Ellickson, P. L., McCaffrey, D. F., Ghosh-Dastidar, B., & Longshore, D. L. (2003). New inroads in preventing adolescent drug use: Results from a large-scale trial of Project ALERT in middle schools. American Journal of Public Health, 93(11), 1830-1836. https://doi.org/10.2105/AJPH.93.11.1830

Type of Study: Randomized controlled trial
Number of Participants: 4,276

Population:

• Age — 7th grade (approximately 11-13 years)
• Race/Ethnicity — 12.5% Non-White (largely Native American)
• Gender — Half were female
• Status — Participants were 7th graders in middle schools in South Dakota.

Location/Institution: South Dakota

Summary: (To include basic study design, measures, results, and notable limitations)
This study evaluated the Project ALERT program across several schools and communities. Fifty-five middle schools were randomly assigned to the Project ALERT program or a control condition. Project ALERT students received 11 lessons in 7th grade and 3 more in 8th grade. Study developed measures were used to assess results; psychometrics were not reported. Results indicated that the Project ALERT curriculum curbed cigarette and marijuana use initiation, current and regular cigarette use, and alcohol misuse. Program effects were not significant for initial and current drinking or for current and regular marijuana use. Limitations include the lack of longer term follow-up to examine whether the impact on drug use persists over time, high rates of alcohol use in the sample at baseline, and concerns about the generalizability of results from a largely rural sample to other areas.

Length of controlled postintervention follow-up: Unclear – follow-up was in the spring of 8th grade, after administration of the 8th-grade lessons.

Ghosh-Dastidar, B., Longshore, D. L., Ellickson, P. L., & McCaffrey, D. F. (2004). Modifying pro-drug risk factors in adolescents: Results from Project ALERT. Health Education & Behavior, 31(3), 318-334. https://doi.org/10.1177/1090198104263333

Type of Study: Randomized controlled trial
Number of Participants: 4,276

Population:

• Age — 7th grade (approximately 11-13 years)
• Race/Ethnicity — 12.5% Non-White (largely Native American)
• Gender — Half were female
• Status — Participants were 7th graders in middle schools in South Dakota.

Location/Institution: South Dakota

Summary: (To include basic study design, measures, results, and notable limitations)
This study used the same sample as Ellickson et al. (2003). This study examined the impact of the Project ALERT program on risk factors for drug use in mostly rural Midwestern schools and communities. Fifty-five middle schools from South Dakota were randomly assigned to Project ALERT or a control condition. Project ALERT students received 11 lessons in Grade 7 and 3 more in Grade 8. Measures utilized Beliefs About Drug Use Consequences, Normative Beliefs, Resistance Self-Efficacy, and Expectations About Future Use. Results indicate that Project ALERT had statistically significant effects on all the targeted risk factors associated with cigarette and marijuana use and more modest gains with the pro-alcohol risk factors. Effect sizes were typically stronger for the low- and moderate-risk groups. Limitations include concerns about the generalizability of these results beyond the rural and small-town setting of this study, the general lack of psychometrics for the measures used, and attrition.

Length of controlled postintervention follow-up: Unclear – follow-up was in the spring of 8th grade, after administration of the 8th-grade lessons.

Orlando, M., Ellickson, P., McCaffrey, D., & Longshore, D. (2005). Mediation analysis of a school-based drug prevention program: Effects of Project ALERT. Prevention Science, 6(1), 35-46. https://doi.org/10.1007/s11121-005-1251-z

Type of Study: Randomized controlled trial
Number of Participants: 4,277

Population:

• Age — 7th grade (approximately 11-13 years)
• Race/Ethnicity — 14% non-White students (primarily Native American)
• Gender — 50% Female and 50% Male
• Status — Participants were 7th graders in middle schools in South Dakota.

Location/Institution: South Dakota

Summary: (To include basic study design, measures, results, and notable limitations)
[This study used the same sample as Ellickson, P. L., McCaffrey, D. F., Ghosh-Dastidar, B., & Longshore, D. L. (2003)]. This study used mediation analyses to examine the mechanisms by which Project ALERT, a social-influence-based school drug use prevention program, achieved its effects on past month cigarette use and alcohol misuse. Measures at baseline and 1 year later on included past month cigarette use and alcohol misuse, as well as cigarette- and alcohol-related mediating variables targeted by the Project ALERT curriculum (i.e., resistance self-efficacy positive and negative beliefs about use, and peer influence). Results indicated for cigarettes showed that all hypothesized mediating variables were significant mediators of Project ALERT's effect on intentions to smoke and past month cigarette use, with peer influence being the strongest. Results for alcohol point to positive beliefs about the consequences of drinking as an important mediator for alcohol misuse. Limitations include small differences between the treatment and control groups at baseline, concerns about the generalizability of the results from primarily White and Native American students from a Midwestern state to students in other locations and with more diverse backgrounds, and the lack of longer-term follow-up.

Length of controlled postintervention follow-up: Unclear – follow-up was in the spring of 8th grade, after administration of the 8th-grade lessons.

St Pierre, T. L., Osgood, D. W., Mincemoyer, C. C., Kaltreider, D. L., & Kauh, T. J. (2005). Results of an independent evaluation of Project ALERT delivered in schools by Cooperative Extension. Prevention Science, 6(4), 305-317. https://doi.org/10.1007/s11121-005-0015-0

Type of Study: Randomized controlled trial
Number of Participants: 1,649

Population:

• Age — 7th grade (approximately 11-13 years)
• Race/Ethnicity — 81.4% Caucasian, 5.4% African American, 2.2% Native American, 1.3% Hispanic, 1.1% Asian American, and 8.5% "Other"
• Gender — 50.5% Male
• Status — Participants were seventh graders at eight Pennsylvania middle schools.

Location/Institution: Eight Pennsylvania middle schools

Summary: (To include basic study design, measures, results, and notable limitations)
This study report results of an independent effectiveness study of the Project ALERT drug prevention program implemented by outside program leaders employed by Cooperative Extension (as opposed to school teachers). Classrooms in each school were randomly assigned to one of three conditions: (1) adult-led Project ALERT; (2) adult-led, teen-assisted Project ALERT; or (3) a control group. Measures were developed by Project ALERT and included a pretest and four waves of posttests over the 2-year program and 1-year follow-up. Analyses failed to yield any positive effects for substance use or mediators for use in the adult or teen-assisted delivery of the Project ALERT curriculum. An extensive set of additional analyses detected no differential program effects by student risk level, gender, school, or level of implementation quality. Limitations include the lack of a comparison condition that involved teacher-delivered Project ALERT.

Length of controlled postintervention follow-up: Approximately 12 months.