Blueprints for Violence Prevention Promising Programs

Project ALERT - Rationale for Removal From Promising List

BPP13 Removal

2009

The Blueprints Advisory Board reviewed Project Alert at its meeting on September 11, 2009. There have been two independent replications conducted since Project Alert was made a Promising Blueprints program, based upon the second evaluation conducted in South Dakota (Ellickson et al., 2003). The following is a brief overview of all the studies that have been conducted.

Study 1
(Ellickson & Bell, 1990; Ellickson, Bell, & Harrison, 1993; Bell, Ellickson, & Harrison, 1993; Ellickson, Bell, & McGuigan, 1993)
This study included 30 schools randomly assigned to three conditions, with over 6,500 7th grade students who received two years of the program. The findings were mixed at the 3, 12, and 15 month follow-ups, with some positive and some negative outcomes. By 10th grade, the positive effects were lost, with continuity of some negative effects. This study when originally reviewed by Blueprints did not meet our criteria.

Study 2
(Ellickson et al., 2003; Longshore et al., 2007)
This study included 55 schools in South Dakota randomly assigned to three conditions. A revised curriculum with three new sessions was used. The revised curriculum had more emphasis on users and misuse of substances. Implementation was in grades 7 and 8. This study showed positive effects for ever, past month, and weekly cigarette use (among baseline non-users, experimenters, and users). There were positive effects for marijuana initiation (among non-users and the moderate risk group, but not among users). Outcomes were not significant for past month or weekly marijuana use. Alcohol misuse was reduced by the program among the highest risk early drinkers (users), but not for the non-user and experimenter groups. This study and its outcomes qualified Project Alert as a Promising Blueprints program.

Study 2a
(Longshore, Ellickson, et al., 2007)
This study uses the sample of South Dakota schools, but reports on the effects of Alert Only and Alert Plus conditions (basic Project Alert curriculum extended to ninth grade with five booster lessons) compared to the control condition. Effects were tested for a subset of at-risk girls and boys (i.e., those youth who had already used either tobacco or marijuana before delivery of the curriculum began in seventh grade). By 9th grade, there were no sustained effects for the 7th-8th grade at-risk Alert Only students, indicating that the previous effects of the middle school program did not persist through ninth grade in the absence of additional prevention lessons. However, even with the additional high school booster (Alert Plus), there were only effects for the high-risk girls, but not for high-risk boys.

Study 3
(St. Pierre et al., 2005)
An independent replication was conducted in eight Pennsylvania middle schools by outside program leaders employed by Cooperative Extension. Each of the eight schools randomly assigned two seventh grade classrooms to one of three conditions (adult-led Alert, adult-led/teen-assisted, or control). The primary analysis yielded no significant reductions on any measure of substance use or its mediators. The program had a significant negative effect on past year marijuana use for students in the teen-assisted program and the combined treatment groups. There was also a significant negative effect for one mediator, expectations of future marijuana use, which was higher in the teen-assisted version of the program.

Study 4
(Ringwalt et al., 2009)
A second independent replication of Project Alert in the sixth grade, with seventh grade booster lessons, randomly assigned 34 schools to treatment and control conditions. Thirty-day and lifetime use of cigarettes, alcohol, marijuana, and inhalants was measured. At the end of the 7th grade, only 30-day alcohol use was significantly reduced for Alert students. At the one-year follow-up, this effect was lost, and no other drug outcomes were significant.

Summary
The combination of all the studies shows results that range from no effects to mixed effects. When effects are found, they are not sustained through follow-ups, or else effects are only for a subgroup of the sample. Additionally, two independent studies have failed to replicate the findings. Because of this, the Blueprints Advisory Board believes that Project Alert should be removed from the Blueprints Promising list.