Comprehensiveness of substance use prevention programs in U.S. middle schools.

ABSTRACT

PURPOSE: To assess how current practice in middle school substance use prevention programs compares with seven recommended guidelines adapted from the Centers for Disease Control and Prevention guidelines for school-based tobacco use prevention programs. METHODS: Substance use prevention practice was analyzed using data from a 1999 mailed questionnaire of a nationally representative sample of 1496 public and private schools with middle school grades that reported having a substance use prevention program. Respondents answered questions about substance use prevention education and activities in the whole school and in their own classroom. Weighted prevalence estimates for the seven recommendations are presented, and multiple regression was used to analyze correlates of implementation of the recommendations. RESULTS: An estimated 64.2% of schools met four or more of the recommendations for school-based substance use prevention practice; 4.0% met all seven recommendations. Schools were most likely to report having and enforcing substance use prevention policies (84.3%) and least likely to report training teachers in substance use prevention (17.9%). More recommendations were implemented in schools that were public and had larger enrollments, greater perceived availability of resources, greater school board and parental support for substance use prevention, and had hired a school substance use prevention coordinator. CONCLUSIONS: The low prevalence of comprehensive substance use prevention programs in U.S. middle schools may limit the potential impact of school programs on the prevalence of youth substance use.