Drug Prevention Programs Research Articles

Differential learning effects in preventive drug education by peer group members

In the drug prevention programme studied here, peers were acting as teachers for their colleagues. We focused on the contribution of student characteristics and of teaching quality to the gain in knowledge about drugs. 165 8th- and 9th-graders in eight classes answered a questionnaire three times: before, immediately after and five months after the intervention. There was a significant increase in knowledge immediately after the intervention (mean m = 6.2) and after five months (m = 6.1) compared to the score before (m = 4.5). Furthermore, non-German speaking students of the "Sekundarschule" (higher level) learned the most, non-German speaking students of the "Realschule" (lower level) learned nothing at all. We found a positive association between teaching quality as assessed by each class and knowledge gain in the same class. Multiple linear regression analysis showed that five months after the intervention student characteristics explained an important part of the variance in knowledge gain (25% of the total variance), while teaching quality explained another 5%. Consequently, these characteristics can serve as predictors of knowledge gain in such programmes.

Evaluating a Community-Based Drug and Alcohol Prevention Program for At-Risk Youth

Changes in psychological functioning as a result of participation in Alternative Community Intervention (ACI), a community-based drug and alcohol prevention program for at-risk children, were investigated. Twenty-three children (ages 10-13) who participated in ACI completed the Achenbach Youth Self-Report (YSR) immediately before the program and again 6-12 months later. A series of t-tests to examine the differences between baseline scores and post-test scores revealed a trend towards significance (p = .059) for change on the self-destructiveness/identity problems scale. Analyses of variance to examine baseline factors that were associated with change from the beginning to the end of the program indicated that socioeconomic status and baseline grades were associated with significant change after the program. Specifically, medium socioeconomic status and fair grades were associated with the greatest improvement in delinquency and cognitive, emotional, behavioral, and social problems.

Identifying adolescents at risk for hard drug use: racial/ethnic variations

Purpose: To examine early risk factors for initiation of hard drug use by 10th grade in a sample of adolescents drawn from diverse high schools and communities, compares the results across different racial/ethnic groups, and to evaluate the predictive performance of a user-friendly risk scale against the more complex logistic model. Methods: Using longitudinal data from 4347 adolescents from California and Oregon, we developed and cross-validated logistic and additive prediction models for non-Hispanic white students (the largest group) and assessed how well each model worked for black, Hispanic, and Asian adolescents. We also developed a best logistic model for each group. Predictor variables were measured at Grade 7; the hard drug use outcome was measured at Grade 10. Results: Major risk factors for initiation of hard drug use included early marijuana and cigarette use, deviant behavior, poor parent–child communication, being offered drugs, and prodrug attitudes and intentions. White adolescents had the most risk factors, followed by Hispanics, Asians, and Blacks. Specific risk factors played more important roles for some groups than others. Early marijuana use provided the strongest warning signal for all groups except Blacks, while exposure to drug offers increased the risk for all but Hispanic youth. Poor communication with parents was particularly important for Hispanic and Asian adolescents, whereas doing poorly in school was a key predictor only for Asians. Social influences to use drugs and intentions to use them were the only predictors for Blacks. Although family disruption and limited parental education were associated with an increase in risk for white adolescents, the latter had the opposite effect for Hispanics and Blacks. The simple additive model worked almost as well as the most complicated logistic model in predicting hard drug use for each group except Blacks. Conclusions: These results suggest that curbing early initiation of marijuana and cigarettes and reducing prodrug influences and attitudes may dampen initiation of other substances for most youth. They also suggest that drug prevention programs need to be sensitive to differences across racial/ethnic groups and that using social background characteristics as indicators of risk can be very misleading. Carefully constructed risk scales based on simple additive models could help guide program development and provide clinicians with useful information about a troubled adolescent’s likely trajectory.

Peer-led and adult-led programs--student perceptions.

This research examines whether peer-led prevention programs are preferable to adult-led programs. Participants were 2,447 students in 94 classes, from 31 schools running drug prevention programs. The schools were divided into two groups according to the model they used in their program: fifteen schools used peer-led model, while sixteen used the adult-led model. A 46-item questionnaire was constructed in order to examine the students' perception of the programs. The results show that all the input measures (content, atmosphere, openness, discipline, facilitators' competence) and the outcome measures (satisfaction, knowledge, avoidance, curiosity, personal relationship) were perceived as more positive in the peer-led model. The differences were small, but significant. While the findings suggest that the peer-led model has a somewhat greater potential for primary prevention, the differences found do not enable us to state with certainty that this model is preferable for primary prevention purposes.

Intrapersonal versus peer group predictors of adolescent drug use

In this third report from the Alberta High School study we present data on the predictors of adolescent drug use. Results revealed that conduct disorder and peer pressure were the best predictors of drug-taking across adolescence generally but that significant age x gender differences existed in the strength of these associations. Contrary to expectations, conduct disorder was found to be more closely associated with the illicit drug use of 12–13 year-old boys than same-age girls. Friends' drug use was also more predictive of the drug use of 12–13 yearold boys, while overt peer pressure was a better predictor of 12–13 year-old girls' drug use. Except for friends' drug use, which remained more important for boys than girls throughout adolescence, differences in intrapersonal and peer predictors between males and females ended after the age of 12–13 years. The implications of these findings for drug prevention programs are considered.

Misperceptions of the Norms for the Frequency of Alcohol and Other Drug Use on College Campuses

Data from surveys of students representing 100 diverse college campuses were used to investigate the difference between the self-reported frequency of a drug's use and students' perceptions of the frequency of use. Students were asked about the frequency of their own use of 11 drugs (alcohol, tobacco, marijuana, cocaine, amphetamines, sedatives, hallucinogens, opiates, inhalants, designer drugs, and steroids) and how often they thought “the average student” on their campus used these drugs. Respondents typically misperceived their peer norms (designated as the median of self-reported use) by substantially overestimating how often the average student used each drug, both in campus samples where abstinence or infrequent use were the median of self-reports and in samples where the median of self-reports revealed more frequent use. To the extent that they may promote or reinforce students' actual use, these misperceptions should be considered in designing college drug prevention programs.

Peer‐Facilitated Adult Education

AbstractThis chapter describes the development of a drug and alcohol prevention program that is facilitated on a parent‐to‐parent basis in an elementary school setting.

Effectiveness of School-Based Drug Prevention Programs for Marijuana Use

Thirty-seven evaluations of universal drug use prevention programs implemented in American schools between grades 6 and 12 were quantitatively synthesized by coding program characteristics and calculating weighted effect sizes (WES) for marijuana use. Programs were divided into two types, Interactive and Non-Interactive, based on a combination of content and delivery method. To determine the characteristics of programs that most effectively reduce, delay or prevent marijuana use, a weighted least squares multiple regression analysis was performed using the WES of marijuana use as the dependent variable, type of program as the predictor and sample size as an additional covariate. Program type and sample size were found to be significant predictors of program effectiveness. Non-Interactive lecture-oriented prevention programs that stressed knowledge about drugs or affective development of students showed minimal reductions in marijuana use. Interactive programs that fostered the development of social competencies showed greater reductions in marijuana use. Larger implementations of both program types showed substantial decreases in effectiveness, although the larger Interactive programs were significantly superior to the larger Non-Interactive ones. The primary finding for prevention program planners is that interactive cultivation of social skills reduces marijuana use.

D.A.R.E.‐ing to be Different? A Drug Prevention and Life Skills Education Programme for Primary Schools

This paper outlines the development and introduction of the D.A.R.E. programme, particularly in the United Kingdom and explores the added value of D.A.R.E. that can be identified from the point of view of children, schools, teachers and the local communities. It also considers the development of the programme in terms of curriculum review to optimise D.A.R.E. development in accordance with current best practice guidance. The appropriateness and effectiveness of drug education in school is currently receiving significant national attention. It is important, therefore, for all programmes to reconsider their strengths and identify any areas for improvement. D.A.R.E. is no exception.

Readiness for Drug Use Prevention in Rural Minority Communities

An assessment of community readiness for drug use prevention in rural communities indicated that most rural communities are at relatively low stages of readiness. Minority communities were particularly low in readiness, with only 2% having functioning drug prevention programs. Rural communities at different levels of readiness require different types of programs to increase readiness, i.e., communities at the no awareness stage require analysis of the historical and cultural issues that support tolerance of drug use, those at the denial and vague awareness stages need specific information about local problems, and communities at the preplanning and preparation stages need information about effective programs, help in identifying resources, and assistance with staff training. In addition, building and maintaining effective programs requires continued evolution of readiness through the stages of initiation, stabilization, confirmation and expansion, and professionalization. Revised and updated scales and methods for assessing community readiness are provided. [Translations are provided in the International s Section of this issue.]

Project DARE: no effects at 10-year follow-up.

The present study examined the impact of Project DARE (Drug Abuse Resistance Education), a widespread drug-prevention program, 10 years after administration. A total of 1,002 individuals who in 6th grade had either received DARE or a standard drug-education curriculum, were reevaluated at age 20. Few differences were found between the 2 groups in terms of actual drug use, drug attitudes, or self-esteem, and in no case did the DARE group have a more successful outcome than the comparison group. Possible reasons why DARE remains so popular, despite the lack of documented efficacy, are offered.

Drug use among African Americans: ethnic identity as a protective factor.

This study examined the multiple components of ethnic identity, the place of this ethnic identity set in the mediational model of the path to drug use predicted by our family interactional framework, and the protective role of each component of ethnic identity. The participants were 259 male and 368 female African Americans in late adolescence. They responded to a structured questionnaire in individual interviews. We found that few of the specific components of ethnic identity were significantly related as main effects to drug use. Most of the effect of ethnic identity was mediated by the family set of variables. Each of the components of ethnic identity offset risks or enhanced protective factors from the ecology, family, personality, and peer domains, thereby lessening drug use. This pattern highlights the importance of incorporating ethnic identity into drug prevention programs which serve African-American youth.

The Use of Cannabis as a Mood Stabilizer in Bipolar Disorder: Anecdotal Evidence and the Need for Clinical Research

The authors present case histories indicating that a number of patients find cannabis (marihuana) useful in the treatment of their bipolar disorder. Some used it to treat mania, depression, or both. They stated that it was more effective than conventional drugs, or helped relieve the side effects of those drugs. One woman found that cannabis curbed her manic rages; she and her husband have worked to make it legally available as a medicine. Others described the use of cannabis as a supplement to lithium (allowing reduced consumption) or for relief of lithium's side effects. Another case illustrates the fact that medical cannabis users are in danger of arrest, especially when children are encouraged to inform on parents by some drug prevention programs. An analogy is drawn between the status of cannabis today and that of lithium in the early 1950s, when its effect on mania had been discovered but there were no controlled studies. In the case of cannabis, the law has made such studies almost impossible, and the only available evidence is anecdotal. The potential for cannabis as a treatment for bipolar disorder unfortunately can not be fully explored in the present social circumstances.

Applying Multilevel Analytic Strategies in Adolescent Substance Use Prevention Research

Background. School-based drug prevention programs have been criticized on methodologic grounds because the unit of analysis is often not the unit of randomization, thus increasing the likelihood of Type I errors. Application of multilevel analytic strategies appropriately corrects this biasing tendency. This study demonstrates the practical use of such analysis.Methods. Data from 2,370 seventh-grade students participating in a substance use prevention trial were analyzed using a multilevel strategy. We examined the effectiveness of a social pressure resistance training and a normative education (NORM) intervention against an information-only control group.Results. The NORM condition revealed 1-year program effects for cigarette and marijuana use with individuals as the unit of analysis and only marginal effects with classroom as the unit of analysis. No program effects were found using school as the analysis unit. A multilevel strategy revealed program effects for cigarettes and marijuana with both class and school as grouping levels. The effect for alcohol use was significant at the 2-year follow-up.Conclusions. Interventions establishing conservative drug use norms in classrooms may be an effective strategy in reducing substance use onset among adolescents. Utilization of appropriate analytic strategies is important in the analysis and interpretation of data containing nested structures.

Peer helping/involvement: an efficacious way to meet the challenge of reducing alcohol, tobacco, and other drug use among youth?

Peer-led drug prevention programs for middle school youth are reviewed as to whether or not they are a vital resource in an overall effort to minimize the use of alcohol, tobacco, and other drugs (ATOD). The paper focuses on the following: a) results of a 120-study meta-analysis of school-based drug prevention programs and positive program features; b) considerations for falsely concluding that peer programs are ineffective; c) features of two model or stellar programs that compared interactive (peer leadership) to teacher/researcher-led (non-interactive) programs that followed National Peer Helpers Association (NPHA) Programmatic Standards; and d) suggestions for designing and implementing high-quality, peer-led programs. The authors conclude that interactive peer interventions for middle school students are statistically superior to non-interactive didactic, lecture programs led by teachers/researchers. Programs implemented according to NPHA Programmatic Standards may eliminate Type II (false negative) and III ("implementation failure" or ineffectively designed and implemented program) errors. Opportunities for prudent application of well-designed peer programs appropriately implemented and evaluated must remain a salient priority.

Current perspectives on anabolic steroids

Steroids are used outside the realm of competitive athletics in Australia among a wide variety of groups with different motivations and goals. This paper provides an overview of the reasons for use; rates of usage; physical and psychological side effects; and sources of steroids. Issues associated with injecting steroids; their current legal status; and drug education and prevention programmes are reviewed briefly. Research involving identified sub-populations is needed to determine user profiles and prevalence rates of users and potential users. Studies of Australian users are also needed to obtain baseline information on areas of potential harm associated with steroids use, e.g. aggressive behaviour, needle-sharing behaviour, physical side effects and potential for dependency. It is concluded that future deterrence strategies should focus more on demand reduction, rather than supply.

Evaluating Hispanic/Latino Programs

SUMMARY This article will provide a summary of existing information related to the evaluation of alcohol and other drug (AODA) treatment and prevention programs for Hispanics/Latinos. In addition, the authors provide an overview of recent survey data which examined actual evaluation practices in a national sample of federally funded substance abuse prevention projects targeting Hispanic/ Latino high risk youth and families.

An illustration of item homogeneity scaling and multilevel analysis techniques in the evaluation of drug prevention programs.

Many reports of successful school-based intervention programs can be criticized for their choice of a unit of analysis and for the neglect of measurement errors. This article is an illustration of how different conclusions can be reached from different choices of units of analyses and/or of different treatment of the data. This is done by a reanalysis of a well-reported data set. The data is thoroughly taken apart, using different statistical techniques. The result of the analyses shows that earlier reported effects of a normative school-based drug prevention program were not found. The subsequent search for moderator effects of the same program, such as a lowering effect on the relationship between the pre- and posttest or on the relationship between respondents' use and the use of their friends, was not successful either. It is concluded that the null hypothesis of zero effects should be retained. More successful was a search for individual characteristics that show significant relationships with respondents' alcohol use. Among them was the abuse of alcohol by adults in respondents' direct social environment and the use of friends.

The irrelevance of evidence in the development of school-based drug prevention policy, 1986-1996.

This article examines development in school-based drug prevention policy and programming since the Anti-Drug Abuse Act of 1986. Using data from national surveys and evaluations of school-based programs, it argues, first, that there was really no need for a massive infusion of money into school-based drug prevention in the late 1980s, and, second, that there was little or no evidence to indicate that a "new generation" of effective programs, based on the so-called social influence model, was emerging at this time. Despite the infusion of resources into school-based prevention efforts, adolescent drug use has risen in recent years. Moreover, evaluations continue to show that the effectiveness of social influence programs is very much in the eye of the beholder. Fundamental questions need to be asked of school-based drug prevention--just as they should be asked of other key components of our current drug control policy.

Attitudes towards drugs among school youths: An evaluation of the Swedish DARE programme

Illicit drug use among high school students is on the rise in Sweden as well as in other countries. This fact has put high demand on the police, who are not only expected to reduce the availability of drugs but also to take part in the effort to affect the students' demand for drugs. The aim of this study was to analyse what impact students' demand for and perceived availability of illicit drugs in the seventh grade have on their attitudes towards and experience with drugs in the eighth grade. Moreover, the purpose was to investigate to what extent a specific police-led school-based drug prevention programme, the project DARE (Drug Abuse Resistance Education), affects students' attitudes and experiences regarding drugs. As a part in an ongoing evaluation of the Swedish DARE programme (called VÅGA) about 1,800 students in 22 Swedish junior high schools on three occasions anonymously answered questions about their attitudes towards and experiences with drugs. Contextual analysis was used to estimate the significance of various student-level risk-factors (such as family bonding, school involvement, and peer activity) and school aggregated contextual factors. The results show that students' curiosity and perceived availability of illicit drugs at the school-level have statistically significant effects on drug-related attitudes and experiences at the individual-student level. The attitudes towards and experiences with drugs in the eighth grade of students who participated in the DARE programme in the seventh grade were not different from those students who did not participate in the programme. A brief discussion of what measures the police should conduct in order to block the availability of drugs and what their role in schools should be are finally presented.