Targeting school and home helps cut risky behaviors
NEW YORK (Reuters Health) - Many interventions aimed at preventing drug use and risky sexual behavior in young people haven't worked so well, suggests a new report which also highlights helpful elements of successful programs.
Interventions that did work targeted multiple areas of kids' lives, including the classroom, community and home, teaching healthy decision-making skills related to alcohol, drugs and sex. Those programs often lasted for a few years.
"To have multiple effects, you can't just have one hour a day for a few weeks and that's it. It's just like learning Math or reading -- you have to keep going over multiple years," said Brian Flay, from Oregon State University in Corvallis, whose research was included in the analysis.
Programs should involve "not just the school, but also getting the parents involved and targeting them. And even with the school, targeting the whole school climate and not just the curriculum," he told Reuters Health.
Researchers led by Caroline Jackson of the Scottish Collaboration for Public Health Research and Policy in Edinburgh tracked down 13 studies, which they determined were of decent quality, all looking at various interventions in kids and teens related to drug use and risky sex.
In the journal Addiction they report that the studies were mostly done in North American cities, and as a whole had high drop-out rates among kids involved.
Three of the interventions studied showed positive effects on at least one measure of drug use and one of risky sexual behavior.
Those included a Chicago-based program involving a social development school curriculum with parent support; an HIV-reduction program delivered through small group discussions and parent monitoring in Baltimore; and an elementary school program in Seattle teaching school and family bonding skills.
All of those programs specifically targeted African-American, low-income or high-crime communities.
Researchers saw improvements in kids who went through those programs over a comparison group in rates of drug use, heavy drinking and smoking, as well as condom use and pregnancy rates during young adulthood.
Programs that only included classes on drugs, sexuality or healthy relationships were less successful.
"It's a lot more than a lesson, it's a lot more than a few lessons," said Flay, of the type of measures needed to produce real results.
He said that while making these kinds of programs a priority in schools may take time away from English and Math, kids who have gone through them often come out with more motivation to learn in the rest of their classes, and are better behaved.
Getting parents involved is always challenging, he acknowledged, but it's important.
In one recent study not included in the review, bringing both parents and teens in for discussions on setting academic goals, resisting peer pressure and practicing self-control led to fewer behavioral incidents and problems with drugs and alcohol in the younger generation (see Reuters Health story of December 12, 2011).
Starting school and community interventions even earlier, in the preteen years, may be most effective in stopping drug and alcohol use and risky sex before they start, according to Jackson and her colleagues.
They concluded the evidence is "somewhat encouraging" that multi-faceted programs can have an impact on different types of risky behaviors, but more research is needed to get at the best way to deliver those interventions.
SOURCE: bit.ly/tDf170 Addiction, online December 7, 2011.
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