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.     

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.     

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.     

Implementation and process evaluation of a student "school-as-community" group. A component of a school-based drug abuse prevention program

Little documentation exists regarding the functioning of formalized adolescent groups as drug abuse prevention agents. Two studies are described that were conducted at high schools whose students are at high risk for drug abuse. Twenty-one schools were randomly assigned to one of three conditions: (a) standard care, (b) classroom drug abuse education only, or (c) classroom plus school-as-community. Results of the first study indicated that the school-as-community component--which involved weekly meetings and periodic events at seven schools--was implemented as planned, drug abused focused, and perceived as productive in discouraging drug abuse. In the second study, staff in the classroom plus school-as-community condition self-reported involvement in the greatest number of community activities across the school year, compared with staff from the other two conditions. These two studies support the feasibility of formalized groups of high-risk youth to promote drug-free events.     

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.     

Secondary school teachers' knowledge and views about drug abuse in Ogun State, Nigeria--a pilot survey

The views and knowledge level of 135 randomly selected secondary school teachers in the Abeokuta Local Government Area of Ogun State in Nigeria on drug abuse were sought through a self-report anonymous questionnaire. The respondents were mostly male (59.3%) under the age of thirty years (89.6%). The majority (59.3%) were never exposed to drug education as students while less than 20 percent have been exposed since qualifying as teachers. Although the majority had a good concept of the definition of drug abuse, their views on the potential drugs of abuse and the concept of "drug dependence" were inadequate. Eighty-five and nine-tenths percent chose "guidance counselling" as the approach to the management of student drug abusers despite the death of this professional cadre in the schools. The authors gave suggestions on the pattern and content of teacher-targeted formal drug education program in light of the findings.     

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.     

Evaluating and improving prevention programs: a strategy from drug abuse.

This paper describes a methodology used to overcome the difficulties in evaluating and improving prevention programs. The methodology was applied in this case to a drug abuse prevention program. The methodology includes using health-oriented rather than pathology-oriented outcome measures, random assignment to groups, multiple settings, multiple outcome measures, goal-free evaluation, and the recording of process variables. The first year results showed program effectiveness in one setting and not in the other. Process analyses pointed toward improvements that could be made. Those improvements were implemented and led to greater program effectiveness in the second year.     

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.     

A re-evaluation of project pride, a redesigned school-based drug abuse prevention program

The present study examined the effectiveness of Project PRIDE, a school-based, counselor-administered, drug and alcohol prevention program. The study is presented in the context of Project PRIDE'S efforts to keep itself current and effective via continual evaluation-based development. In this outcome evaluation, Project PRIDE participants demonstrated greater pretest to posttest gains on five of six outcome measures compared to control students, although many of the changes were small or moderate and only two were statistically significant. Further, as predicted, gains in more factual or objective areas of the program were greater than in more subjective areas dealing with student perceptions and feelings. The limitations and implications of the findings are discussed. Also discussed are the advantages of the Binomial Effect Size Display as a data presentation mode that promotes both client and general audience understanding of results.     

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.     

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.     

Say Yes First: follow up of a five-year rural drug prevention program

Say Yes First--To Rural Youth and Family Alcohol/Drug Prevention (SYF) was a 5-year, federally-funded U.S.D.H.H.S. Center for Substance Abuse Prevention (CSAP) project that involved 859 children in the class of the year 2000. The children in four rural school districts were followed from Grade 4 to Grade 8 from 1991 to 1996. Initial results in a previous publication showed significant lower drug usage in this cohort than comparison students. A follow-up of 120 SYF participants and 136 comparison students in high schools using the National Youth Survey (Follow Up Questionnaire) indicated lower usage of alcohol, tobacco and other drugs for the program students and lower lifetime prevalence of marijuana use for program vs. comparison students. SYF students had higher course grades, lower school absenteeism, more positive attitudes toward school, less trouble in school and less negative self-appraisal. Program students also reported greater participation in sports, more family communication and fewer disagreements or arguments with their parents.     

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.     

An outcome evaluation of refusal skills program as a drug abuse prevention strategy

In recent years successful strategies developed in the antismoking campaign became the basis for widely publicized and federally endorsed antidrug "Just Say No" programs. Similarly, many refusal skills programs have been introduced as a new strategy in adolescent drug abuse prevention. However, none of these programs have been evaluated. While employing a typical refusal skills program entitled "WHOA! A Great Way To Say NO," the effectiveness of the program was examined. Through this outcome evaluation, it has been learned that the program was not able to impact on the "high-risk" attitudinal syndromes that are closely related to student drug involvement. Unexpectedly, a significantly larger proportion of students in the program felt it was more difficult to say "No" at the time of the posttest than during the time of the pretest. This seems to suggest that the program participants became more attentive to the issues surrounding saying "No" or, perhaps, were more sensitized to the whole issue involving saying "No," thereby making it more difficult for them to say "No" during the posttest period.     

The goal-oriented approach to evaluation: Critique and case study from drug abuse treatment

The specification and measurement of program goals remains central to most evaluation research strategies, yet procedures for implementing this approach are not well-articulated. It is the purpose of this discussion to describe a stepwise procedure for programmatic goal setting and monitoring used in a demonstration drug treatment program for women. Three implementation steps are described: (a) goal setting, (b) checking for consistency, (c) monitoring and feedback. The advantages and limitations of this approach are discussed and useful complementary measurement strategies are suggested.     

Feedback from participants and leaders in an intervention program: the 1997-1998 opening doors process evaluation

Parents, students, and program leaders involved in an in-school drug prevention program called Opening Doors were assessed for their perceptions of the efficacy of the program. In general, the feedback indicated a very high program satisfaction level from respondents with parents indicating the highest level satisfaction (92%). Areas for improvement ranged from: parent attendance, invitation process, increased support from schools, and increasing awareness of scheduling and time involvement by leaders and school administration based on program leader feedback as well as invitation process and program duration from the parents (e.g., 37% thought the program was too short). Student satisfaction may be predicted from the perceived impact of the program on significant relationships (e.g., with peers and family) as well as affective reactions to the program (e.g., enjoyment of the program). Finally, a school-level analysis indicated that the application of the Opening Doors Program in different schools was provided uniformly.     

Community drug abuse prevention in a Hmong village in Thailand

The goal of this project was to implement a model of drug abuse prevention, drawing on health care, psychosocial and legal principles, in a selected village community in Thailand. Primary, secondary, and tertiary prevention strategies were used within a nursing conceptual framework that included the interactions among the person, drugs, and environment. An initial community survey revealed 112 addicted individuals and identified many atrisk groups, such as children of addicted parents, adolescents, and women. Primary health care and dental health services were provided in the community, as well as drug abuse education and activities for school children and at-risk groups. Treatment camps were also established in the community on two occasions to provide detoxification and rehabilitation services for addicted individuals. At the end of the 3-year program, there were no new addicted individuals, and the number of addicted individuals decreased from 112 to 50 (after first treatment) and 26 (after second treatment). In addition, the villagers were more aware of problems related to using opium and heroin and of modern, approved drugs to treat illnesses. The prevention strategies were beneficial for the community members, as well as the addicted individuals and theirfamilies.