Pathways of Addiction Opportunities in Drug Abuse Research (1996) / Chapter Skim
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6. Prevention
6. Prevention
Pages 139-158
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From page 139... ...
Public health officials categorize preventive interventions based on when the intervention occurs: primary prevention involves intervening before the behavior appears; secondary prevention involves intervening after the onset of the behavior but before it becomes habitual; tertiary prevention involves intervening after the behavior has become habitual, with the goal of reducing or eliminating the behavior. Since 1990, a second model has been used increasingly to supplement these public health categories for preventive interventions: universal (delivered to the general population)
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Moreover, preventive intervention messages designed specifically for high-risk youth can be delivered within the context of universal prevention programs, avoiding the risk of harmful labeling. Both universal and targeted interventions have promise for prevention science but require more careful examination.
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. Two school-based prevention interventions that have demonstrated long-term success are the Life Skills Training curriculum and the Mid
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Most notably, recent social influence programs have empirically demonstrated short-term effectiveness; fairly consistent research results demonstrate that one can achieve 20 percent or greater net reductions in rates of initiation of drug use from school programs that focus on counteracting social influences to drug use; these include standardized teacher or staff training, multiple class sessions, booster sessions, student peer leaders, and active social learning methods (Pentz, 1994)
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From page 143... ...
and emergent technologies such as analysis of protein in hair samples. Family-Based Interventions Research on risk and protective factors associated with adolescent drug use and abuse provides several rationales for family-based prevention interventions.
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. Another study is currently evaluating a combination of parent training, home visits and family support, social skills training, anger management training, academic tutoring, and modifications in the classroom environment (Conduct Problems Prevention Research Group, 1992)
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A small number of empirically evaluated media interventions have been used to prevent adolescent cigarette smoking. One evaluation found significant main effects for both classroom training and television programming on knowledge and prevalence estimates, and significant impacts of classroom and television programming on knowledge, disapproval of parental smoking, and efforts at coping (Flay et al., 1995)
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found that community prevention programs can be successful in poor neighborhoods with substantial technical assistance. Finally, several promising community interventions are currently under way to reduce adolescent alcohol consumption (Wagenaar and Perry, 1994)
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Thus, rigorous and systematic research on community-based prevention interventions is needed. GAPS AND NEEDS School-Based Interventions Despite important advances in prevention science directly attributable to school-based interventions, many research needs and opportunities remain.
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This research should identify modifiable risk and protective factors associated with the transition to drug abuse, so that intervention programs can be designed to influence these factors. At the present time, some risk factors have been identified, but many are not easily modifiable through school-based intervention (e.g., parental drug abuse and antisocial behavior, family history of psychopathology and disruption, childhood conduct problems, aggression, difficulties in regulating emotional arousal, sensation seeking, impulsivity, poor school achievement, and difficulties in coping [Glantz and Pickens, 1992]
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From page 149... ...
Family-Based Interventions In general, family-based interventions show promise as prevention strategies because they impact known risk and protective factors associated with adolescent drug use and abuse and because they impact important mediating variables (such as childhood conduct problems) that are known risk factors for later drug abuse and dependence.
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From page 150... ...
It is necessary, therefore, to develop reliable and valid screening and assessment instruments, as well as methods of intervention delivery, designed to minimize the likelihood of negative labeling effects for selective interventions. This might be accomplished by incorporating interventions within existing treatment programs for drug-abusing parents, within existing prevention and treatment services for children with conduct problems, or within existing treatment and prevention programs in the juvenile justice system.
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Community-Based Interventions Research on the efficacy of policy-oriented community interventions must overcome several major challenges. A guiding principle of prevention research is that the intervention must effectively manipulate the mediating variables in order to produce change in a desired direction.
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For this reason, adequate evaluation research should be regarded as an essential feature of any preventive intervention. The committee has identified future research needs within each major area of prevention research, but many of its suggestions and recommendations for future research directions converge on several priorities for the field as a whole, including the following areas: • Prevention intervention research should focus more attention on the transition from use to abuse and dependence.
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Etiological and prevention research should be expanded to reach diverse populations. An important question that requires attention concerns the degree to which preventive intervention programs need to be "culturally specific" in order to be maximally effective.
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1995b. Effectiveness of culturally focused and generic skills training approaches to alcohol and drug abuse prevention among minority adolescents: Two year follow-up results.
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1994. Latent transition analysis and how it can address prevention research questions.
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1990. Attrition in substance abuse prevention research: A meta-analysis of 85 longitudinally followed cohorts.
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1991. Mediating mechanisms in a school-based drug prevention program: First year effects of the Midwestern Prevention Project.
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1992. Drug prevention programs can work: Research findings.
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