Every effective prevention program started with a needs assessment of the target school and local community. Needs assessments is an essential part of the planning process. A needs assessment is a way of taking a systematic look at the issues facing a school and community. Through this process, information can be gathered from many sources to identify the issues to be addressedand the resources that might be used to support the implenattion strategy. An assessment can include gathering existing data, such as school offenses and suspensions. It provides objective data to problems that people might sense but not have the evidence to support. The assessment also may reveal issues that team members had not been aware of. Assessments also often include surveys of students, faculty and school administrators as well as focus groups. Many times, coordinators meet with community officials who may have access to key data or have conducted their own needs assessments. Police departments will have data on youth offenses and agencies such as the YMCA or Boys and Girls Clubs may have conducted their own youth needs assessments that could be relevant for this work. The results of a needs assessment may reveal issues that team members have not been aware of.

A needs assessment:

• Defines the nature and extent of substance abuse problems

• Identifies populations and/or neighborhoods statistically associated with the problem

• Identifies the underlying risk and protective factors of the identified population/ group/neighborhood

• Leads to a plausible theory (or theories) of change that, matched to the appropriate program(s), should reduce or prevent substance abuse (SAMHSA, 2003, Pathways to Effective Programs and Positive Outcomes)

Characteristics of Effective Programs

In "What Works in Prevention," Maury Nation and colleagues reviewed reviews of prevention programs of four areas-substance abuse, risky sexual behavioral, school failure, and juvenile delinquency and violence). From their review, they identified principles related to program characteristics of effective prevention programs. Those characteristics are:

• "Comprehensive. This means providing multiple interventions to address the target problem in multiple settings. For instance, Hawkins and Catalano argued that drug prevention programs should address risk and protective factors across domains or settings (e.g., community, family, school, peer group) that have primary influence on the participants.

• Varied Teaching Methods. Students need some type of active, skills-based component in preventive interventions. Effective prevention programs involve interactive instruction and provide hands-on experiences that increase the participants' skills. The National Institute on Drug Abuse concluded that programs that prevent alcohol and drug use help participants develop resistance skills, including the ability to be assertive and effectively communicate around issues related to drug use.

• Sufficient Dosage. Participants need to be exposed to enough of the intervention for it to have an effect. Aspects of dosage include the session length, number of sessions, spacing of sessions, and the duration of the total program. In addition to initial exposure to the intervention, effective interventions generally include some type of follow-up or booster sessions to support durability of impact.

• Theory Driven. This principle refers to the need for scientific justification of a preventive intervention. Although this principle may seem basic, an examination of actual prevention programs used in many communities and schools indicates that it is sometimes overlooked. Two types of theories that play a role in prevention programming are etiological theories and intervention theories. Etiological theories focus on the causes (e.g., risk or protective factors and processes) of the targeted problem. Intervention theories are focused on the best methods for changing these etiological risks.

• Positive Relationships. Providing opportunities for children to develop strong, positive relationships was consistently associated with positive outcomes. Reviews of substance abuse prevention emphasized the necessity to have strong connections between children and significant others (including peers, teachers, community members) as a way of preventing drug use. The reviews support the idea that it is critical for children to have a strong relationship with at least one adult."

The authors also identified principles related to matching the program with a target population. Those principles were:

• "Appropriately Timed. Interventions should be time to occur in a child's life when they will have maximal impact. Unfortunately, many programs tend to be implemented when children are already exhibiting the unwanted behavior or when the programs are developmentally less relevant to the participants. Early intervention allows programs to have a chance to affect the developmental trajectory of the problem behavior. This suggests that the elementary school to middle school transition may be an importance window for intervention.

• Socioculturally Relevant. The relevance of prevention programs to the participants appears to be a primary concern in producing positive outcomes. Culturally tailoring prevention programs goes beyond surface structure language translation to deep structure modifications sensitive to cultural factors that influence development and receptiveness to the intervention."

Finally, the authors identified principles related to implementation and evaluation of prevention programs. Those principles were:

• "Outcome Evaluation. The evaluation of prevention programs is necessary to determine program effectiveness. Otherwise, practitioners may assume that a program is effective on the basis of anecdotal or case study evidence. As evaluation has become more common, the results indicate that many programs that are anecdotally believed to be successful may actually not be effective.

• Well-Trained Staff. A high-quality, research based program can produce disappointing results in dissemination field trials if the program providers are poorly selected, trained, or supervised. The implementation of prevention programs is enhanced when the staff members are sensitive, are competent, and have received sufficient training, support, and supervision."

Following are two case studies which illustrate how school coordinators used these principles when they chose and implemented prevention programs in their schools.

When coordinator Lisa Pisciotta conducted a needs assessment at Kunsmiller Middle School in Denver, she learned that students, teachers and parents were most concerned with school safety and substance abuse. Fights were common and almost half of the students said that their peers picked on others because they were different.

The school administration decided to implement programs that were both evidence-based and shown to be effective with the Latino population. They chose the Olweus Bullying Prevention Program, which attempts to restructure the existing school environment to reduce opportunities and rewards for bullying. The efforts are directed toward improving peer relations and making the school a safe and positive place for students to learn and develop. School staff is largely responsible for introducing and implementing the program.

Pisciotta coordinated the development of an Olweus Bullying Prevention committee that consisted of the principal, assistant principal, student advisors, nurse, social worker, psychologist, counselor, teachers and herself.

Committee participants at Kunsmiller Middle School held a kick-off for students to discuss issues related to bullying and to informing them that a new program was being implemented at their school. All students signed a pledge during the kick-off agreeing to not bully their fellow students. The students' pledge was laminated and placed in the main entrance of the school. Kunsmiller also had a kick-off for parents and members of the community. At this meeting administration discussed bullying and informed parents that they were beginning the Olweus Bullying Prevention program to counteract bullying issues at the school. In addition, school rules against bulling were posted throughout the entire building. All Health teachers began implementing the program by utilizing discussion, video and role playing in their classroom. Also, all teachers began conducting individual interventions with bullies and victims. In addition, the administration secured the school's "hotspots" with increased supervision. Those areas include the locker rooms, hallways, stairways, and the adjacent park. The Bullying Prevention committee also met once a month to discuss specific reports of students who were found to bully and those who were victimized. Plans and strategies were generated to support both groups of students.

The survey results showed that after one year of implementing the program, bullying had decreased significantly. The survey results showed a seven percent decrease in verbal bullying, an 8 percent decrease in physical bullying and an 11 percent decrease in relational bullying from 2002-2003 to 2003-2004.

Following the needs assessment, Pisciotta and her colleagues also decided to implement the Life Skills Training program to support substance abuse prevention. The program focuses on preventing tobacco, alcohol and drug abuse among adolescents. It addresses a range of risk and protective factors by teaching young people general personal social skills in combination with drug resistance skills and education. Every student participates in the program through their physical education class. The 2003-2004 pre- and post-survey showed a significant increase in overall knowledge, drug-related knowledge, and life skills knowledge. There was also a significant decrease in pro-drinking and pro-marijuana attitudes.

In addition to the universal interventions, Pisciotta oversaw interventions directed at specific groups who may be a higher risk for problems with violence and substance abuse. The school implemented the Aggression Replacement Training (A.R.T.) in the Special Education and Alternate classrooms. The program focuses on skill building, anger-control training and training in moral reasoning. The program also works with parents and family members in a parent empowerment component. Key findings from the A.R.T. program showed that teachers in the Special Education classroom went from mainstreaming none of their students to having every student mainstreamed into at least one regular classroom. Similar results took place in the Alternative classroom.

With another grant, Pisciotta brought in a full time substance abuse counselor, to work with students who were caught in school with drugs or alcohol. Another program, the Kunsmiller Middle School Mentoring Program works with ECCOS (Ethnic Counseling Community Outreach Services) Family Center, which is a non-profit organization operating throughout Metro Denver. Volunteers from ECCOS work as mentors for the students who need some extra support.

Pisciotta, who had previously worked at a mental health agency, said that it took a while for teachers and administrators to understand her role. She also had to step back from her inclination to do everything and let teachers and staff take on key responsibilities. It was critical that they do so because her job was only funded for three years. She sent an assistant principal to training on the bullying program and found funding to support him and others to take on extra duties. With the training and support, he will be prepared to oversee the program, she said.

As a result of the prevention work, Kunsmiller was recognized with a visit by the then Attorney General Ken Salazar (now a U.S. Senator) to speak to the students and spotlight the success of implementing the Olweus Bulling Prevention Program. Pisciotta said that the success of that and other programs has helped her receive additional grants including a $300,000 three-year grant from the Colorado Trust. The school has also received a $100,000 grant from Catholic Charities to partner with it in running an after school program. Before the coordinators program, the school did not have these grants or the recognition for its prevention efforts, Pisciotta said.

Through the grants, Pisciotta is sustaining much of the work begun under the coordinators initiative. She also spearheaded a successful effort to have the bullying program, Life Skills and other prevention program include in the school improvement plan. The school board voted to approve their inclusion in the plan. In addition, she has cultivated champions of this work among school administrators and teachers. All of those efforts make it likely that the work will continue.

In Tahlequah, Oklahoma, a simple box might have saved many lives. Fred Poteete, the former middle school coordinator there, learned through his needs assessment that bullying was a major problem in the school there. As part of the anti-bullying work, he installed a drop box for students to report anything that felt unsafe to them anonymously. While some of the reports were false, 90 percent checked out, he said. Poteete or his colleagues checked the box several times a day. One day, four students left notes saying that a new student was planning to bring a weapon to school. With that information, school officials went to the student who expressed relief that they had found out before he could have done anything dangerous, Poteete said.

Poteete also worked with teachers to design a referral form for them to fill out when they see bullying. Before, the teachers never had such a clear and simple way to report bullying. By asking for teachers' input into the design of the form, Poteete won their support.

Students also filled out aerial maps of the school campus that showed "hot spots" where they felt unsafe. They also used the maps to report where tobacco and drug use took place. The results were eye-opening. For example, a student said that in a special education classroom, a student was hitting another behind a cabinet while the teacher stood outside the door. When she learned about this she changed her position and the bullying stopped. Students even added locations not on the maps, such as buses and the athletic building where bullying was taking place. Administrators learned that in the athletic building while the coaches were in their offices talking, seventh grade boys were getting harassed as they got dressed by eighth grade boys. The survey also yielded other useful information, such as where students were getting cigarettes and smokeless tobacco.

Poteete and his colleague also implemented a formal anti-bullying program. They started with one and then moved on to Aggressors, Victims and Bystanders, which they felt had more of a track record and was more empathy based, which the junior high needed.

Poteete and other coordinators emphasize that any prevention program must meet the particular needs of a school. For his school, an empathy-based training was critical because that was lacking among the students. Another school that tackles bullying may need a different emphasis. Schools in the same district might have different needs or be at different stages of readiness to take on prevention programming. Coordinators working in multiple schools need to keep that in mind.

Poteete has been educator for 27 years in Tahlequah, working as a teacher, assistant principal and coach. Lately, he has been filling in as a bus driver to relieve a shortage in the community. He knows the community well, which has helped him in his job. Tahlequah is the western capital of Cherokee Nation and two-thirds of the students are Native American. Most of the rest of the students are white.

The comprehensive anti-bullying program led to a drop in incidents of bullying and an increase in reporting in bullying. It was so successful that the Tahlequah school board passed a measure mandating bullying program in all of its schools. The work also drew the attention of State Senator Herb Rozell who once taught in Tahlequah public schools. He co-authored the School Bullying Prevention Act. Passed in 2002, the law requires all Okalahoma school districts to come up with policies and programs to prevent harassment, intimidation and violence.

To combat drug use, Poteete also implemented the drug prevention programs Project Alert and Life Skills training to combat drug use.

Several coordinators are continuing to do this work in other school positions. One is funded through a drug free communities grant. Others have been absorbed by the school in other positions, such as student advocate.

Select a Research-Based Prevention Program

At the heart of the coordinator program is the reliance on prevention programs that have been validated by research. Coordinators were required to use prevention programs that were on the U.S. Department of Education's list of exemplary or promising programs. All had been shown to be effective in research studies.

Among the key prevention strategies that have been favorably evaluated are:

• Enhancing students' personal and social skills.
• Connecting at-risk students and families with appropriate services.
• Providing safe and supervised alternatives.
• Restructuring classrooms to promote student engagement.
• Influencing school and community norms.
• Establishing and enforcing clear school policies.
• Establishing and enforcing clear community policies.
• Building school-family-community-partnerships

Criteria for Selecting the Right Programs for Your Community

How do you know which strategies and programs are right for your community? You have to do a feasibility study that considers more than just the cost of implementing the program. Your study should look at outcomes, costs, adaptability, and technical assistance available.

In 1998, a panel of experts comprised of nationally recognized researchers, practitioners, and technical assistance providers, identified these six criteria for selecting programs:

• The program must have documented effectiveness and be based on sound theory.
• The program can be easily integrated with existing school practices.
• The program must have data that demonstrate effectiveness or ineffectiveness with particular student groups.
• Data must indicate that the program has a positive impact on student achievement.
• Program developers/sponsors must demonstrate that subscribing schools receive sufficient technical assistance.
• Program components must focus on promoting positive solutions to behavioral and emotional problems. (Safe, Supportive, and Successful Schools, p. 123).

Finally, Nation et. Al. identified well-trained staff as key to the successful implementation, adaptation, and fidelity of evidence-based prevention programs:

Tomorrow we'll look at professional development from both sides -- what coordinators needed to learn and what they needed to share with their prevention teams -- and how that impacted their program implementation.

Resources for Day 3:

Nation, M., Crusto, C., Wandersman, A., Kumpfer, K. Seybolt, D., Morrissey-Kane E., and Davino, K. (June/July 2003) What Works in Prevention: Principles of Effective Prevention Programs, American Psychologist. 58(6/7): 425-432.

National Highway Traffic Safety Administration (NHTSA). (2001). Community how to guide needs assessment and strategic planning. Available: http://www.nhtsa.dot.gov/people/injury/alcohol/Community%20Guides%20HTML/ Book2_NeedsAssess.html#app1

Osher, David, Dwyer, Kevin, & Jackson, Stephanie. (2004). Safe, Supportive, and Successful Schools Step by Step. Colorado: Sopris West.

Pisciotta, L. (April, 2005). Personal communication.

Poteete, F. (April, 2005). Personal communication.