Program Profile: Project Towards No Drug Abuse (Project TND)

This is a school-based program designed to prevent substance use. The program is rated No Effects. There were no statistically significant effects on marijuana use, cocaine use, or on prevalence of getting drunk, and mixed effects on tobacco use, alcohol use, and hard drug use. There was a statistically significant improvement for the treatment group in overall substance use and an index of all hard drug 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.

This program's rating is based on evidence that includes either 1) one study conducted in multiple sites; or 2) two or three studies, each conducted at a different site. Learn about how we make the multisite determination.

Program Goals/Target Population

Project Towards No Drug Abuse (Project TND) is an interactive school-based program designed to prevent substance use in high school youth (ages 14–19). The program was specifically designed to help meet the needs of youth in continuation or alternative high schools; however, the program can also be used in traditional high schools. The program helps youth learn decision-making and social skills, which bonds them to prosocial peers who are at lower risk for substance use, and motivates them to avoid drug use by correcting cognitive misperceptions such as the stereotyping of continuation high school youth as drug users (Sussman et al. 2002).

Program Components

This school-based interactive program takes place over 4 weeks and consists of 12, 40- to 50-minute lessons that include motivational activities, social skills training, and decision-making components that are delivered through group discussions, games, role-playing exercises, videos, and student worksheets. The program provides motivation-enhancement activities to avoid drug use, detailed information about the social and health consequences of drug use, and correction of cognitive misperceptions. It addresses topics such as active listening skills, effective communication skills, stress management, coping skills, tobacco cessation techniques, and self-control—all to counteract risk factors for drug abuse that are relevant to older teens.

Key Personnel

The program is designed to be delivered by a trained classroom teacher or health educator. It can also be implemented in a community setting by trained implementers for community-based organizations. A teacher’s manual details the 12 sessions and instructional techniques.

Program Theory

Project TND is based on the theories of cognitive perception and behavioral skills. Youths’ cognitive perceptions or misconceptions about drug use may be associated with higher drug use overall, as youth may believe that their peers are using substances or that others expect them to use substances (Sussman et al. 2002). Cognitive perception theory posits that people attempt to align their actions and behaviors with their perceptions of the world. Project TND confronts flawed perceptions by providing youth with accurate information about substance use.

Project TND is also informed by behavioral skills theory, which suggests that certain skills can help youth manage their behavior. The theory specifically informs components of the program that address social skills and behavioral self-management. Youth who engage in substance use often have poor socialization skills, anger management problems, and communication difficulties, and lack self-control. By improving youths’ behavioral and social skills, Project TND is designed to help them bond with more prosocial peer groups and improve their ability to communicate with authority figures (Dent, Sussman, and Stacy 2001; Simon et al. 2002; Sussman and Ames 2001).

Study

Sussman and colleagues (2012) conducted a randomized controlled trial in four counties in southern California to determine the potential effects of Project TND and of Project TND with an added motivational interviewing (MI) booster. The MI booster involved one-on-one discussions between the youth and trained interventionists to address discrepancies between current behaviors and future goals. Schools were considered eligible for the study if 1) at least 5 percent of enrolled students were of non-Hispanic white ethnicity (to reflect ethnic composition of previous Project TND studies), 2) the school was within 75 miles of the project headquarters, 3) the school only consisted of grades 9 through 12, and 4) the school offered at least two classes with a minimum of 60 students per school. Sixty-one schools were considered eligible. Schools with the highest scores in drug use risk were approached first, and three schools of similar drug use risk were subsequently recruited. They were then assigned randomly to one of the three groups, until a total of 24 schools were recruited to the Project TND-only treatment group (n = 8), the Project TND with MI treatment group (n = 8), or the control group (n = 8). The CrimeSolution.gov review focused on the comparison between both Project TND groups and the control group.

The age of participants ranged from 14 to 21 years at baseline, with an average age of 16.8 years. A majority of the participants (56.6 percent) were male, 64.9 percent were Hispanic, 13.0 percent were of mixed ethnicity, 11.7 percent were non-Hispanic white, 4.3 percent were Black, and 6.1 percent were of another ethnicity (including Asian and Native American). Approximately 51.3 percent reported living at home with both parents. In addition, 49.2 percent of participants’ fathers and 55.9 percent of participants’ mothers had completed high school. At baseline, 70.1 percent of participants reported using drugs in the previous 30 days (41.0 percent reported use of cigarettes, 58.3 percent reported use of alcohol, 45.5 percent reported use of marijuana, and 26.7 percent reported use of hard drugs). There were no statistically significant differences between groups on baseline characteristics, with the exception of gender (there was a disproportionate number of female participants in the Project TND-only group). To account for this difference, gender was one of the covariates included in the statistical models.

Outcomes of interest included use of tobacco, alcohol, marijuana, and hard drugs; overall substance use; an index of hard drug use; and prevalence of being drunk on alcohol. Participants were asked to self-report on how many times in the last month they used different substances, on a 12-point Likert scale. The responses to the eight drug categories of cocaine, hallucinogens, stimulants, inhalants, ecstasy, pain killers, tranquilizers, and other hard drugs were summed to create the index of hard drug use, and all responses were summed to create the overall substance use index. The outcomes were recorded as use or no use, and the outcome analysis was conducted by using a generalized mixed-linear model to determine the differences between groups in drug use. No subgroup analyses were conducted.

Study

Valente and colleagues (2007) conducted a randomized controlled trial in three counties in southern California to determine the potential effects of Project TND and the modified TND Network program. TND Network followed the Project TND curriculum but encouraged small-group discussions through naturally occurring friendships and was conducted by peer leaders rather than health educators or classroom teachers. Of 14 continuation high schools that participated in the study, 75 classes were randomized to either the Project TND treatment group (n = 22), the TND Network treatment group (n = 25), or the control group (n = 28). The CrimeSolutions review focused on the comparison between the control group and the traditional Project TND treatment group.

The average age of the participants at baseline was 16.3 years, and 62 percent were male. Approximately 72 percent were Hispanic, 11 percent were white, 6 percent were Black, and 11 percent were of other ethnicities, including Asian American and mixed ethnicity. Students in continuation high schools were assigned a grade based on the number of units they completed, and the average grade of participants was 10.6. On a scale of 1 to 6 (1 indicated completion of elementary school, 3 indicated completion of high school, and 6 indicated completion of a graduate degree), the average participant’s mother had an education level of 2.92 There were no statistically significant differences between groups on baseline characteristics.

Outcomes of interest included use of tobacco, alcohol, marijuana, and cocaine. These outcomes were measured through a self-reported survey. Monthly use of tobacco, alcohol, marijuana, and cocaine was measured on an 11-point Likert scale, ranging from no use to 91 or more times per month. The survey was taken at pretest and at the 1-year follow up. A regression analysis was conducted to determine the difference between groups in outcomes. No subgroup analyses were conducted.

Study

Sussman and colleagues (2003) conducted a randomized controlled trial in southern California to determine the potential effects of Project Towards No Drug Abuse (Project TND). Pretest data were collected from 18 continuation high schools (alternative high schools intended for students at high risk of dropping out) between October 1997 and June 1998. Schools were randomized to one of three conditions in blocks that were determined by estimated drug use prevalence, racial composition, school enrollment, and standardized test scores. These were 1) a health-educator-led condition, 2) a self-administered condition, and 3) a control condition with no treatment. The CrimeSolutions review focused on the comparison between the control group and the health-educator-led treatment group.

A total of 1,037 students across 18 schools participated in the study. The age of participants ranged from 14 to 19 years, and 93 percent of the sample was between the ages of 16 and 18. Approximately 54 percent of the participants were male, 45 percent were white, 42 percent were Hispanic, 7 percent were Asian American, 4 percent were Black, and 1 percent were of other ethnicities. Nearly 46 percent of the participants lived with both parents, and 60 percent of the parents completed high school. At baseline, 57 percent of participants reported cigarette use in the previous 30 days, 63 percent reported alcohol use, 54 percent reported marijuana use, and 30 percent reported hard drug use. There were no statistically significant differences between groups on baseline characteristics.

Outcomes of interest were the use of tobacco, alcohol, marijuana, and hard drugs. These outcomes were assessed through a self-reported survey. Monthly use of tobacco, alcohol, marijuana, and hard drugs was measured on an 11-point Likert scale, ranging from no use to 91 or more times per month. The survey was taken at pretest and at the 2-year follow up. A generalized linear mixed model was conducted to determine the difference between groups in drug use. No subgroup analyses were conducted.

Training information for Project Towards No Drug Abuse is available here: https://tnd.usc.edu/?page_id=40

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

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