Helping communities 'PROSPER': A Q&A with prevention researcher Janet Welsh

UNIVERSITY PARK, Pa. — Janet Welsh, associate research professor of health and human development and senior research associate with the Edna Bennett Pierce Prevention Research Center, has worked in prevention research since 1994, with the aim of improving the lives of people and communities impacted by substance abuse and addiction.

LEARN MORE about Welsh’s critical work to reduce teen substance abuse.

As a key member of Penn State’s interdisciplinary PROSPER program — which stands for “PROmoting School-community-university Partnerships to Enhance Resilience” — Welsh has played an important role in bringing data-driven, evidence-based prevention programming to communities across Pennsylvania.

Penn State News recently sat down with Welsh to learn more about how PROSPER is impacting the lives of everyday Pennsylvanians.

Q: Can you provide a high-level overview of the PROSPER program?

PROSPER is a system for delivering evidence-based prevention education, specifically to middle school children and their families, using collaboration among schools, community partners, and Penn State.

At the Penn State level, it’s a collaboration between prevention scientists, like me, and people in the Penn State Extension system who work in communities. At the community level, PROSPER involves an Extension educator who serves as the local coordinator for the PROSPER team, which is a collation made up of community members from different groups like the school, mental health organizations, the county drug and alcohol office, and parents. And that group, led by the Extension educator, is responsible for the oversight of these educational programs.

So PROSPER isn’t a ‘program,’ per se; it’s more a delivery system for programs.

Q: What kind of programs have you found to be most effective?

We target middle school because that’s the age where it’s getting close to when kids are going to start experimenting with substances. It’s not too far down the road, where they already have a problem and a universal educational program is no longer going to help. We want to reach them right on the edge of that risk period.

The first program we ask communities to do is a family-based, extra-curricular program outside of school for both parents and youth. Getting the parents involved is critical. I actually did it myself with all three of my own children. In the parent program, you show up, you have dinner together, and the children do their own activities while they teach us parents things like how to set limits in a sensible way, how to communicate with your child, how to pay attention to what your kid is doing and who they’re with—all parenting skills that improve protective factors for kids. Then you come together at the end and you do activities together to practice what you’ve learned.

That’s a very powerful program, but it only hits a small percentage of the eligible population. In PROSPER, we were able to reach about 20 percent of the eligible families, which we were able to achieve with a lot of hard work. But then, the second program that kids receive in seventh grade is a school-based program that is taught as part of the curriculum. This one is specifically for the kids, and it’s a more ‘light touch’ kind of program, but it reaches everybody. If you went to school, you got that program, so virtually every kid in the community benefits from it.

So when we put those two programs together, what we found is that in the communities where PROSPER was done the kids were, as a group, even if they were in the 80 percent that didn’t come to the parent program, less likely to be binge drinking and using illicit substances. Not only did we see reduction in substance abuse, but we saw reductions in delinquent behavior. Kids were less likely to be out vandalizing or stealing things.

We found that kids were reporting that they were about 15 percent less likely to be misusing prescription opioids by the end of high school and their late teens if they’d had PROSPER when they were in middle school.

That speaks to the durability of these impacts. They went on through high school without any further programming from us. The durability of those interventions done universally in middle school was our big news. The fact is, when you look at the opioid problem in its totality, the big thing communities are struggling with is the lack of treatment options and the cost of treatment, which is expensive. The school-based prevention program, on the other hand, costs only about $1,000 to get up and running. It costs $5 per kid to buy the program workbooks. Think about that versus how much it costs to spend one day in residential treatment for substance abuse disorder. We encourage people to think about it as an investment in the community.

Q: Can you talk more about some of the findings from the PROSPER program?

We have over 100 published papers on PROSPER. We stress the fact that PROSPER is a universal program, but many people want to know if it works for kids or families who are already at risk, and we’ve been able to look at that. It does help them, those high-risk families. It’s not enough; they need more than just universal programs, but they definitely benefit from PROSPER.

We also conducted a peer network study, which examined the ways in which PROSPER influences kids’ peer networks. If you were in a PROSPER community and you were a popular kid, you’re less likely to display deviant norms and attitudes. And because popular kids influence other kids, it’s creating a norm around nondeviant behavior. In the non-PROSPER communities, it was more likely that it was the kids with deviant norms who were influencing other kids.

We also did a gene study. We did a subsample of data collection where we asked people if they would share their DNA. And we found an interaction effect between genes and the PROSPER intervention, which was that if you have a gene associated with alcoholism and you had PROSPER, you were much less likely to be binge drinking. There was similar analysis done for other genes, liked those linked to aggressive behavior.

These results basically say that biology is not destiny, that even if you have these genes that would put you at risk, these educational interventions can be very helpful.

Q: Where in Pennsylvania has PROSPER been implemented?

The way we ended up with the communities in the initial research was that, number one, we had to have schools and Extension educators who were willing and able. We also had some research parameters. Schools had to be matched according to size and demographic characteristics, and we did this study in conjunction with Iowa State University, so we had to match to Iowa communities as well.

Once we got past the research, it was 'whoever wants to do this can do this.' It tended to be, if we did this in one school district, then the community next to them would want to do it, too. So that’s how it’s grown. We have a whole bunch in the northeast, in Carbon, Monroe, Pike, Wayne, Luzerne and Lackawanna counties. We have one in Mifflin County, one in Northumberland County, one in Lehigh County, and we have four in Fayette County and one in Westmoreland County in the southwest region.

We have over 20 school districts in Pennsylvania that are currently active. Over the years, including the ones who are not doing it anymore, like some who lost their funding, I would estimate this has been implemented in about 35 school districts.

Q: Why are you, personally, interested in this kind of community-based work?

I just love it. I really like to see the real-world applications. I’m not very interested in academics for academics’ sake. I want to see how we can use what we have at the University to really help solve social problems, and being able to work with real communities, kids and families has always been important to me.