Merrill Jeffrey C, Pinsky Ilana, Killeya-Jones Ley A, Sloboda Zili, Dilascio Tracey
Division of Addiction Psychiatry, UMDNJ-Robert Wood Johnson Medical School, 671 Hoes Lane, Piscataway, NJ, USA.
Subst Abuse Treat Prev Policy. 2006 Sep 6;1:25. doi: 10.1186/1747-597X-1-25.
The only national drug abuse prevention delivery system that supports the rapid diffusion of new prevention strategies and includes uniform training and credentialing of instructors who are monitored for quality implementation of prevention programming is the Drug Abuse Resistance Education network (D.A.R.E.) linking community law enforcement to schools. Analysis of the organizational structure and function of D.A.R.E. provides an understanding of the essential parameters of this successful delivery system that can be used in the development of other types of national infrastructures for community-based prevention services. Information regarding organizational structure and function around funding issues, training, quality control and community relationships was gathered through telephone surveys with 50 state D.A.R.E. coordinators (including two major cities), focus groups with local D.A.R.E. officers and mentors, and interviews with national D.A.R.E. office staff.
The surveys helped identify several strengths inherent in the D.A.R.E. program necessary for building a prevention infrastructure, including a well-defined organizational focus (D.A.R.E. America), uniform training and means for rapid dissemination (through its organized training structure), continuing education mechanisms (through the state and national conference and website), mechanisms for program monitoring and fidelity of implementation (formal and informal), branding and, for several states, predictable and consistent financing. Weaknesses of the program as currently structured include unstable funding and the failure to incorporate components for the continual upgrading of curricula reflecting research evidence and "principles of prevention".
The D.A.R.E. organization and service delivery network provides a framework for the rapid dissemination of evidence-based prevention strategies. The major strength of D.A.R.E. is its natural affiliation to local law enforcement agencies through state coordinators. Through these affiliations, it has been possible for D.A.R.E. to become established nationally within a few years and internationally within a decade. Understanding how this structure developed and currently functions provides insights into how other such delivery systems could be developed.
唯一支持新预防策略快速传播、包括对教员进行统一培训和认证并对预防项目实施质量进行监督的全国性药物滥用预防服务体系是将社区执法部门与学校联系起来的药物滥用抵抗教育网络（D.A.R.E.）。对D.A.R.E.的组织结构和功能进行分析，有助于理解这一成功服务体系的基本参数，这些参数可用于开发其他类型的基于社区的预防服务国家基础设施。通过与50位州D.A.R.E.协调员（包括两个主要城市）进行电话调查、与当地D.A.R.E.官员和导师进行焦点小组讨论以及与国家D.A.R.E.办公室工作人员进行访谈，收集了有关围绕资金问题、培训、质量控制和社区关系的组织结构和功能的信息。
这些调查有助于确定D.A.R.E.项目中构建预防基础设施所需的几个固有优势，包括明确的组织重点（美国D.A.R.E.）、统一培训和快速传播手段（通过其有组织的培训结构）、继续教育机制（通过州和全国会议及网站）、项目监测和实施保真机制（正式和非正式）、品牌建设，以及对几个州来说，可预测和一致的资金。当前结构的项目弱点包括资金不稳定以及未能纳入反映研究证据和“预防原则”的课程持续更新的组成部分。
D.A.R.E.组织和服务提供网络为循证预防策略的快速传播提供了一个框架。D.A.R.E.的主要优势在于其通过州协调员与地方执法机构的天然联系。通过这些联系，D.A.R.E.有可能在几年内在全国范围内建立起来，并在十年内在国际上建立起来。了解这种结构是如何发展以及目前如何运作，有助于深入了解其他此类服务体系的开发方式。
