|2nd National Conference on Drug Abuse Prevention Research: |
A Progress Update
This Conference was held at the Omni Shoreham Hotel in Washington D.C., August 9-10, 2001.
PLENARY PANEL II: IDENTIFYING EFFECTIVE FEATURES IN PREVENTION INTERVENTIONS
The Prevalence of Effective Middle-School-Based Curricula, Substantive Content, and Teaching Strategies
Christopher Ringwalt, Dr.P.H.
Many of the Nation's middle schools continue to implement strategies that are either untested or ineffective and to use ineffective teaching strategies to do so. This presentation will report on the prevalence of the use of effective content and teaching strategies in U.S. middle schools and the prevalence of the use of evidence-based curricula in schools. Respondents were lead staff members who taught substance use prevention in a representative sample of 1,905 of the Nation's public and private middle schools. Data were collected in 1999 by a self-administered survey. Respondents were more likely to report giving primary emphasis to knowledge content (46.1 percent) and generic skills (29.9 percent) than to affective content (17.3 percent) and refusal skills (6.8 percent). Respondents were also more likely to use didactic (79.5 percent) than interactive (46.8 percent) teaching methods. Furthermore, only 26.8 percent of all schools, including 34.6 percent of public schools and
12.6 percent of private schools, used at least 1 of the 10 curricula deemed effective by NIDA and/or other institutions. These results demonstrate the considerable gap between current school prevention practices and the understanding of effective curricula and their components. Additional research is needed on the processes by which schools consider, adopt, implement, and institutionalize effective curricula and teaching practices.
Evaluation of Community-Based Interventions
Denise Hallfors, Ph.D.
This presentation will review an evaluation of demand-reduction activities initiated by communities, primarily from the Fighting Back Project. Fighting Back brought local community members together to reduce the demand for substances. This approach relied on an inclusive participation process and local knowledge to identify problems and to devise strategies related to the continuum of care, such as public awareness, prevention, early identification, treatment, relapse prevention, and environmental improvement. Through interviews, local recordkeeping, and evaluator site visits, specific strategies were identified and compared across sites. Findings indicate that most planned strategies were not fully implemented. It was particularly difficult for institutions, such as health care organizations, schools, and churches, to sustain prevention interventions. Nevertheless, each site had a small number of strategies that it was able to deliver consistently. Outcome data from both the national survey and a meta-analysis of school surveys were linked to these strategies to examine effects.
Saxe L, Reber E, Hallfors D, Kadushin C, Jones D, Rindskopf D, et al. (1997) Think globally, act locally: Assessing the impact of community-based substance abuse prevention. Evaluation and Program Planning 20(3):357-366.
Substance Abuse Communications Interventions
Mark W. Lipsey, Ph.D.
Meta-analytic techniques were used to synthesize the findings from 72 studies of the effects of a media intervention designed to prevent or reduce youth substance use. The overall effects on substance use knowledge, attitudes, and behavior were positive, of modest magnitude, and highly variable. The magnitude of the effects varied according to the source (radio, TV, print), the substance addressed (illicit drugs, alcohol, tobacco), the characteristics of the recipients (age, gender, risk level), and the characteristics of the message (thematic, repetition, targeting). Outcome research in this area is beset with methodological problems, which make assessment of the effects of media campaigns problematic and add uncertainty to conclusions.
Effective Implementation of Interventions
Linda Dusenbury, Ph.D.
Prior research has identified key elements of effective prevention programs. It is clear that the success of theoretically valid prevention approaches depends, in part, on high-quality implementation. Effectiveness depends on dosage (how much of a program is delivered) as well as quality (how well a program is delivered), and training and technical assistance are important in promoting fidelity. Technologies such as the Internet and videotape also provide tools for standardizing and protecting essential content. However, organizations may be less inclined to maintain or institutionalize programs that cannot be modified, and program developers and program providers need to work together to develop strategies that promote high-quality implementation at the same time they allow programs to adapt to the needs of particular organizations or communities; this might extend to a reconsideration of the structure and design of programs. Prevention researchers, policymakers, and practitioners need to collaborate to overcome barriers to effective implementation.
PLENARY PANEL III: ASSESSING SUBSTANCE ABUSE IN THE COMMUNITY FOR PREVENTION PLANNING
Measuring the Level of Substance Abuse in the Community
Zili Sloboda, Sc.D.
The key to planning and implementing a prevention program in a community lies in understanding the special needs of that community. It is clear from comparisons of substance abuse problems across communities that, although there are many common practices, there are sufficient differences warranting special attention in service delivery. Measuring substance abuse patterns and practices within a community is complex; thus, the use of multiple methods and multiple measurement systems is recommended. Various measurement methods will be discussed, with emphasis on their advantages and disadvantages. Adapting these approaches for prevention programming will be explored by addressing how to set prevention priorities and how to match programming to community needs.
Understanding Community Risk and Protective Factors
Richard F. Catalano, Ph.D.
Researchers have identified risk and protective factors for adolescent health and behavior problems, including substance abuse, mental health disorders, delinquency, violence, teenage pregnancy, and school dropout. Strategies that reduce or counter risk by enhancing protective factors are promising approaches to prevention, suggesting that prevention strategies need to be community-based, collaborative, and specific to each community's unique risk and protective profile. They also need to use prevention programs with demonstrated effectiveness. Thus, community-wide approaches need to (1) mobilize the appropriate leadership in communities, (2) assess the communities' unique risk and protective factor profile so that prevention programming addresses the most prevalent predictors of problem behavior, (3) inventory existing program resources to identify programming strengths and gaps, and (4) utilize programs that have demonstrated effectiveness in strengthening protective factors and reducing risk and problem behaviors.
Hawkins JD, Catalano RF, Kosterman R, Abbott R, Hill KG. (1999) Preventing adolescent health-risk behaviors by strengthening protection during childhood. Archives of Pediatrics and Adolescent Medicine 153(3):226-234.
Hawkins JD, Catalano RF, Miller JL. (1992) Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention. Psychological Bulletin 112(1):64-105.
Assessing Community Readiness for Prevention
Ruth W. Edwards, M.B.A., Ph.D., and Pamela Jumper-Thurman, Ph.D.
Communities are at many different stages of readiness for addressing community issues. This readiness is a major factor in determining whether local prevention efforts can be effectively implemented and supported by the community. The speakers will describe the Community Readiness Model, which was developed to provide a practical tool to help communities mobilize to address a specific issue. Nine stages of community readiness are defined, ranging from "no awareness" of the problem to "professionalization." Assessment of the stage of readiness is accomplished using key informant interviews, with questions covering six different dimensions. Strategies for successful implementation have been developed for each stage of readiness. Once a sufficient level of readiness is achieved, community teams can be trained in use of the model. These teams then can develop specific, culturally appropriate strategies using local resources to guide their communities to more advanced levels of readiness, eventually leading to long-term sustainability of local community drug abuse prevention activities.
Evaluating Community Strategies and Programs
David P. MacKinnon, Ph.D.
This presentation will describe general guidelines for thinking about how prevention programs achieve or fail to achieve reductions in drug abuse. There are three major aspects of this approach to prevention. First, what are the risk and protective factors associated with drug abuse? For example, social norms and beliefs are related to drug abuse. Second, how does a prevention program change these risk and protective factors? For example, enforcement of laws on alcohol sales to minors may reduce alcohol use by reducing the availability of alcohol. Third, does the change in risk and protective factors explain the change in drug abuse? Methods to answer these questions are described in the context of the evaluation of community drug abuse prevention programs. The importance of a substantial sample of communities and the assignment of communities to research conditions will be discussed and illustrated with several examples.
MacKinnon DP. (1994) Analysis of mediating variables in prevention and intervention research. In: A Cazares and LA Beatty. Scientific Methods in Prevention Research. NIDA Research Monograph 139. U.S. Department of Health and Human Services Pub. No. 94-3631. Washington, DC: U.S. Government Printing Office, pp. 127-153.
MacKinnon DP, Johnson CA, Pentz MA, Dwyer JH, Hansen WB, Flay BR, Wang EY. (1991) Mediating mechanisms in a school-based drug prevention program: First-year effects of the Midwestern Prevention Project. Health Psychology 10(3):164-172.
Murray DM. (1998) Design and Analysis of Group-Randomized Trials. New York: Oxford University Press.
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