Efficacy of Training and Fidelity of Implementation of the Life Skills Training Program. (Research Papers)
Hahn, Ellen J., Noland, Melody Powers, Rayens, Mary Kay, Christie, Dawn Myers, Journal of School Health
The Life Skills Training (LST) Program is a substance abuse prevention curriculum based on a multifactorial causal model of youth alcohol, tobacco, and other drug use and on Social Learning Theory. (1,2) More than a decade and a half of efficacy research on the LST Program has consistently shown a 50% reduction in drug use among youth. (2) While the LST Program curriculum allows some implementation flexibility, fidelity (ie, integrity and consistency of program delivery) is critical to its success in reducing alcohol, tobacco, and other drug use among youth. The purposes of this study were to: a) assess effectiveness of a training and implementation model for diffusing the LST Program into middle schools in Kentucky; b) examine implementation fidelity of the LST program; and c) explore factors associated with involvement in training and program implementation.
Exposure to alcohol, tobacco, and other drugs typically starts in early adolescence with use of gateway drugs (tobacco, alcohol, and marijuana) and progresses to use of other illicit drugs. Alcohol use remains widespread among today's teen-agers, (3) contributing to approximately one-half of all homicides, suicides, and motor vehicle crashes. Four of every five students (80%) have consumed alcohol by the end of high school; more than one-half (52%) by eighth grade. (3) Nearly two-thirds (63%) try cigarettes by 12th grade, and almost one-third (31%) of 12th graders are current smokers. (3) Even as early as eighth grade, four of 10 students (41%) try cigarettes, and 15% already are current smokers. (3) Marijuana is the most widely used illicit drug with annual prevalence rates in grades 8, 10, and 12 of 16%, 32%, and 37%, respectively. (3)
The LST Program teaches resistance to social influence by addressing personal self-management skills and social skills needed to cope with the environment and to choose healthy alternatives to substance use. (4) The program is taught by classroom teachers, counselors, nurses, and peers. The LST Program is a three-year intervention consisting of 15 sessions in Year One, 10 booster sessions in Year Two, and five booster sessions in Year Three. Typically, the LST Program is taught in grades 6-8 or 7-9. (5) Tortu and Botvin (6) reported that most teachers did not implement the entire intervention according to protocol, and that on average, only 65% of the material was actually covered during the LST Program. Many teachers focused solely on the cognitive portion and omitted the skills training segment. (7) Students who received at least 60% of the intervention during all three years were more likely to experience lower alcohol, tobacco, and other drug use rates than those who received fewer than 60% of the sessions. (8)
Data for this longitudinal study were collected from 44 master trainers and 45 teachers during the 1999-2001 school years. Master trainer participants were recruited by a letter from the Kentucky Department of Education to various groups describing the opportunity for master training and asking for a representative from each organization to attend. Master trainers included school personnel, health department professionals, substance abuse prevention specialists, and Kentucky Cancer Program personnel from 24 counties. Master trainers received instruction and practice in the LST Program and were expected to return to their local area and provide training for teachers. A convenience sample of primarily middle school teachers from 16 Kentucky counties were invited to attend teacher training sessions and were expected to implement the LST Program with students in the classroom. Data were collected from trainers and teachers by questionnaires and observations during classroom sessions.
The measures were adapted from Rohrbach et al (9) and Noland et al (10) who used them in evaluating program implementation of school-based substance abuse prevention programs. …