LifeSkills® Training (LST) is a school-based drug-use prevention program that was established in the late 1970s. The program incorporates interactive learning, social-skills building, and specific drug-use-prevention-related information. It promotes anti-drug norms and it fosters the development of personal self-management skills such as decision making, problem solving, goal setting, and coping with anxiety. Experimental evaluations show that participants in Life Skills Training have lower rates of cigarette, alcohol, and marijuana use compared with youth who were not in the program. The program has also been shown to increase knowledge about the effects of drugs, reduce behavioral intentions to use drugs, increase anti-drug attitudes, and reduce the extent to which drinking and smoking are perceived as normative. A version of LST designed to also reduce violence and delinquency has had impacts on reducing delinquency. LST has been experimentally evaluated—and shown to be effective—for Hispanic, African American, and white student populations. It has had impacts on urban, suburban, and rural populations. Impacts have been shown to be stronger for high-risk than low-risk girls.
DESCRIPTION OF PROGRAM
There is an elementary school version as well as a middle school version of LST. This description focuses on the middle-school version of LST.
LST is designed for all students regardless of their previous drug use or risk level. The program has three major components. The first teaches general self-management skills, including analyzing problems and reducing stress and anxiety. The second component covers general social skills, such as overcoming shyness and communicating effectively. The final component of the program covers drug resistance skills, such as the ability to challenge misconceptions about drug use, and the ability to resist media pressures to use drugs. Unlike traditional prevention approaches, the program provides only minimal information on the negative health consequences of drug use. The program components can be taught in an intensive schedule with multiple sessions per week or once a week until completed. The middle school program lasts for three years—15 sessions delivered in 6th or 7th grade, followed by two years of booster sessions (10 sessions each year). Sessions are 30 to 45 minutes long.
A variety of instruction methods are used in delivery of LST. Skills are taught using both instruction and demonstration. Skills are broken down into steps and demonstrated through a video or by the instructor. Students are also given the opportunity to practice the skills they have learned. Feedback and encouragement are used to help the students improve their skills. Finally, there is extended practice in the form of homework assignments.
LST can be taught by health professionals from outside the school, older peer leaders, or regular classroom teachers. All program providers are trained during a one- or two-day workshop. The workshop, which is delivered through videotape or live instruction, allows program providers to learn and practice the skills needed to provide the program. The LST program does not follow up with providers to ensure the program is administered with fidelity, or provide booster training sessions.
The program also features an optional violence prevention component that adds three sessions in the first year, two sessions in the second year and two sessions in the third year. A revised version of the material is also available for use with minority youth (the original target population was middle-class white adolescents). There is also an integrated LST (I-LST) program where prevention elements are integrated into the existing academic curricula by teachers for those subject areas. This is in contrast to the standard LST program, which is delivered as a “time-out” for drug abuse prevention.
Cost information: http://www.lifeskillstraining.com/order.php
EVALUATION(S) OF PROGRAM
Spoth, R. L., Redmond, C., Trudeau, L. & Shin, C. (2002). Longitudinal substance initiation outcomes for a universal preventive intervention combining family and school programs. Psychology of Addictive Behaviors, 16(2), 129-134.
Evaluated population: Seventh-graders in 36 randomly-selected rural schools in the Midwestern US. Just over half (53 percent) of the participants were male and the majority were white (96 percent).
Approach: Schools were matched and randomly assigned to one of three study groups. Twelve schools received the LST program only, 12 received the LST program plus the Strengthening Families 10-14 program, and 12 schools were assigned to a control group. Students in the experimental groups were given a 15-session teacher-instructed LST program in seventh grade and five booster sessions in eighth grade. Students received a pre-test several months prior to the intervention and a post-test approximately one month after the intervention and a follow-up one year later, after the booster sessions. The posttest was used as the baseline. Students were given a questionnaire about alcohol, cigarette, and marijuana use. The responses to the questionnaire about lifetime use were summed to create a substance initiation index (SII). Students were also given a a “bogus pipeline” breath test. The bogus pipeline procedure involves asking students to exhale into a balloon that is connected to a carbon monoxide meter, and encourages honesty in answering smoking-related questionnaire items.
The proportion of two biological parent families, on average at the school level, was higher in the control group school than in either of the treatment group schools at pre-test, and was included as a control variable in the analysis.
Results: Participants in both treatment groups had lower SII scores than those in the control group. There was no difference in the SII scores between the two treatment groups. The study calculated the percentage differences in the proportion of new users of alcohol, cigarettes, and marijuana in the intervention groups relative to the control group. The relative reduction rate in new alcohol use for students in the group that received both LST and Strengthening Families was 30 percent, and for students in the LST-only group the relative reduction rate was 4.1 percent. New user rates for marijuana were significantly lower for both treatment groups compared with the control group. There was no difference in cigarette initiation between the groups.
Trudeau, L., Spoth, R., Lillehoj, C., Redmond, C., & Wickrama, K. A. S. (2003). Effects of a preventive intervention on adolescent substance use initiation, expectancies, and refusal intentions. Prevention Science, 4(2), 109-122.
Evaluated population: The evaluated population is the same as in Study 1. A total of 847 students from 24 schools were included in this analysis.
Approach: See Study 1 for randomization methodology. Only the LST group and the control group were compared in this study. The authors measured students’ expectancies, refusal intentions, and substance initiation at pre-test, post-test (one month after the intervention) and follow up (one year after post-test). Expectancies covered youth’s negative expectations about the social and personal consequences of substance use for tobacco, marijuana, and alcohol. Refusal intentions captured how likely a respondent would be to say “No,” change the subject, or make up an excuse to leave when asked to try an illegal substance. Substance initiation was measured by asking respondents whether they had ever smoked, had a drink of alcohol, or used marijuana. The analysis controlled for clustering at the school level.
Students in the control group had lower levels of expectancies and refusal intentions and higher levels of substance initiation at pre-test, compared with the intervention group. The analyses accounted for these differences.
Results: The program had a significant impact on the rate of decrease in refusal intentions and the rate of increase in substance initiation, from 7th grade (pre-test) to 8th grade (follow-up). Both findings were favorable to the LST program. There were marginally significant differences between the treatment and control group in the decline in expectancies (that is, in the perception that there are negative consequences to substance use) over time.
Spoth, R., Trudeau, & L., Shin, C. (2008). Long-term effects of universal preventive interventions on prescription drug misuse. Addiction, 103(7), 1160-1168.
Evaluated population: This is a follow-up of the evaluation described in Study 1. Students were evaluated when they were in 11th (N = 1,443) and 12th grade (N = 1,212).
Approach: For information on randomization and study procedures, see Study 1. When the students were in 11th and 12th grade, they reported whether they had ever used drugs or medications that were prescribed to someone else. The authors did not correct for clustering.
Results: In 11th grade, fewer students in the LST + Strengthening Families 10-14 group reported prescription drug misuse than in the control group. By 12th grade, there was only a marginal difference between the LST + Strengthening Families 10-14 group and the control group. There was no significant impact of the LST-only program on prescription drug misuse.
Spoth, R. L., Randall, G. K., Trudeau, L., Shin, C. & Redmond, C. (2008). Substance use outcomes 5 ½ years past baseline for partnership-based, family-school preventive interventions. Drug and Alcohol Dependence, 96, 57-68.
Evaluated population: This is a follow-up of the evaluation described in Study 1
Approach: This is a 5 ½-year follow-up of Study 1. The response rate at follow-up was 74 percent across all conditions. Analysis accounted for clustering at the school level.
Results: In 12th grade, the mean Substance Initiation Index (a composite measure of initiation of alcohol use, drunkenness, cigarette use, and marijuana use) for the control group was significantly higher than the mean for the LST group and for the LST + Strengthening Families 10-14 group. Both treatment groups also had a slower rate of increase up to the 12th grade, compared with the control group.
There were no differences between the groups in alcohol initiation; however there were differences in the rate of increase of alcohol initiation. The LST + Strengthening Families 10-14 group had a significantly lower rate of increase in alcohol initiation compared to the control group, while differences between the LST-only group and the control group were marginally significant. There was a marginally significant difference in means on drunkenness initiation at 12th grade between the LST and control groups and the rate of growth was significantly lower among the LST group. The LST + Strengthening Families 10-14 group also had a significantly lower rate of growth in drunkenness initiation than the control group.
For cigarette initiation, both the 12th-grade means and growth rates significantly favored the two experimental conditions. For marijuana initiation, the mean for both experimental groups was significantly lower than the control group, but differences in growth were only marginally significant and only for the LST group compared with the control group.
There were no significant differences between the LST-only and the LST + Strengthening Families 10-14 group on any of the initiation outcomes.
There were no significant findings with respect to either the 12th-grade means or the growth of “serious substance involvement” (frequency of use, monthly poly-substance use, and advanced poly-substance use).
Botvin, G. J., Dusenbury, L., Baker, E., James-Ortiz, S., & Kerner, J. (1989). A skills training approach to smoking prevention among Hispanic youth. Journal of Behavioral Medicine, 12(3), 279-296.
Evaluated population: Predominately Hispanic (74 percent) seventh-grade students (N = 471) in eight urban schools in northern New Jersey and New York City
Approach: Four schools were randomly assigned to an experimental group, and four to a control group. Students in experimental schools were given a 15-session teacher-led LST program focused on smoking prevention. Students in the control schools did not receive any special interventions above what was usually offered in the schools. Participants were given a pre-test consisting of a self-report questionnaire and a “bogus pipeline” breath test. The bogus pipeline procedure involves asking students to exhale into a balloon that is connected to a carbon monoxide meter, and encourages honesty in answering smoking-related questionnaire items. Three-and-a-half months after pre-test, students were given the same questionnaire and breath test as a post-test. The questionnaire asked students about the prevalence of smoking and drinking among their friends, their own smoking behavior, their intentions to smoke, their knowledge about tobacco and cigarettes, their attitudes and beliefs about smoking, decision making skills, self-efficacy, and general psychological characteristics. Data were available for 345 students for the final analysis.
Results: A smaller percentage of students in the treatment group had smoked in the past month compared with students in the control group, but this difference was only marginally significant. Students in the experimental group had greater knowledge of smoking consequences compared with control group students.
Botvin, G. J., Batson, H.W., Witts-Vitale, S., Bess, V., Baker, E. & Dusenbury, L. (1989). A psychosocial approach to smoking prevention for urban black youth. Public Health Reports, 104(6), 573-582.
Evaluated population: Seventh-grade students (N=520) in nine schools in New Jersey. The sample was 87 percent black, one percent white, ten percent Hispanic, and two percent “other race.” A plurality lived with their two parents (47 percent), while 43 percent lived with their mother only. Fifty-four percent were female. For this study, the analysis was limited to black students (440 youth).
Approach: Schools were randomly assigned to either a control group (N=6 schools) or an experimental group (N=3 schools). The follow-up response rate among students was 86 percent. Students in the experimental condition were given a 12-session, teacher-led LST program focused on smoking prevention that was modified to be appropriate and relevant for black adolescents in urban schools. The students’ smoking behavior, perceived social influences to smoke, smoking-related knowledge, attitudes and expectations toward smoking, and skills such as self-efficacy were measured at the beginning and end of the program. Students were also given an expired air carbon monoxide test, to improve the quality of the self-reported smoking data (see Study 1). No corrections were made for clustering of the data.
Results: Fewer students in the experimental condition than the control condition reported smoking within the last month (3 percent vs. 7 percent). Treatment students were more likely to provide correct responses on tests of knowledge of smoking consequences and adult smoking prevalence, compared with the control group.
The program did not have impacts on the following measures: smoking last week, smoking yesterday, current smoking, smoking intentions, social acceptability knowledge, anti-smoking attitudes, peer prevalence of smoking, decision-making skills, assertiveness skills, self-efficacy, self-esteem, home personality, peer personality, or school personality.
Botvin, G. J., Baker, E., Dunesbury, L., Botvin, E. M. & Diaz, T. (1995). Long-term follow-up results of a randomized drug abuse prevention trial in a white middle-class population. Journal of the American Medical Association, 273(14), 1106-1112.
Evaluated population: Middle school students (N=3,597) from 56 schools across New York.
Approach: This is a six-year follow up to an earlier study. Schools were divided into groups depending on the prevalence of smoking (high, medium, low) among the students, then randomly assigned from within these groups to one of two treatment groups or a control group. Eighteen schools were assigned to participate in an LST program that had a formal one-day training workshop for teachers and provided feedback by project staff; an additional 16 schools were assigned to participate in an LST training using video tapes and no feedback from project staff. Students in the two intervention groups received booster sessions during their eighth-grade year (ten sessions) and ninth- grade year (five sessions). Twenty-two schools were assigned to the control group.
At pre-test and six years after the study, students completed a questionnaire about tobacco (frequency), alcohol (frequency and quantity), and marijuana (frequency) use; knowledge about substance use prevalence and consequences; attitudinal, skills, and psychological variables related to the initiation of drug use; the perceived prevalence of and attitudes toward substance use by significant others.
There were no baseline differences between students in the three groups. The analyses did not account for clustering of students in schools
Results: There were positive long-term effects on reducing drug use for both of the intervention groups. Monthly cigarette smoking was significantly lower for students in both intervention groups, and also lower for weekly use among the intervention-without-feedback group, compared with the control group. Heavy cigarette smoking was significantly lower in the group that received videotape training. Problem drinking was significantly lower for both intervention groups. Monthly alcohol use was significantly lower in the two intervention groups, compared with the control group. Weekly polydrug use (tobacco, alcohol, and marijuana), and weekly combined tobacco and marijuana use were significantly lower for the two intervention groups, compared with the control group.
Botvin, G. J., Griffin, K. W., Diaz, T., Scheier, L. M., Williams, C., & Epstein, J. A. (2000). Preventing illicit drug use in adolescents: Long-term follow-up data from a randomized control trial of a school population. Addictive Behaviors, 25, 769-774.
Evaluated population: This is a follow up of Study 7 on a sub-sample of students who completed a survey on illicit drug use. The sample examined here is 92.3 percent white and 40 percent male, with a mean age of 18.1 years, and with 82.5 percent living in two-parent families.
Approach: See Study 7 for information on randomization. Questionnaires were sent by mail at the end of twelfth grade (6.5 years after baseline) to individuals who received the LST program in junior high school; from a subsample of students asked to answer questions on illicit drug use other than marijuana, 447 replied (no information was provided about the number of individuals that were attempted to be contacted).The questionnaire asked how often the respondent had ever used any of 13 different drug types, which were collapsed into eight categories: marijuana, cocaine, inhalants, nonmedical pill use, heroin and other narcotics, hallucinogens, total illicit substance use, and total illicit substances other than marijuana. At baseline, the control group had higher levels of drinking frequency and the study analyses controlled for this difference. The authors also adjusted for clustering at the school level.
Results: In comparison with the control group, the intervention group had a significantly lower mean number of times having used the following drugs: heroin and other narcotics, hallucinogens, total illicit substance use, and total illicit substances other than marijuana. The program had a marginally significant impact on marijuana use and did not have an impact on cocaine, inhalants, or nonmedical pill use.
Griffin, K. W., Botvin, G. J., & Nichols, T. R. (2004). Long-term follow-up effects of a school-based drug abuse prevention program on adolescent risky driving. Prevention Science, 5, 207-212.
Evaluated population: Most of this New York sample was middle-class, suburban and rural, white (91 percent), and lived in two-parent families (86 percent). The median age of students was 18.1 years, with a range from 17.3 to 21.0 years. This included 2,042 students from Study 7 who could be matched with state Department of Motor Vehicles (DMV) records at the end of high school.
Approach: See Study 7 for more information. DMV records were matched to study participants. The authors examined the number of driver’s license “points” and number of traffic violations. In New York, points remain on the driving record for 18 months from the date of the citation; only two percent of individuals in the sample (N=42) had violations on their record not accounted for in their points. Analyses adjusted for clustering at the school level.
Results: The program had a significant impact on whether someone had points on their license (OR=0.75), controlling for gender and 12th grade alcohol use. There was also a significant impact on whether one had violations on their record (OR=0.75) such that program participants had a 25 percent reduction in the odds of having points on their license.
Botvin, G. J., Baker, E., Renick, N. L., Filazzola, A. D. & Botvin, E. M. (1984). A cognitive-behavioral approach to substance abuse prevention. Addictive Behaviors, 9(2), 137-147
Evaluated population: Mostly white, middle class, seventh-grade students (N=1,311) from 10 suburban New York schools.
Approach: Ten schools were randomly assigned to one of three conditions: a teacher-led LST condition, an older-peer (10th – or 11th –graders)-led LST condition, and a control group. The students reported on their own tobacco, alcohol, and marijuana use, and completed cognitive, attitudinal, and personality measures. Saliva samples were collected to encourage honest reporting of substance use. Cognitive measures were 30 true-false items on knowledge of substances and prevalence of use in adults and teens. Attitudinal measures gathered information on students’ views of substances, substance users, and perceived social benefits of tobacco, alcohol, or marijuana use. Aspects of personality measured included assertiveness, locus of control, social anxiety, self-esteem, self-confidence, self-satisfaction, probability of yielding to social pressure to smoke, and general susceptibility to influence. Analyses accounted for clustering at the school level.
Results: Posttest means-comparisons showed that fewer participants in the peer-led group reported smoking monthly, compared with either the teacher-led group or the control group. The teacher-led group, however, did not differ from the control group. The peer-led intervention also had an impact on the measures of monthly and weekly marijuana use, compared with the teacher-led and control groups. The peer-led program appeared to reduce total marijuana use by 71 percent, and weekly or daily use by 83 percent, compared with the control group. Researchers also found students in the peer-led experimental group consumed less alcohol per sitting, compared with students in the control group.
On drug-use knowledge and attitudes for each of the three drugs (six measures), the peer-led experimental group had significantly higher scores, compared with the control group, indicating more accurate knowledge and attitudes less conducive to substance use. For the teacher-led group, scores only on the measures of smoking knowledge and marijuana knowledge were higher, compared with the control group.
On the attitudinal measures, the peer-led condition had significant, favorable impacts on anti-smoking, anti-drinking, and anti-marijuana-using views, compared with the teacher-led and control groups.
The peer-led condition had favorable impacts on the personality measures of locus of control and smoking susceptibility to influence. The teacher-led group had social anxiety scores that were significantly higher than that of the control group.
On self-esteem, there were differential impacts by subgroup. Males in the peer-led condition had self-esteem scores significantly higher than those of females in the control condition, females in the peer-led condition, females in the teacher-led condition, males in the control condition, and males in the teacher-led condition.
Botvin, G. J., Dusenbury, L, Baker, E., James-Ortiz, S., Botvin, E., Kerner, J. (1992) Smoking Prevention Among Urban Minority Youth: Assessing Effects on Outcome and Mediating Variables. Health Psychology 11(5): 290-299.
Evaluated population: This study evaluated 3,153 seventh grade students from 47 public and parochial schools in New York City that serve urban minority students from low income families. The mean age of the sample was 12.8 years. More than half the sample were Hispanic and 19 percent were black.
Approach: Schools were randomly assigned to either the treatment (1,795 students across 27 schools) or control group (1,358 students across 22 schools). Students in the treatment group received the 15-session smoking prevention program, taught by their usual classroom teachers. The control group schools received no treatment.
Students gave a carbon monoxide breath sample and completed a survey that measured self-reported smoking status at pre-test and again four months later. The survey also measured knowledge about smoking, attitudes toward smoking, normative expectations about smoking, decision making skills, assertiveness, skills efficacy, self-esteem, and psychological well-being. There were no differences between schools in the control group and the treatment group at baseline.
Results: A smaller proportion of students at schools in the treatment group reported smoking in the past month, compared with schools in the control group. The treatment group schools also had fewer students who reported smoking for the first time during the treatment period than the control group schools. There was no difference between the groups in general smoking status as measured on an 11-point scale.
Botvin, G. J., Griffin, K. W., Diaz, T., Ifill-Williams, M. (2001). Drug abuse prevention among minority adolescents: Posttest and one-year follow-up of a school-based preventive intervention. Prevention Science, 2, 1-12.
Evaluated population: The sample consisted of 3,621 inner-city middle-school students attending 29 schools in New York City. The students were 47 percent male, and the racial/ethnic make-up of the sample was 61 percent African American, 22 percent Hispanic, 6 percent Asian, 6 percent White, and 5 percent mixed or other. About half of students (54 percent) lived in two-parent households, and 62 percent of students received free lunches at school.
Approach: Schools were divided into those with high, medium or low smoking prevalence, then were randomly assigned to intervention or control conditions such that the distribution of school type was equal across both conditions. The intervention condition included 16 schools and the control condition included 13 schools. The intervention group received 15 sessions in 7th grade and 10 booster sessions in 8th grade, taught by a classroom teacher. The control group received the regular New York City schools substance use curriculum.
Data were collected at pretest and a 3-month posttest in 7th grade, and at a one-year follow-up at the end of 8th grade. Students self-reported smoking, alcohol use, and drug use; behavioral intentions to use drugs; perceived peer and adult normative expectations related to drug use; attitudes toward and knowledge of drugs; and social and personal competence (decision-making, assertiveness, risk-taking, efficacy for drug-refusal skills, advertising resistance skills, anxiety reduction skills, communication skills, and how often they had gotten into trouble). Carbon monoxide breath samples were also collected at each assessment to increase the truthfulness of students’ self-reports. The analysis accounted for clustering of students within schools. The attrition rate was 31 percent. At baseline, the intervention group had a higher proportion of African Americans, a lower proportion of Hispanics, and a lower proportion of students who received free/reduced school lunch, compared with the control group. The study analyses controlled for these variables.
Results: At the three-month follow-up, there was no significant impact on drinking frequency and quantity, but a significant impact on drunkenness frequency. There was a marginally significant impact on polydrug use. Students in the intervention group had greater drinking knowledge compared with the control group and lower peer normative expectations for smoking and drinking. They also had lower adult normative expectations for smoking, drinking, cocaine/hard drug use, and inhalant use compared with the control group.
At the one-year follow-up, students who received the program reported less smoking, drinking, drunkenness, inhalant use, and polydrug use, compared to the control group. However, there were no impacts on marijuana use. Additionally, the program had positive impacts on students’ drug knowledge, behavioral intentions to use drugs, anti-drug attitudes, perceived peer normative expectations, and adult normative expectations. In terms of these variables, impacts were more consistent for smoking and drinking than for marijuana, cocaine/hard drugs, and inhalants. The program also had a positive impact on self efficacy for refusal skills, risk-taking, and getting in trouble, but none of the other measures of social and personal competence.
Botvin, G. J., Griffin, K. W., Diaz, T., Ifill-Williams, M. (2001). Preventing binge drinking during early adolescence: One- and two-year follow-up of a school-based preventive intervention. Psychology of Addictive Behaviors, 4, 360-365.
Evaluated population: The evaluated population is a sub-sample of the population from Study 12 who participated in the two-year follow-up (N=3,041). The population was 44 percent male. The racial/ethnic make-up was 57 percent African American, 24 percent Hispanic, 3 percent Asian, 3 percent white, 2 percent Native American, and 6 percent mixed or other backgrounds. About half of students (55 percent) lived in two-parent households, and 62 percent of the students received free lunches at school.
Approach: See Study 12 for randomization procedures and information about the intervention. Outcomes were assessed at baseline (7th grade) and at 1- and 2-year follow-ups. Students reported their current alcohol use, knowledge about drinking (physiological and psychological effects, prevalence, and social acceptability of drinking), favorable attitudes toward alcohol, and normative expectations regarding alcohol use. At baseline, the intervention group had a higher proportion of African Americans, a lower proportion of Hispanics, and a lower proportion of students who received free/reduced school lunch, compared with the control group. The study analyses controlled for these variables. The analysis also accounted for clustering of students within schools.
Results: The percent of students who reported binge drinking was lower among in the intervention group compared to the control group at the one-year follow-up (1.8 percent vs. 4.3 percent, OR = 0.41) and the two-year follow-up (2.2 percent vs. 5.2 percent, OR = 0.40). There was a significant impact on drinking knowledge and pro-drinking attitudes at the one-year follow-up, but not at the two-year follow-up. In both years, there was a significant impact on normative expectations regarding peer drinking.
Vicary, J. R., Henry, K. L., Bechtel, L. J., Swisher, J. D., Smith, E. A., Wylie, R., Hopkins, A. M. (2004). Life Skills Training effects for high and low risk rural junior high school females. The Journal of Primary Prevention, 25, 399-416.
Evaluated population: Rural middle-school girls participated in the program (n = 319). The students attended nine disadvantaged (low socioeconomic status) small rural schools. The program was administered to both boys and girls, but only girls were included in this analysis.
Approach: Nine schools were randomly assigned to one of two treatment conditions or to the control condition. The two treatment conditions were Infused Life Skills Training (I-LST; n = 108 girls), where prevention components were integrated into the standard academic curriculum, and the standard Life Skills Training (LST; n = 128 girls). For both groups, the program started at the beginning of 7th grade and lasted three years. The control group (n = 98 girls) received no treatment. The I-LST condition integrated LST and information about alcohol, tobacco, and other drugs into existing curricula for various subjects, with the goal of making prevention a regular part of the curriculum rather than a special program.
Outcomes were collected at three time points – baseline (beginning of 7th grade), end of 7th grade, and end of 8th grade. There were no baseline differences between treatment and control groups. Sixty-eight percent of LST students, 71 percent of I-LST students, and 72 percent of control students completed the surveys. Measures included self-reported substance use; attitudes towards alcohol, tobacco, and other drugs; normative beliefs about peer substance use; knowledge about substances; decision-making skills; communication skills; refusal skills; media awareness and media resistance skills; assertiveness; and coping with anxiety. Analysis did not account for clustering of students within schools given the small number of schools included in the study.
Results: Girls were classified into low- and high-risk based on their SES, family relations and functioning, psychological health, and academic performance. Treatment impacts were stronger for high-risk versus low-risk girls, as shown by interaction tests. Results were divided by the risk status of the girls. Findings from the end of 7th and 8th grades are reported here together.
Low-risk girls. The LST program reduced alcohol use, binge drinking, and marijuana use; increased knowledge about substance use; and improved decision-making, communication, and coping skills. But, the program also worsened media-resistance skills. There were no impacts on cigarette smoking, drunkenness, inhalant use, attitudes, normative beliefs, refusal skills, media-resistance skills, and assertiveness skills.
The I-LST program reduced cigarette smoking, increased knowledge about substance use, reduced normative beliefs about substance use, and improved decision making skills and coping skills. There were no impacts on alcohol use, drunkenness, binge drinking, marijuana use, inhalant use, attitudes, communication skills, refusal skills, media-resistance skills, or assertiveness skills.
High-risk girls. The LST program had a positive impact on alcohol use, binge-drinking, marijuana use, inhalant use, pro-drug attitudes, normative beliefs about substance use, knowledge about substance use, assertiveness, and refusal skills. There were no impacts on cigarette use, drunkenness, decision making, communication skills, media-resistance skills, and coping skills.
For girls in the I-LST program, there were positive impacts on drinking, binge drinking, marijuana use, cigarette use, frequency of drunkenness, normative beliefs about substance use, attitudes toward substance use, and refusal skills. There were no impacts on inhalant use, knowledge, decision making, communication skills, media-resistance skills, assertiveness skills, and coping skills.
Botvin, G. J., Griffin, K. W., & Nichols, T. D., (2006). Preventing youth violence and delinquency through a universal school-based prevention approach. Prevention Science, 7, 403-408.
Evaluated population: A total of 4,858 sixth graders from 41 New York City public and parochial schools participated in the study. The sample was 51 percent boys, and the racial/ethnic composition of the sample was 39 percent African-American, 33 percent Hispanic, 10 percent white, 6 percent Asian, 2 percent Native American, and 10 percent other or mixed ethnicity. The sample was primarily socioeconomically disadvantaged: 55 percent received free lunch at school and 30 percent lived in mother-only households.
Approach: Schools were randomly assigned to intervention (schools = 20, N = 2,374) and control (schools = 21, N = 2,484) conditions. The intervention was delivered over 15 sessions across 3 months and was delivered by classroom teachers. Control group schools implemented the usual New York City health education curriculum. Adolescents responded to surveys administered pre-intervention and 3 months later (post-intervention). Measures included verbal aggression, physical aggression, fighting, and delinquent behaviors. The fighting and delinquency items assessed behavior “in the past year,” although the interval between pre-test and post-test was three months.
There were no differences between control and treatment students at baseline in terms of aggression, delinquency, or academic performance. However, the intervention group had more Hispanic students than the control group, and the control group had more black students. Analysis took into account clustering of children within schools.
The program had a significant impact on reducing delinquency in the past year, but had no impact on verbal aggression in the past month or year, physical aggression in the past month, or fighting in the past year. For students who self-rated in the top quartile for verbal aggression, physical aggression, fighting, and delinquent behavior, the program had a significant positive impact on delinquency and fighting. There was no impact on verbal or physical aggression for these students.
SOURCES FOR MORE INFORMATION
National Health Promotion Associates
711 Westchester Avenue
White Plains, NY 10604
Program information last updated 3/9/16