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Intervention Summary

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SPORT

SPORT, 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.

Descriptive Information

Areas of Interest Substance abuse prevention
Outcomes Review Date: November 2008
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 2002, 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

Quality of Research
Review Date: November 2008

Documents Reviewed

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.

Study 1

Werch, C., Moore, M. J., DiClemente, C. C., Bledsoe, R. & Jobli, E. (2005). A multi-health behavior intervention integrating physical activity and substance use prevention for adolescents. Prevention Science, 6(3), 213-226.  Pub Med icon

Supplementary Materials

Werch, C. (2007). The Behavior-Image Model: A paradigm for integrating prevention and health promotion in brief interventions. Health Education Research, 22(5), 677-690.  Pub Med icon

Outcomes

Outcome 1: Substance use
Description of Measures The following substance use outcomes were measured using the Youth Alcohol and Health Survey:

  • Frequency and quantity of use in the past 30 days
  • Heavy use in the past 30 days
  • Initiation of use (how long the respondent has used the substance)
  • Stage of initiation (intention to use the substance in the future)
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

The following populations were identified in the studies reviewed for Quality of Research.

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)

External reviewers independently evaluate the Quality of Research for an intervention's reported results using six criteria:

  1. Reliability of measures
  2. Validity of measures
  3. Intervention fidelity
  4. Missing data and attrition
  5. Potential confounding variables
  6. Appropriateness of analysis

For more information about these criteria and the meaning of the ratings, see Quality of Research.

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

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.

Study Weaknesses

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.

Readiness for Dissemination
Review Date: September 2013

Materials Reviewed

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. (2013). SPORT older adolescent booklet. Jacksonville, FL: Author.

PreventionPLUSWellness. (2013). SPORT training of trainers (TOT) [binder]. Jacksonville, FL: Author.

PreventionPLUSWellness. (2013). SPORT young adolescent booklet. Jacksonville, FL: Author.

PreventionPLUSWellness. (n.d.). SPORT older adolescent program [binder]. Jacksonville, FL: Author.

PreventionPLUSWellness. (n.d.). SPORT training of interventionists [binder]. Jacksonville, FL: Author.

PreventionPLUSWellness. (n.d.). SPORT young adolescent program [binder]. Jacksonville, FL: Author.

Program Web site, http://www.preventionpluswellness.com

Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the intervention's Readiness for Dissemination using three criteria:

  1. Availability of implementation materials
  2. Availability of training and support resources
  3. Availability of quality assurance procedures

For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.

Implementation
Materials
Training and Support
Resources
Quality Assurance
Procedures
Overall
Rating
3.5 3.5 3.5 3.5

Dissemination Strengths

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.

Dissemination Weaknesses

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.

Review Date: November 2008

Materials Reviewed

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. (2006). SPORT high school version. Jacksonville, FL: Author.

Brief Programs for Health. (2006). SPORT middle school version. Jacksonville, FL: Author.

SPORT Web site, http://briefprograms.com

Youth Health Survey: Brief Version. (2007).

Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the intervention's Readiness for Dissemination using three criteria:

  1. Availability of implementation materials
  2. Availability of training and support resources
  3. Availability of quality assurance procedures

For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.

Implementation
Materials
Training and Support
Resources
Quality Assurance
Procedures
Overall
Rating
2.3 1.8 2.3 2.1

Dissemination Strengths

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.

Dissemination Weaknesses

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.

Costs

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.

Item Description Cost Required by Developer
Adolescent program binder (includes program materials for younger or older adolescents, program materials on a CD-ROM, five adolescent booklets, orientation Webinar, and 30 days of technical assistance) $699 each Yes
Adolescent booklets $55.99 for 25 booklets Yes
Orientation Webinar and 30 days of technical assistance supported by phone or email Included in cost of program binder No
Webinar training for teacher/coach certification $149 per person No
1-day, on-site teacher/coach workshop $199 per person, plus travel expenses No
1-day, on-site training for trainer certification $299 per person, plus travel expenses No
Quality assurance process and outcome evaluation instruments Included in program binder No
Replications

Selected citations are presented below. An asterisk indicates that the document was reviewed for Quality of Research.

Werch, C., Moore, M. J., & DiClemente, C. C. (2008). Brief image-based health behavior messages for adolescents and their parents. Journal of Child and Adolescent Substance Abuse, 17(4), 19-40.

Werch, C., Moore, M. J., DiClemente, C. C., Owen, D. M., Jobli, E., & Bledsoe, R. (2003). A sport-based intervention for preventing alcohol use and promoting physical activity among adolescents. Journal of School Health, 73(10), 380-388.  Pub Med icon

Contact Information

To learn more about implementation or research, contact:
C. E. Werch, Ph.D.
(904) 472-5022
cwerch@preventionpluswellness.com

Consider these Questions to Ask (PDF, 54KB) as you explore the possible use of this intervention.

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