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Guide
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Adolescent Alcohol Prevention Trial
OVERVIEW
The Adolescent Alcohol Prevention Trial (AAPT) is a school-based drug prevention program that uses different methods of social psychology-based strategies. The program gives students behavioral skills and knowledge to prevent the onset of substance use. Two of the strategies incorporated in the program were particularly successful. The Resistance Skills Training (RT) and the Normative Education Strategy (NORM) are reported to impact students’ beliefs about alcohol and drugs as well as their knowledge of resistance skills. The Normative Education Strategy was also proven to predict and help reduce subsequent substance use and abuse. When evaluating for alcohol, marijuana and tobacco use, those students receiving the combined NORM/RT and the NORM classes reported significantly lower incidence rates of substance use.
Target population: The program is administered in fifth grade, and a booster program is given in the seventh grade.
AAPT incorporates several social psychology-based strategies to prevent the onset of drug use in adolescents. One of these strategies is Resistance Skills Training (RT). RT teaches adolescents behavioral skills for refusing drug offers. The second strategy is a Normative Education Strategy (NORM), which focuses on correcting false perceptions about the prevalence of drug use. Finally, the Information About Consequences of Use (ICU) component provides adolescents information about the social and health consequences on drug use. Each strategy uses lessons taught in the classroom.
The researchers hypothesized that students who receive RT will have better outcomes than students who do not. They also hypothesized that students who receive NORM will have lower drug use than students who do not. Finally the researchers hypothesized that students who received NORM will believe that drug use is less acceptable and consequently participation will be predictive of actual drug use.
The researchers measured outcomes at pre-test when students were in fifth grade, at post-test in seventh grade, and at post-test in eighth grade. Outcomes were measured using a variety of instruments. To measure drug use, alcohol use, cigarette use, and marijuana use indices were used asking students to report their level of use. Resistance skills were measured using a behavioral assessment, where the student was observed and rated by peers, adults, and self on his or her response to a role-play of a persistent offer of alcohol. Finally, beliefs about alcohol and drug use were measured using questionnaires and written scenarios.
Results: Results of the study indicate that Resistance Skill Training (RT) impacts beliefs about alcohol and drug use and resistance skills, however it did not have an impact in reducing actual alcohol and drug use. NORM had an impact on beliefs about alcohol and drugs, resistance skills, as well as alcohol, smoking, and marijuana use. NORM was also found to predict subsequent adolescent substance use. Overall, RT was effective at increasing resistance skills and NORM was effective at strengthening beliefs about alcohol and drug use and reducing the prevalence of drug and alcohol use. Adolescents with the lowest prevalence estimates were those who received a combination of Resistance Skills Training and Normative Education. The researchers stated that teaching resistance skills along with changing beliefs about alcohol and drug use was an effective method of reducing drug use.
The evaluation notes several limitations to its findings. The first limitation is that only self-report was used to measure outcomes. The second limitation which is noted is that students who missed the booster or failed to provide 8th grade data were not included in analyses. The final admitted limitation is that the external validity of the study is questionable because probability sampling was not used to select schools and consequently it is unclear if findings can be generalized to American adolescents or even adolescents in Los Angeles and San Diego Counties, where the study was conducted.
STUDY 2: Hansen, W.B., & Graham, J.W. (1991). Preventing alcohol, marijuana, and cigarette use among adolescents: Peer pressure resistance training versus establishing conservative norms. Preventive Medicine, 20, 414-430.
Evaluated Population: Participants consisted of 2,416 seventh grade students in 12 junior high schools in Los Angeles and Orange counties; FL. Participants were randomly assigned into one of four intervention groups. One group received ICU. A second group received RT. A third group received NORM and a final group received NORM, ICU, and RT.
Approach: Participants were pre-tested prior to the start of the program in seventh grade and then post-tested after the end of the program in eighth grade (the 1987 and 1988 school years). Measures consisted of a questionnaire that assessed participants use of marijuana, alcohol, and cigarettes in their life and recently (e.g., last 30 days, last 7 days). The questionnaire also asked about whether participants had discipline problems at school or had engaged in violent/destructive behavior in the past month.
Results: Results of the study indicate that participants in the NORM group reported significantly lower use of alcohol, marijuana, and cigarettes than participants who did not receive NORM. For example, at pretest the reported prevalence of weekly alcohol use among students was 4.5 percent. Students receiving the NORM program reported an increase in weekly alcohol use of 2.8 percent versus a 5.1 percent increase among those not receiving NORM. Rates of reported marijuana use were similar. NORM classes reported a 2.2 percent increase in rates of marijuana use between pre and posttest whereas non-NORM classes reported an increase as high as 6.2 percent. Cigarette consumption also followed this trend with NORM students reporting consistently lower smoking rates than those who did not receive NORM classes. The NORM and RT combined intervention was most effective in preventing onset of marijuana and cigarette use. Overall, there were no significant outcomes when using only Resistance Skill Training. The researchers concluded that it is important to establish conservative behavioral norms in preventing drug use.
STUDY 3: Taylor, B. J., Graham, J. W., Cumsille, P., & Hansen, W. B. (2000). Modeling prevention program effects on growth in substance use: Analysis of five years of data from the adolescent alcohol prevention trial. Prevention Science, 1(4), 183-197.
Evaluated Population: Participants consisted of 3,027 Los Angeles area 7th grade students that completed participation in 11th grade. The sample was included 47 percent white, 28 percent Hispanic, 16 percent Asian, and 2.5 percent black. Males and females were nearly equal.
Approach: Students were randomly assigned to AART program components (Norm, ICU, RT, or COMB) by school. The ICU group acted as the control.
Results: Norm had an association with a decrease in lifetime and recent cigarette smoking, lifetime and recent alcohol use, and lifetime drunkenness. It also had a beneficial impact on substance use. The growth rate of drug use for the Norm group was significantly slower than the control group. The Norm program also was associated with a change in the trajectory of alcohol use, from an initially high and decelerating rate to a constant, almost linear trend over time.
Donaldson, S.I., Graham, J.W., & Hansen, W.B. (1994). Testing the generalizability of intervening mechanism theories: Understanding the effects of adolescent drug use prevention interventions. Journal of Behavioral Medicine, 17(2), 195-216.
Hansen, W.B., & Graham, J.W. (1991). Preventing alcohol, marijuana, and cigarette use among adolescents: Peer pressure resistance training versus establishing conservative norms. Preventive Medicine, 20, 414-430.
Taylor, B. J., Graham, J. W., Cumsille, P., & Hansen, W. B. (2000). Modeling prevention program effects on growth in substance use: Analysis of five years of data from the adolescent alcohol prevention trial. Prevention Science, 1(4), 183-197.
Program categorized in this guide according to the following:
Evaluated participant ages: Fifth grade students at pre-test/ Program age ranges in the Guide: 6-11, 12-14
Program components: school-based
Measured outcomes: physical health, behavioral problems, life skills
Program information last updated 7/14/2006.
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© Child Trends 2003 |