Welcome to the Excellence in Prevention strategies list and search page. This page provides detailed information about direct service and environmental prevention strategies. Programs and strategies in this list must be shown in at least two studies to produce intended results. All programs listed include substance abuse prevention as an area of interest.
The strategies described in this list come from three primary resources, the National Registry for Evidence-based Programs and Practices(NREPP), a separate list of programs identified as evidence-based by the State of Oregon, and “Scientific Evidence for Developing a Logic Model on Underage Drinking: A Reference Guide for Community Environmental Prevention.”
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Across Ages is a school- and community-based substance abuse prevention program for youth ages 9 to 13. The unique feature of Across Ages is the pairing of older adult mentors (55 years and older) with young adolescents, specifically those making the transition to middle school. The overall goal of the program is to increase protective factors for high-risk students to prevent, reduce, or delay the use of alcohol, tobacco, and other drugs and the problems associated with substance use. The four intervention components are (1) a minimum of 2 hours per week of mentoring by older adults who are recruited from the community, matched with youth, and trained to serve as mentors; (2) 1-2 hours of weekly community service by youth, including regular visits to frail elders in nursing homes; (3) monthly weekend social and recreational activities for youth, their families, and mentors; and (4) 26 45-minute social competence training lessons taught weekly in the classroom using the Social Problem-Solving Module of the Social Competence Promotion Program for Young Adolescents developed by Roger Weissberg and colleagues.
At the aggregate level, a central focus has been on trends in alcohol advertising, per capita consumption and drinking problems. Only a few studies have considered the effects of alcohol advertising restrictions on alcohol consumption or problems.
Al's Pals: Kids Making Healthy Choices is a school-based prevention program that seeks to develop social-emotional skills such as self- control, problem-solving, and healthy decision-making in children ages 3-8 in preschool, kindergarten, and first grade. The program fosters both the personal traits of resilience and the nurturing environments children need to overcome difficulties and fully develop their talents and capabilities. Through fun lessons, engaging puppets, original music and materials, and appropriate teaching approaches, the Al's Pals curriculum helps young children regulate their own feelings and behavior; creates and maintains a classroom environment of caring, cooperation, respect, and responsibility; teaches conflict resolution and peaceful problem-solving; promotes appreciation of differences and positive social relationships; prevents and addresses bullying behavior; conveys clear messages about the harms of alcohol, tobacco, and other drugs; and builds children's abilities to make healthy choices and cope with life's difficulties.
All Stars is a multi-year school-based program for middle school students (11 to 14 years old) designed to prevent and delay the onset of high-risk behaviors such as drug use, violence, and premature sexual activity. The program focuses on five topics important to preventing high-risk behaviors: (1) developing positive ideals that do not fit with high-risk behavior; (2) creating a belief in conventional norms; (3) building strong personal commitments; (4) bonding with school, pro-social institutions, and family; and (5) increasing positive parental attentiveness. All Stars includes highly interactive group activities, games and art projects, small group discussions, one- on-one sessions, a parent component, and a celebration ceremony. The All Stars Core program consists of 13 45-minute class sessions delivered on a weekly basis by teachers, prevention specialists, or social workers. The All Stars Booster program is designed to be delivered 1 year after the core program and includes nine 45-minute sessions reinforcing lessons learned in the previous year.
Athletes Training and Learning To Avoid Steroids (ATLAS) is a school-based drug prevention program. ATLAS was designed for male high school athletes to deter drug use and promote healthy nutrition and exercise as alternatives to drugs. The curriculum consists of 10 45- minute interactive classroom sessions and 3 exercise training sessions facilitated by peer educators, coaches, and strength trainers. Program content includes (1) discussion of sports nutrition; (2) exercise alternatives to anabolic steroids and sports supplements; and (3) the effects of substance abuse in sports, drug refusal role-playing, and the creation of health promotion messages.
The Big Brothers Big Sisters Mentoring Program is designed to help participating youth ages 6-18 ("Littles") reach their potential through supported matches with adult volunteer mentors ages 18 and older ("Bigs"). The program focuses on positive youth development, not specific problems, and the Big acts as a role model and provides guidance to the Little through a relationship that is based on trust and caring. The Big and Little agree to meet two to four times per month for at least a year, with get-togethers usually lasting 3 or 4 hours and consisting of mutually enjoyable activities.
Volunteers applying to be a Big are screened by local Big Brothers Big Sisters of America (BBBSA) agencies for potential safety risks, ability to commit the necessary time, and capability of forming positive relationships with youth. Approved volunteers undergo training, which includes presentations on the developmental stages of youth, communication and limit-setting skills, tips for building relationships, and recommendations on the best way to interact with their matched Little, whose racial, ethnic, or socioeconomic background may differ from that of the Big.
In matching Bigs and Littles, BBBSA agencies often consider practical factors, such as gender, geographic proximity, and availability, as well as the match preferences of volunteers, youth, and parents. Volunteers indicate the type of youth they would like to be matched with, noting age, race, and the types of activities they expect to engage in with the youth.
Youth and their parents state their preference for volunteers, noting such factors as age, race, and religion, and youth also provide their activity preferences. Matching policies may vary across local BBBSA agencies, but in all cases, the parent must approve the match.
The study reviewed for this summary was conducted with eight urban BBBSA agencies and included youth ages 10-16.
Per se laws— a specific BAC level (usually .05 or .08) at which a driver is considered legally impaired and can be arrested (Andenaes, 1988). The BAC can be measured by taking a blood sample from a driver or via an analysis of the exhaled breath. The invention of the breathalyser and other portable devices for collecting samples of drivers’ breaths, combined with per se legislation, revolutionized law enforcement of drinking and driving.
All USA states have longstanding laws prohibiting driving while impaired by alcohol. The U.S. Congress included a provision in the Fiscal Year 2001 Department of Transportation and Related Agencies Appropriations Act 213 requiring states and territories to implement .08 BAC laws by October 1, 2003 or risk losing federal highway construction funds. Certain policies depend upon laws that clearly define drinking and driving with a BAC at or higher than a prescribed level for the whole population (e.g., .08 or .05) or for young drivers (usually zero or .02).
The Border Binge-Drinking Reduction Program provides a process for changing the social and community norms associated with underage and binge drinking that has proven effective at reducing alcohol-related trauma caused by young American's binge drinking across the U.S.-Mexican border. The program is a bi-national effort to curb irresponsible drinking practices, employing environmental management techniques including (1) regular surveys of youths returning from a night of drinking with anonymous blood alcohol concentration (BAC) breath tests; (2) strong media advocacy, using information from the surveys to characterize the problem, mobilize the community to action, and reframe the issue from an accepted norm to a health and safety issue for the bi-national community; (3) formation of the Bi-national Policy Council, which recommends policy changes on both sides of the border and provides spokespeople for the media advocacy and community organizing components; (4) increased enforcement of existing laws and policies, such as ID checks at border crossings and in bars in Tijuana, Mexico; and (5) implementation of policies and practices that impact the environment where dangerous cross- border drinking occurs.
Brief Alcohol Screening and Intervention for College Students (BASICS) is a prevention program for college students who drink alcohol heavily and have experienced or are at risk for alcohol-related problems. Following a harm reduction approach, BASICS aims to motivate students to reduce alcohol use in order to decrease the negative consequences of drinking. It is delivered over the course of two 1-hour interviews with a brief online assessment survey taken by the student after the first session. The first interview gathers information about the student's recent alcohol consumption patterns, personal beliefs about alcohol, and drinking history, while providing instructions for self-monitoring any drinking between sessions and preparing the student for the online assessment survey. Information from the online assessment survey is used to develop a customized feedback profile for use in the second interview, which compares personal alcohol use with alcohol use norms, reviews individualized negative consequences and risk factors, clarifies perceived risks and benefits of drinking, and provides options to assist in making changes to decrease or abstain from alcohol use. Based on principles of motivational interviewing, BASICS is delivered in an empathetic, nonconfrontational, and nonjudgmental manner and is aimed at revealing the discrepancy between the student's risky drinking behavior and his or her goals and values. The intervention is delivered by trained personnel proficient in motivational interviewing and may be tailored for use with young adults in settings other than colleges.
Brief Strategic Family Therapy (BSFT) is designed to (1) prevent, reduce, and/or treat adolescent behavior problems such as drug use, conduct problems, delinquency, sexually risky behavior, aggressive/violent behavior, and association with antisocial peers; (2) improve pro-social behaviors such as school attendance and performance; and (3) improve family functioning, including effective parental leadership and management, positive parenting, and parental involvement with the child and his or her peers and school. BSFT is typically delivered in 12-16 family sessions but may be delivered in as few as 8 or as many as 24 sessions, depending on the severity of the communication and management problems within the family. Sessions are conducted at locations that are convenient to the family, including the family's home in some cases. Hispanic families have been the principal recipients of BSFT, but African American families have also participated in the intervention.
BSFT considers adolescent symptomatology to be rooted in maladaptive family interactions, inappropriate family alliances, overly rigid or permeable family boundaries, and parents' tendency to believe that a single individual (usually the adolescent) is responsible for the family's troubles. BSFT operates according to the assumption that transforming how the family functions will help improve the teen's presenting problem.
CASASTART is a substance abuse and delinquency prevention program serving high-risk young adolescents and their families. CASASTART's primary goals are (1) to provide youths with the services and support they need to become productive, law-abiding citizens; and (2) to create a safer environment for adolescents and their families through the reduction of crime and illegal drugs in their neighborhoods. To attain its goals, CASASTART brings together key stakeholders in a community, including families, schools, law enforcement agencies, and social service and health agencies.
Challenging College Alcohol Abuse (CCAA) is a social norms and environmental management program aimed at reducing high-risk drinking and related negative consequences among college students (18 to 24 years old). The intervention was developed at the University of Arizona based on work previously done at Northern Illinois University. CCAA uses a campus-based media campaign and other strategies to address misperceptions about alcohol and make the campus environment less conducive to drinking. Studies have shown that college students tend to perceive their peers' level of drinking to be higher than it actually is, which in turn influences their own drinking behavior. CCAA's media campaign addresses these misperceptions by (1) communicating norms using data from surveys conducted at the university, (2) educating students on less-known or less-understood facts related to alcohol, and (3) offering an opportunity to change the "public conversation" around alcohol use among students, staff, and the local community. Advertisements and articles in the school newspaper, press releases, campus displays, and other media are used to communicate factual information about alcohol and drugs and related topics such as health and wellness, sexual assault, and sexually transmitted diseases. CCAA provides small grants to fund and promote non-alcohol social events that compete with traditional drinking occasions. Some media coverage is targeted to higher-risk groups such as fraternity and sorority chapters, freshmen, women, and students living in residence halls. CCAA also includes components aimed at faculty and staff, parents, and the local community, such as encouraging increased restrictions and monitoring of on-campus and off-campus alcohol use.
Changes in licensing provisions that substantially modify hours of service can have a significant effect on drinking and drinking-related problems overall. Studies suggest that reduced hours and days of sale can have net effects in reducing overall alcohol consumption and problems levels, with the effects concentrated during the times of closure but not matched by counterbalancing changes at other times of the week. Some states and communities prohibit on-premise or off-premise purchase of alcoholic beverages on Sundays or after a certain evening (not early morning) hour.
In sum, it appears that changes in licensing provisions that substantially reduce hours of service can have a significant impact on drinking and drinking-related problems overall, The evidence that such changes affect young people is more limited as most evaluations have focused on the total drinking population.
The Child Development Project (CDP) is a comprehensive, elementary school-based intervention program. CDP incorporates class meetings, learning activities for partners and small groups, and open-ended discussions on literature to enhance students’ social, ethical, and intellectual development. CDP is based on the belief that prevention efforts are most likely to be effective when they occur early in a child’s development, before antisocial behavioral patterns have a chance to become firmly established. CDP emphasizes the promotion of positive development rather than the prevention of disorder. The central goal of CDP is to help schools become "caring communities of learners" by offering an environment of caring, supportive, and collaborative relationships to build students’ sense of community in school and to promote school bonding.
Children in Between (CIB), formerly known as Children in the Middle, is an educational intervention for divorcing families that aims to reduce the parental conflict, loyalty pressures, and communication problems that can place significant stress on children. CIB consists of one to two 90- to 120-minute classroom sessions and can be tailored to meet specific needs. The intervention teaches specific parenting skills, particularly good communication skills, to reduce the familial conflict experienced by children. Each parent attending classes typically receives two booklets ("What About the Children" and "Children in Between") that give advice for reducing the stress of divorce/separation on children and promote practice of the skills taught in the course. Each parent also watches the intervention video, which illustrates how children often feel caught in the middle of their parents' conflicts.
Class Action is the second phase of the Project Northland alcohol-use prevention curriculum series. Class Action (for grades 11-12) and Project Northland (for grades 6-8) are designed to delay the onset of alcohol use, reduce use among youths who have already tried alcohol, and limit the number of alcohol-related problems experienced by young drinkers. Class Action draws upon the social influence theory of behavior change, using interactive, peer-led sessions to explore the real-world legal and social consequences of substance abuse. The curriculum consists of 8-10 group sessions in which students divide into teams to research, prepare, and present mock civil cases involving hypothetical persons harmed as a result of underage drinking. Using a casebook along with audio-taped affidavits and depositions, teens review relevant statutes and case law to build legal cases they then present to a jury of their peers. Case topics include drinking and driving, fetal alcohol syndrome, drinking and violence, date rape, drinking and vandalism, and school alcohol policies. Students also research community issues around alcohol use and become involved in local events to support community awareness of the problem of underage drinking. Class Action can be used as a booster session for the Project Northland series or as a stand-alone program.alcohol, School,
Communities Mobilizing for Change on Alcohol (CMCA) is a community-organizing program designed to reduce teens' (13 to 20 years of age) access to alcohol by changing community policies and practices. CMCA seeks both to limit youths' access to alcohol and to communicate a clear message to the community that underage drinking is inappropriate and unacceptable. It employs a range of social- organizing techniques to address legal, institutional, social, and health issues related to underage drinking. The goals of these organizing efforts are to eliminate illegal alcohol sales to minors, obstruct the provision of alcohol to youth, and ultimately reduce alcohol use by teens. The program involves community members in seeking and achieving changes in local public policies and the practices of community institutions that can affect youths' access to alcohol.
CMCA is based on established research that has demonstrated the importance of the social and policy environment in facilitating or impeding drinking among youth. CMCA community-organizing methods draw on a range of traditions in organizing efforts to deal with the social and health consequences of alcohol consumption.
Communities That Care (CTC) is a program of the Center for Substance Abuse Prevention (CSAP) in the office of the United States Government's Substance Abuse and Mental Health Services Administration (SAMHSA). CTC is a coalition-based prevention operating system that uses a public health approach to prevent youth problem behaviors such as violence, delinquency, school dropout and substance abuse. Using strategic consultation, training, and research-based tools, CTC is designed to help community stakeholders and decision makers understand and apply information about risk and protective factors, and programs that are proven to make a difference in promoting healthy youth development, in order to most effectively address the specific issues facing their community’s youth.
Developed by Drs. J. David Hawkins and Richard Catalano at the University of Washington’s Social Development Research Group (SDRG), CTC’s principal strategy, the Social Development Strategy, focuses on strengthening protective factors that can buffer young people from problem behaviors and promote positive youth development.
CTC is grounded in rigorous research from social work, public health, psychology, education, medicine, criminology, and organizational development. It engages all community members who have a stake in healthy futures for young people and sets priorities for action based on community challenges and strengths. Clear, measurable outcomes are tracked over time to show progress and ensure accountability.
Community Trials Intervention To Reduce High-Risk Drinking is a multi-component, community-based program developed to alter the alcohol use patterns and related problems of people of all ages. The program incorporates a set of environmental interventions that assist communities in (1) using zoning and municipal regulations to restrict alcohol access through alcohol outlet density control; (2) enhancing responsible beverage service by training, testing, and assisting beverage servers and retailers in the development of policies and procedures to reduce intoxication and driving after drinking; (3) increasing law enforcement and sobriety checkpoints to raise actual and perceived risk of arrest for driving after drinking; (4) reducing youth access to alcohol by training alcohol retailers to avoid selling to minors and those who provide alcohol to minors; and (5) forming the coalitions needed to implement and support the interventions that address each of these prevention components. The program aims to help communities reduce alcohol-related accidents and incidents of violence and the injuries that result from them.
The systematic checking by law enforcement of whether a licensed establishment actually sells alcohol to underage persons or “underage looking persons”.
The Coping Power Program (CPP) is a cognitive-based intervention delivered to aggressive children and their parents during the children’s transition to middle school. The program aims to increase competence, study skills, social skills, and self-control in aggressive children as well as improving parental involvement in their child’s education.
The Coping Power Program is a multi-component intervention based heavily on cognitive–behavioral therapy, which emphasizes increasing and exercising parenting skills and the child’s social skills. The child component of CPP draws from anger management programs that concentrate on decision-making, attributions, and peer pressure.
The program has a component aimed at the parents of children in intervention classrooms. The child component of CPP lasts 16 months and includes 22 fifth grade sessions and 12 sixth grade sessions. The parent component is administered over 16 sessions, which provides the parents with instruction on parenting skills, including rule setting, appropriate punishment, stress management, and family communication.
The parent component concentrates on parenting and stress-management skills, while the child component involves the use of school-based focus groups and emphasizes anger management and social problem–solving skills. Parents also meet with CPP staff to help them understand and prepare for future adolescence-related and general education issues, and to give them the tools necessary for a smooth transition to middle school.
Coping With Work and Family Stress is a workplace preventive intervention designed to teach employees 18 years and older how to deal with stressors at work and at home. The model is derived from Pearlin and Schooler's hierarchy of coping mechanisms as well as Bandura's social learning theory. The 16 90-minute sessions, typically provided weekly to groups of 15-20 employees, teach effective methods for reducing risk factors (stressors and avoidance coping) and enhancing protective factors (active coping and social support) through behavior modification (e.g., methods to modify or eliminate sources of stress), information sharing (e.g., didactic presentations, group discussions), and skill development (e.g., learning effective communication and problem-solving skills, expanding use of social network).
The curriculum emphasizes the role of stress, coping, and social support in relation to substance use and psychological symptoms. The sessions are led by a facilitator who typically has a master's-level education; is experienced in group dynamics, system theory, and cognitive and other behavior interventions; and is able to manage group process. Facilitator training in the program curriculum is required.
Creating Lasting Family Connections (CLFC), the currently available version of Creating Lasting Connections (CLC), is a family-focused program that aims to build the resiliency of youth aged 9 to 17 years and reduce the frequency of their alcohol and other drug (AOD) use. CLFC is designed to be implemented through a community system, such as churches, schools, recreation centers, and court-referred settings. The six modules of the CLFC curriculum, administered to parents/guardians and youth in 18-20 weekly training sessions, focus on imparting knowledge and understanding about the use of alcohol and other drugs, including tobacco; improving communication and conflict resolution skills; building coping mechanisms to resist negative social influences; encouraging the use of community services when personal or family problems arise; engendering self-knowledge, personal responsibility, and respect for others; and delaying the onset and reducing the frequency of AOD use among participating youth. The program emphasizes early intervention services for parents and youth and follow-up case management services for families. Manuals for trainers, notebooks for participants, and other materials are available, but the program is intended to be modified with each implementation to reflect the needs of the participants and the skill level of the trainers.
The Curriculum-Based Support Group (CBSG) Program is a support group intervention designed to increase resiliency and reduce risk factors among children and youth ages 4-15 who are identified by school counselors and faculty as being at elevated risk for early substance use and future delinquency and violence (e.g., they are living in adverse family situations, displaying observable gaps in coping and social skills, or displaying early indicators of antisocial attitudes and behaviors).
Based on cognitive-behavioral and competence-enhancement models of prevention, the CBSG Program teaches essential life skills and offers emotional support to help children and youth cope with difficult family situations; resist peer pressure; set and achieve goals; refuse alcohol, tobacco, and other drugs; and reduce antisocial attitudes and rebellious behavior. Delivered in 10-12 weekly, 1-hour support group sessions, the curriculum addresses topics such as self-concept, anger and other feelings, dreams and goal setting, healthy choices, friends, peer pressure, life challenges, family chemical dependency, and making a public commitment to staying drug free and true to life goals. Lesson content and objectives are essentially the same for all participants but are tailored for age and developmental status.
DARE to be You (DTBY) is a multilevel prevention program that serves high-risk families with children 2 to 5 years old. Program objectives focus on children's developmental attainments and aspects of parenting that contribute to youth resilience to later substance abuse, including parental self-efficacy, effective child rearing, social support, and problem-solving skills. Families engage in parent-child workshops that focus on developing the parents' sense of competence and satisfaction with the parent role, providing knowledge of appropriate child management strategies, improving parents' and children's relationships with their families and peers, and contributing to child developmental advancement.
The number of outlets grows in response to population, and outlets are usually established along roadway systems. Outlet counts are either in terms of population densities (numbers of outlets per person) or geographic densities (numbers of outlets per kilometer of roadway). In developed societies, people may easily drive or use public transport to obtain alcohol. The number of outlets may be restricted directly or indirectly through policies that make licenses more difficult to obtain (e.g., by increasing the cost of a license). Several states limit the number of alcohol outlets and control the price of alcohol by maintaining state-run (rather than privately owned) outlets.
Specifying locations where drinking cannot occur is a policy that has been implemented with laws about public drinking and/or public intoxication, as well as those prohibiting drinking in parks or recreational locations, or at the workplace. These restrictions have real potential for affecting the drinking of youth since youth often prefer recreational venues for drinking, e.g., public parks, beaches, lakes, etc. and limiting drinking in such locations also holds the potential for reducing social access of alcohol provided by others.
The 2003 National Survey on Drug Use and Health (NSDUH), conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), indicated that an estimated 19.5 million Americans (8.2% of the population aged 12 or older) had used an illicit drug during the previous month. Drug abuse, whether it involves controlled substances or the misuse of prescription drugs, has permeated almost every level of society to some degree. In 2003, an estimated 11 million people reported driving under the influence of an illicit drug during the past year. As many as 18% of 21 year-olds report drugged driving at least once during the past year.
To help combat this growing problem of drugs in the educational environment, at least three states, Arizona, Kansas and New York, each independently developed training to address this issue. In cooperation with the International Association of Chiefs of Police (IACP) and the National Highway Traffic Safety Association (NHTSA), the strengths from the three programs were combined to form the Drug Impairment Training for Educational Professionals (DITEP). This training is intended to provide school administrators and nurses with a systematic approach to recognizing and evaluating individuals in the academic environment who are abusing and impaired by drugs, both legal and illegal, in order to provide early recognition and intervention.
DITEP is derived from the national Drug Evaluation and Classification (DEC) Program, a successful law enforcement procedure used to detect drug and alcohol impaired drivers. The methods employed in this training are based on medical and scientific facts. The information is supported by research conducted in both laboratory and field studies. The DEC Program was validated in laboratory by studies conducted at the Johns Hopkins University, and in the field by the Southern California Research Institute.
The training will enable school nurses to determine first of all, whether or not the student is impaired. If it is determined that there is impairment, whether the impairment is due to a medical problem or is drug related. And finally, if the impairment is drug related, through proven diagnostic procedures, what category or categories of drugs that are likely causing the observed impairment.
By providing training to school officials and health care professionals, DITEP enables schools to employ an aggressive evaluation and detection program that will cause drug usage in schools to decline. Consequently, not only will the disruption caused by those abusing drugs be decreased, but also the incidence of those individuals driving to and from schools while impaired by either alcohol or drugs will also be greatly reduced, making our communities and schools a safer place for all.
Early Risers "Skills for Success" is a multi-component, developmentally focused, competency-enhancement program that targets 6- to 12- year-old elementary school students who are at high risk for early development of conduct problems, including substance use. Early Risers is based on the premise that early, comprehensive, and sustained intervention is necessary to target multiple risk and protective factors. The program uses integrated child-, school-, and family-focused interventions to move high-risk children onto a more adaptive developmental pathway.
A "family advocate" (someone with a bachelor's degree and experience working with children/parents) coordinates the child- and family- focused components. The child-focused component has three parts: (1) Summer Day Camp, offered 4 days per week for 6 weeks and consisting of social-emotional skills education and training, reading enrichment, and creative arts experiences supported by a behavioral management protocol; (2) School Year Friendship Groups, offered during or after school and providing advancement and maintenance of skills learned over the summer; and (3) School Support, which occurs throughout each school year and is intended to assist and modify academic instruction, as well as address children's behavior while in school, through case management, consultation, and mentoring activities performed by the family advocate at school.
The family-focused component has two parts: (1) Family Nights with Parent Education, where children and parents come to a center or school five times per year during the evening, with children participating in fun activities while their parents meet in small groups for parenting-focused education and skills training; and (2) Family Support, which is the implementation of an individually designed case plan for each family to address their specific needs, strengths, and maladaptive patterns through goal setting, brief interventions, referral, continuous monitoring, and, if indicated, more intensive and tailored parent skills training.
Increasing excise taxes on alcohol is another type of policy that affects price. Using national samples of youth, several studies indicate that raising alcohol excise taxes may have large effects in reducing youth drinking. Tax increases may influence not only consumption, but also other alcohol-related outcomes, and youth again appear to be more price responsive than adults in terms of these outcomes.
Familias Unidas is a family-based intervention for Hispanic families with children ages 12-17. The program is designed to prevent conduct disorders; use of illicit drugs, alcohol, and cigarettes; and risky sexual behaviors by improving family functioning. Familias Unidas is guided by eco-developmental theory, which proposes that adolescent behavior is affected by a multiplicity of risk and protective processes operating at different levels (i.e., within family, within peer network, and beyond), often with compounding effects. The program is also influenced by culturally specific models developed for Hispanic populations in the United States.
The intervention is delivered primarily through multi-parent groups, which aim to develop effective parenting skills, and family visits, during which parents are encouraged to apply those skills while interacting with their adolescent. The multi-parent groups, led by a trained facilitator, meet in weekly 2-hour sessions for the duration of the intervention. Each group has 10 to 12 parents, with at least 1 parent from each participating family. Sessions include problem posing and participatory exercises. Group discussions aim to increase parents' understanding of their role in protecting their adolescent from harm and to facilitate parental investment.
Families and Schools Together (FAST) is a multifamily group intervention designed to build relationships between families, schools, and communities to increase well-being among elementary school children. The program's objectives are to enhance family functioning, prevent school failure, prevent substance misuse by the children and other family members, and reduce the stress that children and parents experience in daily situations. Participants in the multifamily group work together to enhance protective factors for children, including parent-child bonding, parent involvement in schools, parent networks, family communication, parental authority, and social capital, with the aim of reducing the children's anxiety and aggression and increasing their social skills and attention spans.
FAST includes three components: outreach to parents, eight weekly multifamily group sessions, and ongoing monthly group reunions for up to 24 months to support parents as the primary prevention agents for their children. Collaborative teams of parents/caregivers, professionals (e.g., substance abuse or mental health professionals), and school personnel facilitate the groups, which meet at the school at the end of the school day. With each cycle of FAST implementation, 30 to 50 students in one grade level and their families can participate.
Although versions of FAST have been developed for families with children of all ages (babies through teens), the research reviewed for this summary included only elementary school children.
Family Effectiveness Training (FET) is a family-based program for Hispanics that targets family factors known to place children at risk. FET helps Hispanic immigrant families with children ages 6 to 12, particularly when the child is exhibiting behavior problems, associating with deviant peers, or experiencing parent–child communication problems. The goal of FET is to strengthen families by increasing their ability to adapt to new situations, particularly developmental and cultural challenges the family will face. The program consists of three components: Family Development, Bicultural Effectiveness Training, and Brief Strategic Family Therapy. FET uses two primary strategies to initiate change: 1) didactic lessons and participatory activities that help parents master effective family management skills and 2) organized discussions in which the therapist/facilitator intervenes to correct dysfunctional communications between or among family members. The training sessions last for 13 weeks, are 1½ to 2 hours long, and are tailored to each individual family.
Family Matters is a family-directed program to prevent adolescents 12 to 14 years of age from using tobacco and alcohol. The intervention is designed to influence population-level prevalence and can be implemented with large numbers of geographically dispersed families. The program encourages communication among family members and focuses on general family characteristics (e.g., supervision and communication skills) and substance-specific characteristics (e.g., family rules for tobacco and alcohol use and media/peer influences). The program involves successive mailings of four booklets to families and telephone discussions between the parent and health educators. Two weeks after family members read a booklet and carry out activities intended to reinforce its content, a health educator contacts a parent by telephone. A new booklet is mailed when the health educator determines that the prior booklet has been completed.
Girls Inc Friendly PEERsuasion® (GIFP) is an interactive prevention program aimed at helping girls in middle school (ages 11–14) acquire knowledge, skills, and support systems to avoid substance abuse. Girls Incorporated developed GIFP and offers it through a network of sites nationwide. The program draws on the social influence and life skills models of prevention, using a combination of adult leadership and peer reinforcement to teach girls to respond critically to messages and social pressures that encourage substance use. The program consists of two phases. In the first phase, girls participate in 14 hour-long sessions of curriculum training with a trained adult leader. Girls learn the short- and long-term effects of substance abuse, how to recognize media and peer pressures, and skills for making responsible decisions about drug use. The learning involves hands-on, interactive activities such as games, role-playing, and group discussions. Each session concentrates on a particular objective, while reinforcing skills and knowledge introduced in the previous session. After the completion of this core curriculum, the participants are certified as PEERsuaders. In the program’s second phase, the small teams of PEERsuaders plan and implement about 5 hours (8–10 half-hour sessions) of substance abuse prevention activities for girls (and sometimes boys) ages 6–10 who are called PEERsuade-Me’s. Each PEERsuader team of 2 to 3 girls is responsible for leading a group of 10 to 15 PEERsuade-Me’s. Working with their adult leader, the PEERsuaders draw on skills and activities they learned in the first phase of the program as well as on their own experiences and creativity to present factual information and practice skills related to substance abuse prevention.
Good Behavior Game (GBG) is a classroom-based behavior management strategy for elementary school that teachers use along with a school's standard instructional curricula. GBG uses a classroom-wide game format with teams and rewards to socialize children to the role of student and reduce aggressive, disruptive classroom behavior, which is a risk factor for adolescent and adult illicit drug abuse, alcohol abuse, cigarette smoking, antisocial personality disorder (ASPD), and violent and criminal behavior. GBG is structured around four core elements: classroom rules, team membership, self- and team-behavior monitoring, and positive reinforcement of individual team members and the team as a whole.
In each 1st-grade classroom, the teacher assigns all children to one of three teams with an equal number of girls and boys; aggressive, disruptive children; and shy, socially isolated children. The assignments are made on the basis of an initial 10-week observation period at the start of the school year. Basic classroom rules of student behavior are posted, and the whole team is rewarded if team members commit a total of four or fewer infractions of the classroom rules during game periods. For the first 3 weeks, GBG is played three times a week for 10 minutes each time during periods of the day when the classroom environment is less structured and the students are working independently of the teacher. Game periods are increased in length and frequency at regular intervals; by mid-year the game is played every day. Initially, the teacher announces the start of a game period and gives rewards at the conclusion of the game. Later, the teacher initiates game periods without announcement and defers rewards until the end of the school day or week. Over time, GBG is played at different times of the day and during different classroom tasks, so the game evolves from being highly predictable in timing and occurrence with immediate reinforcement to being unpredictable with delayed reinforcement. The children continue to participate in GBG through 2nd grade, where they are assigned to new classrooms and new teams. Training is required for the teachers who implement the intervention as well as for their coaches, who work with, support, and supervise them.
Schools that implement the program may choose to extend GBG beyond 2nd grade. In the study reviewed for this summary, children received GBG over 2 years, in 1st and 2nd grade, and their class assignments in 1st grade remained the same in 2nd grade.
Guiding Good Choices (GGC) is a drug use prevention program that provides parents of children in grades 4 through 8 (9 to 14 years old) with the knowledge and skills needed to guide their children through early adolescence. It seeks to strengthen and clarify family expectations for behavior, enhance the conditions that promote bonding within the family, and teach skills that allow children to resist drug use successfully. GGC is based on research that shows that consistent, positive parental involvement is important to helping children resist substance use and other antisocial behaviors. Formerly known as Preparing for the Drug Free Years, this program was revised in 2003 with more family activities and exercises. The current intervention is a five-session curriculum that addresses preventing substance abuse in the family, setting clear family expectations regarding drugs and alcohol, avoiding trouble, managing family conflict, and strengthening family bonds. Sessions are interactive and skill based, with opportunities for parents to practice new skills and receive feedback, and use video-based vignettes to demonstrate parenting skills. Families also receive a Family Guide containing family activities, discussion topics, skill-building exercises, and information on positive parenting.
Healer Women Fighting Disease Integrated Substance Abuse and HIV Prevention Program for African American Women (HWFD) targets African American women who are 13 to 55 years old and at risk of contracting HIV/AIDS and transmitting HIV through unsafe sexual activity and substance abuse. Program participants are referred from agencies that provide services in primarily urban areas with high poverty and unemployment rates. The curriculum is based on African-centered precepts, values, and beliefs tied with a conceptual framework called "culture-cology," which poses that an understanding of African American culture is central to behavior and behavioral change. Through a process of re-socialization, or "culturalization," HWFD seeks to instill traditional African and African American health- promoting values that can help participants overcome negative social influences. Goals of the intervention include increasing motivation and sense of self-efficacy, decreasing depression and feelings of hopelessness, increasing knowledge about HIV/AIDS, and promoting less risky sexual practices.
Healthy Alternatives for Little Ones (HALO) is a 12-unit holistic health and substance abuse prevention curriculum for children ages 3-6 in child care settings. HALO is designed to address risk and protective factors for substance abuse and other health behaviors by providing children with information on healthy choices. The program aims to help children understand the complexities of "health" and "healthy choices" by putting these abstract concepts into concrete terms they can understand. In HALO, health is defined as "growing bigger, stronger, and better able to think." The curriculum encourages healthy eating, exercise, and emotion recognition and educates children about the harmful effects of alcohol, tobacco, and other drugs (ATOD) on the body. HALO provides learning opportunities for children through teacher-led, developmentally appropriate, and fun hands-on activities that involve educational songs, videos, group activities, and books. Parental involvement is facilitated through introductory and unit-specific letters that encourage at-home discussion and the practice of identifying and making healthy choices.
The Healthy Living Project for People Living With HIV promotes protective health decision-making among individuals with HIV--heterosexual women, heterosexual men, gay men, and injection drug users--to reduce substance use and the risk of transmitting HIV. The Healthy Living Project is based on social action theory and targets the interactive psychosocial domains of the community environment, internal affective states, and self-regulation. Using a cognitive-behavioral approach, this manual-driven intervention is delivered by facilitators functioning as "life coaches" who work with clients individually to help them make changes in their health behavior, become active participants in their ongoing medical care, and achieve desired personal goals. The Healthy Living Project consists of 15 sessions, each 90 minutes in duration, presented in 3 modules: Stress, Coping, and Adjustment; Safer Behaviors; and Health Behaviors. During tailored counseling sessions, the client is encouraged to identify a life project and work with the coach to set attainable goals and build self- confidence, self-esteem, and motivation to increase protective health behaviors. Intervention strategies include psychosocial education, skills building to improve coping, and problem-solving training involving role-play exercises.
Healthy Workplace is a set of substance abuse prevention interventions for the workplace that are designed for workers who are not substance-dependent and still have the power to make choices about their substance use. The five Healthy Workplace interventions--SAY YES! Healthy Choices for Feeling Good, Working People: Decisions About Drinking, the Make the Connection series, Healthy Life 2000 (formerly Prime Life 2000), and Power Tools--target unsafe drinking, illegal drug use, prescription drug use, and the healthy lifestyle practices of workers. Cast in a health promotion framework and grounded in social-cognitive principles of behavior change, Healthy Workplace interventions integrate substance abuse prevention materials into popular health promotion programs, thereby defusing the stigma of substance abuse and reducing barriers to help-seeking behavior. Intervention materials are designed to raise awareness of the hazards of substance use and the benefits of healthy behaviors and to teach techniques to live healthier lives. The interventions are delivered in small group sessions using videos and print materials that can be used in any order and are selected based on the organization's goals and workforce composition (construction workers, office workers, technical/professional staff, etc.).
Hip-Hop 2 Prevent Substance Abuse and HIV (H2P) is designed to improve knowledge and skills related to drugs and HIV/AIDS among youth ages 12-16 with the aim of preventing or reducing their substance use and risky sexual activity. The program incorporates aspects of hip-hop culture--including language, arts, and history--as a social, cultural, and contextual framework for addressing substance use and HIV risk behaviors.
H2P uses a curriculum consisting of 10 modules, called "ciphers," delivered in 10 2-hour sessions. Through the curriculum's use of hip-hop culture, an interactive, multimedia CD, and a mix of traditional teaching methods, students learn information about drugs, HIV/AIDS, and sexual behavior; resistance and refusal skills; effective communication and negotiation skills; information about healthy alternatives to sex and drugs; and prevention self-efficacy skills.
School staff (e.g., teachers, counselors) deliver the first four modules in after-school or in-school sessions and the remaining modules at H2P camp, a 3-day retreat offering students structured learning and recreational activities, team-building experiences, mentoring, and opportunities for creative expression. Prior to serving as instructors, school staff participates in a 1-day training to learn about the genesis, ideology, and cultural components of hip-hop.
This family therapy approach is used with families of juvenile offenders, between 6 and 18 years of age, and those at risk for juvenile offending and substance abuse. It is a brief structured model delivered in five phases by paraprofessionals and professionals in the participants' home. It is a modification of the Functional Family Therapy model. The orientation is psychoeducational and relies on reducing families' defensiveness, assessing their needs coincident with healthy family relationships, and skills training for parents and teens. Technical aids such as the Parenting Wisely CD-ROM program and videotapes are used at the beginning of treatment to increase commitment to the therapy as well as decrease time in treatment.
The five phases of the program are (1) introduction/credibility, (2) assessment, (3) therapy, (4) education, and (5) generalization/termination. In the early phases, therapists are less directive and more supportive and empathic than in the later phases, when the family's cooperation and resistance is more conducive to increased therapist directiveness. This adapted model has been applied to multipleoffending, institutionalized delinquents, and targets families with lower educational levels and higher levels of pathology than the original Functional Family Therapy Model developed.
Long-range program outcome objectives include: reduced child involvement in the juvenile justice system; reduced self-reported delinquency; reduced teen pregnancy; reduced special class placement; increased graduation rates and; increased employment. Intermediate objectives include: decreased family conflict; increased cohesion; improved communication; improved parental monitoring, discipline, and support of appropriate child behavior; improved problem-solving abilities; improved parent-school communication; improved school attendance and grades and; improved child adjustment.
I Can Problem Solve (ICPS) is a universal school-based program that focuses on enhancing the interpersonal cognitive processes and problem-solving skills of children ages 4-12. ICPS is based on the idea that there is a set of these skills that shape how children (as well as adults) behave in interpersonal situations, influencing how they conceptualize their conflicts with others, whether they can think of a variety of solutions to these problems, and whether they can predict the consequences of their own actions. Rather than addressing specific behaviors as right or wrong, ICPS uses games, stories, puppets, illustrations, and role-plays to help children acquire a problem- solving vocabulary, learn to understand their own as well as others' feelings, think of alternative solutions, and think of potential consequences to an act. In turn, ICPS aims to prevent and reduce early high-risk behaviors, such as impulsivity and social withdrawal, and promote pro-social behaviors, such as concern for others and positive peer relationships. A key principle of the program is that the child, not the teacher, must solve the problem at hand. Giving the child this responsibility allows the child to develop the habit of creating solutions to problems, considering the potential consequences of one's actions, and thinking for oneself.
ICPS consists of three age-specific programs: preschool (containing 59 lessons), kindergarten and primary school (83 lessons), and intermediate elementary school (77 lessons). ICPS lessons are 20 minutes in duration and taught three to five times per week over the course of the academic year. In addition to the lessons, ICPS offers suggestions for integrating problem-solving principles into day-to-day classroom happenings, a technique called "ICPS dialoguing." The studies reviewed for this summary were conducted with children in preschool, kindergarten, and 1st grade.
I'm Special is a substance abuse prevention program for 3rd and 4th graders. The primary goal of the program is to develop and nurture each child's sense of uniqueness and self-worth. It further enhances the protective and resiliency factors of children by teaching them appropriate ways for dealing with feelings; steps for making decisions; and skills for healthy living, effective group interactions, and resisting drugs, as provided through the program's "no use" message.
Incredible Years is a set of comprehensive, multifaceted, and developmentally based curricula targeting 2- to 12-year-old children and their parents and teachers. The parent, child, and teacher training interventions that compose Incredible Years are guided by developmental theory on the role of multiple interacting risk and protective factors in the development of conduct problems. The three program components are designed to work jointly to promote emotional and social competence and to prevent, reduce, and treat behavioral and emotional problems in young children.
The parent training intervention focuses on strengthening parenting competencies and fostering parents' involvement in children's school experiences to promote children's academic and social skills and reduce delinquent behaviors. The Dinosaur child training curriculum aims to strengthen children's social and emotional competencies, such as understanding and communicating feelings, using effective problem- solving strategies, managing anger, practicing friendship and conversational skills, and behaving appropriately in the classroom. The teacher training intervention focuses on strengthening teachers' classroom management strategies, promoting children's pro-social behavior and school readiness, and reducing children's classroom aggression and noncooperation with peers and teachers. The intervention also helps teachers work with parents to support their school involvement and promote consistency between home and school. In all three training interventions, trained facilitators use videotaped scenes to structure the content and stimulate group discussions and problem solving.
Automobile ignition interlock devices that prevent a vehicle from starting until the driver passes a breath test.
Keep a Clear Mind (KACM) is a take-home drug education program for elementary school students in grades 4-6 (ages 9-11) and their parents. KACM is designed to help children develop specific skills to refuse and avoid use of "gateway" drugs. The program consists of four weekly lessons based on a social skills training model: Alcohol, Tobacco, Marijuana, and Tools to Avoid Drug Use. Each lesson introduces the topic for the week and is followed by a sequence of five activities to be completed at home with a parent. The activities include answering a simple question about drugs, listing reasons not to use specific drugs, writing "No" statements to resist social pressure to use drugs, selecting from a list of alternatives the best ways to refuse and avoid drugs, and completing contracts to refuse and avoid drugs. Small incentives such as folders, stickers, and bookmarks are provided to students who return their completed lessons within the indicated period. Parent newsletters prompt parents to reinforce their children for practicing saying no to drugs and provide specific behavior tips for communicating with children about how to avoid drug use. KACM can be facilitated by schools, private practice counselors, community-based youth organizations, and recreation centers.
Keepin' it REAL is a multicultural, school-based substance use prevention program for students 12-14 years old. Keepin' it REAL uses a 10-lesson curriculum taught by trained classroom teachers in 45-minute sessions over 10 weeks, with booster sessions delivered in the following school year. The curriculum is designed to help students assess the risks associated with substance abuse, enhance decision-making and resistance strategies, improve antidrug normative beliefs and attitudes, and reduce substance use. The narrative and performance-based curriculum draws from communication competence theory and a culturally grounded resiliency model to incorporate traditional ethnic values and practices that protect against substance use. The curriculum places special emphasis on resistance strategies represented in the acronym REAL: Refuse offers to use substances, Explain why you do not want to use substances, Avoid situations in which substances are used, and Leave situations in which substances are used.
Beer kegs are often a main source of alcohol at teenage parties and may encourage drinking greater quantities of beer, increasing the risk of driving under the influence of alcohol and other alcohol-related problems. When police arrive at underage keg parties, people often scatter. Without keg tagging, there is no way to trace who purchased the keg. As a result beer key registration is one strategy directed at social events where beer can be provided without restrictions. Keg registration laws require the purchaser of a keg of beer to complete a form that links their name to a number on the keg. In this way, if a beer keg is present in a drinking setting where young people are consuming alcohol, then the person who purchased the keg can be identified and held responsible.
Sanction of suspending or revoking a license.
LifeSkills Training (LST) is a school-based program that aims to prevent alcohol, tobacco, and marijuana use and violence by targeting the major social and psychological factors that promote the initiation of substance use and other risky behaviors. LST is based on both the social influence and competence enhancement models of prevention. Consistent with this theoretical framework, LST addresses multiple risk and protective factors and teaches personal and social skills that build resilience and help youth navigate developmental tasks, including the skills necessary to understand and resist pro-drug influences. LST is designed to provide information relevant to the important life transitions that adolescents and young teens face, using culturally sensitive and developmentally and age-appropriate language and content. Facilitated discussion, structured small group activities, and role-playing scenarios are used to stimulate participation and promote the acquisition of skills. Separate LST programs are offered for elementary school (grades 3-6), middle school (grades 6-9), and high school (grades 9-12); the research studies and outcomes reviewed for this summary involved middle school students.
Lions Quest Skills for Adolescence (SFA) is a multi-component, comprehensive life skills education program designed for school wide and classroom implementation in grades 6-8 (ages 10-14). The goal of Lions Quest programs is to help young people develop positive commitments to their families, schools, peers, and communities and to encourage healthy, drug-free lives. Lions Quest SFA unites educators, parents, and community members to utilize social influence and social cognitive approaches in developing the following skills and competencies in young adolescents: (1) essential social/emotional competencies, (2) good citizenship skills, (3) strong positive character, (4) skills and attitudes consistent with a drug-free lifestyle and (5) an ethic of service to others within a caring and consistent environment. The learning model employs inquiry, presentation, discussion, group work, guided practice, service-learning, and reflection to accomplish the desired outcomes. Lions Quest SFA is comprised of a series of 80 45-minute sequentially developed skill-building sessions, based on a distinct theme that may be adapted to a variety of settings or formats.
Few studies of the specific effects of reduced-alcohol beverages on young people have been conducted.
Media Detective is a media literacy education program for 3rd- to 5th-grade students. The goal of the program is to prevent or delay the onset of underage alcohol and tobacco use by enhancing the critical thinking skills of students so they become adept in deconstructing media messages, particularly those related to alcohol and tobacco products, and by encouraging healthy beliefs and attitudes about abstaining from alcohol and tobacco use. The program consists of 10 45-minute lessons based on established models of decision-making and research on the message interpretation process. Students are taught to deconstruct product advertisements by looking for five "clues": (1) the product, (2) the target audience, (3) the ad hook, (4) the hidden message, and (5) missing information about the health- related consequences of using the product. The program uses a range of pedagogical techniques and can be adapted to a variety of classroom settings and skill levels of students. The Media Detective program kit contains the main materials needed to teach the program, including a teacher manual, poster flipchart, and CD with media examples. Individual student workbooks that accompany the activities taught in each lesson are sold separately. Also available is a comprehensive online training workshop, which provides an introduction to the theory and research underlying the program model and instructions for facilitating each program activity. Those who finish this training and successfully complete assessment tests receive certification as program teachers. Media Detective is related to Media Ready, a media literacy education program for 6th- to 8th-grade students.
Media Ready is a media literacy education program for 6th- to 8th-grade students. The goal of the program is to prevent or delay the onset of underage alcohol and tobacco use by encouraging healthy beliefs and attitudes about abstaining from alcohol and tobacco use and by enhancing the ability to apply critical thinking skills in interpreting media messages, particularly those related to alcohol and tobacco products. Media Ready consists of 10 45-minute lessons based on established models of decision-making and research on the message interpretation process. The program includes homework and extension assignments to further students' understanding of media literacy and to provide additional opportunities for practicing newly learned skills. The curriculum is adaptable to a variety of classroom settings and skill levels of students. The Media Ready program kit contains all materials needed to teach the program, including a teacher manual, poster, and CD with media examples. Also available is a comprehensive 1-day training workshop, which provides an introduction to the theory and research underlying the program model and instructions for facilitating each program activity. Those who successfully complete an online test at the end of this training receive certification of completion. Media Ready is related to Media Detective, a media literacy education program for 3rd- to 5th-grade students.
The Native American Prevention Project Against AIDS and Substance Abuse (NAPPASA) school curriculum consists of a 24-session program that addresses multiple issues facing Native American communities. Classroom sessions were designed to build knowledge, acquire and practice prevention skills with peers, and foster new positive peer group norms for preventive communications and behaviors in the context of Native American values. The curriculum covers facts and issues about alcohol and other drug (AOD) abuse; basic reproductive biology; HIV/AIDS; linking AOD to HIV; sexually transmitted diseases (STDs) and how they are transmitted; how assertive communication skills can prevent unwanted sex, pregnancy, and STDs; decision-making skills; healthy options; social skills; coping with pressures; and reinforced practice and role-plays. Booster sessions involve activities, community meetings, and showing NAPPASA-produced videos and print media.
Not On Tobacco (N-O-T) is a school-based smoking cessation program designed for youth ages 14 to 19 who are daily smokers. N-O-T is based on social cognitive theory and incorporates training in self-management and stimulus control; social skills and social influence; stress management; relapse prevention; and techniques to manage nicotine withdrawal, weight, and family and peer pressure. The program consists of 50-minute group sessions conducted weekly for 10 consecutive weeks, plus four optional booster sessions. The sessions are delivered in gender-specific groups of 10-12 teens by same-gender facilitators. N-O-T can be implemented by schools or other community organizations using teachers, school nurses, counselors, and other staff and volunteers who are trained to facilitate group sessions.
Nurse-Family Partnership (NFP) is a prenatal and infancy nurse home visitation program that aims to improve the health, well-being, and self-sufficiency of low-income, first-time parents and their children. NFP was founded on concepts of human ecology, self-efficacy, and human attachment. Its program activities are designed to link families with needed health and human services, promote good decision-making about personal development, assist families in making healthy choices during pregnancy and providing proper care to their children, and help women build supportive relationships with families and friends. Nurses follow a detailed, visit-by-visit guide that provides information on tracking dietary intake; reducing cigarette, alcohol, and illegal drug use; identifying symptoms of pregnancy complications and signs of children's illnesses; communicating with health care professionals; promoting parent-child interactions; creating safe households; and considering educational and career options. Program objectives include decreased substance use, improved maternal economic self-sufficiency, fewer subsequent unintended pregnancies, reduced child abuse and neglect, and improved school readiness of the children. Individual programs serve a minimum of 100-200 families and are supported by 4-8 trained registered nurse home visitors (each carrying a caseload of 25 families), a nurse supervisor, and administrative support. Nurse home visits begin early in pregnancy and continue until the child's second birthday. The frequency of home visits changes with the stages of pregnancy and infancy and is adapted to the mother's needs, with a maximum of 13 visits occurring during pregnancy and 47 occurring after the child's birth.
The Nurturing Parenting Programs (NPP) are family-based programs for the prevention and treatment of child abuse and neglect. The programs were developed to help families who have been identified by child welfare agencies for past child abuse and neglect or who are at high risk for child abuse and neglect. The goals of NPP are to: Increase parents' sense of self-worth, personal empowerment, empathy, bonding, and attachment. Increase the use of alternative strategies to harsh and abusive disciplinary practices. Increase parents' knowledge of age-appropriate developmental expectations. Reduce abuse and neglect rates.
NPP instruction is based on psycho-educational and cognitive-behavioral approaches to learning and focuses on "re-parenting," or helping parents learn new patterns of parenting to replace their existing, learned, abusive patterns. By completing questionnaires and participating in discussion, role-play, and audiovisual exercises, participants learn how to nurture themselves as individuals and in turn build their nurturing family and parenting skills as dads, moms, sons, and daughters.
Participants develop their awareness, knowledge, and skills in five areas: (1) age-appropriate expectations; (2) empathy, bonding, and attachment; (3) nonviolent nurturing discipline; (4) self- awareness and self-worth; and (5) empowerment, autonomy, and healthy independence. Participating families attend sessions either at home or in a group format with other families. Group sessions combine concurrent separate experiences for parents and children with shared "family nurturing time." In home-based sessions, parents and children meet separately and jointly during a 90-minute lesson once per week for 15 weeks.
Parenting Wisely is a set of interactive, computer-based training programs for parents of children ages 3-18 years. Based on social learning, cognitive behavioral, and family systems theories, the programs aim to increase parental communication and disciplinary skills. The original Parenting Wisely program, American Teens, is designed for parents whose preteens and teens are at risk for or are exhibiting behavior problems such as substance abuse, delinquency, and school dropout. Parents use this self-instructional program on an agency's personal computer or laptop, either on site or at home, using the CD-ROM or online format. During each of nine sessions, users view a video enactment of a typical family struggle and then choose from a list of solutions representing different levels of effectiveness, each of which is portrayed and critiqued through interactive questions and answers. Each session ends with a quiz. All nine sessions can be completed in 2 to 3 hours. Parents also receive workbooks containing program content and exercises to promote skill building and practice.
Adaptations of the original Parenting Wisely program have been created for various groups of youth. One of these adaptations, Young Children, targets children ages 3-9 years. Although the studies reviewed in this summary primarily evaluated the original version of Parenting Wisely, the Young Children version was also evaluated, as were adaptations created to be implemented with groups of parents.
Parents as Teachers (PAT) is an early childhood family support and parent education home-visiting model. Families may enroll in Parents as Teachers beginning with pregnancy and may remain in the program until the child enters kindergarten. Based on theories of human ecology, empowerment, self-efficacy, and developmental parenting, Parents as Teachers involves the training and certification of parent educators who work with families using a comprehensive research-based and evidence-informed curriculum. Parent educators work with parents to strengthen protective factors and ensure that young children are healthy, safe, and ready to learn. The goals of the model are to increase parent knowledge of early childhood development, improve parenting practices, provide early detection of developmental delays and health issues, prevent child abuse and neglect, and increase children's school readiness and school success. Different curriculum materials are used for those working with families of children up to age 3 and those working with families of children from age 3 to kindergarten.
Home visitation is the key component of the Parents as Teachers model, with personal visits of approximately 60 minutes delivered weekly, every 2 weeks, or monthly, depending on family needs. Parent educators share research-based information and use evidence-based practices by partnering, facilitating, and reflecting with families. Parent educators use the Parents as Teachers curriculum in culturally sensitive ways to deliver services that emphasize parent-child interaction, development-centered parenting, and family well-being. Parent- child interaction focuses on promoting positive parenting behaviors and child development through parent-child activities. Development- centered parenting focuses on the link between child development and parenting and on key developmental topics (i.e., attachment, discipline, health, nutrition, safety, sleep, transitions/routines, and healthy births). Family well-being includes a focus on family strengths, capabilities, skills, and the building of protective factors.
A second component of the Parents as Teachers model is monthly or more frequent group connections, which parents can attend with their child to obtain information and social support and share experiences with their peers. Group connection formats include family activities, presentations, community events, parent cafes, and ongoing groups. Annual health, hearing, vision, and developmental screenings, beginning within 90 days of enrollment, are a third component of the model. Additionally, Parents as Teachers affiliates establish ongoing relationships with institutions and community organizations that serve families. Parent educators help families identify needs, set goals, connect with appropriate resources, and overcome barriers to accessing services.
Another major way that underage drinkers gain access to alcohol is at parties (e.g., Wagenaar et al., 1993). Party patrols are a local enforcement strategy in which police arrive at a social event in which alcohol is being served and check the age identifications of party participants. Under- age drinking parties frequently involve large groups and are commonly held in a home, an outdoor area, or other public location such as a hotel room. Party patrols are a recommended strategy to ad- dress underage drinking parties (Little & Bishop, 1998; Stewart, 1999). Parties are frequently cited as one of the settings at highest risk for youth alcohol consumption and related problems, and have been linked to impaired driving, sexual assaults, violence, property damage, and to the initiation of alcohol use of younger adolescents by older adolescents (Mayer, Forster, Murray, & Wagenaar, 1998; Schwartz & Little, 1997; Wagenaar et al., 1993). Decreased sales to older minors, in turn, are expected to reduce availability of alcohol to younger adolescents. Without these special patrols law enforcement agencies sometimes do not have enough manpower to thoroughly investigate under- age drinking parties. They cannot always trace who provided the alcohol or other drugs to minors.
Party patrols involve police entering locations where parties are in progress. The police can use noise or nuisance ordinances as a basis for entering a party to observe if underage drinking is taking place. In party patrol strategies, police are enlisted, as a part of their regular patrol duties, to routinely: (a) enter premises where parties that may involve underage drinking are underway, (b) respond to com- plaints from the public about noisy teenage parties where alcohol use is suspected, and (c) check, as part of regular weekend patrols, open areas and other venues where teen parties are known to occur. When underage drinking is discovered, the drinkers can be cited as well as the person who supplied the alcohol. Even when it is not possible to cite the person who supplied the alcohol, awareness of increased police activity in this regard can act as a deterrent and can express community concerns regarding the unacceptability of providing alcohol to minors. As with other environmental interventions, public awareness and media attention is important to increase the deterrence effect of this strategy. There is some evidence that this technique is effective.
Peacemakers is a curriculum-based violence prevention program for upper elementary and middle school students. It is based on an 18-lesson psychoeducational curriculum delivered by teachers or other youth-serving professionals. The curriculum teaches students positive attitudes and values related to violence, and trains youth in conflict-related psychosocial skills such as anger management, problem solving, assertiveness, communication, and conflict resolution. The program consists of more than delivery of the curriculum; in addition, school staff use a variety of procedures to infuse program principles and techniques into the everyday culture of the school. While the focus of the intervention is on primary prevention for all students, there is also a Counselor's Manual to guide remedial work for youth referred because of aggressive behavior.
The Peacemakers program content is based mostly on studies of psychosocial variables associated with individual differences in aggression and on existing interventions (either preventive or remedial) with evidence of effectiveness. The curriculum addresses: 1) broad causal factors discerned in past research on the psychology of violence, for example, beliefs supporting the acceptability and utility of violent behavior; and 2) deficits in conflict-related psychosocial skills. Thus, the program focuses on what students want to do and on what they can do.
The intervention begins with several sessions on violence-related attitudes, values, and self-concept issues. Then there are sessions on anger management, self-perception, conflict avoidance and resolution, problem solving, communication, assertive behavior, and work on resisting negative peer pressure and acting as an agent of positive peer pressure.
The program includes a variety of classroom activities, including didactic instruction, discussion, use of the Socratic method, role-plays, handouts with graphic design, and experiential exercises. The curriculum includes a series of stories, with accompanying writing exercises, written for the program by a children's author. This component of reading and writing facilitates the integration of the program into the academic mission of schools.
Peer Assistance and Leadership (PAL) is a peer helping program that seeks to build resiliency in youth by pairing youth with peer helpers who receive training and support from teachers participating in the program. The peer-based assistance provided through PAL is designed to help youth avoid risk factors for substance use as well as other problems, such as low achievement in school, dropout, absenteeism, violence, teen pregnancy, and suicide. PAL peer helpers act as guides, tutors, mentors, and mediators to peers or younger students (PAL mentees) by utilizing skills learned through PAL, including cultural competency, effective communication, decision making, higher order thinking, and resiliency building. PAL peer helpers are placed in helping roles with younger students from feeder campuses and peers from their own campus. Through a combination of leadership and assistance, they offer individual and group peer support, tutoring, welcoming and orientation of new students, assistance to students with special needs, classroom presentations, and school/community outreach projects. PAL mentees generally are referred to the program by a contact person at the service site because of concerns about the students' school performance (e.g., absences, tardiness, academic achievement) or personal or other problems. Students also can request to be referred to a PAL peer helper. PAL mentees are linked to specific peer helpers based on the needs of the PAL mentee and the skills and interests of the PAL peer helper.
Positive Action is an integrated and comprehensive program that is designed to improve academic achievement; school attendance; and problem behaviors such as substance use, violence, suspensions, disruptive behaviors, dropping out, and sexual behavior. It is also designed to improve parent-child bonding, family cohesion, and family conflict. Positive Action has materials for schools, homes, and community agencies. All materials are based on the same unifying broad concept (one feels good about oneself when taking positive actions) with six explanatory sub-concepts (positive actions for the physical, intellectual, social, and emotional areas) that elaborate on the overall theme. The program components include grade-specific curriculum kits for kindergarten through 12th grade, drug education kits, a conflict resolution kit, site-wide climate development kits for elementary and secondary school levels, a counselor's kit, a family kit, and a community kit. All the components and their parts can be used separately or in any combination and are designed to reinforce and support one another.
PRIME For Life (PFL) is a motivational intervention used in group settings to prevent alcohol and drug problems or provide early intervention. PFL has been used primarily among court-referred impaired driving offenders, as in the two studies reviewed for this summary. It also has been adapted for use with military personnel, college students, middle and high school students, and parents. Different versions of the program, ranging from 4.5 to 20 hours in duration, and optional activities are available to guide use with various populations.
Based on the Lifestyle Risk Reduction Model, the Transtheoretical Model, and persuasion theory, PFL emphasizes changing participants' perceptions of the risks of drug and alcohol use and related attitudes and beliefs. Risk perception is altered through the carefully timed presentation of both logical reasoning and emotional experience. Instructors use empathy and collaboration (methods consistent with motivational interviewing) to increase participants' motivation to change behavior to protect what they value most in life. Participants are guided in self-assessing their level of progression toward or into dependence or addiction. PFL also assists participants in developing a detailed plan for successfully following through with behavior change. Multimedia presentations and extensive guided discussion help motivate participants to reduce their substance use or maintain low-risk choices. Individual and group activities are completed using participant workbooks.
Project ACHIEVE is a comprehensive school reform and improvement program for preschool through high school (students ages 3-18 years) that focuses on students' academic, social-emotional/behavioral, and social skills outcomes; school-wide positive behavioral support systems and school safety; positive classroom and school climates; and community and parent outreach and involvement. For students, the aim is to improve resilience, protective factors, and effective self-management skills so youth are better able to resist unhealthy and maladaptive behaviors. The aim for staff is to ensure effective instruction and classroom management as well as supports and services to students not responding with academic and behavioral success. The school aim is to help schools to be successful for all students.
Based on social learning theory and effective approaches to school reform and improvement, this school-wide program uses professional development and ongoing technical consultation to target and reinforce critical staff skills and intervention approaches. The program incorporates a continuum of student services, including prevention, strategic intervention, and crisis management, and consists of seven interdependent components implemented over 3 years: Strategic planning and organizational analysis and development Problem-solving, response-to-intervention, teaming, and consultation processes Effective school, schooling, and professional development Academic instruction linked to academic assessment, intervention, and achievement (i.e., Positive Academic Supports and Services) Age-appropriate social skills instruction (i.e., Stop & Think Social Skills Program) linked to behavioral assessment, intervention, and self-management (i.e., Positive Behavioral Support System) Parent and community training, support, and outreach Data management, evaluation, and accountability
Project ACHIEVE involves the school's entire instructional, administrative, and support staff and, following training, can be implemented with resources available in most schools. Training typically involves in-service training, classroom-based demonstrations, and technical consultation and follow-up.
Project ACHIEVE has been used in public schools, alternative schools, special education centers, psychiatric and juvenile justice facilities, Head Start programs, and specialized charter schools. The research study reviewed for this summary involved kindergarten through grade 6 in public schools.
Project ALERT is a school-based prevention program for middle or junior high school students that focuses on alcohol, tobacco, and marijuana use. It seeks to prevent adolescent nonusers from experimenting with these drugs, and to prevent youths who are already experimenting from becoming more regular users or abusers. Based on the social influence model of prevention, the program is designed to help motivate young people to avoid using drugs and to teach them the skills they need to understand and resist pro-drug social influences. The curriculum is comprised of 11 lessons in the first year and 3 lessons in the second year. Lessons involve small-group activities, question-and-answer sessions, role-playing, and the rehearsal of new skills to stimulate students' interest and participation. The content focuses on helping students understand the consequences of drug use, recognize the benefits of nonuse, build norms against use, and identify and resist pro-drug pressures.
Project EX is a school-based smoking-cessation clinic program for adolescents that stresses motivation, coping skills, and personal commitment. Consisting of eight 40- to 45-minute sessions delivered over a 6-week period, the program curriculum includes strategies for coping with stress, dealing with nicotine withdrawal, and avoiding relapses. Project EX uses engaging and motivating activities such as games and yoga to reduce or stop smoking among adolescents and teach self-control, anger management, mood management, and goal- setting techniques. Adolescents are provided with accurate information about the social, emotional, environmental, and physiological consequences of tobacco use. The first four sessions are intended to prepare students for an attempt at quitting smoking, which should take place between sessions 4 and 6. The remaining sessions are designed to maintain quit status and enhance quit attempts. Project EX clinics operate during school hours. Each clinic group can accommodate 8 to 15 students.
Project Northland is a multi-level intervention involving students, peers, parents, and community in programs designed to delay the age at which adolescents begin drinking, reduce alcohol use among those already drinking, and limit the number of alcohol-related problems among young drinkers. Administered to adolescents in grades 6-8 on a weekly basis, the program has a specific theme within each grade level that is incorporated into the parent, peer, and community components. The 6th-grade home-based program targets communication about adolescent alcohol use utilizing student-parent homework assignments, in-class group discussions, and a communitywide task force. The 7th-grade peer- and teacher-led curriculum focuses on resistance skills and normative expectations regarding teen alcohol use, and is implemented through discussions, games, problem-solving tasks, and role-plays. During the first half of the 8th-grade Powerlines peer-led program, students learn about community dynamics related to alcohol use prevention through small group and classroom interactive activities. During the second half, they work on community-based projects and hold a mock town meeting to make community policy recommendations to prevent teen alcohol use.
The Midwestern Prevention Project (MPP) was a comprehensive, community-based, multifaceted program intended to prevent or reduce gateway substance use (alcohol, tobacco, and marijuana) during adolescence. The program strived to help youths recognize the tremendous social pressures to use drugs and to provide them with assertiveness skills to help refuse peer pressure and avoid drug use. MPP was designed to eliminate gateway substance use in middle school students, to reduce the risk of delinquency along the lifespan.
The program was targeted at youths in the transitory period from early adolescence to middle adolescence, as this age presents a high risk for gateway drug use. The program was intended for use in a school-based setting for middle school students, specifically, sixth and seventh graders.
MPP disseminated an antidrug message to students through a system of well-coordinated, communitywide strategies that involved various areas that influence a middle school student’s life, including school, community, family, and mass media.
School. The central component for drug prevention programming is the school. The school component used active social learning techniques (modeling, role playing, and discussion, with student peer leaders assisting teachers). It was included in teachers’ curricula for middle school students and included homework that requires participation from parents in assignments.
Community/policy. A consistent message supporting a non–drug use norm was delivered through community organization and training, as well as through changes in local health policy regarding tobacco, alcohol, and other drugs. This component entailed training community leaders and government officials to plan prevention goals and strategies for implementation.
Parent. The parent education and organization component involved a parent–principal committee that met to review school drug policy and parent–child communications training, and was designed to occur within the school and the school neighborhood. This component was intended to motivate parents to participate in the furtherance of program goals.
Mass media. The mass media component was intended to promote the program’s antidrug message through various media, such as television, radio, and newspaper. Mass media programming was used to support the other components by introducing the program’s concepts to the entire community.
These components were introduced to the community in sequence at a rate of one a year, with the mass media component occurring throughout all the years. All components involved regular meetings of respective deliverers (for example, community leaders for organization) to review and refine programs. Overall, the interrelated components were intended to promote a comprehensive curriculum that disseminated a zero-tolerance attitude toward substance use. While the MPP was mainly school based, the program was designed to elicit participation from the community, schools, and family to promote a comprehensive approach to drug prevention. Therefore, proper implementation of the MPP curriculum required collaboration and effective communication between members from teachers, parents, principals, and student leaders. The MPP used a preventive approach to drug abuse, concentrating on the pressure that adolescents face regarding substance use. The program addressed the fact that adolescents ages 10 to 14 are highly susceptible to experimentation and peer pressure to use drugs and cigarettes, and that cigarette use during formative years can serve as a gateway to further drug use and delinquency. Also taking into account that school transition provides a critical risk period for smoking and risk behavior in youths, the program adopted a comprehensive school-based curriculum to prevent and reduce substance use in middle school students.
Project SUCCESS (Schools Using Coordinated Community Efforts to Strengthen Students) is designed to prevent and reduce substance use among students 12 to 18 years of age. The program was originally developed for students attending alternative high schools who are at high risk for substance use and abuse due to poor academic performance, truancy, discipline problems, negative attitudes toward school, and parental substance abuse. In recent years, Project SUCCESS has been used in regular middle and high schools for a broader range of high-risk students. The intervention includes four components: The Prevention Education Series (PES), an eight-session alcohol, tobacco, and other drug program conducted by Project SUCCESS counselors (local staff trained by the developers) who help students identify and resist pressures to use substances, correct misperceptions about the prevalence and acceptability of substance use, and understand the consequences of substance use. School-wide activities and promotional materials to increase the perception of the harm of substance use, positively change social norms about substance use, and increase enforcement of and compliance with school policies and community laws. A parent program that includes informational meetings, parent education, and the formation of a parent advisory committee. Individual and group counseling, in which the Project SUCCESS counselors conduct time-limited counseling for youth following their participation in the PES and an individual assessment. Students and parents who require more intensive counseling, treatment, or other services are referred to appropriate agencies or practitioners in the community.
Project Towards No Drug Abuse (Project TND) is a drug use prevention program for high school youth. The current version of the curriculum is designed to help students develop self-control and communication skills, acquire resources that help them resist drug use, improve decision-making strategies, and develop the motivation to not use drugs. It is packaged in 12 40-minute interactive sessions to be taught by teachers or health educators. The TND curriculum was developed for high-risk students in continuation or alternative high schools. It has also been tested among traditional high school students.
Project Towards No Tobacco Use (Project TNT) is a classroom-based curriculum that aims to prevent and reduce tobacco use, primarily among 6th- to 8th-grade students. The intervention was developed for a universal audience and has served students with a wide variety of risk factors. Designed to counteract multiple causes of tobacco use simultaneously, Project TNT is based on the theory that youth will be better able to resist tobacco use if they are aware of misleading information that facilitates tobacco use (e.g., pro-tobacco advertising, inflated estimates of the prevalence of tobacco use), have skills that counteract the social pressures to obtain approval by using tobacco, and appreciate the physical consequences of tobacco use.
Project TNT comprises 10 core lessons and 2 booster lessons, all 40-50 minutes in duration. The core lessons are designed to be taught over a 2-week period but may be spread out over as long as 4 weeks. Booster lessons, which are taught 1 year afterward, are intended to be delivered over 2 consecutive days but may be taught 1 week apart. The curriculum uses a wide variety of activities to encourage student involvement and participation. Activities include games, videos, role-plays, large and small group discussion, use of student worksheets, homework assignments, activism letter writing, and a videotaping project. The two-lesson booster program summarizes previously learned material and discusses how this material might be used in daily living.
Project Venture is an outdoor experiential youth development program designed primarily for 5th- to 8th-grade American Indian youth. It aims to develop the social and emotional competence that facilitates youths' resistance to alcohol, tobacco, and other drug use. Based on traditional American Indian values such as family, learning from the natural world, spiritual awareness, service to others, and respect, Project Venture's approach is positive and strengths based. The program is designed to foster the development of positive self-concept, effective social interaction skills, a community service ethic, an internal locus of control, and improved decision-making and problem-solving skills. The central components of the program include a minimum of 20 1-hour classroom-based activities, such as problem-solving games and initiatives, conducted across the school year; weekly after-school, weekend, and summer skill-building experiential and challenge activities, such as hiking and camping; 3- to 10-day immersion summer adventure camps and wilderness treks; and community-oriented service learning and service leadership projects throughout the year.
Promoting Alternative THinking Strategies (PATHS) and PATHS Preschool are school-based preventive interventions for children in elementary school or preschool. The interventions are designed to enhance areas of social-emotional development such as self-control, self-esteem, emotional awareness, social skills, friendships, and interpersonal problem-solving skills while reducing aggression and other behavior problems. Skill concepts are presented through direct instruction, discussion, modeling, storytelling, role-playing activities, and video presentations. The elementary school PATHS Curriculum is available in two units: the PATHS Turtle Unit for kindergarten and the PATHS Basic Kit for grades 1-6. The curriculum includes 131 20- to 30-minute lessons designed to be taught by regular classroom teachers approximately 3 times per week over the course of a school year. PATHS Preschool, an adaptation of PATHS for children 3 to 5 years old, is designed to be implemented over a 2-year period. Its lessons and activities highlight writing, reading, storytelling, singing, drawing, science, and math concepts and help students build the critical cognitive skills necessary for school readiness and academic success. The PATHS Preschool program can be integrated into existing learning environments and adapted to suit individual classroom needs.
Protecting You/Protecting Me (PY/PM) is a 5-year classroom-based alcohol use prevention and vehicle safety program for elementary school students in grades 1-5 (ages 6-11) and high school students in grades 11 and 12. The program aims to reduce alcohol-related injuries and death among children and youth due to underage alcohol use and riding in vehicles with drivers who are not alcohol free. PY/PM consists of a series of 40 science- and health-based lessons, with 8 lessons per year for grades 1-5. All lessons are correlated with educational achievement objectives. PY/PM lessons and activities focus on teaching children about (1) the brain--how it continues to develop throughout childhood and adolescence, what alcohol does to the developing brain, and why it is important for children to protect their brains; (2) vehicle safety, particularly what children can do to protect themselves if they have to ride with someone who is not alcohol free; and (3) life skills, including decision-making, stress management, media awareness, resistance strategies, and communication. Lessons are taught weekly and are 20-25 minutes or 45-50 minutes in duration, depending on the grade level. A variety of ownership activities promote students' ownership of the information and reinforces the skills taught during the lesson.
Parent take-home activities are offered for all 40 lessons. PY/PM's interactive and affective teaching processes include role-playing, small group and classroom discussions, reading, writing, storytelling, art, and music. The curriculum can be taught by school staff or prevention specialists. PY/PM also has a high school component for students in grades 11 and 12. The youth-led implementation model involves delivery of the PY/PM curriculum to elementary students by trained high school students who are enrolled in a peer mentoring, family and consumer science, or leadership course for credit. The program's benefits to high school students are derived from learning about the brain and how alcohol use can impact adolescents, serving as role models to the elementary school participants, and taking coursework in preparation for delivering the curriculum.
Increasing the legal age for purchase and consumption of alcohol to age 21 and therefore reduces alcohol sales, use, and problems among young people.
Reconnecting Youth: A Peer Group Approach to Building Life Skills (RY) is a school-based prevention program for students ages 14-19 years that teaches skills to build resiliency against risk factors and control early signs of substance abuse and emotional distress. RY targets youth who demonstrate poor school achievement and high potential for school dropout. Eligible students must have either (1) fewer than the average number of credits earned for all students in their grade level at their school, high absenteeism, and a significant drop in grades during the prior semester or (2) a record of dropping out of school. Potential participants are identified using a school's computer records or are referred by school personnel if they show signs of any of the above risk factors. Eligible students may show signs of multiple problem behaviors, such as substance abuse, aggression, depression, or suicidal ideation.
RY also incorporates several social support mechanisms for participating youth: social and school bonding activities to improve teens' relationships and increase their repertoire of safe, healthy activities; development of a crisis response plan detailing the school system's suicide prevention approaches; and parent involvement, including active parental consent for their teen's participation and ongoing support of their teen's RY goals.
The Red Cliff Wellness School Curriculum is a substance abuse prevention intervention based in Native American tradition and culture. Designed for grades K-12, the curriculum aims to reduce risk factors and enhance protective factors related to substance use, including school bonding, success in school, increased perception of risk from substances, and identification and internalization of culturally based values and norms. The Red Cliff program is taught by teachers who have been trained in interactive, cooperative learning techniques and facilitation. The manualized curriculum has separate components for grades K-3, 4-6, and 7-12. Each component includes 20-30 developmentally appropriate lessons and activities designed to enhance the values of sharing, respect, honesty, and kindness and to assist students in understanding their emotions. Small-group discussions (described as "talking circles" in Native American terms) are extensively used, along with small-group process activities, independent workbook activities, and collaborative projects for older students.
The school curriculum was created by the First American Prevention Center, an arm of the Red Cliff Band of Lake Superior Chippewa. The curriculum is part of a broader wellness initiative that includes a community curriculum and home wellness kit. The research reviewed in this summary involved only the elementary school component (grades 4-6) of the K-12 program.
The Residential Student Assistance Program (RSAP) is designed to prevent and reduce alcohol and other drug (AOD) use among high-risk multi-problem youth ages 12 to 18 years who have been placed voluntarily or involuntarily in a residential child care facility (e.g., foster care facility, treatment center for adolescents with mental health problems, juvenile correctional facility). Based on the Employee Assistance Program (EAP) model, the intervention focuses on wellness and addresses factors that hinder adolescents from being free from AOD use, such as emotional problems and mental disabilities, parental abuse and neglect, and parental substance abuse. The program is delivered in residential facilities by masters-level counselors who use a combination of strategies, including assessment of each youth entering the facility, an eight-session prevention education series, group and/or individual counseling for youth who have chemically dependent parents and/or are using substances, and referral to substance abuse treatment programs. These services are delivered over 20-24 weeks and are fully integrated into the adolescent's overall experience at the residential facility. The counselors also conduct facility-wide awareness activities, provide training and consultation on AOD prevention to facility staff, and lead a task force for staff and one for residents, both of which aim to change the facility's culture and norms around substance use and facilitate referrals to the program.
The focus of RBS programs is to prevent alcohol service to minor and intoxicated patrons and to intervene so intoxicated patrons do not drive. Efforts to promote RBS consist of the implementation of a combination of outlet policies (e.g., requiring clerks or servers to check identification for all customers appearing to be under the age of 30, cutting off service to intoxicated patrons, limiting sales of pitchers of alcohol, promoting alcohol-free drinks and food, and eliminating last call announcements) and training in their implementation (e.g., teaching clerks and servers to recognize altered or false identification, training servers to recognize intoxicated patrons and deny service). RBS can be implemented at both on-license (Saltz & Stanghetta, 1997) and off-license establishments (Grube, 1997). Voluntary programs appear to be less effective than mandatory pro- grams or programs using incentives such as reduced liability. How RBS is implemented and what elements are included in a particular program may be an important determinant of its effectiveness. Policy development and implementation within outlets may be more important than server training in determining RBS effectiveness. Overall, however, establishing definite alcohol serving policies in each licensed establishment has the potential to reduce sales of alcohol to youth and overall problematic consumption of alcohol.
This strategy involves restricting the flow of alcohol at parties and other events on and off college campuses to reduce overall social availability of alcohol. Policies for preventing underage access to alcohol at parties can also be used to decrease the amount of drinking among older students. Overlapping community policies include banning beer kegs and prohibiting home deliveries of large quantities of alcohol. Overlapping policies for campus events include limiting the quantity of alcohol per person and monitoring or serving alcohol rather than allowing self-service.
Regulation or restriction of “happy hours” and other price promotions of alcohol (e.g., two drinks for the price of one, women drink for free), especially in on-premise outlets (i.e., bars and restaurants). Although not specific to college populations, the study has clear implications for college students; many bars surrounding campuses attract students by promoting drink specials. Restrictions on happy hours can be implemented by individual outlets, campuses (if a licensed establishment is on campus), local communities (if communities are not preempted by state law) and the state. In non- licensed settings on campus where alcohol is served, event planners may want to limit the amount of free alcohol available.
Reward & Reminder, a population-level intervention targeting whole communities, counties, or States, is designed to promote the community norm of not selling tobacco to minors. By using rapid and public rewards and recognition for clerks and retailers/outlets that do not sell tobacco to minors, Reward & Reminder aims to reduce illegal sales of tobacco, perceived access to tobacco, and tobacco use prevalence rates. The intervention emerged from a contextual analysis of factors affecting the behavior of store clerks, retailers, and the tobacco industry overall. At the core of the program is the use of "mystery shoppers," teams of youth who--with parental permission and under the supervision of adults--enter stores and try to buy tobacco products. They provide immediate recognition and rewards, such as gift certificates, to clerks who do the "right thing" and give reminders to those who do not. The results of the mystery shopper visits are entered into a Web-based system where they are made publicly visible, and the results are communicated to local media to promote the positive norm. The mystery shopper visits are scheduled across the year to maximize the immediate and sustained impact.
Schools And Families Educating Children (SAFEChildren) is a family-focused preventive intervention designed to increase academic achievement and decrease risk for later drug abuse and associated problems such as aggression, school failure, and low social competence. SAFEChildren targets 1st-grade children and their families living in inner-city neighborhoods. The intervention has two components. The first component is a multiple-family group approach that focuses on parenting skills, family relationships, understanding and managing developmental and situational challenges, increasing parental support, skills and issues in engaging as a parent with the school, and managing issues such as neighborhood problems (e.g., violence). Families participate in 20 weekly sessions (2 to 2.5 hours each) led by a trained, professional family group leader. Each session includes a review of the previous week's homework, discussion about a focused topic, and in-session role-plays and activities. The second component is a reading tutoring program for the child. Tutoring is provided twice weekly (one 30-minute and one 20-minute session) over 20 weeks, using a modified version of the Wallach program. Each tutoring session involves segments on phonics, sound and word activities, and reading books.
Say It Straight (SIS) is a communication training program designed to help students and adults develop empowering communication skills and behaviors and increase self-awareness, self-efficacy, and personal and social responsibility. In turn, the program aims to reduce risky or destructive behaviors such as substance use, eating disorders, bullying, violence, precocious sexual behavior, and behaviors that can result in HIV infection. SIS began as a school-based program for use in grades 3-12. Its application has been expanded to include students in detention and treatment, student mentors and mentees, parents, high-risk communities, adults in treatment, college students, and the homeless.
SIS is based in social learning and positive psychology, emphasizing values such as resiliency, courage, compassion, and integrity. The change process in SIS begins with the recognition of one's own disempowering behaviors and leads to awareness of one's own deepest wishes to choose empowering behaviors for wellness. These changes lead from relationships of submission and dominance to relationships of equal value. Building on SIS's principle of "rooting diversity in sameness," participants learn to identify with others even when they may disagree or have differences with them. By using a technique called "body sculpting" and creating and acting in role-plays or "movies," they explore how they feel when they engage in empowering and disempowering communication/behavior. In body sculpting, the participants place their bodies in postures that intensify and make overt their internal experiences; for example, a begging posture can be used to represent placating. The movies enable participants to act out difficult interpersonal situations that are important in their lives (e.g., alcohol or drug abuse, drinking and driving, speeding, cheating, stealing, bullying, violence, vandalism, sexual behavior). Movies can be videotaped to give participants the opportunity to observe themselves. SIS also incorporates feedback, journaling, and small- and large-group discussion. Through these processes, participants learn that by empowering themselves, they gain respect and empower others.
School policies are formal regulations which provide for sanctions against youth for the possession of alcohol on school property. The penalties are usually a part of school policies which ban or provide restrictions for possession or provision of alcohol on school property. Many schools are adopting zero-tolerance policies. These policies mandate predetermined consequences or punishments for specific serious student infractions. The vast majority of elementary and secondary schools have alcohol-related policies and the majority of schools have adopted zero tolerance policies. When alcohol violations are detected, suspension and expulsion are the typical responses. However, it is presently unknown what effect, if any, school sanctions have on the prevalence of underage drinking either at the individual or school population levels, whether schools are an appropriate venue for addressing this behavior, or, when compared to other possible venues, whether schools are better, worse, or equally effective in deterring or modifying this behavior.
Although the research on the topic is limited, there are some inferences that can be drawn about efforts to deter underage drinking. For example, all states and a number of municipalities have some type of prohibition against youth drinking, although these prohibitions vary from state to state. The nature and severity of the sanctions associated with violations of these prohibitions vary consider- ably across jurisdictions. It is also apparent that for a variety of reasons, enforcement of these laws is relatively sporadic and inconsistent. In addition, although all schools in this country have an alcohol policy, these policies also vary considerably.
Second Step is a classroom-based social-skills program for children 4 to 14 years of age that teaches socio-emotional skills aimed at reducing impulsive and aggressive behavior while increasing social competence. The program builds on cognitive behavioral intervention models integrated with social learning theory, empathy research, and social information-processing theories. The program consists of in- school curricula, parent training, and skill development. Second Step teaches children to identify and understand their own and others' emotions, reduce impulsiveness and choose positive goals, and manage their emotional reactions and decision-making process when emotionally aroused. The curriculum is divided into two age groups: preschool through 5th grade (with 20 to 25 lessons per year) and 6th through 9th grade (with 15 lessons in year 1 and 8 lessons in the following 2 years). Each curriculum contains five teaching kits that build sequentially and cover empathy, impulse control, and anger management in developmentally and age-appropriate ways. Group decision-making, modeling, coaching, and practice are demonstrated in the Second Step lessons using interpersonal situations presented in photos or video format.
Sembrando Salud is a culturally sensitive, community-based tobacco- and alcohol-use prevention program specifically adapted for migrant Hispanic/Latino adolescents and their families. The program is designed to improve parent-child communication skills as a way of improving and maintaining healthy decisionmaking. Designed for youth 11 to 16 years of age, the 8-week curriculum for adolescents and their families is delivered by bilingual/bicultural college students in classrooms and meeting rooms in school-based settings.
The program interventions are a mix of interactive teaching methods including group discussions led by a leader, videos, demonstrations, skill practice, and role-playing. Adolescents are exposed to how problems can be identified and analyzed, solutions generated, and decisions made, implemented, and evaluated. There is also a focus on developing parental support for the healthy discussions and behaviors of adolescents through enhanced parent-child communications. Parental communication skills, such as listening, confirmation, and reassurance, also are developed.
The program develops new behavioral skills, such as refusing alcohol and tobacco offers, and communicating with peers and adults alike. Program Development Support The National Cancer Institute, U.S. Department of Health and Human Services, funded development of Sembrando Salud.
SMART Leaders is a 2-year booster program that follows from Stay SMART (for Skills, Mastery, And Resistance Training). Both are components of SMART Moves, a comprehensive drug and sexual activity prevention program offered through the Boys and Girls Clubs of America (BGCA). Stay SMART is a curriculum-based program for 13- to 15-year-olds that teaches a broad spectrum of social and personal competence skills to help youths identify and resist peer and other social pressures to smoke, drink, and engage in sexual activity. The program consists of 12 sessions: 1) gateway drugs, 2) decision-making, 3) advertising, 4) self-image and self-improvement, 5) coping with change, 6) coping with stress, 7) communication skills, 8) social skills: meeting and greeting people, 9) social skills: boy meets girl, 10) assertiveness, 11) relationships, and 12) life planning skills.
SMART Leaders reinforces the skills and knowledge learned during Stay SMART and encourages participants to stay involved in prevention activities and to be positive, drug-free role models for their peers. SMART Leaders I involves five small group sessions consisting of role-playing and videotapes about identifying different peer pressures to use drugs and engage in sexual activity and learning to resist those pressures. SMART Leaders II is taught in a three-session video format, with one session dedicated to resisting alcohol, one session to resisting drugs, and one to resisting early sexual activity. Participants are encouraged to become involved in other programs and activities at the BGCA and encourage their peers to be drug-free.
The traditional strategy for increasing perceived certainty of apprehension is to increase the frequency and visibility of drinking-and-driving enforcement, for example, by simply intensifying police enforcement in the form of short-term intensive checkpoints during holidays. Increasing the probability of arrest could translate into a higher perceived probability of detection and fewer accidents. At sobriety checkpoints, only motorists who are judged by police to have been drinking are asked to take a breath test. This approach greatly weakens the deterrent potential because experienced offenders believe (with some justification) that they can avoid detection.
The Social Competence Promotion Program for Young Adolescents (SCPP–YA) is a school prevention program that teaches students cognitive, behavioral, and affective skills and encourages them to apply these skills in dealing with daily challenges, problems, and decisions. The program targets African-American and white youths in middle and junior high schools.
The 45-session SCPP–YA has three modules. The first module includes 27 lessons of intensive instruction in social problem-solving (SPS) skills. Students are taught to 1) stop, calm down, and think before they act, 2) express the problem (aloud) and how they feel, 3) set a positive goal, 4) think of lots of solutions, 5) think ahead to the consequences, and 6) go ahead and try the best plan. These foundational lessons are followed by two nine-session programs that teach students to apply SPS skills to the prevention of substance abuse and high-risk sexual behavior. To foster the application and generalization of SPS concepts and skills to daily life, teachers are trained to model problem-solving to students in situations other than formal classroom lessons and to guide and encourage students to try out problem-solving strategies in school, at home, and in the community.
A local ordinance that establishes either a civil or criminal offense for a person who provides alcohol to persons under 21 years of age and enables law enforcement to cite the individual who hosted the party or who owns or controls the property where parties occur. These responsible individuals may include older peers, parents, landowners and tenants. These ordinances are specifically directed at adults who might dismiss the state laws concerning underage drinking, health- related warnings, insist on serving minors, host parties and/or look the other way when others host on their property. The intent is not to seek out and punish adults who are regularly monitoring their children and who take reasonable precautions to prevent their children from hosting underage parties.
A substantial portion of alcohol obtained by underage persons is from social sources (friends, parties, homes, etc.) and other persons who purchase alcohol and provide it to underage persons (both persons themselves under the legal purchase age and persons who themselves are of legal age). The Office of Juvenile Justice and Delinquency Prevention, U.S. Department of Justice, has created a guide for reducing alcohol access by youth (OJJDP, 1999). The highest priorities recommended by OJJDP is a compendium of environmental strategies including “shoulder taps” and compliance checks. Shoulder taps occur when an underage person asks another person to purchase alcohol on their behalf. These are common means by which adolescents obtain alcohol (e.g., Jones-Webb et al., 1997a, 1997b; Smart, Adlaf, & Walsh, 1996; Wagenaar et al., 1993, 1996), in part because young people believe it to be less risky than purchasing alcohol themselves. Underage persons themselves are breaking the law through this purchase, even if they do not consume the alcohol. Adults of legal purchase age are also breaking the law by purposefully purchasing alcohol for a young person. Shoulder tap interventions occur when an underage person or a person who appears to be underage age, stand outside a licensed alcohol outlet and approach an older person to request that he/she purchase alcohol for them. In such cases, the potential buyer may be offered a small “fee” for making this purchase. If the older person actually makes the alcohol purchase and gives it to the youth, then they can be arrested or cited by the police.
SPORT is a brief, multiple behavior program integrating substance abuse prevention and fitness promotion to help adolescents minimize and avoid substance use while increasing physical activity and other health-promoting habits. It is based on the Behavior-Image Model, which asserts that social and self-images are key motivators for the development of healthy behavior. The intervention promotes the benefits of an active lifestyle with positive images of youth as active and fit, and emphasizes that substance use is counterproductive in achieving positive image and behavior goals. SPORT involves a short, self-administered health behavior screen survey measuring physical activity and sport behaviors and norms, healthy nutrition, sleep, and alcohol use. Participants then receive a 10- to 12-minute personally tailored consultation from a written script, along with a key facts handout. A simple fitness prescription goal plan is completed by participants to motivate positive behavior and image change. In addition, parent/caregiver communication cards addressing key content are provided during the consultation and then sent or mailed home to adolescents for 3 to 5 consecutive weeks.
Start Taking Alcohol Risks Seriously (STARS) for Families is a health promotion program that aims to prevent or reduce alcohol use among middle school youth ages 11 to 14 years. The program is founded on the Multi-Component Motivational Stages (McMOS) prevention model, which is based on the stages of behavioral change found within the Transtheoretical Model of Change. The McMOS model posits a continuum of five stages in the initiation of alcohol use: pre-contemplation (has not tried alcohol in the past year), contemplation (is thinking about trying alcohol soon), preparation (is planning to start drinking soon), action (started drinking in the past 6 months), and maintenance (has been drinking for longer than 6 months). STARS for Families intervention materials are tailored to the individual's stage of alcohol use initiation. STARS for Families has three components. Youth who participate in the program receive brief individual consultations in school or in after- school programs about why and how to avoid alcohol use and they may also receive a follow-up consultation. These standardized sessions are provided by trained adults guided by protocols. A series of eight postcards are mailed to parents/guardians providing key facts about how to talk to their children about avoiding alcohol. In addition, the family completes four take-home lessons designed to enhance parent-child communication regarding prevention skills and knowledge. These three components can be implemented separately or in various combinations. In addition to its implementation in school and after-school settings, the program also has been used in health clinics, youth organizations, and homes.
One form of retail alcohol regulation retail outlets is for the government to monopolize ownership of one or more types. The idea of government ownership of alcohol sales outlets in the interest of public order or public health first arose around 1850. A government monopoly typically greatly reduced the number of outlets, limited the hours of operation for sales, and removed the private profit motive for increasing sales.
Stay on Track is a school-based substance abuse prevention curriculum conducted over a 3-year period with students in grades 6 through 8. The intervention is designed to help students assess the risks associated with substance abuse; enhance decision-making, goal-setting, communication, and resistance strategies; improve antidrug normative beliefs and attitudes; and reduce substance use. The program empowers youth by providing knowledge and life skills relevant to health-promoting behavior. Based on the health belief model and social development model, Stay on Track provides youth at each grade level with 12 45- to 50- minute lessons taught by classroom teachers. Motorsports is a motivational theme, with each lesson relating program objectives to professional racing activities and personalities. Special emphasis is given to tobacco, alcohol, club drugs, hallucinogens, prescription drugs, marijuana, and inhalants.
Storytelling for Empowerment is a school-based, bilingual (English and Spanish) intervention for teenagers at risk for substance abuse, HIV, and other problem behaviors due to living in impoverished communities with high availability of drugs and limited health care services. The program primarily targets Latino/Latina youth and uses cognitive decision-making, positive cultural identity (cultural empowerment), and resiliency models of prevention as its conceptual underpinnings. Storytelling for Empowerment aims to decrease alcohol, tobacco, and other drug (ATOD) use by identifying and reducing factors in the individual, family, school, peer group, neighborhood/community, and society/media that place youth at high risk for ATOD use, while enhancing factors that may strengthen youth resiliency and protect against ATOD use. The core components of the intervention include the Storytelling PowerBook and the Facilitator's Guide. The PowerBook is a series of activity workbooks that include the following sections: Knowledge Power: brain physiology, physical effects of drugs Skill Power: decision-making strategies, role-playing Personal Power: multicultural stories, symbol making Character Power: multicultural historical figures, character traits Culture Power: defining culture, bi-culture, subculture; cultural symbols Future Power: multicultural role models, choosing a role model, goal setting
Other available adaptations of the PowerBook include the (1) StoryBook for HIV, with sections on science, risk factors, relationships, and self-efficacy, and (2) Stories To Live or Die By: Inhalants, Meth, Ecstasy, which teaches facts and myths about methamphetamine, ecstasy, and club drugs.
The Strengthening Families Program (SFP) is a family skills training program designed to increase resilience and reduce risk factors for behavioral, emotional, academic, and social problems in children 3-16 years old. SFP comprises three life-skills courses delivered in 14 weekly, 2-hour sessions. The Parenting Skills sessions are designed to help parents learn to increase desired behaviors in children by using attention and rewards, clear communication, effective discipline, substance use education, problem solving, and limit setting. The Children's Life Skills sessions are designed to help children learn effective communication, understand their feelings, improve social and problem- solving skills, resist peer pressure, understand the consequences of substance use, and comply with parental rules. In the Family Life Skills sessions, families engage in structured family activities, practice therapeutic child play, conduct family meetings, learn communication skills, practice effective discipline, reinforce positive behaviors in each other, and plan family activities together. Participation in ongoing family support groups and booster sessions is encouraged to increase generalization and the use of skills learned.
The Strengthening Families Program: For Parents and Youth 10-14 (SFP 10-14) is a family skills training intervention designed to enhance school success and reduce youth substance use and aggression among 10- to 14-year-olds. It is theoretically based on several etiological and intervention models including the bio-psychosocial vulnerability, resiliency, and family process models. The program includes seven 2- hour sessions and four optional booster sessions in which parents and youth meet separately for instruction during the first hour and together for family activities during the second hour. The sessions provide instruction for parents on understanding the risk factors for substance use, enhancing parent-child bonding, monitoring compliance with parental guidelines and imposing appropriate consequences, managing anger and family conflict, and fostering positive child involvement in family tasks. Children receive instruction on resisting peer influences to use substances. Sessions, which are typically held once a week, can be taught effectively by a wide variety of staff.
Four authors contributed to the development of the Strengthening Multi-Ethnic Families and Communities Program: A Violence Prevention Parent Training Program in 1994, with updates to the program appearing in 1996 and 2005. Now, in 2011, the program has been restructured, re-formatted, and specific topics enhanced. Given the many changes and our commitment to presenting information from a "strengthening perspective" as opposed to a "deficit model", the program has also been renamed: Strengthening Multi-Ethnic Families and Communities: A Parent Program Promoting Peace.
The Strengthening Multi-Ethnic Families and Communities Program is a strength-based prevention-intervention program for parents with children between 3 and 18 years of age. The curriculum is structured into an Orientation Session and twelve weekly 3-hour sessions and promotes parent and child self-esteem, self-discipline, and social competency skills. Facilitators are required to participate in an intensive Five-Day Facilitator Training Workshop (English Language or Spanish Language).
The program goal is to reduce drug/alcohol use, teen suicide, juvenile delinquency, gang involvement, child abuse and domestic violence. Short term objectives are to increase parent sense of competence, positive family/parent/child interactions, positive parent/child relationships, child self-esteem and self-discipline, child social competency skills and increased parental involvement in community activities. Parent training classes have been held at a variety of locations: churches, schools, community agencies and other locations. The program consists of twelve 3-hour sessions taught in consecutive weeks. The curriculum includes five major components: Cultural/Spiritual Focus; Rites of Passage; Positive Discipline; Enhancing Relationships; and Community Involvement. Parent materials are available in English, Spanish, Vietnamese, Korean, Chinese, English UK, Russian, and Somali. Facilitator manuals are available in English and Spanish.
A pre- post test design has been used to evaluate over 3000 parents. Results show significant improvements in parent sense of competence, family/parent/child interactions, and child competence and behavior. Participation in the program had a direct impact on increasing parent involvement in the areas of "Community Activities", "Political Issues" and "School Involvement". Reports indicate that the program helps with child rearing challenges, encourages family bonding, promotes pride in cultural heritage, supports community bonding and reduces life-threatening risks for children.
Information is presented within a "cultural framework" to promote parent and child self-esteem, self-discipline and social competence. The program utilizes a number of different teaching strategies, including a facilitative-discussion model to raise parent level of consciousness by encouraging parent discussion. Information is presented in five component topic areas: Cultural-Spiritual, Enhancing Relationships, Positive Discipline, Ten Rites of Passage, and Community Involvement.
Team Awareness is a customizable worksite prevention training program that addresses behavioral risks associated with substance abuse among employees, their coworkers, and, indirectly, their families. The training seeks to promote social health and increased communication between workers; improve knowledge about and attitudes toward alcohol- and drug-related protective factors in the workplace, such as company policy and Employee Assistance Programs (EAPs); and increase peer referral behaviors. To achieve these objectives, the training focuses on six components: the importance of substance abuse prevention; team ownership of policy (embracing policy as a useful tool for enhancing safety and well-being for the whole workgroup); stress, including stressors, individual coping styles, and other methods for coping; tolerance and how it can become a risk factor for groups; the importance of appropriate help-seeking and help-giving behavior; and access to resources for preventive counseling or treatment (e.g., EAPs, local community resources, 12-step programs, wellness programs). Training is highly interactive and includes group discussions, videos, role-playing, quizzes, games, communication exercises, and optional homework assignments.
The primary goal of tobacco-free environmental policies is to create environments that do not expose youth to the use and possession of tobacco.
Research demonstrates that tobacco use and exposure to secondhand tobacco smoke is a threat to health. Policies restricting the use of tobacco in schools and other environments should reduce adolescents’ exposure to secondhand tobacco smoke and limit places where they can use tobacco and thus reduce the health risks associated with tobacco use and secondhand smoke.
Too Good for Drugs (TGFD) is a school-based prevention program for kindergarten through 12th grade that builds on students' resiliency by teaching them how to be socially competent and autonomous problem solvers. The program is designed to benefit everyone in the school by providing needed education in social and emotional competencies and by reducing risk factors and building protective factors that affect students in these age groups. TGFD focuses on developing personal and interpersonal skills to resist peer pressures, goal setting, decision-making, bonding with others, having respect for self and others, managing emotions, effective communication, and social interactions. The program also provides information about the negative consequences of drug use and the benefits of a nonviolent, drug- free lifestyle. TGFD has developmentally appropriate curricula for each grade level through 8th grade, with a separate high school curriculum for students in grades 9 through 12. The K-8 curricula each include 10 weekly, 30- to 60-minute lessons, and the high school curriculum includes 14 weekly, 1-hour lessons plus 12 1-hour "infusion" lessons designed to incorporate and reinforce skills taught in the core curriculum through academic infusion in subject areas such as English, social studies, and science/health. Ideally, implementation begins with all school personnel (e.g., teachers, secretaries, janitors) participating in a 10-hour staff development program, which can be implemented either as a series of 1-hour sessions or as a 1- or 2-day workshop.
Wellness Outreach at Work provides comprehensive risk reduction services to workplace employees, offering cardiovascular and cancer risk screening and personalized follow-up health coaching that addresses alcohol and tobacco use. Wellness Outreach at Work begins with outreach to all employees through voluntary, worksite-wide health risk screening, including biometric measures of health status, delivered as near to workstations as is practical. The screening directs employees' attention to health issues and to their own health risks and provides baseline information about the health risks of the total workforce. The screening takes approximately 20 minutes per employee and includes immediate feedback on health risks and first steps that might improve them. After the screening, employees are triaged for follow-up based on the number and severity of the health risks identified. Within the context of personalized, one-on-one coaching for cardiovascular health improvement and cancer risk, wellness coaches provide employees with education and counseling on alcohol use, tobacco use, weight control, and health management.
Lower blood alcohol concentration (BAC) limits for underage drivers and/or a risk of loss of license when an underage youth has been found to be drinking, even if the youth was not driving. Usually this limit is set at the minimum that can be reliably detected by breath-testing equipment (i.e., .01-.02 BACs). Zero-tolerance laws also commonly invoke other penalties such as automatic license revocation.