Reducing Interrelated Risks for Substance Abuse, Delinquency and Violence: Effects of the Rainbow Days' Curriculum-Based Support Group Program

3 STUDY OVERVIEW and LOGIC MODEL 4 METHODS • Design 6 • Study Sample 7 • Implementation 15 • Measures 19 • Analysis 35 • Missing Data 38 • Implementation Fidelity 44 • Threats to Internal Validity 60 RESULTS 65 DISCUSSION 77 CONCLUSIONS 81 REFERENCES 82 APPENDIX: 94 A. Research in Support of the Logic Model 95 B. Intervention Description 105 C. High Risk Pool Protocol 114 D. Pre/Post Survey Administration Protocol 117 E. Survey Questionnaire 119 F. Implementation Fidelity – Attendance 124 G. Implementation Fidelity – Observation Tool 125 H. Referring Individual’s Assessment of Risk 152 I. Referring Individual’s Assessment of Improvement 153 J. Facilitator’s Pre-assessment of Student’s Behavior 154 K. Facilitator’s Post-assessment of Student’s Behavior 155 L. Group Participant Evaluation 156 M. Counselor Post-Intervention Survey 158 Rainbow Days’ Curriculum-Based Support Group (CBSG) Program 3 Reducing Interrelated Risks for Substance Abuse, Delinquency and Violence: Effects of the Rainbow Days’ Curriculum-Based Support Group Program ABSTRACT The Rainbow Days Curriculum-Based Support Group (CBSG) Program is 12-week preventive intervention that uses an educational support group process to deliver a coping and social skills curriculum to small groups of children assessed to be at elevated risk for substance abuse, delinquency, and violence due to their living in high-risk situations orThe Rainbow Days Curriculum-Based Support Group (CBSG) Program is 12-week preventive intervention that uses an educational support group process to deliver a coping and social skills curriculum to small groups of children assessed to be at elevated risk for substance abuse, delinquency, and violence due to their living in high-risk situations or exhibiting behaviors of concern. In 2003, a non-equivalent control group study (with random assignment of the intervention group) was conducted to determine if the intervention could decrease interrelated risks for substance abuse, delinquency, and violence among elementary students using measures identified by the Center for Substance Abuse Prevention (CSAP) in its Core Measures Initiative (CSAP, 1998). Risk measures were: substance use, rebellious behavior, anti-social attitudes; a protective factor, anti-substanceuse attitudes and intentions, was also measured. Data were obtained from 661 elementary students ages 8-11 (164 interventions; 497 controls) using a questionnaire consisting of 28 items measuring demographics and the previously mentioned variables. The questionnaire was completed prior to and after the 12-week small group intervention. The data were analyzed using chi square and regression analyses. Immediate effects were found for all intervention variables: reduction in self-reported 30-day use of inhalants; improved antisubstance-use attitudes and intentions; reduced anti-social attitudes; and reduced rebellious behavior. Effects were strongest for those at extremes of the pretest score distributions. Missing data was less than 10%, and analyses using the multivariate normal model for data imputation confirmed the original findings. The intervention was associated with significant improvements on all four outcome measures. Rainbow Days’ Curriculum-Based Support Group (CBSG) Program 4 Reducing Interrelated Risks for Substance Abuse, Delinquency and Violence: Effects of the Rainbow Days’ Curriculum-Based Support Group Program STUDY OVERVIEW and LOGIC MODEL Multiple longitudinal studies have shown that the early predictors of substance abuse, delinquency, and violence are interrelated, that they appear within the elementary school years, and that the earlier these risk factors appear, the more predictable the progression toward deviant behavior becomes. This body of research also demonstrates that interventions to prevent, delay or mitigate risks during the elementary developmental period can significantly reduce future involvement in self-defeating and dangerous behaviors and the negative life consequences associated with such behaviors (Anthony and Petronis, 1995; Arthur, et al., 2002; Clark, et al., 2002; Derzon, 2001; DeWit, et al., 2000; Dinwiddie, 1994; Dishon, et al., 1999; Farrington, 1995; Farrington, et al., 2001; Hawkins, et al., 1992, 1995, 1998, 2000; Huizinga, et al., 1994; Johnston, et al., 1997; Chou, et al., 1992; Grant and Dawson, 1997; Gruber, et al., 1996; Kurtzman, et al., 2001; Lipsey and Derzon, 1998; McGue et al., 2001; Office of the Surgeon General, 2001; Thornberry, et al., 1995; and White, et al., 1999). More recent research has confirmed and strengthened the findings of previous studies (Alltucker, et al., 2006; Australian Institute of Families and Crime Prevention, 2003; Clark, et al., 2005; Ellickson, et al., 2003; and Wasserman, et al., 2003). See Appendix A for “Research in Support of Logic Model. ” Study Purpose: While there are several universal evidence-based programs for use with elementary-aged children and in elementary school settings, few are available for selective and indicated populations in Grades 2-5. The objective of the 2003 Nonequivalent Control Group Study, which is the subject of this report, was to determine if the Rainbow Days’ Curriculum-Based Support Group (CBSG) Program (intervention) could reduce risk factors for substance use and abuse, delinquency, and violence in elementary students, Rainbow Days’ Curriculum-Based Support Group (CBSG) Program 5 assessed as being a elevated risk for such problems, using measures identified by the Center for Substance Abuse Prevention (CSAP) in its Core Measures Initiative (CSAP, 1998). Logic Model: The intervention is based on the “mediating variable framework” (Hansen & McNeal, 1996; Baranowki et al., 1997, 1998), which states that in the risk-effect relationship (X-p*-Y) risk factors are not “causes”; they are “predictors. ” By targeting the reduction of interrelated risk factors (X) and intervening with specific populations at specific times within the developmental pathway with research-based mediating variables (M), a program that produces significant changes in known precursors to the targeted risk factors is predicted (p*) to impact the long term goal (Y). Figure 1 depicts the study Logic Model. Figure 1 2003 Non-Equivalent Control Group Study: Logic Model REDUCED Interrelated Risk Factors: REDUCED Problem Behaviors: • Early Onset Substance Use • Anti-Social Attitudes (inc. Attitudes and Intentions Favorable to Substance Use) • Rebellious Behavior Expected Outcomes: • Reduced Substance Use • Reduced Anti-Social Attitudes • Increased Anti-Substance Use Attitudes & Intentions • Reduced Rebellious Behaviors Rainbow Days’ Curriculum-Based Support Group (CBSG®) Program 2003 Non-Equivalent Control Group Study: Logic Model M /F A ge s 811 : Se le ct ive & I nd ica te d Mediating Variables: • Social & Emotional Support (Support Group, Adult Role Model Group Member/Peer Support) • Social & Emotional Coping Skills (Competence Enhancement in: Separating Emotions from Behaviors, Tolerance and Respect, Anger Management, Making/Being Friends, Dealing with Chemical Dependency in the Family, & Dealing with Changes We Can’t Control) • Goal Setting • Social Norms (Health Choices) •Resistance Skills • Substance Abuse • Delinquency • Violence M eures Se tt ing : Fi ve E le me nt ar y Ca mp us es St ud y P ar tic ip an ts :