Students, Substance Use, and Social Perception: An Evidenced-Based Treatment Approach to Decrease Usage and Affect Norms

Introduction

Although previous research has identified specific risks and protective factors for substance use in adolescents, few studies have examined short, school-based prevention programs as an effective way of reducing substance use and affecting perception among high school students. This study hypothesized that providing a classroom based intervention, would impact both the students use of and perceptions and social norms around substances.  This study measured the effectiveness of a 6-week classroom based intervention in reducing drinking; increasing perceived risk and decreasing social norms of drug use; and increasing perceptions about negative consequences of drug use.

Methods

This study assessed the effectiveness of Refuse, Remove, Reasons (RRR), a classroom based prevention program for urban adolescents. The participants (N=1,352), were current high school students who received the intervention as part of their health class curriculum. Students were part of the treatment group if currently enrolled in health and received RRR, or part of the control group if not enrolled in a health class at that time. Participants were assessed for baseline prior to the intervention and again at post-treatment. The curriculum, delivered by a trained facilitator, over 6 weeks through classroom sessions addressed: alcohol and tobacco, marijuana, steroids, over-the-counter and prescription drugs, heroin usage and consequences of ATOD use. The program curriculum provided students with information about substances, the potential harm of substances, and refusal skills. Each session included 5- to 10-minute video segments that provided age-appropriate information through real-life stories of teenagers. General linear mixed-effects models were used to detect significant differences between treatment and control conditions.

Results

There were a total of 1,352 youth, of which 678 received RRR treatment and 674 who did not and were in the control group.  A large percentage of the youth (42%) identified as Hispanic and ranged in age from 13 to 18, with an average age of 15, evenly split between genders.  General linear mixed-effects models were used to detect significant differences between treatment and control conditions.  The treatment group showed a significant decrease in getting drunk from alcohol (p=0.001) between baseline and posttest after RRR, as compared to the control group.  There was also a significant change in social norms and peer usage and acceptance of alcohol (p=0.038) and cigarettes (p=0.003) with the treatment group, decreasing from pre to post while the control group increased peer usage and acceptance from pre to post.  Additionally, perceived risk of substance use did not increase compared to the control group (p=0.068).  RRR intervention was successful in impacting students perceptions about negative consequences of ATOD use, as there was a significant change for the treatment group from pre- to post-test compared to the control group (p=0.041).

Conclusions

Findings indicated that RRR significantly reduced getting drunk from alcohol, decreased social norms and acceptance of alcohol and cigarette use, and increased perceptions about negative consequences of drug use, compared to the control group. Results support school based prevention models for reducing alcohol use and social norms for adolescents.