Examining the effects of school-based drug prevention programs on drug use in rural settings: Methodology and initial findings

Context: Although there have been substantial advances in knowledge about drug prevention over the last decade, the majority of school-based drug prevention studies have been conducted in urban settings. There is little knowledge about the effectiveness of such programs when they are implemented in rural populations. Purpose: To examine the prevention effects of school-based drug prevention programs implemented in rural populations. Methods: Mixed model or 2-level meta-analysis of trials based on school-based drug prevention programs that included rural populations. A total of 182 trials were coded for urbanicity of schools and 22 separate trials were selected for the analysis conducted in this paper. A total of 435 distinct analyses were examined from these 22 trials. Findings: We found a modest but consistent beneficial impact of drug prevention programs on later use as well as level of use. Regarding later drug use, the largest impact was on those who were not using at baseline and those exposed to an interactive program; the results were much larger for marijuana and other drugs compared to alcohol or tobacco, while inhalant use was less affected than other drug categories. Regarding level of use, the impact was greatest 6 months after the trial ended, with diminishing effects thereafter. Conclusions: Evidence exists for a small but systematic beneficial effect of drug prevention programs in rural settings. It is likely that these programs have produced a mild reduction in new use of substances but have had little impact on those already using substances.