Chapter 3: Synthesis of Effective Prevention Programs
Introduction
The eight programs identified as being well implemented, producing positive effects, and conducting rigorous evaluations represent a diversity of prevention strategies and target groups, yet can be viewed as representing a comprehensive approach to prevention. The purpose of the following discussion is to place these eight programs into the larger context of substance abuse prevention by synthesizing information across programs. In order to achieve this purpose, the discussion highlights how these programs relate to prevention theories generally, as well as how these programs relate to prevention strategies promoted by CSAP in particular.
Three important theoretical concepts can be applied to the eight model programs. The first concept is the level at which the prevention programs are implemented. The programs represent universal, selective, and indicated prevention efforts for youth (Hawkins, Kosterman, Maguin, Catalano, & Arthur, 1996; Kumpfer, 1997). Universal interventions (e.g., The Child Development Project [CDP]) target general population groups without identifying those at particularly high levels of risk. Universal interventions are those that attempt to prevent substance use by addressing the problem within an entire community. All members of the community benefit from prevention efforts, rather than specific individuals or groups within a community. Selective interventions (e.g., Dare To Be You [DTBY]; Smart Leaders [SL]; Involving Parents of HRY in Prevention, Family Advocacy Network [FAN]; Across Ages [AA]; Creating Lasting Connections [CLC]; Greater Alliance of Prevention Services [GAPS]) target those individuals who are at greater-than-average risk for substance abuse. The targeted individuals are identified on the basis of the nature and number of risk factors for substance abuse to which they may be exposed. The cumulative effect of exposure to multiple risks justifies selecting particular youth for intensive preventive efforts. Indicated prevention efforts (e.g., Residential Student Assistance Program [RSAP]) are aimed at individuals who may already display signs of substance use/abuse. These types of programs provide intensive programming for individuals in order to prevent the onset of regular or heavy substance use. The eight programs represent each type of prevention effort and range from programs that are all-inclusive in nature to those that target the most at-risk group of youth, institutionalized youth.
The second theoretical concept is that development occurs across the lifespan and individuals have the potential to change throughout development (Baltes, 1987). As a unit the programs represent a lifespan approach to the prevention of substance abuse. The different efforts addressed developmental issues across childhood and adolescence, as well as issues in adulthood and old age. The programs targeted preschool-aged children (DTBY), elementary school students (CDP), middle school/junior high students (SL, FAN, AA, and CLC), and high school students (RSAP, GAPS). In addition, although these were not the primary target groups, the programs included parents of children and youth (DTBY, CLC, FAN, and AA) and elderly community members (AA). Effective programs have been identified across a range of ages, highlighting the ability to support effective prevention efforts throughout childhood and adolescence.
The third concept relates to the idea that prevention programs should aim to both reduce risk factors and enhance protective factors by employing a variety of prevention strategies. The prevention strategies used by these programs addressed the needs of the target groups, both developmentally and culturally. Prevention programs are most effective when they are tailored to the specific needs of the target audience of interest (Kumpfer, 1997). Each of the theoretically driven programs aims to reduce risk factors and enhance protective factors related to substance abuse using a multifaceted prevention approach. Multifaceted interventions attempt to prevent substance use via multiple prevention strategies (e.g., combining alcohol, tobacco, and drug education and life skills training) and have been identified as key to producing lasting reductions in the prevalence of substance abuse (Biglan, 1995; Hawkins, Catalano, & Miller, 1996; Institute of Medicine, 1994). The successful programs were those that combined multiple well-implemented prevention strategies tailored to the needs of the target audience.
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Last Updated: March 4, 2002
