© Child Trends 2003
Dartmouth Prevention Project
OVERVIEW
The Dartmouth Prevention Project aimed to reduce tobacco and alcohol use and increase safety among elementary school-aged youth by using the family pediatrician to communicate messages to the parents and children. Twelve pediatric practices were paired. One in each pair was randomly assigned to deliver a treatment to prevent alcohol and tobacco use. The other was assigned to deliver a treatment to address gun safety, and use of bicycle helmets and seat belts. An evaluation of the program found an increase in bicycle helmet use, but no significant impacts on smoking, alcohol use, seatbelt use, or gun storage.
Target population: Families with children in elementary school
The Dartmouth Prevention Project utilizes the pediatric primary care clinician to deliver facts and engage the parent and child in discussion about alcohol and tobacco use or bicycle helmet and seatbelt use, and safe gun storage. Clinicians and families sign contracts pledging that the family will talk about these issues and family policies will be developed. The office staff also repeats these messages during interactions with the families. Program staff supports the information with site visits, telephone calls, newsletters, and other informational materials delivered to the clinical site and mailed to families. Ten days after signing the contract, families receive a letter from their clinician reinforcing the agreement with a magnet with which to attach the contract. The clinician continues to provide the family with new risk behavior information at each visit for 36 months. Families also receive reinforcement through 24 newsletter mailings over 36 months. Parent newsletters contain information on communication skills, risk factor data, family activities, and website and book reviews. Child newsletters contain communication strategies, risk-factor data, games, puzzles, and quizzes.
Pediatricians and nurse practitioners are trained in a three-hour on-site session. Training includes a presentation on rationale behind the program's components and data on risk behaviors. Clinicians participate in role-playing exercises to practice increasing parent awareness of risk behaviors and gaining family commitment.
Evaluated Population: 3,145 families with a child in fifth or sixth grade from 12 pediatric primary care practices in Massachusetts, New Hampshire, and Vermont completed baseline assessments. The mean child age was 11 years. Approximately 58% of the families had an income of over $50,000, and approximately 16% of families had an income below $30,000. 84 percent of the families were married-couple families.
Approach: Families were recruited by pediatric clinicians. Families were eligible for the study if they had a child in fifth or sixth grade and parents had to accompany the child to their appointment. Pediatric practices were randomly assigned to receive the safety portion of the intervention or the alcohol/tobacco portion of the intervention. Thus, there was not a no-treatment control group.
Children were assessed, through a self-administered survey, on alcohol and tobacco use, bicycle helmet and seatbelt use, and gun access and use. The parent survey assessed parent and spouse alcohol and tobacco use, perception of child's alcohol and tobacco use, bicycle and seatbelt use, gun storage in the home, parenting style, and child's behavior problems.
Stevens, M. M., Olson, A. L., Gaffney, C. A., Tosteson, T. D., Mott, L. A., & Starr, P. (2002). A pediatric, practice-based, radomized trial of drinking and smoking prevention and bicycle helmet, gun, and seatbelt safety promotion. Pediatrics, 109, 490-497.
Program categorized in this guide according to the following:
Evaluated participant ages: 9-11
Program age ranges in the guide: Middle Childhood
Program components: Clinic-based
Measured outcomes: Physical health, Life skills
KEYWORDS: Middle Childhood (6-11), Clinic-based, Children (3-11), Alcohol Use, Tobacco Use, Elementary
Program information last updated on 4/1/09.
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© Child Trends 2003 |