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Program Profile: Lions Quest Skills for Adolescence (SFA)

Evidence Rating: No Effects - One study No Effects - One study

Date: This profile was posted on July 23, 2012

Program Summary

A multicomponent school-based life skills training curriculum that teaches behavioral and social techniques for middle school students to help resist alcohol and drug use. The program is rated No Effects. The research found mixed results among the various outcome measures based on the 1-year follow-up data of schools that received the training compared to the control schools. There was a lack of evidence regarding the program’s ability to reduce tobacco use or other illicit substances.

Program Description

Program Goals

Lions Quest Skills for Adolescence (SFA) is a comprehensive youth development program that unites educators, parents, and community members to help adolescents develop social skills and competencies for resisting drug use. The program operates based on three specific goals: 1) prevent or significantly delay the initiation of “gateway” (alcohol, tobacco, marijuana) drug use during the study period; 2) reduce the frequency or amount of substances used by those who do initiate use before or during the study period; and 3) prevent or delay the progression to more “advanced” substance use (e.g., binge drinking, regular smoking, and regular marijuana use) or “hard” drug use. In sum, the program strives to promote the development of capable, healthy young people of strong character in the school environment to prevent or delay substance use.


Target Population/Eligibility or Target Sites

The program is designed for schoolwide classroom implementation in grades 6–8 (ages 10–14).


Program Components

SFA focuses on the development of essential social and emotional competencies, good citizenship skills, strong positive character, skills and attitudes consistent with a drug-free lifestyle, and an ethic of service to others within a caring and consistent environment. Accordingly, program elements focus on building self-esteem and personal responsibility, communicating effectively, making better decisions, resisting social influences and asserting rights, and increasing drug use knowledge and consequences. The learning model employs inquiry, presentation, discussion, group work, guided practice, service learning, and reflection to accomplish the desired outcomes. SFA has a five-component structure for addressing protective factors that promote healthy, safe, and drug-free behaviors and risk factors for reducing substance use, violence, and other high-risk behaviors:

  • Classroom curriculum of 102 skill-building lessons. Implementation models range from a minimum 9-week, 40-lesson mini-course to a 3-year program of all 102 lessons; 45-minute lessons are arranged in eight sequential thematic units and a service-learning unit that extends throughout the curriculum.
  • Parent and family involvement. Parents and families participate through shared homework assignments, four parent meetings, a book for parents, and direct involvement in school activities.
  • Positive school climate. School staff, students, parents, and community members establish a school climate committee to reinforce curriculum themes through schoolwide events.
  • Community involvement. School staff, parents, Lions Clubs, and other service organizations participate in training workshops, school climate events, panel discussions, service projects, and parent meetings.
  • Professional development. Each implementer must attend an introductory 2- or 3-day workshop to receive program materials.

Key Personnel

Ongoing program success requires a school district–level advocate and the district’s acceptance of financial responsibility, an onsite program coordinator, continued support for school staff, and ongoing program evaluation. Funding from Lions Clubs and other sources is vital, as is participation from parents and community members.


Program Theory

The SFA program is designed using social influence and social–cognitive approaches to teach cognitive–behavioral skills to youth—specifically, drug-refusal skills. Accordingly, elements and processes use techniques to strengthen students’ behavioral intentions not to use drugs in the near future, to increase the perceived harm of drug use, to increase the sense of self-efficacy about their ability to refuse drugs, and to decrease perceptions that using drugs makes it easier to fit in. The program is based on the theory that these techniques will enable students to resist peer pressure to use drugs, while simultaneously promoting a more ethical school environment.

Evaluation Outcomes

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Study 1
Eisen and colleagues (2003) found mixed results among the various outcome measures based on 1-year follow-up data of schools that received Skills for Adolescence (SFA) training in comparison to control schools. Results provided evidence of the program’s effectiveness to reduce alcohol and marijuana use and increase behavioral skills to resist these substances. However, there was a lack of evidence for the program’s ability to reduce tobacco use or other illicit substances.

Reported Alcohol Use
There were no notable differences between SFA and control students in reported lifetime or recent 30-day alcohol use. However, baseline binge drinkers in treatment schools were less likely to report recent binge drinking at the end of eighth grade (27 percent) than students in control schools (37 percent).

Reported Tobacco Use
There were no notable differences between SFA and control students in reported lifetime or recent use of tobacco.

Reported Marijuana Use
SFA students had lower reported rates of lifetime and recent marijuana use relative to control schools, but this difference was not statistically significant.

Reported Other Illicit Substance Use
There were no notable differences between SFA and control students in reported lifetime or recent use of other illicit substances.

Improvements in Resistance Behaviors
SFA students reported significant positive effects on refusal offers of marijuana and alcohol, but not for cigarettes or cocaine. For SFA students, knowledge, awareness, and attitudes about the risks of alcohol and other drug use improved 43 percent. Further, inner city SFA youths had higher expectations for success in school than control students. Lastly, SFA students’ expectations of future use of beer and liquor were significantly lower than those of non-SFA students.
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Evaluation Methodology

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Study 1
Dr. Marvin Eisen of the Urban Institute in Washington, D.C. and colleagues (2003) conducted a longitudinal randomized controlled trial of Lions Quest Skills for Adolescence (SFA) for the National Institute on Drug Abuse to assess the program’s effectiveness in deterring and delaying students’ substance use through middle school in comparison to usual drug education programming. Thirty-four middle schools were selected for the study during the fall and winter of 1997–1998, including schools in Baltimore, Md.; Detroit, Mich.; Los Angeles, Calif.; and Washington, D.C. The sample population totaled 7,426 sixth graders, and a baseline survey was conducted with all actively consented sixth graders in each school in the spring of 1998. Based on the survey’s results, schools were pair-matched within each district, based on reported prevalence of any recent (within the previous 30 days) substance use (tobacco, alcohol, or other illicit drugs). Accordingly, schools were divided into a treatment group and a control group, each comprising 17 schools. The study cohort in the 17 intervention schools received only SFA as their seventh-grade drug education during the 1998–1999 school year, while their counterparts in the 17 comparison schools received their usual drug education programming. The comparison programs, which were generally left to the discretion of teachers in each school, ranged from school assemblies, to local teacher–devised classroom curricula, to DARE exposure.

To monitor the program’s progress, 1-year posttest data (baseline to end of the intervention school year) was collected from 6,239 seventh graders in May and June of 1999. One-year follow-up data (i.e., 1 year post-intervention) were collected at the end of eighth grade, in May and June of 2000. To assess evidence of the program’s effectiveness, 1-year follow-up data was used to compare drug use outcomes between SFA and control schools from spring of 1998 through spring of 2000. Initiation of “ever” and “recent” use of alcohol, tobacco, marijuana, and other illegal substances (“any other” drugs, including inhalants and cocaine or crack) for baseline nonusers and changes in recent use for baseline were compared using mixed-model regressions to control for school clustering. “Ever” was defined as having ever used the substance in one’s lifetime, while “recent” was defined as use within 30 days prior to data collection. In addition to these measures, alcohol use rates were measured by the occurrence of recent binge drinking (three or more drinks at one time in the previous 30 days). Alcohol, tobacco, and illegal drug use prevalence rates were assessed through a set of standard items that was modified, when necessary, following pretesting with the target population. Use of each substance was measured, with items having five- to seven-point ordinal response categories (e.g., “never” or “none” to “more than 100 cigarettes [more than 5 packs]”). These ordinal indicators of lifetime and recent substance use were then recoded to 0=no/1=yes response categories.

The study also measured potential changes in behavioral and refusal skills by assessing students’ behavioral intentions to use drugs, social influences and interpersonal perceptions, perception of harmful drug effects, and communication skills and self-efficacy regarding drug use refusal. Behavioral intentions to use tobacco, alcohol, marijuana, and cocaine in the following 3 months were assessed using several items regarding such intentions (1=definitely yes to 4=definitely no). Social influence and interpersonal perceptions were assessed using standard questions on students’ normative beliefs about the prevalence of substance use by a best friend (yes/no/I don’t know), friends in general, and same-grade peers (1=all to 5=none), as well as a three-item scale on whether using alcohol, cigarettes, and marijuana makes it easier to ‘‘fit in’’ (1=strongly agree to 5=strongly disagree). Perceptions of the harmful or helpful effects of alcohol, binge drinking, smoking, marijuana, and cocaine were assessed with three-item scales focusing on whether each substance helps or harms one’s health, ability to relax, and popularity (1=very helpful to 4=very harmful). Students’ sense of self-efficacy in refusing alcohol, cigarettes, marijuana, and cocaine in various situations (e.g., “ … how easy or hard would it be to say ‘no’ to marijuana if you are at party with friends/at close friend’s house—no parents home/hanging out with friends after school—not at someone’s house?”) was measured using separate three-item scales. These items were developed after careful review and content analysis of the SFA communication and resistance skills classroom curriculum and role-play exercises used in the eight key sessions.
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There is no cost information available for this program.
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Implementation Information

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Each implementing adult must complete an introductory 2- or 3-day professional development training to receive Skills for Adolescence (SFA) program materials. An extensive 10-day training-of-trainers program is available to qualified school districts. Preset regional workshops scheduled by SFA and onsite contract workshops are also available.
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Evidence-Base (Studies Reviewed)

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These sources were used in the development of the program profile:

Study 1
Eisen, Marvin, Gail L. Zellman, and David M. Murray. 2003. “Evaluating the Lions–Quest ‘Skills for Adolescence’ Drug Education Program: Second-Year Behavior Outcomes.” Addictive Behaviors 28(5):883–97.
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Program Snapshot

Age: 10 - 14

Gender: Both

Race/Ethnicity: Black, American Indians/Alaska Native, Asian/Pacific Islander, Hispanic, White, Other

Geography: Suburban, Urban

Setting (Delivery): School

Program Type: Classroom Curricula, Conflict Resolution/Interpersonal Skills, School/Classroom Environment, Alcohol and Drug Prevention

Current Program Status: Active