Exemplary Programs
Athletes Training and Learning to Avoid Steroids (ATLAS)
Athletes Training and Learning to Avoid Steroids is recommended as an Exemplary Safe, Disciplined, and Drug-Free Schools program.
Program Description. The Athletes Training and Learning to Avoid Steroids (ATLAS) program is a universal program for high school male athletes. The goals of the program are to reduce anabolic steroids use and intent to use; reduce use of alcohol and other illicit drugs; reduce "athletic enhancing" supplement use; reduce substance abuse risk factors; promote substance abuse protective factors; improve nutrition behaviors; and improve athletic self-efficacy.
The rationale of the program is based on the premise that student-athletes are an important group for health promotion and substance abuse prevention as they can be role models and opinion leaders for other students. Their abstinence from drug use has the potential to deter abuse in others. ATLAS relies on an understanding of etiologic risks and protective factors as a prerequisite for the development of a successful program. Bandura's social learning theory and Fishbein's Theory of Reasoned Action are integrated into this predictive model.
The ten 45-minute classroom sessions involve role-play, student-created campaigns, and educational games. Instructional aids include pocket-sized food and exercise guides and easy-to-follow workbooks. Parents are involved with homework and diet goals. The total curriculum is nine hours with approximately 100 hours of team contact during the sport season. The classroom session time allotment is divided into 50% drug issues, 34% sport nutrition, and 16% exercise training.
The program is structured in two components: the Instructor Package and the Athlete Packs. The Instructor Package is a three-ring binder that includes instructions on how to train peer "squad" leaders, background information, and lesson plans for the 10-session curriculum. Also included in the Instructor Package are 10 Athlete Packs. Each Athlete Pack contains 10 curriculum workbooks, 10 sports menu booklets that include nutrition information and specific athletic enhancing snacks before and after training; and 10 training guides that include information on strength training, weight lifting exercises, and workout schedules.
Professional Development Resources and Program Costs. A one-day instructor and peer-led training is available but not required. Ongoing assistance and updated information can be found on the ATLAS Web site, and technical assistance is available through ATLAS via e-mail, fax, or telephone. The cost for the program (Instructor Package with 10 Athlete Packs) is $149.95. Additional Athlete Packs can be purchased for $39.95 for a set of ten. (Current costs need to be verified with the program.)
Program Quality. Reviewers found that the scope and sequence of the activities lead logically to the achievement of the program's clearly articulated goals. They lauded the program's congruence between mission, goals, objectives, activities, and intended behavior change. This program targets a very specific audience, and its materials are appropriate to that audience.
Evidence of Efficacy. Reviewers found that the ATLAS evaluation studies were rigorous and methodologically strong, with excellent designs, internal validity, well-known measures, appropriate analyses, and statistically significant outcomes. The program used a pre-post test design with randomized assignment to control groups, large samples, multiple schools, longitudinal measures, and sophisticated analyses of the data. The researchers carefully and systematically addressed issues of retention, baseline equivalence, short-term and long-term effects, and both individual and school-level results. One reviewer pointed out that the program was thoughtfully contextualized in adolescent psychological and physical development theory and correctly addressed and identified potential statistical issues, such as ethnicity and father's education at baseline.
Reviewers noted the consistent pattern and magnitude of the program's outcomes. Each of the 14 effectiveness claims was substantiated with statistically significant results. Statistically reliable outcomes in favor of the treatment group were found in almost all areas addressed by the program including the following: a) reduced incidence and prevalence of drug use, intention to use and actual use of anabolic steroids, sport supplement use, and drinking and driving occurrences; b) improved drug use resistance skills, perceptions of harmful effects of anabolic steroids, personal susceptibility to harmful effects, perception of athletic competence, and sports nutrition behaviors; and c) increased higher strength training self-efficacy and perception of coach's intolerance of anabolic steroid use.
The evaluation design was a randomized cohort study, over three consecutive years; two cohort studies had a one-year follow-up component, and all three cohort studies had an end-of-the-season follow-up. Thirty-one schools in 10 cities and two states were studied, with random assignment of pair schools to experimental and control conditions, with 15 experimental and 16 control schools and a sample of 3,207 athletes at pre-assessment. There was no differential dropout between experimental and control groups. Positive post-test findings were observed one year after baseline measurement, using a 168-item questionnaire based on prior research that indicated high item reliabilities, validity, and adequate sensitivity.
Contact Information:
Linn Goldberg, ATLAS Program, Oregon Health Sciences University
3181 SW Sam Jackson Park Road (CR 110), Portland, OR 97201
Telephone: (503) 494-6559 Fax: (503) 494-1310
E-mail: goldberl@ohsu.edu
Web site: http://www.ohsu.edu/som-hpsm/info.htm
CASASTART
The CASASTART program is recommended as an Exemplary Safe, Disciplined, and Drug-Free Schools program.
Program Description. CASASTART (Striving Together to Achieve Rewarding Tomorrows) is a substance abuse and violence prevention program serving especially high-risk 8-13 year olds and their families living in socially distressed neighborhoods. The program is a comprehensive, neighborhood-based, school-centered secondary intervention that brings police, schools, and community-based organizations together to achieve two goals: (1) re-direct the lives of youngsters who are considered likely to end up in trouble (i.e., to use drugs, become delinquent, and drop out of school) and (2) reduce and control illegal drugs and related crime in the neighborhoods in which the youth live in order to make them safer and more nurturing environments in which to raise children. The specific objectives of the program are to reduce children's use of substances; to reduce the incidence of their delinquent behavior; and to reduce the incidence of their disruptive behavior while in school.
CASA (The National Center on Addiction and Substance Abuse at Columbia University) selects a low-income neighborhood within a larger city and identifies a target school. Within that school, CASASTART identifies those youth most likely to become involved in negative behaviors and works to increase the protective factors in the youth served to prevent their involvement in substance abuse, violence, and illegal activities. CASA's other roles are to specify the core services; train site staff; develop and sustain the collaborative relationship at the staff and policy levels; support problem-oriented policing strategies in the neighborhood; develop strategies to work through issues of confidentiality; design the data collection and management information systems; structure and conduct the program evaluation; and assess local funding needs and assist in fund development.
The case manager serves as a counselor, mentor, advocate, broker of services, and role model. CASA's comprehensive prevention strategy contains eight core service components that are required at each site: case management, education services, family services, recreational activities, mentoring, community policing, incentives, and criminal/juvenile justice intervention.
Professional Development Resources and Program Costs. CASA's staff regularly visits new sites and provides in-service training to site staff in key components of the model. Training sessions involve staff from all key agencies and include topics on case management, service integration and collaboration, substance abuse prevention, family involvement, and community oriented policing. CASA also holds regular all-site conference calls and an annual all-site conference, bringing together the partners from all CASA communities. A CASASTART newsletter is distributed on a bimonthly basis. (Current costs need to be verified with the program.)
Program Quality. While this program is comprehensive and takes on enormous challenges, reviewers noted that the goals are still very clear and appropriate to the task. Reviewers found that the program's goals and rationale attend to the enormous challenges of working with youth from socially distressed neighborhoods and that the program itself is adaptable to the variety of environments found there. CASASTART clearly addresses how the case management model is flexible in its timeframe, intensity, and availability.
Evidence of Efficacy. Reviewers found considerable evidence of CASASTART's efficacy based on an independent evaluation using treatment vs. control group designs with multiple measures, e.g., surveys of youth and caregivers; court and police records; school records on performance and attendance; and program records on program services and participation. Reviewers commended the rigor of the evaluation design, the integrity of the measures, and the comprehensiveness of the data analyses.
CASASTART is the second iteration of The National Center on Addiction and Substance Abuse at Columbia University's Children at Risk (CAR) research and demonstration program, which was tested in six cities from 1992-1995. Therefore, the program provided efficacy data resulting from the 1992-95 evaluation of CAR programs in five cities. The first year of the evaluation used an experimental design in which eligible youth, ages 11-13, were randomly assigned to treatment and control groups, consisting of 338 CAR participants and 333 control youth selected in five cities during 1992-93 and 1993-94. During the second year of the evaluation, a second comparison group was created using a quasi-experimental design to assign youth to comparison groups in equivalent communities who continued to recruit CAR participants. The comparison group consisted of 203 youth selected in four cities during 1993-94. Data analysis was performed to adjust for attrition, and validity was checked for self-reported data.
The evaluation data yielded statistically significant treatment/control group differences across sites between the CAR youth and the control group on measures of gateway and stronger drug use, drug sales activity, violent crimes, and involvement with delinquent peers. CAR youth had more positive peer support and felt less peer pressure. They also were more likely to be promoted to the next grade in school than the control students.
For further information contact:
Lawrence F. Murray The National Center on Addiction and Substance Abuse at Columbia University
633 Third Ave, 19th Floor, New York, NY 10017
Telephone: (212) 841-5208 Fax: (212) 956-8020
E-mail: lmurray@casacolumbia.org
Web site: http://www.casacolumbia.org
Life Skills Training
Life Skills Training is recommended as an Exemplary Safe, Disciplined, and Drug-Free Schools program.
Program Description. The Life Skills Training Program (LST) addresses a wide range of risk and protective factors by teaching general personal and social skills in combination with drug resistance skills and normative education. LST is a universal, primary, school-based drug abuse prevention program that targets individual adolescents, typically in school classrooms. The goal of the program is to prevent tobacco, alcohol, and drug abuse among adolescents. The designated program consists of a three-year prevention curriculum intended for middle school and junior high students. (An elementary school curriculum has recently been developed.) The three major content areas are personal self-management skills, general social skills, and drug resistance skills and information.
The underlying rationale of this program is based on the premise that preventing drug use with younger populations will ultimately reduce the prevalence of drug use among these same individuals as they become older. LST is based on an understanding of the causes of smoking, alcohol, and drug use/abuse and the knowledge that the initiation of drug use is the result of a complex combination of many diverse factors.
Materials for each year of the LST curriculum consist of a teacher's manual, a student guide, and audio cassette tapes. The curriculum is designed to be delivered in 15 class periods of approximately 45 minutes each during the first year. Ten booster sessions occur in the second year, and five sessions occur during the third year. Another option is to deliver the program as a module or mini-course so that the entire program is conducted on consecutive days. Teachers and parents may also use a smoking and biofeedback video to teach their students and children about the immediate harmful effects that smoking has on the body.
Professional Development Resources and Program Costs. The Life Skills Training program offers provider training at an estimated cost of $200 per provider for a two-day training workshop (curriculum materials not included). The training sponsor is responsible for costs associated with the training site, equipment rental, and promotion. Depending on the grade level, the cost of teacher manuals ranges from $45-$85 and student guides range from $6 to $9 per student. (Current costs need to be verified with the program.)
Program Quality. Reviewers stated that the program's goals and activities are closely aligned with research on changing knowledge, attitudes, and behaviors about drug use. Reviewers also reported that the intended population and the expected changes within that population are clearly articulated and logically appropriate.
Evidence of Efficacy. Statistically significant results were found in a wide variety of settings using randomly assigned groups, with both objective and self-report measures of use. Reviewers found consistent positive results for up to six years for participants who continued with an implementation of the program that is high in fidelity. Measures focused on the three gateway drugs: alcohol, cigarettes, and marijuana. Program measures were as reliable and valid as is possible for these complex variables due to the fact that the program used saliva and carbon monoxide testing to validate self-report data. Results were consistent across large numbers of participants in repeated studies.
Thirteen evaluation studies spanning more than 15 years all demonstrated strong evidence of positive treatment effects extending over periods of time. These studies used very strong research designs, controlled for threats to internal validity including attrition, and used follow-up components. Differential attrition was examined and implementation fidelity of the program was assessed in most of the later studies. All studies used designs in which the schools were randomly assigned to treatment and control conditions. Reviewers found that the treatment group showed a statistically significant decrease in levels of adolescent alcohol, tobacco, and marijuana use in comparison to the control groups, with some studies showing these effects lasting for one year or more. The most powerful impact of the program was on smoking prevalence, an outcome reinforced by positive impact on mediating variables. A six-year longitudinal follow-up study showed statistically significant decreases in weekly and monthly cigarette smoking, getting drunk, and multiple drug use for the experimental conditions.
Almost every study showed statistically significant effects favoring the treatment group with some studies also examining the strength of the program implementation and/or any differential attrition effects. In sum, reviewers concluded that the evidence as a whole showed that the program had been rigorously evaluated using a variety of populations, variations in staff, and different program formats.
Contact Information:
National Health Promotion Associates, Inc.
141 South Central Avenue, Suite 208, Hartsdale, NY 10530
Telephone: (914) 421-2525 Fax: (914) 683-6998
E-mail:
raining@nhpanet.com
Web site:
http://www.lifeskillstraining.com
OSLC Treatment Foster Care (TFC)
OSLC Treatment Foster Care is recommended as an Exemplary Safe, Disciplined, and Drug-Free Schools program.
Program Description. OSLC (Oregon Social Learning Center) Treatment Foster Care (TFC) recruits and trains foster families to house and care for youth with a history of juvenile delinquency. The goals of the program are to provide adolescents who are seriously delinquent and in need of out-of-home care with the following: close supervision, fair and consistent limits and predictable consequences for rule breaking, a supportive relationship with at least one mentoring adult, and a reduction in their exposure to delinquent peers. Foster families work with case workers and therapists to administer an intensive behavior intervention, but biological/adoptive families also have continual input into their child's treatment.
Effective interventions for this population are multidimensional and are implemented in the TFC home, at school, in the community, and with peers. The program has many components that all work together to serve the needs of the youth. Treatment modalities include behavioral parent training for TFC parents and biological parents, skills training for youths, supportive therapy for youths and involved adults, school-based behavioral interventions and other academic support, and psychiatric consultation and medication management, as needed. Family therapy is provided for the youth's biological/adoptive family with the ultimate goal of returning the youth back home.
Placement into TFC homes is carefully considered and highly scripted. The participant moves from a detention facility to the new home with the guidance of the case manager. Youth attend public schools where their behavioral adjustment, attendance, and academic performance are closely monitored and interventions are conducted in the school, as needed. The program is divided into levels that participants attain as they accumulate points for good behavior and compliance. Participants' performance in the foster home, school, and community is monitored and scored. Points earned are "redeemed" by the participants for privileges. Once the youth has returned home, parents are invited to participate in a weekly aftercare group with other parents. An aftercare curriculum is delivered through a manual titled Success Begins At Home.
Professional Development Resources and Program Costs. TFC families are recruited, screened, and then participate in a 20-hour pre-service training. Biological/adoptive parents also receive training in point system assignments. The total program cost for a typical youth is estimated at $3,965 per month per youth. This cost includes family therapy sessions and payments to the foster family. The average length of stay is seven months bringing the average total cost per youth to $27,755 for 7 months. (Current costs need to be verified with the program.)
Program Quality. Reviewers noted that the overall program goals are excellent and commended the program for the specific goal of realizing normal behaviors among adolescents targeted for this program. Reviewers stated that the rationale was well thought-out and the content takes into consideration the diversity of the population it serves. Reviewers found the expectations of performance, the interventions themselves, the methods of providing support, and the feedback all to be exemplary.
Evidence of Efficacy. Reviewers determined that the OSLC Treatment Foster Care program had been rigorously tested through four evaluation studies, with one study using a matched comparison design and three studies using random assignment designs. The program collected evaluation data through well-known measures with established reliability and validity and official organization, state, and court records. All of the evaluations were of high quality in terms of experimental design, selection of measures, data analyses, and, most importantly, long-term program effects. Reviewers found the program's impact to be both statistically and clinically significant. The program presented convincing findings on scientifically established risk factors, such as early and persistent antisocial or aggressive behavior and early initiation of delinquency.
One randomized clinical trial of incarcerated youth, ages 12-18, used a control group receiving an alternative treatment program. This study demonstrated statistically significant evidence of the effectiveness of the program in reducing criminal and delinquent behaviors in serious and chronic adolescent offenders. Multiple measurement points--at baseline, three months after placement, and every six months for two years--strengthened the design. The study's results yielded a number of statistically significant changes one year post-treatment related to conduct problems in favor of the experimental group, including fewer self-reports of delinquent activities, fewer official criminal referrals, fewer days of incarceration, and fewer days on the run from the treatment program. The matched comparison study showed that program youth spent fewer days in lock-up, fewer program youth were incarcerated, and more program youth completed treatment than the comparison youth.
Contact Information:
Patricia Chamberlain, Oregon Social Learning Center Community Programs
1160 East Fourth Avenue, Eugene, OR 97401
Telephone: (541) 485-2711 Fax: (541) 485 7087
E-mail:
pattic@oslc.org
Web site:
http://oslc.org
Project ALERT
Project ALERT is recommended as an Exemplary Safe, Disciplined, and Drug-Free Schools program.
Program Description. Project ALERT is a drug-prevention program for middle-grade students that focuses on alcohol, marijuana, cigarettes, and inhalants. Its goals are: to prevent adolescents from beginning drug use, to prevent those who have experimented with drugs from becoming regular users, and to prevent or curb risk factors demonstrated to predict drug use.
Project ALERT is grounded in an understanding of drug use as a social phenomenon -- a response to pro-drug messages and models presented by peers, adults, and the media. This program attempts to provide the motivation for saying "no" by identifying the pressures to use drugs and countering pro-drug arguments. The program builds and reinforces group norms against drug use and dispels beliefs that use is widespread, desirable, and harmless.
The curriculum consists of 11 lessons in sixth or seventh grade and three booster lessons 12 months later. The curriculum is cumulative and progresses from motivating nonuse to providing multiple opportunities to practice resistance skills and identifying the benefits of resistance. Follow-up with reinforcement is contained in the booster lessons.
Professional Development Resources and Program Costs. The Project ALERT curriculum builds upon the pedagogical skills and training of certified classroom teachers during a highly interactive, one-day workshop. For $125 per teacher, each teacher receives the complete training and materials package that includes the following: a one-day training workshop; a complete teacher's manual with 14 detailed lesson plans; two teacher demonstration videos; eight classroom videos; 12 classroom posters; an optional teen leader component; and complimentary video and print curriculum updates on a periodic basis. Other costs for student materials are limited to a few reproducible handouts.
On-going support for trained Project ALERT teachers is provided through a complimentary technical assistance newsletter three times a year and a toll-free teacher assistance telephone line. Refresher workshops are also available for previously trained teachers. (Current costs need to be verified with the program.)
Program Quality. The program goals of Project ALERT are clearly focused on behavioral changes that are both reasonable and appropriate for the middle-grade age level. The program content and materials are culturally and ethnically sensitive and have been successfully implemented in highly diverse middle schools that encompassed urban, suburban, and rural communities. The rationale for the program is based on the social influence model of drug prevention. Students in the program are motivated and engaged in the learning process due to the participatory nature of the program. Activities highlight consequences of drug use that are immediately relevant to teenagers while avoiding didactic lecturing and scare tactics that might cause students to avoid or block out the message. For example, the "why not use drugs" list that students review is elicited directly from their responses, and therefore automatically reflects the consequences of drug use that students themselves consider serious and likely.
Evidence of Efficacy. Reviewers determined that Project Alert provided convincing evidence of a credible and effective drug prevention program through an extremely well-designed evaluation and consistent results. The evaluation was exemplary in all respects, including large sample size, numerous and varied schools and student populations, two variations of program treatment, random assignment of students to treatment and control groups, longitudinal measurements, validated outcome measures, appropriate adjustment for attrition effects, and thorough and sophisticated analyses. Results demonstrated statistically significant and meaningful effects favoring the treatment students in a variety of settings and over time. Reviewers agreed that high confidence could be placed in the conclusion that the findings were attributable to the intervention.
The evaluation was carried out in 30 middle schools between 1984 and 1990, with three conditions of 10 schools each: a) a control group of 1,105 students, b) an ALERT curriculum group of 1,316 students taught by an adult teacher only, and c) an ALERT curriculum group of 1,413 students taught by an adult teacher plus teen leader. The evaluation design used multiple measurements to validate the self-report survey measures with physiological samples and consistency analyses conducted over time. The evaluators administered and tested saliva samples at the time of measurement to verify student survey ratings; conducted classroom observations monitoring more that one-third of all lessons and examined classroom logs to ensure that materials were covered and the courses were taught as they were designed; and performed a reliability test to determine inconsistencies in self-reported drug use. Data were collected at four points: before and after seventh and after the eighth grade booster lessons with follow-ups at 12 and 15 months after baseline. In addition, a long-term follow-up assessed student outcomes six years later.
Statistically significant and consistent differences were found between the treatment and control students on both use and beliefs about use for marijuana, alcohol, and cigarette use. The evaluation examined complex relationships, including results for students who participated for different amounts of time and who began as users, non-users, or experimenters.
Contact Information:
Project ALERT
725 S. Figueroa St., Suite 1615, Los Angeles, CA 90017
Telephone: (800) 253-7810 Fax: (213) 623-0585
E-mail:
info@projectalert.best.org
Web site:
http://www.projectalert.best.org
Project Northland
Project Northland is recommended as an Exemplary Safe, Disciplined, and Drug-Free Schools program.
Program Description. Project Northland is a research-based, multilevel, multiyear alcohol use prevention program for students in Grades 6-8. Its goals are to delay the age when young people begin drinking, to reduce alcohol use among those who have already tried drinking, and to limit the number of alcohol-related problems among youth. The program addresses both individual behavioral change and environmental change through student participation and experiential learning at home and in peer-led classroom activities.
The sixth grade curriculum, entitled Slick Tracy Home Team Program, is a six-session, six-week classroom and home-based program. Students complete fun and educational activities at home with their families, which promote parent/child discussions of alcohol, peer influence, media influence and home rules. In the classroom, small-group, peer-led discussions are held around each week's theme. Amazing Alternatives! is the seventh grade, teacher- and peer-led classroom-based curriculum that is designed to be taught once or twice a week over four to eight consecutive weeks. It includes audio-taped vignettes, group discussions, class games, problem solving, and role playing to explore why young people use alcohol and how prevention can occur. Sixth and seventh grade peer leaders are selected by their classmates and receive training prior to curriculum implementation.
The Powerlines curriculum for eighth graders is a four-week, eight-session, 45-minute per session interactive program that reinforces the messages and behaviors learned in previous curricula. Through work on small-group projects, students learn about local "power" groups (individuals and organizations) and influences the groups have within their own communities to influence adolescent alcohol use and availability. Students also conduct interviews with local citizens and then hold a "town meeting" in which small groups of students represent various community groups and make recommendations for community action for alcohol use prevention.
Professional Development Resources and Program Costs. The curriculum includes three "teacher friendly" guides for Grades 6, 7 and 8 that provide strategies, resources, implementation plans, and materials needed for optimal benefit. Student-specific handouts enhance ease of delivery at all grade levels.
Training is strongly recommended for administrators or prevention coordinators in order to thoroughly understand research, rationale, and strategies for effective implementation. Participants will receive key implementation tools and technical assistance in developing an individual plan. In order to best meet conditions for replication, classroom teacher training for staff delivering curriculum in Grades 6, 7, and 8 is also suggested. For current costs on all materials and training services, please call Hazelden Publishing at (800) 328-9000. (Current costs need to be verified with the program.)
Program Quality. Reviewers noted that the program content and processes are developmentally appropriate at each grade level and take into consideration the characteristics and needs of diverse populations. The program is grounded in social influence theories, such as problem behavior theory that emphasizes the interaction of social environmental factors, behavior, and personality in predicting adolescent drinking. Reviewers highlighted the program's design that has students exposed to parental involvement, behavioral curricula, peer leadership opportunities, and community awareness activities during the three years of participation. Reviewers noted that roughly 70% of the program's small group discussion activities are led by peers and that peer-led instruction is highly effective at this age. Project Northland uses other strategies to motivate students, including class games, videotapes, and small group projects.
Evidence of Efficacy. Project Northland used a pre-post, randomized community trial with longitudinal follow-up measures to determine program effectiveness. Reviewers found this approach to be an excellent example of a comprehensive evaluation of an alcohol prevention program. The strengths of the evaluation included a strong design, a high-intensity intervention, appropriate analyses, and a comprehensive set of measures. The credibility of the program had been established in repeated trials and in several refereed journals. The evaluation involved a large sample of adolescents, with 2,351 sixth grade students at the 1991 baseline point, and retained a substantial portion of them over the three-year period: 2,191 students at the 1992 sixth grade follow-up, 2,060 students at the 1993 seventh grade follow-up, and 1,901 students at the 1994 eighth grade follow-up points. The program demonstrated statistically significant effects, especially among non-users at baseline, and provided considerable longitudinal evidence of the program's effectiveness in delaying the onset of alcohol and other drug use.
The evaluation used randomization at the school district level, with 24 intervention and reference school districts blocked into two groups of 10 districts, and student questionnaire measures assessing attitudes, beliefs, and use of drugs and alcohol. Results demonstrated consistent statistically significant differences at the end of the three-year intervention in favor of the treatment group on repeated survey measures of students' tendency to use alcohol, recent alcohol use, cigarette use, marijuana use, peer influence, self-efficacy, and functional meanings of alcohol use. The program showed a differential effect for non-users at baseline, indicating that the program was very effective in delaying the onset of alcohol, cigarette, and marijuana use among adolescents who had never used these substances at the sixth grade baseline.
For further information contact:
Ann Standing, Hazelden Information and Educational Services
15251 Pleasant Valley Road, PO Box 176, Center City, MN 55012
Telephone: (800) 328-9000, ext. 4030 Fax: (651) 213-4577
E-mail:
astanding@hazelden.org
Web site:
http://www.hazelden.org
Project T.N.T.: Towards No Tobacco Use
Project T.N.T.: Towards No Tobacco Use is recommended as an Exemplary Safe, Disciplined, and Drug-Free Schools program.
Program Description. Project T.N.T.: Towards No Tobacco Use is a comprehensive, ten-day curriculum that provides students with the information and skills they need to say "no" to tobacco use. The program educates students about short and long-term negative physiologic and social consequences of tobacco use, while addressing social influences and peer norms and building refusal skills. The program addresses both cigarettes and smokeless tobacco.
The program goals for Project T.N.T are to reduce the initiation of cigarette smoking and smokeless tobacco in young teens, and to reduce the frequency of cigarette smoking and smokeless tobacco in young teens. The program combines numerous research-based approaches for program delivery. It teaches replacement of negative thoughts about peer pressure resistance with positive thoughts, provides an interactive approach to the instruction about the physical consequences of tobacco use, and uses novel games to reinforce learning.
Designed for use in middle schools and/or junior high schools, the program consists of ten lessons designed to be presented over a two-week period, beginning either in Grades 5, 6, 7, or 8. Each of the ten core lessons lasts 45 to 50 minutes each, and, while designed to be delivered over a two-week period, can be delivered over as many as four weeks. Two booster sessions are held the year after the program begins.
The curriculum consists of a teacher's manual with step-by-step instructions for completing each of the ten core sessions and the two booster sessions, a student workbook, and two supplementary or optional videos.
Professional Development Resources and Program Costs. Two days of teacher training are recommended. Training is delivered in two ways: (1) Educator Training-a two-day training designed to provide health educators with the knowledge and skills to implement Project T.N.T.; and (2) Train the Trainer-a three-day training designed to provide trainers with the knowledge and skills to train health educators to implement Project T.N.T. Costs for training vary depending on the size of the group trained, location of the training, and duration or extent of the training.
Program materials cost $45 for one curriculum, which includes a teacher's guide and one student workbook. Student workbook, either in English or Spanish, is $18.95 for set of five. (Current costs need to be verified with the program.)
Program Quality. The program's goals were found to be explicit, clear, and appropriate to the audience. The underlying rationale behind these goals and the program activities were compelling to the reviewers; most significantly, the program demonstrates nicotine's addictive nature and emphasizes how that necessitates a continued commitment to preventing tobacco use among young people. Materials were noted by reviewers to be of significant variety and were not found to be culturally biased or insensitive to diverse ethnic groups.
Evidence of Efficacy. Reviewers concluded that the evaluation design of Project T.N.T. was ambitious, methodologically very strong, and well-constructed for strong internal validity. There were large samples, multiple schools, identification of different sub-treatments, random assignment, and sophisticated analysis of the data. Appropriate tests were made for gender and setting effects. The program presented evidence of effectiveness in attenuating increases in initiation and weekly use of cigarettes and smokeless tobacco for seventh grade treatment students. Reviewers commented on the impressiveness of a program that can demonstrate results a full two years after a 10-day treatment intervention.
The pre-post evaluation design involved random assignment of 48 schools to four treatment and one control condition. The schools were further split into Cohort 1, in which a 20-page questionnaire was administered pre-post to 6,716 students in seventh grade from treatment and control schools and during a two-year follow-up with 7,219 students in ninth grade; and Cohort 2, in which a sample of students in each school were given the pre-post questionnaires. The program reported that at the end of the two-year follow-up, as compared to control group schools, students in Project T.N.T. schools reduced initiation of cigarette use by 26% and smokeless tobacco use by 30%, and weekly or regular use of cigarettes by 50%-60% and smokeless tobacco use by 100%. Statistically significant differences were found on differing measures for some of the treatment groups as compared to the control group.
Contact Information:
Sue Wald, ETR Associates
4 Carbonero Way, Scotts Valley, CA 95066
Telephone: (831) 438-4060, ext. 164 Fax: (831) 438-4284
E-mail:
wals@etr.org
Web site:
http://www.etr.org
Second Step: A Violence Prevention Curriculum
Second Step: A Violence Prevention Curriculum is recommended as an Exemplary Safe, Disciplined, and Drug-Free Schools program.
Program Description. Second Step: A Violence Prevention Curriculum is a school-based social skills curriculum that teaches children to change the attitudes and behaviors that contribute to violence. The goals of Second Step are to reduce aggression and promote social competence of children from preschool through Grade 9. The program addresses a range of other behaviors that may be warning signs of violence and aggression, including extreme impulsivity, interrupting, name calling, bullying, and threatening.
Second Step is based on research which suggests that the acquisition of key social competencies will decrease children's risk for engaging in destructive behavior and will expand their repertoire of pro-social skills. Second Step addresses three key pro-social skills: empathy, impulse control, and anger management.
The program is delivered once or twice a week and lessons vary in length from 20 minutes in the lower grades to 50 minutes for older children. There are about 20 lessons for each grade level. For preschool and elementary school students, the Second Step curriculum consists of three kits: Preschool/Kindergarten, Grades 1-3, and Grades 4-5. Each kit includes a set of photo lesson cards, classroom posters, a teacher's guide, a classroom video, and a parent information video. The Pre-K kit also includes a song tape and puppets. Lessons in the middle school/junior high curriculum are divided into three levels with each level containing discussion lessons, overhead transparencies, reproducible homework sheets, and a live-action video. At all grade levels, a teacher's guide explains the underpinnings of the program and provides implementation information to schools.
A video-based parent program, A Family Guide to Second Step, is led by a Family Guide group facilitator in six group meetings and is designed to familiarize parents with the Second Step curriculum and help them reinforce the pro-social skills that their children are learning in the curriculum. A Spanish supplement to Second Step is available for use by teachers in Spanish language or bilingual classrooms.
Professional Development Resources and Costs. Training for teachers is available through a train-the-trainer model. Educators who receive the intensive training as "Second Step Trainers" gain the skills, tools, and resources that enable them to train their school staff to teach the curriculum to students. In addition, the developer provides training for Family Guide facilitators, refresher/booster training sessions, and training programs for non-teaching staff. Free implementation planning assistance is available to schools via telephone.
Typical program costs include the Pre-K kit ($259), the Grades 1-3 kit ($269), the Grades 4-5 kit ($249), materials for three levels of middle school/junior high school ($530), the Family Guide kit ($475) and the Second Step Training for Trainers, a three-day training for one trainer ($345). (Current costs need to be verified with the program.)
Program Quality. Reviewers noted the correlation between the program's goals and the practice skills taught in the curriculum. They also highlighted the program's focus on mastery of three important areas: empathy, impulse control, and anger management. The strategies to achieve these goals and the rationale behind them were found by reviewers to have a strong congruence and to be very logical. Since the program draws experiences from its participants, reviewers found it to be culturally appropriate for the intended population.
Evidence of Efficacy. Second Step provided overall evidence of efficacy based on data from three evaluation studies that included a pre-post randomized control group study, a pre-post nonrandomized comparison group study, and a pre-post treatment group only study. Additional studies are in progress, including a three-year longitudinal evaluation.
Reviewers cited several strengths of the evaluation data: a) the excellent triangulation of teacher rating, parent report, and classroom observation measures; and b) the use of well-known teacher and parent measures with a history of established reliability and validity. Reviewers specifically noted the rigor of the one-year, pre-post randomized clinical trial, involving 418 second and third grade students from six intervention schools and 372 second and third grade students from six control groups, in which the 12 schools were paired to ensure socioeconomic and ethnic comparability. This study yielded statistically significant treatment/control group differences on observational measures of behavioral outcomes, including a decrease in physical aggression and an increase in neutral/pro-social behavior. A six-month follow-up showed these observational effects remained for the most part.
Preliminary results of the pre-post nonrandomized comparison group study indicated that Second Step participants in Grades 6-7 in five sites showed a statistically significant reduction in self-reported attitudes endorsing the use of physical and relational aggression and in the perceived difficulty of behaving pro-socially. The pre-post treatment group-only study used observations of third and fifth grade teachers' practices during the first week of the school year, combined with students' perceptions in the spring. Recommended teaching practices were significantly predictive of students' greater sense of community, which in turn predicted lower self-reports of student aggression.
Contact Information:
Committee for Children, Client Support Services Department
2203 Airport Way South, Suite 500 Seattle, WA 98134
Telephone: (800) 634-4449 or (206) 343-1223 Fax: (206) 343-1445
E-mail:
info@cfchildren.org
Web site:
http://www.cfchildren.org
The Strengthening Families Program: For Parents and Youth 10-14
The Strengthening Families Program: For Parents and Youth 10-14 is recommended as an Exemplary Safe, Disciplined, and Drug-Free Schools program.
Program Description. The long-range goal of the Strengthening Families Program: For Parents and Youth 10-14 (SFP), formerly called the Iowa Strengthening Families Program, is reduced substance use and behavioral problems during adolescence. Intermediate objectives of the curriculum include improved skills in nurturing and child management by parents, improved interpersonal and personal competencies among youth, and improved pro-social skills in youth. The curriculum is a universal preventive intervention designed for parents of all educational levels and their young adolescent children.
The rationale for this program is grounded in enhancing protective factors and reducing risk in the family environment. A substantial body of literature supports a strong predictive relationship between ineffective child rearing in early adolescence and delinquent behavior in later adolescence.
The Strengthening Families Program includes seven two-hour sessions for parents and youth. Parents and youth attend separate skill-building sessions for the first hour and spend the second hour together in supervised family activities. The program is designed for eight to 13 families and is typically held in a public school, church, or community center. Each session requires three facilitators, one for the parent session, and two for the youth session. All three facilitators offer assistance to families and model appropriate skills during the family session. Four booster sessions are designed to be used six months to one year after the end of the first seven sessions in order to reinforce the skills gained in the original sessions.
Program materials include nine videotapes (six for parents, one for youth, and two for family sessions) and a 415-page leader's manual containing a teaching outline; a script for the videotapes; detailed instructions for all activities in sessions one through seven; master copies for each parent, youth, and family worksheet and homework assignment; a master copy of the program flyer; a list of materials; ordering information; and evaluation instruments. The narrators and actors in the video vignettes are African-American, Hispanic and White. For the booster sessions, two additional videotapes and a separate 215-page manual detailing instructions for four booster sessions for parent, youth, and family sessions are also required.
Professional Development Resources and Program Costs. Two days of facilitator training are required. Three days of training are recommended for groups conducting a scientific evaluation of the program and for groups requiring adaptation of the program for different ethnicities or non-English speaking families. Consultation and technical assistance are available by telephone and e-mail for no charge after trainings. All materials for program implementation provide easy-to-follow instructions.
Teaching manuals cost $175 each and the set of nine videos costs $250. Program supplies, not including general supplies, cost about $10 per family. In addition to the two separate rooms needed for the parent and youth sessions, two televisions and VCRs, flip charts or erasable boards, and a slide projector are also needed. (Current costs need to be verified with the program.)
Program Quality. The reviewers found the goals of this program explicit and grounded in solid research (based on the Biopsychosocial Vulnerability Model). Reviewers highly rated the program's approach, which assumes a developmental perspective with families exerting relatively more influence on pre- and young adolescents than on older adolescents. The intensifying focus on high-risk moments of transition from elementary to middle or junior high was highly commended by reviewers for effective intervention timing.
Evidence of Efficacy. Reviewers found that the program used rigorous pre-post, treatment versus control evaluation methods and provided evidence of positive treatment results, especially in the area of decreased drug and alcohol use among youth. The program's five-year longitudinal evaluation design used random assignment into experimental and control groups followed by a series of confirmatory tests of equivalence. The study addressed attrition rates and found no evidence of differential attrition at any of the posttest or follow-up data collection points. Reviewers noted that the integrity of the instruments was well substantiated and the data analyses were appropriate in type and rigor.
Statistically significant results for both the youth and parent components of the program attested to the credibility and soundness of the evidence. Surveys were used to measure youth outcomes; and questionnaires, interviews, and direct observations were used to assess parenting behaviors. The methodology included a range of sophisticated analyses that permitted data to be explored and explained in very convincing ways.
Results were reported for a five-year longitudinal evaluation with 11 schools each assigned to the experimental and minimal contact control conditions, totaling 238 experimental and 208 control group sixth grade students and their families. The program also conducted a tenth grade follow-up with both groups. Reviewers found that the program showed statistically significant reductions in conduct problems and tobacco, alcohol, and substance use in favor of the experimental group. At the tenth grade assessment, results demonstrated statistically significant lower alcohol and tobacco initiation index scores, relative to the control group.
Contact Information:
Virginia Molgaard, Institute for Social and Behavioral Research
2625 N. Loop, Suite 500, Iowa State University, Ames, IA 50010
Telephone: (515) 294-8762 Fax: (515) 294-3613
E-mail:
vmolgaar@iastate.edu
Web site:
http://www.fcs.iastate.edu/families/
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