Valentine, Jeanette, Griffith, John, Ruthazer, Robin, Gottlieb, Barbara, Keel, Stefano

Strengthening causal inference in adolescent drug prevention studies: Methods and findings from a controlled study of the Urban Youth Connection Program

Presents the methods and findings from the Urban Youth Connection, a substance abuse prevention program implemented in an urban public middle school and high school serving predominantly Hispanic and African American students. The program provides counseling, mentoring and academic support. A pre-test, post-test comparison group design estimated the impact of the program on ultimate outcomes of 30-day use of alcohol, tobacco, and other drugs, and intermediate outcomes of risk behaviors, psychosocial well-being, and school involvement, as measured by self-administered questionnaires given each fall and spring from 1993-1996. A comparison group was drawn from non-participants at each school. Unadjusted outcomes at follow-up were significantly worse in the treatment group than in the comparison group. Statistical adjustment eliminated significant differences between the treatment and comparison groups at follow-up, and higher program exposure was associated with better outcomes for some measures. Adjustment for differences between treatment and comparison groups and correction for variation in program exposure within the treatment group are essential for accurate estimation of the benefits of drug prevention interventions. (PsycINFO Database Record (c) 2007 APA, all rights reserved).

Drugs & Society, 12(1-2) : 127- 145

Weiss, Faedra Lazar, Nicholson, Heather Johnston

Friendly PEERsuasion against substance use: The Girls Incorporated model and evaluation

Girls Incorporated Friendly PEERsuasion is a leadership and substance abuse prevention program based on the social influence model. Girls in grades 6-8 (aged 11-15 yrs) considered to be at high risk for substance use were recruited from 4 geographically and ethnically diverse communities, with Ss randomly assigned to Fall 1988 \"treatment\" and Spring 1989 \"comparison\" participation (delayed entry model). Outcomes of interest were avoiding any use of harmful substances and leaving situations in which peers were using harmful substances. An evaluation using survival analysis techniques included 118 girls (47 treatment, 71 comparison). A 2nd evaluation using logistic regression compared the behavior of 354 Ss (1 treatment, 202 comparison) across all 4 sites. Friendly PEERsuasion proved moderately effective, particularly for the youngest Ss. Evaluation results and subsequent research suggest that most girls experiment with substance use in their early teens and that the preteen years are thus a critical time for intervention. (PsycINFO Database Record (c) 2007 APA, all rights reserved).

Drugs & Society, 12(1-2) : 7-22

Rosenbaum, Dennis P., Hanson, Gordon S.

Assessing the effects of school-based drug education: A six-year multilevel analysis of Project D.A.R.E

A randomized longitudinal field experiment was conducted to estimate the short- and long-term effects of the Drug Abuse Resistance Education program (D.A.R.E.) on students' attitudes, beliefs, social skills, and drug use behaviors. 1,798 students from urban, suburban, and rural schools were followed for more than 6 yrs, with surveys administered each year from 6th through 12th grades. Teachers were also surveyed annually to measure students' cumulative exposure to supplemental (post-D.A.R.E.) drug education. Multilevel analyses (random-effects ordinal regression) were conducted on 7 waves of posttreatment data. The results indicate that D.A.R.E had no long-term effects on a wide range of drug use measures, nor did it show a lasting impact on hypothesized mediating variables, with 1 exception. Previously documented short-term effects had dissipated by the conclusion of the study. Some D.A.R.E.-by-community interactions were observed: Urban and rural students showed some benefits, whereas suburban students experienced small but significant increases in drug use after participation in D.A.R.E. (PsycINFO Database Record (c) 2007 APA, all rights reserved).

Journal of Research in Crime & Delinquency, 35(4) : 381-412

Shope, J. T., Copeland, L. A., Kamp, M. E., Lang, S. W.

Twelfth grade follow-up of the effectiveness of a middle school-based substance abuse prevention program

A twelfth-grade follow-up afforded the opportunity to assess the long- term effects of substance abuse prevention delivered in sixth and seventh grades. A social pressures resistance skills curriculum implemented by classroom teachers had been evaluated with short-term positive results previously reported. Students completed self-administered questionnaires at sixth grade pre- and posttests, and at seventh and twelfth-grade posttests. Curriculum group students received lessons on alcohol, tobacco (cigarettes and smokeless), marijuana, and cocaine, which were later incorporated into the Michigan Model for Comprehensive School Health Education. This evaluation used data from 262 students who completed all four questionnaires and who received the complete two-year intervention or no intervention. Repeated measures analyses of variance demonstrated that significant effects evident at seventh grade for alcohol use and misuse, as well as cigarette, cocaine, and other drug use were generally not maintained through twelfth grade. Ongoing reinforcement of effective prevention is recommended.

Journal of Drug Education, 28(3) : 185-197

Snow, D. L., Tebes, J. K., Ayers, T. S.

Impact of two social-cognitive interventions to prevent adolescent substance use: test of an amenability to treatment model

An amenability to treatment model stipulates that interventions may be differentially effective for subgroups of individuals with similar characteristics. Using such a model, the present study tests the impact of two social-cognitive interventions implemented in the sixth (Intervention I) and eighth/ninth (Intervention II) grades on students' skill acquisition and on their ninth and tenth grade substance use. A randomized factorial design was used to examine main and interaction effects within the context of student family household status and gender. Positive program effects were found for Intervention II on skill acquisition and overall drug involvement. Interaction effects of Intervention II x Family Household Status provided support for the amenability to treatment model, but no support for the model was observed based on student gender. Possible explanations for the study findings are presented and future research directions are proposed to address why differences emerge in amenability to intervention and why such differences occur for specific subgroups.

Journal of Drug Education, 27(1) : 1- 17

Tobler, Nancy S., Stratton, Howard H.

Effectiveness of school- based drug prevention programs: A meta-analysis of the research

Conducted a meta-analysis of 120 school-based programs (5th-12th grade) that evaluated success on self-reported drug use measures. Hypothesis tests using weighted least squares regressions were conducted of an a priori classification scheme that was based on program content and its method of delivery. Two major types of programs were identified: interactive and noninteractive. Six factors related to program effectiveness (sample size, targeted drug, type of control group, special populations, type of leader, and attrition) were included as covariates. The superiority of the interactive programs was both clinically and statistically significant to the noninteractive programs for tobacco, alcohol, marijuana and illicit drugs and for all adolescents including minority populations. The larger interactive programs were less effective, although still significantly superior to the noninteractive programs, which suggests implementation failures. (PsycINFO Database Record (c) 2007 APA, all rights reserved).

Journal of Primary Prevention, 18(1) : 71- 128

Waldron, Holly B.

Adolescent substance abuse and family therapy outcome: A review of randomized trials

Provides a comprehensive review of family therapy outcome research on adolescent substance abusers, focusing on controlled, comparison studies and considering the context of the broader adolescent substance abuse literature. The author reviews the major conceptual models underlying family therapy research as well as the studies of the effectiveness and outcomes of family-based treatments. (PsycINFO Database Record (c) 2007 APA, all rights reserved).

Advances in Clinical Child Psychology, 19 : 199-234

Tobler, N. S.

Meta-analysis of adolescent drug prevention programs: results of the 1993 meta-analysis

NIDA Research Monograph, 170 : 5-68

Hurry, Jane, McGurk, Harry

An evaluation of a primary prevention programme for schools

Evaluated a drug education programme developed in the US for primary-aged children. Pupils (aged 7-10 yrs) attending an inner-London junior school were randomly assigned to receive Project Charlie (n=65) or to the control group (n=55). After 1 yr of weekly 30-min lessons, the children who had received Project Charlie had a greater knowledge of the effects of medicinal, social, and illicit drugs. They could generate both more and higher quality solutions to hypothetical social dilemmas and were more secure in their ability to resist peer pressure to commit antisocial acts. However, Project Charlie children did not have significantly higher self-esteem than the control children, nor did the 2 groups differ in their intentions to use drugs, or their reported current use. (PsycINFO Database Record (c) 2007 APA, all rights reserved).

Addiction Research, 5(1) : 23-38

Hostetler, Michelle, Fisher, Kirk

Project C.A.R.E. substance abuse prevention program for high-risk youth: A longitudinal evaluation of program effectiveness

Describes and evaluates Project C.A.R.E., a substance abuse prevention program for 3 cohorts of at-risk 4th graders and their families. Project C.A.R.E. worked intensively with students and their families to increase resiliency factors and decrease risk factors through school, family, and extracurricular activities. The research design was experimental. Project objectives were to decrease substance use, negative behaviors, intent to use substances, school suspensions, and absences; and to increase alternative activities, family communication, academic grades, and consistency of family behavior control and rules. A few positive program effects were found. At posttest, more control Ss' grades needed improvement, and more program Ss participated in community activities. Compared to controls, program Ss increased participation in alternative activities from pretest to posttest and did not increase their school suspensions as much. At the 1-yr follow up, controls were more willing to use substances than were program Ss. The program appeared to have the most impact with the 3rd cohort of students and with Black students. Program Ss with low participation generally had the worst outcomes, often worse than the controls. (PsycINFO Database Record (c) 2007 APA, all rights reserved).

Journal of Community Psychology, 25(5) : 397-419

Oliansky, D. M., Wildenhaus, K. J., Manlove, K., Arnold, T., Schoener, E. P.

Effectiveness of brief interventions in reducing substance use among at- risk primary care patients in three community-based clinics

This project identified patients 'at risk' for substance abuse and provided brief interventions (BI) to encourage behavior change. Substance use patterns of patients were determined using the Substance Use Screening Instrument (SUSI). The SUSI was administered to male and female adults, adolescents, and female adults at three community-based clinics, respectively. 'At-risk' patients were randomly assigned to intervention or control groups, and a BI was administered to the intervention groups. At each site, the SUSI was readministered to both groups at 1 and 3 months to determine the effectiveness of the BI reducing substance use across time. At two sites, the intervention groups, but not the controls, demonstrated significant reductions in substance use from baseline to 1-month follow-up. While there was no additional significant decrease from 1 to 3 months, it was encouraging that the decreased use seen at 1 month was maintained over time without a return to baseline use patterns. The results indicate that brief interventions have a positive impact on substance use behavior. Implications for these results and future directions are discussed.

Substance Abuse, 18(3) : 95- 103

Catalano, R. F., Haggerty, K. P., Gainey, R. R., Hoppe, M. J.

Reducing parental risk factors for children's substance misuse: preliminary outcomes with opiate-addicted parents

Parents in methadone treatment were offered an experimental intervention, Focus on Families, designed to reduce their risk of relapse and their children's risk of substance use. Experimentally assigned volunteers participated in systematic group training in relapse prevention and parenting skills, and received home-based case management services. Immediate posttreatment outcome results reported here include analyses of covariance controlling for baseline measures. Analyses show experimental parents held more family meetings to discuss family fun, displayed stronger refusal/relapse coping skills, demonstrated stronger sense of self-efficacy in role-play situations, and had lower levels of opiate use than control subjects. No significant differences in family bonding, family conflict, or other measures of drug use were found. The utility of intervening with drug-addicted parents in methadone treatment is discussed in light of these findings.

Substance Use & Misuse, 32(6) : 699-721