Substance Abuse Prevention Programs Research Articles

Impact of yohimbine and cocaine-cues on executive function in cocaine-dependent men and women

Aims:Although abuse of prescription opioids (PO) has increased dramatically amongmany age groups in the US in recent years, the rate of abuse in teens is more than 2.6 times the rate in adults. Although science-based, interactive, drug-abuse prevention programs exist focused on preventing use of non-prescription drugs in youth, no science-based, interactive program for the prevention of PO abuse among youth exists. The aims of this project were to: (1) develop 3modules (i.e. Introduction,What are PO?,Misconception that PO are safe and non-addictive) of a web-based PO abuse prevention program for high school-aged youth; and (2) conduct feedback sessions with youth to obtain reactions to beta versions of modules. Methods: To achieve aim 1, we conducted 2 focus groups and 1 interview (audiotaped: ∼ 90min) with high school-aged youth (n=12) along a continuum of exposure to opioids to determine how to best present program information to this age group. To achieve aim 2, thirty youth participated in feedback sessions to assess program acceptability and utility. Results: Focus group results reveal that youth have some accurate information about PO, but also highlight misconceptions and lack of knowledge about PO. Feedback session results demonstrate thatparticipantknowledgeaboutPO increasedsignificantly following exposure to the program (66–100%) and misconceptions were corrected (68–95%), measured by pre-post knowledge tests. Participants also rated the program highly. We are currently developing sixadditionalweb-basedmodules (developmentdata collectedwill be reported at the2015 conference) andwill conduct a randomized, controlled trial to evaluate the effectiveness of the tool. Conclusions: Results reveal the utility of including potential programusers inprogramdevelopment, andhighlight thepotential effectiveness of the tool to increase knowledge about PO. Financial support: NIDA Grant #2R42DA023731.

Neutralization and glorification: Cannabis culture-related beliefs predict cannabis use initiation

Addressing specific pro-cannabis attitudes may be a viable adjunct to school-based substance abuse prevention programs. To study the predictive value of cannabis culture-related beliefs in relation to initiation of cannabis use, a prospective cohort study of 1223 students attending high school or equivalent education programs in Denmark were administered a questionnaire containing demographic information, questions about cannabis use, normative perception and personal beliefs in relation to two dimensions of cannabis culture-related beliefs: (1) beliefs about the negative consequences of cannabis use (neutralization) and (2) beliefs about positive aspects of cannabis use (glorification). Normative perception and glorification were both robustly associated with incidence of cannabis use at the 6- and 12-month follow-up. Neutralization was associated with initiated cannabis use only at the 12-month follow-up. These findings suggest that beliefs about the benefits of cannabis use may be as important in targeted programs to prevent cannabis use as beliefs about whether cannabis use is common or harmful.

107: A Systematic Review of Primary Substance Abuse Prevention Programs For School-Age Children and Youth

Youth substance abuse has been described as an international public health problem (Tortolero, 2012). In Canada, recent statistics demonstrate concerning trends in youth substance abuse toward increasing usage and a lower age at first use (Health Canada, 2012). Given these trends, recent decades have seen a proliferation in primary substance abuse prevention programs for children and youth focused on preventing the initial onset of alcohol and drug use. However, evidence for the effectiveness of these programs is fragmented, with heterogeneous measures and a variety of mediating factors reported in the literature (Riggs, Black, & Ritt-Olson, 2014). The aim of the current project was to conduct a systematic review that synthesizes evidence in this area by: (i) identifying substance abuse prevention programs available for school-aged children and youth; and (ii) reporting the type and quality of evidence to support the effectiveness of identified programs. We undertook a systematic search process using Cochrane Collaboration (2009) methods. To begin, a research librarian created a search strategy designed to identify studies relevant to the stated objectives. Eight academic databases were searched. All studies that met the following criteria were eligible for the first stage of inclusion: i) published in English; ii) evaluated the effectiveness of a substance abuse prevention program; iii) the program was delivered to school-age children and youth; and iv) the study included a control group. After screening articles using these initial criteria, two researchers independently engaged in a second stage screening process using the following criteria: i) the program was delivered to a general population of children/youth; ii) the program was designed as a primary prevention program; iii) the article described a final evaluation, as opposed to a pilot evaluation; and iv) the program only targeted children. The combined results of these two search strategies yielded over 100 articles that met inclusion criteria. Results indicate a number of primary prevention programs that demonstrate varying levels of evidence to support their effectiveness. This presentation will discuss the key characteristics shared by programs at each evidence level, with the aim of providing practical information for decision-makers, practitioners, and other service providers seeking to select the most appropriate prevention initiatives for their communities. This review has a number of implications for the implementation of primary substance abuse prevention programs. This review also highlights a number of areas in which the quality of research in this field can be strengthened.

English

Substance abuse is a current and serious problem all around the globe. In fact, the number of substance abusers including school children and teenagers is growing. This study aims to identify challenges faced by secondary schools and the supports needed in the effort to curb substance abuse. A total of 18 high risk secondary schools were selected from Selangor, Wilayah Persekutuan Kuala Lumpur, Penang, Negeri Sembilan and Melaka. The questionnaire survey involved a total of 258 teachers from 18 selected schools. Data were analyzed descriptively using frequency counts and percentages. The results identifi ed the lack of student participation, time constraints and fi nancial problem as three main challenges in conducting drug prevention programmes in schools while the most crucial support needed by schools in organizing substance abuse programmes are material and fi nancial support, anti-drug talk/clinic and professional advice. It is recommended that substance abuse prevention programmes should involve the students’ families and the community to have better result. As for every substance abuse prevention programme held in schools, feedback from the participants should be obtained and analyzed in order to gauge the effectiveness and relevance of the programme. This study concluded that there are many challenges faced by schools in curbing substance abuse with lack of student participation, time constraints and fi nancial problem posed as the main challenges. Hence, involvement of all parties is needed to provide support needed to ensure the success of the implementation of substance abuse prevention programmes.

Preventing substance abuse and relationship violence: Proof-of-concept evaluation of a social, multi-user, tablet-based game

Increasing evidence suggests that using technology and Internet-based methods in prevention programming can be an efficacious delivery practice. This literature implies that applying digital technologies to prevention may provide a unique opportunity to carry out interventions with reliability and in a manner that is more appealing and suitable to youth. This exploratory study reports on a proof-of-concept evaluation of Choices & Consequences, a substance abuse and relationship violence prevention program that integrates digital technologies and devices with game-based behavior change techniques. Six focus groups (N=44) were conducted with youth living in a Southwestern city. Results suggest that youth preferred various aspects of this prevention game to traditional methods. They especially liked that the game was engaging and that they were able to learn in both formal and informal environments, that is interacting with each other and a facilitator or playing the game on their own. Results also found that youth learned many lessons while playing the game and they believe the game may help prevent substance abuse and relationship violence among the target population of early adolescents. Thus, this research suggests that prevention programs for youth that combine interactive methods, mobile technology, social networking, and competitive gaming could be a strong alternative to traditional delivery methods.

Developing a Web-Based Intervention to Prevent Drug Use among Adolescent Girls.

Girls' rates of drug use have met up with, and in some instances, surpassed boys' use. Though girls and boys share risk and protective factors associated with drug use, girls also have gender-specific risks. Interventions to prevent girls' drug use must be tailored to address the dynamics of female adolescence. One such intervention, called RealTeen, is a 9-session, web-based drug abuse prevention program designed to address such gender-specific risk factors associated with young girls' drug use as depressed mood, low self-esteem, and high levels of perceived stress as well as general drug use risk factors of peer and social influences. Web-based delivery enables girls to interact with the program at their own pace and in a location of their choosing. This paper describes the processes and challenges associated with developing and programming a gender-specific, web-based intervention to prevent drug use among adolescent girls.

A large-scale initiative to disseminate an evidence-based drug abuse prevention program in Italy: Lessons learned for practitioners and researchers

Across developed countries, experimentation with alcohol, tobacco, and other drugs often begins in the early adolescent years. Several evidence-based programs have been developed to prevent adolescent substance use. Many of the most rigorously tested and empirically supported prevention programs were initially developed and tested in the United States. Increasingly, these interventions are being adopted for use in Europe and throughout the world. This paper reports on a large-scale comprehensive initiative designed to select, adapt, implement, and sustain an evidence-based drug abuse prevention program in Italy. As part of a large-scale regionally funded collaboration in the Lombardy region of Italy, we report on processes through which a team of stakeholders selected, translated and culturally adapted, planned, implemented and evaluated the Life Skills Training (LST) school-based drug abuse prevention program, an evidence-based intervention developed in the United States. We discuss several challenges and lessons learned and implications for prevention practitioners and researchers attempting to undertake similar international dissemination projects. We review several published conceptual models designed to promote the replication and widespread dissemination of effective programs, and discuss their strengths and limitations in the context of planning and implementing a complex, large-scale real-world dissemination effort.

Preventing Drug Use Among Sexual-Minority Youths: Findings From a Tailored, Web-Based Intervention

PurposeRates of drug use among sexual-minority youths are disproportionately high. Yet, expressly designed prevention programs targeting this population are absent. This study developed and tested a web-based drug abuse prevention program for sexual-minority youths. MethodsA sample (N = 236) of sexual-minority youths was recruited via Facebook. Online, all youths completed pretests; youths randomly assigned to the intervention received a 3-session prevention program; and all youths completed posttest and 3-month follow-up measurements. ResultsAt 3-month follow-up and compared to youths in the control arm, intervention-arm youths reported less stress, reduced peer drug use, lower rates of past 30-day other drug use, and higher coping, problem solving, and drug-use refusal skills. ConclusionsOutcome data suggest the potential of tailored intervention content to address sexual-minority youths' drug use rates and related risk factors. Moreover, study procedures lend support to the feasibility of using the Internet to recruit sexual-minority youths, collect data, and deliver intervention.

American Indian Substance Abuse Prevention Efforts: A Review of Programs, 2003-2013.

The purpose of the review was to assess substance abuse prevention (SAP) efforts in American Indian and Alaska Native (AI/AN) communities from 2003-2013. In the past, many SAP programs were unable to meet the unique cultural needs of AI/AN communities adequately. It has been suggested that a disconnect may exist between the theories that are used to guide development of prevention programs in AI/AN communities and culturally appropriate theoretical constructs of AI/AN worldviews. To explore this possible disconnect further, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to assess a total of 18 articles (N = 31 programs) on program location and method, participant characteristics, described program cultural elements, use of theory, program outcomes, program measures, and future recommendations. Results indicated that SAP programs in AI/AN communities vary widely in their use of theory, implementation strategies, view and definition of cultural constructs, overall evaluational rigor, and reporting methods. Future research is needed to integrate appropriate theory and cultural elements into SAP programs to tie them to measurable outcomes for AI/AN communities.

Meta-analysis of the effectiveness of school substance abuse prevention programs in Spain.

There has been an increase in adolescent substance use that has led to the development and implementation of prevention programs. New evidence is needed in order to improve them and optimize the resources. The aim of this paper is to use a meta-analysis to analyze the effectiveness of school drug prevention programs in Spain. Twenty-one studies that evaluated drug abuse prevention programs in schools, were published between 2002 and 2013, and that met the selection criteria were identified. Preventive program effectiveness was low ( d = 0.16), although it was higher at the follow-up ( d = 0.30). The programs were most effective in changing attitudes ( d = 0.44) towards drugs. The models of health education ( d = 0.48) and social learning ( d = 0.20) were also very effective, especially in combination with oral, written, and audiovisual support material ( d = 0.21) and the implementation of joint programs by health education professionals and faculty members ( d = 0.25). Is possible to determine the need for more rigorous evaluations of interventions to establish useful programs.

A Cluster Randomized Trial of Alcohol Prevention in Small Businesses: A Cascade Model of Help Seeking and Risk Reduction

The current study adapted two workplace substance abuse prevention programs and tested a conceptual model of workplace training effects on help seeking and alcohol consumption. Questionnaires were collected 1 month before, 1 month after, and 6 months within a cluster randomized field experiment. Texas small businesses in construction, transportation, and service industries. A total of 1510 employees from 45 businesses were randomly assigned to receive no training or one of the interventions. The interventions were 4-hour on-the-job classroom trainings that encouraged healthy lifestyles and seeking professional help (e.g., from the Employee Assistance Program [EAP]). The Team Awareness Program focused on peer referral and team building. The Choices in Health Promotion Program delivered various health topics based on a needs assessment. Questionnaires measured help-seeking attitudes and behavior, frequency of drinking alcohol, and job-related incidents. Mixed-model repeated-measures analyses of covariance were computed. Relative to the control group, training was associated with significantly greater reductions in drinking frequency, willingness to seek help, and seeking help from the EAP. After including help-seeking attitudes as a covariate, the correlation between training and help seeking becomes nonsignificant. Help-seeking behavior was not correlated with drinking frequency. Training improved help-seeking attitudes and behaviors and decreased alcohol risks. The reductions in drinking alcohol were directly correlated with training and independent from help seeking.

Validation of the Communities That Care Measure Adapted for Use in Malaysia

In order to address drug use among adolescents and young adults in Malaysia, research is needed on risk and protective factors across multiple domains. The current study describes the adaptation of the Communities That Care (CTC) assessment tool for use in Malaysia, and assessment of its reliability and validity. Participants were 338 adolescents (58.3% male) from secondary schools (87%) and a juvenile center for youth with substance abuse or delinquency problems who completed the adapted version of the CTC. The risk and protective factor scales had adequate to good internal consistency. The measure demonstrated construct validity in that risk and protective factors differed across adolescents in riskier versus less risky settings. Further, risk and protective factors were inversely associated, demonstrating discriminant validity. In logistic regression analyses predicting membership in either the riskier or less risky group of youth, peer drug use and community disorganization both uniquely predicted group membership in the analysis with risk factors; religious practices uniquely predicted group membership in the analysis with protective factors. Collectively, these data supported the utility of this measure for use in Malaysia. The adapted CTC may be useful to school counselors and others in designing and evaluating drug abuse prevention programs.

Effective HIV and substance abuse prevention programs for African-American women: Attending to culture and context

Effective HIV and substance abuse prevention programs for African-American women: Attending to culture and context

Investigation of the educational effectiveness of including small group discussion as part of a drug abuse prevention program for junior high school students

We evaluated the effectiveness of small group discussion (SGD) in association with a drug abuse prevention program for junior high school students. The students first received a lecture about drug abuse prevention, then participated in SGD. The discussion focused on how to take action when tempted to abuse drugs. We gave a questionnaire 3 times; before and after the lecture (before SGD), and after SGD. Seventy-seven students replied to these questionnaires. After the lecture, knowledge about drug abuse was improved and all students answered that they had never abused drugs. However, in answer to a different question, a few students noted that they might use drugs in some situations. We consider it necessary to give more consideration to this problem. After the lecture, 35.5% of the students felt that they had definitely acquired skills for drug abuse prevention, whereas after the SGD this was increased to 73.7%. In addition, more than 75% of the students answered that the SGD program was useful since the opinions of other students could be heard. These results suggest that more students acquired skills to prevent drug abuse by participation in SGD. Our findings showed that SGD was useful and that the students were able to more effectively understand important concepts related to drug abuse prevention.

THEORIES OF SUBSTANCE ABUSE PREVENTION IN THE WORKPLACE

Workplaces have been identified as important structures for the implementation of alcohol abuse prevention programmes (Ames, 1993; Cook & Youngblood, 1990; Gill, 1994; Heirich & Sieck, 2000; Parry & Bennets, 1998; Roman, 1990; Roman & Blum, 2002; Snow, Swan & Wilton, 2002). The need for substance abuse prevention programmes in the workplace has also been recognised by South African authors (Albertyn & McCann, 1993; Parry & Bennetts, 1998; Strydom, 1997). The National Drug Master Plan: 2006-2011 (Department of Social Development, 1997), which directs all substance abuse services in South Africa, has prevention amongst workers as one of its priority areas.

Early initiation of alcohol or marijuana use and nonmedical use of prescription drugs

Early initiation of alcohol or marijuana use and nonmedical use of prescription drugs

Partnership, Knowledge Translation, and Substance Abuse Prevention With a First Nations Community

Partnership, Knowledge Translation, and Substance Abuse Prevention With a First Nations Community Lola Baydala, Fay Fletcher, Stephanie Worrell, Tania Kajner, Sherry Letendre, Liz Letendre, and Carmen Rasmussen What Is the Purpose of This Study? • To understand the benefits of culturally adapting and implementing a 3-year, school-based, drug and alcohol prevention program for First Nation children and youth. What Is the Problem? • Substance abuse is a significant area of concern within Aboriginal communities across Canada. However, effective school-based substance abuse prevention programs are not typically available to the majority of First Nations schools. • Prevention programs that are available often fail to integrate the cultural beliefs and values of individuals outside of the dominant culture. • More research is required on the benefits of culturally appropriate drug and alcohol prevention programs that incorporate the beliefs, values, language, and visual images of the community. What Are the Findings? • Qualitative measures revealed a positive effect of the culturally adapted program on youth. • Elders and community members observed positive changes in student’s cultural knowledge and cited observed behavioral changes as evidence of the adapted program’s success. • The culturally adapted program is seen as surpassing the original in terms of embodying the values of the community. • Positive community developments occurred as a result of the program adaptation process, which followed a community-based participatory research approach. • Results of the quantitative measures were mixed, in part as a result of inconsistent and unpredictable student school attendance. Who Should Care Most? • Educators, school officials, and health care providers working in First Nations communities. • Policymakers in the areas of health and education. • Community members and leaders. • Substance abuse, public health, and youth program providers. [End Page 139] Recommendations for Action • Highly effective, evidence-based substance abuse prevention programs for school-aged children can be successfully adapted to incorporate the cultural beliefs, values, language, and visual images of the community where the program is delivered. • Community Elders are the keepers of the Nation’s oral traditions and knowledge and their input and guidance is an important and necessary part of program adaptation, implementation, and evaluation. • Culture, language, history, and spirituality are the foundations of Aboriginal identity and are essential components of program adaptation. • Cultural adaptations should go beyond surface level cultural markers to include Aboriginal worldviews and ways of knowing, as well as recognition of historical impacts on health and education. • A community-based participatory research approach is a catalyst for community development and an important component of program sustainability. • Attention to both community capacity building and academic capacity building is important to ensure a successful project. [End Page 140] Lola Baydala University of Alberta Fay Fletcher University of Alberta Stephanie Worrell University of Alberta Tania Kajner University of Alberta Sherry Letendre University of Alberta Liz Letendre Alexis Heritage Program, Alexis Nakota Institute Carmen Rasmussen University of Alberta Copyright © 2014 The Johns Hopkins University Press

The impact of mindfulness education on elementary school students: Evaluation of the Master Mind Program.

Children need to be equipped with the skills to respond effectively to stress and prevent poor decision-making surrounding alcohol and tobacco use. Training and practice in mindfulness is one possible avenue for building children's skills. Recent research has revealed that mindfulness education in the classroom may play a role in enhancing children's self-regulatory abilities. Thus, the goal of the current study was to extend existing research in mindfulness education in classrooms and conduct an assessment of the feasibility and effectiveness of a new mindfulness education, substance abuse prevention program for 4th and 5th grade children (Master Mind). Two elementary schools were randomly assigned to be an intervention group (N = 71) or waitlist control group (N = 40). Students in the intervention group were taught the four-week Master Mind program by their regular classroom teachers. At pre- and post-intervention time points, students completed self-reports of their intentions to use substances and an executive functioning performance task. Teachers rated students on their behavior in the classroom. Findings revealed that students who participated in the Master Mind program, as compared to those in the wait-list control condition, showed significant improvements in executive functioning skills (girls and boys), as well as a marginally significant increase in self-control abilities (boys only). In addition, significant reductions were found in aggression and social problems (girls and boys), as well as anxiety (girls only). No significant differences across groups were found for intentions to use alcohol or tobacco. Teachers implemented the program with fidelity; both teachers and students positively rated the structure and content of the Master Mind program, providing evidence of program satisfaction and feasibility. Although generalization may be limited by the small sample size, the findings suggest that mindfulness education may be beneficial in increasing self-regulatory abilities, which is important for substance abuse prevention.

Commentary--Project Towards No Drug Abuse: an evidence-based drug abuse prevention program.

Project Towards No Drug Abuse (Project TND) is a research-based program that has been examined over seven group-randomized controlled trials. In all trials, an effect has been found on hard drug use. An effect has been found on alcohol use in four trials, and on cigarettes and marijuana in two trials. (Arguably, an effect is found on marijuana in three trials.) Program effects on violence-related behavior were established in earlier trials, though such effects were not assessed in later trials. Certainly, as in most scientific studies, there are limitations in the interpretation of the effects obtained, particularly regarding cigarette and marijuana use and violence-related behavior, and more empirical work is needed. For Project TND, however, numerous trial replications have been completed, and the effects within each trial could not have been obtained by chance alone more than 10 % of the time (two-tailed). These results suggest that Project TND is indeed evidence-based. To be evidence-based means that evidence has accumulated to suggest that the program is likely to work, at least under conditions that are comparable to those in which it has been tested.

Advancing school-based interventions through economic analysis.

Commentators interested in school-based prevention programs point to the importance of economic issues for the future of prevention efforts. Many of the processes and aims of prevention science are dependent upon prevention resources. Although economic analysis is an essential tool for assessing resource use, the attention given economic analysis within school-based prevention remains cursory. Largely, economic analyses of school-based prevention efforts are undertaken as secondary research. This limits these efforts to data that have been collected previously as part of epidemiological and outcomes research. Therefore, economic analyses suffer from gaps in the knowledge generated by these studies. This chapter addresses the importance of economic analysis for the future of school-based substance abuse prevention programs and highlights the role of prevention research in the development of knowledge that can be used for economic analysis.