- ENGAGE framework organises evidence into six complementary strategies to guide coalitions in implementing evidence based interventions for youth substance use prevention.
- Rural case studies show data driven planning, cross sector collaboration, integrated EBIs across settings, and adapted implementation while maintaining fidelity.
- Policy support for coalition infrastructure, workforce development, robust data systems and multiyear funding is essential for equitable, sustainable youth substance use prevention.
J Public Health Manag Pract. 2026 Nov-Dec 01;32(6S):S197-S205. doi: 10.1097/PHH.0000000000002470.
ABSTRACT
CONTEXT: Youth substance use continues to be a persistent public health concern in the United States, worsened by an evolving substance landscape that includes high-potency cannabis, nicotine vaping devices, and exposure to multiple substances. Although substantial evidence supports the effectiveness of evidence-based interventions (EBIs) for preventing youth substance use, many communities encounter difficulties in translating prevention science into coordinated and sustainable practices.
PROGRAM: The Drug-Free Communities (DFC) Support Program provides critical infrastructure for coalition-based prevention efforts but does not mandate specific interventions. To facilitate the implementation of EBIs by both DFC coalitions and non-DFC coalitions, the Centers for Disease Control and Prevention (CDC) developed ENGAGE: Evidence-Based Strategies to Prevent Youth Substance Use. This framework systematically categorizes prevention evidence into 6 complementary strategies targeting individual, family, school, peer, community, and service-system factors.
IMPLEMENTATION: An overview of the ENGAGE framework and case studies showing how strategies can be put into action within DFC-supported coalitions are provided. Two rural coalition case studies demonstrate how ENGAGE facilitates data-driven planning, cross-sector collaboration, and the integration of EBIs across different settings. The coalitions used local data to prioritize strategies, implemented evidence-based curricula and youth engagement initiatives, coordinated community and environmental approaches, and adapted implementation processes to local contexts while maintaining attention to implementation fidelity.
DISCUSSION: The case studies highlight common implementation challenges, such as limited workforce capacity, funding instability, data constraints, and the necessity to balance fidelity with cultural and contextual adaptation. ENGAGE supports coalitions in overcoming these obstacles by offering a systems-level framework that aligns activities, mitigates fragmentation, and enhances accountability.
IMPLICATIONS FOR POLICY AND PRACTICE: Integrating ENGAGE within DFC coalitions can enhance the implementation of EBIs into sustainable community prevention systems. Policy initiatives that bolster coalition infrastructure, workforce development, data management systems, and multiyear funding are essential for advancing equitable and effective youth substance use prevention on a broader scale.
PMID:42770998 | DOI:10.1097/PHH.0000000000002470
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