Project Options: Outcomes Past and Present

Project Options provides students with the opportunity to explore alcohol and other drug-related decision making within a developmentally relevant framework. The program provides a safe and confidential space for teens to meet needs for autonomy, independence, and exploration of identity in the process of facilitating self-change efforts related to alcohol engagement in the school setting (Brown et al., 2001; Brown et al., 2005). Project Options integrates empirically-supported cognitive-behavioral intervention techniques including normative feedback, exploring outcome expectancies, behavioral management, alternative activity exploration, coping skills, and communication training, with motivational-enhancement techniques (ME) to increase student engagement with the program and to support teens’ autonomy in making decisions about alcohol use (Brown, 2001; D’Amico et al., 2004). 

In its first decade, Project Options was implemented in San Diego County, CA. The program successfully recruited diverse samples of youth (gender, race, ethnicity, grade; Brown et al., 2005; D’Amico et al., 2006), and students at high-risk for negative developmental outcomes, including higher intensity of drinking in the past 30 days, more alcohol related problems, higher rates of solitary drinking, and greater experience with bullying and victimization, as compared to the general school population (McGee et al., 2011).  Importantly, Project Options was effective in fostering quit attempts among youth with the greatest alcohol experience within the program, supporting its use as a targeted prevention paradigm (Brown et al., 2005).

As indicated above, we are currently evaluating Project Options in geographically diverse locations, with a particular focus on the contribution of ME techniques over-and-above the CB-based aspects of the program. Given the sparse literature on the effects of gender on substance use prevention outcomes we also consider how gender might moderate the additive effects of ME on self-change cognitions and behaviors. Among lifetime marijuana users endorsing quit attempts (N=170), boys in the ME+CB condition endorsed more MJ quit attempts at 3 month follow up compared to boys in the CB condition; the effect for girls was relatively flat, but in the opposite direction (F [3, 169] = 3.00, p = .03).  While preliminary, these findings provide a window on the opportunities provided by this study to examine complex and interacting processes that contribute to prevention outcomes for youth. Given the rich data available for Project Options, we will examine and report on some of the complex relations between group processes, mechanisms of action, and important moderating influences on prevention outcomes for youth.