Rural Principal Views on the Sustainability of Drug Education Interventions within Their School

Introduction: The sustainability of an evidence-based intervention (EBI) is generally influenced by several factors: (a) contents of the EBI curriculum, (b) features or the institution or organization, and (c) characteristics participating individuals (Barrera et al, 2017). A gap in the literature is the lack of in-depth analyses from principals who must advocate for resources to support these programs. The present study examines factors internal and external school factors in the sustainability of drug prevention interventions within these schools located within rural communities in central Pennsylvania and Ohio, a region identified as the epicenter of the national drug epidemic.

Methods: Our target sample consisted of principals from 39 middle schools who participated over seven year ago in a randomized controlled trial of the youth drug education and prevention intervention, keepin' it REAL. Using our structured interview protocol, we asked middle school principals from this region about factors that serve as major influences on the sustainability of a drug prevention intervention We used NVivo 11, to identify response code phrases that could then be categorized into themes. The Overarching Focus Question on sustainability was: "What factors, internal and external to your school have affected the ability to deliver and sustain drug education within your school?”

Results: The thematic analysis of the responses of these 15 principals on sustainability is based on 187 response code phrases that yielded six emergent themes. These themes were: (a) funding, which is regarded as the biggest influence on sustainability, (b) the detrimental effects of losing key teachers or staff capable of presenting a drug education program (c) allocated time to present the curriculum, (d) intervention responsiveness to local community and needs, (e) support from various constituencies including teachers, the local school board, and parents, and (f) curriculum flexibility for fit and function within the local setting. Each theme contains several quotes that add depth of analysis for on each theme. For example, regarding the theme of funding, one principal stated: “Most funding is directed at science, math,…[with less for drug prevention] because [these subjects are] were we are assessed.” A core theme among all 15 principals involves their daily struggles in response to imposed statewide mandates.

Conclusions: Our qualitative data present distinct and more nuanced view regarding program sustainability. In addition to the other factors, these accountability mandates present a challenge to the sustainability of drug education. We will provide details on these challenges, and principal actions to “keep drug education alive” with their school despite these challenges.