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The Peer Effect

How Individuals Can Create School-Level Change

by Michael Woodward, Project ALERT Technical Coordinator

 A recent after-school drug education and prevention program offered in 16 middle schools in 3 southern California districts found that a very interesting phenomenon had taken place - positive school-wide effects despite a relatively small percentage of students attending the program.[1]


Using an innovative approach called “motivational interviewing (MI),”[2],[3] middle school youth were offered a brief, voluntary prevention/intervention program called CHOICE, consisting of five 30-minute group sessions on the following topics:


What’s happening in your school?

  • Examining why some youth choose to experiment with alcohol or drugs

  • Learning about actual vs. perceived normative use of alcohol and drugs


What’s in your head vs. what’s in your bottle, or myths about substance use

  • Distinguishing drug myths from the realities

  • Understanding the Balanced Placebo Design experiment


What happened to you last night?

  • Understanding how to cope with negative feelings

  • Recognizing how alcohol and drug use can affect their lives and social relationships


How to resist pressures to use alcohol, cigarettes, and drugs

  • Forming ready responses to peer pressure

  • Practicing roleplays


How to have fun on the weekend without paying for it later

  • Identifying situations where alcohol or other drugs may be present

  • Planning and preparing healthy alternatives to these situations


Students were offered a lot of flexibility with this program across the 8 schools that offered it. With parental consent, they could drop in for any of the sessions, which rotated and repeated during the school year. Dynamic program facilitators made the information interesting, fun, and relevant and encouraged lots of student participation. The program reached about 15% of the school populations and youth that attended were racially and ethnically diverse.[4] Researchers compared surveys from the beginning of the school year with surveys at the end of the school and found that teens that attended CHOICE were less likely to begin drinking.

However, what researchers were not expecting was that although only 15% of the student body attended the program at treatment schools, the influence of peer and social networks was far-reaching, as schools that had the CHOICE program also showed fewer teens drinking across the whole school. They discovered that CHOICE attenders were sharing the information they had learned in the sessions with peers who did not attend the program, suggesting high program endorsement rates. Participating teens were excited about the material and non-participants ended up learning a lot through informal conversations with their friends.[5]

News of these school-wide effects in the CHOICE study can be encouraging for all educators and community leaders implementing drug prevention education programs, including Project ALERT. Critical information designed to help teens make healthy choices about substance use is having an effect - not solely through formal instruction and drug counselors, but among peer networks, and it’s helping to shape the decisions of many adolescents.  Have you noticed the "peer effect" in your educational setting? We would appreciate hearing your thoughts, whether or not your school or other instructional venue mandates a drug education program.  Share your story with us at projectalert@rand.org.

Please check out these references below related to the MI approach.  See the Group MI for Teens website to learn more about the CHOICE study development and outcomes.  Like Project ALERT, all materials for CHOICE are available online at no cost.







[1] D’Amico, E. J., Tucker, J. S., Miles, J. N. V., Zhou, A. J., Shih, R. A, & Green, H. D. (2012). Preventing alcohol use with a voluntary after school program for middle school students: Results from a cluster randomized controlled trial of CHOICE. Prevention Science, 13(4):415-25.


[2] Miller, W. R., & Rollnick, S. (2012). Motivational Interviewing: Helping People Change (3rd ed.). New York, NY: Guilford Press.


[3] Rollnick S., & Miller, W.R. (1995). What is motivational interviewing? Behavioural and Cognitive Psychotherapy, 23, 325-334.


[4] D’Amico, E. J., Green, H. D., Miles, J. N. V., Zhou, A. J., Tucker, J. S., & Shih, R. A.  (2012). Voluntary after school alcohol and drug programs: If you build it right, they will come. Journal of Research on Adolescence, 22(3), 571–582.


[5] Edelen, M. O., Tucker, J. S., & D’Amico, E. J. (2015). Spreading the word: A process evaluation of a voluntary AOD prevention program. American Journal on Addictions, 24(4): 315–322.


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