Research Issues in Prevention

What Should Substance Abuse Prevention Programs Target?

An inherent difficulty in conducting prevention research is the fact that the problem (substance abuse) has not started, making it difficult to measure the effects of the prevention program. Thus, some prevention studies measure intentions to use, attitudes about substance use, and knowledge of problematic substance use as proxies for behavior. Although this research is important, the link between cognition and behavior is not fully understood, and existing prevention studies have shown that changes in attitudes and beliefs do not necessarily reflect changes in behavior. A more widely accepted method for directing prevention programs and assessing their effectiveness is to focus on the risk and protective factors of substance abuse. Developed by David Hawkins and Richard Catalano and based on years of research, the risk and protective factor theory suggests that problematic behaviors such as substance abuse can be mitigated by limiting the number or preventing the development of risk factors and by bolstering protective factors within individuals. Risk factors are defined as anything within individuals, their families, peers, or communities that increase the likelihood of developing substance abuse.

The majority of individuals exposed to risk factors will not develop problematic substance use. Moreover, individuals exposed to the same risk factors to an equal degree do not necessarily have the same chance of developing problematic substance use. The risk and protective factor theory posits that the individuals who do not develop problems are equipped with factors that buffer or moderate the effect of the risk factors. This notion is analogous to the medical model of human disease: People with a family history of diabetes can offset their increased risk of developing this disease by increasing physical activity and maintaining a healthy diet (both protective factors). Similarly, positive parental attachment can moderate the effects of living in an impoverished neighborhood on the odds of abusing substances. Thus, just as addressing modifiable risk factors may decrease the probability of an individual developing problematic substance use, bolstering their protective factors may be equally influential.

...