Diffusion of a school-based substance abuse prevention program: predictors of program implementation

Prev Med. 1993 Mar;22(2):237-60. doi: 10.1006/pmed.1993.1020.


Background: The present study addresses diffusion of a psychosocial-based substance abuse prevention program, including: (a) teacher adoption, implementation, and maintenance; (b) teacher characteristics associated with implementation; (c) the relationship between integrity of program delivery and program outcomes; and (d) the effectiveness of teacher training and school principal involvement in increasing implementation.

Methods: Participants were teachers (n = 60), school principals (n = 25), and fifth-grade students (n = 1147) from four Los Angeles area school districts. Districts were randomly assigned to an intensive or brief teacher training condition. Schools were randomly assigned to a principal-intervention or a no-principal-intervention condition. Assessments included teacher and principal self-reports, classroom observations of program delivery, and evaluation of immediate program outcomes.

Results: During the first year, 78% of trained teachers implemented one or more program lessons. During the second year, only 25% maintained implementation of the program. Implementors reported fewer years of teaching experience and stronger self-efficacy, enthusiasm, preparedness, teaching methods compatibility, and principal encouragement than did nonimplementors. The principal intervention increased rates of implementation, but the intensive teacher training did not. Integrity of program delivery was positively associated with immediate program outcomes.

Conclusions: Program implementation was highly variable, suggesting that widespread teacher use of psychosocial-based programs cannot be taken for granted. Strategies for increasing implementation and maintenance need to be developed.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Alcoholism / prevention & control
  • Analysis of Variance
  • Child
  • Diffusion of Innovation
  • Discriminant Analysis
  • Female
  • Health Education / methods
  • Health Education / organization & administration*
  • Health Plan Implementation*
  • Health Promotion
  • Humans
  • Inservice Training / organization & administration
  • Los Angeles
  • Male
  • Marijuana Abuse / prevention & control
  • Motivation
  • Multivariate Analysis
  • Program Development
  • Program Evaluation
  • School Health Services / organization & administration*
  • Social Support
  • Substance-Related Disorders / prevention & control*
  • Surveys and Questionnaires
  • Teaching / methods
  • Teaching / organization & administration