Longitudinal substance initiation outcomes for a universal preventive intervention combining family and school programs.

Abstract

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.

Substance use outcomes 5½ years past baseline for partnership-based, family-school preventive interventions

“…Analyses conducted in this and an earlier intervention trial have found minimal significant relationships between fidelity and outcome variables (Spoth et al, 2002), likely due to the generally high level of implementation quality and its limited variability. In this vein, the earlier report describes factors related to how the community-university partnership-based implementation (e.g., selection of implementers and their training) likely played a major role in the consistently high quality implementation.…”

“…An examination of nonidentical but parallel items from the in-home and in-school questionnaires through 9th grade conducted by Azevedo et al (2003) suggested that students may tend to underreport levels of substance use during interviews conducted in their home (despite the presence of an interviewer to protect confidentiality); it was not unusual for reporting level differences at pretesting to be more than 50% lower for data collected in the home (reporting differences tended to decline over the time frame evaluated, but remained substantial at the 9th grade assessment). These findings, in conjunction with the smaller in-home sample size, led us to focus on the data collected through the in-school surveys for this and the two previously published outcome studies (Spoth et al, 2002. Work continues toward arriving at definitive conclusions about setting effects in our and similar studies.…”

“…Earlier reports on study results through the 9th grade supported hypotheses that students in both intervention conditions would demonstrate significantly lower substance initiation than the control condition students at 1½ years and 2½ years past baseline (Spoth et al, 2002. In addition, when the students were in 9th grade, the latter study found significantly lower levels of monthly alcohol use and weekly drunkenness for the LST + SFP 10-14 combined intervention students relative to the control group, as well as significant intervention-control differences for the LST-only condition on weekly drunkenness.…”

“…Observers' assessments varied by an average of 2.6% for the family sessions, 3.4% for the parent sessions, and 2.5% for the youth sessions. As noted earlier, prior study of community-university partnership-based program implementation has shown consistently high levels of implementation quality and, related to those findings, limited evidence of implementation quality-outcome relationships (Spoth et al, 2002). In addition, dose-effect relationships have been examined for an earlier version of the family intervention (Spoth et al, 1999), with the conclusion that the limited dosage effects observed in initial follow-up assessments tended to dissipate as the years past intervention increased.…”

“…This research shows that a developmental window of opportunity exists to intervene with general population adolescents who have not yet initiated or have recently initiated substance use; substantial public health benefits might be gained if appropriately-timed interventions are applied to delay onset or, following initiation, to delay transition to more serious use (Anthony, 2003). Moreover, with data collected through participants' senior year of high school, more serious and problematic substance use attained a sufficiently high frequency to examine intervention-control differences on these outcomes, as projected in earlier reports (Spoth et al, 2002. Accordingly, the current study not only addressed the preventive interventions' effects on delaying initiation of substance use through 5½ years past baseline, but also examined more serious and problematic substance involvement (namely, frequency of alcohol, cigarettes, and marijuana use, as well as drunkenness; monthly poly-substance use [alcohol, cigarettes, and marijuana]; and more advanced poly-substance use).…”