The present longitudinal study examined the relationship between patterns of cigarette smoking and alcohol use during adolescence and illicit drug abuse (DA) and prescription drug abuse (PDA) in early adulthood. The sample consisted of 984 predominantly minority young adults (57% women) who completed (a) six annual surveys as adolescents attending New York City public schools (grades 7 through 12) and (b) a follow-up telephone interview as young adults (mean age = 23). Findings from a series of latent growth models indicated that growth in cigarette smoking and alcohol use during adolescence each independently predicted DA in adulthood. Baseline levels of alcohol use in 7th grade also predicted DA in adulthood. Growth in alcohol consumption during adolescence predicted PDA in young adulthood. Results indicate that an escalation during adolescence in the use of substances that are legal for adults (cigarettes and alcohol) contributes to greater DA and PDA in young adulthood. One implication of these findings is that interventions that can prevent cigarette smoking and alcohol use during adolescence may also reduce DA and PDA in young adults.

A substantial barrier to translating prevention science into practice is the potential for low implementation fidelity when evidence-based interventions are delivered in real-world settings. This study tested the extent to which enhanced training and technical assistance can improve implementation fidelity of LifeSkills Training, an evidence-based drug abuse prevention program. Method: We recruited and randomly assigned middle schools (N 5 34) to either a standard provider training condition or a fidelity-enhancement (FE) condition. Teachers in both conditions participated in a standard 1-day training session led by a certified trainer. Teachers in the FE condition received supplemental training and technical assistance (TA), which included planning workbooks, interactive DVD training tools, just-in-time e-mail reminders, and access to TA via the Internet and telephone.Trained coders rated videotapes of classroom teachers implementing curriculum sessions. An intent-to-treat analysis included all videotapes received, including sessions that were only partially implemented or videotaped. Results: Teachers in the FE condition covered significantly more curriculum points and objectives, taught longer sessions, and spent more time using facilitated group discussion and skills practice than teachers in the standard condition. Conclusions: Findings suggest that providing program providers with planning tools and telephone, e-mail and Internetbased TA can significantly enhance implementation fidelity.

BackgroundEffective school-based programs for preventing substance abuse offer considerable public health potential. Yet limited class time and uneven implementation fidelity can be barriers to widespread adoption and high-quality implementation. A hybrid digital approach may be effective and help address these barriers.ObjectiveTo evaluate the effectiveness of a hybrid substance abuse prevention program for middle school students consisting of e-learning modules and in-person class sessions.DesignTwenty-three United States (U.S.) middle schools were randomly assigned either to an intervention condition (13 schools) or a treatment-as-usual control condition (10 schools) where standard health education material was delivered. There were 1,447 participants who completed the pre-test and post-test assessments, of which 48.3% were male and 51.7% female.InterventionThe hybrid digital intervention consisted of 14 brief e-learning modules and six classroom sessions adapted from an evidence-based program designed for classroom implementation to increase knowledge of adverse consequences of substance use and improve social skills, personal coping skills, and skills for resisting social influences to smoke, drink, or use drugs.MeasuresParticipating students completed online pre-test and post-test surveys to assess substance use, knowledge, and life skills.ResultsThere were significant reductions in substance use for the hybrid digital condition compared to the control condition as well as significant increases in health knowledge, skills knowledge, and life skills.ConclusionsA hybrid digital approach to substance abuse prevention is effective and offers potential for overcoming common barriers to widespread adoption and high-quality implementation.

Bullying is a widespread public health problem with significant behavioral and mental health consequences. The current study tested the effectiveness of combining interactive digital material for students, educators, and parents with class sessions to prevent bullying among middle school students. Fourteen middle schools were randomly assigned to intervention and comparison conditions. Both conditions received a classroom-based drug and violence prevention program that taught social skills, self-management skills, and social resistance skills. The intervention condition included class material on bullying and an educational video game for students that reinforced the classroom program; it also included digital material on bullying for parents and school staff. All students completed online pre- and post-test surveys to assess bullying-related behavior, knowledge, and life skills. Results indicated that students in the intervention schools reported significantly less bullying and cyberbullying perpetration and increased life skills knowledge relative to comparison schools. This study provides evidence that a school-based drug abuse and violence prevention program, when enhanced with a set of digital tools for students, parents, and school staff, holds considerable potential for addressing bullying among middle school adolescents.