Programs that Work

Project STAR/Midwestern Prevention Project

Program Info

Outcome Areas

Healthy and Safe Children

Indicators

Youths not using alcohol, tobacco, or illegal drugs

Topic Areas

     Age of Child
       Middle Childhood
       Adolescence
     Type of Setting
       Middle School
     Type of Service
       Parent Education
       Youth Development
     Type of Outcome Improved
       Physical Health
       Substance Abuse

Evidence Level (What does this mean?)

Proven

Program Overview

The Midwestern Prevention Project (MPP) is a comprehensive, community-based prevention program whose goal is to reduce the use of cigarettes, alcohol, and marijuana among adolescents. The primary component is a school program offered to sixth and seventh graders. This is supported by four other components: a parent program, a community organization program, a program aimed at changing local drug policy, and mass-media events. MPP began in 1984 in Kansas City, Missouri, where it is known as Project STAR (Students Taught Awareness and Resistance).

The program’s components were designed to address the multiple influences adolescents face regarding drug use. On the demand side, the program tries to change behavior through teaching resistance skills. On the supply side, the program tries to change the environment by involving the entire community in drug-prevention activities. The different components of Project STAR were introduced sequentially over the course of several years, beginning with the school program. About 30 mass-media events, ranging from news articles to conferences, occurred every year.

Project STAR was replicated in 1987 in Indianapolis where it was known as I-STAR. In 1998, the MPP program began to be used in other communities around the country. Currently, it is available on a limited basis with plans for general distribution by in the future.

Program Participants

The evaluation sample consisted of a cohort of sixth and seventh graders from public schools in the Kansas City, Missouri area. In the baseline sample of 5,400 students, 79 percent were white, 17 percent were African-American, 2 percent were Hispanic, 1 percent were Asian, and 2 percent were from other backgrounds.

Evaluation Methods

Project STAR was fielded using a 1984 to 1985 cohort of sixth and seventh graders, drawn from 42 middle and junior high public schools in the Kansas City area. Eight schools were randomly assigned to either the program or control group, with four in each. Of the remaining schools, those that could accommodate the scheduling were assigned to the program, for a total of 24 program schools and 18 control schools. Students in the control schools were also exposed to the multi-media events because they were broadcast throughout the Kansas City area.

Several evaluations have been done that drew on two samples of students. The first sample consists of all students (1,607) from the eight randomly assigned schools who were tracked individually over time. The second sample consists of 25 percent of the remaining students (3,771), randomly sampled by classroom. The measures used in all evaluations included self-report surveys, school records, and a biochemical measure of smoking. The surveys were administered in the fall of each year and included 133 items that assessed alcohol, cigarette, and marijuana use, demographic characteristics, and psychosocial variables.

Pentz et al. (1989a) examined overall program effects after one and two years, controlling for urbanicity, socioeconomic status, and race. A second study, Pentz et al. (1989b), used the school as the unit of analysis to examine the two-year effect on smoking habits. MacKinnon et al. (1991) also examined first-year effects, but concentrated on the mediating variables, or factors, that influence adolescent drug use. Finally, Johnson et al. (1990) examined a panel of individually tracked students after three years, drawn from the set of schools randomly assigned to either the program or control group.

Key Evaluation Findings

Pentz et al. (1989a) found that:

At the one-year follow-up, weekly and monthly cigarette, alcohol, and marijuana use was significantly lower for the program students as compared with the control students.
The increase in drug use over time was significantly lower among the program cohort as compared with students in the control schools.

The Pentz el al (1989b) study examined the proportion of monthly, weekly, and daily cigarette smokers and found that:

The rate of increase in smoking at control schools was about 1.5 times the rate of increase in program schools. For example, after two years, students in program schools had increased their monthly smoking by 9.1 percent compared with a 15.4 percent increase among control students.

The MacKinnon et al. (1991) study reported that:

Significantly fewer program students reported an intention to use cigarettes, alcohol, and marijuana within the next two months.
Program students were significantly less likely to believe that there were positive consequences from drug use.
Program students were more likely to report that their friends had negative views toward drug use.

The Johnson et al. (1990) assessment of the panel group found that after three years:

Program students were significantly less likely to have used tobacco and marijuana in the past month.
Previous use of alcohol, cigarettes, and marijuana were significant predictors of later use of the same drugs.
Parents’ use of alcohol, cigarettes, and marijuana in 1984 were significant predictors of adolescent use in 1987.

Probable Implementers

Middle and junior high schools

Funding

National Institute on Drug Abuse, E. M. Kauffman Foundation.

Implementation Detail

Program Components

School Program. This is a two-year program presented to students in the transition year to middle or junior high school (typically sixth or seventh grade). The first year of the school program consists of about ten sessions that focus on increasing skills to resist pressures to use drugs. A five-session booster program follows in the second year. Peer leaders help teachers facilitate the program. Methods include group discussion, role-playing, and homework to be completed with the family.
Parent Program. This was implemented in the second year of the program and includes workshops on parenting skills and neighborhood activities, with at least three planning meetings and an educational seminar.
Community Organization. In the third year, the program brings together and trains community leaders to plan and implement drug-prevention services.
Policy Program. Using some of the leaders from the third component, the goal of this component is to change local ordinances to further restrict students’ access to cigarettes, alcohol, and marijuana and to support prevention efforts.
Media Program. An ongoing component of the multi-year effort, this component uses television, radio, and newspapers to introduce the program to the community, inform the community about its activities, and reinforce the program components.

In order to reach as many students as possible, the program is designed to be introduced in middle school or junior high school because absenteeism and dropout rates are lower in those grades than in high school.

Staffing
Regular school teachers are trained in a two-day workshop for the school program, followed by annual half-day training sessions. Principals and volunteer parents receive training during a one-day workshop to become leaders for the parent program component. The training for the community leaders takes place over several sessions.

Issues to Consider

This program received a “proven” rating. The program was evaluated over a three-year period, involving several thousand sixth and seventh graders who were randomly assigned to program and control groups. Several evaluations have shown significant effects on several positive outcomes over differing lengths of time.

One potential concern regarding the methodology used in the Kansas City area might be that only eight of the 42 schools were randomly assigned to either the program or control group. The others were assigned based on the flexibility of the school to incorporate the program. Although a random-assignment study is ideal, there were no significant differences between the program and control schools in covariates or grade-adjusted drug use at baseline. The Johnson study, which was based on a randomized sample, did find significant program effects on cigarette and marijuana use after three years.

Example Sites

Kansas City, Missouri, and Indianapolis, Indiana

Contact Information

For more information about Project STAR, contact:

Mary Ann Pentz, Ph.D. or Karen Bernstein, MPH
University of Southern California
Institute for Prevention Research
1000 S. Fremont Ave., Unit 8
Alhambra, CA 91803
Phone: (626) 457-6687
Fax: (626) 457-6695
Email: pentz@usc.edu
Email: karenber@usc.edu

Available Resources

A Blueprints for Violence Prevention monograph on MPP with information on implementing the program is available from the Center for the Study and Prevention of Violence at the University of Colorado, Boulder. An overview of the project is available at www.colorado.edu/cspv and the full book may be purchased for $15.

Bibliography

Johnson, C. A., M. A. Pentz, M. D. Weber, J. D. Dwyer, et al.,   Relative Effectiveness of Comprehensive Community Programming for Drug Abuse Prevention with High-Risk and Low-Risk Adolescents   Journal of Consulting and Clinical Psychology, Vol. 58, No. 4, pp. 447-456, 1990.

MacKinnon, D. P., C. A. Johnson, M. A. Pentz, J. H. Dwyer, et al.,   Mediating Mechanisms in a School-Based Drug Prevention Program: First-Year Effects of the Midwestern Prevention Project   Health Psychology, Vol. 10, No. 3, pp. 164-172, 1991.

Pentz, M. A., D. P. MacKinnon, J. H. Dwyer, E. Wang, et al.,   Longitudinal Effects of the Midwestern Prevention Project on Regular and Experimental Smoking in Adolescents   Preventive Medicine, Vol. 18, pp. 304-321, 1989b.

Pentz, M. A., J. H. Dwyer, D. P. MacKinnon, B. R. Flay, et al.,   A Multi-Community Trial for Primary Prevention of Adolescent Drug Abuse: Effects on Drug Use Prevalence   1989. Journal of the American Medical Association, 261: 3259-3266

Last Reviewed

April 2004

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