Understanding how to attract and sustain participation in after-school programs can increase the potential benefits for those who may choose to participate, and can also increase the benefit of the program overall. The current study is the first to take an in-depth look at attendance at a voluntary after-school program for middle school youth that specifically targeted AOD use. Given the extensive development of the program with this age group and the school community, we wanted to examine whether it would attract a diverse group of students and whether these students would be comparable to the general school population on a number of characteristics, including demographics, alcohol and drug beliefs and use, social standing, leadership and cultural values.
Overall, across all eight schools, 15% of consented students chose to attend CHOICE indicating that youth are willing to come and voluntarily discuss issues related to alcohol and drug use. Of note, a recent report from the After school Alliance on a nationally representative sample of youth showed that 15% of youth attend after-school programs, which includes programs that focus on a variety of activities, such as academics, sports, mentoring, etc. (After school Alliance, 2009
). In the only other study that provided a voluntary after-school program for middle school youth that targeted alcohol and drug use, but
also provided additional, more comprehensive services, including tutoring, academics, and leisure activities, participation averaged 14.5% across five different schools (Gottfredson, et al., 2010
). Thus, the participation rate for CHOICE is the same as other after-school programs, which tend to address a variety of behaviors. Furthermore, a 2006 review of the effects of after-school programs on student outcomes (Zief, Lauver, & Maynard, 2006
) found that only 20% of after-school programs targeted middle school youth. Therefore, the current study addresses an important prevention and intervention gap by focusing on this population.
Students utilized the rolling admission process of CHOICE, with one-half of the attendees entering the program at sessions 3, 4 or 5. There appeared to be slightly more attendance at sessions 1 and 2, which may have been due to the timing of our advertising for the program. Overall, we found that approximately 35% of youth attended one session, 27% attended two to four sessions, and 38%attended all five sessions. This suggests that the voluntary nature of the program met adolescents’ needs. In other words, youth could choose what fit for them—it was not mandatory that they return for another session, but if they wanted to, they could come to all five sessions. Thus, having a rolling admission and voluntary attendance may encourage more youth to try a new program and to get prevention information. Results emphasize that by taking the time to build programs with the community, it is possible to obtain a representative sample of youth who will voluntarily attend an after-school program that discusses AOD use.
One effect we found was that younger students were more likely to initially attend CHOICE and continue attending after their first session. Additionally, we found three effects for AOD use: past month drinkers were more likely to initially attend CHOICE and past month marijuana users were more likely to continue attending, although lifetime drinkers were less likely to continue attending. In addition, youth who reported higher best friend substance use were also more likely to initially attend CHOICE. It may be that adolescents who are more regularly drinking or using marijuana and who have friends who use substances more regularly have more questions about the effects of these substances or concerns about how to avoid pressure to use than abstainers or those who have only tried it once or twice ; therefore, they may be more inclined to seek out this information. These adolescents may also have experienced more consequences due to more regular use(e.g., blackouts, hangovers, got in trouble with their parents) and may be more interested in learning about how people may decide to make changes in their substance use compared to those youth who are not using substances regularly.
We also found some evidence that youth who initially attended CHOICE tended to be more popular than those who did not attend. Although participants and non-participants did not differ in terms of their self-rated popularity, participants tended to receive more friendship nominations from other students and nominate more students as their friends. However, it is interesting to note that participants who received more friendship nominations were less likely to continue to attend CHOICE. Popular students tend to be heavier substance users, even in middle school( Tucker, et al., 2011
), which may initially attract them to an after-school program such as CHOICE. However, recent evidence suggests that popular students tend to be less conscientious (van der Linden, Scholte, Cillessen, Nijenhuis, & Segers, 2010
), which may help explain why they were less likely to stick with the program over time.
CHOICE was developed as both a prevention and intervention program (D’Amico & Edelen, 2007
) given that middle school is a time of both initiation and escalation of alcohol and marijuana use (Donovan, 2007
; Johnston, et al., 2009
). Because AOD use substantially increases as youth transition from 6th
grade to 8th
grade (D’Amico, Ellickson, Wagner, et al., 2005
), it is crucial to provide services to those youth who use substances more regularly (e.g., in the past month) and may also tend to escalate their use during this developmental period. CHOICE was able to reach these higher risk youth who are typically less likely to access prevention or intervention services (e.g., Sterling, et al., 2010
), and provide them with information and resistance skills to help them make healthier choices in the future. Another difference we found was that CHOICE participants were more likely to be African American and multiethnic compared to non-participants. This contrasts with previous after-school research, which has found less participation among youth from minority backgrounds (Harvard Family Research Project, 2007
), and suggests that students of all races and ethnicities felt comfortable attending and continuing their attendance at CHOICE, demonstrating the cultural relevance of the program.
It is important to note some of the limitations of this study. First, the youth that participated in this study were from southern California schools and therefore these findings may not be generalizable to youth in other geographic locations. In addition, we did not ask youth why they attended more or fewer sessions of CHOICE. It could have been due to interest, comfort level with the facilitator, or whether or not they had other activities scheduled when CHOICE was offered. We are currently working to address this question as CHOICE is now being implemented in the original eight control schools and we will be surveying youth on reasons they choose (or do not choose) to attend CHOICE. Finally, we had fewer 8th
graders attend CHOICE compared to 6th
graders. Given the increase in AOD use during 8th
grade and subsequently in high school( Johnston, et al., 2011
), it is important to try to reach these older middle school youth with these types of programs.
Our research has shown that this program is successful in decreasing alcohol use at both the individual and school level (D’Amico & Edelen, 2007
; D’Amico, et al., in press
). It is also cost-effective (Kilmer, et al., 2011
), which is an important consideration in whether or not schools are able to provide these types of resources (D’Amico, et al., 2009
). Given the pressure on schools for test performance, this often means less classroom time for prevention-related activities; thus, this type of after-school program could be an attractive alternative to providing programming to youth in the classroom setting.
In sum, our findings highlight the importance of building prevention programs with community and youth input. There is often a large gap between research and practice (Green, 2001
; Wandersman & Florin, 2003
), which is partly due to limited resources in real world settings. For example, many prevention and intervention programs are developed in resource-intense research settings that cannot be replicated in real world settings (D’Amico, et al., 2009
). Understanding the needs of the community and collaborating on program development is one way to decrease this gap and ensure that programs are created so that they can be easily implemented and accessed in the real world. CHOICE reached students of different ethnicities and races and was able to attract higher risk youth who may not typically obtain prevention or intervention services. Results emphasize that a collaborative approach leads to programs that fit well in the community setting for which they were designed and can help ensure that programs reach a diverse group of youth.