Running Head: TWO SCHOOL-BASED DRUG PREVENTION PROGRAMS 1

An Article Critique: Two School-Based Drug Prevention Programs

Stephanie Janzen
EDPS 612.03
June 25, 2014
Prof. Yvonne Hindes

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The first article I have chosen to critique is entitled A Randomized Controlled Trial of the
Middle and Junior High School D.A.R.E. and D.A.R.E. Plus Programs, written by Cheryl L. Perry et al. and
published in 2003 in Archives of Pediatrics & Adolescent Medicine. This article was chosen as it explores
the efficacy of a well-known drug and alcohol prevention program aimed at school aged children. More
specifically, it examines the effectives of the traditional D.A.R.E. program against both a control group
and supplemental intervention material that was developed for this purpose.
Although the typical research article begins with an abstract which summarizes the experiment
and the results, this particular paper begins rather, by giving very brief summaries under eight different
headings. These being: objective, design, setting, participants, interventions, main outcome measures,
results, and conclusion. This is useful in that is provides all of the relevant information about the research
in a clear and precise way, particularly for those who are interested in details such as the research design
and participant demographics. At the same time, I believe that an abstract that includes a brief
discussion as to why such research is needed is more interesting and beneficial. Also, the
aforementioned headings do not match the headings within the body of the paper.
The article begins introducing the D.A.R.E. program and stating that the primary school program
has been effective in modifying behavior, yet the middle, junior, and high school D.A.R.E. programs have
been developed but have yet to be evaluated. The authors also state that multi-component programs in
particular have proven to be effective, yet they do not reference any studies pertaining to this claim at all.
It would benefit this article to briefly discuss previous research pertaining to both of these topics so as to
give the paper more depth.
It should also be noted that this articles lacks a literature review. They do not mention any other
studies that have been done that research other drug prevention programs, or even similar multi-
component programs. In fact, not a single author or title is mentioned at all. Instead the authors have
chosen to merely reference other pieces of work in a numbered style so that the articles themselves are
listed at the very end. It would be preferable to instead reference in APA style so that the reader can
immediately see what work they are referring to. A literature review would also be helpful in educating
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the reader as to what types of similar research has been done already in regards to the D.A.R.E. program
as well as other similar programs.
The design of this research is a randomized control trial, involving 24 middle and junior high
schools from districts within Minnesota. These schools were randomly assigned to either the delayed
program control group, the D.A.R.E. only group, or the D.A.R.E. Plus group. The total number of
students involved was about 7000 seventh-grade students. As the population in this area (Minnesota) is
considered to be heterogeneous, a large sample is crucial in order to obtain valid results. A sample of
7000 is considered to be adequate for this purpose (Cargan, 2007). The schools involved in the study
are from urban, suburban and rural areas so that the results can represent a variety of different settings.
At the same time, the sample itself is primarily white (67.3%), meaning that it may not represent
populations in other more diverse settings. A study involving a population over several states would be
preferable as it would be comprised of a more diverse population.
The method of obtaining data was done by survey method which was done at baseline in the fall
of 1999, at the first follow-up in the spring of 2000, and then a final follow-up completed in the spring of
2001. The major outcomes for the study were use of cigarettes, alcohol, marijuana, multidrug use, and
violent behavior, all of which were measured through a self-administered questionnaire. Although this
may be the most obvious form of data collection, the authors do not discuss any issues that may arise as
a result. For instance, as the questions presented have to do with behaviors and attitudes that are
deemed illegal or unsafe, it is possible that many students may fall prey to the social desirability bias.
Meaning that some might over-report good behavior, or under-report bad or undesirable behavior. The
results of which might yield the results to be invalid. It is also possible that the age of the respondents
might determine the seriousness of their responses, as it can be assumed that some grade seven
students may not consider the gravity of the research and how false responses may affect results.
The questionnaire itself should also be considered. Although the span of topics is representative
of D.A.R.E.s objective, the length of the portions might be improved. For instance questions pertaining to
alcohol are only 9 questions and the portion on marijuana is only 6 questions. So although it does cover
a broad spectrum of drug use, the limited number of questions may not fully capture the attitudes,
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intentions and behaviors of the respondents. Consequently it would be helpful if the authors included a
short summary of the reliability and validity of the surveys that were used (they write only that such
information is published elsewhere followed by a numbered reference).
The final comment section of the article was succinct yet interesting in that it discusses not only
the results but also the strengths of the design, the limitations, and directions for future research. For
instance, the authors note that their significant finding was that not only was the D.A.R.E. Plus program
the most successful in changing attitudes, intentions and behavior about drugs, but that their results
showed a significant difference between the two sexes. They then hypothesize that this might be due to
having male role models involved in the program, or the more competitive games that were utilized. They
also state that boys have significantly higher rates of alcohol use etc. and therefore were at a higher risk
of the beginning of the project, so the intervention may have been more salient to them. Such
hypotheses and interesting and provide a direction for future research.
The limitations that they acknowledge concern the length of the intervention and follow-up.
Although distributing another survey 2 years after baseline does qualify as long-term, behavior and
attitudes regarding drug use in grade 9 is likely not representative of the action and opinions in the later
grades. High school is a time a great change, so we can assume that those students who have negative
opinions of alcohol in grade 9 for example, might change by the time they get to grade 12. Furthermore,
the design doesnt allow the authors to determine if the D.A.R.E. Plus program was effective because of
the addition of the extra components or if it was the extra components were solely responsible for the
results. Thus I believe that the authors did a commendable job of identifying their limitations.
Although I enjoyed this article and learned quite a bit about the D.A.R.E program, I so think that
some improvements could be made. Firstly, a literature review would do much to educate the reader
about drug prevention programs, which would give it some depth. I believe they should also include a
short discussion about the benefits and limitations of using self-administered questionnaires. At the same
time I do think the authors do discuss several interesting points that are raised as a result of their
research which evolves into a discussion about directions for future research.
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The second article I have chosen to critique is entitled Preventing Adolescent Drug-Use: Long-
Term Results of a Junior High Program, written by Phyllis L. Erickson et al. and published in the
American Journal of Public Health in 1993. This study utilized a drug prevention program called Project
Alert to demonstrate whether this 6-year program is effective throughout high school or if only short-term
gains were made.
The article begins with an abstract that summarizes the objectives, methods, results and
conclusions. It is very succinct and is helpful for those who need only a brief summary. The introduction
though to the article is rather short (three paragraphs) and does not go into depth regarding why such a
study is important or necessary. Rather it gives a brief history of drug prevention programs in general
and then states that this paper provides the first assessment of a broader drug prevention program that
covers the 6-year period from grade 7 through grade 12 (Ellickson, 1993). Although other studies are
referenced in number style, there is no literature review to speak of. Thus this article would benefit from a
more in-depth discussion of drug prevention programs, similar studies and their results, and how they
have impacted the goals of this particular study. It would also be helpful if the article was referenced in
APA style so that the reader could identify the studies being discussed without having to flip pages.
The Project ALERT experiment took place in 30 California and Oregon schools drawn from eight
urban suburban and rural communities. The variety of locales is beneficial in that the results are
representative different types of populations, thus increasing its validity. At the same time, they limited
themselves to western United States; therefore results may not necessarily be generalized to other parts
of the country. The articles does not explicitly state how many students were involved though, so we
cannot make assumptions about the actual sample size and whether it is adequate for a study of such
scope. It would have been preferred that the authors indicate how many students were involved at
baseline and how many were still involved after the six years. A percentage rate of attrition may give us
an idea of how many were left near the end of the study, but an actual number is helpful.
In describing the sample, the authors state that nine of the 30 schools had a minority population
of 50% or more. Although it is helpful to know that the authors took this into consideration, more detailed
information regarding the actual make-up of the sample should be included. For example, perhaps one of
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these eights schools might have a high South Asian population, while another might have a large
Mexican population. This is helpful information as different ethnicities might have different attitudes
towards drug use which could affect the results.
The study itself had schools randomly assigned to two treatment groups and one control group.
Within the treatment group, schools were either taught by health educators, while in the other tech
schools older teens assisted the teachers in half of the 7
th
grade lessons. They also took some steps to
enhance pretreatment equivalence by making sure that schools in each district belonged to different
groups. They also undertook extensive classroom monitoring over the two year implementation period to
ensure that the curriculum was delivered as intended. Inclusion of such information is helpful as it
conveys to the reader that they took great pains to ensure that the study was carried out carefully and
methodically so that they results can be deemed valid.
The data collection consisted of having students fill out questionnaires about their drug use and
related attitudes and behaviors. They completed this questionnaire seven times between grades 7 and
12. The questions included pertained only to alcohol, cigarettes and marijuana which I believe is
satisfactory for this population (as these are the most popular drugs for teenagers), and included
questions asking about their lifetime use, frequency of use within the past month and year, as well as the
amount used. They also included questions pertaining to cognitive risk factors which provided
information on their attitudes towards short- and long-term consequences of use, normative beliefs about
the prevalence of use and its acceptability, resistance self-efficacy, as well as expectations of use in the
next six months. This seems fairly comprehensive so that will results will provide enough data to make
confident statements about the efficacy of this program.
When discussing the previous study, I mentioned my concerns regarding questionnaires aimed at
adolescents and how the social desirability bias might affect results. My same concern applies to this
study, although the authors note that they have taken pains to motivate students to participate and tell the
truth. For instance they described the procedures for ensuring data privacy to the students, and informed
them of their right not to participate. For those who gave consent, they collected saliva samples which
they told the students would be tested for drug use. According to the authors, such efforts have been
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found to improve participation rates and the accuracy of reports of drug use. I appreciated that they went
to such pains and feel that it gives the reader more faith in the questionnaire results.
The results portion of the article was effective as it divided it into early results and long-term
results. They used plain language to discuss the data and why it is significant when determining whether
drug intervention programs for adolescents are effective. They also divided up the discussion into
sections pertaining to each type of drug and how the results pertain to current criticisms about such
prevention programs. In discussing the long-term results, they address the rate of use among the
participants, their beliefs about drugs, as well as their beliefs about their own resistance self-efficacy.
Such organization was helpful in relaying the information and demonstrating the significance of each.
They were also very honest in discussing the results, such as when they admitted that by the end of high
school, early positive impacts on cigarette and marijuana use had completely disappeared.
The discussion portion was also well done as it started by stating what their two major
conclusions were. They then addressed some issues that might be a concern, and directions for future
research, as well as the significance of their findings in relation to current drug prevention programs.
What they did not include was any mention of limitations that they encountered in the study such as the
demographics of the sample. They also didnt mention any ethical concerns, such as perhaps taking
saliva samples from adolescents or having possession of information pertaining to illegal activities.
In summary, this was a very interesting study that was well presented in this article. It was easy
to understand and was comprehensive in discussing the method and the results. I also appreciate the
pains they took to ensure the reader that the results were true representations of the participants
attitudes and behaviors. My only recommendations would be to include a literature review so that the
reader can understand what other studies have already discovered about such programs and how this
study adds to that body of information. I would have also appreciate more detailed information about the
study itself such as the number of participants and their ethnic make-up, rather than just presenting them
in percentages. Lastly, due to the nature of the study and their methods, the article would have benefitted
from a discussion on any ethical concerns, especially as it deals with an adolescent population collecting
data on illegal behavior.
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References
Cargan, L. (2007). Doing social research. Rowman & Littlefield Publishers.
Ellickson, P. L., Bell, R. M., & McGuigan, K. (1993). Preventing adolescent drug use: long-term results of
a junior high program. American Journal of Public Health, 83(6), 856-861.
Perry, C. L., Komro, K. A., Veblen-Mortenson, S., Bosma, L. M., Farbakhsh, K., Munson, K. A., ... & Lytle,
L. A. (2003). A randomized controlled trial of the middle and junior high school DARE and DARE
Plus programs. Archives of Pediatrics & Adolescent Medicine, 157(2), 178-184.