A school-based universal substance abuse prevention program targeted toward middle school youths. The program is rated No Effects. The outcome evaluation found that the program had negative effects on student participants. Participants actually had worse outcomes than the control group.
This program’s rating is based on evidence that includes at least one high-quality randomized controlled trial.
Program Goals/Target Population
Taking Charge of Your Life (TCYL) targets students during their years most at risk—seventh through ninth grade—to prevent the use of alcohol, tobacco, and other drugs.
The program is administered through 10 lessons delivered in seventh grade and seven booster lessons in ninth grade. The program highlights the personal, social, and legal risks and consequences involved with using tobacco, alcohol, and other drugs. It delivers data from national studies on substance use to dispel the concept that “everybody does it.” Students receive life skills training such as communication, decision-making, assertiveness, and refusal skills. The consequences of drug use and making good choices are reinforced.
Content is based on a series of scenarios of problem situations addressing the use of tobacco, alcohol, and other drugs. Content is structured to be appropriate for the different ages. In the seventh grade curriculum, alcohol and tobacco are addressed in nine of the lessons; marijuana and other drugs are covered in five and three lessons, respectively. Most of the lessons concentrate on normative beliefs, the consequences of substance use, effective decision-making, and resistance skills. In the ninth grade, most lessons include material on the consequences of substance use and decision-making; alcohol is addressed in five lessons; and all other substances are addressed in three lessons.
All lessons are administered by police officers with Drug Abuse Resistance Education (DARE) training. Teachers schedule time for these lessons to be taught in the classroom during the normal school day.
The program incorporates large and small group discussions, as well as role-playing, and follows a spiral structure that introduces skills and key points that are revisited and practiced in increasingly complex situations. This allows students to build on their knowledge and learn how to incorporate it into real-world decision-making and refusal techniques. Homework provides further practice and helps keep parents informed.
This redesigned program, an updated version of DARE, has an active or constructivist learning approach. This approach encourages students to understand their experiences, ideas, and values about the consequences of substance abuse by relating them to their existing beliefs. Learning occurs through interactions with one another and the instructor, using in-depth deliberations, authentic problem-solving, and realistic role-playing.
Additional Information: Negative Program Effects
An outcome evaluation (described below in Evaluation Methodology and Outcomes) looked at the effects of TCYL in six major metropolitan areas, including Detroit, Michigan; Houston, Texas; Los Angeles, California; Newark, New Jersey; New Orleans, Louisiana.; and St. Louis, Missouri. The results showed that students who participated in TCYL had worse outcomes than control group participants who did not receive the program. Students who participated in the program reported significantly more alcohol use, binge drinking, and cigarette use than students who did not participate in the program.
Sloboda and colleagues (2009) found that Taking Charge of Your Life (TCYL) participants had worse outcomes than control group participants who did not receive the program. The researchers concluded that the main effect of TCYL indicated an iatrogenic or negative treatment effect on student use of alcohol and tobacco.
By the 11th grade, students in treatment schools reported statistically significant higher alcohol use in the past 30 days, compared with students in the control schools. Binge drinking, defined as having five or more drinks in a row, in the past 14 days was statistically significant and greater for students in the treatment schools (28.1 percent) than for students in the control schools (24.7 percent).
Further examining the outcomes by gender provided more details about the contradictory and negative effects of the treatment program on students. Most of the negative alcohol use–related outcomes (alcohol use, getting drunk, and binge drinking) were for male students in the treatment schools. Female students in the treatment schools were more likely to binge drink in the past 30 days than female students in the control schools.
The research team further examined the outcomes by race/ethnicity. They grouped participants into white and nonwhite, as preliminary analyses showed that white students differed from other racial groups in drug use outcomes. Additionally, individual racial groups (e.g., African American, Latino) were more alike in their drug use outcomes. The negative program effects appeared to be consistent among the white students, but these effects were absent or not as consistent in the other race/ethnicity groups. That is, the negative alcohol outcomes were primarily and consistently evidenced among white students in the treatment schools and were not as consistent among nonwhite students in the treatment schools.
Differences among baseline nonusers
Analyses were also run to determine whether prior use of substances may have influenced the effects of the treatment program. In the TCYL group, there was a statistically significantly negative effect for nonusers at baseline on alcohol use (binge drinking, past 30-day use of alcohol, and getting drunk). However, there were no statistically significant differences found for alcohol use or getting drunk in the past 12 months between baseline nonusers in treatment schools and control schools.
By the 11th grade, students in treatment schools reported statistically significant higher cigarette use in the past 30 days than students in the control schools. Female students in the treatment schools were significantly more likely to smoke cigarettes in the past 30 days than female students in the control schools.
The research team further examined the outcomes by race/ethnicity. They grouped participants into white and nonwhite, as preliminary analyses showed that white students differed from other racial groups in drug use outcomes. Additionally, individual racial groups (e.g., African American, Latino) were more alike in their drug use outcomes. The only statistically significant difference among nonwhite students was for cigarette use. Nonwhite students in treatment schools displayed a statistically significant higher risk ratio than nonwhite control students for cigarette use in the past 30 days.
Differences among baseline nonusers
Researchers examined baseline differences of substance use and the effect of the treatment program. A larger number of students in treatment schools who had no prior experience with any substances reported smoking by the 11th grade, compared with students in control schools. This difference was statistically significant.
There were no statistically significant differences found for marijuana use in the past 30 days or the past 12 months between students in the treatment schools and the control schools.
Sloboda and colleagues (2009) used a longitudinal randomized field trial design to determine the effects of Taking Charge of Your Life (TCYL) on adolescent substance use. Six major metropolitan areas, representing 83 school clusters (41 treatment and 42 control) produced a study sample of 19,529 seventh graders enrolled for the 5-year study. The study sites were Detroit, Michigan; Houston, Texas; Los Angeles, California; Newark, New Jersey; New Orleans, Louisiana.; and St. Louis, Missouri. Schools from the same metropolitan area selected to be in the study were not grouped together. There was a 50-mile radius between chosen schools. School clusters represent a high school and its associated feeder middle schools. All participating schools agreed to the randomized design. At baseline, treatment and control groups were comparable on demographic characteristics and substance use. TCYL was administered to students at the start of seventh grade and again in the ninth grade.
Seven survey waves were administered at baseline, 30–60 days postbaseline (the post–7th grade intervention survey), 1 year postintervention (during 8th grade), pre– and post–9th grade intervention, and then again in 10th and 11th grades. Final analyses were conducted with data from 17,320 students (10,028 treatment and 7,292 control). The outcome measures were self-reported tobacco, alcohol, and marijuana use for the past 30 days and the past 12 months. Survey items were drawn from existing national surveys, primarily the Monitoring the Future Study. Questions covered prevalence (e.g., how often did you use tobacco in the past 30 days?) and frequency (e.g., how many times did you get drunk? did you binge drink in the past 14 days?) of substance use.
Because of the clustered nature of the data (students within schools within districts), a multilevel or hierarchical logistic model was used to adjust for intracluster correlation of students nested within school clusters. The analyses first looked for main effects of TCYL on substance abuse. Baseline exposure/use of substances and exposure to the treatment program were treated as fixed effects. A random effects model that permitted variation in the effect of baseline substance use was run and compared with the fixed-effects model, and there were no significant differences. Further analyses were conducted examining the effects of gender, race/ethnicity, and baseline use of substances.
There is no cost information available for this program.
Evidence-Base (Studies Reviewed)
These sources were used in the development of the program profile:Study 1Sloboda, Zili, Richard C. Stephens, Peggy C. Stephens, Scott F. Grey, Brent Teasdale, Richard D. Hawthorne, Joseph E. Williams, and Jesse F. Marquette. 2009. “The Adolescent Substance Abuse Prevention Study: A Randomized Field Trial of a Universal Substance Abuse Prevention Program.” Drug and Alcohol Dependence 102:1–10.
These sources were used in the development of the program profile:Sloboda, Zili, Peggy C. Stephens, Amod Pyakuryal, Brent Teasdale, Richard C. Stephens, Richard D. Hawthorne, Jesse F. Marquette and Joseph E. Williams. 2008. “Implementation Fidelity: The Experience of the Adolescent Substance Abuse Prevention Study.” Health Education Research 24(3):394–406.