New Substance Use Prevention Program Being Developed

The University of Rhode Island's Cancer Prevention Research Center will bring tailored programs to younger children to prevent them from substance abuse. The outcome is based on decades of research and success in helping to change smoking and other high-risk behaviors of teenagers and adults.

The University received a $3.5 million, 5-year grant from the National Institute of Drug Abuse to support its innovative research for the prevention of substance abuse and other high-risk behaviors. Led by URI Psychology Professor Wayne Velicer, one of the developers of the Transtheoretical (stages of change) Model, the research will for the first time focus on prevention of health-risk behaviors among children in grades 6-8.

National studies have shown that the use of substances like tobacco and alcohol develops relatively rapidly during early adolescence. More than one million Americans start smoking each year - and more than half of those who start are under the age of 14.

Based on these sobering facts, Velicer and his team have built a new program focusing on substance use prevention with younger participants. The research will use computer-based expert systems to develop effective prevention and intervention strategies that will reinforce children's healthy behaviors and evaluate the processes that may influence children to adopt certain high-risk behaviors.

"I'm very excited about developing new ways to prevent these unhealthy behaviors from starting," said Velicer, who co-directs the Cancer Prevention Research Center with Psychology Professor James Prochaska. "These programs represent a very new approach. We are employing the latest in computer information technology combined with the knowledge that we have been able to gain from fifteen years of research. We have been able to follow two large samples of adolescents who were substance use-free for three years to see what might predict increased risk behaviors. The new program will help prevent and reduce major long-term and immediate risk behaviors among these pre-teens when they become teenagers."

"We are very proud of these efforts to prevent unhealthy behaviors from starting in a whole new generation," said URI President Robert L. Carothers. "This is a new program that will take place in Rhode Island's middle schools, and it is one more example of the way in which the work of the University is changing the lives of thousands in this state and beyond."

Nicknamed Project BEST (Behavior Expert System Trial), this will be the first interactive study focused on prevention that will involve early adolescents. The University has received letters of support for the project from 20 Rhode Island middle schools and is now meeting with schools to arrange for their participation in September.

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One of the unique features of these interventions is that they are tailored to each student. They are also fully interactive, making them very engaging for the students. If the expert system intervention results in the predicted outcomes, it will be an important breakthrough for school-based multiple risk factor studies and practical interventions.

Project BEST will involve children in two treatment groups. Researchers from the University will bring laptop computers with the health-focused multimedia interventions to the classrooms. As each student uses the program, it becomes tailored to his or her own individual level of risk behavior. The programs seek to prevent tobacco and alcohol use and promote healthy eating habits and physical exercise. Use of the expert system provides one-on-one contact and feedback with students that may supplement classroom-wide discussions by teachers. Participation in the study will also help schools meet the National Standards in Health Education for Grades 6-8. The computers will remember each student’s responses and can use that information to provide individual feedback on progress in future interactions.

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"School-based smoking prevention programs are typically identical for all students. We've found that tailoring prevention materials to focus on individual needs with an emphasis on students at highest risk is a promising alternative," said Velicer of Peace Dale, who has pioneered the application of computer-based intervention to health promotion and disease prevention. "Instead of inundating kids with anti-smoking or drinking lectures and films, our expert system will reach out to students individually and based on their profile provide information to help prevent them from adopting high-risk behaviors."

"This highly competitive research award is a strong vote of confidence by the federal government in the behavior change-related work underway here. It is a classic example of the public benefits directly realized from the research and outreach of a State's robust research university," said Peter Alfonso, vice provost for research, graduate studies and outreach.

In previous studies conducted by the URI Cancer Prevention Research Center, computer-based technology for health behavior research has been demonstrated to be effective with high school students. The expert system approach provides an opportunity for users to receive individually tailored, stage-based information to track and help prevent high-risk health behaviors. The use of computer-based expert systems recognize that health behaviors vary -widely by individuals and demonstrates to users that a 'one size fits all' approach doesn't always work for health.

According to national studies, school-based prevention programs generally have had limited success. Velicer said that most of the approaches taken lack individualized attention.

The University's high school programs used an innovative, interactive computer program as the primary means of intervention with the students. At a laptop computer during a typical 40-minute health education classroom session, students answer numerous health questions regarding smoking habits and receive immediate on-screen feedback based on their individual needs and behaviors. The interventions are fully multimedia with print, sound, pictures, figures, and brief movies, all designed to engage the students.

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