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Educational Intervention
School-based educational fetal alcohol syndrome (FAS) prevention curriculum for Native adolescents.
The intervention was an education-based fetal alcohol syndrome (FAS) prevention program for Native American adolescents, grades 6 through 8. Formative work included conducting a needs assessment to identify risk factors and best approaches to early prevention intervention in Native American middle school children. A 19-session curriculum was developed that consisted of culturally-appropriate educational materials including lectures, research projects, experiential learning activities, and class discussions. The curriculum was accompanied by a videotape, project flyer, and informational program brochures.
Outcomes
Beneficial changes in knowledge and attitudes were documented.
The intervention had a positive influence on knowledge and attitudes. Changes in knowledge were greater than changes in attitudes. There was a mixed level of change; the ranges were 7.0% to 48.2% for change in knowledge and 5.4% to 30.3% for change in attitude. No tests of statistical significance of differences were reported.
Costs
Moderate initial costs associated with intervention development followed by lower ongoing costs.
Start-up costs would include development of an educational curriculum, video, print materials, and training of prevention facilitators. If not incorporated into a school’s existing curriculum, this intervention could be expensive to maintain. It would require funds to pay salaries of intervention facilitators and renting of school space.
Cultural Engagment
Cultural elements were incorporated into the curriculum. No Tribal engagement was described.
Professionals, who were not members or leaders of the community, participated in the initial needs assessment. There was no Native youth input in the development of the curriculum. Native American cultural elements were reportedly integrated into the prevention materials, but no details were provided.
Participants
Adolescent; Native; Female, Male
Setting
School
Delivery
Medium Group
Randomly selected students from two middle schools with high proportions of Native students.
Out of 90 randomly selected participants, 85 students completed pre- and post-evaluations. The intervention was conducted in two middle schools with high American Indian/Alaska Native enrollment, but it was unclear how many students were Native or non-Native.
Staffing Needs
Educator
Background and credentials of staff delivering the curriculum were not specified.
School-based delivery of the intervention suggests that educational staff delivered the curriculum. Credentials of those delivering intervention or level of education or training to deliver the intervention were not specified.
Research Design
Pre-/post-intervention data
Developmental stage of research
Limited, but promising, testing of this intervention supports an Early Stage of development.
The curriculum and video were tested in just two schools, indicating an early stage of development. Statistical significance of outcomes is not reported so inference must be made based upon wide-ranging percent change with no control/comparison condition. The evidence base could be improved by adding more follow-ups, including statements of statistical significance, and having a control group.
Potential
This school-based FAS prevention intervention has potential to be effective and transportable.
The study describes a promising educational program for early adolescent FAS prevention. The intervention appears transportable to different Native communities, but the content of the materials may need to be adjusted from region to region.
References
Ma GX, Toubbeh J, Cline J, Chisholm A. Fetal alcohol syndrome among Native American adolescents: A model prevention program. J Prim Prev.1998;19(1):43-55. https://link.springer.com/article/10.1023%2FA%3A1022665308526. https://doi.org/10.1023/A:1022665308526.
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