California Healthy Kids Resource Ctr. - Alcohol and Other Drugs

Annotated Bibliography of Alcohol and Other Drug Abuse Prevention Research

Barton, C., Alexander, J.F., Waldron, H., Turner, C.W., & Warburton, J. (1985). Generalizing treatment effects of functional family therapy: Three replications. The American Journal of Family Therapy, 13(3), 16–26.

Functional Family Therapy with status delinquents has undergone careful scrutiny in well designed studies that included random assignment, realistic comparison treatment programs, formally trained therapists, and reasonable follow-up periods. The current report describes three replications in which FFT has been extended to new populations, has utilized less formally trained therapists, and has been applied in new treatment contexts. Taken together the replications provide important support for the generalizability of FFT across client and therapist populations.

Botvin, G.J., Baker, E., Dusenbury, L., Botvin, E.M., & Diaz, T. (1995). Long-term follow-up results of a randomized drug abuse prevention trial in a white middle-class population. JAMA 273(14), 1106–1112.

This study was designed to evaluate the long-term efficacy of a school-based approach to drug abuse prevention. The study found significant reductions in both drug and polydrug use for two groups of students who received the prevention program relative to controls. The strongest effects were produced for individuals who received a reasonably complete version of the intervention–there were up to 44% fewer drug users and 66% fewer polydrug (tobacco, alcohol, and marijuana) users. Researchers concluded that drug abuse prevention programs conducted during junior high school can produce meaningful and durable reductions in tobacco, alcohol, and marijuana use if they (1) teach a combination of social resistance skills and general life skills, (2) are properly implemented, and (3) include at least 2 years of booster sessions.

Brown, J.H., DEmidio-Caston, M., & Pollard, J. (1997). Students and substances: Social power in drug education. Educational Evaluation and Policy Analysis, 19(1), 65–82.

A statewide evaluation of a school-based substance use and drug education program called California Drug, Alcohol, and Tobacco Education (DATE) was conducted from 1991 to 1994 for the State Department of Education. Researchers used multiple methods to evaluate DATE programs such as Drug Abuse Resistance Education (DATE) and Red Ribbon Weeks. Analysis of 143 field interviews with educators and administrators, and 40 student focus groups (grades 5–12) revealed that educators attempted to prevent student substance use by providing a “no-substance-use” message through high fear appeal; offering rewards; and attempting to improve students self-esteem by teaching refusal skills. Student interviews indicate program dissatisfaction and service-related cognitive dissonance. Random survey results (5,045 students in grades 7–12) showed that over 40% of California’s students were “not at all” influenced by educators or drug education programs, 15% were influenced “a lot” or “completely,” and nearly 70% described a neutral to negative affect toward educators. Regression analyses showed that survey responses did not depend on self-reported substance use, nor the number of drug programs received (among other factors). This large-scale, multi-model evidence suggests that drug, alcohol, and tobacco education programs had no positive influence on a majority of students substance-use decisions, and had other effects counter to those intended. This was especially true during the period when youth are faced with substance-use decisions, grades 7–12. Given the similarity of many U.S. drug education programs, student rejection of DATE programs is significant. Results and the need for a conceptual shift in how students are viewed and educated about substances are discussed.

Bush, P.J. & Davidson, F.R. (1982). Medicines and “drugs”: What do children think? Health Education Quarterly, 9(2&3), 113–128.

Sixty-four urban children grades K-6 were interviewed in an exploratory study in 1980 to provide information about children’s knowledge and orientations toward medicines and abusable substances. Responses indicated children believe themselves to have considerable autonomy in medicine use–72% said they ask for medicines, 67% get medicines for themselves and others, and 19% (more often older and less economically advantaged) buy medicines by themselves. For six or eight common health problems, e.g., colds, headaches, children said they were more likely than their mothers to take something special; for nervousness and trouble sleeping, mothers were perceived as more likely. Most children distinguished among health problems when indicating probabilities, and any distinguished between themselves and their mothers when naming specific medicines. Children exhibited considerable misinformation and confusion about medicines and “drugs,” e.g., one-third of the children said medicines and drugs were the same thing, while nearly one-fifth said they were not. Sixteen percent of the children said “bad drugs” come from commercial establishments such as drug stores. Children might benefit from efforts to provide them integrated information about medicines and abusable substances, and to deal with questions and anxieties provoked by the mixed messages they receive from adults and society. In view of the amount of autonomy indicated, physicians might increase children’s compliance with medicine use by addressing the child as well as the parent. A larger study of 420 children is underway.

Comer, J.P. (1985). The Yale-New Haven Primary Prevention Project: A follow-up study. Journal of the American Academy of Child Psychiatry, 24(2), 154–160.

Because early school problems frequently endure, intensify and predict later, more severe mental health problems and because those from racial and ethnic minority groups show a low rate of benefit from psychotherapy, a program of early intervention and prevention was developed. The program provided a representative governance group, a parent participation program and group, a mental health program and team, and an academic program. Children involved in the program were found to have increased academic and social gains when compared with subjects outside of the program.

Dielman, T.E., Shope, J.T., Butchart, A.T., & Campanelli, P.C. (1986). Prevention of adolescent alcohol misuse: An elementary school program. Journal of Pediatric Psychology, 11(2), 259–282.

An Alcohol misuse prevention study (AMPS) program was developed, implemented, and evaluated. The AMPS program consisted of four sessions which focused on the immediate effects of alcohol, risks of alcohol misuse, and social pressures to misuse alcohol. Social skills to resist peer pressure to misuse alcohol were emphasized. Schools were assigned randomly to treatment or control groups with half of each group pretested and all posttested. Measures focused on awareness of curriculum content, alcohol use, and alcohol misuse. As hypothesized, a significant Treatment X Occasion interaction effect was found with respect to the curriculum. The treatment subjects were significantly higher than the controls on mean curriculum scores. Also as hypothesized, there were no Treatment X Occasion interactions at the first posttest occasion on alcohol use and misuse due to the low prevalence in both groups at both occasions. The significant Treatment X Occasion interaction effects with respect to alcohol use and misuse are expected to appear at later posttest occasions as use and misuse of alcohol among control group students increase at greater rates than among the treatment group students.

Dukes, R.L., Stein, J.A., & Ullman, J.B. (1997). Long-term impact of drug abuse resistance education (D.A.R.E.): Results of a 6-year follow-up. Evaluation Review, 21(4), 483–500.

The long-term effectiveness of Drug Abuse Resistance Education (DARE) was assessed by contrasting drug use and other DARE-related attitudinal latent variables among 356 twelfth-grade students who had received the program in the 6th grade with 264 others who did not receive it. A prior study of these subjects when they were in 9th grade had shown no significant differences. A follow-up survey in 12th grade assessed central DARE concepts such as self-esteem, police bonds, delay of experimentation with drugs, and various forms of drug use. Although the authors found no relationship between prior DARE participation and later alcohol use, cigarette smoking, or marijuana use in 12th grade, there was a significant relationship between earlier DARE participation and less use of illegal, more deviant drugs (e.g., inhalants, cocaine, LSD) in a development sample but not in a validation sample. Findings from the two studies suggest a possible sleeper effect for DARE in reference to the use of harder drugs, especially among teenage males.

Dusenbury, L., & Falco, M. (1995). Eleven components of effective drug abuse prevention curricula. Journal of School Health, 65(10), 420–425

A review of school-based drug abuse prevention programs was conducted for 1989–1994. In addition to a comprehensive literature review, interviews were conducted with a panel of 15 leading experts in prevention research. Key elements of promising prevention curricula were identified. Effective prevention programs were found to be based on a sound theoretical or research foundation. They included developmentally appropriate information about drugs, social resistance skills training, and normative education. Broader based personal and social skills training appeared to enhance program effects. Effective programs used interactive teaching techniques and teacher training, and provided adequate coverage and sufficient follow-up. Cultural sensitivity to the target population was found to be critical to program success. Additional program components were expected to enhance curriculum effectiveness. Finally, experts agreed that adequate evaluation of prevention curricula was critical. Unfortunately, despite information about the types of curricula that are effective, the most promising prevention curricula are not widely disseminated. Reasons for under-utilization are explored, and recommendations made for correcting the situation.

Dwyer, J.H., MacKinnon, D.P., Pentz, M.A., Flay, B.R., Hansen, W.B., Wang, E.Y.I., & Johnson, C.A. (1989). Estimating intervention effects in longitudinal studies. American Journal of Epidemiology, 130(4), 781–795.

Longitudinal studies aimed at assessing the impact of interventions on disease risk factors often confront several statistical problems. Longitudinal data on use of cigarettes, alcohol, and marijuana among adolescents from the Midwestern Prevention Project are used to demonstrate solutions to statistical problems. Panel data fit to the various models yielded the following conclusions concerning intervention effects in the Midwestern Prevention Project: reduction in the prevalence of cigarette users in treatment schools compared with control schools (8% vs. 18% smoked in the last week at one year follow-up), mixed evidence of an effect on marijuana use, and no evidence of an effect on alcohol use.

Ellickson, P.L., Bell, R.M., & McGuigan, K. (1993). Preventing adolescent drug use: Long-term results of a junior high program. American Journal of Public Health, 83(6), 856–861.

Although several studies have reported short-term gains for drug-use prevention programs targeted at young adolescents, few have assessed the long-term effects of such programs. Such information is essential for judging how long prevention benefits last. This paper reports results over a 6-year period for a multisite randomized trial that achieved reductions in drug use during the junior high school years. Once the lessons stopped, the programs effects on drug use stopped. Effects on cognitive risk factors persisted for a longer time (many through grade 10), but were not sufficient to produce corresponding reductions in use. It is unlikely that early prevention gains can be maintained with out additional prevention efforts during high school. Future research is needed to develop and test such efforts.

Epstein, J.L. (1995). School/family/community partnerships. Phi Delta Kappan, 701–712.

This article provides a rationale, practical ideas, and expected results for implementing school/family/community partnerships to promote the health and well-being of youth.

Errecart, M.T., Walberg, H.J., Ross, J.G., Gold, R.S., Fiedler, J.L., Kolbe, L.J. (1991). Effectiveness of teenage health teaching modules. Journal of School Health, 61(1), 26–30.

This article evaluates the effectiveness of the Teenage Health Teaching Modules (THTM) curriculum. The THTM curriculum had a positive impact on health knowledge of both junior high/middle school and senior high school students. THTM also had a positive effect on health attitudes of senior high school students and of junior high/middle school student by preventing deterioration in health attitudes that occurred in control groups. It also had a positive effect on practices of junior high/middle school students and of the combined senior high school population. For senior high school students the curriculum has positive effects in curbing self-reported use of illegal drugs and consumption of alcohol and self-reported cigarette smoking. The article discusses use of different types of statistical analyses in evaluation research and concerns regarding the generalizability of results to schools with different student characteristics or different application of the curriculum.

Evans, A., & Bosworth, K. (1997). Building effective drug education programs. Phi Delta Kappa, Research Bulletin, No. 19.

This research summary reviews the evaluation of several drug prevention programs, including Life Skills Training, School Misuse Prevention Study, Project ALERT, Project Northland, and DARE. The article also reviews effective teaching methods.

Gilham, S.A., Lucas, W.L., & Sivewright, D. (1997). The impact of drug education and prevention programs: Disparity between impressionistic and empirical assessments. Evaluation Review, 21(5), 589–613.

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 objectively. The analysis considers (a) clients risk-level for drug use, (b) expectations as to how programs affect client behavior and attitudes, and© the sensitivity of empirical measures to ascertain ;changes reflecting impact of the program.

Gorman, D.M. (1996). Etiological theories and the primary prevention of drug use. Journal of Drug Issues, Inc., 505–520.

Since the early 1980s, the social influence model has dominated the field of primary prevention research. Social influence programs generally take the form of standardized curricula, aimed at all members of broadly defined target populations. Evaluative research has employed a fundamentally inductive methodology, the goal of which is to generate successive “confirming instances” of program effectiveness among these broad populations. As a result, prevention research has largely stagnated, and has not availed itself of recent findings from basic research such as those reported in this issue. This research tells us that the relationship between peer group affiliation and drug use is reciprocal and not unidirectional as assumed in most social influence programs, that the scope of intervention efforts must be broadened because the processes involved in the initiation of drug use are far more complex than suggested by the theories on which current prevention efforts are based, and that programs should be targeted rather than universal as some individuals are at greater risk of developing a problem with drugs than others.

Hahn, E.J., Simpson, M.R., Kidd, P. (1996). Cues to parent involvement in drug prevention and school activities. Journal of School Health, 66(5), 165–170.

This exploratory study used focus groups methods to identify strategies that promote parent involvement with young children in an alcohol, tobacco, and other drug (ATOD) prevention program. The Health Belief Model (HBM) guided the interview process and data analysis. Five focus groups were conducted with low-income parents and school personnel from two urban elementary schools ini Lexington, Kentucky. Cues to Action was the most frequent HBM construct expressed by both parents and school personnel in regard to ATOD prevention programs and general school activities. Enthusiasm for school activities expressed by children to their parents was identified as the core cue to parent involvement. Transportation, child care, and incentives were the basic requirements for parent involvement. Positive attitudes of school personnel, a combination of communication strategies, and multiple channels for involvement were major cues to parent involvement. Recommendations for involving parents in ATOD prevention and general school activities are suggested.

Knoff, H.M., & Batsche G.M. (1995). Project ACHIEVE: Analyzing a school reform process for at-risk and underachieving students. School Psychology Review, 24(4), 579–603.

As the school reform process initiated by the 1893 report, A Nation At Risk, continues, we cannot ignore that many of today’s children are significantly at risk for both educational and social failure. This article describes Project ACHIEVE, a comprehensive school reform process focused on helping schools to deal more effectively with at-risk and underachieving students. The foundation of Project ACHIEVE is a building-wide in-service training and implementation process providing all regular education, special education, and support staff with needed common knowledge, skill, experience, and confidence in (a) student-focused, intervention-based problem solving, (b) assessment, and intervention techniques for students academic and behavioral problems, (c) classroom-based social skills training, and (d) data-based evaluation of student outcomes. Implemented through seven interdependent components over a 3-year period of time, the training encourages collaboration, consistency, and multidisciplinary sensitivity and understanding. This article describes the seven components of Project ACHIEVE, the 3-year implementation process, the systems-level data and outcomes that are continuously tracked, and the Projects impact in one particular elementary school as contrasted with a demographically matched comparison school,. The results of this study are described from multiple system, teacher, student, and reform perspectives, and future directions and research limitations are addressed.

Levine, B.L. (1995). Adolescent substance abuse: Toward an integration of family systems and individual adaptation theories. The American Journal of Family Therapy, 13(2), 3–16.

Adolescent substance abuse is best understood as an adaptive behavior by an individual embedded within a rigid family organization. Substance abuse helps the individual deal with distress associated with family interactions. It becomes a means for raising estimates of self-appraisal and asserting some control over self and the environment. The family is involved in numerous ways in the substance abuse pattern. The fulcrum upon which adolescent substance abuse is poised is stasis in the developmental trajectories of individual and family. It becomes essential to family members to avoid the trauma of separation and individuation. The substance abuser does not become a unique and autonomous adult, but rather maintains a role within the family that has become imbued with special significance.

McBride, C.M., Curry, S.J., Cheadle, A., Anderman, C., Wagner, E.H., Diehr, P. & Psaty, B. (1995). School-level application of a social bonding model to adolescent risk-taking behavior. Journal of School Health, 65(2), 63–68.

Adolescent bonding–attachment to, commitment to, and involvement in conventional social activities–decreases the likelihood of engaging in some risk-taking behaviors. The extent to which bonding opportunities in the school environment affect individuals bonding and risk-taking behaviors is less explored. This study tested a model that includes individual and environmental indicators of bonding to predict cigarette smoking, drinking, drug use, and sexual activity among ninth grade students. Survey data representing students in 20 schools in seven western states are reported. Twelfth grade students bonding and other demographic variables aggregated by school served as environmental indicators of bonding opportunities to predict ninth grade students bonding and risk-taking behavior. Path analyses indicate the school environment has a direct influence on ninth grade students bonding and, in turn, on the likelihood they will engage in risk behavior. Implications of these findings for future research directions and intervention design are discussed.

McBroom, J.R. (1994). Correlates of alcohol and marijuana use among junior high school students: Family, peers, school problems, and psychosocial concerns. Youth & Society, 26(1), 54–68.

This study analyzes survey data collected from over 400 junior high school students in grades 7 and 8 in an attempt to determine the relationships between family drug use factors; peer drug use factors; school problems; psychosocial concerns; alcohol, marijuana, and other drug use; and abstinence. Socialization theory is used as the theoretical framework, factor analysis is used to create indexes, and analysis of variance and regression procedures are used for analysis. Based on the findings, implications for policy, prevention, and treatment programs are discussed.

Moore, S., Gullone, E. (1996). Predicting adolescent risk behavior using a personalized cost-benefit analysis. Journal of Youth and Adolescence, 25(3), 343–359.

Risk was assessed from the subjective viewpoints of adolescents, with the aim of assessing adolescents perceptions of what constitutes risky behavior and how risk behaviors and risk judgments relate. Participants were 570 school-based adolescents. Students named risk behaviors perceived as common to similarly aged peers, then rated level of engagement in these behaviors. The perceived positive and negative outcomes of risk were also nominated, and rated on perceived likelihood and desirability/undesirability. The sample viewed risky behaviors as smoking, drinking alcohol, dangerous driving, taking drugs, criminal behavior, sporting risks, antisocial behavior, minor rebellion, school-related risks, and sexual activity. Negative outcomes of risk were categorized as death, disablement, punishment, and social consequences. Payoffs included pleasure, material gain, and avoidance of negative outcomes. There was a consistent pattern of relationships between risk participation and outcome judgment, with perceived pleasantness and likelihood of positive outcomes, and unpleasantness of negative outcomes, strongly associated with behavior.

Nelson-Simley, K., & Erickson, L. (1995). The Nebraska “Network of Drug-Free Youth” Program. Journal of School Health, 65(2), 49–53.

This paper describes Nebraska’s six-year experience with a successful prevention program to form and maintain local drug-free youth groups. More than 4,500 youth were involved at the time of a six-year evaluation survey. Nearly 91% of group members who responded reported being alcohol-free in the previous 30 days and almost all (97%) reported being tobacco-free. Thirty-eight percent of members met one or more of the federal criteria for “high-risk” youth. Sixty-eight percent of responding high-risk youth who previously used alcohol credited group membership with helping them quit or reduce use. The program appears to assist in delaying onset of alcohol, tobacco, and other drug use for youth in the program, and to assist in decreasing or eliminating use of alcohol and tobacco by adolescents who used before participating.

Perry, C.L., & Jessor, R. (1985). The concept of health promotion and the prevention of adolescent drug abuse. Health Education Quarterly, 12(2), 169–184.

A three-dimensional conceptual model for health promotion interventions to prevent adolescent drug abuse is elaborated. The model is based on an analysis of the concept of health into four domains–physical, psychological, social, and personal; an analysis of intervention approaches to change behavior into two major strategies–introducing/strengthening health-enhancing behavior, and weakening/eliminating health-compromising behavior; and an analysis of the foci of interventions into three levels–environmental, personality, and behavior. Components of a specific health promotion program, the Minnesota Heart Health Program, that are designed to prevent adolescent drug abuse are described. These include health behavior campaigns, educational interventions, and community organization. The theoretical content of the components is shown to be linked logically to the health promotion model.

Ross, C.K. (1981). Factors influencing successful preventive health education. Health Education Quarterly, 8(3), 187–208.

This paper examines factors which may influence successful preventive health education for all persons and especially poor persons. The discussion is organized within a framework which includes cognitive factors, affective factors and skills. Types of health information and methods for information dissemination are discussed within the cognitive area. The discussion of emotional responses to preventive care examines organizational and individual factors which may be related to utilization. Finally, specific skills which enable an individual to utilize services are defined. Within each section a general presentation is followed by a discussion of implications for poor populations.

Shedler, J. & Block, J. (1990). Adolescent drug use and psychological health: A longitudinal inquiry. American Psychologist, 45(5), 612–630.

The relation between psychological characteristics and drug use was investigated in subjects studied longitudinally, from preschool through age 18. Adolescents who had engaged in some drug experimentation (primarily with marijuana) were the best-adjusted in the sample. Adolescents who used drugs frequently were maladjusted, showing a distinct personality syndrome marked by interpersonal alienation, peer impulse control, and manifest emotional distress. Adolescents who, by age 18, had never experimented with any drug were relatively anxious, emotionally constricted, and lacking in social skills. Psychological differences between frequent drug users, experimenters, and abstainers could be traced to the earliest years of childhood and related to the quality of parenting received. The findings indicate that (a) problem drug use is a symptom, not a cause, of personal and social maladjustment, and (b) the meaning of drug use can be understood only in the context of an individual’s personality structure and developmental history. It is suggested that current efforts at drug prevention are misguided to the extent that they focus on symptoms, rather than on the psychological syndrome underlying drug abuse.

Shope, J.T., Kloska, D.D., Dielman, T.E., Maharg, R. (1994). Longitudinal evaluation of an enhanced alcohol misuse prevention study (AMPS) curriculum for grades six-eight. Journal of School Health, 64(4), 160–165.

For students progressing from sixth to eighth grade, an enhanced Alcohol Misuse Prevention Study (AMPS) curriculum that emphasized social pressure resistance training, peer support, and norm-setting was developed, implemented, and evaluated. Schools were randomly assigned within communities to curriculum or control groups. Students were pretested early in sixth grade before the intervention and posttested at the end of sixth, seventh, and eighth grades. Results indicated the curriculum was effective in increasing students knowledge of curriculum material, and among the subgroup of students who had used alcohol unsupervised by adults before the pretest, in reducing the rate of increase of alcohol misuse. The findings result from a replication of the analytic approach used with the initial AMPS cohort data.

Sussman, S., Dent, C.W. & Stacy, A.W. (2002). Project Towards No Drug Abuse: A review of the findings and future directions. American Journal of Health Behavior, 26, 354–365.

This study reviewed evidence from 3 Project Towards No Drug Abuse (TND) experimental studies. Outcomes were assessed using student questionnaires at baseline and 1 year follow up. Telephone surveys were used to collect data from students who were no longer enrolled in the high school at 1 year follow up. Student questionnaire items and responses were derived from the national Monitoring the Future survey. Unless a gender is specified, results were found for the combined (male and female) student data. The first study was conducted in 21 continuation high schools. Schools received either the standard care control, a 9-session TND program, or a 9-session TND program plus a school-as-community program. When schools receiving Project TND and Project TND plus the school-as-community program were compared to standard care schools at 1 year follow-up, there was a 25% relative reduction in the prevalence of hard drug use, 7% relative reduction in alcohol use for those using alcohol at baseline, 21% relative reduction in weapon carrying in males, and 23% relative reduction in victimization in males. There were no significant behavior differences between students who received the TND program and the TND plus community program. The second study was conducted in 3 traditional high schools. Twenty-six classrooms were randomly assigned to receive the 9-session TND program or the standard care control. At 1 year follow up, the students in Project TND classrooms showed a 25% relative reduction in the prevalence of hard drug use, 12% relative reduction in alcohol use among baseline users, 19% relative reduction in weapon carrying in males, and 17% relative reduction in victimization in males. The third study was conducted in 18 continuation high schools randomly assigned to receive the 12-session TND program, the 12-session self-instructional version of TND, or standard care control. Only the health educator-led condition provided a reduction in problem behavior rates relative to the other conditions. There was a 26% relative reduction in hard drug use, 9% relative reduction in alcohol use among baseline users, 6% relative reduction in victimization among males, 37% relative reduction in weapon-carrying among baseline non-weapon carriers, 27% relative reduction in cigarette smoking, and 22% relative reduction in marijuana use.

Tappe, M.K., Galer-Unti, R.A., & Bailey, K.C. (1995). Long-term implementation of the teenage health teaching modules by trained teachers: A case study. Journal of School Health, 65(10), 411–415.

This evaluation addressed long-term implementation of the Teenage Health Teaching Modules (THTM) by trained teachers in Indiana. Structured random sample telephone interviews and cross-sectional written surveys determined the extent to which teachers implemented THTM and factors related to its implementation. Although most schools and teachers continued to use THTM, many teachers failed to maintain implementation fidelity. Barriers to THTM implementation included insufficient time for health instruction, reassignment of THTM teachers to other instructional areas, and the need for revised middle school modules. ANOVA and Mann-Whitney U Tests revealed more favorable THTM perceptions and implementation practices among teachers without implementation difficulties and among teachers who intended to attend a reconvening workshop. Evaluation of the long-term implementation of THTM revealed the impact of environmental barriers on the use of innovative health education curricula by trained teachers.

Tobler, N.S. (1986). Meta-analysis of 143 adolescent drug prevention programs: Quantitative outcome results of program participants compared to a control or comparison group. Journal of Drug Issues, 16(4), 537–567.

Presented is a meta-analysis of the outcome results for 143 adolescent drug prevention programs to identify the most effective program modalities for reducing teenage drug use. Glass” et al. (1981) meta-analysis techniques provided a systematic approach for the accumulation, quantification and integration of the numerous research findings. Five major modalities were identified and their effect sizes computed for five distinctly different outcomes: Knowledge, Attitudes, Use, Skills and Behavior measures. The magnitude of the effect size was found dependent on the outcome measure employed and the rigor of the experimental design. These factors were controlled for through use of a standard regression analysis. Peer Programs were found to show a definite superiority for the magnitude of the effect size obtained on all outcome measures. On the ultimate criteria of drug use, Peer Programs were significantly different than the combined results of all the remaining programs (p<.0005). Peer Programs maintained high effect size for alcohol, soft drugs and hard drugs, as well as for cigarette use. Recommendations are made concerning the effectiveness of the underlying theoretical assumption for the different program modalities. Future programming implications are discussed as Peer Programs were identified as effective for the average school-based adolescent population, but the Alternatives programs were shown to be highly successful for the “at risk” adolescents such as drug abusers, juvenile delinquents or students having school problems.

Travers, R. & Schneider, M. (1996). Barriers to accessibility for lesbian and gay youth needing addictions services. Youth & Society, 27(3), 356–378.

Using a qualitative research method, this study investigates the ways in which homophobia and heterosexism constitute barriers to treatment for lesbian and gay youth in need of addictions services. Seventeen lesbian and gay youth were interviewed regarding their experiences in addictions services. The major barriers that they report include marginalization, avoidance of gay and lesbian issues, ignoring sexual orientation as an issue, deflection and contradiction, outing harassment, early discharge, and misinformed staff. Recommendations are made for making addictions services more appropriate and accessible for lesbian and gay youth.

Treiman, K., Beck, K. (1996). Adolescent gender differences in alcohol problem behaviors and the social contexts of drinking. Journal of School Health., 66(8), 299–304.

This study of more than 1,300 high school students examined gender differences in the social context of drinking associated with four alcohol problem behaviors (high intensity drinking, binge drinking, driving while intoxicated, and riding with an alcohol impaired driver). A series of analyses treated five social contexts of drinking (Social Facilitation, School Defiance, Stress Control, Peer Acceptance, and Parental Approval) as dependent variables and revealed significant multivariate interaction effects between gender and all four alcohol problem behaviors. Male problem drinkers were more likely to drink in all social contexts than female problem drinkers or non-problem drinkers of both genders. Females were no more likely to drink in the context of Stress Control than males, a finding inconsistent with some previous research. The social contexts of Social Facilitation, School Defiance, and Stress Control were the best discriminators of problems versus non-problem drinkers for both genders (although the order of importance varied by gender and specific problem behavior). Implications for designing targeted interventions are discussed.

Tyler, J., & Lichtenstein, C. (1997). Risk, protective, AOD knowledge, attitude, and AOD behavior: Factors associated with characteristics of high-risk youth. Evaluation and Program Planning, 20(1), 27–45.

Assessment of risk, protective, alcohol and other drug (AOD) knowledge, attitude, and AOD behavior of 1797 youth ages 12–18 who participated in the Community Youth Activity Program demonstration project funded to 14 grantees was accomplished using the Knowledge, Attitude, and Behavior instrument. Findings of three ANOVA and MANOVA models show that (a) males demonstrate more risk than females; (b) African Americans and Native Americans show higher protective levels than whites and Hispanics; (c) males, as grade level increases, report more AOD knowledge than females; (d) males show more unhealthy attitudes than females, but as grade levels increase, attitudes improve for both males and females; (e) males report more AOD behavior than females, and both genders report increased usage as grade levels increase; and (f) protection level is directly related to AOD knowledge and attitude and inversely related to AOD behavior. Therefore, the more protection, the greater the AOD knowledge, the more positive the attitude, and the lower the risk of AOD behavior.

Date: 07/30/2010

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Alcohol and Other Drugs