Independent evaluations of school drug prevention programs found almost no evidence they work

Of 5,071 publications reviewed, only 6 independent RCTs of 4 school-based drug prevention programs met quality criteria, and only 3 of 42 outcome measures showed significant effects.

Flynn, Anna B et al.·JAMA pediatrics·2015·Strong EvidenceSystematic Review
RTHC-00959Systematic ReviewStrong Evidence2015RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Systematic Review
Evidence
Strong Evidence
Sample
Not reported

What This Study Found

Researchers conducted a systematic review specifically targeting independently evaluated randomized controlled trials of middle school drug prevention curricula. The distinction of "independent" evaluation was critical because developer-conducted evaluations tend to overestimate effectiveness.

From 5,071 publications, only 13 articles met initial criteria, yielding 6 RCTs of 4 distinct programs. Among these, 42 single-drug outcome measures were reported. Only 3 of the 42 measures showed statistically significant differences between intervention and control groups. One program, Lions-Quest Skills for Adolescence, showed significant positive effects at final follow-up.

The authors concluded there is a striking lack of independent evidence supporting widely used programs, and new approaches to school-based prevention may be necessary.

Key Numbers

5,071 publications reviewed. 13 articles met criteria. 6 RCTs of 4 programs identified. 42 single-drug outcome measures. Only 3 showed significant effects. 1 program (Lions-Quest) showed positive final follow-up results.

How They Did This

Systematic review searching PsycInfo, ERIC, Science Citation Index, Social Science Citation Index, CINAHL, MEDLINE, EMBASE, and Cochrane databases from January 1984 to March 2015. Included only independently evaluated RCTs of universal, middle school-based drug prevention curricula available for US dissemination.

Why This Research Matters

Schools spend significant resources on drug prevention programs that may not work. When independent evaluators (not the program developers) test these programs, the evidence of effectiveness largely disappears, raising questions about how prevention dollars are spent.

The Bigger Picture

The gap between developer-reported and independently-verified effectiveness in school drug prevention mirrors broader concerns about bias in intervention research. This finding should push schools toward programs with independent evidence and away from programs supported only by their own developers.

What This Study Doesn't Tell Us

The strict inclusion criteria (independent evaluation, RCT, middle school, US-available) may have excluded effective programs tested in other contexts. Some excluded programs may have positive evidence from non-independent evaluators. The small number of qualifying studies limits conclusions.

Questions This Raises

  • ?Why do so few programs have independent evaluations?
  • ?Should schools require independent evidence before adopting prevention curricula?
  • ?What new approaches to drug prevention might be more effective?

Trust & Context

Key Stat:
3 of 42 outcomes significant across independently evaluated programs
Evidence Grade:
Systematic review of RCTs with strict independent evaluation criteria. High-quality methodology revealing low evidence base.
Study Age:
Published in 2015. Prevention program evaluation standards may have evolved since.
Original Title:
Independent Evaluation of Middle School-Based Drug Prevention Curricula: A Systematic Review.
Published In:
JAMA pediatrics, 169(11), 1046-52 (2015)
Database ID:
RTHC-00959

Evidence Hierarchy

Meta-Analysis / Systematic ReviewCombines many studies into one answer
This study
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / Observational
Case Report / Animal Study

Analyzes all available research on a topic using a structured method.

What do these levels mean? →

Frequently Asked Questions

Do school drug prevention programs work?

When evaluated by independent researchers rather than program developers, this review found very little evidence of effectiveness. Only 3 of 42 outcome measures showed significant effects across all qualifying studies.

Which school drug prevention programs have the best evidence?

Of the programs meeting this review's strict criteria, only Lions-Quest Skills for Adolescence showed significant positive effects at final follow-up. The authors suggested new prevention approaches may be needed.

Read More on RethinkTHC

Cite This Study

RTHC-00959·https://rethinkthc.com/research/RTHC-00959

APA

Flynn, Anna B; Falco, Mathea; Hocini, Sophia. (2015). Independent Evaluation of Middle School-Based Drug Prevention Curricula: A Systematic Review.. JAMA pediatrics, 169(11), 1046-52. https://doi.org/10.1001/jamapediatrics.2015.1736

MLA

Flynn, Anna B, et al. "Independent Evaluation of Middle School-Based Drug Prevention Curricula: A Systematic Review.." JAMA pediatrics, 2015. https://doi.org/10.1001/jamapediatrics.2015.1736

RethinkTHC

RethinkTHC Research Database. "Independent Evaluation of Middle School-Based Drug Preventio..." RTHC-00959. Retrieved from https://rethinkthc.com/research/flynn-2015-independent-evaluation-of-middle

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.