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Purpose: To identify appropriate adolescent substance abuse prevention programming for rural populations through the application of three concepts: effectiveness (best clinical evidence), efficiency (benefit to rural populations), and equality (access). Methods: A review of the literature guided by these concepts was conducted to identify criteria essential to the tailored development of rural adolescent substance abuse prevention programming. An advanced search of the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Registry of Evidence-based Programs and Practices (NREPP) was then conducted using criteria tailored to rural populations. Findings: Results from the literature search support the inclusion of two components directed at improving quality of outcomes through a customized approach to rural adolescent substance abuse prevention programming: inclusion of parents in prevention education efforts and use of the Internet as an appropriate method of program delivery. These components were satisfied by one program listed on SAMHSA’s NREPP: Parenting Wisely . Conclusions: While Parenting Wisely is an ideal program for rural adolescent substance abuse prevention strategy, it may not be suitable for all communities. Parallel to recommendations from the SAMHSA and Institute of Medicine, other evidence-based prevention programs need to be expanded to include a web-based delivery option. Strategies for moving forward would include the use of advanced-practice nurses at the forefront of discussion for rural professionals, researchers, educators, and policymakers. Key Words: Access to Care, Technology, Substance Abuse Prevention, Rural

RURAL ADOLESCENT SUBSTANCE ABUSE: PREVENTION IMPLICATIONS FROM THE EVIDENCE