Program

Sep 12, 2008

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
(6th to 8th 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 6th to 7th
grade was related to 6th 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/skillsadol.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.

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.