PREVENTION OF ALCOHOL-RELATED PROBLEMS AMONG ADOLESCENTS Release Date: October 12, 2000 RFA: AA-01-001 National Institute on Alcohol Abuse and Alcoholism (http://www.niaaa.nih.gov/) Letter of Intent Receipt Date: February 9, 2001 Application Receipt Date: April 10, 2001 PURPOSE The National Institute on Alcohol Abuse and Alcoholism (NIAAA) seeks grant applications to conduct research on comprehensive interventions to prevent and reduce alcohol use and misuse among adolescents in racially, ethnically and economically diverse urban communities. Alcohol continues to be the number one substance of abuse used by American adolescents. Both theory and practice indicate that comprehensive interventions, compared to single component interventions, are more likely to be effective in delaying drinking onset, reducing age-related increases in drinking, and preventing and reducing high risk drinking and other alcohol- related problems among adolescents. Comprehensive interventions are those that address the community (including regulatory policies), school environment, parental norms and practices regarding alcohol use by their children, and individual adolescent’s knowledge, cognitions, intentions, and skills. The purpose of this Request for Applications (RFA) is to encourage research that develops and/or tests comprehensive interventions to prevent adolescent alcohol use and misuse in racially/ethnically and economically diverse urban communities. These prevention strategies should seek to change or strengthen community norms, school environments, and parental norms and practices regarding alcohol use by youth, improve adolescent knowledge, attitudes, cognitions, intentions, and refusal skills regarding alcohol use and its consequences, and reduce the availability of alcohol to youth. Additional intervention strategies, such as modifications of after-school environments, are not precluded. Applicants are encouraged to develop and/or test interventions for young adolescents in later grades of elementary school and middle or junior high school, the majority of whom have not yet begun to use alcohol or other substances. HEALTHY PEOPLE 2010 The Public Health Service (PHS) is committed to achieving the health promotion and disease prevention objectives of "Healthy People 2010," a PHS- led national activity for setting priority areas. This Request for Applications (RFA), Prevention of Alcohol-Related Problems Among Adolescents, is related to one or more of the priority areas. Potential applicants may obtain a copy of "Healthy People 2010" at http://www.health.gov/healthypeople/. ELIGIBILITY REQUIREMENTS Applications may be submitted by domestic for-profit and non-profit organizations, public and private, such as universities, colleges, hospitals, laboratories, units of State and local governments, and eligible agencies of the Federal Government. Foreign institutions are not eligible for these grants. Racial/ethnic minority individuals, women, and persons with disabilities are encouraged to apply as Principal Investigators. MECHANISM OF SUPPORT This RFA will use the National Institutes of Health (NIH) Research Project Grant (R01) award mechanism. Responsibility for the planning, direction, and execution of the proposed project will be solely that of the applicant. The total project period for an application submitted in response to this RFA may not exceed 5 years. This RFA is a one-time solicitation. Future unsolicited competing continuation applications will compete with all investigator- initiated applications and be reviewed according to the customary peer review procedures. The anticipated award date is September 28, 2001. Since applications are requesting more than $250,000, the modular grant mechanism will not be used. Applicants also may submit Investigator-Initiated Interactive Research Project Grants (IRPG) under this RFA. Interactive Research Project Grants require the coordinated submission of related regular research project grant applications (R01s) from investigators who wish to collaborate on research but do not require extensive shared physical resources. These applications must share a common theme and describe the objectives and scientific importance of the interchange of, for example, ideas, data, and materials among the collaborating investigators. A minimum of two independent investigators with related research objectives may submit concurrent, collaborative, cross-referenced individual R01 applications. Applications may be from one or several institutions. Further information on the IRPG mechanism is available in program announcement PA-96-001, NIH Guide for Grants and Contracts, Vol. 24, No. 35, October 6, 1995, and from the NIAAA program staff listed under INQUIRIES. FUNDS AVAILABLE The NIAAA intends to commit approximately $2 million in FY 2001 to fund one to three new and/or competitive continuation grants in response to this RFA. Because the nature and scope of the research proposed might vary, it is anticipated that the size of awards will also vary. Although the financial plans of the NIAAA provide support for this program, awards pursuant to this RFA are contingent upon the availability of funds and the receipt of a sufficient number of meritorious applications. At this time, it is not known if this RFA will be reissued. RESEARCH OBJECTIVES Background Alcohol continues to be the number one substance of abuse used by American adolescents. This is true for subgroups defined by race and ethnicity, socio-economic status, or urban-rural residence, as well as within the general population. Although the 1980’s were characterized by decreases in adolescent drinking, as well as in the use of tobacco and illicit drugs, that trend leveled off abruptly in the early 1990 s, and alcohol use may be increasing, especially among younger adolescents. Two major national surveys of adolescents indicate less alcohol use among African Americans, Asians, and some Hispanic subgroups. Yet, the leveling of a downward trend and the possible increase in drinking have been observed among ethnic and racial minority youth as well as youth as a whole (Wallace et al.,1999, Johnston et al., 1999). Research suggests that social-psychological risk (or causal) processes leading to alcohol use and abuse among youth do not necessarily differ across ethnic groups (Catalano et al., 1992, Barnes,1995), but that the prevalence of factors affecting the development of risk does differ. The use and abuse of alcohol by adolescents is associated with high-risk behaviors that can have profound health, economic, and social consequences. These include drinking and driving, participation in deviant peer groups, abuse of other drugs, unprotected sexual intercourse, interpersonal violence, destruction of private property, and poor school performance. Approximately one half to two thirds of adolescents who drink at least monthly engage in high-risk drinking practices, consuming large quantities and drinking to intoxication. In 1999, 31 percent of 12th grade students, 26 percent of 10th graders, and 15 percent of 8th graders reported high risk alcohol use, as indicated by consuming five or more drinks on a single occasion in the previous two weeks (Johnston et al., 2000). Immediate alcohol-related problems experienced by youth include missing school or work, feeling regretful about drinking, getting sick, passing out, getting into fights, having accidents, and getting into trouble at home, at school or with the police. (Ellickson et al., 1996, Johnston et al., 2000). Youth who initiate drinking at an early age are more likely to increase their drinking and to experience alcohol-related problems during adolescence. Moreover, they are at greater risk for life-time alcohol abuse or alcoholism. (Grant & Dawson, 1997, Hawkins et al., 1997) Although causality has not been conclusively demonstrated between early initiation and these deleterious effects, it is reasonable to expect some lasting preventive benefits from delaying the initiation of drinking by adolescents. Use of school-based curricula is the most commonly used preventive intervention approach and has the longest history of research and evaluation. Since the passage of the Drug Free Schools and Communities Act of 1986, virtually all elementary and secondary schools provide some classroom programming on alcohol, tobacco and other substances of abuse. Although early didactic programs were generally found to be ineffective, some of the more recent approaches based on research and theory have shown beneficial effects (Hansen, 1992, Dielman, 1995). School-based interventions that incorporate social influence approaches and skills training have also been successful or shown promising results in minority populations and in economically disadvantaged communities (Sussman et al., 1998, Harrington & Donohew, 1997). However, effect sizes for school-based programs are not large, and it is generally conceded that school curricula, in the absence of broader environmental changes, are not sufficient to make sizeable and lasting changes in alcohol use by adolescents. (Gorman 95, 96, Ellickson, 1995, Moscowitz, 1989, Johnson et al., 1990) Both longitudinal and cross-sectional studies of risk and protective factors consistently find that parenting practices, especially setting clear no-use rules, monitoring children’s behavior, and making alcohol unavailable, can have strong deterrent influences on adolescent drinking. Importantly, many of these relationships are independent of race or ethnicity, and some ethnic differences in the prevalence of alcohol use among youth can be attributed in part to differences in parenting practices. (Barnes, Catalano et al). Furthermore, findings from survey and intervention research indicate that interventions directed toward parents to increase and reinforce positive parenting practices can have a protective effect on their children. (Loveland-Cherry et al., 1999, Spoth et al., 1999). Integrated models of the etiology of underage drinking emphasize the importance of environmental factors that have both direct and indirect influences on drinking behavior through effects on alcohol availability, formal and informal social controls, social norms, and other aspects of the social and physical context within which drinking takes place. (Wagenaar and Perry, 1995, Holder & Giesbrecht, 1990). These durable environmental influences can, over time, overwhelm effects of interventions (such as motivational enhancement and skills training) that are directed toward more proximal, individual-based factors. Theory and research suggest that the most effective intervention approaches are comprehensive and address environmental factors in addition to family practices and individual knowledge, attitudes, motivations, and skills. To date only one comprehensive alcohol preventive intervention for youth has been fully tested (Perry et al., 1996). It included innovative social- behavioral school curricula, peer leadership, parent education and involvement, and community-wide task force activities to address broad environmental issues such as alcohol availability. This program was successful in delaying drinking onset among young adolescents in small, rural, predominantly white Midwestern communities. After three years the prevalence of drinking was lower in intervention communities than comparison sites. It is not clear whether similar, multi-component comprehensive interventions would be practical and effective in diverse urban communities. Interventions Research is encouraged that will test multi-component, comprehensive interventions, to prevent alcohol use by young adolescents in racially and economically diverse urban neighborhoods or communities. These interventions should include at a minimum school-based curricula, parental education and involvement, and environmental change to reduce alcohol availability to underage drinkers and reduce adult acceptance of drinking by youth. These comprehensive interventions should be modeled on similar interventions, such as Project Northland, that have been tested in other populations. School-based components should include: o Curricula with demonstrated effectiveness in delaying and reducing alcohol use and alcohol-related problems among young adolescents, o Theoretical justification for applicability of the underlying approach to the study population, o Plans for developing or adapting materials and program content for the study population, and o Involvement of students in planning alcohol-free educational and recreational events and activities as well as community activities to reduce pressures to drink. Parent-directed components should include: o Demonstrated efficacy, or a strong theoretical justification with evidence of intervention feasibility and acceptability, o Plans for adaptation to the study population if needed, o Content that encourages parental behaviors known to reduce the likelihood of early drinking, such as parental monitoring and establishing clear no-use expectations, o Information on the importance of reducing alcohol availability to young persons, and o Encouragement for parent participation in environmental change at the community level. o Environmental interventions should seek to: o Reduce alcohol availability to all underage drinkers, o Reduce adult acceptance of underage drinking, and o Involve the community and students in efforts to reduce alcohol availability and pressures to drink. Intervention components in addition to those described above are also encouraged. They should be justified by a strong theoretical basis, feasibility, appropriateness of the intervention for the target population, and/or demonstrated efficacy or effectiveness. Interventions should be directed toward early adolescents, generally grades 6 through 8, when most children have not yet begun to drink. Study Population and Research Design The study sites should consist of multiple urban communities that can be distinguished by distinct school districts or sets of schools with distinct and recognizable associated neighborhoods. These communities may exist in different cities or may fall within only one or two metropolitan areas. In the latter case, it must be demonstrated that community-level environmental interventions can be implemented with minimal contamination across study sites. Study sites should be characterized by sizable ethnic/racial minority populations (at least 50 percent) and economic diversity as indicated by census figures for poverty and/or percent of families receiving financial assistance (at least 25 percent). Study sites should be randomly assigned to intervention or comparison conditions. The outcome measures should include, but need not be limited to: o Student drinking behavior, including initiation, quantity and frequency, high-risk or episodic heavy ( binge ) drinking, and alcohol-related problems experienced by students, o Measures of change in alcohol availability at the community level, and o Measures of change in community and parent norms regarding alcohol use. It is not necessary to test and measure the separate effects of intervention components on alcohol use, but process measures should indicate the ease of implementation, fidelity to protocol, and acceptability of the different components. Moreover, If applicants wish to propose designs that permit conclusions about the impact of the separate components, they may do so, keeping in mind possible cost considerations involved. The multi-component comprehensive prevention approach encouraged by this RFA was found to be effective with early adolescents in small rural demographically homogeneous communities. In order to extend the approach to diverse urban communities, adaptations of intervention components and materials or the development of new materials may be necessary. Researchers must demonstrate access to both schools and communities that will be needed for intervention development, implementation, and data collection. SPECIAL REQUIREMENT Grant recipients will be expected to attend periodic meetings with NIAAA staff and other NIAAA-supported researchers. Two-day meetings will be held in the Washington, D.C., area during the first, second, third, and fourth project years. Applicants should include travel expenses in their budgets for three representatives from their project to attend these meetings. INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING HUMAN SUBJECTS It is the policy of the NIH that women and members of minority groups and their subpopulations must be included in all NIH supported biomedical and behavioral research projects involving human subjects, unless a clear and compelling rationale and justification is provided that inclusion is inappropriate with respect to the health of the subjects or the purpose of the research. This policy results from the NIH Revitalization Act of 1993 (Section 492B of Public Law 103-43). All investigators proposing research involving human subjects should read the UPDATED "NIH Guidelines for Inclusion of Women and Minorities as Subjects in Clinical Research," published in the NIH Guide for Grants and Contracts on August 2, 2000 (http://grants.nih.gov/grants/guide/notice-files/NOT-OD-00-048.html), a complete copy of the updated Guidelines are available at http://grants.nih.gov/grants/funding/women_min/guidelines_update.htm: The revisions relate to NIH defined Phase III clinical trials and require: a) all applications or proposals and/or protocols to provide a description of plans to conduct analyses, as appropriate, to address differences by sex/gender and/or racial/ethnic groups, including subgroups if applicable, and b) all investigators to report accrual, and to conduct and report analyses, as appropriate, by sex/gender and/or racial/ethnic group differences. INCLUSION OF CHILDREN AS PARTICIPANTS IN RESEARCH INVOLVING HUMAN SUBJECTS It is the policy of NIH that children (i.e., individuals under the age of 21) must be included in all human subjects research, conducted or supported by the NIH, unless there are scientific and ethical reasons not to include them. This policy applies to all initial (Type 1) applications submitted for receipt dates after October 1, 1998. All investigators proposing research involving human subjects should read the "NIH Policy and Guidelines on the Inclusion of Children as Participants in Research Involving Human Subjects" that was published in the NIH Guide for Grants and Contracts, March 6, 1998, and is available at the following URL address: http://grants.nih.gov/grants/guide/notice-files/not98-024.html. Investigators also may obtain copies of these policies from the program staff listed under INQUIRIES. Program staff may also provide additional relevant information concerning the policy. URLS IN NIH GRANT APPLICATIONS OR APPENDICES All applications and proposals for NIH funding must be self-contained within specified page limitations. Unless otherwise specified in an NIH solicitation, internet addresses (URLs) should not be used to provide information necessary to the review because reviewers are under no obligation to view the Internet sites. Reviewers are cautioned that their anonymity may be compromised when they directly access an Internet site. LETTER OF INTENT Prospective applicants are asked to submit a letter of intent that includes a descriptive title of the proposed research, the name, address, and telephone number of the Principal Investigator, the identities of other key personnel and participating institutions, and the number and title of the RFA in response to which the application may be submitted. Although a letter of intent is not required, is not binding, and does not enter into the review of a subsequent application, the information that it contains allows IC staff to estimate the potential review workload and plan the review. The letter of intent is to be sent to: RFA-AA-01-001 Extramural Project Review Branch National Institute on Alcohol Abuse and Alcoholism 6000 Executive Boulevard, Room 409, MSC 7003 Bethesda, MD 20892-7003 Telephone: (301) 443-8766 FAX: (301) 443-6077 by the receipt date listed. APPLICATION PROCEDURES The research grant application form PHS 398 (rev. 4/98) is to be used in applying for these grants. These forms are available at most institutional offices of sponsored research and from the Division of Extramural Outreach and Information Resources, National Institutes of Health, 6701 Rockledge Drive, MSC 7910, Bethesda, MD 20892-7910, telephone 301/710-0267, E-mail: GrantsInfo@nih.gov. The RFA label available in the PHS 398 (rev. 4/98) application form must be affixed to the bottom of the face page of the application. Type the RFA number on the label. Failure to use this label could result in delayed processing of the application such that it may not reach the review committee in time for review. In addition, the RFA title and number must be typed on line 2 of the face page of the application form and the YES box must be marked. The sample RFA label available at: http://grants.nih.gov/grants/funding/phs398/label-bk.pdf has been modified to allow for this change. Please note this is in pdf format. Submit a signed, typewritten original of the application, including the Checklist, and three signed photocopies in one package to: CENTER FOR SCIENTIFIC REVIEW NATIONAL INSTITUTES OF HEALTH 6701 ROCKLEDGE DRIVE, ROOM 1040, MSC 7710 BETHESDA, MD 20892-7710 BETHESDA, MD 20817 (for express/courier service) At the time of submission, two additional copies of the application must be sent to: RFA: AA-01-001 Extramural Project Review Branch National Institute on Alcohol Abuse and Alcoholism 6000 Executive Boulevard, Suite 409, MSC 7003 Bethesda, MD 20892-7003 Rockville, MD 20852 (for express/courier service) Applications must be received by the application receipt date listed in the heading of this RFA. If an application is received after that date, it will be returned to the applicant without review. The Center for Scientific Review (CSR) will not accept any application in response to this RFA that is essentially the same as one currently pending initial review, unless the applicant withdraws the pending application. The CSR will not accept any application that is essentially the same as one already reviewed. This does not preclude the submission of substantial revisions of applications already reviewed, but such applications must include an introduction addressing the previous critique. REVIEW CONSIDERATIONS Upon receipt, applications will be reviewed for completeness by the Center for Scientific Review (CSR) and for responsiveness by the NIAAA. Incomplete applications will be returned to the applicant without further consideration. If the application is not responsive to the RFA, CSR staff may contact the applicant to determine whether to return the application to the applicant or submit it for review in competition with unsolicited applications at the next review cycle. Applications that are complete and responsive to the RFA will be evaluated for scientific and technical merit by an appropriate peer review group convened by the NIAAA in accordance with the review criteria stated below. As part of the initial merit review, all applications receive a written critique and undergo a process in which only those applications deemed to have the highest scientific merit, generally the top half of the applications under review, will be discussed, assigned a priority score, and receive a second level review by the National Advisory Council on Alcohol Abuse and Alcoholism. Review Criteria The goals of NIH-supported research are to advance our understanding of biological systems, improve the control of disease, and enhance health. In the written comments, reviewers will be asked to discuss the following aspects of the application in order to judge the likelihood that the proposed research will have a substantial impact on the pursuit of these goals. Each of these criteria will be addressed and considered in assigning the overall score, weighting them as appropriate for each application. Note that the application does not need to be strong in all categories to be judged likely to have major scientific impact and thus deserve a high priority score. For example, an investigator may propose to carry out important work that by its nature is not innovative but is essential to move a field forward. 1) Significance: Does this study address an important problem relevant to the prevention and reduction of alcohol use and misuse among adolescents in racially, ethnically and economically diverse urban communities? If the aims of the application are achieved, how will scientific knowledge be advanced? What will be the effect of these studies on the concepts or methods that drive this field? (2) Approach: Are the conceptual framework, design, methods, and analyses adequately developed, well-integrated, and appropriate to the aims of the project? Does the applicant acknowledge potential problem areas and consider alternative tactics? (3) Innovation: Does the project employ novel concepts, approaches or method? Are the aims original and innovative? Does the project challenge existing paradigms or develop new methodologies or technologies? (4) Investigator: Is the investigator appropriately trained and well suited to carry out this work? Is the work proposed appropriate to the experience level of the principal investigator and other researchers (if any)? (5) Environment: Does the scientific environment in which the work will be done contribute to the probability of success? Do the proposed experiments take advantage of unique features of the scientific environment or employ useful collaborative arrangements? Is there evidence of institutional support? In addition to the above criteria, in accordance with NIH policy, all applications will also be reviewed with respect to the following: o The adequacy of plans to include both genders, minorities and their subgroups, and children as appropriate for the scientific goals of the research. Plans for the recruitment and retention of subjects will also be evaluated. o The reasonableness of the proposed budget and duration in relation to the proposed research. o The adequacy of the proposed protection for humans, animals or the environment, to the extent they may be adversely affected by the project proposed in the application. Schedule Letter of Intent Receipt Date: February 9, 2001 Application Receipt Date: April 10, 2001 Peer Review Date: July, 2001 Council Review: September 19, 2001 Earliest Anticipated Start Date: September 28, 2001 AWARD CRITERIA Award criteria that will be used to make award decisions include: o scientific merit (as determined by peer review), o availability of funds, and o programmatic priorities. INQUIRIES Inquiries concerning this RFA are encouraged. The opportunity to clarify any issues or questions from potential applicants is welcome. Direct inquiries regarding applications under this RFA to: Gayle M. Boyd, Ph.D. Division of Clinical and Prevention Research National Institute on Alcohol Abuse and Alcoholism 6000 Executive Boulevard MSC 7003 Bethesda, MD 20892-7003 Telephone: (301) 443-8766 FAX: (301) 443-8774 Email: gboyd@willco.niaaa.nih.gov Direct inquiries regarding review issues to: Mark Green, Ph.D. Extramural Project Review Branch National Institute on Alcohol Abuse and Alcoholism 6000 Executive Boulevard, Suite 409 MSC 7003 Bethesda, MD 20892 Telephone: (301) 443-2860 FAX: (301)443-6077 Email: mg109@nih.gov Direct inquiries regarding fiscal matters to: Linda Hilley Grants Management Branch National Institute on Alcohol Abuse and Alcoholism 6000 Executive Boulevard MSC 7003 Bethesda, MD 20892-7003 Telephone: (301) 443-0915 FAX: (301) 443-3891 Email: lhilley@willco.niaaa.nih.gov AUTHORITY AND REGULATIONS This program is described in the Catalog of Federal Domestic Assistance No. 93.273. Awards are made under authorization of Sections 301 and 405 of the Public Health Service Act as amended (42 USC 241 and 284) and administered under NIH grants policies and Federal Regulations 42 CFR 52 and 45 CFR Parts 74 and 92. This program is not subject to the intergovernmental review requirements of Executive Order 12372 or Health Systems Agency review. The PHS strongly encourages all grant recipients to provide a smoke-free workplace and promote the non-use of all tobacco products. In addition, Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking in certain facilities (or in some cases, any portion of a facility) in which regular or routine education, library, day care, health care or early childhood development services are provided to children. This is consistent with the PHS mission to protect and advance the physical and mental health of the American people. References Bachman, J.G., Wallace, J.M., O Malley, P.M., Johnston, L.D., Kurth, C.L., & Neighbors, H.W. (1991) Racial/ethnic differences in smoking, drinking, and illicit drug use among American high school seniors, 1976-89. American Journal of Public Health, 81(3), 372-377. Barnes, G.M., Farrell, M.P. and Banerjee, S. (1995) Family influences on alcohol abuse and other problem behaviors among black and white adolescents in a general population sample. In Boyd, G.M., Howard, J., and Zucker, R.A (Eds.) Alcohol problems among adolescents: Current directions in prevention research. Hillsdale, N.J.: Lawrence Erlbaum Associates, pp. 13-31. Catalano, R.F., Morrison, D.M., Wells, E.A., Gillmore, M.R., Iritani, B. & Hawkins, J.D. (1992) Ethnic difrferences in family factors related to early drug initiation. Journal of Studies on Alcohol, 53 (3), 208-217. Dielman, T.E. (1995) School-based research on the prevention of adolescent alcohol use and misuse: Methodological issues and advances. In Boyd, G.M., Howard, J., and Zucker, R.A (Eds.) Alcohol problems among adolescents: Current directions in prevention research. Hillsdale, N.J.: Lawrence Erlbaum Associates, pp. 125-146. Ellickson, P.L. (1995) Schools. In R.H. Coombs and D.M. Ziedonis (Eds.), Handbook on drug abuse prevention: A comprehensive strategy to prevent the abuse of alcohol and other drugs, Needham Heights, Mass.: Allyn & Bacon, pp. 93-120. Ellickson, P.L., McGuigan, K.A., Adams, V., Bell, R.M. & Hays, R.D. (1997) Teenagers and alcohol misuse in the United States: By any definition, it’s a big problem. Addiction, Vol. 91, No. 10, 1489-1503. Gorman, D.M. (1995) On the difference between statistical and practical significance in school-based drug abuse prevention. Drugs, Education, Prevention and Policy, 2 (3), 275-283. Gorman, D.M. (1996) Do school-based social skills training programs prevent alcohol use among young people? Addiction Research, 4 (2), 191-210. Grant, B.F. and Dawson, D.A. (1997) Age at onset of alcohol use and its association with DSM-IV alcohol abuse and dependence: Results from the National Longitudinal Alcohol Epidemiologic Survey. Journal of Substance Abuse, 9, 103-110. Hansen, W.B. (1992) School-based substance abuse prevention: A review of the state of the art in curriculum, 1980-1990. Health Education Research, 7 (3), 403-430. Harrington, N.G. and Donohew, L. (1997) Jump Start: A targeted substance abuse prevention program. Health Education & Behavior, 24 (5), 568-586. Hawkins, J.D., Graham, J.W., Maguin, E., Abbott, R., Hill, K.G. & Catalano, R.F. (1997) Exploring the effects of age of alcohol use initiation and psychosocial risk factors on subsequent alcohol misuse. Journal of Studies on Alcohol, 58 (3), 280-290). Holder, H. & Giesbrecht, N. (1990) Perspectives on the community in action research. In Giesbrecht, N., Conley, P., Denniston, R.W., Gliksman, L., Holder, H., Pederson, A., Room, R. & Shain, M. (Eds.) Research, Action, And The Community: Experiences In The Prevention Of Alcohol And Other Drug Problems. OSAP Prevention Monograph No. 4 DHHS Pub. No. (ADM) 89-1651. Rockville, MD: U.S. Department of Health and Human Services, Office of Substance Abuse Prevention, 1990. Pp. 27-40. Johnson, C.A., Pentz, M.A., Weber, M.D., Dwyer, J.H., Baer, N., MacKinnon, D.P. Hansen, W.B. & Flay, B.R. (1990) Relative effectiveness of comprehensive community programming for drug abuse prevention with high-risk and low-risk adolescents. Journal of Consulting and Clinical Psychology, 58 (4), 447-456. Johnston, L.D., O Malley, P.M. and Bachman, J.G. (1999) National survey results on drug use from The Monitoring the Future Study, 1975-1998. Vol. I, Secondary School Students. US DHHS, NIDA, NIH Pub. No. 99-4660. Johnston, L.D., O Malley, P.M. and Bachman, J.G. (2000) The Monitoring the Future National Results on Adolescent Drug Use: Overview of Key Findings, 1999. University of Michigan Institute for Social Research, National Institute on Drug Abuse, USDHHS. Loveland-Cherry, C.J., Ross, L.T. and Kaufman, S.R. (1999) Effects of a home-based family intervention on adolescent alcohol use and misuse. Journal of Studies on Alcohol, Supplement No. 13, 94-102. Moscowitz, J.M. (1989) The primary prevention of alcoholo problems: A critical review of the research literature. Journal of Studies on Alcohol, 50 (1), 54-88. Perry, C.L., Williams, C.L., Veblen-Mortenson, S., Toomey, T.L., Komro, K.A., Anstine, P.S., McGovern, P.G., Finnegan, J.R., Forster, J.L., Wagenaar, A.C. and Wolfson, M. (1996) Project Northland: Outcomes of a communitywide alcohol use prevention program during early adolescence. American Journal of Public Health, Vol. 86, No.7, 956-965. Spoth, R., Redmond, C. and Lepper, H. Alcohol initiation outcomes of universal family-focused preventive interventions: One- and two-year follow- ups of a controlled study. Journal of Studies on Alcohol, Supplement No. 13, 103-111. Sussman, S., Dent, C.W., Stacy, A.W. & Craig, S.(1998) One-year outcomes of Project Towards No Drug Abuse. Preventive Medicine, 27, 632-642. Tobler, NM.S. and Stratton, H.H. (1997) Effectiveness of school-based drug prevention programs: A meta-analysis of the research. Journal of Primary Prevention, 18 (1), 71-128. Wagenaar, A.C. and Perry, C.L. (1995) Community strategies for the reduction of youth drinking: theory and application. In Boyd, G.M., Howard, J., and Zucker, R.A (Eds.) Alcohol problems among adolescents: Current directions in prevention research. Hillsdale, N.J.: Lawrence Erlbaum Associates, pp. 197- 223. Wallace, J.M., Forman, T.A., Gutherie, B.J., Bachman, J.G., O Malley, P.M. & Johnston, L.D. (1999) The epidemiology of alcohol, tobacco and other drug use among black youth. Journal of Studies on Alcohol, 60 (6): 800-809.


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