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Purpose: To be effective, evidence-based programs should be delivered as prescribed. This suggests that adaptations that deviate from intervention goals may limit a program's effectiveness. This study aims to examine the impact that number and quality of adaptations have on substance use outcomes. Design/methodology/approach: The authors examined 306 video recordings of teachers delivering "All Stars", a middle school drug prevention program. Multiple observers coded each recording, noting the number and type of adaptation each teacher made. Each adaptation was given a valence rating. Adaptations that were deleterious to program goals received negative valence ratings; positive ratings were given for adaptations that were likely to facilitate achievement of program goals; neutral ratings were given to adaptations that were expected to have neither a positive nor negative impact on program goals. Findings: All teachers made adaptations. Teachers were consistent across time in the types of adaptations they made, suggesting each teacher has a personalized style of adapting. Those who made few adaptations, and whose average adaptation was rated as being positive had a higher percentage of students who remained non-drug users. In contrast, teachers who made many adaptations, whether their average valence rating was positive, neutral or negative, failed to have as many students remain non-drug users. Measures of fidelity, including quality of delivery and teacher understanding, were related to valence of adaptations, with better performance related to making positive adaptations. Practical implications: Through training and supervision, teachers should be guided and encouraged to follow programs directions, making few adaptations and ensuring that adaptations that are made advance the goals of intervention. Programs should define acceptable and unacceptable ways they may be adapted. Originality/value: This study provides significant evidence about the challenges that face disseminated evidence-based programs. (Contains 7 tables and 1 note. A citation for further reading is included.)

We examine whether teachers' communicator style relates to student engagement, teacher-student relationships, student perceptions of teacher immediacy, as well as observer ratings of delivery skills during the implementation of All Stars, a middle school-based substance use prevention program. Data from 48 teachers who taught All Stars up to 3 consecutive years and their respective seventh-grade students (n = 2,240) indicate that having an authoritative communication style is negatively related to student engagement with the curriculum and the quality of the student-teacher relationship, while having an expressive communicator style improves teachers' immediacy to student needs. Adaptations made by a subsample of teachers (n = 27) reveal that those who were more expressive asked students more questions, used more motivational techniques, and introduced more new concepts than authoritarian teachers.

Purpose: The purpose of this paper is to describe the topics covered by coaches assisting teachers implementing a research-based drug prevention program and explore how coaching affects student outcomes. Design/methodology/approach: The All Stars drug prevention curriculum is implemented by 16 urban teachers who received four coaching sessions. Two coaches participated. Coaches are interviewed by investigators to assess topics covered. Students completed pre-test-post-test measures of mediators and substance use behaviours. Findings: The average teacher is coached on 11.7 different topics, out of a total of 23 topics. Coaching topics most heavily emphasized include: introduction and wrap up; time management; general classroom management; teacher's movement around the class; asking open-ended questions; using students' questions, comments and examples to make desired points; general preparation; engaging high-risk youth; reading from the curriculum; implementing activities correctly; focusing on objectives and goals; maintaining a focus on the task; and improving depth of understanding. Seven coaching topics are found to relate to changes in student mediators and behaviour. Research limitations/implications: The current study is exploratory. Future research should explore how teachers develop the particular skills required by prevention programs and how coaches can assist them. Practical implications: Five levels of skill development are postulated, which coaches may address: fundamental teaching skills, mechanics of program delivery, development of an interactive teaching style, effective response to student input, and effective tailoring and adaptation. Originality/value: The paper is one of a very few studies that explores how coaching impacts outcomes in substance abuse prevention. (Contains 5 tables.)

The purpose of this study was to extend the literature in both substance use implementation and persuasive health communication by examining the extent to which students' need for cognition and impulsive decision-making moderated the relationship between teachers' classroom communication behavior and program outcomes in an evidence-based middle school substance use prevention curriculum. Participants included 48 teachers and their respective 7th grade students who participated in a randomized trial testing the effectiveness of personal coaching as a means to improve the quality with which teachers implemented the All Stars curriculum. Need for cognition and impulse decision-making were both associated with positive changes in lifestyle incongruence and commitments to not use substances for students whose teachers displayed greater interactive teaching. Further, need for cognition was associated with lower alcohol use rates while impulse decision making related to lower rates of marijuana use in classes with interactive teaching. (Contains 2 tables.)

Objective: This study examined the association between restricting calories on intended drinking days and drunkenness frequency and alcohol-related consequences among college students. Participants: Participants included a random sample of 4,271 undergraduate college students from 10 universities. Methods: Students completed a Web-based survey regarding their high-risk drinking behaviors and calorie restriction on intended drinking days. Results: Thirty-nine percent of past 30-day drinkers reported restricting calories on days they planned to drink alcohol, of which 67% restricted because of weight concerns. Restricting calories on drinking days was associated with greater odds of getting drunk in a typical week. Women who restricted were more likely to report memory loss, being injured, being taken advantage of sexually, and having unprotected sex while drinking. Men were more likely to get into a physical fight. Conclusions: These results highlight the importance of considering weight control behaviors in the examination of high-risk college drinking. (Contains 1 figure and 2 tables.)

Research-based substance use prevention curricula typically yield small effects when implemented by school teachers under real-world conditions. Using a randomized controlled trial, the authors examined whether expert coaching improves the effectiveness of the All Stars prevention curriculum. Although a positive effect on students' cigarette use was noted, this finding may be attributed to marked baseline differences on this variable across the intervention and control groups. No effects were found on students' alcohol or marijuana use or on any of several variables thought to mediate curriculum effects. The effects of coaching on teachers may not become evident until future years, when they have moved beyond an initial mechanical delivery of the curriculum. (Contains 3 tables.)

There is now ample evidence that teachers tend to make substantial modifications to both the prescribed content and methods of the curricula they administer, and that such modifications are likely to attenuate curricula effects. We examine the fidelity with which teachers implement "Protecting You, Protecting Me," an underage alcohol use prevention curriculum. Findings suggest that while teachers attempted to implement most sections of a lesson, the lessons taught were consistently--and often extensively--adapted. We conclude that since teachers are likely to continue to modify lessons, curriculum developers and trainers should enhance their understanding of how prevention curricula are taught under real world conditions, help teachers to reinforce key curriculum concepts, and consider modifying those curricular sections that teachers are adapting with greatest frequency. (Contains 5 tables.)

Prevention research continues to focus on school-based substance use programs aimed at adolescents. These programs are designed to reduce substance use and risk behavior by targeting key mediators, such as normative beliefs, which in turn reduce substance use. All Stars is a newly developed program that was recently evaluated in a randomized field trial in 14 middle schools in Lexington and Louisville, Kentucky. The authors examined targeted and nontargeted variables as possible mediators of program effectiveness. Findings indicate that All Stars achieved reductions in substance use and postponed sexual activity when teachers were successful at altering targeted mediators: normative beliefs, lifestyle incongruence, and manifest commitment to not use drugs. The program was not successful when it was delivered by specialists. At least in part, this failure is attributable to specialists' inability to change mediators as intended by the program. (Contains 3 tables and 1 figure.)

Norm setting has been shown to be a crucial element of effective drug education. The purpose of this study was to examine the degree to which a videotape describing concepts and methods for establishing positive norms would enhance standard training. Participants included 35 teachers and 64 health education students who were randomly assigned to the standard training condition or the video-enhanced training. Participants completed pretest and posttest measures of beliefs, attitudes, and knowledge concerning prevention methods. Both the standard and the video-based instruction produced improved understanding of norms and norm setting prevention methods. However, the video-based instruction resulted in several notable improvements beyond what was achieved in standard instruction. Video training can be an important tool as research-based drug abuse prevention achieves wide-scale dissemination. It offers a way of standardizing training and has the potential to increase the fidelity with which prevention programs are implemented. (Contains 2 tables.)

Examined the relationship between students' perceptions of a problem behavior prevention program, All Stars, and changes in program variables-bonding; normative beliefs; ideals; and commitment. Three factors-Program Enjoyment, Student Engagement, and Teacher Relationship-were used to predict changes in four variables. Results indicate Student Engagement and Program Enjoyment had strongest impact on changes in program variables. (Author)

The purpose of this study was to explore the relationship between parental influence, peer norms, body esteem, and disordered eating intentions in a sample of incoming college freshmen women. A [...]