Abstract
Outcome research has shown that drug prevention programs based on theories of social influence often prevent the onset of adolescent drug use. However, little is known empirically about the processes through which they have their effects. The purpose of the present study was to evaluate intervening mechanism theories of two program models for preventing the onset of adolescent drug use. Analyses based on a total of 3077 fifth graders participating in the Adolescent Alcohol Prevention Trial revealed that both normative education and resistance training activated the causal processes they targeted. While beliefs about prevalence and acceptability significantly mediated the effects of normative education on subsequent adolescent drug use, resistance skills did not significantly predict subsequent drug use. More impressively, this pattern of results was virtually the same across sex, ethnicity, context (public versus private school students), drugs (alcohol, cigarettes, and marijuana) and levels of risk and was durable across time. These findings strongly suggest that successful social influence-based prevention programs may be driven primarily by their ability to foster social norms that reduce an adolescent's social motivation to begin using alcohol, cigarettes, and marijuana.
Similar content being viewed by others
References
Aitkin, M. A., and Longford, N. (1986). Statistical modeling in school effectiveness studies.J. Roy. Stat. Soc. 149A: 1–43.
Allison, P. D. (1987). Estimation of linear models with incomplete data. In Clogg, C. (ed.),Sociological Methodology 1987, Jossey Bass, San Francisco, pp. 71–103.
Bangert-Drowns, R. L. (1988). The effects of school-based substance use education—a meta-analysis.J. Drug Educ. 18: 243–264.
Baron, R. M., and Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations.J. Personal. Soc. Psychol. 51: 1173–1182.
Bickman, L. (1987). The functions of program theory.New Direct. Prog. Eval. 33: 5–18.
Biglan, A., Gallison, C., Ary, D., and Thompson, R. (1985). Expired air carbon monoxide and saliva thiocyanate: Relationships to self-reports of marijuana and cigarette smoking.Addictive Behavior 10: 137–144.
Bollen, K. A. (1987). Total, direct, and indirect effects in structural equation models. In Clogg, C. (ed.),Sociological Methodology 1987, Jossey Bass, San Francisco, pp. 37–69.
Botvin, G. J., and Wills, T. S. (1985). Personal and social skills training: Cognitive-behavioral approaches to substance abuse prevention. In Bell, C., and Battjes, R. (eds.),Prevention Research: Deterring Drug Abuse Among Children and Adolescents, NIDA Research Monograph No. 63, Washington, DC: U.S. Government Printing Office, Washington, DC, pp. 8–49.
Brook, J. S., Brook, D. W., Gordon, A. S., Whiteman, M., and Cohen, P. (1990). The psychosocial etiology of adolescent drug use: A Family interactional approach.Genet. Soc. Gen. Psychol. Monogr. 166: No. 2.
Bruvold, W. H., and Rundall, T. G. (1988). A meta-analysis and theoretical review of school based tobacco and alcohol intervention programs.Psychol. Health 2: 53–78.
Bryk, A. S., and Raudenbush, S. W. (1987). Applying Hierarchical Linear Model to measurements of change problems.Psychol. Bull. 101: 147–158.
Chen, H. T. (1990).Theory-Driven Evaluations, Sage, Newbury Park, CA.
Chen, H. T., and Rossi, P. H. (1983). Evaluating with sense: The theory-driven approach.Eval. Rev. 7: 283–302.
Chen, H. T., and Rossi, P. H. (1987). The theory-driven approach to validity.Eval. Prog. Plan. 10: 95–103.
Ellickson, P. L., and Bell, R. M. (1990). Drug prevention in junior high: A multi-site longitudinal test.Science 247: 1299–1305.
Flay, B. R. (1985). Psychosocial approaches to smoking prevention: A review of findings.Health Psychol. 4: 449–488.
Fleming, J. P., Kellman, S. G., and Brown, C. H. (1982). Early predictors of age at first use of alcohol, marijuana and cigarettes.Drug Alcohol Depend. 9: 285–303.
Graham, J. W., and Donaldson, S. I. (1993). Evaluating interventions with differential attrition: The importance of nonresponse mechanisms and use of follow-up data.J. Appl. Psychol. 78: 119–128.
Graham, J. W., Flay, B. R., Johnson, C. A., Hansen, W. B., and Collins, L. M. (1984a). Group comparability: A multiattribute utility measurement approach to the use of random assignment with small numbers of aggregated units.Eval. Rev. 8: 247–260.
Graham, J. W., Flay, B. R., Johnson, C. A., Hansen, W. B., Grossman, L. M., and Sobel, J. L. (1984b). Reliability of self-report measures of drug use in prevention research: Evaluation of the Project SMART questionnaire via the test-retest reliability matrix.J. Drug Educ. 14: 175–193.
Graham, J. W., Rohrbach, C. A., Hansen, W. B., Fhay, B. R., and Johnson, C. A. (1989). Convergent and discriminant validity for assessment of skill in resisting a role play Alcohol Offer.Behavioral Assessment 11: 353–379.
Graham, J. W., Johnson, C. A., Hansen, W. B., Flay, B. R., and Gee, M. (1990). Drug use prevention programs, gender, and ethnicity: Evaluation of three seventh-grade Project SMART cohorts.Prev. Med. 19: 305–313.
Graham, J. W., Marks, G. S., and Hansen, W. B. (1991). Social influence processes affecting adolescent substance use.J. Appl. Psychol. 76: 291–298.
Graham, J. W., Collins, N. L., Donaldson, S. I., and Hansen, W. B. (1993a). Understanding and controlling for response bias: Confirmatory factor analysis of multitrait-multimethod data. In Steyer, R., Wender, K. F., and Widamen, K. F. (eds.),Psychometric Methodology. Proceedings of the 7th European meeting of the Psychometric Society in Trier (pp. 585–590). Gustav Fisher Verlag, Stuttgart and New York.
Graham, J. W. Donaldson, S. I., Hansen, W. B., Rohrbach, L., and Unger, J. (1994). Tracing the process of longitudinal prevention program effects with hierarchical data and complex missing data patterns. (submitted for publication).
Graham, J. W., Hofer, S. M., and Piccinin, A. M. (1993c). Analysis with missing data in drug prevention research. In Collins, L. M., and Seitz, L. A. (eds.),Advances in Data Analysis for Prevention Intervention Research, NIDA Research Monograph 108, Washington, DC (in press).
Hansen, W. B. (1992). School-based substance abuse prevention: A review of the state of the art in curriculum, 1980–1990.Health Educ. Res. Theory Pract. 7: 403–430.
Hansen, W. B., and Graham, J. W. (1991). Preventing alcohol, marijuana, and cigarette use among adolescents: One-year results of the Adolescent Alcohol Prevention Trial.Prev. Med. 20: 414–430.
Hansen, W. B., Collins, L. M., Malotte, C. K., Johnson, C. A., and Fielding, J. E. (1985). Attrition in prevention research.J. Behav. Med. 8: 261–275.
Hansen, W. B., Graham, J. W., Wolkenstein, B. H., Lundy, B. Z., Pearson, J. L., Flay, B. R., and Johnson, C. A. (1988a). Differential impact of three alcohol prevention curricula on hypothesized mediating variables.J. Drug Educ. 18: 143–153.
Hansen, W. B., Johnson, C. A., Flay, B. R., Graham, J. W., and Sobel, J. L. (1988b). Affective and social influences approaches to the prevention of multiple substance abuse among seventh grade students: Results from project SMART.Prev. Med. 17: 135–154.
Hansen, W. B., Tobler, N. S., and Graham, J. W. (1990). Attrition in substance abuse prevention research: A meta-analysis of 85 longitudinally-followed cohorts.Eval. Rev. 14: 677–685.
Hansen, W. B., Graham, J. W., Wolkenstein, B. H., and Rohrbach, L. A. (1991). Program integrity as a moderator of prevention program effectiveness: Results for fifth-grade students in the Adolescent Alcohol Prevention Trial.J. Stud. Alcohol 52: 568–579.
Hawkins, J. D., Catalano, R. F., and Miller, J. M. (1992). Risk and Protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention.Psychol. Bull. 112: 64–105.
Jöreskog, K. G., and Sörbom, D. (1987).Lisrel VII: User's Reference Guide, Scientific Software, Mooreville, IN.
Kandell, D. B. (1982). Epidemiological and psychosocial perspectives on adolescent drug use.J. Am. Acad. Clin. Psychiatr. 21: 328–347.
Kandell, D. B. (1986). Processes of peer influence in adolescence. In Silberstein, R. (ed.),Development as Action in Context: Problem Behavior and Normal Youth Development, Springer-Verlag, New York, pp. 203–228.
Kreft, I. G. G. (1993). Multilevel models for hierarchically nested data: Potential applications in substance abuse prevention research. In Collins, L. M., and Seitz, L. A. (eds.),Advances in Data Analysis for Prevention Intervention Research, NIDA Research Monograph 108, Washington, DC (in press).
Levanthal, H., and Cleary, P. D. (1980). The smoking problem: A review of the research and theory in behavioral risk modification.Psychol. Bull. 88: 370–405.
Lipsey, M. W. (1988). Practice and malpractice in evaluation research.Eval. Pract. 9: 5–24.
Lipsey, M. W. (1993). Theory as method: Small theories of treatments.New Direct. Prog. Eval. 57: 5–38.
Lipsey, M. W., and Pollard, J. A. (1989). Driving toward theory in program evaluation: More models to choose from.Eval. Prog. Plan 12: 317–328.
Little, R. J. A., and Rubin, D. B. (1987).Statistical Analysis with Missing Data, Wiley, New York.
Little, R. J. A., and Rubin, D. B. (1989). The analysis of social science data with missing values.Sociol. Methods Res. 18: 292–326.
MacKinnon, D. P., Johnson, C. A., Pentz, M. A., Dwyer, J. H., Hansen, W. B., Flay, B. R., and Wang, E. Y. (1991). Mediating mechanisms in a school-based drug prevention program: First-year effects of the Midwestern Prevention Project.Health Psychol. 10: 164–172.
McCaul, K. D., and Glasgow, R. E. (1985). Preventing adolescent smoking: What have we learned about treatment construct validity?Health Psychol. 4: 361–387.
Mosokowitz, J. M. (1989). The primary prevention of alcohol problems: A critical review of the research literature.J. Stud. Alcohol 50: 54–88.
Muthen, B., Kaplan, D., and Hollis, M. (1987). On structural equation modeling with data that are not missing completely at random.Psychometrika 52: 431–462.
Newcomb, M. D., and Bentler, P. M. (1986). Substance use and ethnicity: Differential impact of peer and adult models.J. Psychol. 120: 83–95.
Pechacek, T. F., Murray, D. M., Luepker, R. V., Mittlemark, M. B., and Johnson, C. A. (1984). Measurement of adolescent smoking behavior: Rationale and methods.J. Behav. Med. 7: 123–140.
Pentz, M. A., MacKinnon, D. P., Dwyer, J., Flay, B. R., and Johnson, C. A. (1987). Evaluating alcohol resistance skills training using multi-trait, multi-method role playing skills assessment.Health Educ. Res. Theory Pract. 2: 401–407.
Pentz, M. A., Dwyer, J. H., MacKinnon, D. P., Flay, B. R., Hansen, W. B., Wang, E. Y. I., and Johnson, C. A. (1989). A multicommunity trial for primary prevention of adolescent drug abuse.JAMA 261: 3259–3266.
Rachael, J. V., Guess, L. L., Hubbard, R. L., Maisto, S. A., Cavanaugh, E. R., Waddel, R., and Benrud, C. H. (1982). Facts for Planning No. 4: Alcohol misuse by adolescents.Alcohol Health Res. World 6: 61–68.
Robins, L. N., and Pryzbeck, T. R. (1985). Age of onset of drug use as a factor in drug and other disorders. In Jones, C. L., and Battjes, R. J. (eds.),Etiology of Drug Abuse: Implications for Prevention, NIDA Research Monograph No. 56, DHHS Publication No. ADM 85-1335 U.S. Government Printing Office, Washington, DC, pp. 178–192.
Rohrbach, L. A., Graham, J. W., Hansen, W. B., Flay, B. R., and Johnson, C. A. (1987). Evaluation of resistance skills training using multitrait-multimethod role play skills assessment.Health Educ. Res. 2: 401–407.
Rubin, D. B. (1987).Multiple Imputation for Nonresponse in Surveys, Wiley, New York.
Sobel, M. E. (1986). Some new results on indirect effects and their standard errors in covariance structure models. In Tuma, N. B. (ed.),Sociological Methodology 1986, American Sociological Association, Washington, DC, pp. 159–186.
Tobler, N. S. (1986). Meta-analysis of 143 adolescent drug prevention programs: Quantitative outcome results of program participants compared to a control or comparison group.J. Drug Issues 16: 537–567.
United States Department of Health and Human Services (1989).Reducing the Consequences of Smoking: 25 Years of Progress, DHHS Publication No. CDC 89-84111, U.S. Government Printing Office, Washington, DC.
United States Department of Health and Human Services (1991).Healthy People 2000: National Health Promotion and Disease Prevention Objectives, DHHS Publication No. PHS 91-50212, U.S. Government Printing Office, Washington, DC.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Donaldson, S.I., Graham, J.W. & Hansen, W.B. Testing the generalizability of intervening mechanism theories: Understanding the effects of adolescent drug use prevention interventions. J Behav Med 17, 195–216 (1994). https://doi.org/10.1007/BF01858105
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01858105