Soledad Sambrano

Risk, protection, and substance use in adolescents: a multi-site model.

This article reports findings from a national longitudinal cross-site evaluation of high-risk youth to clarify the relationships between risk and protective factors and substance use. Using structural equation modeling, baseline data on 10,473 youth between the ages of 9 and 18 in 48 high-risk communities around the nation are analyzed. Youth were assessed on substance use (cigarette, alcohol, and marijuana use), external risk factors including family, school, peer and neighborhood influences, and individual risk and protective factors including self-control, family connectedness, and school connectedness. Findings indicate strong direct relationships between peer and parental substance use norms and substance use. Individual protective factors, particularly family and school connectedness were strong mediators of individual substance use. These findings suggest that multi-dimensional prevention programming stressing the fostering of conventional anti-substance use attitudes among parents and peers, the importance of parental supervision, and development of strong connections between youth and their family, peers, and school may be most effective in preventing and reducing substance use patterns among high-risk youth.

Prevention Programming for African American Youth: A Review of Strategies in CSAP’s National Cross-Site Evaluation of High-Risk Youth Programs:

The purpose of this paper is to add to the knowledge base on prevention programming by explicating the characteristics of 12 programs (out of 47) serving African American youth funded by the Center for Substance Abuse Prevention (CSAP). Findings show that African American youth exhibit lower use rates than most other ethnic and racial groups, but by the time they reach ages 16 to 18, use is prevalent. Data on correlations of risk and protective factors with substance use reveal a very similar pattern of rank order in the strength of correlations for African American youth with youth who are not African American in the CSAP sample. The African American programs integrated Africentric principles and themes into other prevention strategies: education-and-awareness, risk-andprotection, and positive-alternative-interventions. The analysis shows that Africentric programming contributes to higher rates of satisfaction and perceived program importance to youth participating in the African American programs, compared to African American youth in other programs.

Effectiveness of Culturally Specific Approaches to Substance Abuse Prevention: Findings from CSAP's National Cross-Site Evaluation of High Risk Youth Programs

Abstract This study assesses the degree to which culturally specific interventions enhance substance abuse prevention effectiveness for targeted cultural groups. A large and diverse (African American, Hispanic, American Indian, and Asian) sample of 10,500 youth across 48 programs was obtained. Youth participating in culturally specific programming showed greater program satisfaction and felt programs were more personally meaningful than youth in non-culturally specific progra. Culturally specific programs for African American youth were also more effective in preventing substance use. This finding may be attributable to the fact that Africentric programs apply a comprehensive and structured approach to substance abuse prevention and that cultural messages are clearly linked to important protective factors.

Understanding prevention effectiveness in real-world settings: the National Cross-Site Evaluation of high risk youth programs.

The National Cross-Site Evaluation is a large multisite evaluation (MSE) of 48 substance abuse prevention programs, 5,934 youth participating in programs, and 4,539 comparison youth programs. Data included a self-report questionnaire administered at 4 points in time, detailed dosage data on over 217,000 program contacts, and detailed site visit information. In a pooled analysis, the programs did not demonstrate significant positive effects on a composite outcome measure of tobacco, alcohol, and marijuana use in the previous 30 days. However, disaggregated analyses indicated that 1) sites in which comparison groups had strong opportunity to participate in prevention programs suppressed observed effects; 2) youth who had already started using before they entered programs reduced use significantly more than comparison youth who had started using; and 3) both males and females who participated in programs significantly reduced use relative to comparisons, but in very different patterns. Combining these patterns produced an apparent null effect. Finally, programs that incorporated at least 4 out of 5 effective intervention characteristics identified in the study significantly reduced use for both males and females relative to comparison youth. The lessons produced by this study attest to the value of MSE designs as a source of applicable knowledge about prevention interventions.

Informing the next generation of prevention programs: CSAP's cross-site evaluation of the 1994–95 high-risk youth grantees

With more than 400 projects funded since its initiation, the Substance Abuse and Mental Health Services Administrations Center for Substance Abuse Prevention (CSAP) High-Risk Youth Demonstration Program (HRY) is a prime example of federally sponsored demonstrations for generating and disseminating policy and program lessons in the area of substance abuse prevention. The HRY demonstration has provided strong support for both local and cross-site evaluation, and incorporated evaluation results into demonstration policy to (a) encourage stronger local evaluation, (b) encourage more coherent program planning and management, (c) encourage use of the risk and resiliency approach(es) to designing programs, and (d) encourage more comprehensive program purposes and activities. In April 1995, the Division of Knowledge Development and Evaluation within CSAP initiated the third cross-site evaluation of HRY programs which utilizes a clear conceptual framework emphasizing the risk and resiliency approach utilized by HRY grantees funded in 1994 and 95. The study implements a common quasi-experimental design across 48 selected sites, and will involve approximately 6,000 treatment and 4,000 comparison subjects. A common questionnaire will be used in all sites, generating data that will support a flexible, regression-based analysis plan. In addition to contributing to the systematic development of substance abuse prevention knowledge, the CSAP National Cross-Site Evaluation of HRY Programs will advance understanding of the design, implementation, and utilization of large, multi-site evaluations as sources of policy learning.