LIONS-QUEST SKILLS FOR ADOLESCENCE (SFA)

OVERVIEW

LionsQuest Skills for Adolescence (SFA) is a comprehensive life skills and drug prevention curriculum for children in grades 6-8 that is designed to prevent and deter alcohol and drug use, bullying and violence, and academic failure. Using strategies such as team teaching, service learning, and interactive, student-focused lessons, the program teaches character development, anger management, communication, decision making, and conflict and stress management Three randomized-controlled evaluations of the program have been conducted. The first study (a study of intermediate outcomes) found that the program was effective in delaying or preventing initiation to cigarette and marijuana smoking. The program was also effective in reducing the progression to more advanced drug and alcohol use. The second study found that the program decreased the rate of recent cigarette use, at the one-year post-test, among students who did not report recent cigarette use at baseline. Among baseline non-users, program impacts on reducing recent and lifetime alcohol use were found for Hispanics students but not for non-Hispanic students. Among baseline users, the program delayed sixth graders who reported using alcohol at baseline from progressing to smoking cigarettes by the end of the year and delayed baseline binge drinkers from progressing to marijuana use. Finally, a mediation study found improvements in adolescents’ self-reported capacity to refuse alcohol and marijuana, but not on behavioral intentions for using drugs, the perceived drug use of peers, or on the perceived harm of using drugs.

DESCRIPTION OF PROGRAM

Target population: Middle school children (6^th to 8^th grades)

LionsQuest Skills for Adolescence (SFA) is a classroom-based, 40-session drug prevention program that is implemented with adolescents in grades 6 through 8. and based on social influence and social-cognitive approaches to substance abuse prevention. Prior to the beginning of the intervention, select teachers attend a three-day workshop conducted by certified trainers. During this training, they learn how to effectively deliver the SFA curriculum and become familiar with various classroom data collection requirements and procedures.

There are seven units in the SFA curriculum which include: building self-esteem and personal responsibility, managing emotions, making better decisions, resisting social influences, increasing drug knowledge, improving peer relationships, strengthening family bonds, and life goals setting. Each 35-40 minute session begins with a quotation and discussion period about the quotation. This discussion period is followed by a 10-minute, teacher-led presentation which introduces the skill for the day. After the presentation, students work individually or cooperatively for approximately 10-30 minutes, to practice the new skill. Closure questions are then asked by the teacher to help students analyze what happened in the session. The students are then given a practice assignment and are expected to write a notebook entry which is a reflection of the skills they worked on for that day.

EVALUATION(S) OF PROGRAM

Study 1: Eisen, M. (2002). Intermediate outcomes from a life skills education program with a media literacy component. In Crano, W. D. & Burgoon, M. (Eds.) Mass media and drug prevention: Classic and contemporary theories and research, 187-214. Mahwah, NJ: Lawrence Erlbaum.

Evaluated population: The sample consisted of 6,239 sixth-grade students from 34 schools that were recruited via a cluster-randomized sampling design. The race/ethnicity composition was 34% Hispanic, 26% White, 18% African American, 7% Asian American, and 15% other. About two-thirds of the sample lived with both parents/guardians, one-fourth lived only with their mothers, and about one-tenth had some other living arrangement (with father only or with neither parent). Most parents (79%) had attained a college or graduate degree. The sample was 52% female and a majority of children (96.2%) were ages 11 or 12.

Approach: School districts and middle schools were recruited via a two-stage cluster sampling plan. In the first stage, four metropolitan areas with a large population size were randomly selected for a list of 10 areas, lists of all public schools meeting certain eligibility criteria were generated for each of the public school districts within these areas that had at least four middle schools during the 1996-1997 academic year. Only non-SFA middle schools (grades 6-8 or grades 7-9) with enrollment exceeding 200 students were eligible. To participate in the study, schools had to agree to accept the results of randomization, complete data collection activities, and implement at least 40 sessions of the curriculum. Out of the eligible population of 10,035 students, 71% (7,426) of the students received active parental consent for program participation. Within this group, those with post-test data (84%; N=6,239) were included in the analytic sample.

The study utilized a pre-test/post-test experimental design. The 34 middle schools were pair-matched based on prevalence of recent substance use within the past 30 days. Schools were then randomly assigned to SFA program or a control condition which received the usual drug education programming conducted by the school. Follow up data were collected one-year after program completion. Classrooms were observed by research staff to insure program fidelity. Surveys were administered to classrooms annually from the sixth through the eighth grade, by trained interviewers. Spanish versions of the survey were available to students if needed.

Self-report items were used to assess the incidence and prevalence of tobacco, alcohol, marijuana, and other illicit substances. In addition, items on binge drinking were included. Items also assessed the following factors considered to play a role in adolescent drug use: (a) behavioral intentions to use drugs; (b) perceptions of peers’ drug use; (c) judgments of drugs’ harmful effects; (d) demographic factors; and (e) psychosocial factors. Pre-test and post-test changes in drug use were analyzed separately for baseline users and nonusers to determine whether program impacts varied by baseline status. Analyses corrected for clustering due to random assignment at the school level.

Results: At baseline, approximately 9.5% of sixth-graders had used alcohol in the past month, 3.5% have smoked cigarettes, 3.0% had smoked marijuana, 1.1% had used cocaine or crack, and 2.3% had used some other illicit drug. At follow-up, students in the SFA program who were non-users of drugs and alcohol at baseline were less likely (2.9%) to have smoked in the past month compared to their counterparts in the control condition (3.8%). Likewise, non-users in the experimental condition were less likely to use marijuana (9.5%) than students in the control condition (11.6%). The program impacts were found to be especially powerful in the Hispanic population. There were no significant effects found on measures of alcohol use, lifetime cigarette use, recent marijuana use, and other illicit substance use. The program also did not have any impacts on recent drug and alcohol use for those who reported using drugs or alcohol at baseline.

The program did have some impacts on delaying or preventing the progression to more advanced substances. For those who reported drinking alcohol at baseline, students in the experimental condition were less likely to have smoked cigarettes in the past month (8.02%) compared to those in the control condition (12.79%). For students who reported drinking alcohol in the past month or binge drinking at baseline, fewer students in the experimental condition reported using marijuana over their lifetime (16.81% for recent alcohol use and 21.11% for binge drinking) compared with their counterparts in the control condition (23.52% for recent alcohol use and 37.57% for binge drinking). The program did not have any impacts on delaying the progression from alcohol use to binge drinking, from binge drinking to cigarettes, and from cigarettes to marijuana.

There were several limitations of this study design which are discussed by the researchers. The first is that the population may not be representative of the US population because schools self-selected into the study. Another is that the students whose parents did not give permission for participation may differ from students whose parents gave permission to be included in the data collection. Additionally, attrition from 6^th to 7^th grade was related to 6^th grade marijuana use which, while it affected both experimental and control conditions, could have had bias effects on the results.

Study 2: Eisen, M., Zellman, G. L., Massett, H. A., & Murray, D. M. (2002). Evaluating the Lions-Quest "Skills for Adolescence" drug education program: First-year behavior outcomes. Addictive Behaviors, 27, 619-632.

Evaluated population: This study is an extension of the study described in Study 1. Thus, the evaluated population was the same.

Approach: Approaches to sample selection, treatment assignment, and data collection were the same as those described in Study 1. Also the same measures were employed. Analyses corrected for clustering due to random assignment at the school level.

Results: This study reports one-year outcomes for data collected at post-test. Few impacts were found for the overall sample. Refusal efficacy increased for alcohol and marijuana; however, no impacts were found for use of alcohol, cigarettes, marijuana, or other illicit substances. A number of impacts were found for subgroups. Specifically, SFA had an impact on recent (30-day) cigarette use: one year after program completion, pre-test nonusers enrolled in SFA reported lower recent cigarette use than their peers in the control group. With regard to lifetime and recent alcohol use, the program had an impact only on Hispanic students were who baseline non-users. Finally, the program delayed the progression from alcohol to cigarettes in SFA students who reported recent alcohol use (but not recent cigarette or lifetime marijuana use) at baseline and delayed baseline binge drinkers (who had never used marijuana and had not recently used cigarettes) from progressing to marijuana use.

Study 2: Eisen, M., Zellman, G. L., & Murray, D. M. (2003). Evaluating the Lions-Quest “Skills for Adolescence” drug education program: Second-year behavior outcomes. Addictive Behaviors, 28, 883-897.

Evaluated population: 7,426 students who were in sixth grade at baseline. Thirty-four middle schools from 4 metropolitan areas (Baltimore, Washington, Detroit, and Los Angeles) were studied.

Approach: Seventeen schools were randomly assigned to receive the SFA treatment while the other 17 were randomly assigned to be comparison schools. The experimental schools received the drug component of the SFA in their seventh grade year. Data were collected at baseline in sixth grade, post-tests were collected one year after baseline, and a one-year follow-up was collected one year after that. In total, students in the evaluation received a condensed, 40 sessions version of the SFA.

This evaluation of SFA only examined effects of the SFA on drug use. Data were collected in questionnaire format in classrooms by trained interviewers. Items on the survey consisted of items from the Monitoring the Future Survey.

Results: Results of the study indicate that students in the SFA group had lower rates of lifetime (27.24% vs. 30.5%) and recent marijuana use (11.32% vs. 13.79%). The researchers also found that baseline binge drinkers in the SFA group were less likely to report recent binge drinking. However, SFA did not have an effect on alcohol, cigarette, cocaine/crack, or other illicit drug use.

Limitations of this study include that all data were obtained from self-report and this may have caused a bias. Further, attrition from the program was associated with marijuana use, and schools self-selected into the study. It is possible that attrition and self-selection skewed the results of the study.

SOURCES FOR MORE INFORMATION

Link to program curriculum:

http://www.lions-quest.org/curriculum/index.php

References:

Study 1: Eisen, M. (2002). Intermediate outcomes from a life skills education program with a media literacy component. In Crano, W. D. & Burgoon, M. (Eds.) Mass media and drug prevention: Classic and contemporary theories and research, 187-214. Mahwah, NJ: Lawrence Erlbaum.

Study 2: Eisen, M., Zellman, G. L., Massett, H. A., & Murray, D. M. (2002). Evaluating the Lions-Quest "Skills for Adolescence" drug education program: First-year behavior outcomes. Addictive Behaviors, 27, 619-632.

Study 3: Eisen, M., Zellman, G. L., & Murray, D. M. (2003). Evaluating the Lions-Quest "Skills for Adolescence" drug education program: Second-year behavior outcomes. Addictive Behaviors, 28, 883-897.

Program categorized in this guide according to the following:

Evaluated participant ages: 11-12

Program age ranges in the Guide: Adolescence

Program components: Classroom curriculum and teacher training

Measured outcomes: physical health; behavioral problems; lifetime incidence and prevalence of cigarette and alcohol use.

KEYWORDS: Adolescence (12-17), Substance Abuse, Cognitive Development, Behavioral Problems, Tobacco Use, Alcohol Use, Social/Emotional Health and Development, School-Based, Marijuana Use, Illicit Drug Use, Physical Health, Education, Middle School, Drug Prevention, White or Caucasian, Hispanic or Latino, Asian, American Indian or Alaska Native.

Program information last updated on 9/12/08.