Drug Abuse Prevention

Research Findings from May, 2004 Director's Report

This section lists selected summaries from NIDA funded research projects that investigate youth drug abuse prevention. The summaries provided were selected from recent issues of the Director's Report to the National Advisory Council on Drug Abuse. For a more comprehensive listing of NIDA funded projects see the Director's Report.

The Deterrence Hypothesis Reexamined: Sports Participation and Substance Use Among Young Adults

The widely held notion that sports participation reduces subsequent risk of substance use is evaluated with longitudinal survey data of a representative sample of 1,172 youth when they were in their preteen and young adult years. Unlike previous inquiries into the deterrence hypothesis, the present study controls for other major factors previously found to be predictive of alcohol and drug use, such as family structure and stress exposure. Results of analyses revealed that contrary to the deterrence hypothesis, playing high school sports does not appear to be a protective factor that lowers one's involvement in young adult alcohol or drug use--with one exception. Subgroup analyses revealed that among blacks, the greater the extent of high school sports participation the less the risk of substance use. In direct contradiction to the deterrence hypothesis, playing high school sports was found to be positively associated with alcohol use for whites, even in the context of other major predictors of alcohol use. Further analyses revealed that the positive association between sports participation and alcohol use appeared to exist only for white males. These findings cast doubt about the contention that playing high school sports is protective against alcohol and illegal substance use. Eitle, D., Turner, R.J. and Eitle, T.M. The Deterrence Hypothesis Reexamined: Sports Participation and Substance Use Among Young Adults. Journal of Drug Issues, 33, pp. 193-222, 2003.

Evaluation of the National Youth Anti-Drug Media Campaign: 2003 Report of Findings

The National Youth Anti-Drug Media Campaign (NYAMC) was funded by the Congress to reduce and prevent drug use among young people both directly, by addressing youth and indirectly, by encouraging their parents and other adults to take actions known to affect youth drug use. The major intervention components include television, radio, and other advertising, complemented by public relations efforts including community outreach and institutional partnerships. The goals of the evaluation are to determine: 1) if there is change in the behaviors, attitudes and beliefs targeted by the Campaign and 2) determine if such change can be attributed to the Campaign. The findings summarized below are from the fifth Evaluation report; the first three waves of data collection involved enrolling nationally representative samples of about 8,100 youth from 9 to 18 and 5,600 of their parents. The 2003 report includes the second (of three) follow-up interviews of the initial samples. The new report covers the period from September 1999 through June 2003. For the youth component of the Campaign, the Report focuses on evidence concerning the possible effects of the Marijuana Initiative that began in late fall 2002 and refocused the Campaign to emphasize marijuana use among youth. The report examines 1) exposure of youth and their parents to anti-drug messages (general exposure and specific exposure to ads run in the 2 months prior to the interview that are played on a computer to respondents); 2) effects on parents in terms of beliefs and behaviors associated with talking about drugs, and beliefs and behaviors regarding monitoring their child, and doing fun activities with their child; and 3) effects on youth cognitions, intentions, and initiation of marijuana use.

• Recall of Campaign Messages:
  As in the 5th Report, most parents and youth recalled exposure to Campaign anti-drug messages. About 70 percent of parents and nearly 80 percent of youth report exposure to one or more messages through all media channels every week. Recall of TV advertising has climbed across the 3.5 years of the Campaign. In 2000, 24 percent of parents and 37 percent of youth recalled weekly exposure to specific TV ads; in 2002, before the Marijuana Initiative, recall among parents reached 51 percent and among youth reached 52 percent; in 2003, after the launch of the Marijuana Initiative recall rates had moved to 58 percent and 76 percent respectively. Both parents and youth also reported substantial recognition of the Campaign's "anti-drug" brand phrases. The 2003 youth component of the Campaign focused on strong marijuana Negative Consequences ads; they were evaluated positively by youth at a level comparable to most of the previous ads.

• Effects on Parents:
  There continues to be evidence suggesting a favorable Campaign effect on parents. Overall, there are favorable changes on 4 of 5 parent belief and behavior outcome measures including talking about drugs with their children, doing fun activities with children and beliefs about monitoring of children. Evidence for Campaign effects on parents' monitoring behavior was much weaker. Lack of influence on monitoring behavior is a concern because it has been the focus of the parent Campaign for the past several years and is the parent behavior most strongly associated with youth nonuse of marijuana. In addition, there is no evidence for favorable indirect effects on youth behavior or beliefs as the result of parent exposure to the Campaign.

• Effects on Youth:
  There is little evidence of direct favorable Campaign effects on youth, either for the Marijuana Initiative period or for the Campaign as a whole. The trend data in marijuana use is not favorable and for the (new) primary target audience, 14- to 16-year olds, past year use increased from 2000 through 2003, although the increase was already in place prior to the start of the Marijuana Initiative. However, an independent source of trend information, the Monitoring the Future Study, showed a decline in use for some age groups. In any case, youth who were more exposed to Campaign messages are no more likely to hold favorable beliefs or intentions about marijuana than are youth less exposed to those messages, both during the Marijuana Initiative period and over the entire course of the Campaign.

Because the Marijuana Initiative began just before the final wave of data collection, it is not possible to supplement the same-time comparisons of exposure and outcomes with delayed-effects comparisons of Marijuana Initiative exposure with later outcomes. These delayed-effects analyses will be examined in the final report planned for December, 2004.

Effectiveness of the Coping Power Program and of Classroom Intervention with Aggressive Children at One-Year Follow-Up

This study examines key substance use, delinquency, and school-based aggressive behavior outcomes at a 1-year follow-up for a cognitive-behavioral intervention delivered to aggressive children and their parents at the time of these children's transition to middle school. This effectiveness study explored whether a classroom intervention directed at teachers and at all of the parents in the intervention classrooms enhanced the effects of the Coping Power program with at-risk children. The at-risk sample of boys and girls was identified through 4th-grade teacher ratings, and intervention took place during the 5th- and 6th-grade years. The Coping Power child component included school-based groups focusing on anger management and social problem solving skills, and the Coping Power parent component addressed parenting and stress-management skills. The current results indicate that prior findings of post-intervention improvement for this sample (Lochman & Wells, 2002b) has led to preventive effects on delinquency and on substance use for older and moderate-risk children. The Coping Power program, in conjunction with a classroom-level intervention, also reduced school aggression one year after the intervention was completed. In addition, it appears that the classroom intervention facilitates radiating effects on reduced substance use for other at-risk children in the same classrooms who did not receive Coping Power. Lochman, J.E. and Wells, K.C., Effectiveness of the Coping Power Program and of Classroom Intervention with Aggressive Children at One-Year Follow-Up. Behavior Therapy, 34(4), pp. 493-515, 2003.

Reasons for Teachers' Adaptation of Prevention Curricula for Non-White Students

There is increasing evidence to suggest that the adaptation of classroom-based prevention curricula in the nation's middle schools is widespread. This study investigated the reasons for teachers' adaptation of prevention curricula. A randomly selected sample of nationally representative lead middle school substance abuse prevention teachers from 50 states and the District of Columbia answered questions concerning eight student problems or needs (i.e., poverty; violence; gang activity; discipline problems; sexual activity; various racial/cultural groups; special needs/disabilities; student and parent substance use) that were hypothesized to constitute reasons for curriculum adaptation. Controlling for a variety of school and teacher characteristics, teachers in high minority schools were more likely to adapt curricula in response to three of the eight characteristics presented (i.e., youth violence; limited English proficiency; and various racial/ethnic or cultural groups within classroom). It is suggested that curriculum developers make a systematic effort to understand how teachers are adapting their curricula in high minority schools and incorporate these modifications, if found effective, into their curricula. Ringwalt, C.L., Vincus, A., Ennett, S., Johnson, R., and Rohrbach, L.A. Reasons for Teachers' Adaptation of Substance Use Prevention Curricula in Schools With Non-While Student Populations. Prevention Science, 5(1), pp. 61-67, 2004. Preventing Early Onset Substance Use by Parental Monitoring The Family Check-Up (FCU) is a brief family-centered intervention focused on family management practices. Within the context of a randomly assigned multilevel family intervention, high-risk youth and families (n = 71) were selected for videotaped home observation that includes a task to assess parent monitoring. Parents in the intervention group were offered annual feedback on the yearly assessment, including their home observation. Using an intention-to-treat design, analyses revealed intervention effects on early-adolescent substance use and observed parent monitoring by the first year of high school (Year 4 of follow-up). As in previous research, parents of high-risk adolescents were observed to decrease monitoring from Grades 7 to 9. However, families randomly assigned to the family intervention maintained their monitoring practices. Regression analyses revealed the prevention effect of the FCU on substance use was mediated by changes in parental monitoring. Dishion, T.J. Nelson, S.E. and Kavanagh, K. The Family Check-Up with High-Risk Young Adolescents: Preventing Early Onset Substance Use by Parent Monitoring. Behavior Therapy, 34, pp. 553-571, 2003.

Monetary Incentives Increase Community-Based Prevention Participation Rates

This investigation was designed to examine the influence of a research incentive ($100) and requirement (videotaping) on decisions to participate in prevention research. The participants were 685 parents of 6th graders from 36 rural Iowa schools who completed a telephone survey prospectively assessing factors relevant to their participation in a prevention intervention research project. The parents were later recruited for actual participation in the project. Individuals were significantly attracted by the incentive and marginally deterred by the requirement. Interaction analyses revealed that the positive incentive effect was stronger among prospective participants with less education and who were otherwise less likely to participate. These findings indicate that monetary incentives can be useful for increasing participation rates and may help reduce sampling bias by increasing rates most strongly among individuals who are typically less likely to take part in research projects. Guyll, M., Spoth, R., and Redmond, C. The Effects of Incentives and Research Requirements on Participation Rates for a Community-Based Preventive Intervention Research Study. The Journal of Primary Prevention, 24, pp. 25-41, 2003.

Familism, Parental Monitoring & Knowledge as Predictors of Adolescent Drug Use

The authors investigated relationships between marijuana and inhalant use and measures of familism, parental monitoring, drug use knowledge and acculturation as well as demographic factors in 1,094 Anglo and Hispanic youth from 5 school districts in southwest Arizona. Outcome measures addressed lifetime and 30-day marijuana and inhalant use. Hispanics exhibited higher use across all measures. Among Hispanic youth, high acculturation was associated with low marijuana but high inhalant use. In both Hispanics and Anglos positive family relations and parental monitoring were strongly associated with reduced marijuana use but only among youth most knowledgeable about drugs. Familism and monitoring were not associated with diminished use among the less knowledgeable. For inhalants, monitoring combined with high knowledge or with high familism was associated with attenuated use. The role of knowledge in reducing drug use suggests continuing to disseminate factual material. Prevention strategies also should incorporate a family component to inform parents and open lines of communication. Ramirez, J.R., Crano, W.D., Quist, R. Burgoon, M., Alvaro, E.M. and Grandpre, J. Acculturation, Familism, Parental Monitoring, and Knowledge as Predictors of Marijuana and Inhalant Use in Adolescents. Psychology of Addictive Behaviors. 18(1), pp. 3-11, March 2004.

Preventive Interventions for Externalizing Disorders in Adolescents

Adolescent externalizing dimensions refer to the cluster of highly co-occurring behaviors and disorders that include conduct disorders, oppositional defiant disorders, Attention Deficit Hyperactivity Disorder, substance use disorders and-more recent to the literature-problem gambling. Externalizing disorders are likely influenced by several personal (e.g., personality, attitudes, values) and environmental (e.g., peers, parenting practices, intervention or treatment experiences) factors. The emerging discipline of developmental psychopathology provides a conceptual framework that is applicable to the study of the etiology, prevention and intervention of externalizing disorders of youth. Developmental psychopathology is a macroparadigm, which emphasizes the contrast between typical and atypical development. This conceptualization allows for qualitative changes in functioning over time, and the influence by mediator and moderator variables at varying developmental stages from adolescence to young adulthood. In the past, preventive interventions for youth with externalizing disorders, many of which have focused on substance abuse, were designed as one-size-fits-all. The disappointing results have drawn attention to the complexity and multiplicity of the risk factors involved. In order to prevent the onset, maintenance and course of externalizing behaviors among adolescents, a prevention framework must include strategies crafted to respond to the unique risk profiles of various subgroups of the population. Consequently, prevention efforts that are initiated early in a child's life, adjusted with emerging developmental tasks and sustained over time, are the best possible tools available today. Winters, K.C., August, G.E., and Leitten, W. Preventive Interventions for Externalizing Disorders in Adolescents. In D. Rowe (Ed.), Reducing Adolescent Risk: Toward An Integrated Approach. Newbury Park, CA: Sage Press, 2003.