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Preventing Adolescent Drug Abuse: Intervention Strategies, 47 RESEARCH ANALYSIS and UTILIZATION SYSTEM Preventing Adolescent Drug Abuse: Intervention Strategies U. S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service • Alcohol, Drug Abuse, and Mental Health Administration Preventing Adolescent Drug Abuse Intervention Strategies Editors: Thomas J. Glynn, Ph.D. Carl G. Leukefeld, D.S.W. Jacqueline P. Ludford, M.S. National Institute on Drug Abuse NIDA Research Monograph 47 A RAUS Review Report DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Alcohol, Drug Abuse, and Mental Health Administration National Institute on Drug Abuse 5600 Fishers Lane Rockville, Maryland 20857 For sale by the Superintendent of Documents, U.S. Government Printing Office Washington, D.C. 20402 NIDA Research Monographs are prepared by the research divtsrons of the National lnstitute on Drug Abuse and published by its Office of Science. The primary objective of the series is to provide critical reviews of research problem areas and techniques, the content of state-of-the-art conferences, and integrative research reviews. Its dual publication emphasis is rapid and targeted dissemination to the scientific and professional community. Editorial Advisors MARTIN W. ADLER, Ph D. SIDNEY COHEN, M.D Temple University School of Medicine Los Angeles, California Philadelphia, Pennsylvania SYDNEY ARCHER, Ph.D. MARY L. JACOBSON Rensselaer Polytechnic lnstitute National Federation of Parents for Troy, New York Drug Free Youth Omaha, Nebraska RICHARD E. BELLEVILLE, Ph.D. NB Associates, Health Sciences Rockville, Maryland REESE T. JONES, M.D. KARST J. BESTEMAN Langley Porter Neuropsychiatric Institute Alcohol and Drug Problems Association San Francisco, California of North America Washington, D.C DENISE KANDEL, Ph.D. GILBERT J. BOTVIN, Ph.D. College of Physicians and Surgeons of Cornell University Medical College Columbia University Now York. New York New York, New York JOSEPH V. BRADY, Ph.D. The Johns Hopkins University School of HERBERT KLEBER, M.D. Medicine Yale University School of Medicine Baltimore, Maryland New Haven, Connecticut THEODORE J. CICERO, Ph. D. Washington University School of RICHARD RUSSO Medicine New Jersey State Department of Health St. Louis, Missouri Trenton, New Jersey NIDA Research Monograph Series CHARLES R. SCHUSTER, Ph.D. Director, NIDA JEAN PAUL SMITH, Ph.D. Acting Associate Director for Science, NIDA Acting Editor Parklawn Building, 5600 Fishers Lane, Rockville, Maryland 20857 Preventing Adolescent Drug Abuse Intervention Strategies ACKNOWLEDGMENT This monograph is based upon papers and discussion from the RAUS Review Conference on strategies for prevention of adolescent drug abuse, held April 14 and 15, 1983, in Rockville, Maryland, sponsored by the Office of Science, National Institute on Drug Abuse. Editor Thomas J. Glynn, Ph.D., who served on the staff of the NIDA Division of Clinical Research, is now with the National Cancer Institute. COPYRIGHT STATUS The National Institute on Drug Abuse has obtained permission from the copyright holders to reproduce certain previously published material as noted in the text. Further reproduction of this material is prohibited without specific permission of the copyright holders. All other material in this volume except quoted passages from copyrighted sources is in the public domain and may be used or reproduced without permission from the Institute or the authors. Citation of the source is appreciated. Opinions expressed in this volume are those of the authors and do not necessarily reflect the opinions or official policy of the National Institute on Drug Abuse, or any other part of the U.S. Department of Health and Human Services. The U.S. Government does not endorse or favor any specific commercial product or commodity. Trade or proprietary names appearing in this publication are used only because they are considered essential in the context of the studies reported herein. Library of Congress catalog card number 83-600601 DHHS publication number (ADM)86-1280 Printed 1983 Reprinted 1985, 1986 NIDA Research Monographs are indexed in the Index Medicus. They are selectively included in the coverage of American Statistics Index, Biosciences Information Service, Chemical Abstracts, Current Contents, Psychological Abstracts and Psychopharmacology Abstracts. iv Preface The Research Analysis and Utilization System (RAUS) is designed to serve four functions: Collect and systematically classify the findings of all intramural and extramural research supported by the National Institute on Drug Abuse (NIDA); Evaluate the findings in selected areas of particular interest and formulate a state-of-the-art review by a panel of scientific peers; Disseminate findings to researchers in the field and to administrators, planners, instructors, and other interested persons; Provide a feedback mechanism to NIDA staff and planners so that the administration and monitoring of the NIDA research program reflect the very latest knowledge gleaned from research in the field. Since there is a limit to the number of research findings that can be intensively reviewed annually, four subject areas are chosen each year to undergo a thorough examination. Distinguished scientists in the selected field are provided with copies of reports from NIDA-funded research and invited to add any information derived from the literature and from their own research in order to formulate a comprehensive view of the field. Each reviewer is charged with writing a state-of-the-art paper in his or her particular subject area. These papers, together with a summary of the discussions and recommendations which take place at the review meeting, make up a RAUS Review Report in the NIDA Research Monograph series. v “Preventing adolescent drug abuse” was chosen as a subject for a comprehensive RAUS review in FY 1983 because a large body of knowledge has developed relative to preventing tobacco smoking in youth and the time seemed propitious for review of the state-of-the-art in light of its possible applicability to the prevention of other forms of drug abuse. The results of this review are presented in this monograph. vi Contents Preface . v Executive Summary Jacqueline P. Ludford . 1 The Role of Mass Media in Preventing Adolescent Substance Abuse Brian R. Flay and Judith L. Sobel . 5 Social-Psychological Approaches Alfred L. McAlister . 36 Doing the Cube: Preventing Drug Abuse Through Adolescent Health Promotion Cheryl L. Perry and Richard Jessor . 51 Comprehensive Community Programs for Drug Abuse Prevention: Implications of the Community Heart Disease Prevention Programs for Future Research C. Anderson Johnson and Julie Solis . 76 Prevention of Adolescent Substance Abuse Through the Development of Personal and Social Competence Gilbert J. Botvin . 115 Alternatives to Drug Abuse: Some Are and Some Are Not John D. Swisher and Teh-Wei Hu . 141 Empirical Foundations of Family-Based Approaches to Adolescent Substance Abuse Brenna H. Bry . .. 154 A Value Approach to the Prevention and Reduction of Drug Abuse Milton Rokeach . 172 vii Prevention of Adolescent Substance Abuse Through Social Skill Development Mary Ann Pentz . 195 Preventing Adolescent Substance Abuse Through Drug Education Joel M. Moskowitz . 233 Discussion and Recommendations Carl G. Leukefeld and Joel M. Moskowitz . 250 List of NIDA Research Monographs . 256 viii Executive Summary Jacqueline P. Ludford, M.S. From a public health view, the prevention of drug abuse among adolescents is an enormous and pressing problem. Recognizing that it was time to review prevention strategies which have been used with a certain degree of success in the tobacco smoking area and evaluate their applicability to drug abuse prevention strategies, NIDA convened a RAUS meeting on “Preventing Adolescent Drug Abuse” on April 14-15, 1983. The presentations included: Media Approaches to Dr. Brian Flay Adolescent Substance University of Abuse Prevention Southern California Social Psychologically-Based Dr. Alfred McAlister Approaches to Adolescent University of Texas Substance Abuse Prevention Health Promotion Approaches Dr. Cheryl Perry to Adolescent Substance University of Minnesota Abuse Prevent ion Dr. Richard Jessor University of Colorado Community-Level Interventions Dr. C. Anderson Johnson in the Prevention of University of Adolescent Substance Abuse Southern California Prevention of Adolescent Dr. Gilbert Botvin Substance Abuse Through Cornell University Life Skills Development Medical College Provision of Alternative Dr. John Swisher Activities as an Adolescent Pennsylvania State Substance Abuse Prevention University Approach Family-Based Approaches to Dr. Brenna Bry Adolescent Substance Abuse Rutgers University Prevent ion 1 Value Approaches to Adolescent Dr. Milton Rokeach Substance Abuse Prevention Washington State Univ. Prevention of Adolescent Dr. Mary Ann Pentz Substance Abuse through University of Tennessee Social Skill Development Prevention of Adolescent Dr. Joel Moskowitz Substance Abuse through “The NAPA Project” Drug Education Dr. Richard Jessor, of the University of Colorado, and Dr. Thomas Glynn, of the Division of Clinical Research, NIDA (now at the National Cancer Institute), served as cochairmen for the meeting and led the discussions. Dr. Flay discussed the role of mass media campaigns in drug abuse prevent ion. He emphasized the importance of media in the lives of children and suggested that campaigns must not only give information but also give skills to resist other media influences such as “models,” anti- versus pro-social programming,
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