There is an extensive body of literature on school-based drug education extending over several decades. The quality of this literature varies and there is a need to adequately collate the information to define the components that have the potential to contribute to effective drug education based on literature that is of acceptable quality and scope.
The structure of this analysis involves: 1) assessment of all reasonably available published and grey literature, that in themselves provide a review of the field (1990 to June 2001); 2) identification and assessment of primary studies on which past reviews based their recommendations; and 3) assessment of recent primary studies with a focus on school drug education (1997 to June 2001). A set of predetermined selection and acceptance criteria ensured that only good quality reviews and primary studies were included in this review. Defining the dimension of this review also allows for comparisons to be readily made with previous reviews of school drug education.
Search strategy
A combination of key words were used to identify appropriate publications for both the reviews and recent primary studies. These included: school, drug education, review, research, evaluation, project, study. Searches were undertaken in the following databases: ERIC (research in education and current index to journals in education); Science Direct (multidisciplinary); Current Contents (multidisciplinary); Expanded Academic (ASAP); EMB Reviews (Cochran database of systematic reviews); Eventline (International conferences); PsycInfo; Medline; EMBASE; ETOH (NIAAA Alcohol and alcohol problems database); Dissertation Abstracts; SIGLE; Social Work Abstracts; National Clearinghouse on Alcohol & Drug Information; DRUG database; Alcohol & Alcohol Problems; Cochrane Collaboration Reviews; Internet search; and the University of Sydney Health Education Unit 'Healthed' database. The reference lists of articles accessed via database searches were also assessed for potential articles.
Results of the searches
An initial electronic data base search produced 113 reviews for potential inclusion. Examination of the reference lists of the selected reviews revealed a further 52 publications that indicated potential worth as inclusions within a comprehensive review of alcohol and drug education in schools. Nineteen of the total 165 reviews revealed by the searches were eventually accepted into this review based on the acceptance criteria. Past primary studies that were acknowledged as good quality effective programs by the accepted reviews of drug education were then identified and documented. To be included, at least three reviewers were required to consider the program as effective. Ten programs were identified through this process, eight reporting main group effects and two reporting sub-group effects. Only two of these programs would have been accepted using the selection criteria for this current review.
The total number of recent primary study publications (1997 to June 2001) revealed during electronic data based searches, and the scanning of reference lists of previously accessed papers, totalled sixty-nine papers representing sixty five programs. The total number of primary studies accepted into this review based on the above mentioned criteria was five (7.7%), two of which were of the same program. Three of these programs reported main group effects and two reported sub-group effects only.
Findings
While earlier examinations of school drug education program have had mixed success and even negative results, there are now a number of rigorously conducted and evaluated programs with meaningful behavioural effects. The findings of this systematic review attempt to identify the essential ingredients that can be adopted for future programs to enhance behavioural effectiveness as well as identifying areas of further research. In summary, programs can be improved by: adopting adequate research design; encouraging program planners to adopt a formative phase of development that involves talking to young people and testing the intervention with young people and teachers; providing the program at relevant periods in young people’s development; programs that are interactive and based on skill development; programs that have a goal that is relevant and inclusive of all young people; booster sessions in later years; utility knowledge that is of immediate practical use to young people; appropriate teacher training for interactive delivery of the program; making effective programs widely available and adopting marketing strategies that increase the exposure of effective programs. However, these improvements to school drug education research and program development cannot occur in isolation to the practical implementation of programs at the school level. Identification of barriers and strategies to overcome these barriers to effective drug education in schools, is just as important as testing out and making such programs readily available to schools.
The findings and recommendations from this review should be read in conjunction with the full text so that the background and intention is clear.
Conclusion
This systematic literature review of school drug education has attempted to synthesise understandings about the development, implementation and evaluation of programs that can contribute to better drug education in schools, and particularly those programs, or program components, that can potentially impact on young people’s behaviour. Additionally, the review has attempted to identify potential areas in which more work can be undertaken to increase understandings and abilities in the area.
There is much refinement that can occur in school drug education and the way forward is to continue to create and test interventions in an attempt to bring together all components of the development, implementation and evaluation of school drug education that have the potential for behaviour change.