Substance Abuse Prevention: A Failed Replication of Life Skills Training

Purpose: The recent embrace of EBPs, is not without controversy. Among the array of criticisms leveled at EBP is the issue of generalizability of treatment effects. One critical issue is whether local characteristics may limit the effectiveness of model approaches. Despite the current focus on the dissemination of EBPs, less attention has been paid to the replication of findings by independent researchers and across diverse community settings. This presentation describes one essentially failed attempt to replicate the positive findings associated with Life Skills Training (LST), a model program aimed at preventing substance use in early adolescence.

Method: A total of 93 sixth grade students, 111 seventh grade students, and 100 eighth grade students were recorded on the LST attendance sheets. The 304 students ranged from 10 to 16 years of age, with an average age of 12 years. Most of the students were male (56%). The largest group of students self-identified as Hispanic (46%), followed in frequency by white (33%), other (15%), and equal proportions of African American and American Indian students (3%).

A quasi-experimental design was used to measure changes in the outcome and mediating variables. Of the 304 students participating in LST, 242 (80%) completed both the pretest and the posttest. The program educator completed a fidelity checklist and attendance record in each LST session. The program fidelity checklists included a list of all program topics and objectives specific to LST. The proportion of curriculum material delivered in terms of session topics, objectives, and homework, was estimated between 90% and 100% for all sessions, indicating excellent fidelity to the program. The majority of sixth grade students (86%) attended at least 80% of the curriculum. Similarly, 86% of seventh grade students and 91% of eighth grade students attended at least 80% of the sessions. Multiple measures of outcome were used to evaluate the program including self reports of substance use, and belief, attitude, skills, and knowledge scales recommended by the curriculum.   All scales had reliabilities of .76 (lowest) to .94 (highest).

 

Results: The findings on the replication of LST demonstrate that the program was delivered with high fidelity and that over 80% of the students attended at least 80% of the sessions in all three grade levels. Despite this, there were no significant differences in reported drug use from pretest to posttest in any of the grades. The mediating skill variables that the program theory rests upon found no significant changes in drug refusal skills, general assertiveness, decision making, advertising resistance, anxiety reduction, or communication. In fact, two skill scores, decision-making and advertising resistance, showed significant changes in the opposite direction than expected.

 

Conclusions and Implications:    These results do not match the claim that LST dramatically reduces tobacco, alcohol, and drug use. Only through continued replication in community-based settings can we discover the potential and limitations of evidence based practice.