Program Profile: LifeSkills® Training

This is a classroom-based, drug abuse–prevention program for upper elementary and junior high school students. This program is rated Effective. Students who participated in the program reported a statistically significant decrease in prevalence of cigarette, alcohol, and polydrug use; and slower growth in initiation of substance use, compared with control students. However, there were no significant differences between groups on self-reported marijuana use.

An Effective rating implies that implementing the program is likely to result in the intended outcome(s).

This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.

This program's rating is based on evidence that includes either 1) one study conducted in multiple sites; or 2) two or three studies, each conducted at a different site. Learn about how we make the multisite determination.

An Effective rating implies that implementing the program is likely to result in the intended outcome(s).

This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.

This program's rating is based on evidence that includes either 1) one study conducted in multiple sites; or 2) two or three studies, each conducted at a different site. Learn about how we make the multisite determination.

Program Goals

LifeSkills® Training (LST) is a classroom-based tobacco-, alcohol-, and drug abuse–prevention program for upper elementary and junior high school students. The goals of LST are to prevent tobacco, alcohol, and illicit drug abuse by targeting key risk and protective factors associated with these behaviors.

LST is designed to: (1) increase knowledge of the adverse consequences of substance use; (2) promote anti-drug attitudes and norms; (3) teach personal self-management skills; (4) teach general social skills; and (5) teach skills for resisting social influences to smoke, drink, use illicit drugs, and engage in aggressive or violence-related behaviors.

Target Population

LST is designed to target students who have not yet initiated substance use or are early stage users. The target age group for LST is early adolescence when peer groups and social pressures begin to influence children into substance use experimentation, particularly with tobacco, alcohol and marijuana.

Program Components

LST has five key elements: a cognitive component, self-improvement component, a decision-making component, a coping with anxiety component, and a social skills training component. The LST prevention curriculum specifically:

• Provides students with the necessary skills to resist social pressures to drink alcohol, smoke cigarettes, and use drugs
• Helps students develop greater self-esteem, self-mastery, and self-confidence
• Increases knowledge of the immediate consequences of substance abuse
• Gives students tools to cope effectively with social anxiety
• Enhances cognitive and behavioral competency to prevent and reduce a variety of health risk behaviors

The LST curriculum is centered on the development of drug resistance, personal self-management and increased social skills in the students.

The Drug Resistance Skills components teach students to recognize and challenge common misconceptions about tobacco, alcohol, and other drug use. Using coaching and practice, students learn information and practical drug resistance skills for dealing with peer and media pressure to engage in alcohol, tobacco, and other drug use, and other risk behaviors such as violence and delinquency. The main goal is to decrease normative expectations regarding substance use and to promote the development of drug refusal skills.

The Personal Self-Management Skills components teach students to examine their self-image and its effects on behavior; set goals and keep track of personal progress; identify everyday decisions and how they may be influenced by others; analyze problem situations and consider the consequences of each alternative solution before making decisions; reduce stress and anxiety; and look at personal challenges in a positive light.

The Social Skills components teach students the necessary skills to overcome shyness, communicate effectively and avoid misunderstandings, initiate and carry out conversations, handle social requests, use both verbal and nonverbal assertiveness skills to make or refuse requests, and recognize that they have choices other than aggression or passivity when faced with tough situations. LST uses developmentally appropriate and collaborative learning strategies taught through lecture, discussion, coaching, and practice to enhance students’ self-esteem, self-confidence, ability to make decisions, and ability to resist peer and media pressure.

The middle school program is designed to be taught in a sequence over three years, with the first year’s curriculum more intensive (with 15 class meetings) and booster sessions in the following two years’ acting as a refresher and review for participants. The elementary school program offers 24 classes to be taught during either third, fourth, fifth, or sixth grade. An LST program for parents is also available.

Program Theory

The LST program is guided by a comprehensive theoretical framework that addresses multiple risk and protective factors, provides developmentally appropriate information relevant to the target age group and the important life transitions they face, includes comprehensive personal and social skills training to build resilience and help students navigate developmental tasks, and uses interactive teaching methods (e.g., facilitated discussion, structured small group activities, role-playing scenarios) to stimulate participation and promote the acquisition of skills.

The specific program activities are based on cognitive–behavioral principles, including role-playing, modeling, immediate feedback, and reinforcement of positive behaviors. Students are encouraged to practice the lessons of the day through homework assignments. The LST approach aims to reduce substance use (and uptake, in particular) by increasing coping, refusal, social skills, and knowledge in the participants. The prevention of substance use is understood in terms of social influence theory and is treated through enhancing both competence and knowledge to encourage resistance.

Study

Botvin and colleagues (1995) studied the effectiveness of LifeSkills® Training (LST) by randomly assigning schools in three areas of New York State (around Albany, Syracuse, and Long Island) to either treatment or control conditions. The study presented two treatment groups: one group of 18 schools (T1), whose teachers received formal 1-day training and provided instruction implementation feedback; and a second group of 16 schools (T2), in which teachers’ training was delivered through videotape with no feedback about the implementation of the instruction. The first treatment group (T1) consisted of 1,128 students; the second treatment group (T2) consisted of 1,327 students. A subsample of the treatment groups was identified as participants who had received at least 60 percent of the intervention (high-fidelity treatment groups). There were 762 students in the high-fidelity first treatment group (high-fidelity for T1) and 848 in the second high-fidelity treatment group (high-fidelity for T2). The control group was made up of students at 22 schools where the LST intervention was not implemented (n = 1,142 students). The CrimeSolutions review of this study focused on the differences between the T1 treatment group and the control group. 

At the time that the 6-year follow-up data was collected, the full study sample was 52 percent male and 91 percent white, with a mean age of 18. Eighty-five percent of participants came from two-parent families; 53 percent of the sample had a father who attended some college; and 48 percent had a mother who attended some college.

Drug use was assessed using students’ self-reported tobacco, alcohol, and marijuana use. Students were asked about frequency of use: their self-reported use of drugs was assessed in terms of weekly and monthly use. Polydrug use (the use of two of the three assessed drugs during the same time period, or all three drugs) was also assessed by weekly and monthly use. Polydrug use included tobacco and alcohol, tobacco and marijuana, alcohol and marijuana, and all three drugs. Data was tested for baseline equivalence and differential attrition using general linear models. Mean proportions were computed for each drug and polydrug variable and aggregated by school. The school means were analyzed using ordinary least-squares regression, with schools as the unit of analysis. The authors conducted subgroup analyses on treatment fidelity.

Study

Trudeau and colleagues (2003) used random assignment of schools in a rural Midwestern State to test the effectiveness of LST. The sample was observed at three time periods: a pretest was conducted in the fall of the seventh grade; a posttest was conducted in the spring of seventh grade after the participants had received 15 LST sessions; and a final measure was taken in the spring of eighth grade after the participants were administered five LST booster-sessions.

The total sample consisted of 847 students in 24 schools. The size of the treatment group was 458 students, and the control group was 389 students. Fifty-four percent were male, and 97 percent were white. Seventy-seven percent of the sample lived with both their biological parents, and just over one fifth (21 percent) were eligible for reduced-cost or free school lunches.

Data was examined using growth curve analyses, which estimate the effects of the intervention on the increase of substance use initiation, the decrease of substance refusal intentions, and the decrease of negative expectancies related to substance use. The substances included marijuana, alcohol, and tobacco. As the sample of middle school students aged, their rates of substance initiation naturally rose, and the substance refusal intentions and negative expectations of substance use naturally decreased because of the increase in their exposure to various drugs. Growth curve estimates measure the moderating effects of the treatment on these trends.

The study assessed the long-term effects of the LST program by examining the treatment and comparison groups at two points in time: a pretest baseline measurement and a 6-year follow-up. In 1985, while they were in the seventh grade, the treatment groups (T1 and T2) were administered 15 class-period LST sessions. In 1986, the treatment groups (while in the eighth grade) received 10 class-period LST booster sessions, and in 1987 (in ninth grade), they received five class-period LST booster sessions. In 1991, data was collected in one class period in the 12th grade. Some follow-up data was also collected by telephone (n = 812) or mail (n = 211). The authors did not conduct subgroup analyses.

Customizable training services for LifeSkills Training (LST) are available through the National Health Promotion Associates, Inc. (NHPA), a health consulting, research, and development firm. LifeSkills Provider Training Workshops prepare teachers, school counselors, prevention specialists, community youth educators, and other program providers to implement state-of-the-art prevention education activities and teaching strategies found in the LST program. Please see the LifeSkills Training website for additional information about training sessions: http://www.lifeskillstraining.com/

Subgroup Analysis

Botvin and colleagues (1995) conducted a subgroup analysis on treatment fidelity. A subsample of the treatment groups was identified as high fidelity, which comprised participants who had received at least 60 percent of the intervention. The effects of LifeSkills® Training (LST) on the high-fidelity subsample were found to be greater than the effects that were found on the overall treatment sample. For example, there were statistically significant reductions on all but one of the alcohol measures for the high-fidelity treatment groups, compared with the control group. The only exception was in monthly alcohol use for the first high-fidelity group, which did not reach significance. The high-fidelity treatment groups also reported statistically significant reductions in weekly use of alcohol, heavy use of alcohol (more than three drinks per drinking session), and problem drinking, compared with the control group.

The high-fidelity treatment groups also reported statistically significant reductions in marijuana use and polydrug use, compared with the control group, on nearly every measure. For instance, only five percent of both high-fidelity treatment groups reported weekly marijuana use, compared with nine percent of the control group. For polydrug use, 19 percent of both treatment groups reported monthly cigarette smoking and alcohol use, compared with 27 percent of the control group. Additionally, only five percent of the first high-fidelity treatment group reported monthly use of all three drugs, compared with 10 percent of the control group.

These sources were used in the development of the program profile:

These sources were used in the development of the program profile:

Botvin, Gilbert J., and Kenneth W. Griffin. 2004. “LifeSkills Training: Empirical Findings and Future Directions.” Journal of Primary Prevention 25(2):211–32.

Botvin, Gilbert J., Kenneth W. Griffin, and Tracy Diaz Nichols. 2006. “Preventing Youth Violence and Delinquency Through a Universal School-Based Prevention Approach.” Prevention Science 7:403–08.

Gorman, Dennis M. 2004. “Does Measurement Dependence Explain the Effects of the LifeSkills Training Program on Smoking Outcomes?” Preventive Medicine 40:479–87.

Griffin, Kenneth W., Gilbert J. Botvin, and Tracy Diaz Nichols. 2004. “Long-Term Follow-Up Effects of a School-Based Drug Abuse Prevention Program on Adolescent Risky Driving.” Prevention Science 5(3):207–12.

Griffin, Kenneth W., Gilbert J. Botvin, and Tracy Diaz Nichols. 2006. “Effects of a School-Based Drug Abuse Prevention Program for Adolescents on HIV Risk Behavior in Young Adulthood.” Prevention Science 7(1):103–12.

Griffin, Kenneth W., Gilbert J. Botvin, Tracy Diaz Nichols, and Margaret M. Doyle. 2003. “Effectiveness of a Universal Drug Abuse Prevention Approach for Youth at High Risk for Substance Use Initiation.” Preventive Medicine 36:1–7.

MacKillop, James, Karen A. Ryabchenko, and Stephen A. Lisman. 2006. “LifeSkills Training Outcomes and Potential Mechanisms in a Community Implementation: A Preliminary Investigation.” Substance Use & Misuse 41:1921–35.

Smith, Edward A., John D. Swisher, Judith R. Vicary, Lori J. Bechtel, Daphne Minner, Kimberly L. Henry, and Raymond Palmer. 2004 “Evaluation of LifeSkills Training and Infused-Life Skills Training in a Rural Setting: Outcomes at 2 Years.” Journal of Alcohol and Drug Education 48(1):51–70.

Spoth, Richard L., Scott Clair, Chungyeol Shin, and Cleve Redmond. 2006. “Long-Term Effect of Universal Preventive Interventions on Methamphetamine Use Among Adolescents.” Archives of Pediatric & Adolescent Medicine 160:876–82.

Spoth, Richard L.; G. Kevin Randall; Linda Trudeau; Chungyeol Shin; and Cleve Redmond. 2008. “Substance Use Outcomes 5½ Years Past Baseline for Partnership-Based, Family–School Preventive Interventions.” Drug and Alcohol Dependence 96:57–68.

Spoth, Richard L., Linda Trudeau, Chungyeol Shin, and Cleve Redmond. 2008. “Long-Term Effects of Universal Preventive Interventions on Prescription Drug Misuse.” Addiction 103:1160–68.

Zollinger, Terrell W., Robert M. Saywell Jr., Carolyn M. Muegge, J.S. Wooldridge, S.F. Cummings, and V.A. Caine. 2003. “Impacts of the LifeSkills Training Curriculum on Middle School Students’ Tobacco Use in Marion County, Indiana, 1997–2000.” Journal of School Health 73(9):338–46.

Following are CrimeSolutions-rated programs that are related to this practice:

School-Based Social and Emotional Learning (SEL) Programs

Designed to foster the development of five interrelated sets of cognitive, affective, and behavioral competencies, in order to provide a foundation for better adjustment and academic performance in students, which can result in more positive social behaviors, fewer conduct problems, and less emotional distress. The practice was rated Effective in reducing students’ conduct problems and emotional stress.

Evidence Ratings for Outcomes

	Juvenile Problem & At-Risk Behaviors - Multiple juvenile problem/at-risk behaviors
	Mental Health & Behavioral Health - Internalizing behavior

Interactive Programs for Preventing Marijuana Use in Middle School Students

This practice consists of skill-building and interaction-based activities integrated into school-based programs for grades 6–8 that are aimed at preventing marijuana use among adolescents ages 12–14. This practice is rated Effective for preventing marijuana use.

Evidence Ratings for Outcomes

Drugs & Substance Abuse - Marijuana

Why might a practice's outcome ratings differ from the ratings of specific programs encompassed by that practice?