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Project Toward No Drug Abuse (TND) is an interactive program designed to help high school youths (ages 14–19) resist substance use. This school-based program consists of twelve 40- to 50-minute lessons that include motivational activities, social skills training, and decision-making components that are delivered through group discussions, games, role-playing exercises, videos, and student worksheets over a 4-week period. The program was originally designed for high-risk youth in continuation, or alternative, high schools and consisted of nine lessons developed using a motivation-skills–decision-making model. The instruction to students provides cognitive motivation enhancement activities to not use drugs, detailed information about the social and health consequences of drug use, and correction of cognitive misperceptions. It addresses topics such as active listening skills, effective communication skills, stress management, coping skills, tobacco cessation techniques, and self-control—all to counteract risk factors for drug abuse relevant to older teens. The program can be used in a self-instruction format or run by a health educator.
TND has been evaluated numerous times. Twenty-one continuation high schools in Southern California were blocked according to risk factors, then randomly assigned to one of three experimental conditions: a nine-lesson TND classroom component only, a nine-lesson TND classroom plus community events, and standard care. Of the 2,863 students at the schools, 1,318 students agreed to participate and completed a pretest and posttest on program process measures. One year later, 67 percent of the sample was reassessed on drug use. There were no statistically significant differences on any assessment variables between those students who remained in the study at 1 year and those that did not. The final sample was 62 percent male, 46 percent Latino, 37 percent white, 8 percent African-American, 4 percent Asian-American, 3 percent Native American, and 2 percent other or mixed ethnicities. The students’ ages ranged from 14 to 19, with a mean age of 16.7.
Using the same sample, researchers assessed the risk for violence among the three groups. Data was analyzed on 850 students who answered all the questions regarding perpetration, victimization, and weapons-carrying at baseline and at the 1-year follow-up. The sample was 55 percent male, 49 percent Latino, 34 percent white, 9 percent African-American, 4 percent Asian-American, 3 percent Native American, and 1 percent other or mixed ethnicities.
The nine-lesson TND program was evaluated again to determine whether the program could be generalized to mainstream high school students. Researchers used 1,208 students enrolled in three public high schools in the Los Angeles, Calif., area. The sample was 47 percent male, 38 percent Latino, 34 percent white, 26 percent African-American, and 2 percent other, ages 14 to 17. Science classes within each school were randomly assigned to the control condition (n=13) or the TND classroom education program (n=13). Data on drug use was collected before the program began and 13 months later for a 1-year follow-up. The final sample size used for analysis was 679.
The most comprehensive evaluation to date assessed 1,037 students for 2 years at continuation high schools in California. Eighteen high schools were blocked and randomly assigned to condition: standard care, 12-lesson TND self-instruction, or 12-lesson TND led by a health educator. The sample was 54 percent male, 45 percent white, 42 percent Latino, 7 percent Asian-American, 5 percent African-American, and 1 percent “other.” Of the 1,037 that completed the pretest survey, 575 (55 percent) participated in the 2-year follow-up. Data was collected on current drug use.
Results show that in both continuation and mainstream high schools, TND led to significant reductions in hard drug and alcohol use. The original evaluation of continuation high school students revealed that those who received the intervention showed roughly half the monthly drug use frequency at follow-up as those in the control condition. It was also found that adding a community component did not increase the benefits of the TND program. The evaluation conducted on mainstream high school students also showed a significant reduction in hard drug and alcohol use among intervention students at the 1-year follow-up. When looking at the perpetration of violence in continuation high school youth at the 1-year follow-up, males in the treatment groups had a significantly lower risk of victimization than the control group. They were also less likely to carry weapons. There was no difference between the groups as far as violence perpetration. There were no differences in any of these categories for females in the sample.
The evaluation testing two TND delivery modes against a standard care condition showed that the health educator–led program succeeded in significantly lowering the probability of 30-day tobacco use and hard drug use at the 2-year follow-up. This particular TND program was also significantly effective at reducing marijuana use among male nonusers at pretest. The self-instruction program did not result in any significant differences when compared with the control group.
Dent, Clyde W., Steve Sussman, M. Hennesy, E.R. Galaif, Alan W. Stacy, M.A. Moss, and S. Craig. 1998. “Implementation and Process Evaluation of a School-Based Drug Abuse Prevention Program: Project Toward No Drug Abuse.” Journal of Drug Education 28(4):361–75.
Dent, Clyde W., Steve Sussman, and Alan W. Stacy. 2001. “Project Toward No Drug Abuse: Generalizability to a General High School Sample.” Preventive Medicine 32(6):514–20.
Simon, T.R.; Steve Sussman; L.L. Dahlberg; and Clyde W. Dent. 2002. “Influence of a Substance Abuse Prevention Curriculum on Violence-Related Behavior.” American Journal of Health Behaviors 26(2):103–10.
Sussman, Steve 1996. “Development of a School-Based Drug Abuse Prevention Curriculum for High-Risk Youths.” Journal of Psychoactive Drugs 28(2):169–82.
Sussman, Steve, and S.L. Ames. 2001. Social Psychology of Drug Use and Abuse. Buckingham, United Kingdom: Open University Press.
Sussman, Steve, Clyde W. Dent, S. Craig, Anamara Ritt-Olson, and William J. McCuller. 2002. “Development and Immediate Impact of a Self-Instruction Curriculum for an Adolescent-Indicated Prevention Drug Abuse Prevention Trial.” Journal of Drug Education 32(2):121–37.
Sussman, Steve, Clyde W. Dent, and Alan W. Stacy. 2002. “Project Toward No Drug Abuse: A Review of the Findings and Future Directions.” American Journal of Health Behavior 26(5):354–65.
Sussman, Steve, Clyde W. Dent, Alan W. Stacy, and S. Craig. 1998. “One-Year Outcomes of Project Toward No Drug Abuse.” Preventive Medicine 27(4):632–42.
Sussman, Steve, E.R. Galaif, T. Newman, M. Hennesy, Mary Ann Pentz, Clyde W. Dent, Alan W. Stacy, M. Moss, A. Craig, and T.R. Simon. 1997. “Implementation and Process Evaluation of a Student ‘School as Community’ Group: A Component of a School-Based Drug Abuse Prevention Program.” Evaluation Review 21(1):94–123.
Sussman, Steve, L. Rohrbach, and Sharon F. Mihalic. 2004. “Book 12 Project Toward No Drug Abuse.” In D.S. Elliott and Sharon F. Mihalic (eds.). Blueprints for Violence Prevention. Boulder, Colo.: University of Colorado, Center for the Study and Prevention of Violence.
Sussman, Steve, P. Sun, William J. McCuller, and Clyde W. Dent. 2003. “Project Toward No Drug Abuse: 2-Year Outcomes of a Trial That Compares Health Educator Delivery to Self-Instruction.” Preventive Medicine 37(2):155–62.
Steve Sussman, Ph.D., FAAHB
Institute for Health Promotion and Disease Prevention
University of Southern California, Department of Preventive Medicine
1000 South Fremont Avenue, Unit 8, Suite 4124
Alhambra, CA 91803
Phone: (626) 457-6635
Fax: (626) 457-4012
E-mail: ssussma@usc.edu
Web site: http://www.cceanet.org/Research/Sussman/tnd.htm
