THE APPLICATION OF A PRIMARY PREVENTION
LIVING SKILLS PROGRAM FOR ELEMENTARY SCHOOL STUDENTS

Susan D. Witt, Ph.D.
University of Akron
School of Home Economics and Family Ecology
215 Schrank Hall South Akron, Ohio 44325-6103
e-mail: susan8@uakron.edu

ABSTRACT
Because drug and alcohol abuse is occurring in so many families and at ever-younger ages, some elementary schools have opted to implement primary prevention programs into their curriculums. One of these programs, BABES, is designed to educate young people about the consequences of drug and alcohol abuse. The program teaches students living skills that will be helpful in resisting the pressure to use drugs.

With so many substance abuse prevention programs available, it is important to determine whether or not the goals of the programs are being met with regard to the population they serve. One hundred thirty two second and third-grade students were evaluated to determine what their knowledge levels and attitudes toward the topic were before and after experiencing the BABES program. Results indicate that this particular prevention program has realistic goals and is successful in meeting those goals.

BACKGROUND INFORMATION
There is little doubt that our country has a serious drug problem. Because of chemical abuse, suicides and accidental deaths of young people are increasing dramatically, creative potential is being lost, and emotional growth is being stopped [1]. In our society today it is almost impossible for a young person to get through adolescence without having some exposure to drugs and alcohol. This may happen early or late in adolescence, but, according to Johnston [2], the trend seems to be that experimentation begins at younger and younger ages every year, particularly with marijuana.

When examining the motives for adolescent drug use, researchers agree that there can be many different reasons or combinations of reasons involved [3]. Reasons commonly given by adolescents include relief from stress, curiosity and stimulation, lack of self-esteem, peer expectations and pressure, boredom and dissatisfaction with life, immediate self- gratification, inadequate coping skills and feelings of vulnerability, rebelliousness and nonconformity. Even transcendental and mystical urges have been cited as the root cause of drug use by school-age children [4].

In a study conducted to examine the factors associated with drug use of fifth through eighth grade students, it was found that peer influences are usually among the strongest predictors of adolescents' drug use. Beginning as early as 1954, peer group urging has been shown to have significant impact upon the initiation, promotion, and continuation of adolescent drug use [5]. This same research found that adolescents choose low self-esteem as a major cause of their drug abuse.

Since experimentation with chemicals has been shown to occur in children as young as age ten, the suggestion is that drug abuse programs in schools should begin as early as possible [5]. Kindergarten is not too young to teach students to "just say no," and implementing programs into elementary school curriculums can be a positive step in dealing with the problem.

The importance of treatment programs cannot be overemphasized, and there are many worthwhile programs that report much success. It is vital, however, to realize that while treatment programs come "after the fact," prevention programs can aid in stopping the problem before it starts. Because there has been so much attention directed toward adolescent drug use, many states now require junior and senior high schools to offer drug education in the standard curriculum [6].

Three commonly-used models of drug education are the legal-political model, which is oriented around the premise that drugs are immoral and illegal; the fear-induction model, which uses films and personal accounts of the debilitating effects of alcohol and drug abuse as scare tactics; and the information- processing model, which is based on the premise that the information is convincing and the students are able to make the decision that alcohol or drugs are not worth the risks [7].

In actuality, all of these drug education models can work for certain types of adolescents. One problem is that often programs are offered too late in the cognitive development of youngsters. Further, most programs concentrate on the rationality of a drug free life, rather than emphasizing the emotional aspects of drug use and abuse.

With peer pressure, low self-esteem, and poor coping and decision-making skills often being cited as reasons for adolescent drug abuse, those involved with drug education programs would do well to concentrate on enhancing these skills in the younger grades in order to better prepare children for the situations they will face when they are older.

DESCRIPTION OF THE PROGRAM
The BABES (Beginning Alcohol and Addiction Basic Education Studies) Program was developed in 1978 in Detroit, Michigan and seeks to address some of the factors cited in use of alcohol and drugs. The originators of the program feel that if students have a strong sense of self, are able to weigh alternatives and risks of behavior and make appropriate decisions, and can develop positive coping strategies, they will be better able to resist the pressure to experiment with and possibly abuse drugs. BABES is supported by the National Council on Alcoholism, Inc. and is best described as a primary prevention, non-judgmental, living skills program [8]. Through the use of puppets, stories, and class discussion, students learn important lessons about having a positive self-image, making good decisions, coping with unhappy events, and getting help when you need it. They also receive information on alcohol and other drugs and learn what to do if they or someone they know is in an abusive situation.

Lessons are presented once a week for a period of seven weeks. The lessons last one hour each and are taught by a trained presenter/facilitator. The stories are centered around seven puppet characters and are geared toward elementary school students. By listening to the presenter and then participating in an instant replay while manipulating the puppets themselves, students are able to absorb and remember the information. Presentation of the lessons is followed by questions and discussion, with the students offering their understanding of the concepts and ideas that have been presented.

The puppet characters are very appealing to young children, and they play an important part in illustrating the concepts of the stories. The seven characters are Buttons and Bows, a brother and sister around whom each story is centered; Myth Mary, who overflows with misinformation and very often needs to be corrected in her thinking; Recovering Reggie, a cross-addicted, recovering alcoholic who very often tells about some of the problems his drinking caused for his family and friends; Early Bird, the character who gives the other characters a warning whenever they are contemplating doing something that may be unsafe or unwise; Donovan Dignity, the old owl who imparts his wisdom whenever it is needed; and Rhonda Rabbit, who lives in an abusive home with her chemically dependent mother.

It should be stressed that the stories involved with these lessons deal with topics to which second and third grade students can relate. Titles and topics of the lessons are listed below: - Lesson 1 - I'm Looking Good and Feeling Fine deals with self-image and feelings. Students learn that it is important to have a good self-image and that there are ways to feel better when they are feeling unhappy.

- Lesson 2 - She Made Me Do It, Didn't She? deals with peer pressure and decision making. Students learn that it is unrealistic to blame friends for decisions that they themselves make and also learn ways to resist pressure when it occurs.

- Lesson 3 - Accepting the Things I Cannot Change and Changing the Things I Can deals with anger and learning to cope with unhappy situations. Students learn that there are some situations that they can control and some that they cannot and what they can do when they are faced with unhappy events.

- Lesson 4 - Let's Play Party is the lesson that gives the students drug and alcohol information and suggests things that they can do to have fun without using chemicals. They also learn that alcoholism and drug dependency are illnesses and that people with these illnesses can be helped.

- Lesson 5 - Retreat is not Defeat and Failure is not Final deals with the importance of asking for help when it is needed and not feeling stupid or like a failure if you cannot do something by yourself. Students learn that there are people and places available to help them.

- Lesson 6 - A Review Session, is a recapitulation of the previous five lessons.

- Lesson 7 - When You Don't Know What To Do introduces the Rhonda character who is from an abusive home. Rhonda is very confused and thinks that her mother's problems may her fault She feels that there should be something she could do to make her mother better. She is also being physically abused. Students learn about their own private bodies and ways that it is inappropriate to be touched. They also learn what to do if they or someone they know is in an abusive situation. This lesson is longer than the others and is presented over a two-day period. All the living skills learned in the previous lessons come into play in this lesson.

PURPOSE AND GOALS OF THE PROGRAM
Fullerton [9] states that a priority for alcohol and drug education programs should be to help children gain enough understanding of the nature of chemical dependency so they can effectively cope with it regardless of whether they are a user, a family member affected by a user, or a non-affected, non-user who needs to empathize with those who are directly involved. Persons involved in the BABES Program understand that while most young children do not themselves abuse drugs and alcohol, many are living with family members who are. Children who live in these situations often have very confusing emotions. They may feel ashamed, guilty, sad, angry, hurt, or frightened. They are sometimes forbidden to speak about family problems with anyone. These children need to know that help is available for them and their families. They need to know that other people are experiencing the same things they are going through. They also need knowledge about alcohol and alcoholism, drugs and drug abuse, and resources that exist to help.

The purpose of the BABES Program is to present information to elementary school-age students that will increase their knowledge base regarding drugs and alcohol and teach them basic living skills that will be beneficial to them in many situations. Among goals set for students are:

EVALUATION PROCEDURES
SUBJECTS
Participants in the Babes Program were second and third grade students from one parochial and one public school in Stark County, Ohio. A total of 61 girls and 71 boys from seven to nine years of age were administered a test before beginning the program and again after the program ended. The test was designed to evaluate students' knowledge of the terms and concepts presented during the Babes lessons.

In addition to the pretest and posttest, a synthetic follow-up cohort of 39 fourth grade students were tested 1 year following their participation in the BABES program to determine how much of the material the students had retained. These students were from identical schools and were the same age at the time of participation in the program.

MEASURES
To determine whether or not the goals of the program were met, a test was designed to evaluate students' knowledge base and understanding of the concepts, both before and after the lessons were presented. Because of the young ages of the children, the test was kept fairly simple. The test was composed of 16 fill-in questions, eight on each of two pages, with a word list from which to choose the answers. Each question dealt with a single concept from one of the lessons, with multiple concepts from each lesson. Word lists and statements were read to students twice, and were repeated if necessary. The number of correct responses corresponding to a lesson number were summed and averaged to yield pretest and posttest scores. Fourth grade students were tested once in a follow-up session at the same time as posttesting occurred for the younger students, which was one year after their participation in BABES.

To alleviate any worries or concerns of the students, it was stressed that the fill-in questionnaire was not a test being given for a grade and that it was all right if they did not know or understand all of the words. After completing the first page of the test, students were encouraged to stand up and take a stretch to relieve any stress or tension they may have felt.

RESULTS
Students consistently scored higher on posttest for every concept set in each of the six substantive lessons. Students appear to have retained the least from Lesson One; that is, there was a minimum difference of .10, or roughly ten percent between observations on that lesson. With this exception, all other mean differences proved significant in means comparisons t-tests.

Further, each of the concept sets was retained one year following the student participation. Since means comparisons of posttest and follow-up indicate no significant differences, one could assume no loss of knowledge of the concepts taught in each lesson. Of course, because the one year follow-up group is synthetic, interpretation should be drawn carefully. Still, these findings suggest a possible growth in understanding of the concepts taught in BABES. The possibility of differences in retention of concepts due to gender of student or type of school are taken into account in Tables 2 and 3. The average difference in knowledge gain, calculated by subtracting pretest from posttest scores, was compared between girls and boys, and between students from public and private schools. No significant differences emerged between genders; however, public school students learned more from lessons two and five than public school children. One explanation could be that private schoolers come from slightly richer social environments, especially regarding the content of these lessons: peer pressure, and asking for help in a crisis.

DISCUSSION
Based on the evaluation of pretest and posttest scores, it is obvious that the BABES Program meets its goals. This particular primary prevention program does increase students' knowledge about drugs and alcohol. The majority of students in this group exhibited improved attitudes toward handling their own anger, coping with problems, and making decisions. They were also more aware of what they themselves can do when faced with difficult or unpleasant situations.

Because many youngsters live in homes with alcohol or drug abusing adults, or may be in abusive situations themselves, second grade is not too young to begin educating students about chemical abuse. Based on the results of this particular presentation and evaluation of the program, it is obvious that young children will learn the ideas and concepts presented and incorporate them into their own lives.

Programs such as BABES should be encouraged to continue in elementary schools, with teachers, principals, and the BABES presenter all being involved in determining what the procedure will be in dealing with children who come forward and need help. Reinforcement in the form of repeating the program or adding a "booster" program that would be targeted to the pre-adolescent would be positive additions to what is already a beneficial element in the classroom.

REFERENCES

1. National Institute on Drug and Alcohol Abuse, Newsletter, (1987)

2. L.D. Johnston, Student Drug Use, Attitudes, and Beliefs: National Trends, 1975-1982, Rockwell, Maryland, National Institute on Drug Abuse, 1987.

3. L.C. Jensen, Adolescence: Theories, Research, Applications. St. Paul: West Publishing Company, 1985.

4. C.R. Carroll, Drugs in Modern Society, 2nd Edition, DuBuque, IA: Wm.C. Brown Publishers, 1989.

5. D. Ried, O. Martinson, L. Weaver, Factors Associated with the Drug Use of Fifth Through Eighth Grade Students, Journal of Drug Education, Vol. 17, 2, pp. 149-160, 1987.

6. G. Ingersoll, Adolescents, Englewood Cliffs, Prentice-Hall, 1989.

7. M.R. Wong, Different Strokes: Models of Drug Abuse Education, Contemporary Educational Psychology, Vol. 1, pp. 1-20, 1976.

8. National Council on Alcoholism & Other Depencies of Greater Detroit, Substance Abuse Prevention for Children, Babesworld Publication, Southfield, MI, 1978.

9. M.S. Fullerton, Practical Considerations for Adopting, Adapting, and Implementing Alcohol/Drug Curriculums, Journal of Alcohol and Drug Education, Vol. 28, 2, pp. 8-14, 1983.


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