1995JAMARequires access

Long-term Follow-up Results of a Randomized Drug Abuse Prevention Trial in a White Middle-class Population

Gilbert J. Botvin

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Abstract

OBJECTIVE: To evaluate the long-term efficacy of a school-based approach to drug abuse prevention. DESIGN: Randomized trial involving 56 public schools that received the prevention program with annual provider training workshops and ongoing consultation, the prevention program with videotaped training and no consultation, or "treatment as usual" (ie, controls). Follow-up data were collected 6 years after baseline using school, telephone, and mailed surveys. PARTICIPANTS: A total of 3597 predominantly white, 12th-grade students who represented 60.41% of the initial seventh-grade sample. INTERVENTION: Consisted of 15 classes in seventh grade, 10 booster sessions in eighth grade, and five booster sessions in ninth grade, and taught general "life skills" and skills for resisting social influences to use drugs. MEASURES: Six tobacco, alcohol, and marijuana use self-report scales were recorded to create nine dichotomous drug use outcome variables and eight polydrug use variables. RESULTS: Significant reductions in both drug and polydrug use were found for the two groups that received the prevention program relative to controls. The strongest effects were produced for individuals who received a reasonably complete version of the intervention--there were up to 44% fewer drug users and 66% fewer polydrug (tobacco, alcohol, and marijuana) users. CONCLUSIONS: Drug abuse prevention programs conducted during junior high school can produce meaningful and durable reductions in tobacco, alcohol, and marijuana use if they (1) teach a combination of social resistance skills and general life skills, (2) are properly implemented, and (3) include at least 2 years of booster sessions.

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OBJECTIVE: To evaluate the long-term efficacy of a school-based approach to drug abuse prevention. DESIGN: Randomized trial involving 56 public schools that received the prevention program with annual provider training workshops and ongoing consultation, the prevention program with videotaped training and no consultation, or "treatment as usual" (ie, controls). Follow-up data were collected 6 years after baseline using school, telephone, and mailed surveys. PARTICIPANTS: A total of 3597 predominantly white, 12th-grade students who represented 60.41% of the initial seventh-grade sample. INTERVENTION: Consisted of 15 classes in seventh grade, 10 booster sessions in eighth grade, and five booster sessions in ninth grade, and taught general "life skills" and skills for resisting social influences to use drugs. MEASURES: Six tobacco, alcohol, and marijuana use self-report scales were recorded to create nine dichotomous drug use outcome variables and eight polydrug use variables. RESULTS: Significant reductions in both drug and polydrug use were found for the two groups that received the prevention program relative to controls. The strongest effects were produced for individuals who received a reasonably complete version of the intervention--there were up to 44% fewer drug users and 66% fewer polydrug (tobacco, alcohol, and marijuana) users. CONCLUSIONS: Drug abuse prevention programs conducted during junior high school can produce meaningful and durable reductions in tobacco, alcohol, and marijuana use if they (1) teach a combination of social resistance skills and general life skills, (2) are properly implemented, and (3) include at least 2 years of booster sessions.

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Available abstract

OBJECTIVE: To evaluate the long-term efficacy of a school-based approach to drug abuse prevention. DESIGN: Randomized trial involving 56 public schools that received the prevention program with annual provider training workshops and ongoing consultation, the prevention program with videotaped training and no consultation, or "treatment as usual" (ie, controls). Follow-up data were collected 6 years after baseline using school, telephone, and mailed surveys. PARTICIPANTS: A total of 3597 predominantly white, 12th-grade students who represented 60.41% of the initial seventh-grade sample. INTERVENTION: Consisted of 15 classes in seventh grade, 10 booster sessions in eighth grade, and five booster sessions in ninth grade, and taught general "life skills" and skills for resisting social influences to use drugs. MEASURES: Six tobacco, alcohol, and marijuana use self-report scales were recorded to create nine dichotomous drug use outcome variables and eight polydrug use variables. RESULTS: Significant reductions in both drug and polydrug use were found for the two groups that received the prevention program relative to controls. The strongest effects were produced for individuals who received a reasonably complete version of the intervention--there were up to 44% fewer drug users and 66% fewer polydrug (tobacco, alcohol, and marijuana) users. CONCLUSIONS: Drug abuse prevention programs conducted during junior high school can produce meaningful and durable reductions in tobacco, alcohol, and marijuana use if they (1) teach a combination of social resistance skills and general life skills, (2) are properly implemented, and (3) include at least 2 years of booster sessions.

Key concepts: Medicine, Randomized controlled trial, Substance abuse, Substance abuse prevention, Population, Alcohol abuse, Intervention (counseling), Family medicine

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