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...on Prevention
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www.ProjectCork.org
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Spring 2010
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Project SUCCESS' effects on the substance use of alternative high school students.
Clark HK; Ringwalt CL; Hanley S; Shamblen SR; Flewelling RL; Hano MC. Addictive Behaviors 35(3): 209-217, 2010. (50 refs.)
Project SUCCESS is a selective and indicated substance use prevention program that targets high risk students in secondary school settings. We evaluated the effects of Project SUCCESS on adolescents' substance use immediately following program implementation, and again one year later. Two successive cohorts of alternative high schools were randomly assigned to an intervention or control group, yielding seven schools per condition. Main outcomes included 30-day use of alcohol, marijuana, and illegal drugs excluding marijuana, and drinking to intoxication. We conducted exploratory analyses on 30-day cigarette use. Using Hierarchical Linear Modeling, we found that students in the control schools reported significantly less use of illegal drugs excluding marijuana than those in the intervention group at the first posttest; however, this effect did not persist one year later. There were no other outcome effects of even a marginal nature. While results of this study do not provide evidence of Project SUCCESS' effectiveness, students' program exposure was low. It is possible that Project SUCCESS would perform better in schools with higher and more regular rates of attendance. Copyright 2010, Elsevier Science.
Reducing adolescent use of harmful legal products: Intermediate effects of a community prevention intervention.
Gruenewald PJ; Johnson K; Shamblen SR; Ogilvie KA; Collins D. Substance Use & Misuse 44(14): 2080-2098, 2009. (55 refs.)
Purpose: Preliminary results are presented from a feasibility study of a comprehensive community prevention intervention to reduce the use of inhalants and other harmful legal products (HLPs) among adolescents in three Alaskan frontier communities conducted in 2004-2007. The legal products used to get high include over-the-counter drugs, prescription drugs, and common household products. Community mobilization, environmental and school-based strategies were implemented to reduce access, enhance knowledge of risks, and improve assertiveness and refusal skills. Methods: Pre- and post-intervention survey data were collected from 5-7th grade students from schools in three communities using standardized instruments to assess knowledge, assertiveness, refusal skills, perceived availability, and intent to use. The intervention consisted of community mobilization and environmental strategies to reduce access to HLPs in the home, at school, and through retail establishments. In addition, the ThinkSmart curriculum was implemented in classrooms among 5th grade students to increase the knowledge of harmful effects of HLPs and improve the refusal skills. Data were analyzed using hierarchical linear models that enable corrections for correlated measurement error. Results: Significant increases in knowledge of harms related to HLP use and decreases in perceived availability of HLP products were observed. The environmental strategies were particularly effective in reducing the perceived availability of HLPs among 6th and 7th graders. Discussion: Although limited by the absence of randomized control groups in this preliminary study design, the results of this study provide encouragement to pursue mixed strategies for the reduction of HLP use among young people in Alaskan frontier communities. Copyright 2009, Taylor & Francis.
An evaluation of a heroin overdose prevention and education campaign.
Horyniak D; Higgs P; Lewis J; Winter R; Dietze P; Aitken C. Drug and Alcohol Review 29(1): 5-11, 2010. (18 refs.)
Introduction and Aims. Following detection of an upward trend in the frequency of fatal heroin overdoses in Victoria between 2001 and 2003, Victoria's Department of Human Services planned a campaign aimed at increasing injecting drug users' (IDU) awareness of overdose risks and prevention strategies. Stickers, wallet cards and posters featuring five key messages were distributed via needle and syringe programs (NSP) and other drug and alcohol services between November 2005 and April 2006. An evaluation of the campaign was commissioned to be conducted in late 2006. Design and Methods. The evaluation consisted of analysis of three independent data sets--quantitative data collected from IDU during the campaign period (n = 855 at baseline; and a range of 146-656 at follow up); qualitative interviews with IDU who were NSP clients during the campaign period (n = 16) and qualitative interviews with NSP staff and other key stakeholders (n = 9). Results. While key experts felt that the campaign messages had engendered lasting impact for at least some IDU, these positive impressions were not borne out by the NSP client data, with less than one quarter of all campaign messages being mentioned by a significantly higher proportion of clients during the post-campaign period compared with baseline. Key experts perceived the greatest weakness of the campaign to be the delay between issue identification and the introduction of campaign materials. Discussion and Conclusions. While IDU are generally responsive to health promotion campaigns, future initiatives in this domain should be designed and implemented rapidly and in ways that are sufficiently flexible to cope with shifts in drug markets which could influence the reception of key messages. Copyright 2010, Australian Medical and Professional Society on Alcohol and Other Drugs.
Web-based alcohol prevention for incoming college students: A randomized controlled trial.
Hustad JTP; Barnett NP; Borsari B; Jackson KM. Addictive Behaviors 35(3): 183-189, 2010. (36 refs.)
College students are an at-risk population based on their heavy alcohol consumption and associated consequences. First-year students are at particular risk due to greater freedom and access to alcohol on campus. Web-based (electronic) interventions (e-interventions) are being rapidly adopted as a universal approach to prevent high-risk drinking, but have not been well evaluated. The objective of this study was to investigate the effectiveness of the two most widely adopted EIs, AlcoholEdu and The Alcohol eCHECKUP TO GO (e-Chug), in reducing both alcohol use and alcohol-related consequences in incoming college students. To do so, we conducted a 3-group randomized trial (N=82) comparing AlcoholEdu and e-Chug to an assessment-only control group. Compared to the assessment-only control group, participants in the AlcoholEdu and e-Chug groups reported lower levels of alcohol use across multiple measures at 1-month follow-up. Participants who received AlcoholEdu showed significantly fewer lower alcohol-related consequences than assessment-only controls, while there was a trend for reduced consequences in participants who received e-Chug versus assessment-only. Findings indicate that e-intervention is a promising prevention approach to address the problem of college student alcohol consumption, especially for campuses that have limited resources. Copyright 2010, Elsevier Science.
A systematic review of school-based marijuana and alcohol prevention programs targeting adolescents aged 10-15.
Lemstra M; Bennett N; Nannapaneni U; Neudorf C; Warren L; Kershaw T et al. Addiction Research & Theory 18(1): 84-96, 2010. (35 refs.)
Aims: The purpose of this systematic review was to determine if school-based marijuana and alcohol prevention programs are effective in preventing marijuana and alcohol use in adolescents between the ages of 10-15 years. In particular, we examined knowledge versus comprehensive type prevention programs in order to better understand the inconsistency of results in school-based marijuana and alcohol prevention programs found in the literature. Methods: We performed a systematic literature review to identify published or unpublished papers between January 01, 1980 and December 02, 2007 that reviewed the long-term effectiveness (I year or longer) of school-based marijuana and alcohol primary prevention programs targeting adolescents aged 10-15 years. Results: Long-term marijuana and alcohol prevention programs that utilized a "comprehensive" program content resulted in: (a) a mean absolute reduction of 12 days of alcohol usage per month and (b) a mean absolute reduction of 7 days of marijuana usage per month among adolescents aged 10-15 years old. In comparison, school-based marijuana and alcohol prevention programs that utilized "knowledge only" program content resulted in a mean absolute decrease of 2 days of alcohol usage per month among adolescents aged 10-15 years old. Only one study used knowledge-based content and marijuana use as an outcome measure and as such statistical pooling was not possible. Conclusions: The most effective primary prevention programs for reducing marijuana and alcohol use among adolescents aged 10-15 years in the long-term were comprehensive programs that included anti-drug information combined with refusal skills, self-management skills and social-skills training. Copyright 2010, Taylor & Francis.
Environmental strategies for prevention of drug use and risks in clubs.
Miller BA; Holder HD; Voas RB. Journal of Substance Use 14(1): 19-38, 2009. (73 refs.)
Environmental prevention strategies in club settings where music and dance events are featured could provide an important new arena for the prevention of drug use and other risky behaviours (e.g. sexual risk taking, intoxication and drug use, aggression, and driving under the influence). Electronic music dance events (EMDEs) occur in clubs that attract young, emerging adults (18-25 years of age) and attract individuals who engage in various types of drug use. Borrowing from the environmental prevention studies that focus on reducing alcohol use and related problems, a model for drug prevention in the club setting is proposed. Initially, an overview of the relationships between EMDEs and drug use, and other risky behaviours are presented. Next, rationales for environmental strategies are provided. Finally, an environmental approach to prevention of drug use and risky behaviours in clubs is described. This comprehensive set of environmental strategies, is designed to be mutually supportive and interactive. Environmental strategies are believed to provide potential for developing an efficacious prevention strategy. The environmental prevention approach presented here is composed of three intervention domains: (1) mobilization, (2) strategies for the exterior environment, and (3) strategies for the interior environment. Copyright 2009, Informa Healthcare.
Alcohol abuse prevention in young people: An economic simulation.
Pacileo G; Fattore G. Journal of Substance Use 14(6): 385-392, 2009. (26 refs.)
Severe alcohol abuse can lead to death and disability. A large number of educational programmes for young people's drinking behaviour have been developed to counteract alcohol abuse. The aim of this research was to assess whether those programmes are rational from an economic point of view. It relies on a systematic review of economic evaluation analysis providing evidence on the status of those programmes. Only one study met all the inclusion criteria. This result suggested the performance of an economic evaluation of secondary data. A second systematic literature review with different inclusion criteria was therefore carried out. Nine studies met the inclusion criteria, but only three provided evidence of effectiveness. According to our simulations, if the interventions are effective they are also cost-effective. In other words if they can provide evidence of a decrease in alcohol use and abuse they can also provide evidence that the interventions are rational from an economic point of view. The review suggests two final comments. First, the current investment in preventive programmes is very limited. Secondly, larger studies and more adequate systems of evaluation are needed to provide scientific evidence of the impact of preventive educational strategies on alcohol abuse in young people. Copyright 2009, Informa Healthcare.
A qualitative comparison of parent and adolescent Reasons for non-participation in a parental program concerning underage drinking: A mixed-method study.
Pettersson C; Linden-Bostrom M; Eriksson C. BMC Public Health9: 478, 2009. (50 refs.)
Background: Alcohol consumption among adolescents is a serious public health concern. Research has shown that prevention programs targeting parents can help prevent underage drinking. The problem is that parental participation in these kinds of interventions is generally low. Therefore, the aim of the present study is to examine non-participation in a parental support program aiming to prevent underage alcohol drinking. The Health Belief Model has been used as a tool for the analysis. Methods: To understand non-participation in a parental program a quasi-experimental mixed-method design was used. The participants in the study were invited to participate in a parental program targeting parents with children in school years 7-9. A questionnaire was sent home to the parents before the program started. Two follow-up surveys were also carried out. The inclusion criteria for the study were that the parents had answered the questionnaire in school year 7 and either of the questionnaires in the two subsequent school years (n = 455). Multinomial logistic regression analysis was used to examine reasons for non-participation. The final follow-up questionnaire included an opened-ended question about reasons for non-participation. A qualitative content analysis was carried out and the two largest categories were included in the third model of the multinomial logistic regression analysis. Results: Educational level was the most important socio-demographic factor for predicting non-participation. Parents with a lower level of education were less likely to participate than those who were more educated. Factors associated with adolescents and alcohol did not seem to be of significant importance. Instead, program-related factors predicted non-participation, e. g. parents who did not perceive any need for the intervention and who did not attend the information meeting were more likely to be non-participants. Practical issues, like time demands, also seemed to be important. Conclusion: To design a parental program that attracts parents independently of educational level seems to be an important challenge for the future as well as program marketing. This is something that must be considered when implementing prevention programs. Copyright 2009, BioMed Central.
Adolescents' binge drinking when on holiday: An evaluation of a community intervention based on self-regulation.
Van De Luitgaarden J; Knibbe RA; Wiers RW. Substance Use & Misuse 45(1/2): 190-203, 2010. (25 refs.)
This paper presents a case study of a community intervention aimed at reducing excessive drinking in young men on holiday in seaside camping resorts in the Netherlands. The self-regulated voluntary covenant of parties concerned was evaluated on the basis of several types of data (all collected in 2004): questionnaires administered to young men (N = 191), observations carried out by trained "peers", nuisance questionnaires among city center residents (N = 121), and interviews with local actors. Compliance with measures as well as the effects of measures are discussed. Limitations are noted and recommendations for optimizing the potential of community interventions are made. Copyright 2010, Taylor & Francis.
The project Towards No Drug Abuse (TND) dissemination trial: Implementation fidelity and immediate outcomes.
Rohrbach LA; Gunning M; Sun P; Sussman S. Prevention Science 11(1): 77-88, 2010. (75 refs.)
One of the important research issues in the emerging area of research on dissemination of prevention programs relates to the type and extent of training needed by program providers to prepare them to implement effective programs with fidelity. The present paper describes the immediate outcomes of a dissemination and implementation trial of Project Toward No Drug Abuse, an evidence-based prevention program for high school students. A total of 65 high schools in 14 school districts across the USA were recruited and randomly assigned to one of three experimental conditions: comprehensive implementation support for teachers, regular workshop training only, or standard care control. The comprehensive intervention was comprised of on-site coaching, web-based support, and technical assistance, in addition to the regular workshop. Students (n =
2,983) completed self-report surveys before and immediately after program implementation. Fidelity of implementation was assessed with a classroom observation procedure that focused on program process. Results indicated that relative to the controls, both intervention conditions produced effects on hypothesized program mediators, including greater gains in program-related knowledge; greater reductions in cigarette, marijuana and hard drug use intentions; and more positive changes in drug-related beliefs. There were stronger effects on implementation fidelity in the comprehensive, relative to the regular, training condition. However, seven of the ten immediate student outcome measures showed no significant differences between the two training conditions. The implications of these findings for dissemination research and practice are discussed. Copyright 2010, Springer.
Preventing drug abuse among adolescent girls: Outcome data from an Internet-based Intervention.
Schwinn TM; Schinke SP; Di Noia J. Prevention Science 11(1): 24-32, 2010. (40 refs.)
This study developed and tested an Internet-based gender-specific drug abuse prevention program for adolescent girls. A sample of seventh, eighth, and ninth grade girls (N = 236) from 42 states and 4 Canadian provinces were randomly assigned to an intervention or control group. All girls completed an online pretest battery. Following pretest, intervention girls interacted with a 12-session, Internet-based gender-specific drug prevention program. Girls in both groups completed the measurement battery at posttest and 6-month follow-up. Analysis of posttest scores revealed no differences between groups for 30-day reports of alcohol, marijuana, poly drug use, or total substance use (alcohol and drugs). At 6-month follow-up, between-group effects were found on measures of 30-day alcohol use, marijuana use, poly drug use, and total substance use. Relative to girls in the control group, girls exposed to the Internet-based intervention reported lower rates of use for these substances. Moreover, girls receiving the intervention achieved gains over girls in the control group on normative beliefs and self-efficacy at posttest and 6-month follow-up, respectively. Copyright 2010, Springer.
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