Implementing the LifeSkills Training drug prevention program: factors related to implementation fidelity

<p>Abstract</p> <p>Background</p> <p>Widespread replication of effective prevention programs is unlikely to affect the incidence of adolescent delinquency, violent crime, and substance use until the quality of implementation of these programs by community-based organizations can be assured.</p> <p>Methods</p> <p>This paper presents the results of a process evaluation employing qualitative and quantitative methods to assess the extent to which 432 schools in 105 sites implemented the LifeSkills Training (LST) drug prevention program with fidelity. Regression analysis was used to examine factors influencing four dimensions of fidelity: adherence, dosage, quality of delivery, and student responsiveness.</p> <p>Results</p> <p>Although most sites faced common barriers, such as finding room in the school schedule for the program, gaining full support from key participants (i.e., site coordinators, principals, and LST teachers), ensuring teacher participation in training workshops, and classroom management difficulties, most schools involved in the project implemented LST with very high levels of fidelity. Across sites, 86% of program objectives and activities required in the three-year curriculum were delivered to students. Moreover, teachers were observed using all four recommended teaching practices, and 71% of instructors taught all the required LST lessons. Multivariate analyses found that highly rated LST program characteristics and better student behavior were significantly related to a greater proportion of material taught by teachers (adherence). Instructors who rated the LST program characteristics as ideal were more likely to teach all lessons (dosage). Student behavior and use of interactive teaching techniques (quality of delivery) were positively related. No variables were related to student participation (student responsiveness).</p> <p>Conclusion</p> <p>Although difficult, high implementation fidelity by community-based organizations can be achieved. This study suggests some important factors that organizations should consider to ensure fidelity, such as selecting programs with features that minimize complexity while maximizing flexibility. Time constraints in the classroom should be considered when choosing a program. Student behavior also influences program delivery, so schools should train teachers in the use of classroom management skills. This project involved comprehensive program monitoring and technical assistance that likely facilitated the identification and resolution of problems and contributed to the overall high quality of implementation. Schools should recognize the importance of training and technical assistance to ensure quality program delivery.</p

Running away experience and psychoactive substance use among adolescents in Taiwan: multi-city street outreach survey

<p>Abstract</p> <p>Background</p> <p>This study aimed to examine: 1) the relationship between being a runaway and the time since the first absconding event and adolescent substance use; 2) whether different kinds of psychoactive substances have a different temporal relationship to the first absconding event; and 3) whether the various reasons for the first absconding event are associated with different risks of substance use.</p> <p>Methods</p> <p>Participants were drawn from the 2004-2006 nationwide outreach programs across 26 cities/towns in Taiwan. A total of 17,133 participants, age 12-18 years, who completed an anonymous questionnaire on their experience of running away and substances use and who were now living with their families, were included in the analysis.</p> <p>Results</p> <p>The lifetime risk of tobacco, alcohol, betel nut, and illegal drug/inhalant use increased steadily from adolescents who had experienced a trial runaway episode (one time lasting ≤ 1 day), to those with extended runaway experience (≥ 2 times or lasting > 1 day), when compared to those who had never ran away. Adolescents who had their first running away experience > 6 months previously had a greater risk of betel nut or illegal drug/inhalant use over the past 6-months than those with a similar experience within the last 6 months. Both alcohol and tobacco use were most frequently initiated before the first running away, whereas both betel nut and illegal drug/inhalant use were most frequently initiated after this event. When adolescents who were fleeing an unsatisfactory home life were compared to those who ran away for excitement, the risk of alcohol use was similar but the former tended to have a higher risk of tobacco, betel nut, and illegal drug/inhalant use.</p> <p>Conclusions</p> <p>More significant running away and a longer time since the first absconding experience were associated with more advanced substance involvement among adolescents now living in a family setting. Once adolescents had left home, they developed additional psychoactive substance problems, regardless of their reasons for running away. These findings have implications for caregivers, teachers, and healthcare workers when trying to prevent and/or intervening in adolescent substance use.</p

Leisure Time Activities, Parental Monitoring and Drunkenness in Adolescents

<p>Background: The aim of this cross-sectional study was to explore the association between adolescent drunkenness and participation in risky leisure time activities and parental monitoring. Methods: A sample of 3,694 Slovak elementary school students (mean age 14.5 years; 49.0% males) was assessed for drunkenness in the previous month, participation in risky leisure activities and parental monitoring. Results: Participation in risky leisure time activities increased the probability of drunkenness among adolescents, while parental monitoring decreased it. The effect did not change after adding the mother's and father's monitoring into the models. Conclusion: Our results imply that adolescents involved in going out with friends, having parties with friends and/or visiting sporting events every day or several times a week are at a higher risk of drunkenness, as are those less monitored by their parents. These less monitored adolescents and their parents should become a target group in prevention. Copyright (C) 2012 S. Karger AG, Basel</p>

Pregnancy and Parenting Among Runaway and Homeless Young Women

Homeless youth face numerous challenging life circumstances, both prior to leaving home and while homeless. Examples of such difficult experiences include exceptionally high rates of pregnancy and early parenthood, particularly in comparison to their housed peers. This chapter reviews the complexity of causes, risk factors, and adverse outcomes associated with homeless youth pregnancy and early parenthood. Homeless youth pregnancy and early parenthood are notably under-researched topics, and as homeless youth have unique and complex life experiences, this chapter also highlights opportunities for further advancing culturally responsive prevention and intervention services in efforts to more effectively decrease pregnancies and improve sexual, reproductive, maternal-child health, and parenting outcomes among this highly vulnerable population