1 THE NIDA NATIONAL PREVENTION RESEARCH INITIATIVE NIDA Advisory Council February 20, 2002

2 FOUNDATIONS OF PREVENTION SCIENCE Epidemiology Origins and pathways to drug abuse Hypotheses derived from prior prevention research Theories and models from basic biological, social, psychological and behavioral sciences

3 RISK AND PROTECTIVE FACTORS Risk FactorsDomainProtective Factors Sensation-seeker Individual Successful student Child of drug userBonds with family No supervision Family Consistent discipline Parent/sibling drug useAnti-drug family rules Pro-drug use norm School Anti-drug use norm Availability of drugsHigh academics Crime/poverty Community Consistent anti-drug message No afterschool programsStrong law enforcement

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5 PAST PORTFOLIO: Primarily efficacy trials of universal school-based interventions Few selective or indicated interventions Few multi-component interventions Limited developmental focus Few independent replication studies

6 Many multi-component programs Universal through indicated levels Early childhood through adulthood Broadened contexts of intervention More independent replications and meta-analyses Prevention services focus PRESENT PORTFOLIO:

7 SELECTED FINDINGS ON PROGRAM COMPONENTS -Parents who smoke can lower the risk of smoking among their children by engaging in anti-smoking socialization (Jackson, et al., 1997). -Intervening as early as grade one to decrease aggression and increase academic success substantially reduces subsequent substance abuse, depression and anti-social behavior (Ialongo, et al., 1999).

8 SELECTED FINDINGS ON AUDIENCE -Gender significantly affects drug offers and types of offers (Moon, et al., 2000). -Programs adapted to address the needs of specific ethnic audiences have greater effects in reducing substance use than universal non-adapted programs (Botvin, et al.,1997).

9 SELECTED FINDINGS ON AUDIENCE Media intervention for high sensation seeking youth resulted in major reductions in marijuana use (Palmgreen, et al., 2001). Misperceptions about normative use of drugs increases initiation and escalation of drug use (Hawkins, et al., in press). Associations with drug using peers accounts for monthly bursts in use among adolescents (Dishion, et al., 2000).

10 SELECTED FINDINGS ON PROGRAM IMPLEMENTATION -Providing accommodations to families helps to attract and retain them in preventive interventions (Spoth, et al., 1999). -Grouping anti-social youth in interventions can lead to unintended negative effects such as increases in substance use and violence (Dishion et al., 1999).

11 CURRENT AREAS OF GROWTH: Basic Prevention Science Developing reciprocity between basic and applied sciences to determine what strategies work, for whom and under what conditions. Prevention Services Research Studying aspects of organization, management and delivery of prevention services that affect selection, adoption and sustainability.

12 NEW FRONTIERS IN PREVENTION SCIENCE? Broadening the scope of theories and models on which prevention strategies are based. Adapting successful strategies from other diseases to drug abuse prevention.

13 Prevention needs to address both initial use and ESCALATION of use. For example…

14 SOME IMPORTANT FACTORS IN ESCALATION: Poor refusal skills (Petraitis, et al, 1998). Cognitive preparation to use drugs (Sussman, et al., 2000). Coping motives for substance use (Johnson & Pandina, 2000). Poor parental monitoring (Eddy et al., 2000). Parent/sibling drug use (Kilpatrick, et al., 2000).

15 We now target mostly risk and protective factors. Might we also target initiating motivations? What are other factors proximal to drug abuse that are modifiable? What can we learn about actual decisions to use drugs? Back to the issue of initial use….

16 In particular, we need to know more about adolescent decision making, taking into account a developmental neurocognitive perspective.

17 WHERE ARE WE GOING? NIDA’s National Prevention Research Initiative: -To accelerate research on innovative approaches to preventing initiation and progression of drug abuse; -To aggressively foster research on the adaptation, adoption, and sustainability of science-based prevention in diverse populations and communities throughout the Nation.

18 NATIONAL PREVENTION RESEARCH INITIATIVE Basic Science In Prevention Research Basic Science In Prevention Research Transdisciplinary Prevention Research Centers Community Multi-site Prevention Trials

19 Transdisciplinary Prevention Research Centers Accelerate the development of innovative drug abuse prevention interventions From basic to prevention From prevention to basic NATIONAL PREVENTION RESEARCH INITIATIVE

20 Basic Science In Prevention Research Basic Science In Prevention Research Development of innovative prevention interventions based on findings from basic biological, psychological, and social sciences. NATIONAL PREVENTION RESEARCH INITIATIVE

21 Community Multi-site Prevention Trials Test efficacious and effective drug abuse prevention interventions in multiple ‘real world’ settings to examine processes involved in adaptation, adoption and sustainability. NATIONAL PREVENTION RESEARCH INITIATIVE

22 NIDA’s National Prevention Research Initiative Goal: To accelerate the development and testing of new interventions and to study the factors involved in the successful dissemination of proven, science-based interventions.

23 PREVENTION WORKGROUP W. Cartwright, DESPR J. Colliver, DESPR K Davenny, CAMCODA S. David, DESPR P. Delany, DESPR S. Grant, DTR&D M. Green, OEA D. Grossman, DTR&D M. Lynch, DNBR L. Miner, OSPC I. Montoya, DTR&D M. O'Brien, DESPR L. Onken, DTR&D M. Racioppo, DTR&D S. Rao, OSPC E. Reider, DESPR E. Robertson, DESPR D. Shurtleff, DNBR V. Smeriglio, CAMCODA J. Stein, OSPC M. Volkov, OEA H. Weingartner, DNBR

24 PREVENTION RESEARCH BRANCH STAFF Liz Robertson, Ph.D., Chief Aria Crump, Sc.D. S. Jackie Kaftarian, Ph.D. Susan Martin, Ph.D. Eve Reider, Ph.D. Larry Seitz, Ph.D. Liz Cooper, Branch Secretary