In-school and community media prevention

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DESCRIPTION (provided by applicant): This proposal is a competing continuation intended to extend our initial findings in order to provide a firm basis for future dissemination efforts. In the prior project, a combined community- and school-based media prevention effort significantly reduced alcohol and marijuana use among middle-school youth (assessed in 8 treatment vs. 8 control communities in a RGT). Several questions need to be answered before moving to large-scale dissemination. First, can we replicate our findings, and what is the cost-effectiveness of the intervention, as a basis for informed decision by potential users of the interventions? Second, is the school-based media intervention sufficient alone to show significant reduction in substance uptake or key mediators, and what is the associated cost-effectiveness? The potential for widespread dissemination due to low costs and simplicity of implementation of in-school media is extremely promising. Third, what is the incremental contribution of the community-based media effort, and the cost-effectiveness associated with that effort? In addition, we can examine with greater precision, based on our experience with the prior study, the mediators that lead to the behavioral impacts of these media-based interventions. This study will use a randomized group trial employing 24 communities to provide increased sensitivity to examine these research questions. Two schools will participate in each community, one of which will be randomly assigned to the school media treatment and one of which will serve as control. Half of the communities will be randomly assigned to the community media treatment. As a result, the school and community treatments are crossed and can each be assessed within an HLM framework. Cost-effectiveness data will also be collected and assessed.