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Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention J. David Hawkins, Richard F. Catalano and Janet Y. Miller The key to preventing frequent or abusive use of ATOD by adolescents, say these authors, may lie in identifying early individual and societal risk and protective factors, understanding how these factors can be changed, and applying this knowledge to the design and controlled study of early childhood prevention programs targeted to high-risk groups with multiple risk factors. The authors review the literature on societal factors - such as laws and behavior norms, availability of drugs, poverty, neighborhood quality - and on individual and interpersonal factors - such as physiological makeup, family ATOD use and attitudes, family disorganization and parenting skills, low educational commitment, friendships with drug users, and anti-societal behavior. Studies of recent ATOD prevention programs show that successful strategies reduce individual and societal risk factors, either directly or by enhancing protective and resiliency factors across multiple domains (individual, peer, family, school, community, and society). Despite changing social norms, the same risk factors predict ATOD use and are good preventive targets, while some risk factors are more significant at different developmental stages. For example, early academic problems are less predictive than early aggressive behavior. The risk for ATOD use increases as the number of factors increase. Several situations limit current ATOD prevention activities: a focus on risk factors at the time drug use starts, especially on laws and norms that favor drug use (e.g. low legal drinking age), and on changing social behavior norms; a lack of attention to multiple or protective factors; and questions about research methods. The authors outline prevention activities and specific programs that have shown success in reducing the early risk factors for ATOD use (as well as other social problems) and call for controlled research on combinations of activities, such as: early childhood and family support programs that enhance children's health, nutrition, child care, and education, and mother's social support, education, employment, and family planning services; parenting skills education and family functioning training for parents of children and adolescents; and social competence skills training for young children. School-based approaches include promoting academic achievement by changing classroom education methods to incorporate "cooperative learning" and individual tutoring; reorganizing schools to adapt their curricula, promote student-teacher-community involvement, and improve discipline methods; creating alternative activities for youths in schools and other settings, such as promoting involvement in school governance, career education, and peer tutoring. Participation in helping programs outside of school, physical challenges like Outward Bound, and comprehensive programs that focus on multiple risks simultaneously in all settings: home, school, community, and the mass media, should also be studied. Psychological Bulletin, 1992, 112(1): 64-105
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Disclaimer Free To Grow is a national program supported by the Robert Wood Johnson Foundation and the Doris Duke Charitable Foundation with direction and technical assistance provided by the Mailman School of Public Health of Columbia University. |