Substance abuse prevention infrastructure: a survey-based study of the organizational structure and function of the D.A.R.E. program.
BACKGROUND
The only national drug abuse prevention delivery system that supports the rapid diffusion of new prevention strategies and includes uniform training and credentialing of instructors who are monitored for quality implementation of prevention programming is the Drug Abuse Resistance Education network (D.A.R.E.) linking community law enforcement to schools. Analysis of the organizational structure and function of D.A.R.E. provides an understanding of the essential parameters of this successful delivery system that can be used in the development of other types of national infrastructures for community-based prevention services. Information regarding organizational structure and function around funding issues, training, quality control and community relationships was gathered through telephone surveys with 50 state D.A.R.E. coordinators (including two major cities), focus groups with local D.A.R.E. officers and mentors, and interviews with national D.A.R.E. office staff.


RESULTS
The surveys helped identify several strengths inherent in the D.A.R.E. program necessary for building a prevention infrastructure, including a well-defined organizational focus (D.A.R.E. America), uniform training and means for rapid dissemination (through its organized training structure), continuing education mechanisms (through the state and national conference and website), mechanisms for program monitoring and fidelity of implementation (formal and informal), branding and, for several states, predictable and consistent financing. Weaknesses of the program as currently structured include unstable funding and the failure to incorporate components for the continual upgrading of curricula reflecting research evidence and "principles of prevention".


CONCLUSIONS
The D.A.R.E. organization and service delivery network provides a framework for the rapid dissemination of evidence-based prevention strategies. The major strength of D.A.R.E. is its natural affiliation to local law enforcement agencies through state coordinators. Through these affiliations, it has been possible for D.A.R.E. to become established nationally within a few years and internationally within a decade. Understanding how this structure developed and currently functions provides insights into how other such delivery systems could be developed.
Merrill
Jeffrey C
JC
Division of Addiction Psychiatry, UMDNJ-Robert Wood Johnson Medical School, 671 Hoes Lane, Piscataway, NJ, USA. lakj@duke.edu
Pinsky
Ilana
I
Killeya-Jones
Ley A
LA
Sloboda
Zili
Z
Dilascio
Tracey
T
D003159:Community-Institutional Relations; D005381:Financing, Organized; D017144:Focus Groups; D019538:Health Care Surveys; D006801:Humans; D017146:Models, Organizational; D016495:Police / Q000193:education; D011314:Preventive Health Services / Q000191:economics / Q000458:organization & administration*; D015397:Program Evaluation; D011786:Quality Control; D012572:School Health Services / Q000191:economics / Q000458:organization & administration; D013192:Staff Development; D019966:Substance-Related Disorders / Q000191:economics / Q000517:prevention & control*; D014481:United States