Prevention Programs Reduce Drug Use Among High-Risk Youth
A nationwide study of federally funded substance abuse prevention
programs for youth at high risk for substance abuse found that the
programs yielded reduced rates of alcohol, tobacco, and marijuana
use according to a SAMHSA report.
Reported first-time use of cigarettes, alcohol, and marijuana
was 12 percent lower at program exit than for comparison youth,
and 6 percent below comparison youth 18 months later. Substance
use by youth who had already begun to use substances was 10 percent
lower at exit than among comparison youth; and 18 months later,
use levels were 22 percent below comparison youth.
The 5-year study, the National Cross-Site Evaluation of the
High-Risk Youth Demonstration Program, involved more than 10,500
youth in 48 communities that are characterized by high levels of
risk, such as poverty, crime rates, and ambient substance use.
"This study provides an unprecedented opportunity to learn
about preventing and reducing substance abuse among high-risk youth,"
said SAMHSA Administrator Charles G. Curie, M.A., A.C.S.W. "We
will use the findings on what works and why to provide a benchmark
and help strengthen prevention programs in communities across the
The study identified six program components that can help reduce
the likelihood of substance use. Among the successful programs were
those emphasizing life skills development, connectedness to constructive
peers and adults, and self-examination.
Program design and implementation also had an effect. Favorable
results were more likely when programs had a clear purpose and evidenced-based
strategy, maintained intensive participant contact, and were offered
in after-school settings at times when youth are most at risk for
The diversity of program participants also allowed analysis of
patterns in risk and protective factors, and substance use as youth
mature through adolescence, across genders, and across racial and
ethnic groups. The study confirmed a "web of influence"
among individual, family, peer, school, and community factors on
youth substance use.
For example, when families are strong, family supervision and
parental attitudes have a strong influence on the peers with whom
young people choose to associate and also influence the choice to
use substances or not. Likewise, when youth are strongly connected
to school and are successful in school, they tend to associate with
peers who do not use substances and tend not to use them themselves.
Gender plays an important role in risk, protection, and substance
use. Boys participating in the study programs used substances at
a much lower rate than comparison boys at program exit (29 percent
lower), and at 6 months after exit (22 percent lower), but this
effect had faded by 18 months after the program ended.
Program benefits for girls developed later, but were increasingly
positive throughout the study period. Substance use rates for girls
participating in the study program were 3 percent lower than comparison
girls at program exit, and 9 percent lower 18 months later.
While programs that use multiple, science-based practices identified
in the study produced stronger and longer lasting effects for both
boys and girls, some program elements work better for one gender
than the other. For girls, programs that focus on behavior-related
life skills are particularly important for sustaining positive effects
on substance abuse throughout the 18-month period of followup. For
boys, participation in programs that emphasize interactivity with
peers or adults are particularly important for strengthening program
effects on substance use.
The 48 community programs studied were funded by SAMHSA's
Center for Substance Abuse Prevention (CSAP) through the High-Risk
Youth Demonstration Grant Program during 1994 and 1995. Programs
were selected to ensure coverage of different regions of the country,
various funding initiatives, and diverse target population characteristics.
The objective was to assess the effectiveness of programs that spanned
a broad range of strategies, capabilities, and participation.
Of the 10,500 youth involved in the study, 6,031 participated
in High-Risk Youth programs; and 4,579 similar youth from the same
communities did not receive services from the CSAP programs. All
responses from study participants were collected using CSAP's
National Youth Survey at four different times during the study:
at program entry, at program exit, and at 6 and 18 months after
youth exited the program.
"This study has significantly expanded our understanding of
the prevention strategies that have the greatest potential to help
even our most vulnerable youth lead drug-free lives," said
CSAP Director Ruth Sanchez-Way, Ph.D.
For more information on the study, visit SAMHSA's CSAP Web site
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