Alcohol and Tobacco Use Prevention

Effectiveness of LST Among Minority Youth
by National Institute of Health

(Page 5 of 6)

Researchers have conducted several studies to determine the influence of the LST approach on ATOD use among racial and ethnic minority youth. This work is important not only because it examines the effectiveness of the LST approach among a wider target population, but also because it addresses the gap in ATOD abuse prevention research with minorities.

The most recent LST research with minorities targeted African-Americans and Hispanics. This research initially focused on cigarette smoking and subsequently examined other substances. Although intervention materials and methods were modified, as necessary, throughout development and testing, the underlying prevention strategy was not changed. Modifications related to the reading level at which intervention materials were aimed as well as the inclusion of illustrations or pictures of minority youth and appropriate language, role-playing scenarios, and examples.

Research With Hispanic Youth

The first study testing the effectiveness of the LST approach among Hispanic youth was conducted with 471 seventh graders attending eight public schools in the New York metropolitan area. The sample consisted mostly of lower income Hispanic students and included a small percentage of African-American and white students. The schools were randomly assigned to experimental or control conditions. The results indicated significant posttest differences in smoking prevalence between the experimental and control groups after controlling for pretest smoking status, gender, social risk for becoming a smoker, and acculturation. Significant posttest differences also existed between the experimental and control groups on knowledge of the immediate consequences of smoking, smoking prevalence, the social acceptability of smoking, decisionmaking, normative expectations concerning adult smoking, and normative expectations concerning peer smoking.

A large-scale randomized trial that evaluated the LST approach among a sample predominately composed of urban Hispanic students also found significant effects. More than 3,500 students from 47 public and parochial schools in the greater New York City area participated in the study. We modified intervention materials to increase their relevance to Hispanic youth and to ensure a high degree of cultural sensitivity. Schools were randomly assigned to experimental and control conditions. Using school means (the average of all the 12th grade students in the followup sample for each school) as the unit of analysis, researchers found significant reductions in cigarette smoking at the end of 7th grade for students who participated in the LST program, relative to the control group. LST students had nearly 30 percent lower monthly prevalence and onset rates compared with students in the control group.

Research With African-American Youth

Before testing the LST approach with African-American youth, researchers reviewed the intervention materials and methods to determine their cultural appropriateness for this population. Following this review, researchers conducted a small-scale study with nine urban junior high schools in northern New Jersey. The pretest involved a total of 608 seventh-grade students, 87 percent of whom were African-American. Schools were randomly assigned to treatment and control conditions within each of the three participating communities. Students in the treatment schools received the LST program, whereas students in the control schools received the smoking education curriculum normally provided.

Results indicated that at posttest, the treatment group had 57 percent fewer smokers than did the control group. Analysis also found significant treatment effects on knowledge of smoking consequences, normative expectations regarding adult smoking prevalence, and normative expectations regarding peer smoking prevalence.

Tailoring LST to Minority Youth

Although research has demonstrated the generalizability of the LST approach to minority youth, it is often argued that an intervention approach specifically tailored to the target population may have the strongest prevention effects. A recent study tested the relative effectiveness of the LST approach and a prevention approach specifically tailored to African-American and Hispanic youth. Both prevention approaches taught students a combination of generic "life skills" and skills specific to resisting offers to use ATODs. The tailored or culturally focused approach, however, was designed to embed the skills-training material in the African-American and Hispanic cultures. Six junior high schools with predominantly minority students were assigned to receive the LST program, receive the culturally focused prevention program, or serve as an informationonly control group. The sample was 48 percent African- American, 37 percent Hispanic, 5 percent white, 3 percent Asian, and 8 percent "other." Students were pretested in the winter and posttested in the spring while in seventh grade.

Results indicated that 1. students in both skills-training conditions expressed lower intentions to drink beer or wine relative to students in the control group and 2. students in the LST condition had lower intentions to drink hard liquor and use illicit drugs. Both skills-training conditions also influenced several mediating variables found to influence the decision not to use ATODs. According to these results, both prevention approaches were equally effective, producing significant reductions in intentions to drink and use illicit drugs and suggesting that a generic ATOD abuse prevention approach with high generalizability may be as effective as a program tailored to individual ethnic populations. As a result, these data provide support for the hypothesis that a single ATOD abuse prevention strategy can be used effectively with multiethnic populations.

About the Author

NIH is the nation's medical research agency - making important medical discoveries that improve health and save lives. The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the primary Federal agency for conducting and supporting medical research.