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Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Evidence Tools
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Strategy. School-Based Multicomponent Programs to Prevent Underage Alcohol Use and Illegal Drug Use

Approach. Conduct multicomponent educational programs using curricula based on social and character development and focused on health motivation, social skills, social influence recognition, and knowledge development.

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Overview. Studies show that multicomponent educational programs based on social and character development reach the largest number of young people and have the potential to delay the onset of alcohol and drug use, improve peer refusal skills and resiliency, and increase knowledge of drug- and alcohol-related harms.1-7

Evidence. Scientifically Rigorous. Multicomponent educational programs based on social and character development appear to be effective in preventing underage alcohol use and illegal drug use. Programs based on this strategy are likely to work. This strategy has been tested more than once and results trend positive overall. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience. Elementary, middle and high school students.

Outcome. Decreased prevalence of underage alcohol and illegal drug use; improved peer refusal skills and resiliency; increased knowledge of drug- and alcohol-related harms. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the "Intervention Results" for each study.

Examples from the Field. Access descriptions of ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM. You may also want to look at evidence that supports educational programs in other NPM topic areas that can be translated to this specific topic area.

Sample ESMs. Using the approach “Conduct multicomponent educational programs using curricula based on social and character development and focused on health motivation, social skills, social influence recognition, and knowledge development,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework:

Quadrant 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of elementary, middle school, and high school students participating in educational programs.
  • Number of elementary, middle, and high schools offering educational programs to prevent underage alcohol use and illegal drug use.

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of elementary, middle school, and high school students participating in educational programs.
  • Percent of elementary, middle, and high schools offering educational programs to prevent underage alcohol use and illegal drug use.

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of elementary, middle school, and high school students participating in educational programs who showed an increase in knowledge after they finished the curriculum.
  • Number of elementary, middle school, and high school students who reported a decrease in their use of alcohol and drugs or in their intent to use alcohol and drugs.
  • Number of elementary, middle school, and high school students who showed improvement in peer refusal skills and resiliency.

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Percent of elementary, middle school, and high school students participating in educational programs who showed an increase in knowledge after they finished the curriculum.
  • Percent of elementary, middle school, and high school students who reported a decrease in their use of alcohol and drugs or in their intent to use alcohol and drugs.
  • Percent of elementary, middle school, and high school students who showed improvement in peer refusal skills and resiliency.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


References:

1 Beets MW, Flay BR, Vuchinich S, Snyder FJ, Acock A, Li KK, Durlak J, et al. Use of a social and character development program to prevent substance use, violent behaviors, and sexual activity among elementary‐school students in Hawaii. American Journal of Public Health 2009;99(8): 1438–1445.

2 Kellam SG, Wang W, Mackenzie ACL, Brown CH, Ompad DC, Or F, et al. The impact of the Good Behavior Game, a universal classroom‐based preventive intervention in first and second grades, on high‐risk sexual behaviors and drug abuse and dependence disorders into young adulthood. Prevention Science 2014;15(Suppl 1): PS6‐18.

3 Lennox RD, Cecchini MA. The NARCONON drug education curriculum for high school students: a non-randomized, controlled prevention trial. Substance Abuse Treatment, Prevention, and Policy 2008;3(1): 8.

4 Lewis K, Bavarian N, Snyder FJ, Acock A, Day J, DuBois DL, … Vuchinich S. Direct and mediated effects of a social‐emotional and character development program on adolescent substance use. The International Journal of Emotional Education 2012;4(1): 56.

5 Li KK, Washburn I, DuBois DL, Vuchinich S, Ji P, Brechling V., … Berbaum M. Effects of the Positive Action programme on problem behaviours in elementary school students: a matched‐pair randomised control trial in Chicago. Psychology and Health 2011;26(2): 187–204.

6 Newton NC, Teeson M, Vogl LE, Andrews G. Internet based prevention for alcohol and cannabis use: final results of the Climate Schools course. Addiction 2010; 105: 749–59.

7 Vogl L, Teesson M, Andrews G, Bird K, Steadman B, Dillon P. A computerized harm minimization prevention program for alcohol misuse and related harms: Randomized controlled trial. Addiction 2009;104(4): 564–75.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.