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Evaluating Investments for Substance Use Prevention and Treatment

FSG conducted an evaluation of the Robert Wood Johnson Foundation’s $700 million investment in substance use prevention and treatment, assessing the overall strategy and impact of the work and identifying lessons for the field.


For more than two decades, the Robert Wood Johnson Foundation (RWJF) worked to reduce harm from alcohol and other drugs in the United States. The foundation spent nearly $700 million in pursuit of this goal, establishing 33 major national programs and supporting 1,528 individual grants. Investments supported the Partnership for a Drug-Free America’s national media campaign, attention-grabbing research about the prevalence of college alcohol use, and behind-the-scenes efforts to reduce wait times and improve quality of care at treatment centers across the country. These investments contributed to many positive changes in the field and helped to expand the array of approaches to reducing the harm caused by alcohol and other drugs at a time when the approaches were very limited. As the foundation’s investments in this area came to a close, RWJF sought a way to better understand and catalog the story, collective lessons, and impact of this significant body of work.

The foundation engaged FSG to conduct a retrospective assessment exploring the evolution of the foundation’s substance use strategies and goals, examining what RWJF achieved as a result of these efforts, and identifying strengths and challenges of the foundation’s approach. The foundation hoped to use this data to inform its activities in other areas.

FSG developed a detailed account of what the foundation hoped to accomplish and what actually happened, employing a range of methods: a survey of and interviews with current and former staff members, grantees, and field experts; an extensive review of grantee reports, evaluations, and publications; a spending analysis by program area; in-depth case studies of major programs; and a citation analysis to understand the spread of RWJF-supported ideas. FSG also tested interim findings with a nationally recognized expert advisory board.

Through this process, a clear picture of RWJF’s investments and ensuing impact emerged.

  • RWJF’s work evolved through six eras of investments and philosophies for change, from early community-based prevention activities to greater emphasis on policy and environmental approaches to a heavy emphasis on treatment.
  • The foundation contributed toward progress on the substance use problem in five major areas: increasing knowledge, influencing policy, informing and spreading promising programs, improving systems of care, and building field infrastructure.
  • This examination of the foundation’s work in substance use prevention and treatment programs can inform future RWJF and field strategy.

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About the Robert Wood Johnson Foundation
The Robert Wood Johnson Foundation is the nation’s largest philanthropy dedicated solely to health.