TY - JOUR
T1 - The influence of program mediators on eleventh grade outcomes for seventh grade substance users and nonusers
AU - Teasdale, Brent
AU - Stephens, Peggy C.
AU - Sloboda, Zili
AU - Grey, Scott F.
AU - Stephens, Richard C.
N1 - Funding Information:
Funding for ASAPS was provided by the Robert Wood Johnson Foundation under Grant Nos. 039223 and 040371. The Robert Wood Johnson Foundation had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.
PY - 2009/6/1
Y1 - 2009/6/1
N2 - Objectives: In their work examining the effects of the Take Charge of Your Life (TCYL) program, Sloboda and colleagues (This Issue) found that the TCYL program had significant positive effects on baseline marijuana users and significant negative effects on baseline nonusers of cigarettes and alcohol. Methods: Mediational analyses were used to understand why the program had these differential impacts on baseline users and nonusers. Results: Path models for binary outcomes revealed significant program impacts on marijuana normative beliefs and refusal skills. The treatment impacts were between 1.5 and 3 times larger for the baseline users than for nonusers. These direct effects of the program on normative beliefs and refusal skills mediated the treatment impact on use for baseline marijuana users. In contrast, the negative treatment effects on alcohol and cigarette use could not be explained by the program's targeted mediators (normative beliefs, refusal skills, consequences, attitudes and intentions). The direct effects of treatment on use for the baseline nonusers of cigarettes and alcohol remain unexplained. Conclusions: Possible explanations for this pattern and implications for strengthening universal prevention programs that are delivered to both users and nonusers are discussed. The importance of mediational analyses for programs that show negative impacts, as well as for those that show positive impacts is stressed.
AB - Objectives: In their work examining the effects of the Take Charge of Your Life (TCYL) program, Sloboda and colleagues (This Issue) found that the TCYL program had significant positive effects on baseline marijuana users and significant negative effects on baseline nonusers of cigarettes and alcohol. Methods: Mediational analyses were used to understand why the program had these differential impacts on baseline users and nonusers. Results: Path models for binary outcomes revealed significant program impacts on marijuana normative beliefs and refusal skills. The treatment impacts were between 1.5 and 3 times larger for the baseline users than for nonusers. These direct effects of the program on normative beliefs and refusal skills mediated the treatment impact on use for baseline marijuana users. In contrast, the negative treatment effects on alcohol and cigarette use could not be explained by the program's targeted mediators (normative beliefs, refusal skills, consequences, attitudes and intentions). The direct effects of treatment on use for the baseline nonusers of cigarettes and alcohol remain unexplained. Conclusions: Possible explanations for this pattern and implications for strengthening universal prevention programs that are delivered to both users and nonusers are discussed. The importance of mediational analyses for programs that show negative impacts, as well as for those that show positive impacts is stressed.
KW - Mediational analysis
KW - Program impact
KW - Substance use
UR - http://www.scopus.com/inward/record.url?scp=64849116583&partnerID=8YFLogxK
U2 - 10.1016/j.drugalcdep.2008.11.010
DO - 10.1016/j.drugalcdep.2008.11.010
M3 - Article
C2 - 19345519
AN - SCOPUS:64849116583
SN - 0376-8716
VL - 102
SP - 11
EP - 18
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
IS - 1-3
ER -