COMPARE TWO INTERVENTIONS AND SUGGEST A THIRD 1
CompareTwo Interventions and Suggest a Third
In the United States, drug abuse is a major health issue, accordingto health statistics, and it continues to be of national priority.The national survey data show that the use of drugs among the youthis leading among the industrialized countries. For instance,substance use comes with numerous adverse health issues, and massivealcohol consumption may result in a rise in HIV menace. Althoughthere has been a drop in the use of drugs over the past decade, therecent national health survey data indicate a reversal of that trendstarting with the 8th and 10th graders in the early 1990s towards themid-1990s (Botvin et al., 1995). The recent surge in drug use amongadolescents not only does it raise new drug specter in drug menace,but also serves as a continuous reminder to establish more efficientmethods and approaches. One of the promising lines of research studyinclude efforts to develop the prevention of drug abuse, which caneasily be implemented within the school settings, and can cover alarger number of persons at a modest cost.
In recentyears, significant progress and strides have been made usingapproaches on psychological and social factors, which promote theinitiation of drug use. They are designed to change the normsregarding the prevalence and use drug acceptability, raise moresocial influences awareness, and skills to resist those forces.Additionally, few approaches teach general life skills to improve thequality of individual competence, while reducing the vulnerability ofusing drugs. However, the existing research is marred with crucialgaps (Botvin et al., 1995). The paper, therefore, will compare twointerventions, "Project TND – Project towards No Drug Abuse,"and "Healthy Choices," which is a motivational interviewintervention targeted at multiple behaviors among the youth with HIV.
The targeted population for the Project directed at No Drug Abuse –Project TND stood at 1074 high school students aged between 12 and 17attending continuation schools. These youths are at a much greaterrisk of engaging in drug abuse compared to the child going tosecondary. On the other hand, "Healthy Choices" targets 143youths with HIV aged between 16 and 24 years old. According to Botvinet al. (1995), youth involved with at least one of all the threeproblematic behaviors, namely: substance use issue on a youthscreener, engaging in unprotected sex over the last three months, orapproximately less than 90% adherence to HIV medication. Currently,the exclusion criteria involve a behavioral study project(intervention or assessment) targeted at solving any of the abovementioned three problems, took part in a substance abuse program, orhaving a disorder. The two interventions target both sexes. "ProjectTND" applied an indicated method by following in the youthconsidered high risks unlike the "Healthy Choice" response,which was universally looking at the entire risk categories, low,moderate, and high risks.
These two interventions are both randomized control trials. Forinstance, in Project TND, approximately 29 schools from the SouthernCalifornia region having five counties carried out recruitment forall the participants in a procedural approximation of randomselection. The first session within these schools will include themotivation of students to listen to continuing programming whileemphasizing on practical listening skills. The second one instructsthose students in alternative skills of coping and issues of chemicaldependency (Botvin et al., 1995). The third session set encouragesthese students from making choices regarding no-drug-use.Additionally, to the classroom curriculum, the concept of the schoolcommunity was applied in developing the kind of community programcomponent, whereby the students get involved in sponsored activitiesby the faculty from without the classroom. Here, the hypothesis wasthat providing materials for drug abuse outside the classroom, whichincludes the use of other activities, which make a limited movementfrom without the nearby community. The program was handled anddelivered by the well-trained teachers, which saw the enhancement ofeffective classroom-based programming.
The "HealthyChoices" intervention is comprised of four individual sessions,60 minutes each, between a trained therapist and the participant.These sessions paid attention to two of the three probable issuesbased on the screening entry. Among the 143 youths who qualifies forthe substance use intervention, 69 of them assigned randomly to theintervention groups and 75 to the control groups. Of the 143 youth,78.2% of them were African American, 4.3% White, 9.2% Hispanic, and8.5% mixed/other race (Botvin et al., 1995). This intervention wascoined from the Motivational Enhancement Therapy, whereby the MIprinciples combine to form structured personalized feedback tofacilitate changes in behavior.
The first twosessions focus on eliciting the individuals` view of the two issuesunder study, a discussion and elimination of individual`s readinessmake changes, exercises of decisional balance, and the completion ofthe plan for behavior change. The third session involved the study ofstudying progress, demonstration of behavioral reinforcement, and therenewal and maintenance of commitment for future changes in behavior.The final session determined the termination, self-efficacy belongingto participants, and long-term maintenance plans of behavioral change(Botvin et al., 1995). All these sessions were divided across the12-week period, with the first and second sessions occurring in thefirst two weeks following the baseline, and the third meetingoccurred four weeks later. The spacing in between the sessions wasdesigned in a manner that it allowed persons to participate inopportunities put in behavioral change practices.
Project TND isas a result of the cognitive perception theories and behavioralskills. The methods are used to address the issue of drug myths thatcan be involved with bigger drug use levels and misinformed choicesmade by the youths. On the other hand, "Healthy Choices"applied Motivational Interviewing to solve the problems of drug useresult perception and expectancies of drug risks (Botvin et al.,1995). Overall, the "Healthy Choices" reduce the use ofalcohol by 15-months follow-ups. Of importance is the MI-basedsolution, which was effective after some time in reducing the chancesof individuals being heavy drinkers.
The projectdirected at No Drug Abuse plan was identified to have had animplication on the application of the hard drugs. The significance ofthe program conditions was less likely to apply hard drugs thancontrolling the actual situation. Heavy users of alcohol areidentified amidst the participants at pre-test followed withsignificant implications of its use (Botvin et al., 1995). After sometime, the effects of hard drugs remain relevant, while it determinesits use. In the long run, the program was not identified to haveimpacted on marijuana or cigarette use. Additionally,community-building programs also failed to determine the increase inthe programs` effectiveness.
Alternatively, theoretical model refers to the theory ofCommunication Competence, whereby culturally baked resiliency modelapplied another of the intervention known as "Keepin` it REAL."The response is used for youth between the ages of 12 and 14 years,uses a curriculum designed to fit ten lessons, and is trained bytrained tutors with every session taking 45 minutes (Botvin et al.,1995). The performance-based and narrative curriculum borrows fromthe Communication Competence Theory coupled with a culturally-basedresiliency model. It is used to place emphasis on the resistance andstrategies with an acronym shown as "REAL." The "REAL"strategies have been identified to be effective in reducing the useof marijuana over a period. Additionally, this intervention showsthat drug abuse efforts on prevention are enhanced and improved whenall its programs are grounded, culturally for example, reflecting onthe youth receiving these interventions.
Botvin, G. J., Baker, E., Dusenbury, L., & Botvin, E. M. (1995).Long-Term Follow-Up Results of a Randomized Drug Abuse PreventionTrial in a White Middle-Class Population. Jama, 273, 14,1106-1112.