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Director's Report to the National Advisory Council on Drug Abuse
May, 1995
Research Findings
Prevention Research
Culturally Focused Skills Training Approach to Alcohol and Drug Abuse Prevention Among Minority Adolescents
A two year follow-up study of 456 inner-city seventh grade minority adolescents from New York City public schools has been completed by Drs. Gilbert J. Botvin and Steven P. Schinke. Three separate preventions (a) generic skills training prevention approach, (b) a culturally-focused prevention approach, and a (c) information-only control were compared. Students in both prevention approaches engaged less in current alcohol behavior and had lower intentions to engage in future alcohol use relative to students in the control group. Students in the culturally-focused group also engaged less in current alcohol behavior and had lower intentions to drink beer or wine than those in the generic skills group. Both prevention programs influenced several mediating variables in a direction consistent with non-drug use and less alcohol use. This study is the first to demonstrate the effectiveness of school-based approaches to alcohol abuse prevention with inner-city minority adolescents and because prevention effects were present two years after the conclusion of the primary year of intervention. The results of this study are also noteworthy because the two prevention approaches were contrasted with a comparison group receiving an information intervention rather than a "nocontact" control group as in most previous prevention studies. Although the results of this study suggest that it may be possible to develop a preventive intervention that is effective with a relatively broad range of students, tailoring interventions to specific populations appeared to increase prevention effectiveness. Botvin,G., and Schinke, S. Effectiveness of Culturally Focused and Generic Skills Training Approaches to Alcohol and Drug Abuse Prevention Among Minority Adolescents: Two-year Follow-up Results. Psychology of Addictive Behaviors, in press, 1995.
Long-term Efficacy of a School-based Prevention Approach
The results of a six year followup of a randomized drug abuse prevention trial evaluating the long-term efficacy of a school-based approach to drug abuse prevention have just been published by Dr. Gilbert J. Botvin and colleagues. The research design was a randomized trial involving 56 public schools that received the prevention program with annual provider training workshops and ongoing consultation, the prevention program with videotaped training and no consultation, or "treatment as usual" (i.e., controls). Follow-up data were collected 6 years after baseline using school, telephone, and mailed surveys. The participants were 3,597 12th grade students. The intervention consisted of 15 classes in seventh grade, 10 booster sessions in eight grade, and five booster sessions in ninth grade. The prevention taught general "life skills" and skills for resisting social influences to use drugs. Measures included six tobacco, alcohol, and marijuana use self-report scales that were recorded to create nine dichotomous drug use outcome variables and eight polydrug use variables. Significant reductions in both drug and polydrug use were found for the two groups that received the prevention program relative to controls. The strongest effects were produced for individuals who received a reasonably complete version of the intervention--there were up to 44% fewer drug users and 66% fewer polydrug (tobacco, alcohol, and marijuana) users. The findings demonstrate that drug abuse prevention programs conducted during junior high school can produce meaningful and durable reductions in tobacco, alcohol, and marijuana use if they (1) teach a combination of social resistance skills and general life skills, (2) are properly implemented, and (3) include at least 2 years of booster sessions. Botvin,G. et.al. Long-term Follow-up Results of a Randomized Drug Abuse Prevention Trial in a White Middle-Class Population. JAMA, (April 12), 273, (14), 11061112, 1995.
Reaching At-Risk Populations in a Mass Media Prevention Campaign
The relationship of sensation seeking to both drug use and preferences for highly novel, arousing and/or unconventional messages and TV programs have been investigated by Donohew et al. In a fivemonth televised anti-drug PSA campaign, targeted at high sensation seeking young adults, data from several sources demonstrated the success in reaching the target population members with drug prevention messages and motivating them to call a hotline featuring alternatives to drug use. The authors conclude that the results illustrate the effectiveness of drug prevention strategies based on a sensation seeking model of drug use.
Palmgreen, P., Pugzles Lorch, E., Donohew, L, Grant Harrington, N., Dsilva, M., Helm, D. Reaching At-Risk Populations in a Mass Media Drug Abuse Prevention Campaign: sensation seeking as a targeting variable. Drugs and Society, in press, 1995.
Attention, Need For Sensation, and Health Communication Campaigns
Noting that sensation seeking has been strongly related to early trial and use of drugs and other activities involving risk taking in numerous research reports, Donohew, Palmgreen and Lorch of NIDA's Prevention Research Center at the University of Kentucky, are studying the factors and co-factors of attention to novelty as it relates to the need for sensation and health communication campaigns. In their efforts to produce public service announcements (PSA) as a vital part of a drug prevention intervention campaign, they have found that the sensation value of the programming in which PSAs are embedded is a critical factor. Donohew, L., Palmgreen, P., Pugzles Lorch, E. Attention, Need for Sensation, and Health Communication Campaigns. American Behavioral Scientist, 38, 310-322, 1994.
Influence of Sensation-Seeking, Message Sensation Value and Program Content on the Effectiveness of Anti-Cocaine PSAs
In order to determine if sensation seeking and message sensation value interacted to affect recall, attitude, behavioral intentions and perceived recall of televised anti-cocaine Public Service Announcements (PSAs), a study was conducted by Everett and Palmgreen at the Prevention Research Center. 120 participants (half high-sensation seekers - HSS and half low sensation seekers - LSS) were randomly assigned to one of four experimental conditions where the sensation value (SV), high (H) or low (L), of the PSA context was varied. After observing the PSAs, participants completed questionnaires dealing with free/cued recall, attitude toward cocaine, behavioral intention to use cocaine, and perceived effectiveness of the PSAs. HSSs tended to recall more, have more negative attitudes toward cocaine, cite less likelihood to use cocaine and perceive messages as more effective after viewing HSV PSAs. LSSs tended to recall more, have more negative attitudes toward cocaine, cite less likelihood to use cocaine, and perceive messages as more effective after viewing LSV PSAs. Everett, M., Palmgreen, P. Influence of Sensation Seeking, Message Sensation Value, and Program Context on Effectiveness of Anti-Cocaine PSA. Health Communication, in press, 1995.
The A.T.L.A.S. Prevention Program
The use of anabolic steroids (AAS) among athletes continues to rise. Researchers from the Oregon Health Sciences University have developed and are testing a school-based intervention to prevent AAS use among high risk adolescent athletes. Eight weekly, one hour classroom sessions delivered by the coach and adolescent team leaders and eight weight room sessions delivered by research staff were part of the intervention. Other components were sports nutrition and strength training as alternatives to AAS use, drug refusal role play and anti-AAS media campaigns. Results indicate that compared to controls, experimental subjects were significantly less likely to want to try AAS after the intervention, less likely to want to use AAS even if their friends used, less likely to believe AAS use was a good idea, believed AAS were more dangerous, had better knowledge of alternatives to AAS use, had improved body image, increase their knowledge of diet supplements, had less belief in these supplements as beneficial and improved their knowledge of other drugs. Significant beneficial effects were found despite a small sample size, suggesting that the effect of the intervention was large. Goldberg, L., Elliot, D., Clarke, G., Zoref, L., MacKinnon, D., Moe, E., Green, C., Wolf, S., Schoenherr, D. The Adolescent Training and Learning to Avoid Steroids (A.T.L.A.S.) Prevention Program: Background and results of a Model Intervention. JAMA, in press, 1995.
Coaches' Perceptions About Patterns of Drug Use Among Their Teams
Women's sport teams provide a strong peer group and influential coaches to deter drug use and channel students' athletic goals into healthy behaviors. To investigate coaches' perceptions about patterns of drug use among their teams, Drs. Elliot, Wolf and Goldberg surveyed women coaches from Oregon high schools. Regardless of sport, they each estimated their team's prevalence of drug use as follows: Alcohol (25%), cigarettes (4%), anabolic steroids AS (0.1%), other teams' use AS (1.9%), women pro athletes use AS (11-20%), and eating disorders (5-10%). However, although the coaches felt they knew about nutrition and strength training, they demonstrated significant knowledge deficits in both areas. Despite overestimating their knowledge and underestimating prevalence of drug use and eating disorders, coaches strongly agreed with the need for coaching staff and team programs about ergogenic drugs, eating disorders, nutrition and strength training. Elliot, D., Goldberg, L., Moe, E. Health promotion/drug prevention for young women athletes: coaches' assessments of needs and behavioral norms. Medicine and Science in Sports and Exercise, 27(5), 1995.
Assessment of a Health Promotion Program's Nutritional Curriculum Component
In order to deter high school athletes from using anabolic steroids (AAS), effective behavioral alternatives need to be established. As appropriate nutrition is a major contributing factor to overall athletic ability, Goldberg and colleagues assessed the nutritional curriculum component of a comprehensive 8-week (1-hour/week) health promotion program for high school football players. As expected, baseline data indicated that habits were not optimal. Following the program, students indicated increased satisfaction with their weight and greater awareness of foods' caloric content. However, no changes were observed in meal or food frequencies or in student's self-assessment of their diets. Diet habits are resistant to modification and influenced by many peer and environmental factors. The authors postulate that longer programs, involvement of the school environment or more attention to explicit behavioral goals are needed to alter teen athletes' eating habits. Wolff, S., Elliot, D., Goldberg, L., Moe, E., Clarke, G., Foref, L., Green, C. Evers, C., MacKinnon, D. High School Football Players' Nutrition Knowledge and Behavior: Effects of a Prevention curriculum. Medicine and Science in Sports and Exercise, 27(5), 1995.
Preventing Drug Use Escalation and Problem Behavior
To evaluate the impact of the Adolescent Transitions Project (ATP) on problem behavior and drug use, analysis of project data was conducted by Drs. Thomas Dishion and David Andrews of the Oregon Social Learning Center. Data revealed that the parent and teen interventions both reduced family conflict and negative interaction. The long term effect of each component is different. The parent intervention reduces escalation in tobacco, alcohol and marijuana use in the one year period following the families' involvement. In contrast the teen condition had an iatrogenic effect on tobacco use and problem behavior up to a year following the intervention. These findings suggest that parent interventions are needed for high risk youth to reduce escalation and that repeated booster sessions are needed throughout the period of risk. Also, high risk
youth should not be placed in groups as this seems to contribute to their problem behavior. Dishion, T. and Andrews, D. Preventing escalations and problem behavior. Journal of Consulting and Clinical Psychology, in press, 1995.
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