Program Profile: CHOICE

This is a voluntary afterschool program for middle school aged youths to inform them about substance use and prevent them from starting or continuing alcohol use. The program is rated No Effects. The program was shown to have a statistically significant effect on delaying the initiation of alcohol use, but not on other measures of past or future alcohol use.

A No Effects rating implies that implementing the program is unlikely to result in the intended outcome(s) and may result in a negative outcome(s).

This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.

Program Goals

CHOICE is a voluntary afterschool program for middle school aged youths to inform them about substance use and prevent them from starting or continuing alcohol use. The program focuses on enhancing protective factors and reducing risk factors for alcohol use.

Program Theory

CHOICE is based on components of social learning theory (Bandura 1977), decision-making theory (Kahneman and Tversky 2000), and self-efficacy theory (Bandura 1997). For example, social learning theory suggests that youths make assumptions (which are at times inaccurate) about their peers’ alcohol use and then engage in alcohol use themselves. To address this, the CHOICE curriculum provides students with facts on youth alcohol use from Monitoring the Future statistics.

Program Activities

CHOICE consists of five 30-minute sessions offered once a week after school. Sessions are rotated weekly throughout the school year and focus on providing normative feedback on substance use, challenging unrealistic beliefs about substances, resisting pressure through role play, discussing benefits of cutting back or abstaining from substance use, and discussing risky situations and appropriate coping mechanisms.

Study 1

D’Amico and colleagues (2012) evaluated the impact of participation in CHOICE on 6th through 8th grade students’ behaviors toward alcohol, using a cluster randomized controlled design in 16 middle schools (8 treatment and 8 control) from three school districts in southern California.

Schools were selected and matched with comparable neighboring schools on multiple measures before being randomized into treatment or control conditions. While close to 15,000 students were originally recruited for the study, 9,828 students received parental permission to participate and 8,932 students (4,243 treatment school students and 4,689 control school students) completed the baseline survey. Final outcome analysis was based on data from 9,528 students in two waves of the study. After controlling for grade, there were no significant differences between treatment and control students. The sample was mostly Hispanic (54 percent) and female (51 percent). Only 15 percent of treatment school students actually attended CHOICE during the school year (703 students). Students could choose to attend as many of the sessions as they preferred. Students attended an average of three sessions and one third of the treatment students attended all five sessions.

Baseline surveys were completed in September–October 2008 and follow-up surveys were completed in May–June 2009. Surveys were completed in physical education classes during the school day. Outcomes included lifetime and past month alcohol use frequency; intention to drink in the next 6 months; resistance self-efficacy; and perceived alcohol use among peers at school using measures from the California Healthy Kids Survey, Monitoring the Future, and Project ALERT.

In the study by D’Amico and colleagues (2012), facilitators were bachelor- and master-level project staff who received 30 hours of training over 4 weeks in CHOICE session topics and the motivational interviewing approach. To ensure program fidelity, evaluators employed practices such as weekly supervision of facilitators and two session observations a year by trained observers for adherence to program components. They used the Motivational Interviewing Treatment Integrity (MITI 3.1) scale to measure overall adherence. CHOICE facilitators received a motivational interviewing adherence average of 93 percent.

These sources were used in the development of the program profile:

These sources were used in the development of the program profile:

Following are CrimeSolutions-rated programs that are related to this practice:

After-School Programs

After-school programs generally take place during after school hours and are designed decrease the amount of time youth are unsupervised. Examples of such programs may include recreation-based activities, mentoring, and tutoring services. The practice is rated Promising for child self-perceptions, school bonding, school grades, positive social behaviors, problem behaviors, readings scores, and mathematics scores; and No Effects for delinquency, drug use, and school attendance.

Evidence Ratings for Outcomes

	Education - Math Achievement
	Attitudes & Beliefs - Child Self-Perceptions
	Education - School Bonding
	Mental Health & Behavioral Health - Social Behaviors
	Mental Health & Behavioral Health - Externalizing behavior
	Education - Reading Achievement
	Education - Academic achievement/school performance
	Crime & Delinquency - Multiple crime/offense types
	Drugs & Substance Abuse - Multiple substances
	Education - Attendance/truancy

Interactive Programs for Preventing Marijuana Use in Middle School Students

This practice consists of skill-building and interaction-based activities integrated into school-based programs for grades 6–8 that are aimed at preventing marijuana use among adolescents ages 12–14. This practice is rated Effective for preventing marijuana use.

Evidence Ratings for Outcomes

Drugs & Substance Abuse - Marijuana

Why might a practice's outcome ratings differ from the ratings of specific programs encompassed by that practice?