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What Makes Project ALERT Unique?

by Phyllis Ellickson, PhD

With schools and localities battered by budget cuts, getting good value for all instructional programs has taken on increasing importance.  What does this mean for drug prevention?  Ultimately, the argument for drug prevention programs rest on their ability to reduce use of alcohol and other drugs and, in so doing, to capture the benefits of improved attention in the classroom and less risky behavior outside the classroom.   Schools can best ensure that their students get these benefits by using programs with proven results and implementing them with fidelity.


Project ALERT does the job on both counts.  It has solid drug prevention results and it provides experience-based training and technical assistance designed to help teachers get the most of the materials for their students.  RAND’s two multi-site evaluations of ALERT, one on the West Coast and one in the Midwest, have received the highest rankings possible on the National Registry for Evidence-Based Prevention Programs; BEST’s technical assistance strategies and materials win very high marks as well. 


But what makes Project ALERT stand out from other programs with positive outcomes that also offer implementation assistance?  Why should teachers and schools continue to implement it in these difficult times?   We think there are several reasons.  Some derive from RAND’s studies of the program’s effectiveness; some derive from the depth and breadth of BEST’s support system for effective implementation. 


ALERT helps both high- and low-risk youth

Let’s look first at who ALERT helps. A major criticism of drug prevention is that it only helps   the kids who need it least, those who are least likely to become regular drug users.  In an unusual move for prevention research, RAND directly addressed this criticism in its evaluations of ALERT.  Both studies showed that Project ALERT helps both high and low risk kids—those who need it most because they have already shown a propensity to drug use and those who are less risk-prone because they have not tried different substances by the time they enter grade 7.

 

That’s a big plus.  If we can help high-risk youth avoid making the transition to more regular use, we may also help them avoid getting in trouble because of other risky behaviors that are highly correlated with drug use.  These include, for example, driving after drinking (or drug use), having unprotected sex, getting into fights, shoplifting and multiple other actions linked with impulsive or impaired decision-making.  Those benefits are important for the lower risk kids as well, but their timetable for engaging in risky behavior is likely to lag behind that for their more risk-prone peers.  With documented results for kids at different levels of risk, Project ALERT countered the argument that drug prevention works only for low-risk youth and showed that it helps kids drawn from across the spectrum of prior drug use experience.  And, of course, it also helps all kids considered together.

 

ALERT works in diverse communities and schools

Another criticism of drug prevention is that it works only for middle class youth from homogeneous white communities.  RAND countered that argument as well.  Its West Coast evaluation of Project ALERT, which included 30 urban, suburban and rural schools with varying socioeconomic profiles, worked across all these environments.  And, when RAND compared high and low minority schools, we found that the program worked equally well in both groups. In fact, where there were differences across the two groups, the results favored the high minority schools.  The second RAND study, which included 55 midwestern schools from urban, small town and rural communities, extended ALERT’s results to the country’s heartland and to small towns and very rural areas.

 

ALERT curbs multiple risky behaviors and has long-term effects into young adulthood

A third criticism of drug prevention is that it is not cost-effective, targeting a single risk behavior and only helping youth during adolescence.  RAND’s research has addressed that argument in several ways.   The West Coast and Midwestern studies showed that the program curbs multiple forms of drug use--from alcohol and marijuana use, which can lead to accidents and other negative consequences in the near future, to cigarette use, which has extremely deleterious health effects in the long-term (cites 1 and 2).  Finding results for all three substances means that the potential benefits from ALERT extend from reducing the likelihood of lung cancer, alcoholism and heart attacks to reducing the likelihood of more immediate alcohol-and- marijuana related problems such as poor school performance and vehicular accidents.  Helping vulnerable adolescents avoid consequences that could affect their lives over many years is a plus that all parents understand.

 

In addition, we now know that Project ALERT has effects that last into young adulthood and curbs other risky behavior besides drug use.  RAND found that 21 year olds who had ALERT during middle school are less likely to engage in risky sexual behavior that is linked with HIV and unwanted pregnancy (cite 3).  Furthermore, these effects, which occurred many years after receiving the program lessons, are partly attributable to program-induced reductions in alcohol and drug misuse at ages 19 and 21.  The bottom line, therefore, is twofold:        1. ALERT’s positive outcomes for drugs extend into the young adult years and include mitigating the consequences of misuse; and  2. ALERT curbs multiple risky behaviors that can harm the health and future of young people.  The message for schools is that using ALERT in the classroom ensures good value and is cost-effective:  the program yields both immediate and long-term benefits and it affects multiple risky behaviors.

 

ALERT offers experience-based training and technical assistance

Nevertheless, achieving these benefits also requires effective implementation.  This is where the curriculum, training and technical assistance offered by The BEST Foundation is invaluable.  As teachers who have used Project ALERT often attest, the materials are easy to use, the videos and posters capture students’ attention and the rationale underlying the program is clear.  That’s because hundreds of teachers and their students actually contributed to the curriculum—providing implementation tips, ideas about how to introduce and wrap up different activities, comments on video “treatments” and posters, and classroom management advice.  These ideas are written into the curriculum that BEST disseminates today.  Similar teacher input has informed the workshop and web-site training, as well as the regular updating and refreshing of the posters, videos and drug information.

 

ALERT’s evaluations led to curriculum improvements and better information about program delivery

Taking into account the lessons learned from research, teachers and students are notable hallmarks of Project ALERT.  After the West Coast evaluation of the program, RAND developed lessons aimed at improving the program’s effects on alcohol use, as well as its impact on the early high-risk smokers who initially responded negatively to the program.  The next evaluation showed that the program helped these early smokers reduce cigarette use and curbed alcohol misuse, important gains in student benefit (cite 2). Two other evaluations confirmed our belief that the program should be given to all students in a particular cohort, not just some of them (cite 4), and that it has better results when delivered to 7th graders, as opposed to 6th graders (cite 5).

 

The BEST Foundation continues to learn from teachers and to help teachers learn from each other through a variety of technical assistance strategies that go far beyond the basics of providing teacher-friendly curriculum materials and training. Newsletters provide updated information about drugs; the opportunity to find out how others have handled difficult problems in the classroom; and in-depth examples of how different districts, schools and teachers have implemented ALERT.  Direct help-lines provide immediate answers to teacher questions.  And, new this year are Project ALERT social networks on Facebook and YouTube.

 

ALERT’S dedicated and skilled teachers make it unique

All of these strategies are designed to help teachers do what they do best—inject enthusiasm, dedication and skill into making Project ALERT come alive with their particular students in their particular classrooms.  Because, in the final analysis, Project ALERT is only as good as the teachers who deliver it to their students.  It is the motivation and skill of its teachers, all of whom have participated in training and many of whom provide help and assistance to others, that make this program really unique.

 

CITES:

Ellickson, Phyllis L., and Robert M. Bell, "Drug Prevention In Junior High:  A Multi-Site Longitudinal Test," Science, 247, 1299-1305, 1990; also RAND, R-3919-CHF, March 1990.

 

Ellickson, Phyllis L., Daniel F. McCaffrey, Bonnie Ghosh-Dastidar, and Douglas L. Longshore, “New Inroads in Preventing Adolescent Drug Use:  Results from a Large-Scale Trial of Project ALERT in Middle Schools,” American Journal of Public Health, 93(11), 1830-1836, 2003, also RAND RP-1088, 2003.

 

Ellickson, Phyllis L., Daniel F. McCaffrey, and David J. Klein, "Long-term Effects of Drug Prevention on Risky Sexual Behavior among Young Adults”, Journal of Adolescent Health, 45 (2), 111-117, 2009 (Epub, 5/09).

 

St. Pierre, Tena L., D. Wayne Osgood, Claudia C. Mincemoyer, D. Lynne Kaltreider, and Tina J.

Kauh, “Results of an Independent Evaluation of Project ALERT Delivered in Schools by Cooperative Extension”, Prevention Science, 6 (4), 305-317, 2005.

 

Ringwalt, Christopher L., Heddy KovachClark, Sean Hanley, Stephen Shamblen, and Robert L. Flewelling, “Project ALERT: A Cluster Randomized Trial”, Archives of Pediatric Adolescent Medicine,  163 (7), 625-632,2009.

<p>Phyllis Ellickson, PhD</p> <p>Senior Behavioral Scientist</p> <p>RAND Developer, Project ALERT</p>

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