URI researchers work on substance use prevention with Rhode Island middle school students

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KINGSTON, R.I. — May 16, 2008 — Based on decades of research and success in helping to change smoking and other high-risk behaviors among teen-agers and adults, the University of Rhode Island’s Cancer Prevention Research Center is now bringing tailored programs to younger children to prevent these behaviors from even getting started.

In fact, URI researchers have been bringing these programs to 6th through 8th grade children in 20 middle schools throughout the state. In cooperation with school leaders, officials and parents, URI Psychology Professor Wayne Velicer is bringing “Tailored Interventions to Prevent Substance Abuse” programs, also known as “Project BEST,” to children in Bristol/Warren, Burrillville, Central Falls, Cranston, Jamestown, Johnston, Middletown, Newport, North Kingstown, Ponagansett, Portsmouth, South Kingstown, Tiverton, West Warwick, and Westerly.

Last year, the University received a $3.5 million, 5-year grant from the National Institute of Drug Abuse to support this innovative research for the prevention of substance abuse and other high-risk behaviors and the promotion of healthy behaviors such as diet and exercise as children mature.

One of the developers of the Transtheoretical (stages of change) Model used by health practitioners worldwide, Velicer is providing the program using laptop computers in the schools to give each student confidential, individualized information and feedback about their health decisions.

National studies have shown that the use of substances like tobacco and alcohol develops relatively rapidly during early adolescence. More than 1 million Americans start smoking each year — and more than half of those who start are under the age of 14. Two other behaviors involved in the study, exercise and diet, are critical for developing healthy bodies and preventing obesity.

The research uses computer-based expert systems to develop effective intervention strategies that will reinforce children’s healthy behaviors and evaluate the processes that may influence children to adopt certain high-risk behaviors.

“These programs represent a very new approach. We are using the latest in computer information technology combined with the knowledge that we have gained from 15 years of behavior research. Through these years we have followed two large samples of adolescents who were substance use-free for three years to see what might predict increased risk behaviors. The new program will help prevent and reduce major long-term and immediate risk behaviors among these pre-teens when they become teen-agers,” said Velicer, who co-directs the Cancer Prevention Research Center with Psychology Professor James Prochaska.

One of the unique features of Project BEST is that interventions are tailored to each student. They are also fully interactive, making them very engaging for the students. If the expert system intervention results in the predicted outcomes, it will be an important breakthrough for school-based multiple risk factor studies and practical interventions.

Through Project BEST, children have the opportunity to learn more about important health issues on a regular basis throughout their middle school careers. The objective of Project BEST is to maintain healthy behaviors in diet and physical activity and to prevent tobacco and alcohol use in early adolescence through the use of innovative computer-based interventions tailored to each student’s particular risk profile. The interventions are fully multimedia with print, sound, pictures, figures, and brief movies.

Results from a similar project conducted from 1995 through 1998 by the Cancer Prevention Research Center showed improvements in students’ health behavior decisions regarding smoking, diet and sun protection.

Use of the Project BEST expert system provides one-on-one contact and feedback with students that may supplement classroom-wide discussions by teachers. Participation in the study will also help schools meet the National Standards in Health Education for grades 6 through 8. The computers will retain each student’s responses and will use that information to provide individual feedback on progress in future interactions.

Velicer explains the difference between the BEST project approach and traditional prevention programs. “School-based smoking prevention programs are typically identical for all students. We’ve found that tailoring prevention materials to focus on individual needs, with an emphasis on students at highest risk, is a promising alternative,” said Velicer of Peace Dale, who pioneered the application of computer-based intervention to health promotion and disease prevention. “Instead of inundating kids with anti-smoking or drinking lectures and films, our expert system will reach out to students individually and, based on their profile, provide information to help prevent them from adopting high-risk behaviors.”

In previous studies conducted by the URI Cancer Prevention Research Center, computer-based technology for health behavior research has been demonstrated to be effective with high school students. The use of computer-based expert systems recognize that health behaviors vary widely by individuals and demonstrates to users that a one-size-fits-all approach doesn’t always work for health.

According to national studies, school-based prevention programs generally have had limited success. Velicer said that most of the approaches taken lack individualized attention.

The University’s earlier high school programs used an innovative, interactive computer program as the primary means of intervention with the students. At a laptop computer during a typical 40-minute health education classroom session, students answer numerous health questions regarding smoking habits and receive immediate on-screen feedback based on their individual needs and behaviors.

The other principal investigators on the grant include Prochaska, intervention development expert Colleen A. Redding, research and development Director Kathryn Meier, and school coordinator Karin Oatley all of Wakefield, and Robert Laforge of East Greenwich.