title: Reducing adolescent use of harmful legal products: intermediate effects of a community prevention intervention.
abstract: OBJECTIVE
  Preliminary results are presented from a feasibility study of a comprehensive community prevention intervention to reduce the use of inhalants and other harmful legal products (HLPs) among adolescents in three Alaskan frontier communities conducted in 2004-2007. The legal products used to get high include over-the-counter drugs, prescription drugs, and common household products. Community mobilization, environmental and school-based strategies were implemented to reduce access, enhance knowledge of risks, and improve assertiveness and refusal skills.
  
  
  METHODS
  Pre- and post-intervention survey data were collected from 5-7th grade students from schools in three communities using standardized instruments to assess knowledge, assertiveness, refusal skills, perceived availability, and intent to use. The intervention consisted of community mobilization and environmental strategies to reduce access to HLPs in the home, at school, and through retail establishments. In addition, the ThinkSmart curriculum was implemented in classrooms among 5th grade students to increase the knowledge of harmful effects of HLPs and improve the refusal skills. Data were analyzed using hierarchical linear models that enable corrections for correlated measurement error.
  
  
  RESULTS
  Significant increases in knowledge of harms related to HLP use and decreases in perceived availability of HLP products were observed. The environmental strategies were particularly effective in reducing the perceived availability of HLPs among 6th and 7th graders.
  
  
  CONCLUSIONS
  Although limited by the absence of randomized control groups in this preliminary study design, the results of this study provide encouragement to pursue mixed strategies for the reduction of HLP use among young people in Alaskan frontier communities.
authors.affiliation: Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California 94704, USA. paul@prev.org
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Gruenewald
authors.forename: Knowlton
authors.initials: K
authors.lastname: Johnson
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Shamblen
authors.forename: Kristen A
authors.initials: KA
authors.lastname: Ogilvie
authors.forename: David
authors.initials: D
authors.lastname: Collins
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000294:Adolescent Behavior; D003153:Community Health Services / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D040261:Harm Reduction; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006795:Household Products / Q000009:adverse effects; D006801:Humans; D008297:Male; D008960:Models, Psychological; D004366:Nonprescription Drugs / Q000008:administration & dosage / Q000009:adverse effects; D055553:Prescription Drugs / Q000008:administration & dosage; D011314:Preventive Health Services / Q000379:methods*; D012309:Risk-Taking; D012572:School Health Services; D012646:Self Administration; D019966:Substance-Related Disorders / Q000517:prevention & control*
chemical_list: D004366:Nonprescription Drugs; D055553:Prescription Drugs