Clayton R R, Cattarello A M, Johnstone B M
Center for Prevention Research, Lexington, Kentucky 40504, USA.
Prev Med. 1996 May-Jun;25(3):307-18. doi: 10.1006/pmed.1996.0061.
This article reports the results of a 5-year, longitudinal evaluation of the effectiveness of Drug Abuse Resistance Education (DARE), a school-based primary drug prevention curriculum designed for introduction during the last year of elementary education. DARE is the most widely disseminated school-based prevention curriculum in the United States.
Twenty-three elementary schools were randomly assigned to receive DARE and 8 were designated comparison schools. Students in the DARE schools received 16 weeks of protocol-driven instruction and students in the comparison schools received a drug education unit as part of the health curriculum. All students were pretested during the 6th grade prior to delivery of the programs, posttested shortly after completion, and resurveyed each subsequent year through the 10th grade. Three-stage mixed effects regression models were used to analyze these data.
No significant differences were observed between intervention and comparison schools with respect to cigarette, alcohol, or marijuana use during the 7th grade, approximately 1 year after completion of the program, or over the full 5-year measurement interval. Significant intervention effects in the hypothesized direction were observed during the 7th grade for measures of students' general and specific attitudes toward drugs, the capability to resist peer pressure, and estimated level of drug use by peers. Over the full measurement interval, however, average trajectories of change for these outcomes were similar in the intervention and comparison conditions.
The findings of this 5-year prospective study are largely consonant with the results obtained from prior short-term evaluations of the DARE curriculum, which have reported limited effects of the program upon drug use, greater efficacy with respect to attitudes, social skills, and knowledge, but a general tendency for curriculum effects to decay over time. The results of this study underscore the need for more robust prevention programming targeted specifically at risk factors, the inclusion of booster sessions to sustain positive effects, and greater attention to interrelationships between developmental processes in adolescent substance use, individual level characteristics, and social context.
本文报告了一项为期5年的纵向评估结果，该评估针对药物滥用抵抗教育（DARE）的有效性展开，DARE是一种为小学教育最后一年设计的校内初级药物预防课程。DARE是美国传播最广泛的校内预防课程。
23所小学被随机分配接受DARE课程，8所被指定为对照学校。接受DARE课程学校的学生接受16周的标准化指导，对照学校的学生接受作为健康课程一部分的药物教育单元。所有学生在六年级课程开始前进行预测试，课程结束后不久进行后测试，并在随后每年直至十年级进行重新调查。采用三阶段混合效应回归模型分析这些数据。
在课程结束约1年后的七年级，或在整个5年的测量期内，干预学校和对照学校在吸烟率、酒精或大麻使用率方面未观察到显著差异。在七年级时，观察到在假设方向上的显著干预效果，涉及学生对药物的总体和特定态度、抵抗同伴压力的能力以及对同伴药物使用估计水平的测量。然而，在整个测量期内，这些结果在干预组和对照组中的平均变化轨迹相似。
这项为期5年的前瞻性研究结果与之前对DARE课程的短期评估结果基本一致，此前的评估报告该课程对药物使用的影响有限，在态度、社交技能和知识方面效果更佳，但课程效果总体上有随时间衰减的趋势。本研究结果强调需要针对特定风险因素开展更有力的预防项目，纳入强化课程以维持积极效果，并更加关注青少年药物使用中的发展过程、个体层面特征和社会环境之间的相互关系。
