***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: A  grade five through eight substance abuse prevention program , later incorporated into the Michigan Model for Comprehensive School Health Education , was developed , implemented , and evaluated . Results focus on students who received seven lessons on alcohol in grade six , and eight lessons on tobacco , alcohol , marijuana , and cocaine in grade seven taught by their regular classroom teachers ( after a 6-hour training in the social pressures resistance skills curriculum ) . Students ( N = 442 ) received either two years of the program or none , and completed individually-coded question naires . Repeated measures analysis of variance result ed in significant treatment by occasion interactions on the use of alcohol , cigarettes , marijuana , cocaine , and other drugs , as well as on knowledge . At the end of grade seven , program students '  rates of substance use had increased significantly less and knowledge of alcohol pressures , effects , and skills to resist had increased significantly more than those of comparison students OBJECTIVES This paper presents the 1-year outcomes evaluation of Project Towards No Drug Abuse ( Project TND ) , a large-scale indicated drug abuse prevention program in southern California applied to continuation high school youth , who are at high risk for drug abuse . METHODS The efficacy of nine-lesson health motivation -- social skills -- decision-making curriculum was evaluated in a three-condition experimental design . Twenty-one schools were r and omly assigned by block to one of three conditions -- st and ard care ( control ) , classroom program , and classroom program plus a semester-long school-as-community component . A pretest was followed by a 3-week-long drug abuse prevention program and then a posttest at 14 continuation high schools . The 7 st and ard care schools received only the pretest followed by the posttest ( same time duration ) . Subjects were followed up 1 year later . RESULTS Changes in use of cigarettes , alcohol , marijuana , and hard drugs were assessed in a pretest-1-year follow-up time interval . The follow-up rate was 67 % ( analysis n = 1,074 ) . Indicated preventive effects were found on alcohol and hard drug use . No differences were found across the two program conditions . CONCLUSIONS Project TND is the first program to demonstrate 1-year self-reported behavioral effects on alcohol use and hard drug use among older , high-risk youth by using a school-based , limited-session model This paper presents the findings from a controlled prospect i ve study of the effectiveness of a school-based alcohol education package for 13 year olds . The research had three phases : ( 1 ) baseline survey of alcohol-related knowledge , attitudes and behaviour ; ( 2 ) development and teaching of a short alcohol education package and ( 3 ) follow-up survey . The results indicate that the students who received the alcohol education  knew more about alcohol than the controls . In addition , the educational intervention was found to have influenced the self-reported last consumption of alcohol and maximum consumption , with the ' educated ' youngsters generally exhibiting more restrained behaviour . There has been little scientific evidence that past alcohol education has been effective in changing  young people 's drinking behaviour . The outcome of this research reinforces some recent studies which suggest the way forward may lie in an educational approach which takes account of social influences on substance use and misuse The entire early adolescent population of the 15 communities that constitute the Kansas City ( Kansas and Missouri ) metropolitan area has participated in a community-based program for prevention of drug abuse since September 1984 . The Kansas City area is the first of two major metropolitan sites being evaluated in the Midwestern Prevention Project , a longitudinal trial for primary prevention of cigarette , alcohol , and marijuana use in adolescents . The project includes mass media programming , a school-based educational program for youths , parent education and organization , community organization , and health policy components that are introduced sequentially into communities during a 6-year period . Effects of the program are determined through annual assessment s of adolescent drug use in schools that are assigned to immediate intervention or delayed intervention control conditions . In the first 2 years of the project , 22,500 sixth- and seventh- grade adolescents received the school-based educational program component , with parental involvement in homework and mass media coverage . Analyses of 42 schools indicate that the prevalence rates of use for all three drugs are significantly lower at 1-year follow-up in the intervention condition relative to the delayed intervention condition , with or without controlling for race , grade , socioeconomic status , and urbanicity ( 17 % vs 24 % for cigarette smoking , 11 % vs 16 % for alcohol use , and 7 % vs 10 % for marijuana use in the last month ) , and the net increase in drug use prevalence among intervention schools is half that of delayed intervention schools OBJECTIVE To examine the effectiveness of a brief , school-based intervention for preventing alcohol use . DESIGN AND SETTING R and omized , control trial assigning inner-city public school students to an intervention program or a comparison program . PARTICIPANTS Sixth , seventh , and eighth grade students in Jacksonville , Fla ( N=104 ) . INTERVENTIONS Students assigned to the intervention program were given a self-instructional module and corresponding audiotape , a health consultation with a physician or nurse , and a follow-up consultation with a trained peer health model . MAIN OUTCOME MEASURES Alcohol consumption during the month after the intervention and students ' assessment s of the interventions were measured . RESULTS Students ' t tests showed participants were more satisfied with physician or nurse consultations than with peer consultations or the self-instructional module and audiotapes ( P=.05 ) . Analysis of covariance tests showed significant main effects for 30-day quantity of alcohol use ( F=5.15 , P=.02 ) , with intervention students reporting less alcohol consumption at follow-up than comparison students , and for 30-day frequency of alcohol use ( F=5.92,P=.01 ) with intervention students again showing less frequent use at follow-up . CONCLUSIONS A multicomponent , school-based intervention using print and audiotape media , brief physician or nurse consultations , and follow-up peer contacts holds promise in altering short-term alcohol use and selected behavioral factors among inner-city youth This study evaluated the substance initiation effects of an intervention combining family and school-based competency-training intervention components . Thirty-six rural schools were r and omly assigned to 1 of 3 conditions : ( a ) the classroom-based Life Skills Training ( LST ) and the Strengthening Families Program : For Parents and Children 10 - 14  , ( b ) LST only , or ( c ) a control condition . Outcomes were examined 1 year after the intervention posttest , using a substance initiation index ( SII ) measuring lifetime use of alcohol , cigarettes , and marijuana and by rates of each individual substance . Planned intervention-control contrasts showed significant effects for both the combined and LST-only interventions on the SII and on marijuana initiation . Relative reduction rates for alcohol initiation were 30.0 % for the combined intervention and 4.1 % for LST only An alcohol misuse prevention curriculum for tenth- grade students  was developed , implemented , and evaluated through twelfth grade with 1041 students from four school districts . The curriculum emphasized social pressures resistance training , immediate effects of alcohol , risks of alcohol misuse , and social pressures to misuse alcohol . There were desirable program effects on alcohol misuse prevention knowledge ( p < 0.001 ) , alcohol misuse ( p < 0.02 ) , and refusal skills ( p < 0.09 ) . Gender by occasion differences were found on alcohol use , alcohol misuse , and driving after drinking , with boys ' rates increasing more than those of girls . Exposure to a sixth- grade , as well as the tenth- grade , program did not result in better outcomes . Despite high levels of alcohol use among high school students , a tenth- grade curriculum can result in some desirable effects . Creative approaches are needed , however , especially for boys who tend to use and misuse alcohol at rates that increase more steeply than those of girls Alcohol-related injuries are a leading cause of death in mid and late adolescence . Schools might contribute to the prevention of these injuries by affecting adolescent drinking . Few school programmes , however , have succeeded . In view of this shortcoming , a previously investigated school based health counselling programme for mid adolescents was applied to work in conjunction with a municipal alcohol policy initiative . A pre-test/post-test quasi-experimental study of 118 sixteen year old students was carried out . The development of alcohol consumption was not found to differ significantly between the experimental and control groups . The students ' perceptions of the negative effects of use of alcohol did not increase . The lack of effect of the counselling programme might be related to the low significance initially attributed by the students to alcohol as a health issue . A shift of emphasis in the schools , from normative education , to discussion s of the immediate threats of serious injuries might alter this perception This r and omized controlled trial evaluated the efficacy of a brief intervention design ed to reduce the harmful consequences of heavy drinking among high-risk college students . Students screened for risk while in their senior year of high school ( 188 women and 160 men ) were r and omly assigned to receive an individualized motivational brief intervention in their freshman year of college or to a no-treatment control condition . A normative group selected from the entire screening pool provided a natural history comparison . Follow-up assessment s over a 2-year period showed significant reductions in both drinking rates and harmful consequences , favoring students receiving the intervention . Although high-risk students continued to experience more alcohol problems than the natural history comparison group over the 2-year period , most showed a decline in problems over time , suggesting a developmental maturational effect OBJECTIVE To evaluate the long-term efficacy of a school-based approach to drug abuse prevention . DESIGN R and omized trial involving 56 public schools that received the prevention program with annual provider training workshops and ongoing consultation , the prevention program with videotaped training and no consultation , or " treatment as usual " ( ie , controls ) . Follow-up data were collected 6 years after baseline using school , telephone , and mailed surveys . PARTICIPANTS A total of 3597 predominantly white , 12th- grade students who represented 60.41 % of the initial seventh- grade sample .  INTERVENTION Consisted of 15 classes in seventh grade , 10 booster sessions in eighth grade , and five booster sessions in ninth grade , and taught general " life skills " and skills for resisting social influences to use drugs . MEASURES Six tobacco , alcohol , and marijuana use self-report scales were recorded to create nine dichotomous drug use outcome variables and eight polydrug use variables . RESULTS Significant reductions in both drug and polydrug use were found for the two groups that received the prevention program relative to controls . The strongest effects were produced for individuals who received a reasonably complete version of the intervention -- there were up to 44 % fewer drug users and 66 % fewer polydrug ( tobacco , alcohol , and marijuana ) users . CONCLUSIONS Drug abuse prevention programs conducted during junior high school can produce meaningful and durable reductions in tobacco , alcohol , and marijuana use if they ( 1 ) teach a combination of social resistance skills and general life skills , ( 2 ) are properly implemented , and ( 3 ) include at least 2 years of booster sessions This study developed and tested skills- and community-based approaches to prevent substance abuse among Native American youth . After completing pretest measurements , 1,396 third- through fifth- grade Native American students from 27 elementary schools in five states were divided r and omly by school into two intervention arms and one control arm . Following intervention delivery , youths in all arms completed posttest measurements and three annual follow-up measurements . Youths in schools assigned to the intervention arms learned cognitive and behavioral skills for substance abuse prevention . One intervention arm additionally engaged local community residents in efforts to prevent substance use among Native American youth . Outcome assessment batteries measured youths ' reported use of smoked and smokeless tobacco , alcohol , and marijuana . Over the course of the 3.5-year study , increased rates of tobacco , alcohol , and marijuana use were reported by youths across the three arms of the study . Though cigarette use was unaffected by intervention , follow up rates of smokeless tobacco , alcohol , and marijuana use were lower for youths who received skills intervention than for youths in the control arm . Community intervention components appeared to exert no added beneficial influence on youths ' substance use , beyond the impact of skills intervention components alone . Finally , gender differences were apparent across substances , measurements , and study arms , with girls smoking more cigarettes and boys using more smokeless tobacco , alcohol , and marijuana This study assessed the impact of school-based social competence training on skills , social adjustment , and self-reported substance use of 282 sixth and seventh grade rs . Training emphasized broad-based competence promotion in conjunction with domain-specific application to substance abuse prevention . The 20-session program comprised six units : stress management , self-esteem , problem solving , substances and health information , assertiveness , and social networks . Findings indicated positive training effects on Ss ' skills in h and ling interpersonal problems and coping with anxiety . Teacher ratings revealed improvements in Ss ' constructive conflict resolution with peers , impulse control , and popularity . Self-report ratings indicated gains in problem-solving efficacy . Results suggest some preventive impact on self-reported substance use intentions and excessive alcohol use . In general , the program was found to be beneficial for both inner-city and suburban students OBJECTIVE Systematic evaluation of theoretically and empirically based family programs to prevent  adolescent alcohol use/misuse is limited . Data presented here are from a longitudinal study evaluating a home-based universal adolescent alcohol use prevention program . The intervention was design ed to enhance protective factors and minimize risk factors identified as influencing adolescent alcohol use . METHOD A r and omized pretest/posttest repeated measures design was used . Adolescents ( N = 428 ; 54 % females ,  
    Output:
    
No firm conclusions about the effectiveness of prevention interventions in the short- and medium term were possible .
Over the longer term ( > 3 years ) , the Strengthening Families Programme ( SFP ) showed promise as an effective prevention intervention .