Sloboda Zili, Stephens Richard C, Stephens Peggy C, Grey Scott F, Teasdale Brent, Hawthorne Richard D, Williams Joseph, Marquette Jesse F
Institute for Health and Social Policy, The University of Akron, 225 S. Main Street, Suite 520, Akron, OH 44325-1915, United States.
Drug Alcohol Depend. 2009 Jun 1;102(1-3):1-10. doi: 10.1016/j.drugalcdep.2009.01.015. Epub 2009 Mar 29.
The purpose of the study was to determine whether a universal school-based substance abuse prevention program, Take Charge of Your Life (TCYL), prevents or reduces the use of tobacco, alcohol, or marijuana.
Eighty-three school clusters (representing school districts) from six metropolitan areas were randomized to treatment (41) or control (42) conditions. Using active consenting procedures, 19,529 seventh graders were enrolled in the 5-year study. Self-administered surveys were completed by the students annually. Trained Drug Abuse Resistance Education (D.A.R.E.) police officers presented TCYL in seventh and ninth grades in treatment schools. Analyses were conducted with data from 17,320 students who completed a baseline survey. Intervention outcomes were measured using self-reported past-month and past-year use of tobacco, alcohol, and marijuana when students were in the 11th grade.
Main effect analyses show a negative program effect for use of alcohol and cigarettes and no effect for marijuana use. Subgroup analyses indicated that the negative effect occurred among nonusers at baseline, and mostly among white students of both genders. A positive program effect was found for students who used marijuana at baseline. Two complementary papers explore the relationship of the targeted program mediators to the use of alcohol, tobacco, and marijuana and specifically for students who were substance-free or who used substances at baseline.
The negative impact of the program on baseline nonusers of alcohol and tobacco indicate that TCYL should not be delivered as a universal prevention intervention. The finding of a beneficial effect for baseline marijuana users further supports this conclusion. The programmatic and methodological challenges faced by the Adolescent Substance Abuse Prevention Study (ASAPS) and lessons learned offer insights for prevention researchers who will be designing similar randomized field trials in the future.
本研究旨在确定一项基于学校的通用药物滥用预防计划——“掌控你的生活”（TCYL）能否预防或减少烟草、酒精或大麻的使用。
来自六个大都市地区的83个学校集群（代表学区）被随机分为治疗组（41个）或对照组（42个）。通过主动同意程序，19529名七年级学生参与了这项为期5年的研究。学生每年完成自我管理的调查问卷。经过培训的药物滥用抵抗教育（D.A.R.E.）警官在治疗学校的七年级和九年级讲授TCYL。分析使用了17320名完成基线调查的学生的数据。干预结果通过学生11年级时自我报告的过去一个月和过去一年烟草、酒精和大麻的使用情况来衡量。
主效应分析显示该计划对酒精和香烟的使用有负面效果，对大麻的使用没有效果。亚组分析表明，负面效果出现在基线时的非使用者中，且主要出现在男女白人学生中。对于基线时使用大麻的学生，发现了该计划的积极效果。两篇补充论文探讨了目标计划中介因素与酒精、烟草和大麻使用之间的关系，特别是针对基线时无药物使用或有药物使用的学生。
该计划对基线时不使用酒精和烟草的学生产生负面影响，这表明TCYL不应作为通用预防干预措施实施。对基线时使用大麻的学生有有益效果这一发现进一步支持了这一结论。青少年药物滥用预防研究（ASAPS）面临的计划和方法挑战以及吸取的经验教训为未来将设计类似随机现场试验的预防研究人员提供了见解。
