Friday, 14 January 2005 - 10:00 AM

This presentation is part of: Intervening with At-Risk Adolescents

Effects of a Universal Prevention Program on Cessation and Reduction of Adolescent Substance Use

Efforts to address youth substance use have focused on prevention among non-users and treatment among severe users with less attention given to youth occupying the middle ground who have some substance use experience but have not yet progressed to serious abuse or addiction. Using a sample from 35 middle schools of 1,365 youth who reported current substance use at baseline, this study examined the effectiveness of a universal youth substance use prevention program, the SAMHSA Model Program keepin' it R.E.A.L., in promoting cessation and reduction of alcohol, cigarette, and marijuana use. A previous evaluation of keepin' it R.E.A.L. in a randomized trial in a large Southwestern city involving 7,300 students and 250 teachers demonstrated the program's high levels of effectiveness in preventing the onset of gateway drug use (alcohol, tobacco, and marijuana), strengthening anti-drug norms and attitudes, and increasing the use of drug resistance strategies (Hecht, Marsiglia, Elek-Fisk, Wagstaff, Kulis, & Dustman, 2003). The evaluation did not explore, however, any effects the program may have had on use cessation or reduction. Although the program is not geared specifically toward moderate users (i.e., youth in the middle ground of use) and does not explicitly promote quitting use, it is based on the idea that some youth use drugs because they don't know how, despite their desire, to successfully refuse drug offers. Since keepin' it R.E.A.L. aims to enhance the resistance skills of its participants, it's possible that youth with substance use experience who participate in the program may succeed in resisting future offers, thereby ceasing or reducing their use, once they have gained these skills. Discrete-time event history methods modeled the rate of quitting substance use and the rate of reducing substance use. Person-survey waves were the units of exposure to the risk of quitting and reducing across four waves of data. Each substance (alcohol, cigarettes, and marijuana) was modeled separately. Beginning at the second wave, participants who reported use at wave 1 were considered at risk of quitting or reducing use. Since the data sampled students in schools, multi-level models accounted for the nesting of data at the school level. Results indicated that prevention program participation influenced only the rate of quitting or reducing alcohol use but not the rate of quitting or reducing cigarette or marijuana use, controlling for baseline use severity, age, grades, socioeconomic status, ethnicity and gender. For program participants who reported use of alcohol in wave 1 (N=1,020), the rate of quitting was 78% higher than the rate for control students. The rate of reducing use was 74% higher than the rate for control students. For program participants who reported use of one or more of the three substances in wave 1 (N=601), the rate of quitting entirely was 54% higher than the rate for control students who were users of one or more substances. Limitations and implications of these findings and plans for further research will be discussed.

See more of Intervening with At-Risk Adolescents
See more of Oral and Poster

See more of Celebrating a Decade of SSWR (January 13 - 16, 2005)