February 8, 2012
A voluntary substance prevention program held after school and presented by trained facilitators can help reduce alcohol use among young adolescents, according to a new RAND Corporation study.
Results suggest that if prevention researchers build programs with developmentally relevant content, and provide this content in an engaging, confidential and non-judgmental way, it can help middle school-aged children avoid alcohol. The article is published online in the journal Prevention Science.
"There are many mandatory school-based programs aimed at preventing youth alcohol and drug use, but voluntary after-school models are less common," said Elizabeth D'Amico, the study's lead author and a psychologist at RAND, a nonprofit research organization. "Such programs may become more important as school resources and teachers' time are spread thinner. In addition, they offer parents and students a familiar environment that may be less stigmatizing than being referred to off-site services."
Research shows that alcohol drinking is widespread among American adolescents, with nearly half of eighth graders reporting they have drunk alcohol at some point in their lives.
This RAND study evaluated the CHOICE program, which is presented during five 30-minute sessions in a non-confrontational and non-judgmental manner. The program dispels myths about the prevalence of alcohol use, challenges unrealistic beliefs about substance use, presents ideas on resisting pressure to use substances and stresses the benefits of reducing or ceasing substance use.
To date, only three voluntary after-school programs focusing specifically on substance use have been evaluated, and CHOICE is the only program for middle school youth. The Prevention Science article presents results from the evaluation of CHOICE through a cluster-randomized controlled trial in 16 middle schools in Southern California. The study focused on alcohol use, which is the most frequently used substance in this age group.
The study found that African American and multi-ethnic students, as well as alcohol and marijuana users, were more likely to attend CHOICE. Most students surveyed after completing the program said they liked the style of the program and found the facilitators helpful.
Researchers found a school-wide effect on alcohol use for all students at the intervention schools, regardless of whether they attended CHOICE. Students at the eight schools that offered the CHOICE program were less likely to initiate alcohol use during the academic year compared to students at the eight control schools where the program was not offered.
"Our data showed that in schools where CHOICE was offered, one adolescent out of 15 was prevented from initiating alcohol use during this time period," D'Amico said. "In other words, only 15 people would have to be exposed to this brief, voluntary program to significantly benefit one individual."
"Overall, results of the study were modest and additional research in this area is definitely needed," D'Amico said. "But our findings suggest that adolescents will voluntarily attend an after-school program that specifically provides information on alcohol and drugs, and that this type of program can reduce alcohol use at the school level. This study is the next step in understanding how voluntary after-school programs can help younger adolescents make healthier choices."
D'Amico has been conducting research in this area for over 15 years. She has a large body of work that is specifically focused on developing and implementing individual and group interventions for adolescents that target alcohol and drug use and risky sexual behavior.
Support for the study was provided by the National Institute of Alcohol Abuse and Alcoholism. Other authors of the study are Joan S. Tucker, Jeremy N.V. Miles, Annie J. Zhou, Regina A. Shih and Harold D. Green Jr.
RAND Health, a division of the RAND Corporation, is the nation's largest independent health policy research program, with a broad research portfolio that focuses on health care costs, quality and public health preparedness, among other topics.