Implementation and process evaluation of a school-based drug abuse prevention program: Project Towards No Drug Abuse

The present study provides an implementation, process, and immediate outcomes evaluation of the classroom component of Project Towards No Drug Abuse (TND). This project involves development and evaluation of a school-based drug abuse prevention curriculum for continuation high school youth, who are at relatively high risk for drug abuse. Three randomized conditions were evaluated: a standard care, classroom only, and classroom plus school-as-community. The latter condition was an enhanced school-based condition which involved outside-of-classroom meetings and activities. Implementation was high in both program conditions even though this was a higher risk context. Process evaluation data were favorable and did not vary between the two program conditions. Immediate outcomes data (knowledge) was higher in the two program conditions than in the standard care condition. Regarding the classroom program, addition of extra-classroom activities does not appear to alter the quality of delivery of the program.     

An evaluation of the fidelity of implementation of a school-based drug abuse prevention program: project toward no drug abuse (TND)

This article provides an implementation fidelity evaluation of the fourth experimental trial of Project Towards No Drug Abuse (TND). Two theoretical content components of the curriculum were examined to increase our understanding of the active ingredients of successful drug abuse prevention programs. A total of 18 senior high schools were randomly assigned by block to receive one of three conditions: cognitive perception information curriculum, cognitive perception information + behavioral skills curriculum, or standard care (control). These curricula were delivered to both regular and continuation high schools students (n=2331) by trained project health educators and regular classroom teachers. Across all program schools, the two different curricula were implemented as intended, were received favorably by students, and showed significant improvements in knowledge specific to the theoretical content being delivered. This pattern of results suggests that the experimental manipulations worked as intended, and thus, permit the attribution of future behavioral outcome differences between conditions to differences in content of Project TND material provided rather than to differences in the fidelity of delivery. Further, our findings indicate that Project TND can be implemented effectively with low and high risk youth in a general environment as well as with high risk youth in a more specialized environment.     

An evaluation of immediate outcomes and fidelity of a drug abuse prevention program in continuation high schools: project towards no drug abuse (TND)

The present study provides an implementation fidelity, process, and immediate outcomes evaluation of Project Towards No Drug Abuse (TND), a drug prevention program targeting continuation high school youth (n=1426) at risk for drug abuse. A total of 24 schools participated in three randomized conditions: TND Only, TND and motivational interviewing follow-up, and no treatment control. Fidelity was high: across program schools the curriculum was implemented as intended and was received favorably by students. Relative to controls, intervention conditions produced effects on hypothesized mediators, including greater gains in program related knowledge, greater reductions in drug use intentions, and positive changes in motivation. However, few generalizations to attitudes and intentions regarding risky sexual behavior were found. The pattern of results suggests that the experimental manipulations worked as intended.     

Development and immediate impact of a self-instruction curriculum for an adolescent indicated drug abuse prevention trial

This article describes the development and immediate impact of a self-instruction indicated drug abuse prevention program, Project Towards No Drug Abuse (TND). Self-instruction programming often is used to help youth that are at high risk for dropout and drug abuse to complete their high school education, and is a method of choice among educators at alternative high schools. This article describes the justification for the self-instruction program, keys to good programmed self-learning, and how a 12-session health educator delivered program was converted to a self-instruction format. In addition, the immediate impact of a 3-group experimental trial is presented. Health educator led, self-instruction, and standard care control conditions are compared on knowledge change, and the two program conditions are compared on process ratings. Self-instruction programming can be successfully adapted from a health educator-led format, though the lack of student group interaction in this modality may limit its receptivity among students.     

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     

Correlates of drinking and drug use by higher education faculty and staff: implications for prevention

The prevalence and frequency of drug and alcohol abuse among higher education faculty and staff is not known. Higher education is a cultural environment which, on the one hand, is stressful and, on the other, permits a high degree of autonomy. This relationship of stress and autonomy is predicted to produce drug and alcohol abuse. Information is gathered by anonymous, self-report questionnaires, on the frequency and prevalence of faculty and staff drug and alcohol use at a regional university. Responses show alcohol and drug use within the last year and month among four higher education occupational groups: faculty, administrators, clerical staff, and physical plant/custodial staff. While stress was found to be weakly correlated with some drug use in the last month, depression was consistently correlated with drug use and moderately correlated with suicidal thoughts and tendencies, as well as job dissatisfaction. Drug and alcohol abuse is a factor in behavioral problems that affect faculty/staff and can be addressed through Employee Assistance Programs.     

Evaluation of a comprehensive elementary school curriculum-based drug education program

This study was designed to evaluate the effectiveness of a province-wide chemical abuse prevention education program for grades two through six. Two separate studies were conducted. Study 1 measured pre- and post-scores on a test with 1101 experimental and 991 control subjects in a quasi-experimental design. Study 2 surveyed 500 elementary school teachers on their opinions and practices regarding drug education, and on the prevalence of the program in schools. The study found that: 1) students had a high initial knowledge level; 2) students showed modest but statistically significant knowledge gains for urban schools and grades three, four, and five of rural schools; 3) the program was most effective with students with a low base knowledge; 4) an estimated 20 to 30 percent of Manitoba elementary teachers had been in-serviced and/or were using the program across the province; and 5) the program was received well among teachers.     

Drug abuse treatment training in Peru. A social policy experiment

A social policy experiment is presented that was conducted from 1997 to 2000 in a setting with a high level of readiness for implementing a randomized experiment of therapeutic community (TC) drug treatment training in Peru. Seventy-six drug abuse treatment organizations were randomly assigned into three groups, and data were collected at multiple assessment periods. Staff and directors in organizations assigned to the training groups participated in either 6-week basic training or 8-week basic plus booster training sessions, which were theoretically grounded. Small- to medium-size positive effects were found on increased staff empowerment to use actual tools and principles from the training; medium and large positive effects were found on the implementation of TC methods with fidelity after the training. A follow-up with the funding and training organizations 1 year later showed use of the evaluation results in decision making in both organizations.     

The deaf and the classroom design: a contribution of the built environmental ergonomics for the accessibility

In any concept of school design, classroom occupies the central place. Dimensions, lighting, the equipment needed, ventilation are old questions already answered, even in form of laws and standards adopted. However, the best use of available materials and physical conditions of comfort is not sufficient for a classroom design guaranteed success. The classroom should provide deaf students elements to facilitate the learning process, eliminating as much as possible the obstacles created by lack of hearing and allowing them to have the same access to learning as a listener student. As users of a school building, teachers, students, parents and staff are the best evaluators of the physical environment of schools. The environmental comfort is a largest ally of pedagogy. The learning comes from the perception and the concentration of students in the classroom. The purpose of this study is to detect the role of direct perception (physical) and indirect (intangible) elements that informs and have symbolic value, and propose layouts for accessible classrooms to deaf students. The ergonomics of the built environment evaluation methods could use the participatory design method tools as basis to assessing how users perceive and use the school environment.     

Evaluation of the In Touch training program for the management of alcohol and other drug use issues in schools

In Touch is a professional training program designed to develop staff skills and support structures so as to enable schools to manage alcohol and other drug (AOD) matters in a coordinated manner that maximizes beneficial outcomes for at-risk students, while at the same time maintaining school discipline and community relationships. This study is an evaluation of the impact of the program on alcohol and other drug (AOD) related knowledge, attitudes and activity of participating school staff, and on AOD management practice in their schools. Data from 53 intervention participants and 21 controls were compared at pre- and post-intervention. These data indicated a 46% increase in AOD knowledge among those who participated in In Touch training. Attitudes favorable to integrated, supportive management of AOD issues also increased significantly in this group, as did desirable practice. However, change in school practice was limited. Significantly more schools whose staff participated in In Touch training had a written drug policy at post-intervention, but schools' usual responses to AOD-related incidents were substantially the same. These findings indicate that professional training on the management of AOD matters can change the understanding and practice of individual staff, but if school structures and practice are to be substantially influenced, a broader program is required.     

Current drug education policies in NCAA institutions: perceptions of head athletic trainers

This study compared the perceptions of head athletic trainers (HATS) from NCAA member Divisions I, II, and III regarding current athletic department drug education policies in their institutions. A Web-based questionnaire collected responses from 353 HATS. Drug education programs focused more on providing information about the negative consequences of drugs than changing the attitudes and behaviors of students in relation to drug use. More Division I and II schools offered comprehensive ATOD education programs to their athletes compared to Division III schools; however, the majority of these programs were not scheduled on a regular basis. HATS in all divisions reported that the abuse of alcohol and other drugs by student athletes during and after athletic and social events was a significant concern and indicated the importance of scheduling drug education programs closer to such events. Majority of HATS did not view participating in the drug education programs as part of their professional duties; however, they expressed an interest to increase their involvement in these activities.     

Assessment of drug abuse prevention curricula developed at the local level

Public schools are a critical site for drug abuse prevention and education. Although in recent years prevention curriculum developers have been able to identify successful strategies, it is not clear how well these findings have been transferred to local schools. This article reports on a study of schools that have developed their own drug abuse prevention curriculum. The process that these schools used is compared to a model of curriculum development. In general, the process that local schools use is characterized by high levels of involvement by a variety of personnel, low levels of training, little use of resources outside the school corporation, poor training of teachers who will be implementing the curriculum, and little evaluation. Availability of external funds for development from federal or state sources were powerful motivators for curriculum development. Recommendations for changes in professional development and curriculum materials availability are made.     

香港中学生滥用药物:危险因子、保护因子与抗逆力

在探讨香港中学生的滥用药物情况时考虑其与危险因子及保护因子的相互关系,学生的抗逆力,对危险因子及保护因子的相互作用至关重要。实证研究发现,价值观及自我效能均对滥用药物有显著的负相关;家庭、学校及朋辈等支持因子对滥用药物有显著的负相关,尤以学校支持的负相关最为显著;答题者的心身焦虑症状、朋辈影响及学习压力等危险因子均对滥用药物有显着的正相关,尤以朋辈影响的相关性最为显著。整体来说,危险因子与滥用药物在加入价值观和自我效能等变项后,有轻微的正面力量,有助减少中学生滥用药物。     

Scandalous Care: Interpreting Public Enquiry Reports of Scandals in Residential Care

ABSTRACT

This article reviews an earlier study written for the Wagner Committee (1988) on scandals in residential care. That review was based on a study of ten enquiry reports, only two of which were about homes for older people. The main events that were described are grouped as: institutionalised practices, indifference and neglect, physical cruelty, humiliation, too authoritarian a life-style, a dull and depressing life-style, an overcrowded and run down environment, disharmony amongst the staff team, and staff misappropriating goods or money. Now, more weight should be given to: residents' abuse of residents and of staff, an improper influence on the life-style of others, and sexual abuse. Explanations proposed are: structural, environmental, and individual and worker style. Abuse is considered in the context of the nature of direct care and the acts of intimate caring of others.     

Identifying abused children using assessments and observations in the classroom: a preliminary study

The paper presents two pilot studies that attempt to identify maltreated children in the classroom. The aim of pilot study 1 was to determine whether six British physically abused children performed signi?cantly worse than matched non‐abused children on a battery of tests and rating scales over an 18‐month period. The aim of pilot study 2 was to concurrently identify maltreated children from a classroom of children using standardized tests and observed negative behaviours. The method used in study 1 was a cross‐comparison design with six physically abused and 12 comparison children, all between 4 and 8 years old. They were assessed over 18 months at four time‐points on a battery of standardized tests and rating scales. Study 2 was based on a concurrent prediction of child abuse in a class of 30 children (18 male and 12 female) 10 years old. They were assessed on a battery of standardized assessments and by the direct observation of negative behaviour in order to predict those who were on the child protection register (CPR) for actual or suspected abuse and those who were not. The results of study 1 showed signi?cant differences on the teacher rating scales and on a measure of sibling dependency. Study 2 used standardized assessments and identi?ed three of ?ve abused children. Direct observations identi?ed one of ?ve abused children. These two preliminary studies suggest standardized assessments are more useful than behavioural observations in identifying abused children in the classroom setting. Further con?rmation is required using larger‐scale investigations. Copyright © 2003 John Wiley & Sons, Ltd.     

Experience with a drug screening program at a school of pharmacy

Abstract Substance use and abuse among pharmacy students is a concern of pharmacy schools, boards of pharmacy, and training sites alike. Pharmacy students must complete approximately 30% of their academic coursework in experiential settings such as community pharmacies, hospitals, and other health systems as part of any accredited pharmacy school's curriculum, and these training sites are starting to require drug testing of pharmacy students as part of their contractual agreements with schools of pharmacy. The authors describe the implementation of a mandatory random urine drug screening program at their school as well as the changes that occurred owing to assessment of the program. The authors report the basic results to date of the drug screening program. The authors also speculate on secondary benefits of the drug screening program. Finally, the authors describe current and future evaluations that they are undertaking regarding this program.     

"Course is team taught": dimensions of difference in classroom pedagogy

We report on students' response to kinds of difference in the classroom as we have assessed it in our personal experience as a same-sex, mixed race, leftist couple team teaching in two disciplines and at five separate schools over a number of years. We argue that students are more accepting of differences arising out of sexual preference and race and most resistant to differences arising out of class, especially poverty.     

A short-term outcome evaluation of the "I'm Special" drug abuse prevention program: a revisit using SCAT inventory

In the previous evaluation of "I'm Special" (ISP) drug abuse prevention/education program, the long-term impact was reported. The current study examines the short-term outcome of the ISP to establish a conceptual link between what has been observed longitudinally to the short-term outcome. The evaluation instrument used is children's Self-Concept Attitudinal (SCAT) Inventory. Subjects are the third grade students in the Charlotte-Mecklenburg public schools located in Charlotte, North Carolina. The evaluation design employed is before and after-measurement without a control group. In the absence of a control group, the treatment effect of the ISP is estimated on the basis of individual growth curve models. Through the study, it has been learned that the ISP was able to generate positive changes along six attitudinal dimensions included in the SCAT Inventory. The six scales have shown close relationships to student performance at school: student-teacher relationship; self-esteem, attitude toward school, basic social values, advanced social values, and the perception of family cohesiveness. Of these, the first four scales have shown statistical significance at the .05 level. It is estimated that the ISP is capable of generating a significant amount of positive attitudinal changes on a short-term basis with a time span of about four months between pre- and posttests. These findings are consistent with the conclusions obtained from the longitudinal study where student alcohol and other drug using behavior and other related student problem behaviors were significantly lower among the ISP recipients than non-recipients of the program.     

Experience With a Drug Screening Program at a School of Pharmacy

Abstract

Substance use and abuse among pharmacy students is a concern of pharmacy schools, boards of pharmacy, and training sites alike. Pharmacy students must complete approximately 30% of their academic coursework in experiential settings such as community pharmacies, hospitals, and other health systems as part of any accredited pharmacy school's curriculum, and these training sites are starting to require drug testing of pharmacy students as part of their contractual agreements with schools of pharmacy. The authors describe the implementation of a mandatory random urine drug screening program at their school as well as the changes that occurred owing to assessment of the program. The authors report the basic results to date of the drug screening program. The authors also speculate on secondary benefits of the drug screening program. Finally, the authors describe current and future evaluations that they are undertaking regarding this program.     

Physical abuse of older adults in nursing homes: a random sample survey of adults with an elderly family member in a nursing home

Few empirical studies have focused on elder abuse in nursing home settings. The present study investigated the prevalence and risk factors of staff physical abuse among elderly individuals receiving nursing home care in Michigan. A random sample of 452 adults with elderly relatives, older than 65 years, and in nursing home care completed a telephone survey regarding elder abuse and neglect experienced by this elder family member in the care setting. Some 24.3% of respondents reported at least one incident of physical abuse by nursing home staff. A logistic regression model was used to estimate the importance of various risk factors in nursing home abuse. Limitations in activities of daily living (ADLs), older adult behavioral difficulties, and previous victimization by nonstaff perpetrators were associated with a greater likelihood of physical abuse. Interventions that address these risk factors may be effective in reducing older adult physical abuse in nursing homes. Attention to the contextual or ecological character of nursing home abuse is essential, particularly in light of the findings of this study.