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RESEARCH AND PRACTICE |
Steven L. West is with the Department of Rehabilitation Counseling, Virginia Commonwealth University, Richmond. Keri K. O’Neal is with the Center for Developmental Science, University of North Carolina, Chapel Hill.
Correspondence: Requests for reprints should be sent to Steven L. West, PhD, Virginia Commonwealth University, Department of Rehabilitation Counseling, 1112 East Clay St, Box 980330, Richmond, VA 23298-0330 (e-mail: slwest2{at}vcu.edu).
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ABSTRACT |
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 TOP ABSTRACT INTRODUCTIONMETHODSRESULTSDISCUSSIONReferences |
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Objectives. We provide an updated meta-analysis on the effectiveness of Project D.A.R.E. in preventing alcohol, tobacco, and illicit drug use among school-aged youths.
Methods. We used meta-analytic techniques to create an overall effect size for D.A.R.E. outcome evaluations reported in scientific journals.
Results. The overall weighted effect size for the included D.A.R.E. studies was extremely small (correlation coefficient = 0.011; Cohen d = 0.023; 95% confidence interval = –0.04, 0.08) and nonsignificant (z = 0.73, NS).
Conclusions. Our study supports previous findings indicating that D.A.R.E. is ineffective.
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INTRODUCTION |
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TOPABSTRACTINTRODUCTIONMETHODSRESULTSDISCUSSIONReferences |
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Given the recent increases in alcohol and other drug use among high school and college students,7 the continued use of D.A.R.E. and similar programs seems likely. In a meta-analysis examining the effectiveness of D.A.R.E., Ennett et al.3 noted negligible yet positive effect sizes (ranging from 0.00 to 0.11) when outcomes occurring immediately after program completion were considered. However, this analysis involved 2 major limitations. First, Ennett et al. included research from non-peer-reviewed sources, including annual reports produced for agencies associated with the provision of D.A.R.E. services. While such an inclusion does not necessarily represent a serious methodological flaw, use of such sources has been called into question.8
Second, Ennett and colleagues included only studies in which postintervention assessment was conducted immediately at program termination. As noted by Lynam et al.,6 the developmental trajectories of drug experimentation and use vary over time. Thus, if individuals are assessed during periods in which rates of experimentation and use are naturally high, any positive effects that could be found at times of lower experimentation will be deflated. Likewise, assessments made during periods in which experimentation and use are slight will exaggerate the overall effect of the intervention.
Ideally, problems such as those just described could be solved by the use of large-scale longitudinal studies involving extensive follow-up over a period of years. There have been several longer term follow-ups, but the cost of such efforts may limit the number of longitudinal studies that can be conducted. In the present analysis, we attempted to overcome this difficulty by including a wider range of follow-up reports, from immediate posttests to 10-year postintervention assessments, in an updated meta-analysis of all currently available research articles reporting an outcome evaluation of Project D.A.R.E.
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METHODS |
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TOPABSTRACTINTRODUCTIONMETHODSRESULTSDISCUSSIONReferences |
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Using these criteria, we refined the original list of studies to 11 studies (Table 1
). We calculated effect sizes using the procedures outlined by Rosenthal.9 Meta-analysis results are commonly presented in the form of either a correlation coefficient (r) or the difference in the means of the treatment and control conditions divided by the pooled standard deviation (Cohen’s d).10 Since both are ratings of effect size, they can readily be converted to one another, and, if not provided in the original analyses, they can be calculated via F, t, and 
2 statistics as well as means and standard deviations.9
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RESULTS |
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TOPABSTRACTINTRODUCTIONMETHODSRESULTSDISCUSSIONReferences |
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Furthermore, the 6 reports indicating that D.A.R.E. had more positive effects were, for the most part, small (Figure 1). The largest effect size was found in a report14 in which the only outcome examined was smoking. Finally, we conducted a test of cumulative significance to determine whether differences existed between D.A.R.E. participants and non–D.A.R.E. participants. This test produced nonsignificant results (z = 0.73, NS).
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DISCUSSION |
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TOPABSTRACTINTRODUCTIONMETHODSRESULTSDISCUSSIONReferences |
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Our findings also indicate that D.A.R.E. was minimally effective during the follow-up periods that would place its participants in the very age groups targeted. Indeed, no noticeable effects could be discerned in nearly half of the reports, including the study involving the longest follow-up period. This is an important consideration for those involved in program planning and development.
As noted earlier, progression in regard to experimentation and use varies over time. Use of alcohol and other drugs reaches a peak during adolescence or young adulthood and decreases steadily thereafter.7,15 Such a developmental path would be expected of all individuals, regardless of their exposure to a prevention effort. Ideally, individuals enrolled in a program such as D.A.R.E. would report limited or no use during their adolescent and young adult years. The fact that half of the included studies reported no beneficial effect of D.A.R.E. beyond what would be expected by chance casts serious doubt on its utility.
One shortcoming of our analysis should be noted. In many of the studies we included, individual students were the unit of analysis in calculating effects. As noted by Rosenbaum and Hanson,16 this practice tends to lead to overestimates of program effectiveness, since the true unit of analysis is the schools in which the students are "nested." Because our meta-analysis was limited to the types of data and related information available from the original articles, the potential for such inflation of program effectiveness exists. However, the overall effect sizes calculated here were small and nonsignificant, and thus it is unlikely that inclusion of studies making this error had a significant impact on the current findings.
An additional caveat is that all of the studies included in this analysis represent evaluations of what is commonly referred to as the "old D.A.R.E.": programs generally based on the original formulations of the D.A.R.E. model. In response to the many critiques of the program, the D.A.R.E. prevention model was substantially revamped in 2001, thanks in part to a $13.6 million grant provided by the Robert Wood Johnson Foundation.17 The revisions to the model have since given rise to programs working under the "new D.A.R.E." paradigm. However, at the time of the writing of this article we were unable to find any major evaluation of the new D.A.R.E. model in the research literature, and the effectiveness of such efforts has yet to be determined.
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Acknowledgments |
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Human Participant Protection
No protocol approval was needed for this study.
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Footnotes |
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Accepted for publication January 5, 2003.
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References |
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TOPABSTRACTINTRODUCTIONMETHODSRESULTSDISCUSSIONReferences |
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2. Donnermeyer J, Wurschmidt T. Educators’ perceptions of the D.A.R.E. program. J Drug Educ.1997;27:259–276.[Web of Science][Medline]
3. Ennett ST, Tobler NS, Ringwalt CL, Flewelling RL. How effective is Drug Abuse Resistance Education? A meta-analysis of Project DARE outcome evaluations. Am J Public Health. 1994;84:1394–1401.
4. Hanson WB. Pilot test results comparing the All Stars Program with seventh grade D.A.R.E.: program Integrity and mediating variable analysis. Subst Use Misuse. 1996;31:1359–1377.[Web of Science][Medline]
5. Hanson WB, McNeal RB. How D.A.R.E. works: an examination of program effects on mediating variables. Health Educ Behav. 1997;24:165–176.
6. Lynam DR, Milich R, Zimmerman R, et al. Project DARE: no effects at 10-year follow-up. J Consult Clin Psychol. 1999;67:590–593.[Web of Science][Medline]
7. Johnston LD, O’Malley PM, Bachman JG. National Survey Results on Drug Use From the Monitoring the Future Study, 1975–1998. Volume I: Secondary School Students. Rockville, Md: National Institute on Drug Abuse; 1999. NIH publication 99-4660.
8. Gorman DM. The effectiveness of DARE and other drug use prevention programs. Am J Public Health. 1995;85:873.
9. Rosenthal R. Meta-Analytic Procedures for Social Research. 2nd ed. Thousand Oaks, Calif: Sage Publications; 1991.
10. DasEiden R, Reifman A. Effects of Brazelton demonstrations on later parenting: a meta-analysis. J Pediatr Psychol. 1996;21:857–868.
11. Amato PR, Keith B. Parental divorce and well-being of children: a meta-analysis. Psychol Bull. 1991;110:26–46.[Web of Science][Medline]
12. Shadish WR, Haddock CK. Combining estimates of effect size. In: Cooper H, Hedges LV, eds. The Handbook of Research Synthesis. New York, NY: Russell Sage Foundation; 1994:261–281.
13. Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988.
14. Ahmed NU, Ahmed NS, Bennett CR, Hinds JE. Impact of a drug abuse resistance education (D.A.R.E.) program in preventing the initiation of cigarette smoking in fifth- and sixth-grade students. J Natl Med Assoc. 2002;94:249–256.[Medline]
15. Shedler J, Block J. Adolescent drug use and psychological health: a longitudinal inquiry. Am Psychol.1990;45:612–630.[Medline]
16. Rosenbaum DP, Hanson GS. Assessing the effects of a school-based drug education: a six-year multilevel analysis of Project D.A.R.E. J Res Crime Delinquency. 1998;35:381–412.
17. Improving and evaluating the DARE school-based substance abuse prevention curriculum. Available at: http://www.rwjf.org/programs/grantDetail.jsp?id=040371. Accessed January 8, 2003.
18. Ringwalt C, Ennett ST, Holt KD. An outcome evaluation of Project DARE (Drug Abuse Resistance Education). Health Educ Res. 1991;6:327–337.
19. Becker HK, Agopian MW, Yeh S. Impact evaluation of drug abuse resistance education (DARE). J Drug Educ. 1992;22:283–291.[Web of Science][Medline]
20. Harmon MA. Reducing the risk of drug involvement among early adolescents: an evaluation of drug abuse resistance education (D.A.R.E.). Eval Rev. 1993;17:221–239.
21. Ennett ST, Rosenbaum DP, Flewelling RL, Bieler GS, Ringwalt CL, Bailey SL. Long-term evaluation of drug abuse resistance education. Addict Behav. 1994;19:113–125.[Web of Science][Medline]
22. Rosenbaum DP, Flewelling RL, Bailey SL, Ringwalt CL, Wilkinson DL. Cops in the classroom: a longitudinal evaluation of drug abuse resistance education (D.A.R.E.). J Res Crime Delinquency. 1994;31:3–31.
23. Wysong E, Aniskiewicz R, Wright D. Truth and DARE: tracking drug education to graduation and as symbolic politics. Soc Probl. 1994;41:448–472.[Web of Science]
24. Dukes RL, Ullman JB, Stein JA. Three-year follow-up of drug abuse resistance education (D.A.R.E.). Eval Rev. 1996;20:49–66.
25. Zagumny MJ, Thompson MK. Does D.A.R.E. work? An evaluation in rural Tennessee. J Alcohol Drug Educ. 1997;42:32–41.
26. Thombs DL. A retrospective study of DARE: substantive effects not detected in undergraduates. J Alcohol Drug Educ. 2000;46:27–40.
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| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
