The aims of this research are to 1) reduce the incidence and prevalence of alcohol abuse among adolescents; 2) test the relative efficacy of social psychologically based prevention programs which focus on social influence resistance training versus normative education versus a combined approach; 3) test the efficacy of prevention programs which are delivered at seventh versus ninth grades. All programs will feature the use of same age peer leaders a program facilitators. A five year study is proposed. The study will be divided into two phases. In Phase I, materials will be refined and process evaluation will be the focus of research activities. During this period, comparability of programs in terms of peer leader involvement and health educator delivery of programs will be assured via empirical tests of these as confounding variables. During this period, the combined curriculum will also be developed. All program materials will be tested for student receptivity and theoretical integrity. Phase II will involve a formal test of the three curricula as preventive treatments for seventh and ninth grade students. In a 3x2 + controls experimental design in which cohort and year of treatment are partially unconfounded, schools are assigned randomly to receive a resistance training, normative education or combined program each of which focuses on preventing the onset of alcohol abuse. The resistance training and normative education programs will consist of six sessions. The combined program is expected to consist of nine sessions (the exact length to be determined empirically in Phase I). Junior-senior high school complexes will be assigned randomly to receive intervention at either the seventh or ninth grade levels. Non-intervention (randomly assigned) controls will be included. Subjects will be pre and posttested with a questionnaire which will assess alcohol use (including contextual use), attitudes, beliefs, normative expectations, self-efficacy, and use by others. Special attention will be devoted to assessing variables hypothesized to mediate program effectiveness.

National Institute of Health (NIH)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Research Project (R01)
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Alcohol Psychosocial Research Review Committee (ALCP)
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University of Southern California
Schools of Medicine
Los Angeles
United States
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Palmer, R F; Graham, J W; White, E L et al. (1998) Applying multilevel analytic strategies in adolescent substance use prevention research. Prev Med 27:328-36
MacKinnon, D P; Williams-Avery, R M; Pentz, M A (1995) Youth beliefs and knowledge about the risks of drinking while pregnant. Public Health Rep 110:754-63
Donaldson, S I; Graham, J W; Piccinin, A M et al. (1995) Resistance-skills training and onset of alcohol use: evidence for beneficial and potentially harmful effects in public schools and in private Catholic schools. Health Psychol 14:291-300
Donaldson, S I; Graham, J W; Hansen, W B (1994) Testing the generalizability of intervening mechanism theories: understanding the effects of adolescent drug use prevention interventions. J Behav Med 17:195-216
Aloise-Young, P A; Graham, J W; Hansen, W B (1994) Peer influence on smoking initiation during early adolescence: a comparison of group members and group outsiders. J Appl Psychol 79:281-7
Rohrbach, L A; Graham, J W; Hansen, W B (1993) Diffusion of a school-based substance abuse prevention program: predictors of program implementation. Prev Med 22:237-60
Graham, J W; Donaldson, S I (1993) Evaluating interventions with differential attrition: the importance of nonresponse mechanisms and use of follow-up data. J Appl Psychol 78:119-28
Graham, J W; Marks, G; Hansen, W B (1991) Social influence processes affecting adolescent substance use. J Appl Psychol 76:291-8
Graham, J W; Collins, L M; Wugalter, S E et al. (1991) Modeling transitions in latent stage-sequential processes: a substance use prevention example. J Consult Clin Psychol 59:48-57
Hansen, W B; Graham, J W; Wolkenstein, B H et al. (1991) Program integrity as a moderator of prevention program effectiveness: results for fifth-grade students in the adolescent alcohol prevention trial. J Stud Alcohol 52:568-79

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