The primary aim of this revised competing continuation application is to test the efficacy of innovative, brief alcohol abuse prevention strategies in the form of an interpersonal consultation (Consult), parent communication (Parent), and combined strategy (Combined), which integrate positive youth development messages and health risk messages for substance using adolescents in diverse high school settings. A secondary aim is to examine these strategies in various combinations as interventions and re-interventions (i.e., boosters) for sustaining or enhancing behavior change effects over time. These strategies are founded upon an emerging conceptual framework titled the Behavior-Image Model emanating from findings of our recent trials examining multiple health behavior intervention outcomes. The long-term objective of this project is to reduce alcohol abuse and problems among older high-risk adolescents who currently use alcohol or other drugs, but are often ignored in prevention research and services. We propose to conduct an initial formative research phase, followed by two separate trial phases. The first trial is a randomized pilot study to evaluate the feasibility and efficacy of two enhanced strategies (Consult vs. Parent) and a Combined strategy (Consult plus Parent) constituting the second generation integrative, multiple behavior preventive intervention Project SPORT II for high-risk substance using adolescents. The second trial is a randomized longitudinal evaluation of the effects, cost, and cost-effectiveness of the strategies as initial interventions, as well as re-interventions using various combinations, among substance using adolescents from diverse high school environments, including urban, suburban, and rural settings. We will also examine mechanisms of action to see whether any effects of the preventive intervention on alcohol consumption, including current use, heavy use, and alcohol-related problems, as well as on exercise habits and cigarette and marijuana use, were mediated by various theory-based cognitive, social, and environmental risk and protective factors. ? ? ?
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