1. Evidenced Based Programs

2. Agenda  Review of Programs in Missouri  How to Select Programs of Your Own

3. Rigorously Defining EBP  Evaluation research shows that the program produces the expected positive results;  The results can be attributed to the program itself, rather than to other extraneous factors or events;  The evaluation is peer-reviewed by experts in the field; AND  The program is “endorsed” by a federal agency or respected research organization and included in their list of effective programs.

4. Practically Defining EBP  Included on Federal Lists or Registries of evidence based interventions (as an effective program); OR  Reported (with positive effects) in peer- reviewed journals / government publications; OR  Convincing scientific research proving the intervention’s effectiveness.

5. WHAT IS GOING ON IN MISSOURI?

6. Programs Used in Missouri  Regional Support Centers were asked which programs they used  12 total responses, 59 programs

7. Statewide Programs  Mental Health First Aid  QPR (Question, Persuade, and Refer)

8. Programs Used in Missouri (>33%) Evidenced Based Program (EBP) Currently Implementing Implemented in the Past but not Now Life Skills Training33%42% All Stars 33%42% Strengthening Families Program (SFP)33%25% Project Alert17%42% HALO33%8% Signs of Suicide (SOS)33%0% Peace Builders17%8% Too Good For Drugs and Violence17% Guiding Good Choices8%42% Project Towards No Drug Abuse8%25%

9.  Love and Logic  Olweus  BASICS (Brief Alcohol Screening and Intervention of College Students)  Lifelines  Project Northland  Above the influence Programs Used in Missouri (<33%)

10.  Al’s Pals  Building Strong Families  Families and Schools Together (FAST)  SMART Moves (Skills Mastery and Resistance Training)  Wyman’s Teen Outreach Program (TOP)  Protecting You / Protecting Me Programs Used in Missouri (<33%)

11.  ABC’s of Secondhand Smoke  Alcohol: True Stories  Ask Listen Refer  Aggressors, Victims, and Bystanders (AVB)  Big Brothers, Big Sisters Mentoring Program  Communities Mobilizing for Change on Alcohol Programs Used in Missouri (1 RSC)

12.  Choose Respect  How to Cope (youth & adult versions)  Creating Lasting Family Connections (CLFC)  Curriculum-Based Support Group (CBSG)  Good Behavior Game (GBG)  Not On Tobacco  Parents and the Law Programs Used in Missouri (1 RSC)

13.  Parents as Teachers  Positive Action  Project Toward No Tobacco Use  Second Step  Short, Brief Intervention and Referral to Treatment (SBIRT)  SmokeBusters Programs Used in Missouri (1 RSC)

14.  Too Smart to Start  SISTA  The Seven Challenges  Why Try Programs Used in Missouri (1 RSC)

15. LOOKING AT A FEW EBPs Note: This is a very brief overview of each program designed to illustrate some things to consider. It is not intended to fully describe the program. If you are considering choosing an EBP, please fully review all literature.

16. Mental Health First Aid - Design  What is it supposed to do?  Potential to reduce stigma, improve mental health literacy, and empower individuals  Who is the target audience?  Friends and family of individuals with mental illness or addiction, key professionals (such as police officers, human resource directors and primary care workers), school and college leadership, faith communities, or anyone interested in learning more about mental illness and addiction

17. Mental Health First Aid - Evidence  Research showing:  Improved mental health in those who attend the training  Decreases in stigmatising attitudes  Increases in the amount and type of support provided to others  Publication in peer reviewed journals

18. QPR - Design  What is it supposed to do?  Teach "gatekeepers” the warning signs of a suicide crisis and how to respond by following three steps  Who is the target audience?  Parents, friends, neighbors, teachers, coaches, caseworkers, police officers, etc.

19. QPR - Evidence  Research showing:  Increases in declarative and perceived knowledge about suicide; maintained at the 3- month follow-up  Higher gatekeeper self-efficacy score  Higher knowledge of suicide prevention resources  Publication in peer reviewed journals

20. Life Skills - Design  What is it supposed to do?  Prevent alcohol, tobacco, and marijuana use and violence  Who is the target audience?  Separate programs offered for elementary, middle, and high school; the research studies and outcomes reviewed involved middle school students

21. Life Skills - Evidence  Research showing:  Significant decrease in cigarette smoking, alcohol use (drunkenness), and polydrug use  Lower normative expectations than control students for peer smoking and drinking  Significant reductions in violence and delinquency at 3-month follow-up  Publication in peer reviewed journals

22. All Stars - Design  What is it supposed to do?  Prevent and delay the onset of high-risk behaviors such as drug use, violence, and premature sexual activity  Who is the target audience?  Middle school students (11-14 years old)

23. All Stars - Evidence  Research showing:  Average scores for personal commitment increased from pre- to posttest  Average scores for lifestyle incongruence increased from pre- to posttest  Average scores for school bonding increased from pre- to posttest  Publication in peer reviewed journals

24. Strengthening Families - Design  What is it supposed to do?  Designed to increase resilience and reduce risk factors for behavioral, emotional, academic, and social problems in children 3-16 years old  Who is the target audience?  Parents & Children

25. Strengthening Families - Evidence  Research showing:  Children who received SFP had lower scores on conduct disorder symptoms, oppositional defiance symptoms, and behavior problems than children in the control group.  Improvements in positive parenting, parental involvement, parenting skills, parental supervision, and parenting efficacy  Publication in peer reviewed journals

26. NREPP DEMONSTRATION Picking Your Own Programs

27. NREPP  SAMHSA’s tool  Good place to look for Behavioral Health  Not the only list out there!

28. http://www.nrepp.samhsa.gov/

42. NREPP Limitations  From NREPP’s website  “NREPP ratings do not reflect an intervention's effectiveness. Users should carefully read the Key Findings sections in the intervention summary to understand the research results for each outcome.”  “Use of NREPP as an exhaustive list of interventions is not appropriate, since NREPP has not reviewed all interventions.”

43. Not on NREPP!? Next Steps  Do a web search  Check for Program Website  Do they claim EBP? How?  Do they have positive evaluation results?  May pop up on another list (CDC, Dept of Ed, etc)  Google Scholar for Peer Reviewed Journals  Call Program Developer  Pilot test it yourself (Service to Science)

44. One Size does NOT Fit All  Targeted towards a particular problem  Targeted towards a particular population  (A cheesy comparison)

45. Start Small (if you can)  Get 1 copy of all materials to review  Pilot test with 1-2 groups

46. Fidelity  Programs are EBP based on implementing them as designed  The more modifications made, the less EBP they are  Possibly still effective but no proof  Care should be taken when calling it EBP

47. Contact Information Susan Depue, Ph.D. Research Assistant Professor Missouri Institute of Mental Health University of Missouri - St. Louis 5400 Arsenal St., St. Louis, MO 63139-1403 PHONE: (314) 877-5942 E-MAIL: susan.depue@mimh.edususan.depue@mimh.edu