Acculturation Status and Substance Use Prevention with Mexican and Mexican-American Youth

SUMMARY

This study examined whether language preference, as an indicator of acculturation, moderated the effects of a culturally grounded substance use prevention intervention for Mexican and Mexican American middle school students (N = 2,146) in Phoenix, Arizona. The main hypothesis was that levels of program effectiveness would vary based on the language preference of the students and the specific culturally grounded version of the intervention they were assigned. Findings show that matching language preference to particular versions of the intervention did not influence substance use related program outcomes, but that overall program effects (intervention versus control) did vary by language preference. English-language dominant participants, the most at risk sub-group, responded more positively to the intervention, while Spanish dominant, who had low substance use rates at baseline, and bilingual participants did not demonstrate significant differences between the intervention and control groups. Implications for school social work prevention interventions and prevention science in general, are discussed.     

Mexican/Mexican American Adolescents and keepin' it REAL: An Evidence-Based Substance Use Prevention Program

A randomized trial tested the efficacy of three curriculum versions teaching drug resistance strategies, one modeled on Mexican American culture; another modeled on European American and African American culture; and a multicultural version. Self-report data at baseline and 14 months post-intervention were obtained from 3, 402 Mexican heritage students in 35 Arizona middle schools, including 11 control sites. Tests for intervention effects used simultaneous regression models, multiple imputation of missing data, and adjustments for random effects. Compared with controls, students in the Latino version reported less overall substance use and marijuana use, stronger intentions to refuse substances, greater confidence they could do so, and lower estimates of substance-using peers. Students in the multicultural version reported less alcohol, marijuana, and overall substance use. Although program effects were confined to the Latino and multicultural versions, tests of their relative efficacy compared with the non-Latino version found no significant differences. Implications for evidence-based practice and prevention program designs are discussed, including the role of school social workers in culturally grounded prevention.     

Reconnecting Youth: Promoting emotional competence and social support to improve academic achievement

Previous research indicates that students who drop out of high school are at risk for a number of negative outcomes. Both ecological and individual risk factors contribute to students' propensity for dropout. This study examined the effectiveness of a targeted dropout prevention program at improving academic achievement and investigated whether improved social support and emotional competencies partially mediated the association between intervention participation and student outcomes. A sample of 110 middle and high school students (55 intervention participants and 55 students in a matched control group) completed surveys investigating their social-emotional assets and schools provided academic data for participants. Structural equation modeling revealed that students who participated in the program had higher academic achievement compared to the control group. Prior levels of academic achievement moderated the effectiveness of the program with students with low initial levels of academic achievement benefiting more. Emotional competencies and social support did not mediate the relation between participation and achievement. The intervention was related to improved academic achievement among participants; however, the means by which it was effective was unclear. Given the evidence that the program was more effective for some students than others, targeting interventions to meet specific needs of students may be advantageous.     

Majority Rules? The Effects of School Ethnic Composition on Substance Use by Mexican Heritage Adolescents

This article examines key aspects of the school environment - its composition by ethnicity and acculturation - as important social contexts for understanding Mexican immigrant and Mexican American adolescents' drug use norms and behaviors. Results are presented based on surveys completed by Mexican-background students from 35 Phoenix. Arizona middle schools, whose enrollment ranged from a numerical minority to an overwhelming majority. Multivariate mixed models tested for the influence of school ethnic composition measures on substance use outcomes, while accounting for individual level predictors and for the nesting of data at the school level. The proportional representation of Latinos in the school was not a factor in an individual's drug use norms or drug use for the sample overall. Once students were broken down by acculturation status, however, ethnic composition had an effect. Less acculturated Mexican heritage students in schools with higher proportions of Latino students reported less substance use and less adherence to pro-drug norms. Further investigation using other measures of ethnic composition suggested that these effects were attributable to the larger presence of less acculturated Latinos in the school rather than more acculturated Latino students. These school-level effects support the individual-level results indicating that less acculturated Mexican American students face less daunting substance use risks. The results suggest that ethnic group size, but not necessarily numerical predominance, matters and that within-group differences influence the effect of a particular ethnic group's presence in the school. In other words, the majority does not always rule. These findings are interpreted using the concepts of segmented assimilation and school level social capital.     

Evaluation of a family-based substance abuse prevention program targeted for the middle school years

A family-based substance abuse prevention program was evaluated which emphasizes family cohesion, school and peer attachment, self-esteem, and attitudes about adolescent use of alcohol and tobacco. The program was implemented in rural communities and targeted families with students entering middle or junior high school. Baseline surveys were conducted with students and parents in four schools and were readministered one year later. Because the program was voluntary, a quasi-experimental design was used to compare participants (29 students and 28 parents) and nonparticipants (268 students and 134 parents). Analyses of covariance indicated that student participants, as compared to nonparticipants, had higher family cohesion, less family fighting, greater school attachment, higher self-esteem, and believed that alcohol should be consumed at an older age at the one year follow-up. There were fewer significant results for parent participants. Strategies for involving parents in prevention programs are discussed.     

Impact of a classroom behavior management intervention on teacher risk ratings for student behavior

Classroom behavior management interventions have been used successfully with drug prevention programs to prevent subsequent antisocial behavior and substance use among youth. This article presents results from implementation of the All Stars Challenge, a classroom-based behavior management component to a drug prevention program for fifth graders. Risk ratings for shyness and lack of awareness of social norms among high-risk students who received the All Stars Challenge were reduced compared with fifth graders who did not receive the intervention. In contrast, physical and social aggressivity among low-risk students who received the program increased when compared to similar control students.     

Parent training to reduce problem behaviors over the transition to high school: Tests of indirect effects through improved emotion regulation skills

Adolescent problem behaviors are costly for individuals and society. Promoting the self-regulatory functioning of youth may help prevent the development of such behaviors. Parent-training and family intervention programs have been shown to improve child and adolescent self-regulation. This study helps fill gaps in knowledge by testing for indirect effects of the Common Sense Parenting® (CSP) program on reduced substance use, conduct problems, and school suspensions through previously identified short-term improvements in parents' reports of their children's emotion regulation skills. Over two cohorts, 321 low income families of 8th graders were enrolled and randomly assigned to either the standard CSP program, an adapted CSP Plus program, or a minimal-contact control condition. Pretest, posttest, 1-year follow-up, and 2-year follow-up survey assessments were completed by parents and students with 94% retention. Intent-to-treat multivariate path analyses were conducted. Neither intervention had statistically significant total effects on the three targeted adolescent outcomes. CSP, but not CSP Plus, had statistically significant indirect effects on reduced substance use and school suspensions at the 1-year follow-up as well as conduct problems and school suspensions at the 2-year follow-up through increased child emotion regulation skills at posttest. Findings provide some support for emotion regulation as one pathway through which the intervention was associated, indirectly, with reduced substance use, conduct problems, and school suspensions among at-risk students over the high school transition.     

Programa shortstop: a culturally focused juvenile intervention for Hispanic youth

Culturally sensitive juvenile delinquency and substance abuse interventions are relatively limited and unavailable to many first-time Hispanic juvenile offenders. The purpose of this study was to test the effectiveness of a culturally focused juvenile and substance abuse intervention program for first time Hispanic youth offenders. The intent of the program was to decrease juvenile recidivism and increase substance abuse resistance. Programa Shortstop is a family based intervention designed for Hispanic youth ages 9-17. The intervention was delivered to 352 youth and at least one parent/caregiver over the 5-year study period. For intervention youth, the results of the recidivism study (n = 321) indicated that 89% of youth participating in Programa Shortstop between 1995 to 1997 were not rearrested within one year of completing Programa Shortstop. Additionally, statistical paired t-test analysis found that the intervention model had a positive effect on legal knowledge and school related factors associated with substance abuse and delinquency. Parent participants demonstrated significant increases in knowledge related to substance abuse and the legal system.     

Efficacy of a web-based, tailored, alcohol prevention/intervention program for college students: 3-month follow-up

This study presents the results of an efficacy evaluation of a web-based brief motivational alcohol prevention/intervention program called Michigan Prevention and Alcohol Safety for Students (M-PASS). Four on-line sessions providing individually-tailored feedback were delivered to first-year college students over 9 weeks. Non- and low-risk drinking participants received risk prevention, while high-risk drinking participants received a risk-reduction intervention. Both intervention and control groups were surveyed at baseline and at a 3-month follow-up. Analysis showed positive effects for both men and women on stage of change, drinking behavior, drinking motivation and attitudes, and use of risk-reduction strategies. These results provided evidence of efficacy and found that M-PASS had both intervention and prevention effects, making it unique among currently developed brief alcohol interventions for college students.     

Long-term impact of a district-wide school/community-based substance abuse prevention initiative on gateway drug use

This study examined long-term effects of a school/family/community substance abuse prevention partnership intervention lead by a Midwestern school district. Previous findings suggested that the program contributed to decreased tobacco and marijuana, but not alcohol, use prior to and after implementation between 1987 and 1991. The current study examined 8th-12th grade student drug use prevalence data from 1991 and 2003 to determine whether previous program effects were sustained. With one exception, reported lifetime and monthly cigarette use decreased below 1991 levels for all grades. Lifetime and monthly alcohol use decreased below 1991 levels for most grades, a result not previously detected. While still below national rates, reported lifetime use of marijuana increased for all grades over time. The intervention was effective in reducing cigarette and alcohol use over time and in suppressing marijuana use levels below national rates; however, these gains tended to erode in later high school grades.     

The effects of Project SUCCESS on student academic performance: a quasi-experimental study

Project SUCCESS (PS) is a substance use prevention program that targets indicated high school students. We used archival data to explore the program's effects on students' academic achievement and disciplinary problems. It is essential to demonstrate such effects, if prevention curricula are to survive in schools that face multiple competing demands for class time. Using a quasi-experimental design that compared students exposed to the program to those not exposed in five schools, we examined the effects of PS on grades, absenteeism, and disciplinary problems. Using longitudinal analyses that linked individual students' program exposure data to their academic performance, we found that PS had a positive impact on both grades and absenteeism for two years following exposure. We note that these findings are particularly fortuitous, as PS was not designed to affect these outcomes. We recommend that future evaluations of school-based prevention curricula routinely include academic performance.     

A short-term, quasi-experimental evaluation of D.A.R.E.'s revised elementary school curriculum

We present the short-term results of a quasi-experimental evaluation of the revised D.A.R.E. (Drug Abuse Resistance Education) curriculum. Study outcomes examined were D.A.R.E.'s effects on three substances, namely students' lifetime and 30-day use of tobacco, alcohol, and marijuana, as well as their school attendance and academic performance. The study comprised students in 17 urban schools, each of which served as its own control; 5th graders in the 2006-2007 school year constituted the comparison group (n = 1490), and those enrolled as 5th graders in the 2007-2008 school year constituted the intervention group (n= 1450). We found no intervention effect on students' substance use for any of the substance use outcomes assessed. We did find that students were more likely to attend school on days they received D.A.R.E. lessons and that students in the intervention group were more likely to have been suspended. Study findings provide little support for the implementation and dissemination of the revised D.A.R.E. curriculum.     

Two-year follow-up of a social-cognitive intervention to prevent substance use.

This study presents two-year follow-up results of the Adolescent Decision-Making Program initially implemented when students were in their sixth grade. The intervention was found to maintain a positive effect on mean tobacco use, but no differences were observed for mean alcohol, marijuana, or hard drug use. In a test of the differential effectiveness of the intervention, program students living with married parents reported lower mean tobacco use than control students living with married parents and program and control students living with single parents. Logistic regression analyses examining the proportion of users at follow-up revealed a negative program effect for alcohol and no differences for the other substances. Subsequent attrition analyses strongly suggested that the positive effect for tobacco use at follow-up was most likely even stronger, and that the negative effect for alcohol was spurious. The importance of examining both program and attrition effects when evaluating the impact of longitudinal preventive interventions was emphasized, and the need to consider alternative models to guide the conceptualization and evaluation of adolescent substance use prevention programs was discussed.     

Effects of the 5th and 7th grade enhanced versions of the keepin' it REAL substance use prevention curriculum

This study assessed the outcomes of adapting the culturally-grounded, middle school, substance-use prevention intervention, keepin ' it REAL (kiR), to target elementary school students and to address acculturation. At the beginning of 5th grade, 29 schools were randomly assigned to conditions obtained by crossing grade of implementation (5th, 7th, 5th + 7th, and control/comparison) by curriculum version [kiR-Plus vs. kiR-Acculturation Enhanced (AE)]. Students (n = 1984) completed 6 assessments through the end of 8th grade. The kiR curricula generally appear no more effective than the comparison schools' programming. Students receiving either version of the kiR intervention in only the 5th grade report greater increases in substance use than did control students. Receiving the kiR-AE version twice (both 5th and 7th grades) has benefits over receiving it once.     

A covariance structure model test of antecedents of adolescent alcohol misuse and a prevention effort

As part of an alcohol misuse prevention evaluation, questionnaires were administered to 4,157 junior high school students to determine levels of alcohol misuse, exposure to peer use and misuse of alcohol, susceptibility to peer pressure, internal health locus of control, and self-esteem. A conceptual model of the antecedents of adolescent alcohol misuse and the effectiveness of a prevention effort was tested using covariance structure modeling techniques. The factor loadings for the model were all moderate to high, indicating that the observed variables served well as measurement instruments for the latent variables. The hypothesized structural relationships among the latent variables of alcohol misuse, exposure to peer use and misuse of alcohol, susceptibility to peer pressure, internal health locus of control, and self-esteem were supported by the data. The full model explained 45 percent of the variance in alcohol misuse in the analysis based on the total sample. The direct effect of the intervention on alcohol misuse was small but significant in the hypothesized direction. The direct effects of the intervention on susceptibility to peer pressure and internal health locus of control were not significant. The model was tested separately for groups of students who had high versus low scores on susceptibility to peer pressure in order to test the interaction between susceptibility to peer pressure and exposure to peer use and misuse of alcohol. The percentage of variance accounted for in alcohol misuse did not increase upon testing the model separately for students who had high versus low scores on susceptibility to peer pressure. Observed differences in the significance of the parameter estimates between the high and low susceptibility to peer pressure groups suggest that different approaches to the design and evaluation of substance abuse prevention programs may be necessary for different subgroups of students.     

Evaluation of an STD-Prevention Program for Swedish University Students

Abstract

The authors evaluated a sexually transmitted disease (STD)-prevention program that combined a mass media campaign with peer education. The program was designed to increase Swedish university students' knowledge about STDs. improve attitudes toward condom use, and tell students where to get an STD checkup. Preintervention and postintervention postal questionnaires were used with an intervention group and two types of control groups. Responses ranged from 32% to 67% for the randomly selected students and from 93% to 99% for classroom and clinic participants. The intervention was noticed by a majority of the students (85–98%) and discussed by 43% to 57%; more women than men observed and discussed the campaign. Knowledge about STDs. where to turn for STD checkups, and the intention of having an STD checkup increased. Attitudes toward condom use were equally positive before and after the intervention. Although it was successful in attracting attention and leading to discussions of STD prevention, the campaign did not encourage students to have an STD checkup.     

The other side of the story. Student narratives on the California Drug, Alcohol, and Tobacco Education Programs

Within the context of a large-scale, comprehensive evaluation of the California Drug Alcohol Tobacco Education (DATE) program, this study sought to extend knowledge of student perceptions of prevention education using a naturalistic approach. The constant comparative method was used to analyze 40 focus group interviews of risk and thriving groups conducted in 11 high, middle, and elementary school districts. This article presents three assertions generated solely from 490 "narrative stories" found in the data set. "At-risk" and "thriving" students at all three levels of schooling (a) use "story" to make sense of prevention education, and (b) distinguish use from abuse. High school students of both groups (c) believe that hearing only one side of the substance use/abuse story and strict expulsion policies further alienate students most in need of help. Implications for the use of story as an assessment tool are discussed, as are implications for substance use prevention policy.