This prospective study examined the relation between 308 adolescents' images of typical dinkers and nondrinkers and their subsequent alcohol consumption. The results indicate that both images are associated with changes in consumption between ages 16 and 18 but that they operate in different ways. Contrary to previous assumptions, drinker images do not represent goal states for adolescents in that they are more negative than their self-images and nondrinker images and are not correlated with their ideal selves. In contrast, nondrinker images do appear to represent goal states for adolescents who abstain from drinking. Implications for intervention are discussed.

This study evaluated the substance initiation effects of an intervention combining family and school-based competency-training intervention components. Thirty-six rural schools were randomly assigned to 1 of 3 conditions: (a) the classroom-based Life Skills Training (LST) and the Strengthening Families Program: For Parents and Children 10-14, (b) LST only, or (c) a control condition. Outcomes were examined 1 year after the intervention posttest, using a substance initiation index (SII) measuring lifetime use of alcohol, cigarettes, and marijuana and by rates of each individual substance. Planned intervention-control contrasts showed significant effects for both the combined and LST-only interventions on the SII and on marijuana initiation. Relative reduction rates for alcohol initiation were 30.0% for the combined intervention and 4.1% for LST only.

This article reports adolescent substance use outcomes of universal family and school preventive interventions 5½ years past baseline. Participants were 1677 7th grade students from schools (N = 36) randomly assigned to the school-based Life Skills Training plus the Strengthening Families Program: For Parents and Youth 10-14 (LST + SFP 10-14), LST-alone, or a control condition. Selfreports were collected at baseline, 6 months later following the interventions, then yearly through the 12th grade. Measures included initiation-alcohol, cigarette, marijuana, and drunkenness, along with a Substance Initiation Index (SII)-and measures of more serious use-frequency of alcohol, cigarette, and marijuana use, drunkenness frequency, monthly poly-substance use, and advanced poly-substance use. Analyses ruled out differential attrition. For all substance initiation outcomes, one or both intervention groups showed significant, positive point-in-time differences at 12th grade and/or significant growth trajectory outcomes when compared with the control group. Although no main effects for the more serious substance use outcomes were observed, a higher-risk subsample demonstrated significant, positive 12th grade point-in-time and/or growth trajectory outcomes for one or both intervention groups on all measures. The observed pattern of results likely reflects a combination of predispositions of the higher-risk subsample, the timing of the interventions, and baseline differences between experimental conditions favoring the control group.

In this article, the authors examine whether delayed substance initiation during adolescence, achieved through universal family-focused interventions conducted in middle school, can reduce problematic substance use during young adulthood. Sixth-grade students enrolled in 33 rural midwestern schools and their families were randomly assigned to 3 experimental conditions. Self-report questionnaires provided data at 7 time points for the Iowa Strengthening Families Program (ISFP), Preparing for the Drug Free Years (PDFY), and control groups through young adulthood. Five young adult substance frequency measures (drunkenness, alcohol-related problems, cigarettes, illicit drugs, and polysubstance use) were modeled as distal outcomes affected by the average level and rate of increase in substance initiation across the adolescent years in latent growth curve analyses. Results show that the models fit the data and that they were robust across outcomes and interventions, with more robust effects found for ISFP. The addition of direct intervention effects on young adult outcomes was not supported, suggesting long-term effects were primarily indirect. Relative reduction rates were calculated to quantify intervention-control differences on the estimated proportion of young adults indicating problematic substance use; they ranged from 19% to 31% for ISFP and from 9% to 16% for PDFY. Keywordsuniversal family-focused prevention; adolescent substance use; mediation of long-term outcomes; young adult substance useIn this article, we examine whether universal family-focused interventions conducted during sixth grade can reduce problematic substance use during young adulthood through their impact on adolescent substance initiation. Epidemiological data highlight how problematic or serious types of substance use often are more prevalent in young adulthood than in earlier developmental stages (Johnston, O'Malley, Bachman, & Schulenberg, 2007 Administration, 2007). The consequences of problematic adult substance use include less competent functioning and lower educational and occupational attainment (Ackerman, Zuroff, & Moskowitz, 2000), risky sexual practices (Park, Mulye, Adams, Brindis, & Irwin, 2007), mental health problems (Windle & Windle, 2001), adult crime (Kosterman, Graham, Hawkins, Catalano, & Herrenkohl, 2001), and increased mortality (Park et al., 2007).Many of the risk and protective factors for adolescent substance misuse originate in the family environment (Hawkins, Catalano, & Miller, 1992;Wood, Read, Mitchell, & Brand, 2004). These include parental monitoring, consistent discipline, clear communication about rules and expectations, and parent-child affection and warmth. For this reason, family-focused preventive interventions designed to reduce substance use among elementary and middle school age children have been developed. Reviews of the literature on family-focused intervention reveal a number of effective strategies (see Alexander, Robbins, & Sexton, 2000;Lochman & van den Steenhoven, 2002;Spoth, 2008;Sp...

Objectives Examine long-term prescription drug misuse outcomes from three RCTs of brief universal preventive interventions conducted during middle school. Methods Study 1 tested the Iowa Strengthening Families Program (ISFP); 22 schools participated, with pretesting at grade 6 (1993) and outcomes measured at age 25. Study 2 evaluated a revised ISFP, renamed Strengthening Families Program: For Parents and Youth 10–14—SFP 10–14, plus the school-based Life Skills Training (SFP 10–14 + LST); 24 schools participated, with pretesting at grade 7 (1998) and outcomes at ages 21–25. Study 3 examined SFP 10–14 plus one of three school-based interventions selected from a menu (SFP 10–14 + School Program); 28 schools participated, with pretesting at grade 6 (2002) and outcomes at 12th grade. Self-reported outcomes were Prescription Opioid Misuse (POM) and Lifetime Prescription Drug Misuse Overall (PDMO). Results Study 1: ISFP showed significant effects on POM and PDMO, Relative Reduction Rates (RRRs) of 65%, and comparable benefits for higher- and lower-risk subgroups. Study 2: SFP 10–14 + LST showed significant or marginally-significant effects on POM/PDMO across all ages; higher-risk participants showed stronger effects (RRRs 43–79%). Study 3: significant results were found for POM/PDMO (RRRs 20–21%); higher-risk and lower-risk participants showed comparable outcomes. Conclusions Brief universal interventions have potential for public health impact by reducing prescription drug misuse among adolescents and young adults.

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Considering the prevalence and consequences of health-risking sexual behaviors (HRSBs) and STDs among young adults, their prevention is a public health priority. Emerging etiological and prevention outcome literatures suggested study of the long-term effects of universal family-focused interventions on young adult HRSBs and STDs. Although earlier studies have demonstrated intervention impact on adolescent substance misuse, no study has examined universal family-focused intervention effects on young adult HRSBs and STDs via reductions in adolescent misuse. Sixth grade students and their families enrolled in 33 rural Midwestern schools were randomly assigned to experimental conditions. Self-report questionnaires provided data at pretest (Ns=238, 221, and 208 for the Iowa Strengthening Families Program [ISFP], Preparing for the Drug Free Years [PDFY], and control groups, respectively), with seven data points through young adulthood (age 21). In latent growth modeling, three young adult HRSB measures (number of sexual partners, condom use, substance use with sex) and lifetime STDs were specified as distal outcomes mediated by adolescent substance initiation growth factors (average level and rate of change). Results showed that the models fit the data and, except for condom use, there were significant indirect effects, with a higher frequency of significant findings for ISFP. The model additions of direct intervention effects on young adult outcomes generally were not supported, consistent with a model positing that long-term intervention effects on young adult HRSBs and STDs outcomes are indirect. As an indication of the practical significance of long-term effects, analyses revealed relative reduction rates ranging from 6 % to 46 % for significant outcomes.

Consistent with intervention effects on other substance use outcomes reported earlier, results suggest that universal interventions have potential for pubic health impact by reducing some types of prescription drug misuse among adolescents and young adults.