Two YEP grantees are featured with innovative programs to address prevention of drug, alcohol, and tobacco use. Swarthmore College, located in Swarthmore, PA, works with Black, non-Hispanic youth, while Stone Child College in Box Elder, MT, serves an American Indian population on Rocky Boy’s Reservation. In both communities, drug, alcohol, and tobacco use pose major health concerns. Each specific program’s data are discussed below.
Swarthmore College’s Project Blueprints YEP focuses on substance abuse as one of its top two priority health issues in Black, non-Hispanic, students. Project Blueprints engages at-risk, minority youth from Chester, PA, in the Chester Upland School District with opportunities for academic support, life skills training, personal development, cultural enrichment, and career exploration. The program provides after-school programming for more than 30 students. A previous grant from the Office of Minority Health enabled Swarthmore College and its partners to work with these students from grades 7-9. Currently, the Project Blueprints, continues to nurture and educate the same group of students who have now reached their senior year of high school. Youth in this community use alcohol and tobacco at rates that cause serious health concerns. Further, they report lower perceived risk of harm from drug use, and 71% report they have personally witnessed drug deals.
Swarthmore’s approach does not focus directly on alcohol, tobacco, and other drugs (ATOD), but rather uses positive peer pressure and staff interactions to discourage participants from choosing risk-taking behaviors. Project Blueprints’ participants are trained to serve as peer educators in the local middle schools, and to present interactive workshops on life skills and healthy relationships. These are very high-profile positions in the community, and they know they are “seen” everywhere by the middle school students and teachers to whom they speak. This forces Blueprints’ students to lead by example. Swarthmore’s theory of change is based on the notion that leadership opportunities lead to increased adoption of leadership behavior and decreased use of ATOD, fighting, and other risky behaviors. The second way Project Blueprints impacts students is through formal and informal staff interactions and positive role modeling. The majority of training topics engage participants in conversations about leadership, their future, and how students need to consider their behavior. The program reinforces the formal training through informal conversations with participants.
Self-reported outcome measures addressed substance abuse in an anonymous participant survey, which could not be linked to the participants in any way. Swarthmore chose this approach to enhance the likelihood of truthful answers about various risk behaviors. Accordingly, aggregate means of Blueprints participants’ substance use were compared with normative local data from the same school district. Lifetime and past 30-day use of cigarettes, alcohol, and marijuana were compared to the self-reports of non-YEP students from the same grade in Chester Upland School District (Figures 3-6 and 3-7).
Compared to the same-school comparison group, Project Blueprints participants report higher lifetime percentages of ATOD use, but lower usage within the past 30 days. The data suggest that Project Blueprints’ youth were at higher risk for substance abuse over their lifetime, but after five years of Project Blueprints, use of both tobacco and alcohol was nearly half that of the local normative rate. Similarly, use of marijuana in the YEP cohort, which originally was 15% higher than the normative lifetime rates, is now 4% less than the local comparison group from Chester–Upland Schools. These data strongly suggest a positive effect of Project Blueprints on substance abuse when compared to local rates. (View the Project Blueprints video).
On Rocky Boy’s Reservation in northern Montana, Stone Child College serves 523 students, of whom 98% are American Indian, 89% qualify for free or reduced price lunch, and 58% live below the poverty level. Seasonal unemployment rates have historically been higher than 70%. According to law enforcement and court data, the major social problem on Rocky Boy’s Reservation is substance abuse — both drugs and alcohol. Prior to YEP, over half of the Rocky Boy youth had ridden in a car whose driver was under the influence. Further, 55% confirmed smoking cigarettes in the past 30 days, and four of five youth have smoked marijuana in their lifetimes. These normative rates from the reservation are more than double the rates for the State of Montana (2009 YRBSS).
The PEAK (Positive Empowered Active Kids) Project provides positive activities for 30 American Indian youth, ages 12-17, on the Rocky Boy’s Reservation. Stone Child College’s YEP is currently in its third year of operation with 100% retention of the same 30 participants. The PEAK Project partners with Rocky Boy and Box Elder Schools, the Rocky Boy Health Board, the White Sky Hope Center, the Boys and Girls Club of the Bear Paws, the Chippewa Cree Tribe Vocational Rehabilitation and the Chippewa Cree Wellness Center. The overall goal of PEAK is to improve the socioeconomic well-being of the Rocky Boy youth participants in the program with goals to drastically reduce or eliminate high-risk behaviors.
Academic enrichment, life skills, personal development, wellness, cultural enrichment, career development, mentorship, and tutorials are provided to PEAK youth. At least four hours of programming per week is offered during the school year, and 110 hours during the summer session. Essential PEAK activities that address drugs, alcohol, and tobacco use include: 1) Health symposia offered by the Rocky Boy Health Board; 2) “Talking Circles,” which are group discussions between youth, tribal elders, and PEAK counselors; and 3) After-school recreational activities, including all-nighters, which occupy PEAK youth during hours when substance abuse is especially prevalent. A self-reported anonymous questionnaire was used to assess risky behaviors such as substance abuse. The data were collected after completion of Year 2 of PEAK and compared to normative data from the Rocky Boy Reservation for non-PEAK students (Table 3-1).
“Driving under the influence” in non-PEAK juveniles on the same reservation was three to four times higher than in PEAK youth. Use of both alcohol and marijuana by PEAK students, and “riding in a car with a driver who is under the influence,” were roughly half the normative rate on the reservation. The PEAK Project has transformed its youth in two short years of YEP programming (view the PEAK Project video).