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Intervention

Urban Women Against Substance Abuse (UWASA) is a 28-week, school-based program targeting Puerto Rican, Latina, African-American, and Caribbean-American girls (ages 9–11) and their female caregivers. UWASA is theoretically grounded in social learning theory, which suggests a strong connection between certain risk factors (such as juvenile drug-abuse violations and high teen-birthrates) and the absence of positive female role models within a young girl’s immediate family, community, and culture. A central feature of UWASA is a self-development curriculum that teaches girls to build their cultural and gender identity, discourages alcohol and drug use, promotes HIV awareness, and explores possible career options. The program is composed of several distinct components, including

• A curriculum-based intervention for preadolescent girls
• A parallel curriculum for mothers
• Monthly mother–daughter sharing sessions
• Recreational and cultural activities
• Culturally appropriate art projects

A variety of support and referral services, such as home visits and regular telephone contact, are also provided to participants on an as-needed basis.

Evaluation

The evaluation employed a self-selected, quasi-experimental, pretest–posttest design, with measurements at baseline, program exits, and 6- and 18-month follow-ups after program exit. Three cohorts of treatment and comparison groups participated in the study. Sampling strategies varied by implementation cycle.

During cycle 1, random cluster sampling of households was conducted within census blocks within neighborhoods, and participants were assigned to treatment or comparison groups. Treatment and comparison girls were matched by race/ethnicity and age. Because of difficulties in door-to-door recruitment among selected households, the sampling strategy shifted to convenience sampling in the same geographic areas.

During cycle 3, sampling was performed within two schools that volunteered for the study. Girls in grades 4–6 (ages 9–11) were eligible to participate. Comparison and treatment groups were matched along ethnicity, age, and grade. Equivalence was established by comparing group means and variance for each measure at baseline. If nonequivalence was found on a measure, it was entered as a covariate in subsequent analyses of outcomes that had a statistically significant relation with that measure.

Measures of final outcomes included individual substance use, individual substance use attitudes, alcohol and tobacco and other drug (ATOD) resistance, self-efficacy, school bonding, all scales from the cross-sites National Youth Survey (NYS), HIV/AIDS protective knowledge, and attitudes and sexual self-efficacy instruments developed by the UWASA as part of a 1995–96 Center for Substance Abuse Prevention supplemental grant. Measures of intermediate outcomes encompassed the Parent–Adolescent Communication Scale, the Multigroup Ethnic Identity Measure, the Me and My Mother/Me and My Daughter scale assessing mother–daughter intimacy, (developed by the UWASA for this project), peer substance abuse, peer ATOD attitudes, social confidence, self-efficacy, and belief in self. All these are scales from the NYS.

Outcome

The evaluation revealed positive outcomes in several areas:

• The program had a positive and significant effect on the girls’ knowledge about HIV/AIDS. At the beginning of the study, treatment and comparison girls exhibited almost the same level of understanding about the causes and transmission of HIV/AIDS. However, at the end of treatment (and at 6-month follow-up), comparison girls were significantly less knowledgeable about HIV/AIDS than their counterparts in the treatment group.
• Treatment girls maintained the same level of healthy substance use attitudes throughout the 18-month intervention. The comparison group, by contrast, experienced a noticeable deterioration in both use and attitudes, falling below the baseline at the 18-month follow-up.
• The level of participation in the intervention had an effect on sexual self-efficacy. Girls who attended 20 percent or less of the intervention were least likely to see themselves as able to refrain from sexual intercourse if they were in a romantic relationship. Girls who participated in 20 to 50 percent of the program activities were most likely to see themselves as avoiding sexual activity under the same circumstances.
• Mother–daughter communication was the single most important variable associated with intermediate and final outcomes, confirming the theoretical underpinning of the UWASA project.

Overall, the study indicated the need for further research on mother–daughter relationships, particularly among Latina and African-American dyads, to deepen understanding of the dynamics of interaction between mothers and daughters and their effect on risk behavior.

Endorsements

• SAMHSA: Model Programs

References

Berg, Marlene J. 2000. Urban Women Against Substance Abuse, Final Report. Hartford Conn.: Institute for Community Research.

Contact

Marlene J. Berg
Institute for Community Research
Two Hartford Square, Suite 100
Hartford, CT 06106–5138
Phone: (860) 278-2044
Fax: (860) 278-2141
E-mail: info@icrweb.org
Web site: http://www.icrweb.org