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Am Fam Physician. 2003;68(3):550-553

Effective programs to prevent drug use and violence have multiple components and are theory driven. One of the most common U.S. programs is Drug Abuse Resistance Education (DARE). DARE curriculum usually is presented to students in elementary school and has been shown to produce some short-term changes in rates of cigarette smoking, but these are substantially less than changes from other multiple component programs. DARE programs have been developed to present the information to students in middle school and junior and senior high schools, but the efficacy of these programs has not been evaluated. Perry and associates evaluated the DARE program and developed and implemented supplemental components (DARE Plus). The objective was to evaluate the impact of DARE and DARE Plus on drug use and violence when presented to middle and junior high school students.

Participants in this randomized controlled trial included all of the seventh-grade students from 24 schools during the 1999 to 2000 academic year. The students were randomly selected to receive DARE, DARE Plus, or delayed implementation of the program for a control group. Eight schools received DARE curriculum, eight received DARE and DARE Plus curriculum, and eight did not receive any DARE curriculum until after completion of the trial. DARE Plus consisted of the standard DARE curriculum, including peer-led parental involvement, a classroom program called “On the VERGE,” youth-led extracurricular activities, community adult action teams, and postcard mailings to parents. This program was implemented during the seventh- and eighth-grade school years. All groups were surveyed in the fall and spring of their seventh-grade year and again during the spring of their eighth-grade year (see accompanying table). The survey was a self-reported instrument based on previous published surveys and included information about the use of cigarettes, alcohol, marijuana, and multiple drugs, plus information on violent behavior and victimization.

By the end of the trial, there was an 84 percent retention rate among the 6,237 seventh-grade students who participated in the program. In outcomes measured, there were no significant differences between the students who participated in the DARE program and those in the control group. Significant differences were evident between boys in the DARE Plus and control groups with regard to tobacco, alcohol, and multidrug use, and victimization. Boys in the DARE Plus and DARE groups also differed significantly in rates of tobacco use and violence, while there were no significant behavior differences among girls.

The authors conclude that DARE Plus enhances the effectiveness of the DARE program among adolescent boys, a high-risk group for these behaviors. This finding underscores the importance of a multiple component intervention program, which is better at preventing drug use and violent behavior. The authors add that the gender difference in responses to the program needs to be explored in future studies.

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