•  

Intervention Summary

Back to Results Start New Search

Lead & Seed

Lead & Seed is an intervention for middle and high school youth designed to increase their knowledge and problem-solving skills for preventing and reducing alcohol, tobacco, and other drug (ATOD) use; guide them in developing strategic prevention plans for use in their schools and communities; and help them implement these plans. The intervention also aims to affect ATOD risk factors for these youth (e.g., increase perception of risk of harm from use) and decrease their use of these substances.

In the first phase, Lead, youth and their adult mentors receive training on preventing ATOD use. Using a process model of team building and strategic planning, the training is based on SAMHSA's five-step Strategic Prevention Framework, which covers needs assessment, capacity building, strategic planning, implementation, and evaluation. The training is designed to help the participants identify problem priorities in their school or community, which can include prescription drug misuse, underage drinking, drunk driving, illicit drug use, or teen tobacco use; discuss the origin of these problems; and identify a theory of change that will dictate the appropriate course of action to affect the physical, economic, legal, or sociocultural environment. Participants generate an overall logic model with detailed action plans outlining their intentions to change policies, practices, and procedures that contribute to the identified problems. They also formulate plans for mobilizing the community and using print, broadcast, and electronic media to promote awareness. The 12-hour training takes place over a 2-day period and involves approximately 18 youth and 6 adults.

During the second phase of the program, Seed, the plans formulated during the Lead phase are put into action. Ongoing technical assistance is provided to the youth and adult mentors. The outcomes reviewed for this summary reflect only the Lead phase of this intervention and not the Seed phase.

Descriptive Information

Areas of Interest Substance abuse prevention
Outcomes Review Date: November 2012
1: General knowledge about prevention of ATOD use
2: Knowledge about environmental strategies to prevent ATOD use
3: Youth empowerment
4: Perception of risk of harm from alcohol use
5: Alcohol use
Outcome Categories Alcohol
Drugs
Tobacco
Ages 6-12 (Childhood)
13-17 (Adolescent)
Genders Male
Female
Races/Ethnicities Hispanic or Latino
White
Race/ethnicity unspecified
Settings School
Other community settings
Geographic Locations Urban
Suburban
Rural and/or frontier
Implementation History Since 2005, Lead & Seed has been implemented in an estimated 200 schools in Arkansas, Florida, Indiana, Massachusetts, Montana, New Jersey, Pennsylvania, South Carolina, Texas, and Washington. Approximately 20,000 youth and 5,000 adults have participated in the intervention.
NIH Funding/CER Studies Partially/fully funded by National Institutes of Health: No
Evaluated in comparative effectiveness research studies: No
Adaptations Some program materials, including handouts depicting examples of environmental change, have been translated into Spanish.
Adverse Effects No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories Universal

Quality of Research
Review Date: November 2012

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

Imm, P., & Lamont, A. (2011). Lead & Seed comprehensive report. Submitted to Alutiiq International Solutions, LLC.

Supplementary Materials

Alutiiq, LLC. (2010). Lead & Seed brief youth empowerment scale. Vienna, VA: Author.

Alutiiq, LLC. (2010). Lead & Seed knowledge assessment. Vienna, VA: Author.

Alutiiq, LLC. (2010). Lead and Seed tracking action plans. Vienna, VA: Author.

Alutiiq, LLC. (2010). Lead & Seed training curriculum: Trainer fidelity checklist. Vienna, VA: Author.

Alutiiq, LLC. (2010). Lead and Seed youth environmental survey. Vienna, VA: Author.

National Outcome Measures (NOMs), Youth Revised 8-17-2011

Outcomes

Outcome 1: General knowledge about prevention of ATOD use
Description of Measures General knowledge about the prevention of ATOD use was assessed using the Lead & Seed Knowledge Assessment, a 15-item, multiple-choice survey developed for the program. Sample items include:

  • "Environmental change in terms of drug prevention involves . . ." (response options: "recurring audience," "population level change," "saving the trees and animals," "a teacher's guide for classroom use only," and "none of the above")
  • "The ultimate goal of alcohol and drug prevention is to change . . ." (response options: "knowledge," "behavior," "skills," "attitude," and "none of the above")
Key Findings Students who participated in the intervention at 11 high schools and 11 middle schools were compared with high school and middle school students who attended a YMCA afterschool program. Data were collected at pretest (before the school year) and posttest (after the school year) for the intervention group and at pretest (middle of the school year) and posttest (3.5 months after pretest) for the comparison group. From pre- to posttest, general knowledge about prevention of ATOD use increased for the intervention group (p < .001) and comparison group (p < .05). In a separate analysis comparing the two groups at posttest, the increase was greater for the intervention group than comparison group after controlling for age, gender, ethnicity, and pretest scores (p < .001).
Studies Measuring Outcome Study 1
Study Designs Quasi-experimental
Quality of Research Rating 1.3 (0.0-4.0 scale)
Outcome 2: Knowledge about environmental strategies to prevent ATOD use
Description of Measures Knowledge about environmental strategies to prevent ATOD use was assessed using the Lead and Seed Youth Environmental Survey developed for the program. Students used a 7-point Likert scale ranging from 1 (strongly disagree) to 7 (strongly agree) to reflect their level of agreement with 8 statements about their environmental prevention skills. Sample items include "I know how to plan environmental prevention strategies to target alcohol and drug use in my school/community" and "I know how to develop logic models (master work plans) for preventing alcohol and drug use in my school/community."
Key Findings Students who participated in the intervention at 11 high schools and 11 middle schools were compared with high school and middle school students who attended a YMCA afterschool program. Data were collected at pretest (before the school year), posttest (after the school year), and 6-month follow-up for the intervention group and at pretest (middle of the school year) and posttest (3.5 months after pretest) for the comparison group. Knowledge about environmental strategies to prevent ATOD use increased for the intervention group from pre- to posttest (p < .001) and from posttest to follow-up (p < .001). Knowledge about these strategies decreased from pre- to posttest for the comparison group (p < .01). In a separate analysis comparing the two groups at posttest, knowledge about these strategies increased for the intervention group relative to the comparison group after controlling for age, gender, ethnicity, and pretest scores (p < .01).
Studies Measuring Outcome Study 1
Study Designs Quasi-experimental
Quality of Research Rating 1.3 (0.0-4.0 scale)
Outcome 3: Youth empowerment
Description of Measures Youth empowerment was assessed using the Lead & Seed Brief Youth Empowerment Scale developed for the program. Students used a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree) to reflect their level of agreement with 5 statements:

  • "My school involves youth in important decisions."
  • "I am given lots of chances to make my school better."
  • "I am given chances to work with other young people and adults in my school to make it better."
  • "Young people my age are able to make a difference in my school."
  • "If I felt strongly about an issue, I would talk to people in power (such as principal, superintendent, school board, city council, etc.) about my opinion."
Key Findings Students who participated in the intervention at 11 high schools and 11 middle schools were compared with high school and middle school students who attended a YMCA afterschool program. Data were collected at pretest (before the school year), posttest (after the school year), and 6-month follow-up for the intervention group and at pretest (middle of the school year) and posttest (3.5 months after pretest) for the comparison group. Youth empowerment increased for the intervention group from pre- to posttest (p < .001), but this increase was not sustained at follow-up. Youth empowerment decreased from pre- to posttest for the comparison group (p < .001). In a separate analysis comparing the two groups at posttest, empowerment skills increased for the intervention group relative to the comparison group after controlling for age, gender, ethnicity, and pretest scores (p < .01).
Studies Measuring Outcome Study 1
Study Designs Quasi-experimental
Quality of Research Rating 1.6 (0.0-4.0 scale)
Outcome 4: Perception of risk of harm from alcohol use
Description of Measures Perception of risk of harm from alcohol use was assessed using an item from SAMHSA's National Outcome Measures: "How much do people risk harming themselves physically and in other ways when they have 5 or more drinks of an alcoholic beverage once or twice a week?" Students selected their response from the following options: "no risk," "slight risk," "moderate risk," and "great risk."
Key Findings Students who participated in the intervention at 11 high schools and 11 middle schools were compared with high school and middle school students who attended a YMCA afterschool program. Data were collected at pretest (before the school year), posttest (after the school year), and 6-month follow-up for the intervention group and at pretest (middle of the school year) and posttest (3.5 months after pretest) for the comparison group. Perception of risk of harm from alcohol use increased for the intervention group from pre- to posttest (p < .05) and from posttest to follow-up (p < .05) and decreased for the comparison group from pre- to posttest (p < .05). In a separate analysis comparing the two groups at posttest, perception of risk of harm from alcohol use increased for the intervention group relative to the comparison group after controlling for age, gender, ethnicity, and pretest scores (p < .01).
Studies Measuring Outcome Study 1
Study Designs Quasi-experimental
Quality of Research Rating 2.3 (0.0-4.0 scale)
Outcome 5: Alcohol use
Description of Measures Alcohol use was assessed using an item from SAMHSA's National Outcome Measures: "During the past 30 days, on how many days did you drink one or more drinks of an alcoholic beverage?" Students selected the number of days from the following options: 0, 1-2, 3-5, 6-9, 10-15, 16-20, 21-25, and 26-30.
Key Findings Students who participated in the intervention at 11 high schools and 11 middle schools were compared with high school and middle school students who attended a YMCA afterschool program. Data were collected at pretest (before the school year), posttest (after the school year), and 6-month follow-up for the intervention group and at pretest (middle of the school year) and posttest (3.5 months after pretest) for the comparison group. Alcohol use decreased for the intervention group from pre- to posttest (p < .05). Although use continued to decrease from posttest to follow-up, the decrease was not significant. Alcohol use increased from pre- to posttest for the comparison group (p < .05). In a separate analysis comparing the two groups at posttest, alcohol use decreased for the intervention group relative to the comparison group after controlling for age, gender, ethnicity, and pretest scores (p < .01).
Studies Measuring Outcome Study 1
Study Designs Quasi-experimental
Quality of Research Rating 2.3 (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 6-12 (Childhood)
13-17 (Adolescent)
64% Female
36% Male
88% White
7% Race/ethnicity unspecified
5% Hispanic or Latino

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: General knowledge about prevention of ATOD use 0.0 2.0 1.5 0.5 1.0 2.5 1.3
2: Knowledge about environmental strategies to prevent ATOD use 0.0 2.0 1.5 0.5 1.0 2.5 1.3
3: Youth empowerment 1.5 2.5 1.5 0.5 1.0 2.5 1.6
4: Perception of risk of harm from alcohol use 4.0 4.0 1.5 0.5 1.0 2.5 2.3
5: Alcohol use 4.0 4.0 1.5 0.5 1.0 2.5 2.3

Study Strengths

Two outcomes were assessed using items from the National Outcome Measures, an instrument with good reliability and validity. The empowerment measure has some evidence of reliability and validity from previous studies, and the two instruments measuring knowledge have face validity. The training appears to have been standardized, and a trainer implementation fidelity checklist was used. The use of regressions with numerous controls was appropriate.

Study Weaknesses

The two instruments used to measure knowledge do not have documented psychometric properties. No results from use of the fidelity checklist were presented. Attrition was high for the intervention group between posttest and follow-up, and data on attrition were not provided for the comparison group. Because intervention group participants volunteered for the program and were socially active and doing well in school before the study, it is difficult to draw inferences from the study findings. The two study groups varied greatly at pretest; although efforts were made to control for age, gender, ethnicity, and pretest scores, the effect of gender and ethnicity should have been analyzed separately, as they are key variables that may have affected the results.

Readiness for Dissemination
Review Date: November 2012

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.

Alutiiq, LLC. (2010). Lead & Seed: Curriculum. Vienna, VA: Author.

Alutiiq, LLC. (2010). Lead & Seed: Instructor guide. Vienna, VA: Author.

Alutiiq, LLC. (2010). Lead & Seed: Juniata Valley High School video: Part 1 [DVD]. Vienna, VA: Author.

Alutiiq, LLC. (2010). Lead & Seed: Juniata Valley High School video: Part 2 [DVD]. Vienna, VA: Author.

Alutiiq, LLC. (2010). Lead & Seed training curriculum: Trainer fidelity checklist. Vienna, VA: Author.

Alutiiq, LLC. (2012). Lead & Seed: Online data collection system [PowerPoint slides]. Vienna, VA: Author.

Alutiiq, LLC. (2012). Lead & Seed prevention program. Keystone youth in focus: "20/20" for 2012 [PowerPoint slides]. Vienna, VA: Author.

Alutiiq, LLC. (n.d.). Lead & Seed: Resource materials for communities [CD-ROM]. Vienna, VA: Author.

Alutiiq, LLC. (n.d.). Lead & Seed: Resource materials for train the trainers [CD-ROM]. Vienna, VA: Author.

Alutiiq, LLC, & Drexler, N. (2010). Lead and Seed: Participant workbook. Vienna, VA: Alutiiq.

Lead & Seed adult assessments:

  • Lead and Seed Adult Survey
  • Lead & Seed Course Critique
  • Lead & Seed Knowledge Assessment
  • National Outcome Measures (NOMs), Adult Revised 8-23-2011
  • Training Evaluation "Day 1" of Lead & Seed
  • Training Evaluation "Day 2" of Lead & Seed

Lead & Seed youth assessments:

  • Attitude Toward Use--Favorable Attitudes Toward Use
  • Lead & Seed Brief Youth Empowerment Scale
  • Lead & Seed Leadership Survey
  • Lead & Seed Youth Efficacy Survey
  • Lead and Seed Youth Environmental Survey
  • National Outcome Measures (NOMs), Youth Revised 8-17-2011

Program brochure

Program Web site, http://www.leadandseed.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
4.0 4.0 3.5 3.8

Dissemination Strengths

The program materials are clear and practical and can be adopted easily in a variety of youth and community programs. The materials provide guidance for accessing existing assets within a community and information on how to secure local resources. The training materials are highly interactive and focus on skills and strategies for program implementation. Phone, email, and on-site technical assistance is available to support implementation. Two options for training (community model or train-the-trainer model) are clearly articulated. Several checklists, self-assessments to be used before and after the intervention, and other tools are available to monitor knowledge acquisition and training quality. Clear instructions are provided on how and when to use each measure.

Dissemination Weaknesses

Insufficient information is provided on use of the trainer fidelity checklist (i.e., for mentoring and providing feedback).

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
2-day, on-site community model training, including all program materials (participant workbooks, CD with community resources, and evaluation materials), phone and email technical assistance, and quarterly follow-up reviews for 1 year following training $6,500 for up to 24 participants Yes, one training option is required
4-day, on-site training of trainers, including all trainer materials, phone and email technical assistance, and a license for each trainee to conduct up to 20 in-state trainings per year with follow-up technical assistance $21,500 for up to 10 participants (plus $250 each for up to 2 additional participants) Yes, one training option is required
On-site technical assistance for implementation sites $150 per hour, plus travel expenses No
Replications

No replications were identified by the developer.

Contact Information

To learn more about implementation, contact:
Nora L. Drexler, M.Ed.
(703) 399-1825
ndrexler@alutiiq.com

To learn more about research, contact:
Pamela Imm, Ph.D.
(803) 808-2316
pamimm@windstream.net

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

Web Site(s):