Adolescents' perceptions of substance abuse prevention strategies

Adolescence, Summer, 1998 by Lisa Lisnov, Carol Gibb Harding, L. Arthur Safer, Jack Kavanagh

INTRODUCTION

Experimentation with alcohol and other drugs is no longer characteristic of only a small proportion of youth; rather, it has become the norm among the current generation of American adolescents (Schinke, Botvin, & Orlandi, 1991). It appears that adolescents may even perceive drug experimentation as a "transition" to maturity (Jessor & Jessor, 1980). Awareness of the extensiveness of substance use has led to numerous attempts at prevention, particularly in schools. Evaluation of prevention programs indicates that improvement in knowledge and some attitude change may occur; however, there is little evidence that these programs serve to actually reduce or eliminate drug use (Bangert-Drowns, 1988). This lack of evidence of program effectiveness may be due to at least two factors: the complexity of risk factors leading to adolescent substance abuse (Beman, 1995) and the difficulty of evaluating prevention programs.

Most research on substance abuse prevention strategies has employed pretest-post-test designs to identify changes in either knowledge, attitude, or behavior, or some combination of the three. While these designs indicate that prevention strategies are producing only limited change, the findings provide little information about why particular methods are not successful. Several studies have sought to extend our knowledge of why strategies are or are not successful by investigating participants' perceptions of what is required for preventing substance use. For example, Blount and Dembo (1984) and Schwartz (1991) examined adolescents' perceptions of the effectiveness of prevention strategies regarding such outcomes as learning the consequences of drug use, improving decision-tasking skills, and learning ways to "say no to drugs."

The present study examined junior and senior high school students' perceptions of prevention strategies currently used in Chicago. Two school-based programs were assessed: Project DARE (Drug Abuse Resistance Education), a national program involving police officers, and Captain Clean, a musical theater program followed by an interactive discussion and role-playing session (Safer & Harding, 1993). In addition, four public approaches were included for the students' evaluation: television ads, testimonials by famous people, billboards, and print ads displayed on public transportation.

The theoretical framework employed in this study is based on problem behavior theory (Jessor & Jessor, 1980). Jessor and Jessor have posited that an individual's proclivity for problem behavior, such as substance abuse, depends on the interaction of personality, perception of the environment, and repertoire of behaviors. For each of these, there are variables that are proximal, or more powerfully related (e.g., peer support of the problem behavior), and those that are distal, or indirectly related to the problem behavior (e.g., an emotionally unsupportive household). This model provides a way to examine variables related to both drug use and nonuse, or prevention. For example, some objectives focus on preventing drug use behavior (such as improved knowledge of the legal consequences of substance abuse), while others deal with attributes more indirectly related to preventing abuse (such as improved self-esteem). Following Jessor and Jessor's model, prevention objectives in this study were classified as proximal - directly preventing drug use behavior, or distal-indirectly preventing drug use behavior.

METHOD

Sample

The sample included 719 Chicago public school students in grades six through nine. The students were predominantly African-American and Hispanic/Latino, and were from low-income families. They were identified by school administrators as "high risk" for substance abuse. Each student had been involved in both school-based prevention programs and reported familiarity with each of the prevention strategies assessed in this study.

Procedure

A survey instrument (available on request from the first author) was used to obtain students' perceptions of various prevention strategies. Students gave each strategy letter grades (consistent with the grading system used in their schools and quantified on a Likert-type scale for statistical analysis): "A" (coded as 5) through "F" (coded as 1). Prevention was operationalized in terms of six issues. The letter grades were assigned to four proximal prevention objectives: How well does this strategy prevent teens from using drugs and alcohol? (coded in our analysis as PREVENT); How well does it help them resist peer pressure to use drugs? (coded as RESIST); How well does the strategy encourage students to seek help if they have a drug problem? (coded as SEEK); and How well does the strategy provide information on where to get help for a drug problem? (coded as WHERE). In addition, students rated the prevention strategies on two distal objectives: How well does the strategy help students discuss their feelings surrounding personal situations and issues they are facing? (coded as TALK); and How well does the strategy relate to students' ethnic/racial backgrounds? (coded as RELATE).