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Intervention

The Midwestern Prevention Project (MPP) is a comprehensive, community-based, multifaceted program for adolescent drug abuse prevention that targets the entire population of middle school students. Its ultimate goal is to prevent or reduce gateway substance use (alcohol, tobacco, and marijuana). MPP strives to help youths recognize the tremendous social pressures to use drugs and provides skills in how to avoid drug use. MPP disseminates this message through a system of well-coordinated, communitywide strategies, including mass media programming, a school program, continuing school boosters, a parent education and organization program, community organization and training, and local policy change regarding tobacco, alcohol, and other drugs. These components are introduced to the community in sequence at a rate of one a year, with the mass media component occurring throughout all the years.

The central component for drug prevention programming is the school. The school component uses active social learning techniques (modeling, role playing, and discussion, with student peer leaders assisting teachers). The parental program involves a parent–principal committee that meets to review school drug policy and parent–child communications training. A consistent message supporting a non–drug use norm is delivered through the other three components: mass media coverage and programming, community organization, and the local health policy change component. All components involve regular meetings of respective deliverers (e.g., community leaders for organization) to review and refine programs.

Evaluation

The evaluation was a 6-year longitudinal study with a quasi-experimental design. A random selection of public middle schools and junior high schools in Kansas City, Mo., and Kansas City, Kan., were chosen to participate in the study. Schools were assigned to the treatment group or the control group. Though this process was not randomized, there were no significant differences between the schools at baseline. Sixth and seventh graders in the treatment schools received all of the components of the MPP, while the control schools could access mass media and community organization components but neither the school-based program nor the parent component. Participants (n=5,065) completed a 133-item questionnaire before the intervention, and annually thereafter. Measures included demographic characteristics, “gateway” drug use (cigarettes, alcohol, and marijuana), and psychosocial variables related to drug use. The sample was 51 percent female, 79 percent white, 17 percent African-American, 2 percent Hispanic, 1 percent Asian-American, and 2 percent “other.”

Outcome

Results from the longitudinal MPP evaluations have demonstrated for program youths, compared with control youths, the following:

• A smaller increase in students who intend to use cigarettes, alcohol, and tobacco within the upcoming months.
• Significant effects on the proportion of students reporting the use of cigarettes, alcohol, and tobacco.
• Less likelihood that the youths will believe in the positive consequences of using cigarettes, alcohol, and tobacco.
• A greater likelihood that they will believe their friends would be unfriendly toward their use of drugs.

Further, these evaluations have demonstrated that MPP facilitated development of prevention programs, activities, and services among community leaders.

Endorsements

• OJJDP: Blueprints
• SAMHSA: Model Programs
• HHS: Surgeon General
• Department of Education
• NIDA: Preventing Drug Abuse

References

MacKinnon, David P., C. Anderson Johnson, Mary Ann Pentz, James H. Dwyer, William B. Hansen, Brian R. Flay, and Eric Yu Wang. 1991. “Mediating Mechanisms in a School-Based Drug Prevention Program: 1-Year Effects of the Midwestern Prevention Project.” Health Psychology 10(3):164–72.

Pentz, Mary Ann 1994. “Target Populations and Interventions in Prevention Research: What Is High Risk?” In A. Cazares and L.A. Beatty (eds.). Scientific Methods for Prevention Research, NIDA Research Monograph 139:75–94 (NIH Publication No. 94–3631).

Pentz, Mary Ann, James H. Dwyer, David P. MacKinnon, Brian R. Flay, William B. Hansen, Eric Yu Wang, and C. Anderson Johnson. 1989. “A Multicommunity Trial for Primary Prevention of Adolescent Drug Abuse: Effects on Drug Use Prevalence.” Journal of the American Medical Association 261:3259–66.

Pentz, Mary Ann, David P. MacKinnon, Brian R. Flay, William B. Hansen, C. Anderson Johnson, and James H. Dwyer. 1989. “Primary Prevention of Chronic Diseases in Adolescence: Effects of the Midwestern Prevention Project on Tobacco Use.” American Journal of Epidemiology 130(4):713–24.

Pentz, Mary Ann, Sharon F. Mihalic, and Jennifer K. Grotpeter. 1998. Blueprints for Violence Prevention, Book 1: The Midwestern Prevention Project. Boulder, Colo.: Center for the Study and Prevention of Violence.

Pentz, Mary Ann, Elizabeth A. Trebow, William B. Hansen, David P. MacKinnon, James H. Dwyer, Brian R. Flay, Stacey Daniels, Calvin Cormack, and C. Anderson Johnson. 1990. “Effects of Program Implementation on Adolescent Drug Use Behavior: The Midwestern Prevention Project.” Evaluation Review 14(3):264–89.

Pentz, Mary Ann, and Thomas W. Valente. 1995. “Project STAR: A Substance Abuse Prevention Campaign in Kansas City.” In Thomas E. Backer and Everett M. Rogers (eds.). Successful Health Communications Campaigns: Organizational Dimensions.California: Sage, 37–60.

Contact

Mary Ann Pentz, Ph.D., or Karen Bernstein, M.P.H.
Institute for Prevention Research
1000 South Fremont Avenue, Unit 8
University of Southern California
Alhambra, CA 91803
Phone: (626) 457-6687
Fax: (626) 457-6695
E-mail: pentz@usc.edu