DIADS: computer-based system for development of school drug prevention programs

The Drug Information, Assessment and Decisions for Schools (DIADS) is a computer-based information and decisions support system for the development of school drug abuse prevention programs. DIADS provides access to a cost-effective planning resource that has information to programs about alcohol, other drugs, and prevention. Also, DIADS helps the school assess the effectiveness of its current prevention efforts using an expert-generated school assessment model containing fourteen factors. Feedback from the assessment provides suggestions for improvements in current prevention programs. DIADS guides the selection of future activities and helps in program planning. Pilot test of DIADS at several sites indicates school personnel find the information on DIADS helpful, timely and easy to access.     

Family violence and substance use: the perceived effects of substance use within gay male relationships

The purpose of this research endeavor is to examine the life situations of gay men where domestic violence was present. The current article expands on previously published works by examining respondents' perceptions of what role alcohol and other drug use plays in causing substance use-related domestic violence. Three different perceptions emerged from the data and are presented here. First, drugs and alcohol use was perceived to be causally related to the domestic violence our respondents endured. Second, our respondents believed substance abuse resulted from the violence--it was used as a coping mechanism. Finally, many respondents did not believe there was any association between substance abuse and violence. The need for further in-depth data related to the relationship between drugs, alcohol, and domestic violence is noted.     

An Ecological Assessment of Drug-Related Problem Situations for American Indian Adolescents of the Southwest

This study examined difficult situations related to drug and alcohol use as identified by American Indian youth in the South-west. Sixty-two contextually based items were developed from focus group data, and were administered to 71 American Indian youth. The items measured the frequency in which youth experienced specific drug-related situations, as well as the perceived difficulty in resisting drug use offers in those situations: The results indicated that the most frequent and difficult drug and alcohol situations occurred primarily with friends or cousins at their homes or after school. Implications for culturally specific assessment, prevention, and treatment are discussed.     

A large-scale initiative to disseminate an evidence-based drug abuse prevention program in Italy: Lessons learned for practitioners and researchers

Across developed countries, experimentation with alcohol, tobacco, and other drugs often begins in the early adolescent years. Several evidence-based programs have been developed to prevent adolescent substance use. Many of the most rigorously tested and empirically supported prevention programs were initially developed and tested in the United States. Increasingly, these interventions are being adopted for use in Europe and throughout the world. This paper reports on a large-scale comprehensive initiative designed to select, adapt, implement, and sustain an evidence-based drug abuse prevention program in Italy. As part of a large-scale regionally funded collaboration in the Lombardy region of Italy, we report on processes through which a team of stakeholders selected, translated and culturally adapted, planned, implemented and evaluated the Life Skills Training (LST) school-based drug abuse prevention program, an evidence-based intervention developed in the United States. We discuss several challenges and lessons learned and implications for prevention practitioners and researchers attempting to undertake similar international dissemination projects. We review several published conceptual models designed to promote the replication and widespread dissemination of effective programs, and discuss their strengths and limitations in the context of planning and implementing a complex, large-scale real-world dissemination effort.     

Social skills, competence, and drug refusal efficacy as predictors of adolescent alcohol use

Numerous alcohol and drug abuse prevention trials have included social resistance training as a strategy for reducing early-stage adolescent alcohol use. Evaluations of these trials has shown them to be moderately effective, although the precise impact of the resistance training in comparison to other programmatic features has not been clearly identified. The current study examined the extent to which assertiveness and related social skills, personal competence (perceived cognitive mastery), and refusal efficacy predict alcohol involvement. Males were at greater risk for poor refusal skills and reported higher alcohol involvement. Cross-sectionally, youth characterized by poor social skill development reported lower refusal efficacy, lower grades, poor competence, and more alcohol use. Poor refusal efficacy was associated with more risk-taking, lower grades, less competence, and more alcohol use. Longitudinally, both poor refusal skills and risk-taking were associated with higher alcohol use. High personal competence was associated with lower alcohol use in both the eighth and tenth grades, but had no long-term effects on alcohol use. Findings highlight the close interplay between perceived competence and refusal skill efficacy, both of which should be included as essential components of school-based prevention strategies.     

An Ecological Assessment of Drug-Related Problem Situations for American Indian Adolescents of the Southwest

ABSTRACT

This study examined difficult situations related to drug and alcohol use as identified by American Indian youth in the Southwest. Sixty-two contextually based items were developed from focus group data, and were administered to 71 American Indian youth. The items measured the frequency in which youth experienced specific drug-related situations, as well as the perceived difficulty in resisting drug use offers in those situations. The results indicated that the most frequent and difficult drug and alcohol situations occurred primarily with friends or cousins at their homes or after school. Implications for culturally specific assessment, prevention, and treatment are discussed.     

Evaluating the effectiveness of a school drug and alcohol prevention curriculum: a new look at "Here's Looking at You, Two"

The article reports on the results of an evaluation of a school drug and alcohol prevention curriculum marketed under the title, "Here's Looking at You, Two." Previous evaluations, unreported in the literature and having unresolved methodological problems, have found that while the program appears effective at transmitting information regarding drug and alcohol abuse, it has not been effective at changing the underlying attitudes and behaviors that, in part, explain substance abuse. Employing a more rigorous methodology, our examination of a relatively large sample across five school districts provides support for previous findings. Over the short-term of one year, the program was particularly effective at transmitting substance information to primary and middle school students. The program, however, produced very little of the expected effect on the underlying attitudes that are critical to changing substance abuse behaviors.     

Sexual victimization and substance abuse in psychiatrically hospitalized adolescents

This article investigates the relationship between substance abuse and sexual abuse in a population of 260 psychiatrically hospitalized adolescents. Seven hypotheses are set forth to test a model that uses parental alcohol abuse, sexual abuse status, and gender as exogenous variables, perceived benefit of alcohol or drugs as an endogenous mediating variable, and substance abuse as the dependent variable. Using these variables, a path model was constructed and revised based on empirical testing. The revised model achieved an adjusted R2 of .38, thus explaining 38 percent of the variance in this sample's abuse of alcohol or drugs. The model suggests that within clinical populations, sexually abused adolescents should be screened for substance abuse, and attention should be given to parental alcohol abuse as well as the degree to which adolescents perceive benefits from their alcohol or drug use.     

Student desires for a university drug education program

A questionnaire was designed to determine the type of drug education program most desired by undergraduate students attending a major university. The survey was to provide the basis for a comprehensive drug education program. The 101 item questionnaire elicited responses from 656 undergraduates in categories ranging from knowledge base to credible information sources. The analysis of student desires as they relate to program design is included in this article. The students strongly believed the university should provide a drug education program. In particular they desired a credit course dealing with both drugs and alcohol. They also wanted regularly published articles on drugs in school publications. The most credible knowledge sources were PhDs and MDs. Students also wanted contact with former drug users. More than half the students believed that values clarification and "coping skills" training would decrease their drug use. In general more women than men were likely to utilize such resources.     

Adolescent attitudes toward random drug testing in schools

The current research examined students' perceptions of random drug testing for students participating in after-school activities. Results found students were more likely to endorse drug testing at their school if they are already engaged in after-school activities and not currently using drugs and/or alcohol. While middle and high school students' scores fell within the median, most reported if drug testing were implemented in their school they believed it would not deter continued participation in after-school activities. However, if drug testing were a prerequisite for participating in after-school activities, high school students were more apprehensive about getting tested than middle school students. Student respondents were more likely to endorse drug testing, if all members of the school system (i.e., teachers, coaches and staff) participated in drug testing. High school students' believed they had enough knowledge about drug abuse and were less likely to endorse drug testing because they believed it would violate their personal privacy compared to grade school students. Results also differed as a function of gender and self-reported drug and alcohol use.     

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.     

Constructing a consensus-based prevention outcome measurement instrument

This article describes Ohio's Prevention Evaluation Project (PEP). The purpose of the project was to develop a process and instrument to assess behavioral and attitudinal outcomes in primary drug abuse prevention programs targeting young people aged twelve to seventeen. One of PEP's principal achievements was the inclusion of community prevention program providers from throughout the state in the evaluation instrument development. The effort produced a self-administered questionnaire to capture data on young peoples' drug use practices, attitudes toward drugs, and problematic behaviors. Most significantly, the product produced was the acceptance and endorsement of community-based programs. The forty-one-item questionnaire has good to excellent reliability for virtually all measures, as assessed by the test-retest method. The instrument is a product of a process that brought together a university-based research team, state alcohol and drug abuse prevention administrators, and representatives of public programs. PEP demonstrates how to productively link service providers, administrators, and evaluators to develop a process for assessing the effectiveness of prevention programs. The process and tools described serve as a model for other communities wanting to evaluate their prevention programming.     

Longitudinal Associations Between Other‐Sex Friendships and Substance Use in Adolescence

The impact of the changes in the gender composition of friendship networks during early adolescence on substance use in late adolescence was examined. The hypothesis was that initial level and increase in the proportion of other‐sex friends in the network would be associated with higher levels of substance use among girls, but not among boys. Girls and boys (n=390) were interviewed annually from ages 12 to 18 (79% retention). For both boys and girls, initial level in the proportion of other‐sex friends predicted alcohol use in late adolescence, whereas it was predictive of drug use in girls only. Moreover, for girls only, a faster increase in the proportion of other‐sex friends in the network predicted later use of alcohol and drugs.     

Peer influence and drug use among adolescents in rural areas

A sample of 1,004 eighth and tenth grade students in twenty-three small Central/East Texas communities was assessed to determine 1) their perception of the number of their friends who use drugs, 2) the amount of information they received about drugs from their friends, and 3) the connection between those perceptions and drug use. A multiple regression model which included grade, gender, the degree to which friends are perceived to use drugs and the amount of information about drugs received from friends explained 39 percent of the variance in the degree to which rural adolescents were involved in drug use. An item specific analysis of the subcomponents of these composite variables explained 44 percent of the variance in the degree to which rural adolescents were involved in drug use. This same four-factor model accurately classified over 81 percent of non-drug-users and 67 percent of users using discriminant analysis. Students who perceived a higher degree of drug use among their friends and who received more information about drugs from their friends used drugs more frequently. Lower marijuana use in these rural areas as compared to the nation, both as a peer perception and as a fact, may protect these students to a degree from broader patterns of drug use. The findings of this study support the theory that peer pressure is related to drug abuse, even in rural areas.     

A qualitative exploratory study of substance abuse prevention outcomes in a heterogeneous prevention system

The prevention of abuse of alcohol and other drugs is a concern for parents, policy-makers, educators, and social service professionals. Prevention programs are sponsored by many different types of social and educational agencies using a variety of intervention strategies. This article reports a study of a sample of such programs in the state of Nevada. The overall prevention system in the state espouses a "risk and resiliency" approach to prevention. Focus group methodology was used to study perception of outcomes of these programs from the viewpoints of various program stakeholders (youth participating in the programs, parents of participants and program staff). Analysis of the qualitative data yielded findings about potential outcomes as well as implicit program theories. Implications for future planning efforts as well as further evaluation efforts are discussed.     

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.     

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.     

The impact of drug education and prevention programs. Disparity between impressionistic and empirical assessments

In the course of evaluating drug prevention programs for youth, we observed that although staff perceived the programs had quite favorably affected youths' attitudes and behavior, responses from these youths showed little significant impact on their use or attitudes related to drugs. This article explores several explanations for the disparity between staff impressions of the impact of these programs and results from attempts to measure impact objectivity. The analysis considers (a) clients' risk-level for drug use, (b) expectations as to how programs affect client behavior and attitudes, and (c) the sensitivity of empirical measures to ascertain changes reflecting impact of the program.     

Therapeutically Managing Reunification After Abuse Allegations

School-based programs have been the central strategy to educate children about the serious nature of child sexual abuse in the hope of prevention or early intervention. Virtually all evaluations have been quantitative, seldom allowing children to directly comment on their experiences. This article presents the results of qualitative research with 116 students (51 boys and 65 girls) ranging from age 6 to 12 who had participated in the Who Do You Tell child sexual abuse education program. Ten focus groups were conducted with students in separate grades, from kindergarten through sixth grade, two to three months after program participation. The core themes that emerged from the focus group interviews are presented, as are implications for child sexual abuse prevention programs.