Field Of Substance Abuse Prevention Research Articles

Moving the Risk and Protective Factor Framework Toward Individualized Assessment in Adolescent Substance Abuse Prevention

ABSTRACT The field of substance abuse prevention has evolved towards a risk and protective factor paradigm in explaining the onset and escalation of adolescent substance use. This framework for understanding the problem has been developed and employed by researchers at the University of Washington, under Doctors Hawkins and Catalano, to assess communities for high-risk and low protection. Currently, there are no individual instruments to assess adolescents on these risk and protective factors. This article argues for the need of such an instrument, one that is time manageable and comprehensive. It is suggested that using a two-step method for assessment could meet these goals.

A General Causal Model to Guide Alcohol, Tobacco, and Illicit Drug Prevention: Assessing the Research Evidence

The problems associated with the use of alcohol, tobacco, and other drugs (ATOD) extract a significant health, social, and economic toll on American society. While the field of substance abuse prevention has made great strides during the past decade, two major challenges remain. First, the field has been disorganized and fragmented with respect to its research and prevention practices; that is, there are often separate ATOD prevention "specialists." Second, both the prevention researchers who test the efficacy of specific prevention strategies and the practitioners who implement prevention efforts often lack an overall perspective to guide strategy selection. To address these limitations, we present an ATOD causal model that seeks to identify those variables (Domains) that are theoretically salient and empirically connected across alcohol, tobacco, and illicit drugs. For the researcher, the model demonstrates important commonalities, as well as gaps, in the literature. For the practitioner, the model is a means to recognize both the complexity of the community system that produces ATOD problems and the multiple intervention points that are possible within this system. Researchers and practitioners are thus challenged to work synergistically to find effective and cost-effective approaches to change or reduce ATOD use and associated problems.

A Conceptual Three-Dimensional Model for Evaluating Community-Based Substance Abuse Prevention Programs

ABSTRACT Evaluators of substance abuse prevention programs are being asked to assess multiple and simultaneous interventions occurring in complex settings. The field of substance abuse prevention currently has no overarching conceptual evaluative framework for evaluating its programs. This paper presents a three-dimensional model for conceptualizing existing prevention programs, defining and measuring effects of prevention programs, and making a connection between those programmatic effects, and the interests of the funder. This paper describes the methodology and its use for promoting the efficiency and effectiveness of substance abuse prevention programs.

Prevention validation and accounting platform: a framework for establishing accountability and performance measures of substance abuse prevention programs.

The field of substance abuse prevention has neither an overarching conceptual framework nor a set of shared terminologies for establishing the accountability and performance outcome measures of substance abuse prevention services rendered. Hence, there is a wide gap between what we currently have as data on one hand and information that are required to meet the performance goals and accountability measures set by the Government Performance and Results Act of 1993 on the other. The task before us is: How can we establish the accountability and performance measures of substance abuse prevention programs and transform the field of prevention into prevention science? The intent of this volume is to serve that purpose and accelerate the processes of this transformation by identifying the requisite components of the transformation (i.e., theory, methodology, convention on terms, and data) and by introducing an open forum called, Prevention Validation and Accounting (PREVA) Platform. The entire PREVA Platform (for short, the Platform) is designed as an analytic framework, which is formulated by a collectivity of common concepts, terminologies, accounting units, protocols for counting the units, data elements, and operationalizations of various constructs, and other summary measures intended to bring about an efficient and effective measurement of process input, program capacity, process output, performance outcome, and societal impact of substance abuse prevention programs. The measurement units and summary data elements are designed to be measured across time and across jurisdictions, i.e., from local to regional to state to national levels. In the Platform, the process input is captured by two dimensions of time and capital. Time is conceptualized in terms of service delivery time and time spent for research and development. Capital is measured by the monies expended for the delivery of program activities during a fiscal or reporting period. Program capacity is captured by fourteen measurement units, tapping into the dimensions of staff resources and community assets. Staff resources are, in turn, operationalized in terms of staff size, staff certification status, staff turnover rate, and the accreditation status of a provider agency. Community assets are operationalized by the number of community centers accessible to the funded agency, number of formalized teams or antidrug coalitions active in the catchment area, and other social/human services providers with whom the prevention agency has formalized networks. The totality of process output from all sources of program activities is reduced to eighteen classes of measures. These are operationalized by thirty-three summary measures. Some of these include: total count of events facilitated; total number of clients served; average number of clients served per event; clients served by single and multiple program sessions; classification of target population in terms of the severity of risk as defined by the Institute of Medicine; age groups and race/ethnicity of clients served; number of program participants retained by recurring programs; number of clients who have completed the program; penetration rates to the target population; client attrition rates; average referral rates per provider per time interval; referral success rates; and so on. All process output measures specified in the Platform are derived from two broad classes of events classified as either products or services. The collectivity of these measures is expected to present a cost-effective, parsimonious, yet comprehensive picture of the entire spectrum of the process output, i.e., "what came out of the program as program activities". For the measurement of performance outcomes, two types of data are incorporated into the Platform: outcome data from individuals and the behavior (or performance) of social indicators from aggregated data bases. Individual data are used to evaluate the outcome of substance abuse programs

Promotion of Evaluation as a Strategy towards an Effective Substance Prevention

A growing number of European initiatives focusing on the evaluation and monitoring of substance abuse prevention is observed. At the beginning of the 90s a team from the Institute of Psychiatry and Neurology in Warsaw, Poland, began a project designed for the promotion of evaluation in the field of substance abuse prevention. The project included outcome studies on popular school-based programs and development of teaching materials and publications to popularize the concept and methods of evaluation. As results of the project several outcome studies were completed, several scales for evaluating alcohol prevention programs were developed, a number of articles and a handbook on evaluation were published.

Toward a new paradigm in substance abuse and other problem behavior prevention for youth: youth development and empowerment approach.

The purpose of this article is to 1) address a paradigm shift taking place in the field of substance abuse prevention directed for youth and 2) to introduce an innovative approach to substance abuse and other problem behavior prevention that reflects this shift in prevention paradigm. The new path introduced is youth development and empowerment (YD&E) approach. In order to establish a conceptual foundation for this approach, this article 3) reviews the theoretical advances made in the field of substance abuse prevention during the last three decades. This is followed by a conceptualization of the processes of implementing the YD&E program by 4) specifying the mechanism used for the empowering processes and by 5) identifying the structural components of the youth empowerment model that serve the empowering processes. It is hoped that this article serves as a conduit for an improved approach to adolescent substance abuse prevention and youth development that goes beyond, rather than against, the traditional risk-factor approach. In this new approach, youths are viewed as assets and resources to our community rather than social problems or community liabilities. The organizing concept of this new paradigm is: social, economic, and public opportunity denied to youth is equal to social problems imposed on youth by adults.

Enhancing resiliency in girls and boys: A case for gender specific adolescent prevention programming

Resiliency is the ability to bounce back or cope well in the face of adversity, and preventionists are recognizing the promise of this approach, with its emphasis on strengths and the enhancement of individual and environmental protective factors. Feminist scholars and resiliency researchers have highlighted significant gender differences in susceptibility to, and protection from, situations of risk. However, there are few prevention programs that have incorporated gender-specific resiliency strategies. This paper will argue for the importance in the field of substance abuse prevention of developing different strategies for girls and boys to meet their varying needs.

Benefit-cost analysis of drug abuse prevention programs: a macroscopic approach.

To date, benefit-cost analysis has rarely been used to justify the drug abuse prevention field. However, there is an increasing demand for this type of analysis as the field of substance abuse prevention enters a new phase--a phase characterized by a competitive marketplace, an increased demand for accountability, and the desire to measure return on the money invested in prevention. In response, an effort is made to stimulate discussion and further research on the topic. This article first determines the overall strategy for initiating benefit-cost analysis (BCA), followed by definitions of BCA and cost-effectiveness analysis (CEA). This is followed by the determination of some of the major variables used in BCA along with the algorithm for determining the benefit-cost efficiency ratio (R) as it applies to the macro level analysis. In estimating a value for the R, a decision has been made to incorporate uncertainty into the BCA. In a macroscopic approach to BCA, four independent variables are identified for computing R. These independent and dependent variables are assumed to be random variables with normal distributions. The population means and standard deviations pertaining to these independent variables are estimated from the existing literature. In order to incorporate uncertainty into the computation of R, ten measurements have been randomly selected for each of the four independent variables. Following this procedure, fifteen benefit-cost efficiency ratios are calculated by selecting one of the ten values at random per variable used in the R equation. In this way, we were able to determine the most likely population benefit-cost efficiency ratio of 15:1, indicating that there is a $15 savings on every dollar spent on drug abuse prevention. The 95 percent confidence level pertaining to the R has an interval from $13.7 to $16.1. This indicates that the population R resides within the range 95 percent of the time.

Substance abuse prevention: competence enhancement and the development of positive life options.

Recent advances in the field of substance abuse prevention have derived from a consideration of the etiology of substance use and have also been solidly grounded in psychological theory. Evaluation studies of psychosocial prevention interventions have become increasingly rigorous, and clearly demonstrate that there are effective approaches to prevention. The Life Skills Training Program is an example of a competence enhancement approach to substance abuse prevention. While research with this approach demonstrates its effectiveness at reducing substance use behavior, experience working with disadvantaged youth suggests the need to broaden the concept of competence enhancement. Specifically, recommendations are made for formalizing the concept of positive life options as a potentially important component of substance abuse prevention.