Sande Craig

Project towards no tobacco use: 1-year behavior outcomes.

OBJECTIVES We present 1-year follow-up data from a school-based tobacco use prevention project designed to test the effectiveness of three main components of social influence programs. The components teach refusal skills, awareness of social misperceptions about tobacco use, and misconceptions about physical consequences. METHODS Four different curricula were developed and tested in a randomized experiment involving 48 junior high schools. The outcome variables examined were changes in initial and weekly cigarette and smokeless tobacco use 1 year after the intervention. RESULTS Analyses indicated that each of the component programs were effective in decreasing both the initial and the weekly use of cigarettes except for the curriculum in which refusal skills were taught. Also, each curriculum was effective in decreasing the initial use of smokeless tobacco except for the one aimed at correcting social misperceptions. Only the combined curriculum showed an effect on the weekly use of smokeless tobacco. CONCLUSIONS The combined intervention was the most effective overall in reducing the initial and weekly use of cigarettes and smokeless tobacco. This suggests that different reasons for use exist and need to be counteracted simultaneously. However, since single programs were also effective in reducing all but weekly smokeless tobacco use, any of these components may be worthwhile prevention tools.

Two-Year Behavior Outcomes of Project Towards No Tobacco Use

The article presents 2-year follow-up data from a school-based tobacco use prevention project designed to test the effectiveness of 3 primary components in social influence programs. The components either teach refusal skills, awareness of social value misperceptions, or physical consequences. Curricula were tested with a randomized experiment involving 48 junior high schools. These data suggested that (a) a physical-consequences curriculum is successful at attenuating increases in adolescent smokeless tobacco use, (b) cigarette experimentation may be attenuated by various approaches, and (c) a comprehensive program with all 3 components was necessary to attenuate increases in weekly use of both forms of tobacco. These results also indicate that school-based tobacco use interventions can be effective at least 2 years postprogram, after students make their transition to high school.

Continuation High Schools: Youth at Risk for Drug Abuse

Students at alternative high schools may be at substantial risk for drug abuse. The present article provides a general overview of the drug use-related context of continuation high schools in southern California. A total of 144 students and ninety-six staff were interviewed from twenty continuation high schools. The interview data revealed that continuation school students show high levels of substance use. However, only 20 percent of the students report that they received any drug abuse prevention programming. Also, students at continuation high schools aspired to a productive life after high school including continued education. Thus, these youth may still be amenable to preventive educational interventions which deter them from drug use and help them to fulfill their future goals.

Implementation and process evaluation of a school-based drug abuse prevention program: Project Towards No Drug Abuse.

The present study provides an implementation, process, and immediate outcomes evaluation of the classroom component of Project Towards No Drug Abuse (TND). This project involves development and evaluation of a school-based drug abuse prevention curriculum for continuation high school youth, who are at relatively high risk for drug abuse. Three randomized conditions were evaluated: a standard care, classroom only, and classroom plus school-as-community. The latter condition was an enhanced school-based condition which involved outside-of-classroom meetings and activities. Implementation was high in both program conditions even though this was a higher risk context. Process evaluation data were favorable and did not vary between the two program conditions. Immediate outcomes data (knowledge) was higher in the two program conditions than in the standard care condition. Regarding the classroom program, addition of extra-classroom activities does not appear to alter the quality of delivery of the program.

Implementation and process evaluation of a student "school-as-community" group. A component of a school-based drug abuse prevention program.

Little documentation exists regarding the functioning of formalized adolescent groups as drug abuse prevention agents. Two studies are described that were conducted at high schools whose students are at high risk for drug abuse. Twenty-one schools were randomly assigned to one of three conditions: (a) standard care, (b) classroom drug abuse education only, or (c) classroom plus school-as-conununity. Results of the first study tndicated that the school-as-communtty component—which involved weekly meetings and periodic events at seven schools—was imple mented as planned, drug abused focused, and perceived as productive in discouraging drug abuse. In the second study, staff in the classroom plus school-as-community condition self- reported involvement in the greatest number of community activities across the school year, compared with staff from the other two conditions. These two studies support the feasibility of formalized groups of high-risk youth to promote drug-free events.

Development and Immediate Impact of a Self-Instruction Curriculum for an Adolescent Indicated Drug Abuse Prevention Trial

This article describes the development and immediate impact of a self-instruction indicated drug abuse prevention program, Project Towards No Drug Abuse (TND). Self-instruction programming often is used to help youth that are at high risk for dropout and drug abuse to complete their high school education, and is a method of choice among educators at alternative high schools. This article describes the justification for the self-instruction program, keys to good programmed self-learning, and how a 12-session health educator delivered program was converted to a self-instruction format. In addition, the immediate impact of a 3-group experimental trial is presented. Health educator led, self-instruction, and standard care control conditions are compared on knowledge change, and the two program conditions are compared on process ratings. Self-instruction programming can be successfully adapted from a health educator-led format, though the lack of student group interaction in this modality may limit its receptivity among students.

Tracking Procedures for Locating High-Risk Youth

Few published works are available that provide a comprehensive description of tracking procedures. This article describes the data collection tracking protocol that was used in Project Towards No Drug Abuse (Project TND), to follow high-risk youth over a 5 1/2 year period. Youth were followed from 1994 through 2000. A total of 35% of these youth were assessed 5 1/2 years later. Collapsing across the last two waves, 46% of these youth were followed an average of 5 years later. These procedures may be helpful in tracking highly mobile youth.

Media Manipulation of Adolescents' Personal Level Judgments regarding Consequences of Smokeless Tobacco Use

Videotapes were developed to try to impact on personal level judgments of concern and risk in the context of smokeless tobacco use, a growing substance use problem in adolescents. In a within-and-between-subjects design, convincingness (i.e., dramatic portrayal) of the videotaped message (high and low) and perceived probability of consequences portrayed in the message (high and low) were manipulated. Both manipulations were done by varying presentation style of the same, accurate information. The manipulation of convincingness did not alter the impact of the message on most judgments, whereas the manipulation of probability of consequences did. Two individual difference predictors, prior use of smokeless tobacco and male sex role orientation, were also found to enhance the amount of change in personal level judgments, but these variables did not interact with the message manipulations. These results suggest that a media manipulation of probability of consequences would be more effective than a manipulation of convincingness of message on impacting adolescent judgments of concern and risk regarding the use of smokeless tobacco.