School-Level Longitudinal Predictors of Alcohol, Cigarette, and Marijuana Use

This study analyzed measures aggregated at the school level to identify key predictors of drinking alcohol, binge drinking, smoking cigarettes, and using marijuana. Using data collected from 6th through 12th grade students between 2011 and 2015, we identify school-level variables that predict school-level prevalence in the subsequent year. Data included prior year assessments of: (1) school-wide prevalence, (2) perceived ease of access to drugs, (3) perceived adult disapproval of drug use, (4) perceived peer disapproval of drug use, and (5) perceived prevalence of drug use. We regressed grade-level behaviors on predictor variables from the previous school year. In middle schools, prior grade prevalence and prior grade perceived norms were significant predictors of subsequent grade prevalence. For high schools, prior year prevalence, aggregated peer norms, and perceived ease of access predicted subsequent use. These analyses provide evidence that a school's culture is predictive of changes in prevalence over time.

The Impact of a High School-Based Positive Youth Development Program on Sexual Health Outcomes: Results from a Randomized Controlled Trial

BACKGROUND

Although positive youth development (PYD) programs have demonstrated effectiveness in improving adolescent reproductive health outcomes, there is a lack of evidence on effective school-based interventions designed especially for high school settings. This study examined the efficacy of Peer Group Connection (PGC-HS), a school-based PYD program, in improving sexual health outcomes for high school participants.

METHODS

A total of 1523 ninth-grade students at 18 schools were randomly assigned to be offered PGC-HS or a classes-as-usual control condition during 2016 to 2017 and 2017 to 2018 school years. Impacts were assessed on three confirmatory and 6 exploratory outcomes via self-reported participant questionnaire data collected at the beginning of 10th grade.

RESULTS

Although the offer of PGC-HS had no statistically detectable effect on confirmatory behavioral outcomes (sexual initiation, frequency of sex, and number of sexual partners) at 10th grade follow-up, causal impact estimates indicate that PGC-HS participants were less likely than control participants to ever have had vaginal sex. PGC-HS participants also scored higher on decision-making skills and perceived connection to peer connectedness.

CONCLUSIONS

Results suggest that by building social and emotional skills and helping students form supportive peer relationships, PGC-HS may encourage students to make healthier choices and avoid risky behaviors during a critical period in high school, thus, reducing the risk of pregnancy.

Perception, Attitude and Support of Society Towards Drug Abuse: Do Gender, Age and Education Matter?

This article highlights the support, attitude and perception of the general public towards drug abuse so that appropriate policies can be framed for the prevention of drug abuse among youth. The study aims to understand the relationship among variables influencing behaviour change with respect to drug abuse. Questionnaire from 1,159 respondents was administered comprising of 39 items exploring Perception, Attitude, Support pertaining to illicit drugs. Positive or negative attitude towards drug abuse is evolved out of the perception of problems associated with drug abuse and the support provided to dissuade drug-abusing behaviour, and relationship among these variables was tested using SEM-Path analysis. The perception of problems related to drug addiction significantly influences the attitude towards drug addiction. The perceived nature of the support structure augments the influence further (partial mediation). The augmenting effect of the support structure can be seen among gender, age and education. Moderator effects of age, gender and education were studied by estimating multi-group path coefficients. This article is useful to local government as they may take some of the findings of this article for framing policy related to educating youth related to drugs, creating a campaign regarding the harm of drug abuse and involving those volunteers in drug assistance programmes that are more supportive of drug addicts. This article is helpful for society to make them understand that their positive attitude and support towards drug abuse will give a second chance to drug addicts to leave drugs and live a normal life again.

Evaluation of an infused alcohol and drug prevention programme

Purpose

Alcohol, tobacco, marijuana and other drugs use typically increases in prevalence and frequency during middle and late adolescence. School health instruction often focusses on providing facts and rarely provides tools for addressing the psychosocial risk factors needed to prevent substance use. The purpose of this paper is to report about the effectiveness of a prevention programme delivered in US high school health classes. The intervention augments typical instruction by providing teachers with activities that can be infused in their daily teaching.

Design/methodology/approach

In total, 26 schools were randomly assigned to receive the intervention or serve as controls. Pupils were pretested near the beginning of the school year, posttest near the end of the school year and administered a final test near the beginning of the following school year. Teachers in treatment schools were provided with activities designed to target psychosocial variables known to mediate substance use onset and self-initiated cessation. These include normative beliefs, intentionality, lifestyle incongruence, beliefs about consequences of use, peer pressure resistance skills, decision-making skills, goal setting skills and stress management skills.

Findings

Hierarchical modelling analytic strategies revealed the intervention to have definable positive impacts on alcohol and cigarette use. Moreover, the intervention had strongest effects on alcohol and cigarette use among pupils who were identified at pretest as being lower-than-average risk.

Originality/value

This research provides support for providing teachers with a strategy for preventing alcohol, tobacco and other drugs that can be used in a flexible manner to augment the instruction they are already mandated to provide.

Self-Initiated Cessation from Substance Use: A Longitudinal Study of the Relationship between Postulated Mediators and Quitting

This study examines psychosocial predictors of self-initiated substance use cessation among youths who have had recent substance use experience. Variables included those that are the focus of many primary prevention programs. Middle school and high school students who used either alcohol, cigarettes, smokeless tobacco, marijuana, or inhalants were surveyed on two occasions, one year separating the pretest and posttest. Pretest differences distinguished those who would quit versus those who would continue using alcohol, tobacco, and marijuana, but not inhalants. The largest pretest differences were youths' normative beliefs, manifest commitments to not use substances, and perceived incongruence between drug use and their desired lifestyles. Those who continued to use had scale values for most mediators that continued to worsen in programmatic terms, whereas measures among those who quit significantly improved. School-aged users may benefit from programs that target some of the same mediators currently promoted as effective in primary prevention programs.

How all Stars Works: An Examination of Program Effects on Mediating Variables

Prevention research continues to focus on school-based substance use programs aimed at adolescents. These programs are designed to reduce substance use and risk behavior by targeting key mediators, such as normative beliefs, which in turn reduce substance use. All Stars is a newly developed program that was recently evaluated in a randomized field trial in 14 middle schools in Lexington and Louisville, Kentucky. The authors examined targeted and nontargeted variables as possible mediators of program effectiveness. Findings indicate that All Stars achieved reductions in substance use and postponed sexual activity when teachers were successful at altering targeted mediators: normative beliefs, lifestyle incongruence, and manifest commitment to not use drugs. The program was not successful when it was delivered by specialists. At least in part, this failure is attributable to specialists’ inability to change mediators as intended by the program.

Using Attitudes, Age and Gender to Estimate an Adolescent's Substance Use Risk

PURPOSE

The purpose of this paper is to present a strategy for estimating an individual's risk of alcohol, cigarette and cannabis use that relies on an assessment of an adolescent's age, gender and attitude.

METHODOLOGY

The authors assembled surveys from 35,987 11 through 17 year-olds assembled from 36 databases were analysed to examine the relationship between attitude and behaviour.

FINDINGS

Attitudes were strongly correlated with concurrent use of alcohol, drunkenness, smoking, and cannabis, with point biserial correlations of -0.555, -0.517, -0.552 and -0.476, respectively. Logistic regression provided a means for using age, gender and attitudes to estimate an individual's risk of engaging in substance use behaviour. Developmental changes in attitudes were estimated by analysing changes in scores associated with percentile rankings for each age and gender group. Projected year-to-year changes in attitude were used as a heuristic for estimating future risk.

RESEARCH LIMITATIONS

Analyses relied on cross-sectional panel data. Analyses would benefit from longitudinal data in which age-related changes in attitudes could be more precisely modelled.

PRACTICAL IMPLICATIONS

Information about estimated current and future risk may use useful for motivating the adoption and implementation of effective prevention approaches by parents and care providers.

ORIGINALITY

The authors present a novel method for estimating an individual's risk of substance use knowing attitude, age and gender.

A Peer-Led High School Transition Program Increases Graduation Rates Among Latino Males

The present study investigated the impact of a manualized high school transition program, the Peer Group Connection (PGC) program, on the graduation rate at a low-income, Mid-Atlantic high school. The program utilized twelfth grade student peer leaders to create a supportive environment for incoming ninth grade students. Results of a randomized control trial demonstrated that male students who participated in the program during ninth grade were significantly more likely to graduate from high school within four years than male students in the control group (81% versus 63%). Findings suggest that peers can be effective in delivering a school-based, social emotional learning intervention and that it is possible to intervene in the ninth grade to influence the probability of high school graduation.

Coverage of adolescent substance use prevention in state frameworks for health education: 10-year follow-up

BACKGROUND

The use of alcohol, tobacco, and other drugs (ATOD) by adolescents is a national health issue. One way in which the United States approaches the prevention of substance use among adolescents is by teaching high school students about ATOD at school. The curriculum for health education courses is based upon each state's framework. The purpose of this study was to conduct a 10-year follow-up to a study that analyzed state frameworks for key mediators of adolescent substance use.

METHODS

Researchers performed an extensive content analysis of all 50 states' curriculum frameworks for high school health education to identify if, and to what degree, key mediators of adolescent substance use were included in each state's curriculum framework. After training, inter-rater agreement was greater than 95%.

RESULTS

Mediators identified most often in the 50-state curriculum frameworks for high school health education were beliefs about consequences, decision making, social skills, assistance skills, and goal setting. Twenty-two of 50-state curriculum frameworks for high school health education had dedicated sections for ATOD.

CONCLUSION

There were modest improvements since 2001 in the inclusion of mediators of adolescent substance use within state curriculum frameworks. There still exists many opportunities to more effectively use curriculum frameworks to improve classroom health instruction.

Collaborative evaluation of a high school prevention curriculum: How methods of collaborative evaluation enhanced a randomized control trial to inform program improvement

Blending high-quality and rigorous research with pure evaluation practice can often be best accomplished through thoughtful collaboration. The evaluation of a high school drug prevention program (All Stars Senior) is an example of how perceived competing purposes and methodologies can coexist to investigate formative and summative outcome variables that can be used for program improvement. Throughout this project there were many examples of client learning from evaluator and evaluator learning from client. This article presents convincing evidence that collaborative evaluation can improve the design, implementation, and findings of the randomized control trial. Throughout this paper, we discuss many examples of good science, good evaluation, and other practical benefits of practicing collaborative evaluation. Ultimately, the authors created the term pre-formative evaluation to describe the period prior to data collection and before program implementation, when collaborative evaluation can inform program improvement.

From the macro to the micro: a geographic examination of the community context and early adolescent problem behaviors

This study examined how multiple dimensions and levels of the community context associated with early adolescent problem behaviors in rural communities. Four thousand, five hundred and nine eighth-grade students in 28 rural and small town school districts in two states participated in surveys regarding substance use and delinquency in 2005. Locations of alcohol retailers, tobacco retailers, youth-serving organizations, and student residences were geocoded. Associations of the number of proximal alcohol and tobacco retailers, and youth-serving organizations with an early-adolescent problem behavior index were tested in Nonlinear Mixed Models that controlled for multiple district-level and individual characteristics. Multi-level model results demonstrated that the number of alcohol and tobacco retail locations within a one-mile radius of each adolescent's home positively associated with student-reported problem behaviors above and beyond the influence of school district and individual characteristics. Results suggest that the proximal community context added significantly to the district context when understanding the occurrence of early adolescent problem behaviors. Recognizing this variability in geographically determined risk within a community will likely enhance the effectiveness of community prevention activities.

Project success' effects on substance use-related attitudes and behaviors: a randomized controlled trial in alternative high schools

Using a randomized controlled effectiveness trial, we examined the effects of Project SUCCESS on a range of secondary outcomes, including the program's mediating variables. Project SUCCESS, which is based both on the Theory of Reasoned Action and on Cognitive Behavior Theory, is a school-based substance use prevention program that targets high-risk students. We recruited two groups of alternative high schools in successive academic years, and randomly assigned schools in each group to either receive the intervention (n = 7) or serve as a control (n = 7). Students completed surveys prior to and following the administration of the program, and again 1 year later. Although participation in Project SUCCESS significantly increased students' perceptions of harm resulting from alcohol and marijuana use, students in the control group reported greater increases in peer support. We also found conflicting evidence in two opposing trends related to students' perceptions of the prevalence and acceptability of substance use. Therefore, the effects of Project SUCCESS on substance use-related beliefs and behaviors must be considered mixed.

BELIEFS ABOUT COUGH MEDICINE ABUSE AMONG CHINESE YOUNG PEOPLE IN HONG KONG

Beliefs about cough medicine abuse among Chinese young people were examined using the Beliefs about Cough Medicine Abuse Scale (BACMAS; developed by Shek). A total of 225 Chinese young people, including 160 cough medicine abusers and 65 noncough-medicine abusers, participated in this study. Results showed that the scale was internally consistent, and was able to differentiate between those who did and did not abuse cough medicine. Higher BACMAS scores were related to higher levels of endorsement of cough medicine abuse and severity of consumption, thus providing support for the concurrent and construct validities of the scale. The respondents abusing cough medicine generally did not perceive the benefits of abusing cough medicine and they recognized the harmful effects of such abuse. However, 40.7% of them believed that cough medicine was not addictive and 57% believed that there was no harm in associating with friends who abused cough medicine. Results suggest that it is important to understand the beliefs of cough medicine abusers regarding cough medicine abuse.

An innovation in drug prevention programs for adolescents: the Hong Kong Astro project

Recent approaches to drug prevention have turned to focus on comprehensive strategies that target early risk factors and that strengthen protective factors in adolescence.

OBJECTIVE

To develop a drug prevention program that is evidence-based and conceptually sound for the Chinese community.

STUDY GROUP

The "Astro" project was designed for high-risk youths in Hong Kong and consisted of three psychosocial primary prevention programs conducted in structured group sessions.

METHODS

A three-year longitudinal study and control group comparisons are integrated in this project for the program evaluation.

RESULTS AND CONCLUSIONS

The findings showed that the experimental group, after participating in the programs, was generally better than the control group in terms of social skills, knowledge of drugs, refusal skills, attitudes towards drugs, and the behavioral intention to avoid drug abuse. It suggests that this program could function well as a drug prevention program.

How can statistical approaches enhance transdisciplinary study of drug misuse prevention?

Application of statistical techniques in transdisciplinary research includes statistical model selection and model specification. This paper presents statistical models used in drug misuse prevention research. The historical roots of these models are discussed to illustrate the numerous disciplines from which different techniques originated. Single and multilevel approaches are described to illustrate methods of synthesizing perspectives from different scientific arenas. Using single-level approaches in transdisciplinary research, these models can easily incorporate broader theoretical considerations and more integrated hypotheses by representing each discipline with a set of variables. Simultaneous testing of every set of variables obtained from different disciplines may provide more comparable results to identify critical factors associated with substance-use behavior. Using multilevel approaches, more powerful syntheses across disciplines can be achieved by representing each discipline at a different level.

A sport-based intervention for preventing alcohol use and promoting physical activity among adolescents

This study tested the potential of a novel intervention addressing alcohol prevention within the context of a sport program. Study participants were randomly assigned to one of three groups, with one group receiving the sport consultation (Sport), a second the sport consultation plus an alcohol consultation (Sport Plus), and a third a sport consultation, alcohol consultation, and mailed parent print materials (Sport Plus Parent). Researchers recruited 465 eighth graders from three schools in the northeast Florida region to participate in the study. The Youth Alcohol and Health Survey was used to collect data on alcohol and drug consumption, alcohol use risk and protective factors, and exercise habits at baseline and three-month post-intervention. Significant time effects (p's < .05) were found on three of six alcohol measures, both exercise measures, and four risk/protective factors, with all but one risk factor showing improvements over time. Time by assignment by current drinking status (yes/no) interaction effects (p's < .05) were found on alcohol initiation, length of alcohol use, quantity, heavy use, moderate physical activity, and four risk/protective factors, with preintervention drinking adolescents exposed to the Sport intervention showing the greatest improvements on all but two measures. Findings suggest that a brief sport-based screen and consultation tailored to adolescents' health habits, with and without parent materials, may potentially reduce alcohol use while increasing exercise frequency.

Sensation-seeking as a moderator of the effects of peer influences, consistency with personal aspirations, and perceived harm on marijuana and cigarette use among younger adolescents

Concurrent effects of peer influence and protective cognitive variables on marijuana and cigarette use are hypothesized to be contingent on adolescent sensation-seeking. The hypothesis was tested in 1999-2000 using a survey given to eighth graders (N=3127) in 20 U.S. middle schools. Results largely supported the hypothesis that peer pressure and perceived peer marijuana use had only a relatively trivial effect on low sensation-seekers and a much greater effect on high sensation-seekers. In addition, aspirations inconsistent with marijuana use appeared protective for high sensation-seekers.

Coverage of adolescent substance use prevention in state frameworks for health education

Ten secondary health education state curriculum frameworks were reviewed for their inclusion of 12 mediators commonly used to prevent adolescent substance use. Specific aims of the investigation were: a) to identify the extent to which the 12 mediators were found in each framework; and b) to identify those frameworks that included Alcohol, Tobacco, and Other Drugs (ATOD) sections and determine to what extent the 12 mediators were found in those sections. A panel of three researchers independently reviewed each framework. Beliefs about consequences, decision-making skills, and stress management skills were identified most often while commitment, lifestyle incongruence, and normative beliefs were identified least often. Among states that included ATOD sections, beliefs about consequences and resistance skills were the most commonly identified mediators. Commitment, goal setting, and normative beliefs were not identified in any ATOD sections. Research in prevention and implications for health education are discussed.