Primary Prevention in Adolescent Substance Abuse

Kumpfer K.L., Pinyuchon M., de Melo A.T., Whiteside H.O.

The Strengthening Families Program (SFP) is an evidence-based family skills training intervention developed and found efficacious for substance abuse prevention by U.S researchers in the 1980s. In the 1990s, a cultural adaptation process was developed to transport SFP for effectiveness trials with diverse populations (African, Hispanic, Asian, Pacific Islander, and Native American). Since 2003, SFP has been culturally adapted for use in 17 countries. This article reviews the SFP theory and research and a recommended cultural adaptation process. Challenges in international dissemination of evidence-based programs (EBPs) are discussed based on the results of U.N. and U.S. governmental initiatives to transport EBP family interventions to developing countries. The technology transfer and quality assurance system are described, including the language translation and cultural adaptation process for materials development, staff training, and on-site and online Web-based supervision and technical assistance and evaluation services to assure quality implementation and process evaluation feedback for improvements.

Spoth R.L., Greenberg M.T.

This article articulates joint priorities for the fields of prevention science and community psychology. These priorities are intended to address issues raised by the frequent observation of natural tensions between community practitioners and scientists. The first priority is to expand the knowledge base on practitioner-scientist partnerships, particularly on factors associated with positive outcomes within communities. To further articulate this priority, the paper first discusses the rapid growth in community-based partnerships and the emergent research on them. Next described is an illustrative research project on a partnership model that links state university extension and public school delivery systems. The article then turns to the second, related priority of future capacity-building for diffusion of effective partnership-based interventions to achieve larger-scale health and well-being across communities. It outlines two salient tasks: clarification of a conceptual framework and the formulation of a comprehensive capacity-building strategy for diffusion. The comprehensive strategy would require careful attention to the expansion of networks of effective partnerships, partnership-based research agendas, and requisite policy-making.

Streke A., Roona M., Marshall D.

This entry examines what research can tell us about school-based and family-based programs for children 5–12 years old related to the use of alcohol, tobacco, and other drugs (ATOD). Our purpose is not to provide an exhaustive review but to evaluate effectiveness of these two different types of programs to prevent the use of ATOD in childhood.

Tadmor C.S.

For the last 20 years, a novel crisis intervention model has been successfully implemented by physicians and nurses in a general hospital setting for populations at risk to develop emotional impairment. This preventive intervention model is directed at the prevention of emotional dysfunction for a population free of psychiatric symptomatology. This model, known as the Perceived Personal Control (PPC) Crisis Intervention Model, has been empirically verified (Tadmor, 1983; Tadmor & Brandes, 1984; Tadmor, Brandes, & Hofman, 1987), and is designed to serve as a generic, preventive intervention model to be implemented by professional caregivers to populations at high risk of encountering emotional dysfunction in the fields of medicine, education, and the military.

Spoth R.L., Guyll M., Day S.X.

Tobler N.S., Roona M.R., Ochshorn P., Marshall D.G., Streke A.V., Stackpole K.M.

This paper reports on a meta-analysis of 207 universal school-based drug prevention programs that compared the self-reported drug use of treatment to control or comparison youth. Programs are classified into Interactive and Non-Interactive groups based on a combination of content and delivery method. Weighted categorical and weighted regression methods have been used to determine the attributes that most effectively reduce, delay, or prevent drug use, including program size, type of control group and leader, attrition, target drug, intensity, grade, special population and level of drug use. Program type and size are found to be significant predictors of effectiveness. Non-interactive lecture-oriented prevention programs that stress drug knowledge or affective development show small effects. Interactive programs that foster development of interpersonal skills show significantly greater effects that decrease with large-scale implementations.

Gullotta T.P.

This paper discusses primary prevention's basic tenets and generic principles. It describes its essential elements and explains how prevention's technology of education, social competency, community organization/systems intervention, and natural caregiving can be used to prevent dysfunctional behaviors while promoting healthy lifestyles.

Werner E.E.

AbstractThis article summarizes the major findings of a longitudinal study that traced the developmental paths of a multiracial cohort of children who had been exposed to perinatal stress, chronic poverty, and a family environment troubled by chronic discord and parental psychopathology. Individuals are members of the Kauai Longitudinal Study, which followed all children born in 1955 on a Hawaiian island from the perinatal period to ages 1, 2, 10, 18, and 32 years. Several clusters of protective factors and processes were identified that enabled most of these high-risk individuals to become competent and caring adults. Implications of the findings for developmental theory and social action programs are discussed, and issues for future research are identified.

Werner E.E., Smith R.S.

Schinke S.P., Gilchrist L.D.

Sixth-grade students (N = 56) were assigned randomly to one of four experimental conditions: pretest and primary prevention; primary prevention; pretest; and neither pretest nor primary prevention. In eight group sessions, primary prevention students learned facts, problem solving, decision making, self-instructions and interpersonal skills to help keep them from using tobacco. All students completed posttests and a six-month follow-up. Compared with untrained controls, trained students had greater knowledge of smoking, more perspectives on tobacco problems, better linkages between problems and solutions, more insights on the consequences of nonsmoking decisions and greater nonverbal and verbal competence in tobacco use situations. Follow-up data showed trained students with stronger commitments to tobacco abstinence, more frequent refusals of tobacco, and less smoking than controls. Midway through seventh grade, 8% of trained students and 37.5% of controls had smoked in the most recent month.

Albee G.W.

The problem of defining mental disorders is examined and models to explain emotional disturbances are considered. Arguments against a sickness explanation are advanced, and definitions of mental health are reviewed. All of these concerns lead into a discussion of primary prevention. Sources of opposition to prevention efforts include those persons committed to organic models, to one-to-one intervention, and those who oppose social change efforts as inappropriate for mental health workers. An agenda for community change is proposed.

Leukefeld C.G., McDonald H.M., Stoops W.W., Reed L., Martin C.

Adolescent substance misuse and abuse have been the changing focus of the popular press in the United States and the general public since the late 1970s. In fact, it was in the late 1970s when the United States first became aware of the widespread use of alcohol and drugs among adolescents in the general population. The high levels of drug and alcohol use were reported by the national Monitoring the Future Study. Although the overall rates of alcohol and drug misuse and abuse have changed over time and decreased from the highest levels in the late 1970s, substance misuse and abuse continue to be problems among U.S. adolescents.

Sexton T.L., Gilman L., Johnson—Erickson C.

The last decade has witnessed a dramatic change in the landscape of treatment and prevention programs for adolescents and their families. There is now a wide range of treatment and prevention program choices for service providers and communities hoping to impact at-risk youth positively. Of the prevention and treatment program options currently available, there are a growing number rooted in both clinical trial and community-based outcome research. Other programs also have strong process research that identifies the critical and central mechanism(s) of change that result in successful outcomes. These outcomes have been identified not just by model developers, but as a result of a number of systematic efforts to scrutinize carefully the scientific evidence to ensure that programs work, the outcomes last, and that these outcomes are replicable in local communities (Elliott, 1998; U.S. Public Health Service, 2001, etc). Over the last five years, many evidence-based programs have been successfully implemented in local communities and some across entire statewide systems of care with impressive results (Barnoski, 2004).