Diffusion of the D.A.R.E and syringe exchange programs

Am J Public Health. 2006 Aug;96(8):1354-8. doi: 10.2105/AJPH.2004.060152. Epub 2006 Jun 29.


We examined the diffusion of the D.A.R.E program to reduce use of illicit drugs among school-aged children and youths and the diffusion of syringe exchange programs to reduce HIV transmission among injection drug users. The D.A.R.E program was diffused widely in the United States despite a lack of evidence for its effectiveness; there has been limited diffusion of syringe exchange in the United States, despite extensive scientific evidence for its effectiveness. Multiple possible associations between diffusion and evidence of effectiveness exist, from widespread diffusion without evidence of effectiveness to limited diffusion with strong evidence of effectiveness. The decision theory concepts of framing and loss aversion may be useful for further research on the diffusion of public health innovations.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Decision Making, Organizational
  • Decision Theory
  • Diffusion of Innovation*
  • Drug and Narcotic Control / organization & administration*
  • Evidence-Based Medicine*
  • HIV Infections / prevention & control*
  • Health Education / organization & administration*
  • Health Services Research
  • Humans
  • Needle-Exchange Programs / supply & distribution*
  • Public Health
  • School Health Services / organization & administration*
  • Substance Abuse, Intravenous / complications
  • Substance Abuse, Intravenous / prevention & control*
  • Syringes / supply & distribution*
  • Syringes / virology
  • United States