Project Alliance 1

Understanding and Preventing Adolescent Drug Abuse
Funding period: January 1, 1991–April 30, 2011
Principal Investigator: Dr. Thomas Dishion
Co-Investigators: Dr. Kate Kavanagh, Dr. Bernadette Bullock
Project Director: Dr. Allison Caruthers
Funded by: National Institute on Drug Abuse, National Institutes of Health

Project Alliance is the longest running grant-funded research project at CFC. In 1996 the Project Alliance 1 team (Dishion and Kavanagh) received a prestigious NIH Merit Award for this program of research, which provided 10 years of funding. This project has been studying the effectiveness of embedding a family-based intervention in a public middle school context. Specific aims for the remaining years of this project are to evaluate and report the patterns of engagement, mediation, and long-term effectiveness of the family-centered intervention, and to refine and test an ecological model of risk behaviors and psychopathology in young adulthood.

This study reflects the second generation of research on the Adolescent Transitions Program (Dishion & Kavanagh, 2003). The Project Alliance 1 (PAL 1) sample includes 998 young adults and their families who were originally recruited in 1996 or 1998 when they were enrolled in 6th grade at one of three middle schools in Northeast Portland. Upon consent, participating youth were randomly assigned to either a “family resources” group or a “developmental” group. Families who were assigned to the family resources group were offered the opportunity to participate in our family-centered intervention described as an ecological approach to family intervention and treatment (EcoFIT). A cornerstone of EcoFIT is the Family Check-Up (FCU), a brief family intervention designed to motivate and support parents’ monitoring of their youth. For older adolescents, we developed the Teen Check-Up, which adapts motivational interviewing to reduce problem behavior and increase school engagement. These interventions use positive behavior support strategies to promote competence and to reduce problem behavior, and they are described in detail in a recently published book by Dishion and Stormshak (2007).

The PAL 1 project has collected data from all participating youth and families using multiple methods, including face-to-face interviews, diagnostic interviews, self-report surveys, peer nominations, teacher ratings, school records, criminal records, DMV records, and videotaped observations of family and peer interactions. Long-term follow-up of these youth reveals the benefit of integrating family interventions into the school context. To date, we have seen reductions in risk for substance use with an average of five to six sessions during the middle school years for youth in high-risk community contexts. As an added benefit, our program is complementary to other existing, empirically based prevention strategies, both within and outside the schools.

In 2007 we began to publish the long-term effects of the EcoFIT in public middle schools. In one article, we document that engagement in the Family Check-Up in middle schools was more likely among the youth and families experiencing more difficulties and was associated with long-term reductions in the rates of arrests; tobacco, alcohol, and marijuana use; and antisocial behavior in general (Connell, Dishion, et al., 2007). In addition, Connell and Dishion (2008) reported that our Family Check-Up was associated with reductions in adolescent depression over a three-year period for the highest risk adolescents. Stormshak, Connell, and Dishion (under review) have also found that our family-centered approach improved school attendance and grades during the high school period. These findings taken together suggest that the EcoFIT model prevents escalations in problem behavior among youth, improves mental health, and increases school engagement, especially in the highest risk settings.

Our intervention model and results have strong implications for policy and public health practices because they contribute to the prevention of adolescent substance use and problem behavior. In addition, our ecological approach to engaging and intervening with families seems to produce moderate to strong effects among high-risk students with relatively few intervention sessions. This finding is noteworthy because of the cost effectiveness of our family-based approach to preventing substance use.

Progress

2010: Wave 9 data were collected for 86% of Cohort 2 young adults (age 24–25) and from 76% of their parents. The young adult survey assessed adaptation to young adult roles, social support, substance use, and other risk behaviors; the parent survey assessed parents' perspectives on their child's development and ways parents offer support and guidance during early adulthood. By the end of 2010 court and police records of this young adult sample in Oregon and Washington were collected and coded, and the process was begun for all remaining states where participants had lived since age 18. Enggement in the FCU during early adolescence was shown to be associated with reduced levels of tobacco and marijuana use by age 23, but not alcohol use. Longitudinal models of drug use and dependence up to age 23 revealed that although parental monitoring was highly correlated with peer support for drug use at age 16, peer support for drug use at this age was quite prognostic of progression from alcohol and marijuana use to dependence by age 23. In a cascade model describing the progression from relatively minor problem behavior during early adolescence to serious violence, school marginalization was shown to predict young adolescents' movement into gangs, which in turn predicted observed deviancy training in middle adolescence, which in turn predicted seriously violent behaviors.

2009: Wave 8 survey data were collected for 81% of Cohort 1 and 83% of Cohort 2 young adults, and Wave 9 survey data from 85% of Cohort 1 and 76% of Cohort 2 young adults. Data continued to be collected from the remaining Cohort 2 participants. The team collected survey data, which assesses parents' perspectives on their child's development and the ways in which parents offer support and guidance during early adulthood, from 75% of Cohort 1 parents and 67% of Cohort 2 parents. All observational coding of PAL 1 data collected in Wave 6 was completed. Coder impressions (COIMPs) and microsocial Topic-Affect Coding System (TACS) were completed for the Peer Interaction Tasks collected as part of the Wave 6 sample. COIMP captures a wide range of global coder impressions, including characteristics of the dyadic relationship, drug and alcohol use information, eating disorder talk, sexual behavior, and more. TACS captures deviant versus normative behaviors and display of affect. COIMPs and microsocial Relationship-Affect Coding System (RACS) were completed for the family assessment tasks for Wave 6. RACS captures affective display, verbal content codes (including bids for behavior change), and physical behavior codes.

2008: The Wave 8 survey focused on the developmental shift from late adolescence to early adulthood. In it, we asked questions about substance use, risky behaviors, life stresses, important relationships, and life competencies (e.g., educational and vocational success, coping, and prosocial behaviors). In July 2008, we completed Wave 8 data collection for Cohort 1 (N = 676; age 22–23), with survey data from 81% of the original group. We began Wave 8 assessments with Cohort 2 (N = 323; age 21–22) in September 2008 and collected data from 25% of the young adults in this group within the first month. The Wave 9 survey continued to focus on adjustment during early adulthood, and data were collected from parents and young adults. The parent survey assesses parents’ perspectives on their child’s development and the ways in which parents offer support and guidance during early adulthood. We began Wave 9 with Cohort 1 in July 2008 and had collected surveys from 46% of this cohort as of October 2008.