Substance misuse and associated health-risking behaviors are prevalent in emerging adulthood. There is a knowledge gap concerning the post-high school effects of community-based delivery systems for universal preventive interventions implemented during young adolescence. This study reports effects of the PROSPER delivery system through age 19, 7.5 years past baseline.

A cohort sequential design included 28 public school districts randomly assigned to the PROSPER partnership delivery system or usual-programming conditions. PROSPER community teams implemented a family-focused intervention in 6th grade and a school-based intervention in 7th grade. Outcomes for the age 19, post-high school report included lifetime, current, and frequency of substance misuse, as well as antisocial and health-risking sexual behaviors. Intent-to-treat, multi-level analyses of covariance of point-in-time outcomes were conducted, along with analyses of risk-related moderation of intervention effects.

Results showed emerging adults from PROSPER communities reported significantly lower substance misuse across a range of types of substances, with relative reduction rates of up to 41.0%. No significant findings were observed for associated antisocial and health-risking sexual behavior indices; or for lifetime rates of sexually transmitted infections. Risk-related moderation effects were non-significant, suggesting generally comparable outcomes across higher- and lower-risk subgroups of emerging adults.

The PROSPER delivery system for brief universal preventive interventions has potential for public health impact by reducing long-term substance misuse, with positive results extending beyond high school.

To determine the effectiveness of a redesigned Fe supplementation delivery system (ISDS) in improving Hb concentrations and compliance among pregnant women.

A controlled before and after study design was used. Interviews and Hb measurements of randomly selected pregnant women in both treatment areas were conducted at baseline and after 6 months. The redesigned ISDS, reached by consensus based on the surveys and focus group discussions, involved the health workers in spot mapping and clustering; Fe tablets’ distribution, monitoring and promotion; and counselling of pregnant women.

Negros Occidental and Negros Oriental, Philippines.

In total, 1180 pregnant women given Fe/folic acid tablets daily through the redesigned ISDS in the experimental areas and the existing ISDS in the control areas.

There were significantly more anaemic pregnant women in the experimental than in the control area at baseline (50·7 v. 37·3 %; P = 0·001). However, at endline, the anaemia prevalence rate in the experimental area was comparable to that of the control (35·6 v. 33·1 %; P = 0·530). Also, the mean Hb concentration increased significantly in the experimental area by 0·5 g/dl (P = 0·002). An increase in the actual number of prenatal visits/trimester in the experimental area was observed (from 0·99 to 1·66; P < 0·0001). Pregnant women in the experimental area were four times more likely to take Fe tablets (OR = 3·79; P < 0·001) and sixteen times more likely to being monitored for Fe intake (OR = 16·86; P < 0·001) compared to the control.

The redesigned ISDS was effective in improving the Hb concentration and health-related behaviour of pregnant women.