Leona L. Eggert

Preventing Adolescent Drug Abuse and High School Dropout Through an Intensive School-Based Social Network Development Program

Purpose. The hypothesis tested was that experimental subjects, relative to controls, would demonstrate significant increases in school performance and decreases in drug involvement at program exit (5 months) and at follow-up (10 months). Design. A two-group, repeated-measures, intervention trial was the design used. Setting. The study involved four urban Northwest high schools. Subjects. Participants included 259 youth at high risk of potential school dropout, 101 in the experimental group and 158 in the control group. Intervention. The Personal Growth Class experimental condition was a one-semester, five-month elective course taken as one of five or six regular classes. It had a 1:12 teacher-student ratio, and integrated group support and life-skills training interventions. The control condition included a regular school schedule. Measures. School performance measures (semester GPA, class absences) came from school records. Drug use progression, drug control, and adverse consequences were measured by the Drug Involvement Scale for Adolescents. Self-esteem, school bonding, and deviant peer bonding were measured using the High School Questionnaire: Inventory of Experiences. All multi-item scales had acceptable reliability and validity. Results. As predicted, trend analyses revealed significantly different patterns of change over time between groups in drug control problems and consequences; in GPA (but not attendance); and in self-esteem, deviant peer bonding, and school bonding. The program appeared to stem the progression of drug use, but group differences only approached significance. Conclusion. Program efficacy was demonstrated particularly for decreasing drug control problems and consequences; increasing GPA and school bonding; and desired changes in self-esteem and deviant peer bonding. Program effects on progression of drug use were less definitive.

Effects of a School-Based Prevention Program for Potential High School Dropouts and Drug Abusers

This study tested the effects of a prevention program based on an integrated social support and psychoeducational model. A semester-long Interpersonal Relations (IPR) class was predicted to deter school drop-out problems and drug abuse among adolescents. Quasi-experimental designs were used to field test the IPR program with 264 high-risk students in one of two conditions: (1) pretest, treatment, and posttest; (2) pretest and posttest. All hypotheses were supported. Significantly more potential dropouts were retained in the treated (74%) versus the comparison group (61%); differences in daily attendance (F = 12.88) and GPA, school achievement (F = 16.89), were significantly better in the treatment group (p less than .0001); drug involvement declined significantly from pre- to posttreatment for IPR program participants (t = 4.61, p less than .0001). Implications for treatment and recommendations for future research are discussed.

Prevention Research Program: Reconnecting At-Risk Youth

This research program focuses on some of societys most profound problems: adolescent drug involvement, school failure, and suicide behaviors. The program goals address several interdisciplinary research challenges: (a) testing theory-driven preventive interventions focusing on the multifaceted etiology of adolescent drug involvement and suicide potential; (b) targeting potential school dropouts from a distinctly underserved high-risk population; and (c) integrating preventive interventions into school-based programs that utilize a multidisciplinary team of clinicians and researchers. Three sets of studies are described; they illustrate how ethnographic, experimental, and causal modeling designs and methods were intricately woven in successive theory construction and testing steps. Ethnographic and etiologic studies revealed a profile of vulnerabilities in personal, peer, family, and school contexts. Instrumentation studies led to reliable and valid process and outcome measures of key constructs. Tests of the preventive intervention demonstrated its efficacy for decreasing school deviance, drug involvement, and suicide potential among high-risk youth.

Enhancing Outcomes in an Indicated Drug Prevention Program for High-Risk Youth

This study examined the net effects of refining a high school-based indicated drug prevention program. The Personal Growth Class (PGC), tailored to meet the needs of high-risk youth, was designed to increase control of drug use, school performance, and emotional well-being. The program integrates social support and life-skills training. Process evaluation revealed the need for program enhancements to address underestimated levels of depression, anger, and suicidal behaviors prevalent among high-risk youth and to ensure that core content was being emphasized consistently. Youth participating in Late cohorts received the refined PGC with enhanced skills training. Study participants (N = 280) were youth, primarily ages fifteen to seventeen, at high-risk for school failure or dropout. Indicators of emotional well-being (e.g., depression, stress, anger, self-esteem, personal control), drug involvement, and school performance were compared for Late versus Early cohorts. Regression analyses revealed the Late versus Early cohorts showed significantly greater decreases in hard drug use, depression, perceived stress, and anger; and greater increases in self-esteem. The results support arguments that effective indicated prevention programs should target specific high-risk youth employing strategies to counteract the multifaceted risk factors they experience and enhance needed protective factors.

School Difficulties and Co‐Occurring Health Risk Factors: Substance Use, Aggression, Depression, and Suicidal Behaviors

PROBLEM Effective prevention requires understanding vulnerable populations, early signs of health risks, and the impact of social contexts. We tested a model of co-occurring mental health risks among at-risk youth experiencing school difficulties. METHODS We analyzed data from a random sample of 336 at-risk youth, grades 9-12, who completed a comprehensive risk/protective factors assessment. FINDINGS Simultaneously controlling for correlations among health risks, we observed systematic associations among risk factors, with generally consistent patterns for males and females. CONCLUSIONS The findings underscore the importance of developing interventions that incorporate contextual influences and of identifying common adaptable strategies for attenuating co-occurring health risks for at-risk youth.

Drug Prevention Research for High-Risk Youth

Indicated prevention research with youth at high risk has the potential for extending the empirical base for preventive interventions that lead to accepted, sustained, and effective programs. Such research has great potential for directly improving public health and decreasing the enormous social costs incurred from drug abuse and its impact on the leading causes of death among our youth. The need for these programs is substantial: approximately 25% of adolescents lead high-risk lifestyles and fit the criteria for indicated drug abuse prevention efforts. Combining school, peer, and parent approaches appear to be necessary to reconnect high-risk youth to school and halt the progression from drug involvement to drug abuse and addiction. The goal of indicated prevention trials is to produce proven programs that reduce the occurrence and extent of drug abuse among high-risk youth. Much work remains to be done in this field. It will take concerted efforts, funding for preintervention studies, and complex, methodologically sound, indicated prevention efficacy trials to make reaching this goal possible.

Preventing youth suicide: issues for law enforcement personnel.

Suicide is a leading cause of death for adolescents. A number of problem behaviors associated with youth suicide fall into the purview of law enforcement personnel, and they are therefore in a position to detect risk and prevent suicidal behaviors. Eight hundred one youth identified as having school difficulty, a group at increased risk for both suicide and legal problems, participated in a paper and pencil survey followed by an interview focusing on suicide risk and protective factors. Linear regression was used to examine the ability of factors within each risk and protective factor dimension to predict current suicide risk. The study goal was to determine the most relevant factors influencing suicide risk in each domain examined. Findings are discussed in terms of implications for assessment and policy for law enforcement personnel.

School Difficulties and Co-Occurring Health Risk Factors

PROBLEM Effective prevention requires understanding vulnerable populations, early signs of health risks, and the impact of social contexts. We tested a model of co-occurring mental health risks among at-risk youth experiencing school difficulties. METHODS We analyzed data from a random sample of 336 at-risk youth, grades 9-12, who completed a comprehensive risk/protective factors assessment. FINDINGS Simultaneously controlling for correlations among health risks, we observed systematic associations among risk factors, with generally consistent patterns for males and females. CONCLUSIONS The findings underscore the importance of developing interventions that incorporate contextual influences and of identifying common adaptable strategies for attenuating co-occurring health risks for at-risk youth.

School Difficulties and Co-Occurring Health Risk Factors: Substance Use, Aggression, Depression, and Suicidal Behaviors: School Difficulties and Co-Occurring Health Risk Factors: Substance Use, Aggression, Depression, and Suicidal Behaviors

PROBLEM Effective prevention requires understanding vulnerable populations, early signs of health risks, and the impact of social contexts. We tested a model of co-occurring mental health risks among at-risk youth experiencing school difficulties. METHODS We analyzed data from a random sample of 336 at-risk youth, grades 9-12, who completed a comprehensive risk/protective factors assessment. FINDINGS Simultaneously controlling for correlations among health risks, we observed systematic associations among risk factors, with generally consistent patterns for males and females. CONCLUSIONS The findings underscore the importance of developing interventions that incorporate contextual influences and of identifying common adaptable strategies for attenuating co-occurring health risks for at-risk youth.