Intervention Summary
SPORT Prevention Plus Wellness
SPORT Prevention Plus Wellness, a motivational intervention designed for use by all adolescents, integrates substance abuse prevention with health promotion to help adolescents minimize and avoid substance use while increasing physical activity and other health-enhancing habits, including eating well and getting adequate sleep. SPORT is based on the Behavior-Image Model, which asserts that social and self-images are key motivators for the development of healthy behavior. The intervention promotes the benefits of an active lifestyle with positive images of youth as active and fit, and emphasizes that substance use is counterproductive in achieving positive image and behavior goals. Adolescents participating in SPORT complete a short, self-administered health behavior screen measuring physical activity and sport behaviors and norms, healthy nutrition, sleep, and alcohol use. During a one-on-one session with a fitness specialist--a teacher, coach, or other professional (e.g., fitness trainer, nurse)--participants receive a booklet and a personally tailored consultation that follows a written script. Participants complete a simple fitness prescription goal plan intended to encourage positive behavior and image change. In addition, flyers addressing key content of the intervention are provided to parents/caregivers for 4 consecutive weeks after the intervention.
The documents below were reviewed for Quality of Research. The research point of
contact can provide information regarding the studies reviewed and the availability
of additional materials, including those from more recent studies that may have been conducted. Werch, C., Moore, M. J., DiClemente, C. C., Bledsoe, R. & Jobli, E. A multi-health behavior intervention integrating physical activity and substance use prevention for adolescents. Prevention Science, 6(3), 213-226. Werch, C. The Behavior-Image Model: A paradigm for integrating prevention and health promotion in brief interventions. Health Education Research, 22(5), 677-690.
The following populations were identified in the studies reviewed for Quality of
Research.
External reviewers independently evaluate the Quality of Research for an intervention's
reported results using six criteria:
For more information about these criteria and the meaning of the ratings, see Quality of Research.
The YRBS is a widely used instrument with strong psychometric properties and has been used with diverse populations. To bolster treatment fidelity, the developers provided systematic training for project staff and a standardized research and data collection protocol. Attrition and missing data were low. Little information was provided on the psychometric properties of the Health and Fitness Screen or its appropriateness for use with diverse ethnic and gender groups; while not an outcome measure, this screening tool is a core component of the intervention. Given the known health disparities among ethnic groups and differential activity levels by gender, the lack of information provided about group differences at baseline or in the outcomes was a concern.
The materials below were reviewed for Readiness for Dissemination. The implementation
point of contact can provide information regarding implementation of the intervention
and the availability of additional, updated, or new materials. PreventionPLUSWellness. SPORT older adolescent booklet. Jacksonville, FL: Author. PreventionPLUSWellness. SPORT training of trainers (TOT) [binder]. Jacksonville, FL: Author. PreventionPLUSWellness. SPORT young adolescent booklet. Jacksonville, FL: Author. PreventionPLUSWellness. SPORT older adolescent program [binder]. Jacksonville, FL: Author. PreventionPLUSWellness. SPORT training of interventionists [binder]. Jacksonville, FL: Author. PreventionPLUSWellness. SPORT young adolescent program [binder]. Jacksonville, FL: Author.
External reviewers independently evaluate the intervention's Readiness for Dissemination
using three criteria: For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.
Materials are well organized, concise, and easy to follow with step-by-step instructions for implementers. Program materials are designed for implementation in a variety of settings (i.e., schools, communities, health centers, recreational centers) and include engaging handouts and other materials appropriate for younger and older adolescents. Program materials and additional resources can be found on the program Web site. Several levels of training are offered by the developer, and individual consultation is also available. For implementers interested in becoming certified, the developer offers trainings with a competency-based certification test. Fidelity is strengthened by implementation guidelines that are clear and succinct and include scripts for teachers and coaches. Feedback sheets for use after each coaching session, an outcome evaluation survey, and a follow-up phone call protocol for use when calling parents further support quality assurance. The program Web site is dense and challenging to navigate. No opportunities for peer support (e.g., through Web forums or other collaborative opportunities) are available for implementers. No written protocol for fidelity monitoring is provided.
The materials below were reviewed for Readiness for Dissemination. The implementation
point of contact can provide information regarding implementation of the intervention
and the availability of additional, updated, or new materials. Brief Programs for Health. SPORT high school version. Jacksonville, FL: Author. Brief Programs for Health. SPORT middle school version. Jacksonville, FL: Author. Youth Health Survey: Brief Version.
External reviewers independently evaluate the intervention's Readiness for Dissemination
using three criteria: For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.
Most of the implementation materials are straightforward and easy to use. Developers are available to provide guidance to interested implementation sites on program implementation and evaluation. An outcome measure and several tools for facilitating implementation fidelity are provided to support quality assurance. The fitness consultation scripts could be awkward if implemented without training, and additional guidance is needed for adapting these scripts for use with some audiences. Additional information for implementation planning and recruiting participants is needed. The program does not have a standardized training curriculum for implementer training. Additional guidance is needed for administering and using data derived from the outcome measure.
The cost information below was provided by the developer. Although this cost information
may have been updated by the developer since the time of review, it may not reflect
the current costs or availability of items (including newly developed or discontinued
items). The implementation point of contact can provide current information and
discuss implementation requirements. Descriptive Information
Areas of Interest
Substance use disorder prevention
Outcomes
1: Substance use
2: Substance use risk and protective factors
3: Physical activity
Outcome Categories
Alcohol
Drugs
Education
Family/relationships
Tobacco
Ages
13-17 (Adolescent)
Genders
Male
Female
Races/Ethnicities
Black or African American
White
Race/ethnicity unspecified
Settings
Home
School
Other community settings
Geographic Locations
Urban
Suburban
Rural and/or frontier
Implementation History
Since it was first implemented in SPORT has been used in 20 States as well as in Turkey. The intervention has been implemented in more than 300 sites and delivered to more than 2,500 youth. SPORT has been evaluated in five studies.
NIH Funding/CER Studies
Partially/fully funded by National Institutes of Health: Yes
Evaluated in comparative effectiveness research studies: Yes
Adaptations
Program materials have been translated into Turkish.
Adverse Effects
No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories
Universal
Documents Reviewed
Study 1
Supplementary Materials
Outcomes
Outcome 1: Substance use
Description of Measures
The following substance use outcomes were measured using the Youth Alcohol and Health Survey:
Outcomes were measured at baseline and at 3- and 12-month follow-up.
Key Findings
Findings were based on a comparison of outcomes of students randomly assigned to either the SPORT intervention or a minimal-contact control group that received a wellness brochure (provided in school) and a pamphlet about teen health and fitness (mailed to the home).
At 3-month follow-up, students who participated in SPORT reported lower frequency and quantity of alcohol use and less heavy use of alcohol in the past 30 days compared with the control group (p < .002). In addition, students who participated in SPORT reported having been drinking for shorter periods of time and had less intention to use alcohol in the future compared with students in the control group (p < .002). Students who participated in SPORT also reported less frequent cigarette use in the past 30 days compared with students in the control group (p = .01).
At 12-month follow-up, students who participated in SPORT reported shorter duration of alcohol use (p = .03) and less intention to use cigarettes in the future (p < .001) compared with students in the control group.
Drug-using students who participated in SPORT showed significant positive effects at 3-month follow-up compared with drug-using control students in alcohol consumption (frequency, quantity, heavy use), current drug use (cigarette smoking, marijuana use), and past drug use (cigarette smoking, marijuana use), p < .005 for all findings. Positive effects for past cigarette and marijuana use continued through 12-month follow-up (p < .003 for both findings).
Studies Measuring Outcome
Study 1
Study Designs
Experimental
Quality of Research Rating
3.0
(0.0-4.0 scale)
Outcome 2: Substance use risk and protective factors
Description of Measures
Substance use risk and protective factors were measured using the Youth Alcohol and Health Survey and the Youth Risk Behavior Survey (YRBS). Measures of risk factors associated with alcohol use included positive expectancy beliefs (perceived benefits of alcohol use), perceived prevalence of alcohol use by peers, influenceability by peers, subjective norms, environmental opportunities for alcohol use, and environmental availability of alcohol. Measures of protective factors associated with alcohol use included negative expectancy beliefs (perceived harm or "cons" of alcohol use), behavioral capability, self-efficacy, self-control, perceived susceptibility to alcohol use, parental monitoring, parent-child communication, parent-child communication about alcohol, value incompatibility, school bonding, and bonding with parents. Substance use risk and protective factors were measured at baseline and 3- and 12-month follow-up.
Key Findings
Findings were based on a comparison of outcomes of students randomly assigned to either the SPORT intervention or a minimal-contact control group that received a wellness brochure (provided in school) and a pamphlet about teen health and fitness (mailed to the home).
At 3-month follow-up, compared with students in the control group, students who participated in SPORT demonstrated greater protection from alcohol use on measures of negative expectancy beliefs, behavioral capability, perceived susceptibility to alcohol use, parental monitoring, and parent-child communication (p < .05 for all findings) and less risk on measures of intentions to use alcohol in the next 6 months, attitudes toward alcohol, perceived prevalence of alcohol use by peers, and influenceability toward alcohol use (p < .02 for all findings).
At 12-month follow-up, compared with students in the control group, students who participated in SPORT demonstrated greater protection from alcohol use on measures of parent-child communication (p = .006) and positive parent-child relationship (p = .05). However, SPORT participants showed less protection relative to control group students on measures of perceived susceptibility at 12-month follow-up (p = .03). On risk factors, students who participated in SPORT demonstrated lower risk for alcohol use than students in the control group on measures of intentions to use alcohol in the next 6 months (p = .05).
Studies Measuring Outcome
Study 1
Study Designs
Experimental
Quality of Research Rating
2.8
(0.0-4.0 scale)
Outcome 3: Physical activity
Description of Measures
Physical activity was measured using the YRBS, which assesses a student's engagement in moderate and vigorous physical activity. Physical activity was measured at baseline and 3- and 12-month follow-up.
Key Findings
Findings were based on a comparison of outcomes of students randomly assigned to either the SPORT intervention or a minimal-contact control group that received a wellness brochure (provided in school) and a pamphlet about teen health and fitness (mailed to the home).
At 3-month follow-up, students who participated in SPORT reported higher levels of moderate physical activity compared with students in the control group (p = .007). No overall effects were found for vigorous physical activity at 3- and 12-month follow-up.
Drug-using students who participated in SPORT showed no effects on exercise habits at 3-month follow-up. However, significant positive effects were found for exercise habits (moderate physical activity, vigorous physical activity) at 12 months relative to drug-using control students (p = .01 for both findings).
Studies Measuring Outcome
Study 1
Study Designs
Experimental
Quality of Research Rating
2.9
(0.0-4.0 scale)
Study Populations
Study
Age
Gender
Race/Ethnicity
Study 1
13-17 (Adolescent)
56% Female
44% Male
51% White
27.5% Race/ethnicity unspecified
21.5% Black or African American
Quality of Research Ratings by Criteria (0.0-4.0 scale)
Outcome
Reliability
of Measures
Validity
of Measures
Fidelity
Missing
Data/Attrition
Confounding
Variables
Data
Analysis
Overall
Rating
1: Substance use
2.8
3.0
3.0
3.0
3.0
3.0
3.0
2: Substance use risk and protective factors
2.5
2.5
3.0
3.0
3.0
3.0
2.8
3: Physical activity
2.5
2.8
3.0
3.0
3.0
3.0
2.9
Study Strengths
Study Weaknesses
Materials Reviewed
Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)
Implementation
Materials
Training and Support
Resources
Quality Assurance
Procedures
Overall
Rating
3.5
3.5
3.5
3.5
Dissemination Strengths
Dissemination Weaknesses
Materials Reviewed
Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)
Implementation
Materials
Training and Support
Resources
Quality Assurance
Procedures
Overall
Rating
2.3
1.8
2.3
2.1
Dissemination Strengths
Dissemination Weaknesses
Item Description
Cost
Required by Developer
Teacher's Manual (includes program implementation and evaluation materials for younger or older adolescents, reproducible program materials on a CD-ROM, recorded introductory webinar, and technical assistance)
$399 each
Yes
DVD Training Webinar
$149 each
No
Introductory webinar and technical assistance supported by phone or email
Included in cost of teacher's manual
No
Live four-hour online certified implementer or trainer workshop
$599 for 1-2 participants
No
On-site 1-day certified implementer or trainer workshop
$2,000 plus travel expenses for trainer
No
Site and area licenses to reproduce all program and training materials
Depends upon number of sites or area size
No
Quality assurance process and outcome evaluation instruments
Included in teacher's manual
No