Evaluations of school-based substance abuse prevention programs with schools or school districts randomly assigned to either the treatment or control condition have demonstrated effective strategies over the past 30 years. Although control schools were never considered "pure" (i.e., no other interventions were being offered), school-based programming in the 1980s did not include evidence-based interventions. Since the late 1990s, funding agencies have required schools either to select programming from approved lists of prevention strategies or to demonstrate the efficacy of the strategies that would be used. This has increased the number of schools delivering evidence-based programs to their students. As a result, "treatment as usual" is more challenging to researchers. This paper describes exposure to prevention programming as reported by 204 school administrators from 83 districts and their 19,200 students who are participating in the Adolescent Substance Abuse Prevention Study, a national randomized evaluation trial of the program, Take Charge of Your Life. In order to determine the extent of student exposure to prevention programming in both the control and treatment schools, data were collected in each of the 5 years of the study from two sources: principals and prevention coordinators and from students. The data provided by the principals and prevention coordinators indicate that the vast majority of schools assigned to the control condition offered students drug prevention programming. This finding has implications for the evaluation of Take Charge of Your Life but also for other evaluation studies. The students were asked questions regarding participation in drug education posed on annual surveys. When their responses were compared to the reports from their school principals and prevention coordinators, it was found that the students underreported exposure to drug education. A follow-up qualitative study of a sample of students suggests the need for rewording of the questions for students in future studies. The implications of our findings for evaluation studies are discussed.

While researchers have developed more effective programs and strategies to prevent the initiation of substance use and increasingly communities are delivering these interventions, determining the degree to which they are delivered as they were designed remains a significant research challenge. In the past several years, more attention has been given to implementation issues during the various stages of program development and diffusion. This paper presents the findings from a substudy of an evaluation of a newly designed middle and high school substance abuse prevention program, Take Charge of Your Life delivered by local Drug Abuse Resistance Education officer instructors. A key aspect of the study was to determine the extent to which implementation fidelity, using the measures of content coverage and appropriate instructional strategy, was associated with improvement in the program mediators of realistic normative beliefs, understanding the harmful effects of substance use and the acquisition of decision-making and resistance skills. Although it was found that higher fidelity was associated with better scores on some of the mediators, this was not a consistent finding. The mixed results are discussed within the context of the lesson activities themselves.

There is still much that we do not know about the effects of international migration on mental health, but we know even less about the mental health consequences of rural‐to‐urban migration. This may be particularly important in developing countries where the health of internal migrating populations may affect economic development. We use a large representative sample of adults residing in Kathmandu, Nepal to investigate the utility of a stress process model for understanding the mental health effects of rural‐to‐urban migration. Because our sample contains both migrants and non‐migrants, we are able to compare the importance of stressors common to all urban dwellers and those specific to migrants (i.e. acculturation stressors) as they affect the well‐being of urban residents. Results show that acculturation‐related stressors and social support problems are less salient for explaining distress and mental health symptoms than common stressors and social support problems. Migrants do face more chronic stressors, have more social support problems and report higher levels of distress and symptoms. We speculate that this has more to do with the social inequality that results from migration than with specific migration‐related stressors or loss of social resources. Copyright © 2010 John Wiley & Sons, Ltd.

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