In the early 1980s, NIDA began to encourage research on comprehensive drug abuse prevention programs that involve many components of a community. The theory behind this approach is that children are more likely to pay attention to antidrug messages that are repeated throughout the community than they are to heed messages from only one source, such as in school or at home.
One of the first of these comprehensive prevention programs was the Midwestern Prevention Project conducted by Dr. Mary Ann Pentz and her colleagues at the University of Southern California in Los Angeles. The research program was first implemented in Kansas City, Kansas, and Kansas City, Missouri, in 1984 and later replicated in Indianapolis, Indiana, starting in 1987.
The program involved schools, mass media, parents, community, and health policymakers. Sixth- and seventh-graders were taught in school how to resist social influences to use drugs. This learning was reinforced through public service announcements and news stories. Parents were encouraged to help their children on drug abuse prevention homework assignments and to talk with their children about drugs. Volunteers from the community provided leadership, developed community antidrug campaigns, and raised funds for related prevention activities. Finally, the community established policies that discouraged the use of drugs, cigarettes, and alcohol in schools, at work, and in public places.
Research findings indicated that students in the 107 participating schools in Kansas City and Indianapolis used significantly less marijuana, cigarettes, alcohol, and cocaine than did students whose schools did not participate. Substance abuse increased for both groups of students as they got older, but the increase was substantially less for students in participating schools.
Data from the Indianapolis study showed that the program could also reduce the use of marijuana, cigarettes, and alcohol by sixth- and seventh-graders who were already users of these substances. "Studies have shown that young people who use drugs and alcohol earlier than their peers are particularly likely to continue to abuse these substances later, so the fact that this program reduced substance use in this high-risk group was particularly promising," says Dr. William Bukoski of NIDA's Division of Epidemiology, Services, and Prevention Research.
"Our studies have shown that a substance abuse prevention strategy that involves many components of the community can slow the rate of increase of drug, alcohol, and cigarette use among early adolescents and also decrease the use of these substances by adolescents who are already using them," says Dr. Pentz. "This strategy works because it changes social norms and expectations. Changing social norms about drug use changes drug use behavior in turn."