Abstract
There are many mandated school-based programs to prevent adolescent alcohol and drug (AOD) use, but few are voluntary and take place outside of class time. This cluster randomized controlled trial evaluates CHOICE, a voluntary after-school program for younger adolescents, which reduced both individual- and school-level alcohol use in a previous pilot study. We evaluated CHOICE with 9,528 students from 16 middle schools. The sample was 51% female; 54% Hispanic, 17% Asian, 15% white, 9% multiethnic and 3% African American. Fifteen percent of students attended CHOICE. All students completed surveys on alcohol beliefs and use at baseline and 6–7 months later. We conducted intention-to-treat (ITT) school-level analyses and propensity-matched attender analyses. Lifetime alcohol use in the ITT analysis (i.e., school level) achieved statistical significance, with an odds ratio (OR) of 0.70 and a NNT of 14.8. The NNT suggests that in a school where CHOICE was offered, 1 adolescent out of 15 was prevented from initiating alcohol use during this time period. Although not statistically significant (p = .20), results indicate that past month alcohol use was also lower in CHOICE schools (OR = 0.81; NNT = 45). Comparisons of attenders versus matched controls yielded results for lifetime use similar to school-wide effects (OR = 0.74 and NNT = 17.6). Initial results are promising and suggest that a voluntary after-school program that focuses specifically on AOD may be effective in deterring alcohol use among early adolescents; however, further research is needed as program effects were modest.
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Notes
Approximately 3–5% of students used the Spanish survey version and less than 1% of students used the Korean survey version.
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Acknowledgements
Work on this article was supported by a grant from the National Institute of Alcohol Abuse and Alcoholism (R01AA016577) to Elizabeth D’Amico. The authors wish to thank the districts and schools who participated and supported this project. We would also like to thank Kirsten Becker and Megan Zander-Cotugno for overseeing the survey administrations at the 16 schools. We thank the eight facilitators for implementing CHOICE in the schools (Dionne Barnes, Erin dela Cruz, Blanca Dominguez, Mary Lou Gilbert, Marcia Gillis, Robert Reaugh, Jimmy Rodriguez and Stefanie Stern) and we thank Karen Osilla, Jennifer Parker and Qiana Montazeri for their help with coding adherence and MI of the CHOICE sessions. Finally, we thank Michael Woodward for his help and creativity in developing the CHOICE logo and our project materials.
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D’Amico, E.J., Tucker, J.S., Miles, J.N.V. et al. Preventing Alcohol Use with a Voluntary After-School Program for Middle School Students: Results from a Cluster Randomized Controlled Trial of CHOICE. Prev Sci 13, 415–425 (2012). https://doi.org/10.1007/s11121-011-0269-7
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DOI: https://doi.org/10.1007/s11121-011-0269-7