Drug Prevention Intervention Research Articles

Predictors, motives, sources and patterns of nonmedical use of prescription drugs among youths in Buea, Southwest region of Cameroon: A mixed method analysis

BackgroundThe non-medical use of prescription drugs (NMUPD) is an emerging phenomenon of serious public health concern among young people globally. This study seeks to determine the predictors, motives, sources, patterns of use of NMUPD among youths in the Buea Health District of the South west region. Materials and MethodsA mixed-method community-based, cross-sectional study conducted from May to June 2018, enrolled participants aged 15 - 29 years from schools and community. A pretested semi-structured questionnaire was used to capture data and focus group discussions and key informant interviews were conducted. Quantitative and qualitative analyses were performed with SPSS version 24 and ATLAS.ti version 7 respectively. Logic regression analysis were carried at 5 % significance level. ResultsThe study enrolled 464 participants (median age of 21 years, IQR: 18 – 23.8 years) into the quantitative study, 63 % were females. Forty-nine participants were enrolled for the qualitative study. A total of 90 (19.6 %; CI: 15.9 – 23.3 %) participants accepted they have used prescriptions medications in the last 12 months for non-medical purposes. Opioids (74.4 %) particularly tramadol (60.1 %) were the most common drugs used. Male gender (p = 0.001), the age group 20–24-year, smoking (p = 0.043) and use of illicit substances (p < 0.001) were independent predictors of NMUPD. Prominent motivations were:- curiosity (31.1 %) and enhancement of work performance (30 %). Unregistered pharmacies and private health facilities were the main sources of these drugs which are acquired mainly without prescription. ConclusionMale gender, young adults, smoking and use of illicit substances were independent predictors of NMUPD. Motives were hinged to enhancement of performance in various domains of social life. Opioids, particularly tramadol was the predominant drug used, acquired without prescription from unregistered pharmacies. Findings of this study provide baseline evidence that could guide policies on drug prevention, treatment and harm reduction interventions.

Comparing Alternative Corrections for Bias in the Bias-Corrected Bootstrap Test of Mediation.

Although the bias-corrected (BC) bootstrap is an often-recommended method for testing mediation due to its higher statistical power relative to other tests, it has also been found to have elevated Type I error rates with small sample sizes. Under limitations for participant recruitment, obtaining a larger sample size is not always feasible. Thus, this study examines whether using alternative corrections for bias in the BC bootstrap test of mediation for small sample sizes can achieve equal levels of statistical power without the associated increase in Type I error. A simulation study was conducted to compare Efron and Tibshirani's original correction for bias, z0, to six alternative corrections for bias: (a) mean, (b-e) Winsorized mean with 10%, 20%, 30%, and 40% trimming in each tail, and (f) medcouple (robust skewness measure). Most variation in Type I error (given a medium effect size of one regression slope and zero for the other slope) and power (small effect size in both regression slopes) was found with small sample sizes. Recommendations for applied researchers are made based on the results. An empirical example using data from the ATLAS drug prevention intervention study is presented to illustrate these results. Limitations and future directions are discussed.

Implementation of a Web-based Alcohol and Other Drug Prevention Intervention for Collegiate Student-athletes

Implementation of a Web-based Alcohol and Other Drug Prevention Intervention for Collegiate Student-athletes

Association of Screen Time and Depression in Adolescence

Increases in screen time have been found to be associated with increases in depressive symptoms. However, longitudinal studies are lacking. To repeatedly measure the association between screen time and depression to test 3 explanatory hypotheses: displacement, upward social comparison, and reinforcing spirals. This secondary analysis used data from a randomized clinical trial assessing the 4-year efficacy of a personality-targeted drug and alcohol prevention intervention. This study assessed screen time and depression throughout 4 years, using an annual survey in a sample of adolescents who entered the seventh grade in 31 schools in the Greater Montreal area. Data were collected from September 2012 to September 2018. Analysis began and ended in December 2018. Independent variables were social media, television, video gaming, and computer use. Symptoms of depression was the outcome, measured using the Brief Symptoms Inventory. Exercise and self-esteem were assessed to test displacement and upward social comparison hypothesis. A total of 3826 adolescents (1798 girls [47%]; mean [SD] age, 12.7 [0.5] years) were included. In general, depression symptoms increased yearly (year 1 mean [SD], 4.29 [5.10] points; year 4 mean [SD], 5.45 [5.93] points). Multilevel models, which included random intercepts at the school and individual level estimated between-person and within-person associations between screen time and depression. Significant between-person associations showed that for every increased hour spent using social media, adolescents showed a 0.64-unit increase in depressive symptoms (95% CI, 0.32-0.51). Similar between-level associations were reported for computer use (0.69; 95% CI, 0.47-0.91). Significant within-person associations revealed that a further 1-hour increase in social media use in a given year was associated with a further 0.41-unit increase in depressive symptoms in that same year. A similar within-person association was found for television (0.18; 95% CI, 0.09-0.27). Significant between-person and within-person associations between screen time and exercise and self-esteem supported upward social comparison and not displacement hypothesis. Furthermore, a significant interaction between the between-person and within-person associations concerning social media and self-esteem supported reinforcing spirals hypothesis. Time-varying associations between social media, television, and depression were found, which appeared to be more explained by upward social comparison and reinforcing spirals hypotheses than by the displacement hypothesis. Both screen time modes should be taken into account when developing preventive measures and when advising parents.

Framing ‘drug prevention’ for young people in contact with the criminal justice system in England: views from practitioners in the field

ABSTRACTDrawing on the work of Rein and Schon (1993. “Reframing Policy Discourse.” In The Argumentative Turn in Policy Analysis and Planning, edited by F. Fischer, and J. Forester, 145–166. London: UCL Press., 1996. “Frame-Critical Policy Analysis and Frame-Reflective Policy Practice.” Knowledge and Policy: the International Journal of Knowledge Transfer and Utilization 9 (1): 85–104), we explore the ways in which ‘young people’, ‘vulnerability’, ‘risk’, ‘prevention’ and ‘prevention practice’ were defined and framed by practitioners engaged in the design, delivery and commissioning of drug prevention interventions for young people in contact with the criminal justice system. We argue that practitioners describe their work in terms of both a preventative frame – based on a ‘deficit’ model – and a transformative praxis frame, more in line with an increasing shift towards ‘positive youth justice’ where practitioners aspire to actively involve the young person in a process of change. The implications of those, often competing, frames are discussed in relation to the development of prevention approaches and the challenges in designing drugs prevention for this group of young people. The paper is based on interviews and focus groups with thirty-one practitioners in England and is part of the EU funded EPPIC project (Exchanging Prevention Practices on Polydrug Use among Youth in Criminal Justice Systems 2017–2020).

The Effects of Trait Emotional Intelligence on Adolescent Substance Use: Findings From a Hungarian Representative Survey

Previous research has emphasized the importance of emotions in the development of adult and adolescent substance use. There is substantial evidence for deficits in emotional processing among teenagers with substance use, but few studies have investigated the association between emotional intelligence and adolescent substance use. The aim of the present study was to examine the relationship between the use of tobacco, alcohol, and illicit drugs and level of emotional intelligence among adolescents. A representative sample of high school students participated in the study (N = 2,380). Substance use patterns were assessed using data from the European School Survey Project on Alcohol and Other Drugs (ESPAD) Survey, and emotional intelligence was assessed with the Bar-On Emotional Quotient Inventory Youth Version. Self-esteem and depressive symptomatology were also assessed to compare their effects on the frequency of substance use with the effect of emotional intelligence. Results demonstrated that greater difficulty in stress management and empathy predicted a higher frequency of tobacco, alcohol, and cannabis use. However, the level of emotional intelligence showed only a weak relationship to substance use habits. Latent profile analyses supported the hypothesis that different emotional patterns and problems underlie different types of psychoactive substances. Using a multiple linear regression model, the present study found that although emotional intelligence is not a key factor underlying substance use habits, it has an individual effect on substance use beyond depressive tendencies and self-esteem. These results can be applied to both drug prevention programs and interventions in substance abuse treatment.

Proportion and predictors of loss to follow-up in a longitudinal cohort study of female entertainment and sex workers in Cambodia.

We examined the proportion and correlates of loss to follow-up (LTFU) among female entertainment and sex workers (FESWs) in a longitudinal HIV prevention intervention trial in Cambodia. The Cambodia Integrated HIV and Drug Prevention Intervention trial tested a comprehensive package of interventions aimed at reducing amphetamine-type stimulant use and HIV risk among FESWs in ten provinces. The present study estimated the proportion of women LTFU and assessed factors associated with LTFU. Logistic regression analyses were used. Of a total 596 women enrolled, the cumulative proportion of LTFU was 29.5% (n = 176) between zero- and 12-month follow-up. In multivariate analyses, women with no living children (adjusted odds ratio [AOR] 1.6; 95% confidence interval [CI]: 1.1, 2.3) and those who experienced recent food insecurity (AOR 1.7; 95%CI: 1.1, 2.7) were more likely to be LTFU. Women who were members of the SMARTgirl HIV prevention programme for ≥ 6 months compared to non-members were less likely to be LTFU (AOR 0.3; 95%CI: 0.2, 0.6). LTFU was moderately high in this study and similar to other studies, indicating a need for strategies to retain this population in HIV prevention programmes and research. Interventions aimed at stabilizing women's lives, including reducing food insecurity and creating communities of engagement for FESWs, should be considered.

Adaptation of the ASSIST peer-led smoking intervention to deliver information from the Talk to FRANK drug education website (ASSIST+FRANK): a pilot cluster-randomised controlled trial

BackgroundIllicit drug use increases the risk of poor physical and mental health. Few effective school-based drug prevention interventions are available. We adapted an effective school-based peer-led smoking prevention intervention (ASSIST) to deliver information from the UK national drug education website, FRANK MethodsWe conducted a four-arm pilot cluster-randomised control trial of 1567 students aged 12–13 years in 12 schools in Wales. Three schools each (mean number students per year 131) were randomly allocated to: ASSIST+FRANK, FRANK friends, ASSIST, or usual practice which may or may not include drug eduation. ASSIST+FRANK is a peer-led smoking prevention intervention in UK Year 8 (ASSIST) followed by a drug prevention adjunct in Year 9 (+FRANK). FRANK friends is a stand-alone peer-led drug prevention intervention in Year 9. ASSIST involves 2 days off-site training, plus four follow-up sessions. +FRANK involves 1 day off-site training plus 3 follow-ups. FRANK friends involves 2 days off-site training and four follow-ups. Influential students were trained to disseminate information on the risks of drug use and minimising harms. Primary outcome was the acceptability of the +FRANK and FRANK friends, which was assessed through interviews with students, staff, parents, and intervention staff (n=66), structured observations of delivery (195), exploratory effectiveness analysis (multilevel logistic models), and estimated costs. Secondary outcome was the lifetime use of any illicit drugs at 18 months. Intention-to-treat analyses were conducted unmasked to the intervention allocation. This trial was approved by Cardiff University School of Social Sciences Research Ethics Committee (SREC/ 1103; ISRCTN 14415936). FindingsAll 12 schools were recruited, randomised, and retained (ASSIST+FRANK 419 students, FRANK friends 440, ASSIST 347, usual practice 361). At the 18 month follow-up the student retention rate was 93% (1460/1567). +FRANK and FRANK friends were acceptable to students, teachers, and parents, and delivered as intended, but FRANK friends was preferred over +FRANK. Some staff felt pressured to meet all the learning objectives for +FRANK in 1 day training versus 2 days in FRANK friends. There could also have been a lack of novelty for +FRANK peer supporters since they had previously experienced the ASSIST intervention. The odds of lifetime drug use at 18 months was marginally lower in both the +FRANK arm and the FRANK friends arm than in the usual practice arm (38 [12·4%] of 307 vs 34 [13·4%] of 254 [odds ratio 0·96, 95% CI 0·58–1·59] and 30 [9·3%] vs 34 [13·4%] [0·70, 0·39–1·24], respectively). The estimated cost per school was £1942 for +FRANK and £3041 for FRANK friends. All progression criteria were met. InterpretationAlthough both interventions were acceptable to students, teachers, and parents, FRANK friends was preferred over +FRANK. There is, therefore, sufficient evidence to warrant a full-scale cluster-randomised controlled trial of FRANK friends. FundingNational Institute for Health Research Public Health Research programme (for the research), Public Health Wales (for the intervention delivery).

Adapting the ASSIST model of informal peer-led intervention delivery to the Talk to FRANK drug prevention programme in UK secondary schools (ASSIST + FRANK): intervention development, refinement and a pilot cluster randomised controlled trial

BackgroundIllicit drug use increases the risk of poor physical and mental health. There are few effective drug prevention interventions.ObjectiveTo assess the acceptability of implementing and trialling two school-based peer-led drug prevention interventions.DesignStage 1 – adapt ASSIST, an effective peer-led smoking prevention intervention to deliver information from the UK national drug education website [see www.talktofrank.com (accessed 29 August 2017)]. Stage 2 – deliver the two interventions, ASSIST + FRANK (+FRANK) and FRANK friends, examine implementation and refine content. Stage 3 – four-arm pilot cluster randomised control trial (cRCT) of +FRANK, FRANK friends, ASSIST and usual practice, including a process evaluation and an economic assessment.SettingFourteen secondary schools (two in stage 2) in South Wales, UK.ParticipantsUK Year 8 students aged 12–13 years at baseline.Interventions+FRANK is a UK informal peer-led smoking prevention intervention provided in Year 8 followed by a drug prevention adjunct provided in Year 9. FRANK friends is a standalone informal peer-led drug prevention intervention provided in Year 9. These interventions are designed to prevent illicit drug use through training influential students to disseminate information on the risks associated with drugs and minimising harms using content from www.talktofrank.com. Training is provided off site and follow-up visits are made in school.OutcomesStage 1 – +FRANK and FRANK friends intervention manuals and resources. Stage 2 – information on the acceptability and fidelity of delivery of the interventions for refining manuals and resources. Stage 3 – (a) acceptability of the interventions according to prespecified criteria; (b) qualitative data from students, staff, parents and intervention teams on implementation and receipt of the interventions; (c) comparison of the interventions; and (d) recruitment and retention rates, completeness of primary, secondary and intermediate outcome measures and estimation of costs.Results+FRANK and FRANK friends were developed with stakeholders [young people, teachers (school management team and other roles), parents, ASSIST trainers, drug agency staff and a public health commissioner] over an 18-month period. In the stage 2 delivery of +FRANK, 12 out of the 14 peer supporters attended the in-person follow-ups but only one completed the electronic follow-ups. In the pilot cRCT, 12 schools were recruited, randomised and retained. The student response rate at the 18-month follow-up was 93% (1460/1567 students). Over 80% of peer supporters invited were trained and reported conversations on drug use and contact with trainers. +FRANK was perceived less positively than FRANK friends. The prevalence of lifetime illicit drug use was 4.1% at baseline and 11.6% at follow-up, with low numbers of missing data for all outcomes. The estimated cost per school was £1942 for +FRANK and £3041 for FRANK friends. All progression criteria were met.ConclusionsBoth interventions were acceptable to students, teachers and parents, but FRANK friends was preferred to +FRANK. A limitation of the study was that qualitative data were collected on a self-selecting sample. Future work recommendations include progression to a Phase III effectiveness trial of FRANK friends.Trial registrationCurrent Controlled Trials ISRCTN14415936.FundingThis project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full inPublic Health Research; Vol. 5, No. 7. See the NIHR Journals Library website for further project information. The work was undertaken with the support of the Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer). Joint funding (MR/KO232331/1) from the British Heart Foundation, Cancer Research UK, the Economic and Social Research Council, the Medical Research Council, the Welsh Government and the Wellcome Trust, under the auspices of the UK CRC, is gratefully acknowledged.

Risk and Protective Factors for Alcohol and Other Drug Use (AOD) Among Adolescents in Rubavu District, Rwanda

Background: Despite ongoing prevention efforts, alcohol and other drug (AOD) abuse among adolescents remain public health concerns. Rural adolescents, many of whom are underserved, are disproportionately affected. AOD bring a major challenge for affected families and communities and places an enormous burden on mental health and other health service providers in Rwanda as well as the country’s economy. To our knowledge no study has been done to address AOD in Rwanda. Objectives: The purpose of this study was to explore perspectives on risk and protective factors influencing AOD of parents and their adolescents attending parent-adolescent communication (PAC) program in Rubavu district, Rwanda. Methods: This study employed qualitative methods and community-based participatory research (CBPR) guided in large part by community members, in partnership with research and health practitioners from Imbuto Foundation and Rubavu Youth Friendly Center (RYFC). CBPR principles are aimed at improving the effectiveness of research by addressing locally relevant health issues and involve communities in every aspects of the research process. Through a systematic process, community participants and researchers work to achieve a shared understanding of the important influences on AOD in the community and suggestions for how to take action in addressing AOD. Purposive sampling procedure was used to select participants for the study. A total of 20 families (17 fathers, 20 mothers and 20 adolescents aged 14 to 24 years) were participants in PAC program from Rubavu Youth Friendly Center (RYFC) in rural sector of Rubavu district. Focus groups and in-depth interviews in Kinyarwanda language were conducted with all study participants. The interview guide was semi structured, nondirective and informal process to elicit rich information regarding risk and protective factors of AOD abuse among adolescents. Each interview and focus group session were written in narrative format and were analysed using grounded theory approach. Results: This Individual risk and protective factors for AOD, environmental risk and protective factors for AOD and suggestion to AOD among the adolescents were the main themes that emerged from this study. Parents and their children adolescents’ participants in PAC program perceived poor communication as a leading risk factor of alcohol and drugs abuse; other risks included poor family support, stressful life events and availability of drugs. Family support, communication about drugs, employment and religion were viewed as protective factors. Participants suggested strengthening parent-adolescent communication about drugs through parenting and drugs education sessions and community home visit and integration the program in village. Other suggestions included strengthening the parent-adolescent relationship in prevention or reduce AOD. Conclusions: Participants believe that parents and families have the ultimate responsibilities to protect and educate their own children about alcohol and drugs. This study calls for the governments to equip families in performing this task. Establishing a family-based drug prevention intervention that aims to produce competent parents would improve parenting practice in prevention of adolescent risk health behavior including alcohol and other drugs.

Development of a framework for the co-production and prototyping of public health interventions

BackgroundExisting guidance for developing public health interventions does not provide information for researchers about how to work with intervention providers to co-produce and prototype the content and delivery of new interventions prior to evaluation. The ASSIST + Frank study aimed to adapt an existing effective peer-led smoking prevention intervention (ASSIST), integrating new content from the UK drug education resource Talk to Frank (www.talktofrank.com) to co-produce two new school-based peer-led drug prevention interventions. A three-stage framework was tested to adapt and develop intervention content and delivery methods in collaboration with key stakeholders to facilitate implementation.MethodsThe three stages of the framework were: 1) Evidence review and stakeholder consultation; 2) Co-production; 3) Prototyping. During stage 1, six focus groups, 12 consultations, five interviews, and nine observations of intervention delivery were conducted with key stakeholders (e.g. Public Health Wales [PHW] ASSIST delivery team, teachers, school students, health professionals). During stage 2, an intervention development group consisting of members of the research team and the PHW ASSIST delivery team was established to adapt existing, and co-produce new, intervention activities. In stage 3, intervention training and content were iteratively prototyped using process data on fidelity and acceptability to key stakeholders. Stages 2 and 3 took the form of an action-research process involving a series of face-to-face meetings, email exchanges, observations, and training sessions.ResultsUtilising the three-stage framework, we co-produced and tested intervention content and delivery methods for the two interventions over a period of 18 months involving external partners. New and adapted intervention activities, as well as refinements in content, the format of delivery, timing and sequencing of activities, and training manuals resulted from this process. The involvement of intervention delivery staff, participants and teachers shaped the content and format of the interventions, as well as supporting rapid prototyping in context at the final stage.ConclusionsThis three-stage framework extends current guidance on intervention development by providing step-by-step instructions for co-producing and prototyping an intervention’s content and delivery processes prior to piloting and formal evaluation. This framework enhances existing guidance and could be transferred to co-produce and prototype other public health interventions.Trial registrationISRCTN14415936, registered retrospectively on 05 November 2014.

Design of study without drugs--a Surinamese school-based drug-prevention program for adolescents.

BackgroundThe aim of this study was to design the content and accompanying materials for a school-based program—Study without Drugs—for adolescents in junior secondary schools in Suriname based on the starting points and tasks of the fourth step of the Intervention Mapping protocol (which consists of six steps). A program based on this protocol should include a combination of theory, empirical evidence, and qualitative and quantitative research.MethodsTwo surveys were conducted when designing the program. In Survey I, teachers and students were asked to complete a questionnaire to determine which school year they thought would be most appropriate for implementing a drug-prevention program for adolescents (we completed a similar survey as part of previous research). An attempt was made to identify suitable culturally sensitive elements to include in the program. In Survey II, the same teachers were asked to complete a questionnaire to determine the programs’ scope, sequence, structure, and topics as well as the general didactic principles to serve as a basis for program design. After outlining the program plan, lessons, and materials, we conducted a formative pretest evaluation among teachers, students, and parents. That evaluation included measures related to the program’s attractiveness, comprehensibility, and usefulness. The resulting lessons were presented to the teachers for assessment.ResultsThe drug-prevention program we developed comprises 10 activities and lasts 2–2.5 months in an actual school setting. The activities take place during Dutch, biology, physical education, art, religion, and social studies lessons. We based the structure of the lessons in the program on McGuire’s Persuasion Communication Model, which takes into account important didactic principles. Evaluations of the program materials and lesson plans by students, teachers, and parents were mostly positive.ConclusionWe believe that using the fourth step of the Intervention Mapping protocol to develop a drug-prevention intervention for adolescents has a produced promising, feasible program.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2374-1) contains supplementary material, which is available to authorized users.

Agarra el momento/seize the moment: Developing communication activities for a drug prevention intervention with and for Latino families in the US Southwest.

This article presents the development of parent-child communication activities by applying Community-Based Participatory Research and focus group methodology. Three parent-child communication activities were developed to enhance an already efficacious parenting intervention: (1) agarra el momento or seize the moment uses everyday situations to initiate conversations about substance use, (2) hay que adelantarnos or better sooner than later stresses being proactive about addressing critical issues with youth, and (3) setting rules and expectations engages parents in establishing rules and expectations for healthy and effective conversations with youth. Focus group data are presented to illustrate how thematic content from the focus groups was used to inform the development of the activities and, furthermore, how such methods supported the development of a culturally grounded intervention.

Long-term effects of staying connected with your teen® on drug use frequency at age 20.

Drug prevention interventions frequently target early adolescents in order to stop or delay initiation of substance use. However, the prevalence and frequency of drug use escalate and then peak during emerging adulthood, making it important to determine whether drug use prevention efforts in adolescence have lasting effects into adulthood. Additionally, given differences in drug use frequency between ethnic groups, intervention effects by race should be examined when possible. This study evaluates the efficacy of a family-focused prevention program, Staying Connected with Your Teen®, delivered to parents and teens in the 8th grade, on family stressors during 9th and 10th grades, 10th-grade drug use (as potential mediators), and drug use frequency at age 20. Families (N = 331; Black = 163, White = 168) were randomly assigned to three conditions: parent-adolescent group-administered (PA), self-administered with telephone support (SA), and no-treatment control (Haggerty et al. Prevention Science, 8: 249-260, 2007). The impact of the intervention was assessed using latent variable structural equation models. Age 20 drug use frequency was significantly higher among Whites than Blacks as expected. The PA intervention had direct effects on reducing drug use frequency for both Blacks and Whites. The SA intervention had an impact on family stressors during adolescence for Whites, but not for Blacks. Results suggest that both formats for delivery were modestly efficacious for Whites, but only direct delivery was modestly efficacious for Blacks. Given the substantial savings in cost of the self-administered program over the group-administered format, improving the efficacy of self-administered programming for Blacks is recommended.

Prescription opioid injection and risk of hepatitis C in relation to traditional drugs of misuse in a prospective cohort of street youth

ObjectiveDespite dramatic increases in the misuse of prescription opioids, the extent to which their intravenous injection places drug users at risk of acquiring hepatitis C virus (HCV) remains unclear. We...

Adherence and Delivery: Implementation Quality and Program Outcomes for the Seventh-Grade keepin’ it REAL Program

Poor implementation quality (IQ) is known to reduce program effects making it important to consider IQ for evaluation and dissemination of prevention programs. However, less is known about the ways specific implementation variables relate to outcomes. In this study, two versions of keepin' it REAL, a seventh-grade drug prevention intervention, were implemented in 78 classrooms in 25 schools in rural districts in Pennsylvania and Ohio. IQ was measured through observational coding of 276 videos. IQ variables included adherence to the curriculum, teacher engagement (attentiveness, enthusiasm, seriousness, clarity, positivity), student engagement (attention, participation), and a global rating of teacher delivery quality. Factor analysis showed that teacher engagement, student engagement, and delivery quality formed one factor, which was labeled delivery. A second factor was adherence to the curriculum. Self-report student surveys measured substance use, norms (beliefs about prevalence and acceptability of use), and efficacy (beliefs about one's ability to refuse substance offers) at two waves (pretest, immediate posttest). Mixed model regression analysis which accounted for missing data and controlled for pretest levels examined implementation quality's effects on individual level outcomes, statistically controlling for cluster level effects. Results show that when implemented well, students show positive outcomes compared to students receiving a poorly implemented program. Delivery significantly influenced substance use and norms, but not efficacy. Adherence marginally significantly predicted use and significantly predicted norms, but not efficacy. Findings underscore the importance of comprehensively measuring and accounting for IQ, particularly delivery, when evaluating prevention interventions.

Universality Properties of School-Based Preventive Intervention Targeted at Cannabis Use

This study aims to examine the effect of school-based preventive intervention on cannabis use in Czech adolescents with different levels of risk factors and provide evidence of its universality. A randomized controlled prevention trial with six waves was conducted over a period of 33months. We used a two-level logistic random-intercept model for panel data; we first looked at the statistical significance of the effect of the intervention on cannabis use, controlling for the characteristics of the children and time dummies. Then we analyzed the effects of the interactions between the intervention and the characteristics of the children on cannabis use and related it to the definition of universal preventive interventions. The setting for the study was in basic schools in the Czech Republic in the years 2007-2010. A total of 1,874 sixth-graders (mean age 11.82years) who completed the baseline testing. According to our results, the prevention intervention was effective. We found all the selected characteristics of the children to be relevant in relation to cannabis use, except their relationships with their friends. We showed empirically that the intervention is universal in two dimensions for the selected characteristics of the children. First, all adolescents who undergo the intervention are expected to benefit. Second, with respect to the effect of the intervention on cannabis use, the total level of individual risk of cannabis use is superior to the composition of the risk factors in the individual risk profile. We present indicative evidence that the drug prevention intervention may be considered a true universal preventive intervention.

Correlated outcomes of a pilot intervention for people injecting drugs and their family members in Vietnam

BackgroundThe interrelationship between the well-being of injecting drug users (IDUs) and their family environment has been widely documented. However, few intervention programs have addressed the needs of both IDUs and their family members. MethodsThis study describes a randomized intervention pilot targeting 83 IDUs and 83 of their family members from four communes in Phú Thọ province, Vietnam. The IDUs and family members in the intervention condition received multiple group sessions, with the intent to improve psychological well-being and family relationships. The intervention outcomes (depressive symptoms and family relations) were evaluated at baseline, 3-month and 6-month follow-up assessments. ResultsDepressive symptoms and family relations reported by IDUs were found to be correlated to those reported by their family members. Overall, significant intervention effects on depressive symptoms and family relations were observed for both IDUs and family members. A similar improvement pattern in family relations emerged for both the IDU and family member samples, although the intervention effect of reducing depressive symptoms was more sustainable for family members at the 6-month assessment when compared to the IDU sample. ConclusionThe intervention pilot addressed challenges faced by IDUs and their family members and revealed correlated outcomes for the two groups. Findings suggest a vital need to include family members in future drug prevention and harm reduction intervention efforts.

Stimulant Use Among African American and Latino MSM Social Networking Users

High stimulant-using and at-risk HIV populations, such as African American and Latino men who have sex with men (MSM), are increasingly using social networking technologies. However, no known research has explored associations between stimulant use, sexual risk behaviors, and social networking among these populations. Participants were recruited using the Facebook Connect software application, which narrowed the sample to 118 (primarily African American and Latino MSM) active Facebook users. Participants completed demographic, Internet and social media use, and drug use survey items. Participants reported high rates of cocaine and methamphetamine use (both more than 15% within the past 12 months). More than 70% of participants reported using social networking technologies to meet people, and more than 30% used them to find sexual partners. A multivariate logistic regression showed that (1) participants using social networks to find sexual partners were more likely to have used methamphetamines within the past 12 months and (2) those who were more comfortable talking online compared to face-to-face had over 4 times the odds of methamphetamine use and over 6 times the odds of cocaine use within the past 12 months. Minority MSM who used social networks to meet men and find sexual partners had high risk for stimulant use. Understanding drug use among minority social networking users will provide insights to incorporate these technologies into drug prevention interventions.

Participación parental en intervenciones familiares para prevenir drogodependencias: una revisión empírica

Substance use andmisuse are very common in adolescence. Parents play an important part in substance use, both through inducing risk or promoting protection and resilience. Family-based interventions have proven to be a useful approach to prevent adolescent substance use and other youth problem behaviors. However, low participation rates are an important threat to the validity of family-based preventive interventions. It has long been recognized that one of the major problems in implementing familybased preventive interventions has been the recruitment, retention and participation of parents. Besides, the benefits of increased parent participation in preventive parent training are associated with a lasting effect on adolescent behavior. Identify specific determinants of participant engagement in family-based prevention programs is of utmost importance, as the level of parental engagement can be a predictor of program effectiveness. There has recently been increased attention to understanding how individual, contextual and intervention factors can predict parental participation in family-based drug prevention interventions. Research on predictors of participation is helpful in the way it can identify those individuals who may be at highest risk for drop out. In this paper we provide an overview of the more recent developments of the several predictors of family participation in preventive substance use and other problems family-based programs. Keeping inmind the specific dynamic determinants of participation examined in this review, we finally suggest a theoretical framework of family participation that includes four basic components: (1) family interaction patterns; (2) parent cognitions and attributions about child’s behavior problems; (3) parent psychological variables; and; (4) parent perceptions about the preventive intervention.