Abstract
“Xperience” is an innovative alcohol and drug prevention program that has adopted a multilevel, community-based strategy to promote drug-and-alcohol free social activities, venues and norms among urban youth ages 14–20. The intervention aims to strengthen protective factors and reduce risk factors for alcohol and other substance use among high school age youth by addressing multiple factors at the individual, peer, community and city level. The purpose of this paper is to discuss the process of building the different levels of this intervention during the 3-year formative phase. We will explain: (1) Why we chose to adopt a multilevel and participatory strategy, (2) Formative research leading to the intervention model, (3) The theoretical framework underlying the methodology, (4) Pilot intervention development (Years One and Two), (5) Current program methods and outcome goals, and lastly, (6) Some of the lessons learned, goals achieved, and plans for the future. This descriptive account of building a multilevel intervention aims to serve as a useful guide for others wishing to develop similar approaches, and for theorizing about some of the common challenges involved in this process.
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Notes
Middle school is the age that the majority of youth who end up with severe drug abuse problems later in life begin their use. However, high school is the age that the majority of individuals who have ever used drugs beyond alcohol begin their use. Yet, few successful prevention interventions have been developed specifically for high-school age youth. School-based programs also are not likely to reach the large percentage of urban teens, who drop out before high-school, or who end up in alternative educational programs. These youth often end up in drug-treatment programs only after a serious drug problem is identified, or after becoming involved with the criminal justice system. Although some school-based drug prevention programs can be translated into other community-based settings, most are not designed to attract voluntary participation from older teens. By high school, most youth who live in urban areas are actively involved with independent social activities and are seeking paid employment or opportunities for career training. To attract high-school age participants, drug prevention interventions must appeal to their specific developmental needs and interests.
“Pathways to High-Risk Drug Abuse Among Urban Youth”, NIDA 1 R01 DA11421 (J. Schensul); “Club Drugs and Health Risks among Urban Youth”, NIDA 5 R01 DA014863-05 (J. Schensul).
The ingredients of dust in Hartford vary, but most users report dust is composed of mint, tobacco or other dried leaves soaked with embalming fluid, which may or may not also contain PCP (Singer et al. 2005).
Late adolescence is a period when youth typically become more involved in party culture associated with “under-age parties” hosted at commercial entertainment venues such as nightclubs, raves and concerts. At some of these events they are exposed to pro-drug influences and opportunities for selling and use. These settings are often, though certainly not exclusively, concentrated in downtown urban areas—and are sites where both suburban and urban youth interact and may introduce each other to new drugs.
Drug use and dealing in commercial entertainment settings, including those serving minors, was recognized to be a persistent problem not only by youth, but also by law enforcement agents, city officials and others. Outbreaks of violence at these sites were relatively common in some locations, and were often either reported or rumored to be due to drug involvement.
Current research proposes separating social norms into two types—descriptive and injunctive norms (Cialdini et al. 1990; Snyder et al. 2004). Descriptive norms refer to an individual’s perceptions about other people’s patterns of behavior, and injunctive norms are the “forces people experience from their group based on values and morals” (Cialdini et al. 1990). Some researchers have recommended using the term approval norms, instead of injunctive norms to better distinguish these norms from direct strategies used to influence others’ behavior (Rimal and Real 2003; Snyder and Fleming-Milici 2005).
Absorption into the drama allows audiences to vicariously experience the character’s emotions and personality. Absorption is predicted by story line appeal (which could apply similarly to music appeal), quality of production (a subjective notion), and unobtrusiveness of persuasive subtext (to avoid counterarguing). “Character identification” refers to the added dimension whereby an individual perceives similarities between themselves and the character, or imagines that the person is somebody they know, and thus is similar to the concept of “homophily.”
Communication and intervention science research generally show that imaging-based and affective approaches are associated with stronger behavioral change outcomes than knowledge-oriented approaches.
Branding aids in memory recall by providing message cohesion, repetition, and symbolic cues.
Evans defines Brand Equity as “the extent to which consumers affiliate with and aspire to the attributes of a brand and the product (or in public health, the behaviors) it represents” (Evans et al. 2007).
The name Xperience and logo were initially developed through youth focus groups prior to the start of the three-year prevention study in an earlier attempt at piloting a “party” intervention.
There were two Hispanic male youth and one Hispanic female represented in the focus groups. Hispanic youth were underrepresented in the focus groups, due partially to the fact that the largest number of youth was recruited by a community partner located in a predominately African–American neighborhood.
During these discussions, the youth are advised to avoid disclosing personal information about themselves or others, which they do not want revealed. There are a number of sources youth can draw upon in these discussions, which help them to begin the process of creating their original works of art with prevention messages. For example, youth may learn about its negative effects from observations or word-of-mouth from parents, siblings, other relatives and peers (Adesso 1985). Ethnographic studies of youth culture suggest that in "natural settings" what we call "drug testimonials" provide youth with information they use to evaluate the relative risks and benefits of using various drugs to which they are exposed in their environment (Eiserman et al. 2005; Jenks 2001). Youth also obtain information about drug effects and consequences from school teachers, health-care providers, books and magazines, the news and sometimes entertainment media, and the Internet.
Steps in the process reinforce connections between the youth as they work together in producing a show. The Leadership and Craft Development Training Program also provides ongoing opportunities for artists, visual, and communications team to present their WOA in progress or communication strategy their peers from the other groups, and for program staff to provide feedback. Program staff along with peers help guide and monitor the content of the pieces to ensure the messaging is consistent the aims of the intervention and is communicated in a way that is aesthetically pleasing and convincing. Together with program staff, youth review the meaning of the messages, content, potential impact, appropriateness and message integrity and coordinate their dissemination through multi-media channels.
In our pilot shows in 2006 and 2007 there were no instances in which a participant was requested to leave the show site, nor were there any instances in which security personnel have had to approach any youth to address any inappropriate behavior.
Youth in the program are also encouraged to invite their My Space friends to the Xperience events and to use other websites such as Facebook, Blackplanet etc., which they normally use themselves to communicate with their peers and learn about new entertainment opportunities. However, before youth in the program are allowed to post the Xperience brand logo and information about the Xperience events on their personal webpages, we review the content of their web pages to make sure that it is consistent with the overall intervention goals. If there are inconsistencies in the messages, they can decide whether or not they want to change the content of their profile pages, or choose not to promote the program on their page.
For example, our program activities were scheduled to begin at 5 PM and end at 7 PM, however, on numerous occasions youth in the program wanted to stay late to interact with each other and/or with program staff, however, the Mi Casa site closed down promptly at 7:30 PM.
Several major challenges to this plan are having the resources needed to recruit a sizeable enough study sample, and receiving parental consent for youth who are underage. If we can ensure that youth’s information will be protected, we may be able to receive IRB approval to allow for a waiver of parental consent for a phone or web-based survey. However, IRB’s tend to be especially cautious when it comes to data collection involving youth.
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Diamond, S., Schensul, J.J., Snyder, L.B. et al. Building Xperience: A Multilevel Alcohol and Drug Prevention Intervention. Am J Community Psychol 43, 292–312 (2009). https://doi.org/10.1007/s10464-009-9230-3
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DOI: https://doi.org/10.1007/s10464-009-9230-3