Robert L. Flewelling

How effective is drug abuse resistance education? A meta-analysis of Project DARE outcome evaluations

OBJECTIVES Project DARE (Drug Abuse Resistance Education) is the most widely used school-based drug use prevention program in the United States, but the findings of rigorous evaluations of its effectiveness have not been considered collectively. METHODS We used meta-analytic techniques to review eight methodologically rigorous DARE evaluations. Weighted effect size means for several short-term outcomes also were compared with means reported for other drug use prevention programs. RESULTS The DARE effect size for drug use behavior ranged from .00 to .11 across the eight studies; the weighted mean for drug use across studies was .06. For all outcomes considered, the DARE effect size means were substantially smaller than those of programs emphasizing social and general competencies and using interactive teaching strategies. CONCLUSIONS DAREs short-term effectiveness for reducing or preventing drug use behavior is small and is less than for interactive prevention programs.

School and neighborhood characteristics associated with school rates of alcohol, cigarette, and marijuana use.

Previous research has noted that schools vary in substance use prevalence rates, but explanations for school differences have received little empirical attention. We assess variability across elementary schools (N = 36) in rates of early adolescent alcohol, cigarette, and marijuana use. Characteristics of neighborhoods and schools potentially related to school prevalence rates are examined, as well as whether these characteristics have independent effects or whether neighborhood characteristics are mediated by school characteristics. Neighborhood and school characteristics were measured using student, parent, and archival data. The findings show substantial variation across schools in substance use. Attributes of neighborhoods and schools are statistically significantly related to school rates of lifetime alcohol use, lifetime cigarette use, and current cigarette use. Contrary to expectations, lifetime alcohol and cigarette use rates are higher in schools located in neighborhoods having greater social advantages as indicated by the perceptions of residents and archival data. Neighborhood effects are expressed both directly and indirectly through school characteristics. The findings are discussed in light of contagion and social disorganization theories.

Long-term evaluation of drug abuse resistance education☆

Project DARE (Drug Abuse Resistance Education) is the most prevalent school-based drug-use prevention program in the United States, but there is little evidence of its effectiveness. Results from a longitudinal evaluation of the program in 36 schools in Illinois provide only limited support for DAREs impact on students drug use immediately following the intervention, and no support for either continued or emerging impact on drug use 1 or 2 years after receiving DARE instruction. In addition, DARE had only limited positive effects on psychological variables (i.e., self-esteem) and no effect on social variables (e.g., peer resistance skills). Possible substantive and methodological explanations for the relative lack of DAREs effectiveness observed in this study are discussed.

Cops in the Classroom: A Longitudinal Evaluation of Drug Abuse Resistance Education (Dare)

Although aggressive enforcement programs have been the backbone of our national drug control policy, school-based drug education has been widely praised as the most promising strategy for achieving long-term reductions in the demand for drugs and alcohol. Employing specially trained police officers in the classroom, Project DARE has become Americas most popular and prevalent drug education program. Despite this status, the effectiveness of the program has yet to be demonstrated. A longitudinal randomized experiment was conducted with 1,584 students to estimate the effects of DARE on their attitudes, beliefs, and drug use behaviors in the year following exposure to the program. DARE had no statistically significant main effects on drug use behaviors and had few effects on attitudes or beliefs about drugs. However, significant interactions between DARE and other factors (e.g., metropolitan status) suggest that some program effects varied across subgroups of the target population. This research provides a test of the comprehensive model of school-based prevention and helps to identify possible differential effects of this drug education initiative.

Predicting continued use of marijuana among adolescents: the relative influence of drug-specific and social context factors

Most research on the determinants of adolescent drug use has focused on predictors of either initiation or current use. Little attention has been given to the determinants of continued use of drugs after initiation, even though some researchers have found that the consequences of continued use are more serious than those associated with experimental or occasional use. In this study, a longitudinal sample of 456 secondary and high school students who had already tried marijuana was used to examine the determinants of continued use of marijuana. Nearly 38 percent of those who had tried marijuana continued using, according to the definition operationalized in this study. Potential predictor measures were grouped in a drug-specific domain and a social context domain, and their effects on continued use, controlling for background characteristics, were examined in logistic regression models. Results showed that only the drug-specific domain had a statistically significant effect on the likelihood of continued use. Students who felt that the adverse physical and psychological effects of marijuana were not very important reasons for discontinuing use and those who had gotten stoned during their experimental stage of use were the most likely to continue use after initiation. The results suggest that the perceived physical and psychological effects of the drug are more important determinants of continued use than are social factors or benefits related to use. Any relationships between social factors and continued use are mediated by the perceived effects and risks of the drug.

Identifying high school students at risk for substance use and other behavioral problems : Implications for prevention

Attendance and grade point average (GPA) data are universally maintained in school records and can potentially aid in identifying students with concealed behavioral problems, such as substance use. Researchers evaluated attendance (truancy) and GPA as a means to identify high school students at risk for substance use, suicide behaviors, and delinquency in 10 high schools in San Antonio, Texas, and San Francisco, California, during the spring and fall of 2002. A screening protocol identified students as “high risk” if (1) in the top quartile for absences and below the median GPA or (2) teacher referred. Survey responses of 930 high-risk students were compared with those from a random sample of 393 “typical” students not meeting the protocol. Bivariate and multivariate analyses assessed associations between the screening protocol variables and demographics, risk and protective factors, and problem outcomes. The individual contribution of each of the variables was also assessed. Students identified as high risk were significantly more likely than typical students to use cigarettes, alcohol, and marijuana, evidence suicide risk factors, and engage in delinquent behavior. Norms varied between the two districts; nevertheless, high-risk students showed consistent differences in risk and protective factors, as well as problem behaviors, compared with typical students. Because of site differences in data collection and teacher participation, the comprehensive protocol is recommended, rather than individual indicators alone (e.g., truancy). Strengths of the screening protocol are the ready availability of school record data, the ease of use of the adapted protocol, and the option of including teacher referral. More research is recommended to test the generalizability of the protocol and to ensure that there are no unintended negative effects associated with identification of students as high risk.

Relationships among family characteristics and violent behavior by black and white male adolescents

Understanding why violence occurs disproportionately among black male adolescents has become a public health research priority due to recent increases in the rates of homicide and other violent crime in this population. This study examined independent, mediating, and moderating effects of family structure, attachment to parents, and family stress and conflict on self-reported fighting behavior. Subjects were black (n=163) and white (n=397) male 7th and 8th graders. Compared to white males, blacks were exposed to an excess of risk factors for violent behavior, including living in a single-parent household and higher levels of family stress and conflict. Although both groups reported similar levels of past-year fighting, black youth were more likely than whites to report attacking someone or being attacked by someone at school during the prior month. Controlling for age, area of residence, and other family characteristics, logistic regression analyses indicated that living in a nonintact family was a significant risk factor for violent behavior among black male youth, while attachment to parents was a significant protective factor for white males. Family stress and conflict was a risk factor for violent behavior cimmon to both groups of adolescents.

Relationships Among Alcohol Outlet Density, Alcohol use, and Intimate Partner Violence Victimization Among Young Women in the United States

Greater access to alcohol has been widely found to be associated with many negative outcomes including violence perpetration. This study examines the relationship between alcohol outlet density, alcohol use, and intimate partner violence (IPV) victimization among young women in the United States. A direct association between alcohol outlet density in one’s neighborhood and the likelihood of IPV victimization was examined. Data were from Wave III of the National Longitudinal Study of Adolescent Health (Add Health), which followed a nationally representative sample of adolescents into adulthood. Participants were young adult females age 18 to 26 at Wave III. Of the 4,571 female respondents who reported a current heterosexual relationship and had IPV data, 13.2% reported having been the victim of physical violence only and 6.5% experienced sexual only or physical and sexual violence in the relationship during the past year. In the regression models tested, there was no significant direct association between neighborhood alcohol outlet density and IPV victimization nor was there an association between outlet density and drinking behaviors, thus eliminating the possibility of an indirect association. Results of fully adjusted models indicate females who drank heavily, whether infrequently or frequently, were at significant risk for experiencing sexual only IPV or sexual and physical IPV. Asians and Native Americans were at significantly greater odds of experiencing sexual only or sexual and physical IPV compared with non-Hispanic Whites, while non-Hispanic Blacks were at significantly greater odds for physical only IPV. We conclude that a continuous measure of alcohol outlet density was not associated with IPV in models controlling for individual and other neighborhood characteristics. Young women who drink heavily, whether infrequently or frequently, have greater odds of experiencing sexual only or sexual and physical compared to abstainers. Similar to previous study findings, young women living with or married to their partner were at far greater risk of experiencing physical only and/or sexual only or sexual and physical IPV. The study adds to the growing body of literature that examines how community characteristics such as outlet density influence the likelihood of IPV.

Racial Differences in Violent Behavior among Young Adults: Moderating and Confounding Effects

Understanding racial differences in violent behavior has become a research priority due to increasing rates of violence among adolescents and young adults, especially African American males. Socioeconomic status (SES) has been shown to be an important variable in helping to explain racial differences in health-related behaviors. This study investigated the moderating and confounding effects of SES on the relationship between race and violent behavior in a sample of young adults (N = 1,559). The possible confounding effects of selected risk factors (e.g., selling drugs, witnessing violence) also were examined. Findings suggest that racial differences in violent behavior only exist among young adults of low SES and that finer SES distinctions within this group do not explain these differences. However, exposure to violence, a correlate of SES, accounted for racial differences in this subgroup. Future studies on racial differences in violence should examine further the role of SES and related risk factors.

Ethnic differences in relationships between risk factors and adolescent binge drinking: a national study.

This study examines ethnic differences in relationships between a large number of risk factors and adolescent binge drinking with data collected from 14 to 17 year olds who participated in the 1999 National Household Survey on Drug Abuse (NHSDA). Logistic regression analyses were conducted to determine whether 39 risk factors in community, family, school, and peer-individual domains were differentially associated with past-30-day binge drinking among youth in ethnic minority groups (black, Hispanic and Asian) relative to whites. Forty-three percent (17) of the risk factors examined were differentially associated with binge drinking in at least one of the ethnic groups relative to whites. Most of these risk factors were more strongly associated with binge drinking among white adolescents than Hispanic and black youth, but not Asians. The direction of the relationships between these risk factors and binge drinking, however, was usually the same for whites and ethnic minority groups. A multivariate prediction model indicated that risk factors in the community, family, school, and peer-individual domains accounted for 27% of the variance in binge drinking for white adolescents, 22% for Hispanics, 10% for blacks, and 39% for Asians. These findings suggest that research is needed to identify additional risk factors that are associated with binge drinking among adolescents, particularly blacks, Hispanics and possibly other ethnic minority groups.