Objective Outcome Evaluation of a Drug Prevention Program for High-Risk Youths in Hong Kong: The Project Astro

IntroductionThere is a dearth of systematic and documented drug prevention programs in Hong Kong (1,2). In fact, no vigorous evaluation studies exist with a longitudinal design utilizing data from different sources in Chinese communities. As an attempt to fill this gap, this paper introduces the Project Astro and the methods adopted to evaluate the programs.Recent approaches to drug prevention have focused on comprehensive strategies that target early risk factors and strengthen protective factors in adolescence. Risk factors include poor social skills, low self-esteem, adverse family environment, negative peer influence, poor school performance, and delinquent behaviors (3). With these concerns in mind, Hawkins, Catalano and Miller (4) proposed that effective drug prevention strategies include parenting skills training, social competence abilities training, and youth involvement in alternative activities. This risk-focused approach aims at reducing the effects of the known antecedents of adolescent drug abuse and cultivating protective factors in high-risk youths. In a similar vein, McNeal and Hansen (5) also identified four key mediators of adolescent drug use: commitment not to use drugs, lifestyle incompatibility with drug use, beliefs about the consequences of drug use, and normative beliefs such as peer beliefs and endorsement of drug use. Since effective drug prevention work should seek to reduce adolescents' vulnerability to unfavorable environmental factors and eliminate environmental influences that induce drug use (6), an increasing emphasis has been placed on the use of structured intervention programs in drug prevention for young people, such as the -SMART" program (7,8), -Drug Abuse Resistance and Education" (DARE) (9,10), and -Project STAR" (11). Conscious of the need to develop an indigenous drug prevention program that is evidence-based, systematic, and conceptually sound, the -Astro" (Anti Substance Tobacco Refusal Operation) project was designed by this research team for high-risk youths in Hong Kong.A "high-risk youth" was defined as an adolescent who fulfilled any two or more of the following criteria: (a) attending a school of low academic standard; (b) exhibition of conduct problems, such as truancy; (c) a dropout from school and/or unemployed; (d) drug use experience, particularly abuse of stimulants and/or polydrugs; (e) frequent smoking.It was expected that this drug prevention program would: (a) increase the participants' knowledge about drugs and sex; (b) improve their attitudes toward substance abuse and sex; (c) strengthen their ability to refuse drugs and early sex; and (d) reduce their actual usage of drugs and engagement in sex.The Project Astro consisted of three psychosocial primary prevention programs conducted in structured group sessions for youths (i.e., Astro Kids, aged 10 to 13; Astro Teens, aged 13 to 16; and Astro Leaders). Ideally, an adolescent would complete all the programs, but each program had its own independent functions. The goals of the Project Astro were to increase the participants' knowledge about drugs; help them develop proper attitudes toward substance abuse; strengthen their ability to refuse drugs; and reduce the participants' usage of drugs. Apart from providing drug information, the programs also taught young people a broad range of social and personal competence skills to resist peer and other social pressures.Each program consists of 10 to 12 sessions, which cover the following areas: stress and stress management, family relationships, knowledge of gateway drugs (i.e., cigarettes and alcohol), psychotropic drugs (i.e., -ice," ketamine, marijuana, and ecstasy) and sex, peer influence, self-understanding, and refusal skills.The programs were organized in youth centers, primary and secondary schools. A complete set of manuals for program delivery and evaluation were prepared (12). Training sessions for parents, social workers, and community leaders were held as follows:Astro kids programThe total number of groups in the Astro Kids program was 13, with 139 experimental subjects and 213 control subjects (N=352). …