but in practice, that is often infeasible and a researcher must select a more limited number. Prior studies have shown that traditional methods for identifying auxiliary variables do not perform well when missingness follows a nonlinear functional form, but machine learning methods such as random forest analysis (RFA) perform well at successfully identifying correlates of missingness across a variety of missing at random patterns. RFA models can also provide measures of variable importance, allowing researchers to prioritize inclusion of the most relevant variables. Methods like RFA are less familiar to prevention researchers, which serves as an impediment for researchers to use RFA to identify auxiliary variables. This paper provides a tutorial to use RFA to identify correlates of missingness using a real data sample of = 215 participants with more than 100 variables measuring demographics, personality, and psychopathology. The tutorial demonstrates how to run an RFA (including using measures of variable importance to select the variables most related to missingness) and how to incorporate the selected auxiliary variables into an analysis.
A family-centered digital intervention for parents of at-risk middle-school students.
Connell AM, Quinn B, Chu PV … +3 more , Caruthers A, Mauricio AM, Stormshak E
Prev Sci · 2026 Jul · PMID 42384125 · Publisher ↗
This study examined the Family Check-Up Online (FCU-O), which combines app-based parenting support combined with telehealth coaching, to address parent and youth functioning in the wake of the COVID-19 pandemic. Research...
This study examined the Family Check-Up Online (FCU-O), which combines app-based parenting support combined with telehealth coaching, to address parent and youth functioning in the wake of the COVID-19 pandemic. Research since the pandemic has highlighted long-term consequences for parents and youth (including emotional and behavioral difficulties along with long-term learning loss), as well as limitations to available supports. The FCU-O was designed to increase access and reach of such supports in order to promote effective parenting and improvements in youth emotional and behavioral functioning. The current randomized trial examined parent and youth outcomes at baseline, 3-month, and 6-month follow-up assessments among families randomly assigned to the FCU-O (N = 142) or a no-treatment control condition (N = 139). Receipt of FCU-O was associated with significant improvements in parenting skills (greater proactive parenting, limit setting, and warmth, as well as reductions in negative parenting) and perceptions of parenting (including parenting confidence and reduced parenting stress), although the pattern of results was complex with several effects (perceived stress, limit setting, negative parenting, and parenting competence) only observed in post hoc analyses of within-group changes. Significant direct effects of the FCU-O on youth emotional or behavioral problems were not observed, although indirect effects of the FCU-O on youth conduct problems were observed at 6 months, via improvements in parents' sense of competence at 3 months. Results offer further support for the FCU-O as an accessible intervention for families facing ongoing challenges, including those associated with the COVID-19 pandemic.
Understanding Risk and Protective Factors of Intimate Partner Violence: A Public Health and Social Advocacy Approach.
Natarajan M, Irvin-Erickson Y, Suh B … +3 more , Nembhard S, Smith L, Lu YF
Prev Sci · 2026 Jul · PMID 42384124 · Publisher ↗
Intimate partner violence (IPV) is a recurring social problem that has individual, interpersonal, community, and societal level consequences necessitating interdisciplinary knowledge and a holistic, systemic approach for...
Intimate partner violence (IPV) is a recurring social problem that has individual, interpersonal, community, and societal level consequences necessitating interdisciplinary knowledge and a holistic, systemic approach for prevention. Recent research on IPV indicates the need to identify the implications of the COVID-19 pandemic for IPV risk and subsequent consequences to inform mitigation solutions. Using a mixed-methods design, this rapid assessment research aims to address an existing gap by gathering primary data on the perceived risk and protective factors in addressing IPV through interviews, focus group discussions (n = 102), and surveys (n = 324) from a purposive sample of victim service providers (VSPs) in all US states, Washington, D.C., and five major inhabited territories (Puerto Rico, Guam, US Virgin Islands, American Samoa, Northern Mariana Islands). The study findings indicate that existing risk factors have increased, alongside the emergence of new ones at the individual, interpersonal, community, and societal levels. We also identified 35 proactive protection measures that VSPs concocted during the COVID-19 pandemic to mitigate IPV in their communities. Integrating insights from public health and social advocacy theoretical models, this study provides survivor-centered, community-level solutions to prevent IPV in both public emergencies and non-emergency situations. This research highlights the importance of recognizing the convergence of IPV risk factors during the COVID-19 pandemic, as factors such as the political climate, natural disasters, and health crises-including pandemics-can exacerbate existing risk factors, thereby underscoring the need for prevention efforts more than ever.
Reframing Substance Misuse Prevention: a RE-AIM Analysis of Federal Infrastructure and Future Directions.
Minnick D, Curran L, Rigg KK
Prev Sci · 2026 Jun · PMID 42377849 · Publisher ↗
Substance misuse prevention is a significant component of public health policy in the USA. Currently, federal prevention efforts rely primarily on a coalition-based framework supported through four mechanisms: (1) the Su...
Substance misuse prevention is a significant component of public health policy in the USA. Currently, federal prevention efforts rely primarily on a coalition-based framework supported through four mechanisms: (1) the Substance Use Prevention, Treatment, and Recovery Block Grant, (2) the Drug-Free Communities Program, (3) the Partnerships for Success initiative, and (4) Community Anti-Drug Coalitions of America. Using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, this article critically analyzes the performance of this system and considers scalable alternatives. Findings indicate that while coalitions mobilize local stakeholders, the model is resource-intensive, inconsistently implemented, and limited in its capacity to achieve sustained, population-level impact. Proposed alternatives include integrating prevention science into professional education, mandating EBPP delivery in universal settings such as schools, embedding routine screening and early intervention, creating a national repository of free prevention programs, and expanding the use of digital applications and wearable technologies. Implications include restructuring federal funding priorities, embedding prevention within existing infrastructures, and advancing research on cost-effectiveness, sustainability, and equity.
Health Without Barriers: Community-Engaged Adaptation of a Whole Family-Inclusive Intensive Health Behavior and Lifestyle Program in Rural Colorado.
Moran MJ, Gutierrez-Colina A, Jimenez V … +13 more , German-Palacios E, Parrott L, Thompson TT, Sanchez N, Rzonca A, Owen J, Vargas E, Edwards C, Perzow SDE, Chan CL, Haemer MA, Clark N, Shomaker LB
Prev Sci · 2026 Jun · PMID 42360386 · Publisher ↗
Risk factors for type 2 diabetes (T2D) and cardiovascular diseases (CVD) are increasingly apparent in adolescence, and those in rural communities are disproportionately impacted. Intensive health behavior and lifestyle t...
Risk factors for type 2 diabetes (T2D) and cardiovascular diseases (CVD) are increasingly apparent in adolescence, and those in rural communities are disproportionately impacted. Intensive health behavior and lifestyle treatment (IHBLT) interventions have been shown to reduce risk factors for T2D and CVD; yet, for adolescents living in rural communities, these types of interventions are difficult to access and may be less effective due to unique barriers faced by rural adolescents. Tailoring IHBLT to the local rural context, particularly in ways that consider current and historical structural drivers of inequity, offers strong potential to address this need. Guided by the Practical, Robust Implementation and Sustainability Model with an equity focus, we co-created an adapted version of an IHBLT program, Health Without Barriers, for rural families with adolescents ages 11-19 years, emphasizing access for families living on a low-income, for adolescents whose caregivers prefer a language other than English (Spanish), and for adolescents with historically marginalized racial and ethnic identities. The aims of the current project were to (1) illustrate how participatory co-creation with community members can be systematically implemented-through an extensive initial information gathering phase coupled with iterative adaptation and additional information gathering-to make local and cultural adaptations to IHBLT, and (2) evaluate the feasibility and acceptability of those adaptations using multiple methods (self-report survey data, program attendance, and focus groups) among rural families with adolescents (n = 29 adolescents and n = 22 caregivers) who participated in the adapted IHBLT. Findings have implications for other research teams and practitioners looking to increase access and efficacy of IHBLT for the prevention and treatment of T2D and CVD in diverse and underserved rural populations.
Community Navigation: Iterative Development and Implementation of a Prenatal Psychosocial System of Care.
Milojevich HM, Best DL, Goodman WB … +2 more , Rehder PD, Dodge KA
Prev Sci · 2026 Jun · PMID 42350752 · Publisher ↗
We describe the iterative process of developing a universal psychosocial system of primary care across early life, called Community Navigation, and evaluate whether it can be implemented during the prenatal period with h...
We describe the iterative process of developing a universal psychosocial system of primary care across early life, called Community Navigation, and evaluate whether it can be implemented during the prenatal period with high engagement, identification of family needs, connections to community services, and family satisfaction. Community Navigation is a manualized program to improve child and family outcomes by engaging families during pregnancy, co-identifying their family-specific needs, and connecting them with community resources to address their needs. Continuous quality improvement efforts enhanced and refined the program leading to three iterative versions (Navigation 1.0, 2.0, and 2.1). Here, we report implementation metrics across all three versions. In each version, families were recruited during pregnancy and offered 1-3 visits with a trained Navigator. Findings from Versions 1.0 and 2.0 were used to improve the Navigation protocol, resulting in Navigation 2.1. Of the 194 Navigation 2.1 families who were eligible and offered the program, 81% completed the initial Navigation visit and 82% of those families completed at least one follow-up visit prior to birth (net total completion = 65% of the eligible population). Adherence to the protocol was 93%. Nearly all families (98%) reported at least one unmet need, with 75% reporting a major need requiring a community resource connection. Connection rates were high: 66% of families who received referrals were successfully connected to at least one community agency. Families reported high satisfaction with the program. Community Navigation holds promise as a novel system of universal primary psychosocial care for birthing families.
Improvements in Capacity Among Community Coalitions Receiving Technical Assistance Through the Coalition Check-Up.
Gaddy Y, Chilenski SM, Wells R … +1 more , Brown LD
Prev Sci · 2026 Jun · PMID 42337161 · Publisher ↗
Community coalitions are central to the prevention delivery system, yet their ability to implement and sustain effective strategies often depends on technical assistance (TA). TA typically strengthens coalition capacity,...
Community coalitions are central to the prevention delivery system, yet their ability to implement and sustain effective strategies often depends on technical assistance (TA). TA typically strengthens coalition capacity, but many coalitions lack connection to TA, and it is costly to sustain. Low intensity TA models that support coalition capacity exist but have not been rigorously evaluated. This study examines the Coalition Check-Up (CoCU) as a low intensity TA model to strengthen coalition capacity. Using up to 3 years of data, we tested whether capacities selected by coalitions during each CoCU implementation year improved over time. Thirty-two coalitions in Pennsylvania and Missouri received TA to review their summary report on data collected yearly over 3 years and a follow-up after year 3. Each year, coalitions used their report to prioritize a capacity for action planning following the CoCU TA model. Analyses examined data from multiple baselines (i.e., before action planning at year 1, year 2, and year 3) and subsequent data collection timepoints to test for longitudinal change on prioritized capacities. Coalitions receiving TA through the CoCU model demonstrated measurable improvements over time. Capacities prioritized in year 1 significantly improved across the following years measured (β = 0.13, 95% confidence interval (CI) [0.004, 0.26]; p = .04), as did capacities selected in the second year (β = 0.20, CI [0.02, 0.37]; p = .03) and the third year (β = 0.61, CI [0.16, 1.07]; p = .01). Findings suggest that a low intensity TA model like CoCU has the potential to guide coalitions toward strategic capacity development, ultimately enhancing their ability to deliver impactful prevention initiatives.
Building Impact Through Government Partnerships: the Naungan Kasih Positive Parenting Program in Malaysia.
Juhari R, Nadzri FZM, Madon Z … +12 more , Hasbullah M, Gardner F, Cooper H, Rajandiran D, Markle L, Ismail N, Facciola C, Stern D, Zuini ZM, Akir HFM, Blume S, Lachman JM
Prev Sci · 2026 Jun · PMID 42337160 · Publisher ↗
Naungan Kasih (NK) is a hybrid positive parenting program for parents and caregivers of preschool-aged children that blends digital, in-person, and remote support to strengthen parenting skills and promote children's hea...
Naungan Kasih (NK) is a hybrid positive parenting program for parents and caregivers of preschool-aged children that blends digital, in-person, and remote support to strengthen parenting skills and promote children's healthy development. This paper documents the development, evaluation, and scaling pathways in which academic institutions, Malaysian government agencies, and international organizations collaborated as a consortium to translate evidence-based parenting principles into a locally feasible, culturally responsive delivery model. NK progressed through a three-phase implementation journey. It began by strengthening and standardizing in-person parenting support in response to a government request, then shifted to digital delivery during COVID-19 through ParentText and ParentChat, and is currently focused on embedding hybrid NK within the government preschool platform to support scalable, sustainable delivery. The development process involved formative assessment, co-design, and pilot testing of the program. NK is being tested through a cluster-randomized controlled trial with effectiveness outcomes including caregiver parenting practices, mental health, and relationship quality, as well as child developmental and behavioral outcomes, alongside process measures of reach and engagement. The scaling pathway leverages evaluation outputs by building a train-the-trainer system, supervision and quality-assurance mechanisms, standardized monitoring for continuous improvement, a technology-transfer process, and modular materials that can be adapted across local contexts without diluting core components. The NK collaboration framework demonstrates how a multi-stakeholder partnership can produce an evidence-informed, implementation-ready intervention, while simultaneously establishing the operational infrastructure required for rigorous evaluation and scalable delivery within government agencies.
A University-Military Partnership to Establish a Quality Assurance and Training System to Sustain the FAIR System for Determining Incidents of Family Maltreatment in the US Army.
Drew AL, Slep AMS, Lapshina N … +5 more , Rhoades KA, Neglio B, Taylor CJ, Mitnick DM, Heyman RE
Prev Sci · 2026 Jun · PMID 42287582 · Publisher ↗
Congress mandates that each military service maintain a central registry to monitor the frequency of maltreatment incidents by service and installation across time. For over two decades, the Family Translational Research...
Congress mandates that each military service maintain a central registry to monitor the frequency of maltreatment incidents by service and installation across time. For over two decades, the Family Translational Research Group (FTRG; Co-directors: Amy Slep and Richard Heyman) at New York University has partnered with military Family Advocacy Programs (FAPs) to ensure that partner and child maltreatment determinations are fair and consistent. This collaboration resulted in the Field-Tested Assessment, Intervention-Planning, and Response (FAIR) system-an evidence-based practice mandated across all services for determining whether alleged incidents of partner and child abuse or neglect meet criteria as maltreatment. The US Army was the first service to require annual quality assurance (QA) to support FAIR sustainment. This paper will describe (a) FAIR and the evidence supporting its use, (b) the university-military partnership that supported FAIR dissemination in the US Army, and (c) the university-military partnership that established a QA and training system for FAIR sustainment in the US Army. In addition, the manuscript will provide empirical evidence demonstrating that FAIR implementation fidelity and the accuracy of determinations have improved across the first 2 years of QA. Challenges have included perceptions from local committees that FAIR QA is university-driven rather than FAP-owned, maintaining consistent standards, and adapting to policy changes. Collaborative decision-making, a focus on impact, and decades of immersion in military culture have supported this long-term university-government partnership.
Implementing Temporary Financial Assistance for Homelessness Prevention: a CFIR-Guided Study of Provider Perspectives.
Mercado M, Chavez ME, Nolan C … +11 more , Law L, Shuman S, Noll L, Ferguson K, McEntarffer H, Livingston R, Ellis S, Helmes J, Drobnyh K, King K, Wickham R
Prev Sci · 2026 Jun · PMID 42258066 · Publisher ↗
Housing insecurity is a growing public health concern with significant implications for efforts to prevent homelessness. Temporary financial assistance (TFA) is an upstream intervention designed to prevent homelessness b...
Housing insecurity is a growing public health concern with significant implications for efforts to prevent homelessness. Temporary financial assistance (TFA) is an upstream intervention designed to prevent homelessness by addressing urgent housing needs through flexible, short-term financial support. Guided by the Consolidated Framework for Implementation Research (CFIR), this study examined providers' perspectives on implementing TFA across nine Arizona organizations and explored how these determinants may inform the selection and measurement of implementation outcomes. Thirty-six participants participated in interviews or focus groups to share their experiences implementing TFA. Using deductive thematic analysis, findings highlight key internal and external barriers such as complex eligibility criteria, administrative burdens, and limited affordable housing that may have affected the adoption, implementation, and sustainment of TFA delivery. Facilitators included provider training, cross-sector partnerships, and strong vendor relationships that improved adoption and integration of TFA across service settings. Providers used a range of implementation strategies, including reimbursement systems, promise-to-pay arrangements, and tiered intake processes, to overcome systemic barriers and promote recipients' housing stability. Although funding constraints and contextual challenges limited sustainment, providers demonstrated a strong commitment to adapting implementation approaches to meet recipient needs. This study contributes to the growing evidence based on the practical application of implementation science in homelessness prevention, offering insights into how determinants of implementation can strengthen intervention delivery in diverse settings. Findings inform policy, research, and practice aimed at optimizing implementation outcomes for homelessness prevention interventions.
Cost Analysis of BEST in CLASS-Elementary: Average Cost per Teacher-Student Dyad and Marginal Cost per Additional Student.
Sutherland KS, Conroy MA, Blandin A … +2 more , Granger KL, Li I
Prev Sci · 2026 Jun · PMID 42247098 · Publisher ↗
This study used the Ingredients Cost Method (Levin & McEwan, 2001) to calculate the average cost of implementing BEST in CLASS-Elementary, a Tier 2 program that trains and coaches teachers to provide support to focal stu...
This study used the Ingredients Cost Method (Levin & McEwan, 2001) to calculate the average cost of implementing BEST in CLASS-Elementary, a Tier 2 program that trains and coaches teachers to provide support to focal students who have unwanted problem behavior. Data were used from kindergarten to third-grade classrooms in a multisite randomized controlled trial. We describe the average cost of implementing BEST in CLASS-Elementary per teacher-student dyad as well as the marginal cost of adding up to two additional students in classrooms receiving the training and coaching. Data from 136 teacher student dyads (N = 63 teachers) were used in the current study. The average cost to implement the program, including teacher recruitment costs, was $2,866 per teacher-student dyad in a classroom, and the marginal cost of adding an additional focal student per treated classroom was $101. The actual intervention accounted for less than half of the total costs and coaches accounted for the highest investment (almost half of the total costs). Limitations of the current study as well as implications for future research in this area are discussed.
Advantages in Bayesian Approaches to Confirmatory Factor Analysis.
Alvarez-Bartolo D, Cheng CH, Levy R … +2 more , Berkel C, Gewirtz AH
Prev Sci · 2026 Jun · PMID 42240741 · Publisher ↗
To conduct rigorous evaluations of preventive interventions, it is foundational to establish the psychometric or measurement quality of the measures. Confirmatory factor analysis (CFA) is a popular method of modeling and...
To conduct rigorous evaluations of preventive interventions, it is foundational to establish the psychometric or measurement quality of the measures. Confirmatory factor analysis (CFA) is a popular method of modeling and evaluating measurement quality. Such analyses are typically conducted within a frequentist framework, which can pose challenges in an applied research setting due to the strong conditions required to establish measurement quality (e.g., sufficient sample size, exact measurement invariance (MI), and high sensitivity to group differences). An alternative set of approaches involves Bayesian methods, which offer several advantages. However, they remain underutilized by prevention scientists. The main goal of this paper is to illustrate several of the advantages that Bayesian methods offer in the context of analyses of data from the Alabama Parenting Questionnaire (APQ) through five examples. We illustrate the advantages of Bayesian methods over maximum likelihood in terms of result interpretation, and highlight how Bayesian methods allow us to express uncertainty in ways we always intended, avoiding misconceptions associated with frequentist approaches (Example 1). We also show how Bayesian methods help to avoid estimation problems (Example 2), examine parameter MI in both conventional and more flexible ways (Examples 3 and 4), and incorporate substantive prior information into our analysis (Example 5). By highlighting these advantages, we aim to motivate prevention researchers to consider using Bayesian methods for CFA and other analyses.
Characterizing Alcohol and Cannabis Co-use and Related Harms Among Transgender and Gender Diverse Youth.
Penta SM, Uhrig A, Wardell JD … +2 more , Hart TA, Dermody SS
Prev Sci · 2026 May · PMID 42217131 · Publisher ↗
Transgender and gender diverse (TGD) youth are at increased risk of co-using alcohol and cannabis and experiencing related harms due to gender minority stress (GMS). This study aimed to characterize alcohol and cannabis...
Transgender and gender diverse (TGD) youth are at increased risk of co-using alcohol and cannabis and experiencing related harms due to gender minority stress (GMS). This study aimed to characterize alcohol and cannabis co-use and related harms among TGD youth. Forty Canadian TGD youth who drink completed a 21-day ecological momentary assessment (EMA) period where they reported their substance use, corresponding harms, and GMS and resilience experienced each day. Participants reported 180 alcohol-only days, 104 cannabis-only days, and 41 co-use days during the EMA period. The number of alcoholic drinks consumed did not differ between co-use days and alcohol-only days, but the number of substance-related harms was greater on co-use days relative to alcohol-only days. On days when youth reported relatively greater GMS, they were more likely to engage in co-use than alcohol-only use. On days when youth reported relatively greater resilience (i.e., pride, community connectedness), they were more likely to co-use than cannabis-only use. Co-use should be considered when developing substance use policy and treatments for TGD youth.
The Role of Program Implementation Quality in Family-Focused Substance-Use Prevention for Youth with Multiple Risks: PROSPER Project.
Hur YS, Chilenski SM, O'Neill PR … +4 more , Jones DE, Spoth RL, Feinberg ME, Crowley DM
Prev Sci · 2026 May · PMID 42176175 · Publisher ↗
Programming to prevent behavioral problems can effectively build youth skills and enhance bonding to parents and prosocial peers to delay substance use for adolescents, an important challenge for adolescents given the li...
Programming to prevent behavioral problems can effectively build youth skills and enhance bonding to parents and prosocial peers to delay substance use for adolescents, an important challenge for adolescents given the links between early adolescent experimentation and the chance of developing problems related to substance use as an adult. For youth at higher risk, the effective delivery of such programs could be particularly critical. This study examined the impact of implementation outcomes of family-focused evidence-based prevention programming in sixth grade on substance use in ninth grade based on youths' initial levels of risk. Three implementation outcomes were assessed: (1) adherence, (2) facilitation quality, and (3) participant responsiveness. Using multi-level analysis of data from two cohorts across 14 school districts, we examined whether community-level implementation quality moderated the relationship between individual-level baseline risk and later substance use. Results showed higher implementation quality, particularly facilitation quality and participant responsiveness, was significantly associated with lower substance use among high-risk youth. Notably, high implementation quality was significantly associated with lower substance initiation index scores for high-risk students (p < 0.05). Similar results were also found for the initiation of marijuana and cigarette use, as well as for alcohol consumption in the past month.
Using Machine Learning Methodology to Identify Predictors of Non-Response to MTSS-B: a Focus on Discipline Problems and Juvenile Justice Involvement.
Somerville K, Ünlü A, Henneberger AK … +3 more , Rose BA, Pas ET, Bradshaw CP
Prev Sci · 2026 May · PMID 42168693 · Publisher ↗
Multi-tiered systems of support for behavior (MTSS-B) is a widely-used tiered preventive intervention currently used in over 25,000 schools across the USA. This study leveraged data from 16,907 elementary students across...
Multi-tiered systems of support for behavior (MTSS-B) is a widely-used tiered preventive intervention currently used in over 25,000 schools across the USA. This study leveraged data from 16,907 elementary students across 42 schools that participated in a prior randomized controlled trial (RCT) of MTSS-B, where schools were randomly assigned to implement Tier 1 + 2 (intervention) supports or Tier 1 only (comparison). The RCT data, collected between 2008 and 2012, were linked to administrative records of behavior in grades 6-12 collected between 2008 and 2024. We used machine learning methods to identify elementary school predictors of three long-term outcomes (i.e., in-school suspension (ISS), out-of-school suspension (OSS), and arrest) signifying Tier 1 non-response. For ISS, the strongest predictors were family involvement, being female, and internalizing problems, which serve as protective factors. For OSS, they were family involvement, internalizing problems, and academic performance, all of which were protective. For arrest, key predictors included family problems, where lower problems were protective against arrest, and prosocial behavior and family involvement, which were both protective. The top predictors were similar for students in the Tier 1 + 2 and Tier 1 only conditions. These findings can inform early screening for possible non-response to MTSS-B and highlight the need for family engagement practices.
Assessment of Test Strips for Detection of Fentanyl in Powders.
Armstrong JL, Wharton RE
Prev Sci · 2026 May · PMID 42168692 · Publisher ↗
Testing drug powders before consumption is a harm reduction measure that could help prevent accidental overdoses. Fentanyl test strips (FTS) are used to test for fentanyl in powders, but comprehensive, comparative data a...
Testing drug powders before consumption is a harm reduction measure that could help prevent accidental overdoses. Fentanyl test strips (FTS) are used to test for fentanyl in powders, but comprehensive, comparative data assessing commercial test strips' performance is currently unavailable. To address this gap, we analyzed drug powders using FTS from three different vendors using the manufacturer's recommended testing procedures. Each FTS was assessed for sensitivity to fentanyl, cross-reactivity with fentanyl analogs, and selectivity by testing other relevant compounds. None of the FTS was as sensitive as claimed by the manufacturer nor could they detect all fentanyl analogs tested, which were selected based on their recent prevalence. The drugs responsible for the most false positives were stimulants, hallucinogens, synthetic opioids, and the cutting agent, diphenhydramine. Overall, testing of DanceSafe FTS resulted in the highest sensitivity for fentanyl, the highest selectivity when tested with other substances (fewest false positives), and moderate cross-reactivity with analogs. Testing of BTNX FTS resulted in the highest cross-reactivity with fentanyl analogs and moderate sensitivity for fentanyl. These results provide valuable information when selecting FTS for harm reduction as well as understanding the implications of each test's results. While no FTS tested performed as marketed, they still remain valuable as drug checking or screening tools to prevent drug overdose deaths.
Long-Term Efficacy of a Web-Based Sexual Health Promotion Program Using a Media Literacy Education Approach in a National Sample of Community College Students.
Scull TM, Dodson CV, Kupersmidt JB … +3 more , Evans-Paulson R, Stump KN, Reeder LC
Prev Sci · 2026 May · PMID 42159988 · Publisher ↗
Young adults attending community college are an underserved population that is at high risk for STIs and unplanned pregnancy. A recent evaluation of a web-based, sexual health program, Media Aware, that uses a media lite...
Young adults attending community college are an underserved population that is at high risk for STIs and unplanned pregnancy. A recent evaluation of a web-based, sexual health program, Media Aware, that uses a media literacy education approach, revealed positive short-term effects after 1 month on the sexual health cognitions and behaviors of community college students (ages 18-19) including a reduction in risky sexual behaviors. The purpose of the current study is to replicate and extend the findings reported in this earlier evaluation to a larger sample of community college students from across the USA in a longer-term study examining 12-month follow-up data. In a cluster randomized controlled trial, students from 23 community college campuses (N = 1139) either received the intervention (i.e., Media Aware) or were assigned to the Wait-list Control group, and the two groups were compared on their media literacy cognitions and sexual health cognitions and behaviors. Using an intent-to-treat design, results indicate that after 12 months, students who received Media Aware held healthier normative beliefs about risky sex and reported media messages to be less realistic, compared to students in the control group. There were no differences across groups in sexual health behaviors. Moderation analyses by gender and pretest scores were conducted. Findings show the efficacy of Media Aware for bringing about long-term changes in media and health cognitions. The findings also underscore the need for multi-level interventions that reduce community- and system-level barriers to engaging in sexual health behaviors. TRN: NCT04950686; Date of registration: 5/03/2021.
The Effectiveness of the Parent Support Program: a Randomized Controlled Trial of an Online Intervention to Increase Parental Support Among Parents and Caregivers of Trans and Nonbinary Youth.
Matsuno E, Miller ML, Wong GTF … +4 more , Shultz D, Rudo-Stern J, Colson AE, Berkel C
Prev Sci · 2026 May · PMID 42159987 · Publisher ↗
The increasingly hostile sociopolitical climate is heightening psychological distress among trans and nonbinary (TNB) youth, who already face elevated risks for depression, anxiety, suicidal ideation, and substance use....
The increasingly hostile sociopolitical climate is heightening psychological distress among trans and nonbinary (TNB) youth, who already face elevated risks for depression, anxiety, suicidal ideation, and substance use. Parental support is a key protective factor for TNB youth to prevent these negative mental health outcomes. Yet, there are minimal existing evidence-based interventions that aim to increase parental support among parents and caregivers (PCs) of TNB youth. The Parent Support Program (PSP) is a theory-driven, asynchronous, online intervention that was developed and refined based on community and expert feedback. This study used a randomized controlled trial (RCT) with 619 PCs of TNB youth to test the effectiveness of the PSP. We applied linear regression models with multiple imputation adjustments and propensity weights to estimate the effects of being assigned to the intervention condition (intent to treat effects) and global dosage of the PSP (total number of activities completed). Results from our intent to treat (ITT) analyses found that the PSP was effective at increasing self-compassion and PCs' self-rated level of knowledge about gender diversity. However, global dosage predicted self-rated knowledge and the use of affirming language, but not self-compassion. The PSP is a promising intervention that may be a useful resource for some PCs of TNB youth. We address limitations of the PSP and future directions of how the PSP could be further refined and tested to optimize the intervention's effectiveness and implementation, as well as clinical implications.
Translating Science into Practice Using University-State Government Partnerships: The EPIS Model.
Welsh JA, Gayles JG, Chilenski SM … +3 more , Spaw R, Pennington M, Greenberg MT
Prev Sci · 2026 May · PMID 42142217 · Publisher ↗
For more than two decades, the Edna Bennett Pierce Prevention Research Center (PRC) at Penn State University has partnered with state governmental agencies in Pennsylvania to promote the adoption and successful implement...
For more than two decades, the Edna Bennett Pierce Prevention Research Center (PRC) at Penn State University has partnered with state governmental agencies in Pennsylvania to promote the adoption and successful implementation of evidence based prevention programs by schools and community organizations. This translational arm of the PRC, known as EPIS (Evidence based Prevention and Intervention Support) provides implementation and evaluation support to prevention stakeholders throughout Pennsylvania. The EPIS collaboration involves prevention scientists and implementation specialists from the PRC, as well as agency personnel from multiple Pennsylvania state agencies. This partnership began by supporting the implementation of 10 evidence based interventions (EBIs) from the Blueprints for Violence Prevention program registry and has evolved in response to state partners' requests that EPIS provide support broadly and equitably across Pennsylvania. Here we present the current EPIS tiered model of implementation support. This approach begins with light touch support designed for a broad reach to the prevention and intervention workforce and becomes increasingly intensive at higher tiers. Data show widespread reach of TA activities across Pennsylvania's prevention workforce, including over 1,200 online learners from diverse sectors, thousands of group training attendees, and tens of thousands of youths served through EBI delivery. Metrics indicate sustained growth in engagement, high participant satisfaction, improvements in program fidelity and participant program completion rates, and improvements in youth behavioral outcomes over more than a decade of partnership activity. Challenges identified and lessons learned are discussed, leading to five best practice recommendations to continue building prevention infrastructure.
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