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Article Critique
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Article Critique: Effects of a school-based drug use prevention program
Chang, F. C., Chang, Y. C., Lee, C. M., Lung, C. N., Liao, H. J., Lee, S. C., ... & Zeng, W. T.
(2015). Effects of a school-based drug use prevention programme for middle-school
students in Taiwan. Drugs: education, prevention and policy, 22(1), 43-51.
The Purpose of the Study
The purpose of this study was to establish the impacts of school-based drug and
substance use prevention program for middle-school students in Taiwan. The study specifically
targeted two groups of students, one from an urban school and the other one from a rural school.
The curriculum for the adopted for the program comprised of 10 lesson sessions and 4
homework assignments that mainly involved various parent-child activities. The study however,
did not highlight any specific research questions on focus. Nevertheless, the purpose of the
research was clear.
Methods used in the Study
The research methodology and procedures were clearly outlined. A quasi-experimental
design was used in examining the impact of life skills training, the drug use prevention program
on knowledge related to drug use, attitudes on drug prevention, life skills, and drug use
intentions. Two intervention schools were selected from places with higher rates of drug-related
crimes, one urban middle-school in the city of Taipei and the other one was a rural middleschool in Taoyuan county. The intervention group was made up of 327 middle-school students
from 6 rural school classes and 6 urban school classes. The control group comprised of 314
students from 6 classes from each of the respective schools. Data collection was conducted using
the appropriate techniques and measures. Two surveys were conducted to evaluate the effect of

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the life skills training program for drug prevention. A total of 654 seventh grade students from
these schools filled in the questionnaires. A self-administered questionnaire was utilized in
collecting data on the students’ knowledge of drugs, attitudes towards drug prevention, life skills,
drug use intentions, as well as their perception on parental contribution in the prevention of drug
use. The authors used a mixed model approach in examining the effects, where SAS version 9
was used to perform descriptive data analyses, which was an appropriate technique in conducting
the analysis as it was effective in revealing the relationship between the variables under study.
The Results of the Study
The authors used tables to display the results of the study. Additionally, the results were
clearly explained in the study. The results showed that the drug-prevention program improved
the students’ knowledge of drugs, their attitudes towards drug-prevention, enhanced life skills,
and a better parental participation in the prevention of drug-use. The results also indicated that
compared to urban students, the students from the rural middle school had lesser knowledge on
issues of drugs, lower levels involving life skills and perceived parental involvement, but higher
levels of intentions to use drugs. The results supported the findings from the previous studies
reviewed by the authors.
The Authors’ Interpretation of the Results
The authors’ interpretation of the results was significantly detailed and were able to
determine the relationship between the variables under examination. According to the authors, a
school-based prevention program integrating life skills, social influence and normative
components increased drug knowledge, improved drug-prevention attitudes, as well as life skills.
The authors further pointed out that the youth from rural regions in the country are likely to be

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more vulnerable to drug and substance use because their exposure to the respective risk factors
are higher. The authors were able to generalize the findings from their study. The authors’
objective to examine effects of a school-based drug and substance use prevention program was
accomplished and the study findings could potentially be used as a basis for developing effective
drug prevention programs for students in various learning contexts, as well as to strengthen the
institutions’ capacities in adopting life skills training for drug use prevention and enhance the
students’ drug-prevention competency.


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Linton, S. L., Haley, D. F., Hunter-Jones, J., Ross, Z., & Cooper, H. L. (2017). Social causation
and neighborhood selection underlie associations of neighborhood factors with illicit
drug-using social networks and illicit drug use among adults relocated from public
housing. Social Science & Medicine, 185, 81-90.

Purpose of the Study
This study sought to use path analysis in testing whether a significant relationship existed
between the interaction of members of social networks that used illegal drugs and exposure to
neighborhood environments, with the level of drug use in an individual. The research specifically
targeted a group of African American adults who lived in public houses that had been marked for
demolition. In as much as the purpose of the study agreed with the title, it was structured in a
complex manner that could not easily be comprehended by an average reader. Additionally, no
specific research questions were highlighted in the study and one had to read several paragraphs
to clearly understand specific question the researchers were seeking to answer.
Methods Used
There was no outright specification of the study design but the methodology and
procedures were described in a clear and detailed manner. 172 research subjects were chosen for
the study through a non-probability-based quota sampling. The sample used was sufficient to
generate reliable data and the sampling design was also appropriate since the research
participants were not selected randomly but through subjective judgment. Data was collected
through various techniques using the appropriate measures. Self-reported data was collected in
three waves (wave 1, wave 2 and waves 3-7) through the Audio Computer-Assisted Self
Interview (ACASI) instrument while the social network inventory was utilized to capture social

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network information that was relevant for the study. Since the self-reported data focused on the
characteristics of the participants, it was subject to bias as a result of social desirability.
However, the use of the ACASI instrument by the researchers was wise as it helped to minimize
the bias. The path analysis model was used to analyze data across the three waves and this was
an effective technique as it worked well in modeling the relationships between the participants’
neighborhood features, their membership positions in social networks that use illegal drugs and
their corresponding level of illicit drug usage.
Results of the Study
Data obtained from the study was clearly presented in appropriate tables and figures and
thoroughly explained in the text. All the research variables that were being examined were
measured and analyzed in various tables to show the correlation between the different pathways
and illicit drug use. However, only the data displayed in table 1 could be understood well but
those presented in tables 2 and 3 were hard to understand and interpret. The results from the
study concurred with a majority of the previous research studies and perfectly fitted the purpose
of the study.
Author’s Interpretation
The authors’ interpretation of the results was very detailed and easier to connect with the
hypothesis that was being tested. Each result as obtained from the study was well explained in
terms of their relationship to the purpose of the study as well as their concurrence and
disagreement with findings from previous studies. The researchers were able to find a
relationship between residence in neighborhoods with economic disadvantage and high rates of
violent crimes with the use of illicit drugs and connections with illegal drug-using social groups.

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Additionally, the researchers provided alternate interpretations of the research findings and this
helped in further understanding of the results as they related to the topic and the hypotheses. The
authors generalized the research findings which increases their applicability to other situations
and populations. The limitations that were inherent during the study were clearly highlighted as
well as biases that that could impair the validity of the research findings. Overall, the authors
interpreted the results clearly in a way that can be understood by an average reader.


http://informahealthcare.com/dep
ISSN: 0968-7637 (print), 1465-3370 (electronic)
Drugs Educ Prev Pol, 2015; 22(1): 43–51
! 2015 Informa UK Ltd. DOI: 10.3109/09687637.2014.952271

Effects of a school-based drug use prevention programme for
middle-school students in Taiwan
Fong-Ching Chang1, Yu-Chen Chang2, Ching-Mei Lee1, Chih-Ning Lung3, Hsin-Jung Liao4, Shu-Ching Lee5,
Nae-Fang Miao6, Sieh-Hwa Lin7, and Wang-Ting Zeng1
1

Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan, 2Sha-Lu Junior High School,
Taichung, Taiwan, 3Chi-Sui Junior High School, Taipei, Taiwan, 4Wen-Shan Junior High School, Taipei, Taiwan, 5Chung-Ho High School,
Taipei, Taiwan, 6Department of Nursing, Taipei Medical University, Taipei, Taiwan, and 7Department of Educational Psychology and Counseling,
National Taiwan Normal University, Taipei, Taiwan
Abstract

Keywords

This study examined the effects of a school-based drug use prevention programme for
middle-school students in Taiwan. The curriculum consisted of 10 lessons and 4 homework
assignments involving parent–child activities. A quasi-experimental design was used. The study
was conducted in an urban middle-school located in Taipei city and in a middle-school located
in a rural area in Taoyuan county. A total of 327 middle-school students in the intervention
group and 314 students in the comparison group successfully participated in the baseline
(September 2011) and follow-up surveys (November 2011). A mixed-model approach was
used to examine the effects. Multivariate analysis results indicated that the school-based
drug-prevention programme increased the students’ drug-related knowledge, drug-prevention
attitudes, enhanced life skills, and improved perceived parental involvement in the prevention
of drug use. The results of this study endorse the implementation of school-based drug use
prevention programmes that include parent–child activities to enhance youth drug-prevention
knowledge, attitudes, and life skills.

Drug use, prevention programme, school,
youth

Background
This study examined the effects of a school-based drug use
prevention programme for Taiwanese middle-school students.
The 2009 Taiwan National Health Interview and Drug Abuse
Survey showed that 7.5%, 11.6% and 1% of youth between the
ages of 15 and 17 years had ever use tobacco, alcohol, and
illicit drugs, respectively. 3,4-methylenedioxymethamphetamine (MDMA) and Ketamine are the most popular illicit
drugs used by adolescents in Taiwan (Chen et al., 2009). The
percentage of Taiwanese who use MDMA and Ketamine was
0.47% and 0.54%, respectively (Taiwan Food and Drug
Administration, 2011). During the past decade, drug use, and
in particular Ketamine use, among youth has increased
dramatically in Taiwan. The number of youth illicit drug use
cases reported by schools increased from 135 in 2004 to 2432
in 2012 in Taiwan, and the increase was mainly due to the use
of Ketamine (Ministry of Justice, Ministry of Education,
Ministry of Forign Affairs, & Department of Health, 2013).
Youth drug use is associated with a range of risky
behaviours such as poly-drug use (Degenhardt et al., 2009),
violence (Zaha, Helm, Baker, & Hayes, 2013), and risky

Correspondence: Dr. Fong-Ching Chang, Department of Health
Promotion and Health Education, National Taiwan Normal University,
162, Ho-Ping E. Rd., Sec. 1, Taipei 10610, Taiwan. E-mail:
fongchingchang@ntnu.edu.tw

History
Received 11 December 2013
Revised 24 July 2014
Accepted 31 July 2014
Published online 22 August 2014

sexual behaviours (Doku, 2012), which may result in greater
morbidity and mortality (Chen, Wu, Su, Chou, & Lin, 2010;
Yen & Su, 2006). Similar to western societies, Taiwan studies
show that youth drug use risk factors include attitudes
favouring drug use (Yen, Cheng, Tsai, & Hsu, 2007),
sensation-seeking (Huang, Lin, Lee, & Guo, 2013), substance
use (Yen, Yang, Ko, & Yen, 2005), disruptive family (Yen
et al., 2007), peer illicit drug use (Lee et al., 2012), and poor
school attendance (Chiang, Chen, Sun, Chan, & Chen, 2006).
The World Health Organization (WHO) has encouraged
schools to implement skill-based health education in order to
enhance adolescent life skills. Life skills are a group of
psychosocial competencies and interpersonal skills that
include communication, refusal, decision-making, critical
thinking, managing stress, and advocacy (e.g. influencing
and networking skills) (WHO, 2003). Studies have shown that
skill-based drug-prevention programmes have a positive
effect on enhancement of students’ knowledge, anti-drug
attitudes, and improvement in personal and social skills
(i.e. resistance, decision-making, and problem-solving skills)
(Botvin, Griffin, Paul, & Macaulay, 2003; Buhler, Schroder,
& Silbereisen, 2008; Huang, Chien, Cheng, & Guo, 2012;
Seal, 2006), reduction in substance use intentions (Espada,
Griffin, Pereira, Orgiles, & Garcia-Fernandez, 2012), and
reductions in substance use (Botvin & Griffin, 2002; Eisen,
Zellman, & Murray, 2003; Spoth et al., 2013; Wenzel,
Weichold, & Silbereisen, 2009). In addition, a longitudinal

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F.-C. Chang et al.

study showed that adolescents who were highly competent
reported greater psychological wellness traits that were then
associated with less drinking (Epstein, Griffin, & Botvin,
2002).
Botvin’s Life Skills Training programme was based on
social learning theory and problem-behaviour theory, and
focuses on the enhancement of personal competence in basic
life skills and problem-specific skills that could be used to
resist social pressure that leads to substance use (Botvin,
1983). According to social learning theory (Bandura, 1977),
expectations of personal efficacy determine whether coping behaviour will be initiated and sustained. Problem
behaviour theory (Jessor, 1987; Jessor & Jessor, 1977)
consists of three related systems of psychosocial influence:
the perceived-environment system (i.e. social controls,
models, and support), the personality system (i.e. values,
expectations, beliefs, and attitudes), and the behaviour system
(i.e. problem behaviours and conventional behaviours). Drug
abuse is conceptualised as a socially learned and functional
behaviour, resulting from the interaction of social influences
and intrapersonal factors (Botvin, 2000). Consequently,
competence skills serve as protective factors against youth
substance use (Chang et al., 2013; Epstein, Zhou, Bang, &
Botvin, 2007). The United Nations Office on Drugs and
Crime (2013) reviewed youth substance use prevention
programmes and concluded that school-based universal
programmes that enhance youth personal and social skills
and teach them to resist negative social influences have a
positive impact on reducing youth substance use.
Studies have shown that generic competence enhancement
and social skills training programmes have durable effects on
the use of alcohol, cigarettes, and marijuana (Botvin &
Griffin, 2002), but most of these programme evaluations are
conducted in developed countries. Few studies have examined
the effects of implementing skill-based youth drug-prevention
programmes in Asian societies. This study examined the
effects of a school-based drug use prevention programme for
Taiwanese middle-school students. We hypothesised that a
school-based drug use prevention programme would increase
students’ drug-related knowledge, drug-prevention attitudes,
life skills, perceived parental involvement, and decrease drug
use intentions.

School-based drug use prevention programme
The drug use prevention curriculum was designed for
middle-school adolescents. This prevention programme was
developed based on needs assessment and incorporated
programmatic content from Botvin’s life skills training drug
abuse prevention programme (Griffin & Botvin, 2010). Life
Skills Training primarily consists of three programme
modalities including competence enhancement programmes,
social influence programmes, and normative education. The
competence enhancement programmes focus on teaching
drug-resistance skills, and general life skills such as decisionmaking, problem-solving, communication, and assertiveness.
Social influence programmes are designed to increase the
awaren...