Public reporting burden for the collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to a penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. The survey is the eighth in a series of DoD surveys conducted since 1980 and has three broad aims: (a) to continue the survey of substance use among active-duty military personnel, (b) to assess progress toward selected Healthy People 2000 objectives for active-duty military personnel, and (c) to provide baseline data regarding progress toward selected Healthy People 2010 objectives for active-duty military personnel. As such, it provides comprehensive and detailed estimates of the prevalence of alcohol, illicit drug, and tobacco use and the negative effects of alcohol use. In combination with data from the prior surveys in the series, it provides data for trends. It also provides estimates for health behaviors pertaining to fitness and cardiovascular disease risk reduction, injuries and injury prevention, and sexually transmitted disease risk reduction. In addition, it offers an assessment of the mental health of military personnel, including stress and depression, and examines oral health and dental check-ups, gambling behaviors, and special gender-specific health issues pertaining to women's and men's health. REPORT DATE OCT 20032Many individuals contributed to the success of this study. Among DoD and military Services personnel, special appreciation is due to Ms. Kim Frazier, Lieutenant Colonel Michael Hartzell, Lieutenant Colonel Tom Williams, and Dr. Michael Peterson, the Cooperative Agreement Officer's Representatives, who provided valuable guidance and facilitated conduct of the study. Excellent liaison between DoD, RTI, and the Services was provided by Colonel Regina Curtis for the Army, Mr. Linden Butler and Mr. William Flannery for the Navy, Lieutenant Danisha Robbins and Mr. Cruz Martinez for the Marine Corps, and Dr. Paul DiTullio and Mr. Charlie Hamilton for the Air Force. We also gratefully acknowledge the efforts of Mr. Robert Hamilton, Ms. Carole Massey, and Ms. Sue Reinhold of the Defense Manpower Data Center for constructing the installation-level sampling frame, selecting the sample of military personnel, and relaying current military population counts used for the analysis weights. The cooperation of installation commanders, both for the pilot test and the main survey, and the assista...

Teachers' fidelity of implementation of substance use prevention curricula is widely considered desirable and is linked empirically to effectiveness. The authors examine factors pertinent to teachers' fidelity to curricula guides, using data from a nationally representative sample of 1,905 lead substance use prevention teachers in the nation's public and private schools. Findings suggest that about one-fifth of teachers of substance use prevention curricula did not use a curriculum guide at all, whereas only 15% reported they followed one very closely. Positively associated with adherence were teachers' discretion in their coverage of prevention lessons, beliefs concerning the effectiveness of the most recent training they received and the curricula they taught, and level of support they received from their principals for substance use prevention. The authors conclude that some degree of curriculum adaptation is inevitable and suggest how adherence to curricula guides may be improved through teacher training.

Public reporting burden for the collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to a penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. The survey is the eighth in a series of DoD surveys conducted since 1980 and has three broad aims: (a) to continue the survey of substance use among active-duty military personnel, (b) to assess progress toward selected Healthy People 2000 objectives for active-duty military personnel, and (c) to provide baseline data regarding progress toward selected Healthy People 2010 objectives for active-duty military personnel. As such, it provides comprehensive and detailed estimates of the prevalence of alcohol, illicit drug, and tobacco use and the negative effects of alcohol use. In combination with data from the prior surveys in the series, it provides data for trends. It also provides estimates for health behaviors pertaining to fitness and cardiovascular disease risk reduction, injuries and injury prevention, and sexually transmitted disease risk reduction. In addition, it offers an assessment of the mental health of military personnel, including stress and depression, and examines oral health and dental check-ups, gambling behaviors, and special gender-specific health issues pertaining to women's and men's health. REPORT DATE OCT 20032Many individuals contributed to the success of this study. Among DoD and military Services personnel, special appreciation is due to Ms. Kim Frazier, Lieutenant Colonel Michael Hartzell, Lieutenant Colonel Tom Williams, and Dr. Michael Peterson, the Cooperative Agreement Officer's Representatives, who provided valuable guidance and facilitated conduct of the study. Excellent liaison between DoD, RTI, and the Services was provided by Colonel Regina Curtis for the Army, Mr. Linden Butler and Mr. William Flannery for the Navy, Lieutenant Danisha Robbins and Mr. Cruz Martinez for the Marine Corps, and Dr. Paul DiTullio and Mr. Charlie Hamilton for the Air Force. We also gratefully acknowledge the efforts of Mr. Robert Hamilton, Ms. Carole Massey, and Ms. Sue Reinhold of the Defense Manpower Data Center for constructing the installation-level sampling frame, selecting the sample of military personnel, and relaying current military population counts used for the analysis weights. The cooperation of installation commanders, both for the pilot test and the main survey, and the assista...

Transforming natural helpers into lay health advisors (LHAs) is a complex undertaking. Using the North Carolina Breast Cancer Screening Program (NC-BCSP) as a case study, this article describes the steps involved in developing, implementing, and evaluating an LHA intervention, considering factors that make the LHA approach appropriate for the NC-BCSP's population, setting, and health focus. The authors review five phases of implementation (start-up, training, LHA activities, follow-up, resource mobilization) and discuss the NC-BCSP's evaluation strategies and tools in light of difficulties involved in assessing natural helping processes and impact. Program challenges related to resource needs, identification of natural helpers, and LHA monitoring and support also are considered. The authors describe ways in which one large group of older, rural, African American LHAs are helping establish countywide partnerships between health care providers, agencies, and local communities that support and sustain individual changes in health behavior.

Despite a substantial proportion of high school students who initiate substance use following middle school, the implementation of universal evidence-based prevention curricula appears to be scant. We report data collected in 2005 from 1392 school-district based drug prevention coordinators, from a national, representative study of school-based substance use prevention practices. Altogether, 10.3% of districts that included high school grades reported administering one of six such curricula that were then rated as effective by the Substance Abuse and Mental Health Services Administration’s National Registry of Effective Programs and Practices or Blueprints for Violence Prevention, and 5.7% reported that they used one of these curricula the most. Only 56.5% of the nation’s districts with high school grades administered any substance use prevention programming in at least one of their constituent high schools.

This paper examines factors associated with the adoption of evidence-based substance use prevention curricula (EBC) in a national sample of school districts. Substance abuse prevention coordinators in public school districts (n = 1593), which were affiliated with a random sample of schools that served students in Grades 5-8, completed a written survey in 1999. Results indicated that 47.5% of districts used at least one EBC in their schools with middle school grades. Substance use prevention coordinators reported they had the greatest input in decisions about curricula. In a multivariate analysis of factors positively associated with district-level decisions to adopt evidence-based programs, significant factors included input from a state substance use prevention group, use of information disseminated by the National Institute on Drug Abuse or Center for Substance Abuse Prevention, use of local needs assessment data, consideration of research showing which curricula are effective and allocation of a greater proportion of the coordinator's time to substance use prevention activities. State and federal agencies should increase their efforts to disseminate information about evidence-based programs, targeting in particular the district substance use prevention coordinator.

In this study we investigate reasons why teachers adapt substance use prevention curricula in the nation's middle schools. We hypothesize that these reasons will be most salient in schools with racially and ethnically diverse student populations, for whom teachers may believe it appropriate to tailor their curricula. The study sample comprised a nationally representative sample of lead substance use prevention teachers in the nation's middle schools. Respondents answered questions concerning eight student problems or needs that constituted reasons why they might adapt their prevention lessons. Controlling for a variety of school and teacher characteristics, we found that teachers in high minority schools were more likely to adapt curricula in response to three of the eight characteristics presented: youth violence, limited English proficiency, and various racial/ethnic or cultural groups. We suggest 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.

Since the promulgation of its Principles of Effectiveness in 1998, the Office of Safe and Drug-Free Schools of the U.S. Department of Education has promoted the use of evidence-based drug prevention programs in the nation’s schools. We report the results of a survey, conducted in 2005, of a nationally representative sample of 1,721 schools with middle school grades. Respondents comprised the staff member in the school identified as most knowledgeable about the school’s drug prevention programs. The total response rate was 78%. Respondents answered questions concerning which drug use prevention curricula they used, and, if they used more than one, which one they used the most frequently. Three federally-sponsored registries were used to specify which curricula were considered evidence-based. Findings from 2005 were then compared to earlier estimates based on a similar 1999 survey. We found that 42.6% of the nation’s schools with middle school grades were using an evidence-based curriculum, an increase of 8% from our 1999 estimate. The two most prevalent curricula in use, at 19% each, were Life Skills Training and Project ALERT. We note, however, that only 8% of Life Skills Training users and 9% of Project ALERT users reported using those curricula the most, and that only 23% of respondents overall reported that they used an evidence-based curriculum the most. More information is needed as to why over three-quarters of the nation’s schools with middle school grades continue to administer curricula that have not been identified as effective.