Independent Evaluation of Middle School-Based Drug Prevention Curricula: A Systematic Review

Introduction: Lack of robust program evaluation has hindered the effectiveness of school-based drug abuse prevention curricula overall. The lack of consensus as to which programs are effective in reducing substance use among early adolescents raises the question of what constitutes high quality evaluation. Two study elements that contribute greatly to the quality of an evaluation are randomization and independent evaluation. We conducted a systematic review identifying independently evaluated randomized controlled trials of universal, middle school-based drug abuse prevention curricula to assess evidence of program effectiveness.

 

Methods: We searched the following databases: PsycInfo, ERIC, Science Citation Index, Social Science Citation Index, CINAHL, Medline, EMBASE, and the Cochrane Database of Systematic Reviews. Studies were included in the review that were RCTs carried out by independent evaluators of universal school-based drug prevention curricula available for dissemination in the United States that reported alcohol and/or other drug use outcomes. Two researchers extracted data independently using a data extraction form and met to resolve disagreements.

 

Results: A total of 4,810 publications were reviewed, with 15 articles meeting final inclusion criteria. Of the 15 articles, 7 RCTs of 4 distinct school-based curricula (Drug Abuse Resistance Education, Life Skills Training, Project Alert, Skills for Adolescence) were identified for inclusion. Outcomes were reported for 53 single-drug measures in the independent RCTs, with just 6 presenting statistically significant (p<.05) differences between the intervention group and the control group. Two programs revealed some statistically significant positive effects at final follow-up (Skills for Adolescence and Life Skills Training).

 

Conclusions: Our review has shown that very little independent research has been conducted to ascertain the effectiveness of universal, middle school-based drug prevention curricula and that independent evaluations have thus far failed to show high levels of effectiveness in terms of preventing substance use. While we do not recommend discounting the findings of developer-led evaluations outright, caution should be exercised when weighing the strength of the evidence in favor of these programs. With 25 years of research in this area showing mixed results, the time may be right for re-thinking our approach to school-based adolescent drug prevention.