Turning Research into Action
By Jill Lewis-Kelly, American Council for Drug Education

be able to go to college if he or she so chooses; and every adult must be able to continue learning for a lifetime. If students are to achieve any educational goals, the schools where this learning takes place need to be environments free of obstacles to the learning process. If students and teachers fear for their physical safety within the schools, this learning will not occur. Likewise, if drugs are present and if they become entangled in the students’ lives, this learning will not occur. As Gore pointed out, “Because schools are safer, they are more conducive to both teaching and learning.” But he warned the fight for the Safe and DrugFree Schools Program is not over. The Department of Education’s Safe and Drug-Free Schools Program, therefore, hosted a conference this summer to discuss prevention programming for adolescents and how to turn current research into effective action. It is the current research that provides the foundation for the job of weeding the garden. General Barry McCaffrey, Director of the Office of National Drug Control Policy (ONDCP), explained, “There is no question in my mind that we’ve got to kill some of the 100 flowers that have bloomed and evaluate drug prevention programs on the basis of scientific findings.” “We can’t have random activities. We’ve got to have a purpose. We’ve got to have a framework—some conceptual ladder—to build our drug prevention programs,” McCaffrey added.


n June, over 500 educators and drug and violence prevention experts gathered in the nation’s capital to discuss weeding a very large garden. This garden is the garden of prevention programming—a garden that has produced a bumper crop of initiatives, but now needs some careful tending. At the Safe and Drug-Free Schools Program conference this past summer, attendees were warned of the overcrowding of this garden and were given suggestions on how to tend its needs. Prevention programming in the schools—as well as in communities—faces many challenges today. Critical among these challenges is the issue of funding and the issue of success, which go hand in hand. But before facing these challenges, the first question is: Why drug and violence prevention programming in the nation’s schools? Vice President of the United States Al Gore, during the opening session of the conference, explained it simply: “The future of our schools equals the future of our country.” To secure this future, the President and Vice President declared education to be their number one priority during this administration. This priority was set in parameters such as these: every 8-year-old must be able to read; every 12-year-old must have access to the Information Superhighway; every 18-year-old must

Weeding the garden
To take on the task of weeding this rather large garden of prevention programming, one needs the proper gardening tools, or in this case, a set of guidelines. Luckily, within the Safe and Drug-Free Schools and Communities Act, these guidelines have been spelled out. They are the four principles of effectiveness—the four steps that will help ensure success when choosing a prevention program. These principles insist that a chosen program: 1. Is based on a thorough assessment of objective data about the drug and violence problems in the communities served; 2. Can meet measurable goals and objectives; 3. Is based on research and evaluation; and 4. Is evaluated periodically.


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Throughout the conference these steps were emphasized by plenary session speakers, and during the workshop sessions, individual programs told of how these steps led to effectiveness.


Needs Assessment

Before choosing from the many prevention programs that grow in the field, a school or community must understand what the specific problems of its own constituency are. Is the problem connected to drugs, to violence, or to both? How does one ascertain this information? Understanding the national problem first will help to focus on an individual local problem. Dr. Lloyd Johnston, principal investigator of The Monitoring the Future study, expertly described the national problem of adolescent drug use to the conference attendees early on in the three-day event. He report ed current statistics from his study which show an increase in marijuana, tobacco, and heroin use among the nation’s young people. In order to understand these increases, Johnson discussed the relationship of drug use to the amount of risk that adolescents associate with drug use and to whether or not they disapprove of drug use. While these statistics portray disturbing trends across the country, to choose the right prevention program, educators must try to understand these trends within their own communities. Dr. David Hawkins of the Seattle Social Development Project,

explained how to base assessments on risk and protection factors. These factors have been proven in longitudinal studies to greatly influence adolescent behavior. This approach to assessments basically says, “If we want to prevent a problem before it happens, we need to know what factors increase risk for that problem and then reduce those risk factors.” Conversely, one must know what factors prevent or protect against the development of the problem and increase those protective factors.

ment, described how his organization responded to widespread fear caused by an alarming number of youthful homicides that occurred in Boston during the late 1980s and early 1990s. By studying data on the victims, the Department was able to develop a victim profile. But it took a high level of collaboration before police were fully able to understand what they were up against. Only by working with the Probation Department and a network of community leaders was it possible to define the problem of youthful violence in Boston. In Denver, collaboration was also key to understanding the problem. There, the Asian Pacific Center for Human Development conducted a variety of focus groups that included students, parents, school representatives, and evaluators before creating an after-school program for at-risk youths. But not all successful programs have started with a collaborative assessment phase. Azim Khamisa told the conference spoke about starting the Tariq Khamisa Foundation, dedicated to creating safer communities by curbing youthful violence and promoting personal responsibility, after his son, Tariq was killed two years ago. Tariq’s assailant was 14 years old. Khamisa brings the foundation’s program of Violence Impact Forums into local schools to help promote healing and to reduce the traumatic effects of violence. For most programs represented at the conference, the critical first step in bringing drug and violence prevention into the schools has been understanding the local situation. As D.J. Ida, from the Asian

Hawkins, therefore, suggests assessing a community’s unique profile of risk and protection. This allows the school and the community to make decisions about where it should focus its efforts and concentrate its resources. Present at the conference were representatives from a number of successful programs. Assessment of community needs was often the key to their success. Joseph Carter, from the Boston Police Depart-

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lined and easy-to-use with existing resources,” Mary Ann Pentz, developer of Project STAR, reported. One of this program’s goals is to encourage non-drug use and reinforce non-drug social norms and expectations in the community. In Boston, where the overriding goal was to reduce youth homicides, the police commissioner developed 16 community teams involving more than 400 people. These teams included clergy, business leaders, labor officials, and elected officials, as well as police. The teams were charged with developing a strategic plan to change police orientation and give the department a neighborhood focus. It was up to the teams to set out the goals and objectives to realize the desired outcome.

Pacific Center for Human Development in Denver, said about her focus groups, it’s where one can learn what others see as the problems and what are the causes of those problems.

turn, establish the goals that drive selection of appropriate programs. Most participants at the conference described their programs in terms of goals and objectives. Phyllis Ellickson of Rand Corporation, developer of Project ALERT, spoke broadly about increasing student motivation to resist drugs and developing skills of resistance. She offered as one objective, helping young people acquire reasons not to use drugs by, for example, challenging certain normative beliefs about drugs and encouraging adolescents to believe they are capable of resist ing drugs. For the goal of developing resistance skills, Project ALERT helps kids identify pressures that might encourage them to use drugs and learn ways to counter these pressures. Project STAR also emphasizes the development of drug resistance skills as a program goal, but makes a point to include goals and objectives for the community as well. “It’s important when developing or choosing an effective program that it includes community-level objectives and activities that are time-


Measurable Goals & Objectives


Research-based Programs

Determining community needs provides the basis for selecting prevention programs. Schools must ensure that the programs they choose to implement are designed to respond to the needs they have identified, and they should consider only programs that have measurable goals and objectives. The Community That Cares program, developed by Dr. Hawkins, provides a process making it possible to select prevention programs by first defining program goals. Once risk and protective factors have been identified, a set of outcome-based planning tools are used to identify desired mediumand long-term outcomes. These, in

“Turning Research into Action” was the theme of this summer’s conference and research-based programs were in the limelight. “The history of prevention in the area of substance abuse and delinquency does not have a strong record,” Dr. Hawkins told the gathering. General McCaffrey of ONDCP stressed the need to change previous ways of thinking about prevention. “One of our first challenges today is to try to replace ideology and polemics with science and well-thought-out medical and social-based conclusions,” he said. Dr. Gilbert Botvin, developer of Life Skills Training, agreed. “We know the causes of drug abuse and how to prevent it, and therefore there’s no excuse for developing


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prevention programs that are based largely on ideology and intuition. It’s time to move to approaches based on sound science.” Discussing research on risk and protective factors, Dr. Hawkins explained that a lot has been learned in the last 20 years about what factors contribute to making young people both more and less vulnerable to substance abuse and violence. Factors within schools (i.e., failure to ensure academic success of all children), within families (i.e., failure to set clear expectations for children), and for individuals and peer groups (i.e., initiating undesirable behavior at early ages) all contribute to risk. Protective factors include promoting healthy beliefs and clear standards of behavior for young people and making it possible for young people to develop bonds with adults or groups in communities and schools. Providing opportunities for active involvement, teaching the skills that are needed to be successful, and having a consistent system of recognition are the three conditions that must be present if a young person is to develop a healthy bond with an adult or a group. This will increase the protection that guards the young person from violence and substance abuse. Many programs at the conference have developed strategies to limit risk factors and enhance protective factors. These included: The Seattle Social Development Project, Communities that Care, FAST, Life Skills Training, Project STAR, Strengthening Families, Project Family, Reconnecting Youth, and Project ALERT. Much research in recent years has focused on the fundamentals of

effective prevention programming, and much discussion during the three days of the conference dealt with these findings. Mathea Falco, President of Drug Strategies, Incorporated developed a list of key components for effective programs after she reviewed the 47 programs described in her book, Making the Grade: A Guide to School Drug Prevention Programs. But she has plenty of company. A number of conference participants presented their own lists of fundamental elements for effective prevention programs. And Falco noted, “More and more lists are springing up all over. It’s good (to have so many), because this may lead us to operating standards.” Certain fundamentals appear on the vast majority of these lists, indicating significant consensus about what good prevention programs should be doing. They should:
n Target known risk and protective

to implement good prevention programs in their schools.


Evaluate Programs

With needs assessed, programs based on sound research and measurable goals determined, it’s time to discover whether or not everything is working. A program must be evaluated periodically in order to measure its success. D.J. Ida recommends including an evaluation team right at the beginning of program design or during a needs assessment. She found that having evaluators there at the start avoided a “we versus they” situation between the program designer and the evaluators, and before long they were all asking the same questions. Whether or not evaluation is involved in the process from the beginning, it must be conducted in a periodic manner once the program is implemented in order to understand if the program is meeting its desired goals and objectives. Pentz of Project STAR described four ways to evaluate a program. A program can be evaluated by measuring: 1. Change in one particular group (a very weak method of evaluation, according to Pentz); 2. Cross-sectional differences between two groups; 3. Net group difference or reduction; or 4. Net program efficiency. All programs at the conference described their evaluation procedures, whether there was a control group or not, and how the data was

n Teach drug resistance skills, per-

sonal skills, and social skills;
n Emphasize interactive teaching

n Provide age appropriate infor-

mation; and
n Use a comprehensive, multi-

component approach. “The research is finally here!” conference presenters exclaimed. After 20 years, prevention experts now know what works and what doesn’t work; they know what causes the problems and what solutions are available. And educators now have the information and tools available to use this research

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collected. Some programs explained that early evaluation of the program helped them define areas where the program was weak. This allowed them to remedy the weakness and make the overall program more effective. National Institute on Drug Abuse, said, “We have ideologies galore about drug abuse and addiction, but we also have scientific data. And that data tells us that drug use is a preventable behavior and drug addiction is a treatable disease.” There is plenty of evidence that programs developed and targeted to prevent these behaviors work. Many presenters at the conference detailed this evidence. But all this has to go one step further. The entire country, not just political leaders and educators, needs to support prevention, and that won’t happen until the country can see that it works. “Behavior change is the bottom line. Without it you can’t really prove success,” Falco said. Evaluation, research, and sound science are the three tools that need to occupy everyone’s gardening shed. With these tools in hand, weeding the prevention garden will be easier than almost anyone thought.

What does all
of this mean?

Dr. Botvin hailed the dawn of a new day in prevention; Mathea Falco claimed she was delighted that prevention is finally having its day in Washington; but everyone from Vice President Al Gore to the Secretary of Education, Richard Adolescents who are emotionally connected Riley, agreed that the to their families and schools are generally work of creating safe healthier than those who are not, according to and drug-free schools an article in the September 10 issue of The is not over. Journal of the American Medical Association Research has taught those in the prevention field a few things. The most important thing learned is that violence and drug use are preventable behaviors. Dr. Prothow-Stith discussed violence as a preventable behavior and pointed specifically to programs like the Boston Strategy, for reducing youth crime, and Resolving Conflict Creatively as programs that have records of proven success. As for substance use and abuse, Dr. Alan Leshner, Director of the

The American Medical Association reports on adolescent health and the importance of protective factors
such as feelings of warmth, love, and caring from parents.” As with previous studies, the researchers found high rates of risky behaviors among adolescents: n Suicide—10.2% of girls and 7.5% of boys reported having considered suicide without actually attempting it over the past year, while 5.1% of girls and 2.1% of boys reported suicide attempts. n Cigarettes—25.7% of adolescents reported being current smokers, with 10.0% of males and 9.2% of females smoking six or more cigarettes per day. n Alcohol—17.9% of students reported drinking alcohol more than monthly, with 9.9% drinking at least one day per week. n Marijuana—25.2% reported ever having smoked marijuana, with 12.7% reporting that they had smoked at least once during the previous month. n Sexual behaviors—Approximately 17% of 7th and 8th graders and nearly half of 9th through 12 graders indicated that they had ever had sexual intercourse. n Pregnancy—Among sexually experienced females aged 15 years and older, 19.8% reported having ever been pregnant.
Source: The Journal of the American Medical Association Abstracts.

(JAMA). This is the AMA’s first report as a result of the National Longitudinal Study on Adolescent Health. AMA researchers found that when adolescents feel connected to their parents and their school, they are less likely than other adolescents to: n Suffer from emotional distress. n Have suicidal thoughts and behaviors. n Use violence. n Smoke cigarettes, drink alcohol or smoke marijuana. They also have their first sexual experience later than adolescents who are not connected to their parents and schools, but researchers found no protective effect against pregnancy. The researchers write: “... The role of parents and family in shaping the health of adolescents is evident.” They found that perceived high expectations by parents regarding school achievement was protective against some risky behaviors, while the physical presence of a parent in the home reduced the risk of substance abuse. However, physical presence was less significant in the overall health of adolescents than was parental connectedness,


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