Topic 3 Case studies of school-based interventions

In this topic, there is a presentation of three school-based alcohol preventive interventions, which were classified as the most promising by Spoth and Colleagues (2008, 2009, in Stigler, Neusel & Cheryl, 2011), separated according to children’s age.

Children younger than 10 years of age

Raising Healthy Children (RHC)

Description of methodology:

This intervention was designed to promote positive youth development by using a social developmental approach to target risk and protective factors.

The school and family environment are incorporated into the individual programming which targets the child.

The program covers all the range of ages of youth (from kindergarten to high school), suggesting age-appropriate material relevant to the development stages of youth. The main goals of RHC are to increase school commitment, academic performance, and social competency and to reduce antisocial behaviour.

The programme considered that as children grow older, peers have a larger role in their behaviour. Socialisation involves four related principles:

  1. perceived opportunities for involvement in activities and interactions with others,
  2. actual degrees of involvement and interactions,
  3. skills to participate successfully in these interactions and activities, and
  4. reinforcement perceived from these interactions and activities.

When socialising happens continuously, the child develops a bond with the socialising unit (such as peers), which in turn guide the behaviour of the child, by leading it to accept some actions and reject other. The goal of the programme was to have children socialise and form bonds with prosocial people, leading to positive behaviours and youth development.

The programme targeted teachers, parents, and students:

a)Teachers received workshops to use classroom management skills and effective learning strategies that can reduce students’ early aggressive behaviours and academic risk factors while increasing protective factors.

Some topics are proactive classroom management, cooperative learning methods, and strategies to enhance student motivation. These workshops are enriched with classroom coaching and a substitute for a half-day could be in the class so the teachers could observe another teacher using the RHC teaching strategies in the classroom. The school intervention component concentrated on enhancing students’ learning, interpersonal, and problem-solving skills, while also increasing academic performance and bonding to school.

b)Students received classes and exercises in social and emotional development, conflict resolutions, consequential thinking, and problem-solving to improve academic performance, increase bonding to the school, teach refusal skills, and build up prosocial beliefs about healthy and conventional behaviours. The program provided students with peer intervention strategies that teach social, emotional, and problem-solving skills. The classes and lessons were specific to the children’s age. For instance, younger students could participate in afterschool tutoring sessions and study clubs during elementary school, but older students were involved in individualised learning sessions and group-based workshops in middle and high schools. RHC also offered summer camp programs for students with academic or behavioural problems who were personally recommended by their teachers in elementary school as well as social skills booster retreats in middle school.

c)Parents were provided with a structured series of 5 workshops, in-home sessions for selected families and extra support for up to 12 sessions. The parental workshops were delivered by school–home coordinators (SHCs). These staff members were expert classroom teachers and specialists who were specially trained to provide services to parents and families. Parents were taught how to provide reinforcement for good behaviour and consequences for bad behaviour and to communicate with their children, how to make clear rules and standards about specific behaviours (substance use, dating, and sex), and overall to enhance their parenting skills and decrease family conflicts.

Outcomes of evaluation of the programme:

  • Alcohol Use: Brown and colleagues (2005) found that the prevalence rate of alcohol use increased from grades 6 through 10. Specifically, 29% of all students in the 6th grade had used alcohol at least once in the past 12 months, compared with 51% in the 10th grade. The intervention did not show any results on changing rates of alcohol use or non-use.
  • Alcohol frequency: There was significant evidence of frequent alcohol use. The intervention was unable to prevent children of the intervention group from trying or from using alcohol, but it did reduce their frequency of alcohol use compared with the control group.
  • Cigarette use and frequency: The prevalence of cigarette use doubled, from 9% in the 7th grade to 18% in the 10th grade. Also, students receiving the intervention tried and used cigarettes at the same levels as those in the control groups.

In case of interest, check also the Seattle Social Development Project.

Adolescents ages 10 to 15 years

keepin’ it REAL

Description of methodology:

This programme is a substance use prevention and social and emotional competency enhancing program, which was designed to enhance the competencies linked to preventing substance use and abuse.

This program is based on the real stories of young adolescents and program videos serve to provide social modelling of effective strategies, promoting a from kids - through kids - to kids approach.

It enhances social, psychological, and emotional competencies that serve to protect youth from substance use, provides visual behavioural models, and practice opportunities for the application of skills.

The programme consists of ten 45-minutes lessons including role-play scenarios and decision-making applications, which are based on real teens’ stories.

The topics of the lessons include Options and Choices, Risks, Communication and Conflict, Refuse, Explain, Avoid, Leave, Norms, Dealing with Feelings, and Support Networks.

The lessons are designed to promote interaction among the students and the students and teachers so that students are involved in their learning.

Students also learn how to assess risk, value their perceptions and feelings, and communicate effectively. Under this programme, youth have opportunities to create their media with the optional booster intervention which includes three 40-minute lessons and teaches youth to develop their prevention media such as posters and videos.

Outcomes of evaluation of the programme:

It was shown that this programme:

  • Reduces rates of alcohol, tobacco, and marijuana use by as much as 45%.
  • Leads to discontinuation of use. Rates of discontinuing all substance use was 61% higher for program participants than
  • for students who didn’t receive the program.
  • Leads to more realistic perceptions of peer use, increases anti-substance use attitudes, increases efficacy in resisting
  • Offers of substances, improves relationship skills, self-awareness, and responsible decision-making.

In case of interest, check also the Midwestern Prevention Project (MPP), also known as Project STAR. The Project Northland intervention has been shown effective for children of middle-school ages (11-13) and has been implemented and shown to be successful with high-school students (ages 14-18).