Youth substance use prevention takes WVU researchers into rural communities

West Virginia Universitypublic health researchers are working collaboratively with local partners, like county health departments, to stop drug use in youth before it starts, driving federal grant money to some of the state's poorest counties and developing approaches tailored to individual communities.

"We are trying to build an infrastructure to really change the way we operate drug prevention in rural Appalachia," said Alfgeir Kristjansson, co-director of the West Virginia Prevention Research Centerin the WVU School of Public Health. "Instead of saying, 'I've got this one intervention that everybody needs to use,' let's start by collecting data, and based on that, collaborate with local partners to decide what kind of interventions are best for each community."

Youths living in rural areas have higher rates of substance use than those in urban areas. But limited resources and a mistrust of external expertise are among the challenges rural communities face in adopting and sustaining programs to reduce or prevent substance use, Kristjansson explained.

With a five-year, $6.7 million grant from the National Institute on Drug Abuse, Kristjansson will expand an existing pilot project for preventing drug use in kids to encompass approximately 140 schools in 36 of the state's most rural counties. The specific locations are yet to be determined.

In the pilot project, funded by the Centers for Disease Control and Prevention, the West Virginia Prevention Research Center has collaborated with local stakeholders in Fayette and Wyoming counties over the past six years, collecting data through student surveys and working with community leaders on plans for preventing substance use in youth. The data helped those counties acquire nearly $5 million in grants and increased community participation in drug prevention activities in response to "practice-based research findings tailored for local decision-making," Kristjansson said.

The new award funds collaborations between WVU and six regional nonprofit organizations in West Virginia. Within the six regions, prevention coordinators who live in the communities and understand local perspectives will be hired to coordinate project activities and supervise data collection, then will work with area groups to develop prevention activities.

"Although some of the counties are small, there can be very different issues that need tackling from one school community to another, so we are allowing for variations that are led by local initiatives," Kristjansson said. "We'll review the findings with local partners, but then they make their own determination and decision about where to prioritize, with our support and consulting."

In fall 2026, data will be collected through comprehensive anonymous surveys presented to students in grades seven through 12. Questions will focus on topics like peer groups, leisure time, school environment and drug use. Part of the grant funding will go directly to incentivize schools and teachers to help the researchers collect student data.

"Youth who grow up in challenged areas are much more likely to be challenged too," he said. "Drug use onset, just like drug use and continuation, is not randomly distributed in the population. There are some areas that continuously produce most of the new users."

Kristjansson said a cooperative system is needed because effective and sustainable drug prevention programs are lacking.

"A lot of money, manpower, time and resources are spent on treatment, which is the most expensive and least effective way of reducing drug use in society," he said. "If society is the patient, instead of treating the patient retrospectively, let's prevent the patient from becoming sick in the first place."

-WVU-

ls/11/4/25

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