An Online Drug Abuse Prevention Program for Adolescent Girls: Posttest and 1-Year Outcomes.

Early adolescent girls' rates of drug use have matched, and in some instances, surpassed boys' rates. Though girls and boys share risk factors for drug use, girls also have gender-specific risks. Tailored interventions to prevent girls' drug use are warranted. This study developed and tested a web-based, drug abuse prevention program for adolescent girls. The nationwide sample of 13- and 14-year-old girls (N = 788) was recruited via Facebook ads. Enrolled girls were randomly assigned to the intervention or control condition. All girls completed pretest measures online. Following pretest, intervention girls interacted with the 9-session, gender-specific prevention program online. The program aimed to reduce girls' drug use and associated risk factors by improving their cognitive and behavioral skills around such areas as coping with stress, managing mood, maintaining a healthy body image, and refusing drug use offers. Girls in both conditions again completed measures at posttest and 1-year follow-up. At posttest, and compared to girls in the control condition, girls who received the intervention smoked fewer cigarettes and reported higher self-esteem, goal setting, media literacy, and self-efficacy. At 1-year follow-up, and compared to girls in the control condition, girls who received the intervention reported engaging in less binge drinking and cigarette smoking; girls assigned to the intervention condition also had higher alcohol, cigarette, and marijuana refusal skills, coping skills, and media literacy and lower rates of peer drug use. This study's findings support the use of tailored, online drug abuse prevention programming for early adolescent girls.

Risk and protective factors associated with adolescent girls' substance use: Data from a nationwide Facebook sample.

BACKGROUND: Despite overall reductions in teenage substance use, adolescent girls' rates of substance use remain unacceptably high. This article examines whether girls' substance use is associated with general risk and protective factors (goal setting, problem solving, refusal skills, peer use, and self-efficacy) and gender-specific risk and protective factors (communication style, coping skills, self-esteem, body image, perceived stress, anxiety, and depression). METHODS: Cross-sectional data were collected in 2013 via online surveys from a nationwide sample of adolescent girls (N = 788), aged 13 and 14 years, who were recruited through Facebook. RESULTS: In multivariate analyses, controlling for correlates of adolescent substance use, 11 of the 13 general and gender-specific risk and protective factors were consistently associated with past-month alcohol, cigarette, and other drug use in the expected direction; past-month marijuana use was associated with 8 of the 13 factors. Refusal skills, peer use, coping, and depressive mood were most consistently and strongly associated with substance use. CONCLUSIONS: Substance abuse prevention programs targeting adolescent girls should focus on such general risk and protective factors as problem solving, refusal skills, peer influences, and self-efficacy, as well as such gender-specific risk and protective factors as communication style, coping, self-esteem, body image, perceived stress, and mood management.

Preventing Drug Abuse Among Hispanic Adolescents: Developing a Responsive Intervention Approach.

Intervention research is essential to help Hispanic American adolescents avoid drug use. This article describes an intervention research program aimed at preventing drug use among these youths. Grounded in salient epidemiological data, the program is informed by bicultural competence, social learning, and motivational interviewing theories. The program, called Vamos, is aimed at the risk and protective factors as well as the cultural prerogatives that demark the adolescent years of Hispanic American youths. Innovative in its approach, the program is delivered through a smartphone application (app). By interacting with engaging content presented via the app, youths can acquire the cognitive-behavioral skills necessary to avoid risky situations, urges, and pressures associated with early drug use. The intervention development process is presented in detail, and an evaluation plan to determine the program's efficacy is outlined. Lessons for practice and intervention programming are discussed.

Alcohol Use and Related Behaviors among Late Adolescent Urban Youth: Peer and Parent Influences.

Peer and parent influences on alcohol use and related risky behaviors were examined in a sample of late adolescent (M = 17.3 years; SD = 1.11 years) urban youth. Participants (N = 400) completed an online measure assessing peer influences of alcohol use and alcohol offers, and parent influences of rules against alcohol use and perceived levels of emotional family support, relative to youths' alcohol use, binge drinking, alcohol-related consequences, and intentions to drink. Hierarchical regression analyses revealed that increased peer alcohol use and alcohol offers were associated with youths' increased drinking, binge drinking, alcohol-related consequences, and intentions to drink. Controlling for peer influences, parental rules against alcohol use were associated with decreased drinking, binge drinking, and intentions to drink; increased levels of family support was associated with decreased alcohol-related consequences and intentions to drink. These findings suggest that parental influences, albeit small relative to peer influences, are associated with fewer instances of monthly alcohol use and related risky behaviors among late adolescent urban youth.

Longitudinal Outcomes of a Smartphone Application to Prevent Drug Use Among Hispanic Youth.

OBJECTIVE: This trial tested the efficacy of a smartphone application (app) designed to prevent drug use among Hispanic youth. METHOD: Participants were recruited through online advertising and youth service agencies. The baseline sample (N = 644) had a mean age of 14.1 years, was primarily female (60%), and resided in 31 U.S. states and Puerto Rico. Youth assented to study participation and received parental permission to participate. Youth were randomly assigned to an intervention arm or a measurement-only control arm. Intervention-arm youth completed 10 prevention program sessions via a smartphone app. Following intervention delivery, all youth completed posttest and 1-, 2-, and 3-year follow-up measures. RESULTS: Analyzed within an Arm by Time interaction model, follow-up data showed that compared with control-arm youth, intervention-arm youth reported (a) less increase in alcohol use from baseline to 2-year follow-up; (b) less increase in marijuana use from baseline to 2- and 3-year follow-ups; and (c) less increase in polydrug use from baseline to 1-, 2-, and 3-year follow-ups. Compared with youth in the control arm, intervention-arm youth reported (a) less depressed mood and improved skills for refusing offers of alcohol and tobacco at posttest; (b) higher self-efficacy and social self-efficacy at 1-, 2-, and 3-year follow-ups; (c) improved skills for refusing offers of marijuana at 2- and 3-year follow-ups; (d) higher media literacy at 2- and 3-year follow-ups; and (e) better coping skills at 3-year follow-up. CONCLUSIONS: These longitudinal findings suggest that Hispanic youth can profit from tailored, skills-based content delivered via a smartphone app to prevent drug use.

Preventing drug abuse among adolescent girls: outcome data from an internet-based intervention.

This study developed and tested an Internet-based gender-specific drug abuse prevention program for adolescent girls. A sample of seventh, eighth, and ninth grade girls (N = 236) from 42 states and 4 Canadian provinces were randomly assigned to an intervention or control group. All girls completed an online pretest battery. Following pretest, intervention girls interacted with a 12-session, Internet-based gender-specific drug prevention program. Girls in both groups completed the measurement battery at posttest and 6-month follow-up. Analysis of posttest scores revealed no differences between groups for 30-day reports of alcohol, marijuana, poly drug use, or total substance use (alcohol and drugs). At 6-month follow-up, between-group effects were found on measures of 30-day alcohol use, marijuana use, poly drug use, and total substance use. Relative to girls in the control group, girls exposed to the Internet-based intervention reported lower rates of use for these substances. Moreover, girls receiving the intervention achieved gains over girls in the control group on normative beliefs and self-efficacy at posttest and 6-month follow-up, respectively.

Alcohol abuse prevention among high-risk youth: computer-based intervention.

SUMMARYThis study examined the feasibility of a CD-ROM intervention to prevent alcohol abuse among high-risk youths. Youths from 41 community-based agencies in greater New York City participated in a randomized trial of a skills-based interactive CD-ROM. Outcome data were collected on 489 early adolescents in these agencies before and after a randomized subset of youths interacted with a 10-session alcohol abuse prevention program on CD-ROM. Compared to control participants, youths in the intervention arm had a positive increase in perceived harm of alcohol use and increased assertiveness skills. At posttest, drinking rates for control and intervention participants were equal and unchanged from pretest. These findings suggest that CD-ROM technology offers a new and promising medium for engaging high-risk youth in an alcohol abuse prevention program. Study implications and future applications of the present approach are discussed.

Evaluation of a brief computer-mediated intervention to reduce HIV risk among early adolescent females.

PURPOSE: To evaluate the efficacy of a brief computer-mediated intervention, relative to no intervention, in altering HIV/AIDS-related knowledge, protective attitudes, and self-efficacy for risk reduction among early adolescent females aged 11 through 14 years. METHOD: Recruited through the auspices of a large social services agency with multiple sites across New York City, a volunteer sample of 205 Black, White, and Hispanic young women participated in this research. The efficacy of the software intervention was examined in a randomized blocks design with site as the unit of randomization. Young women at experimental arm sites interacted with the software in a single 30-minute session. Youths at control arm sites participated in regular programs offered at these sites, but did not receive the intervention until all planned assessments were concluded. Before and after intervention, participants completed measures of HIV/AIDS-related knowledge, protective attitudes, and self-efficacy for HIV risk reduction. Analyses of covariance were used to test for significant between-arm effects. RESULTS: Between-arm effects were observed for HIV/AIDS-related knowledge and risk reduction self-efficacy. Experimental arm youths evidenced greater improvements from pretest to posttest than control-arm youths on these outcomes. CONCLUSION: Computer-mediated interventions may improve HIV/AIDS-related knowledge and risk reduction self-efficacy among early adolescent females. However, additional research is needed to find effective computer-mediated approaches for enhancing protective attitudes among this population.

Reducing the risks of alcohol use among urban youth: three-year effects of a computer-based intervention with and without parent involvement.

OBJECTIVE: This study tested a CD-ROM intervention with and without a parent involvement component to reduce risk of alcohol use among an urban sample of early adolescents. METHOD: Youths (N = 514, mean age 11.5 years at recruitment) were assigned randomly by community site to receive the CD-ROM intervention, the CD-ROM plus parent intervention, or no intervention. All youths completed pretest, posttest and three annual follow-up measurements. After pretesting, youths and parents received their respective interventions. RESULTS: Main effects of the intervention and for measurement occasion as well as interaction effects of the intervention by measurement occasion were seen for substance use and related outcomes. Over time, youths in all 3 groups reported increased use of alcohol, tobacco and marijuana; youths who received the interventions reported smaller increases than control youths. At 3-year follow-up, alcohol use was lower for CD-ROM plus parent intervention youths than for CD-ROM only youths, who, in turn, reported less use than controls. Cigarette use was lower for youths in either intervention group than in the control group at posttest and at 1-, 2- and 3-year follow-ups. Marijuana use was lower for youths in either intervention than for controls at 1-, 2- and 3-year follow-ups. Youths in both intervention groups outperformed control youths at posttest and at 1- and 3-year follow-ups on levels of negative and peer influence toward substance use. Finally, at the 3-year follow-up, youths in the CD-ROM plus parent intervention group reported more family involvement in their alcohol use prevention efforts than did youths in the CD-ROM group, who, in turn, reported more positive levels of family involvement than youths in the control group. CONCLUSIONS: Study findings modestly support the CD-ROM intervention with and without the parent intervention to reduce alcohol use risks among urban early adolescents.

A web-based, health promotion program for adolescent girls and their mothers who reside in public housing.

This study tested a brief web-based, family-involvement health promotion program aimed at drug use, physical activity, and nutrition for adolescent girls, aged 10 to 12 years, who reside in public housing. Separately, girls (n=67) and their mothers (n=67) completed baseline measures online. Following baseline, 36 randomly assigned mother-daughter dyads jointly completed a 3-session, health promotion program online. Subsequently, all girls and mothers separately completed posttest and 5-month follow-up measures. Attrition at posttest and 5-month follow-up measures was 3% and 9%, respectively. At posttest, intervention-arm girls, relative to control-arm girls, reported greater mother-daughter communication and parental monitoring. Intervention-arm mothers reported greater mother-daughter communication and closeness as well as increased vegetable intake and physical activity. At 5-month follow-up, intervention-arm girls and mothers, relative to those in the control arm, reported greater levels of parental monitoring. Intervention-arm girls also reported greater mother-daughter communication and closeness, reduced stress, greater refusal skills, and increased fruit intake. Findings indicate the potential of a brief, web-based program to improve the health of low-income girls and their mothers.

Preventing alcohol use among late adolescent urban youth: 6-year results from a computer-based intervention.

OBJECTIVE: This study was undertaken to evaluate the efficacy of a skills-based CD-ROM intervention, with and without a parent component, to reduce alcohol use among urban youth at 6-year follow-up. METHOD: At recruitment, 513 youths with a mean age of 10.8 years were randomly assigned to one of three study arms: youth CD-ROM intervention plus parent component, youth CD-ROM intervention only, or control. All youths completed pretest, posttest, and annual follow-up measures. Youths and parents in their respective arms received the initial intervention program between pretest and posttest measures and received booster interventions between each follow-up measure. RESULTS: With 80% sample retention at 6-year follow-up, youths in both intervention arms reported less past-month alcohol and cigarette use and fewer instances of heavy drinking and negative alcohol-related consequences. Despite having similar numbers of drinking peers as youths in the control arm, youths in both intervention arms reported greater alcohol-refusal skills. Only past-month cigarette use differed between the two intervention arms, with youths in the intervention-plus-parent-component arm smoking less than youths in the CD-ROM intervention-only arm. CONCLUSIONS: Six years after initial intervention, youths who received a culturally tailored, skills-based prevention program had reduced alcohol use and lower rates of related risky behaviors than youths in the control arm.

Longitudinal outcomes of an alcohol abuse prevention program for urban adolescents.

PURPOSE: This randomized clinical trial examined longitudinal outcomes from an alcohol abuse prevention program aimed at urban youths. METHODS: Study participants were an ethnically and racially heterogeneous sample of early adolescents, recruited from community-based agencies in greater New York City and its environs. Once they assented to study participation and gained parental permission, youths were divided into three arms: youth intervention delivered by CD-ROM (CD), the same youth intervention plus parent intervention (CD(P)), and control. Once all youths completed baseline measures, those in CD and CD(P) arms received a computerized 10-session alcohol abuse prevention program. Parents of youths in the CD(P) arm received supplemental materials to support and strengthen their children's learning. All youths completed postintervention and annual follow-up measures, and CD- and CD(P)-arm participants received annual booster intervention sessions. RESULTS: Seven years following postintervention testing and relative to control-arm youths, youths in CD and CD(P) arms reported less alcohol use, cigarette use, binge drinking, and peer pressure to drink; fewer drinking friends; greater refusal of alcohol use opportunities; and lower intentions to drink. No differences were observed between CD and CD(P) arms. CONCLUSIONS: Study findings lend support to the potential of computerized, skills-based prevention programs to help urban youth reduce their risks for underage drinking.

Substance use among late adolescent urban youths: mental health and gender influences.

This paper explores gender and mental health influences on alcohol, tobacco, and illicit drug use among late adolescent urban youths. Specifically, we examine whether rates of substance use differ by gender, whether mental health indices differ by gender and are predictive of substance use, and whether gender moderates the relationship between mental health and substance use. Data from our non-clinical sample of 400 youths were collected primarily online. Analysis of cross-sectional data revealed no differences in substance use by gender. Indices of mental health differed by gender, with girls reporting greater symptoms of depression and anxiety. Ratings of hostility were similar for boys and girls. Alcohol, tobacco, and drug use were associated with greater symptoms of depression, anxiety, and hostility; this relationship, however, was not moderated by gender. Study findings provide evidence that among late adolescent youths living in urban areas, poorer mental health status is associated with increased substance use. Evidence of a moderating effect of gender on the relationship between mental health and substance use was not significant.

The relative efficacy of pamphlets, CD-ROM, and the Internet for disseminating adolescent drug abuse prevention programs: an exploratory study.

BACKGROUND: Despite the availability of an increasing array of empirically validated adolescent drug abuse prevention programs, program materials and evaluation findings are poorly disseminated. CD-ROM and the Internet hold promise for disseminating this information to schools and agencies that directly serve youth, and to policy-making bodies that exercise control over funds to support adolescent drug abuse prevention programming. However, data on the relative efficacy of these newer technologies over conventional print means of dissemination are lacking. METHODS: Recruited through schools, community agencies, and policy-making bodies, 188 professionals were randomized to receive prevention program materials via pamphlets (55 participants), CD-ROM (64 participants), and the Internet (69 participants). Participants completed pretest, posttest, and 6-month follow-up measures that assessed their access to prevention program materials; self-efficacy for identifying, obtaining, and recommending these programs; and their likelihood of requesting, implementing, and recommending prevention programs to their constituents. RESULTS: Participants exposed to dissemination via CD-ROM and the Internet evidenced the greatest short- and long-term gains on accessibility, self-efficacy, and behavioral intention variables. CONCLUSIONS: CD-ROM and the Internet are viable means for disseminating adolescent drug abuse prevention programs to schools, community agencies, and policy-making bodies, and should be increasingly used for dissemination purposes.