Implementing Evidence-Based Substance Use Prevention Curricula in North Carolina Public School Districts

By Pankratz, Melinda M.; Hallfors, Denise D. | Journal of School Health, November 2004 | Go to article overview

Implementing Evidence-Based Substance Use Prevention Curricula in North Carolina Public School Districts


Pankratz, Melinda M., Hallfors, Denise D., Journal of School Health


The Safe and Drug-Free Schools and Communities Act (SDFSCA) represents the largest single source of federal funding for the prevention of alcohol, tobacco, and other drug use. (1) Administered by the US Department of Education, SDFSCA provides prevention funding to virtually every school district in the nation. (2) The SDFSCA program has appropriated more than $8 billion since its inception in 1986. (3)

Despite the significant monetary investment, the use of alcohol, tobacco, and other drugs among adolescents remains a major public health concern. In the first year of SDFSCA funding, the Monitoring the Future national survey of high school seniors found that 64% of 12th graders had drank alcohol, 29% had smoked tobacco, and 21% had used an illicit drug during the past month. (4) Adolescent substance use rates declined during the first few years of SDFSCA funding, but this decline was followed by a significant upsurge lasting throughout most of the 1990s. Today, 50% of 12th graders report consuming alcohol, 30% report smoking tobacco, and 26% report using an illicit drug within the past month. (4)

With the realization that adolescent substance use rates had not declined, Congress questioned whether the activities being funded could be effective in preventing substance use. (5) In response to these questions, the federal SDFSCA program increasingly emphasized the importance of using evidence-based prevention programs that have been rigorously tested and found to reduce substance use. In 1998, the US Department of Education promulgated the Principles of Effectiveness, which require SDFSCA recipients to implement prevention programs that have evidence of their effectiveness, (6,7) and appointed an Expert Panel to designate "Exemplary" and "Promising" school-based prevention programs. (8,9) Most recently, the No Child Left Behind Act of 2001 further supported these actions by codifying the Principles of Effectiveness into federal education law. (10)

This paper reports the extent to which North Carolina public school districts had come into compliance with these SDFSCA policies, specifically examining which substance use prevention curricula were most commonly used at each school level, and then to investigate social system characteristics associated with the extensive use of evidence-based substance use prevention curricula. In doing so, a diffusion of innovation theoretical framework was used. Diffusion is the process by which members of a social system learn about, decide about, and act on ideas, practices, or objects that they perceive as new. (11) The ideas, practices, or objects perceived as new are referred to as an innovation. (11) Early evaluations of SDFSCA indicated the implementation of evidence-based prevention programs would represent an innovation for most school districts.

The first evaluation of the SDFSCA program, a longitudinal study of 19 school districts from across the nation, provided evidence that most school districts had a narrow range of prevention program components, and were using curricula that were either ineffective or not evaluated. (2) For example, Project DARE was the most widely used curriculum in their study districts. (2) The preponderance of evidence suggests that Project DARE is not effective in preventing substance use. (12-16) Furthermore, when districts used evidence-based programs, there was tremendous variation in the availability of such programs within a school district. For example, even within the same school, teachers often used different substance use prevention curricula. (2)

The second national evaluation of the SDFSCA program, the National Study of Local Education Activities Under the Safe and Drug-Free Schools and Communities Act, substantiated earlier findings regarding use of evidence-based programs. (17) The study, comprising a representative survey of 520 school districts, found that less than 10% of school districts were using evidence-based substance use prevention programs. …

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