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Intervention Summary

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PALS: Prevention through Alternative Learning Styles

PALS: Prevention through Alternative Learning Styles is an alcohol, tobacco, and other drugs (ATOD) prevention program primarily for middle school students. Goals of PALS include (1) lowering students' intentions to use ATOD, (2) increasing students' use of refusal skills, and (3) enhancing students' knowledge of the effects of ATOD, peer pressure and healthy decisionmaking, and different learning styles.

PALS is implemented through the use of interactive group activities, scientific laboratory demonstrations, videos, games, creative writing and art projects, and small group discussions. The PALS curriculum contains 5 units, presented in 10 lessons:

  • The first unit, Understanding Learning Styles and Differences, focuses on students' unique learning styles and raises awareness of disability issues and how they can be overcome.
  • The next three units, Effects of Alcohol, Effects of Tobacco, and Effects of Other Drugs, describe the effects of ATOD on the brain and body, with the goal of preventing or delaying the onset of use.
  • The fifth unit, Peer Pressure and Healthy Choices, describes the power of peer pressure, including the influence of media, and encourages the use of resistance strategies and healthy alternatives to ATOD use.

Additional, optional lessons, which reinforce the curriculum, are available online through the program Web site's section for students. The site also includes a peer mentoring program section with interactive features (e.g., games, presentations) that provide information on curriculum topics.

PALS can be implemented by PALS staff members or by teachers who receive the 1-day, on-site PALS training, which assists them in adapting classroom activities to meet the unique learning needs of all students, including those with disabilities.

Descriptive Information

Areas of Interest Mental health promotion
Substance abuse prevention
Outcomes Review Date: April 2011
1: Intentions to use ATOD
2: Knowledge of ATOD
3: Knowledge of peer pressure and healthy choices
4: Knowledge of learning styles
Outcome Categories Alcohol
Drugs
Tobacco
Ages 6-12 (Childhood)
13-17 (Adolescent)
Genders Male
Female
Races/Ethnicities American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
White
Race/ethnicity unspecified
Settings School
Geographic Locations Urban
Suburban
Implementation History PALS was first developed in 1992 as a training model for teachers of both special and regular education and for rehabilitation professionals. As PALS continued to grow in scope, PALS staff developed activities that were effective with a variety of populations, including people with various disabilities, and developed a curriculum that teachers could implement with their students. To date, more than 5,000 students and rehabilitation participants have received PALS.
NIH Funding/CER Studies Partially/fully funded by National Institutes of Health: No
Evaluated in comparative effectiveness research studies: No
Adaptations A subset of the PALS materials has been translated into Czech.
Adverse Effects No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories Universal
Selective

Quality of Research
Review Date: April 2011

Documents Reviewed

The documents below were reviewed for Quality of Research. The research point of contact can provide information regarding the studies reviewed and the availability of additional materials, including those from more recent studies that may have been conducted.

Study 1

Huber, M. J., Workman, J., Ford, J. A., Moore, D., & Mayer, T. (2009). Evaluating the Prevention through Alternative Learning Styles program. Journal of Drug Education, 39(3), 239-259.  Pub Med icon

Outcomes

Outcome 1: Intentions to use ATOD
Description of Measures Intentions to use ATOD were assessed using the PALS Questionnaire, a self-report survey that was modeled after the National Household Survey on Drug Abuse (NHSDA). Survey items were read out loud to students, who completed the survey before and after the intervention. The pretest survey contains 24 items (e.g., "After I turn 21, I will probably drink alcohol," "If friends offer to share alcohol with me, I will drink with them," "In high school, do you think you will use marijuana?"), and the posttest survey contains 26 items (the 24 pretest items and 2 additional items). Response options include multiple-choice, true-false, and yes-no formats.
Key Findings In year 1 of the study, 6th- through 8th-grade classrooms in six schools were randomized to the intervention group, which received PALS, or the control group, which received the school's traditional prevention program (i.e., information on decisionmaking, illegal drugs, environmental health, keyboarding, and food). From pre- to posttest, the number of students in the intervention group responding "yes" or "maybe" to questions regarding their intentions to use alcohol, tobacco, or other drugs decreased, and the number of students responding "no" increased (p = .001 for all three substances); data from students in the control group were not analyzed.

In year 2 of the study, all 6th- through 8th-grade students from five of the six original schools were offered PALS. From pre- to posttest, the number of students responding "yes" or "maybe" to questions regarding their intentions to use ATOD decreased, and the number of students responding "no" increased (p = .001 for alcohol and tobacco; p = .002 for other drugs).
Studies Measuring Outcome Study 1
Study Designs Quasi-experimental
Quality of Research Rating 2.4 (0.0-4.0 scale)
Outcome 2: Knowledge of ATOD
Description of Measures Knowledge of ATOD was assessed using the PALS Questionnaire, a self-report survey that was modeled after the NHSDA. Survey items were read out loud to students, who completed the survey before and after the intervention. The pretest survey contains 24 items (e.g., "One or two drinks of alcohol can make it hard to make good decisions," "If someone really wants to, it's pretty easy to quit smoking," "Can people become addicted to marijuana?"), and the posttest survey contains 26 items (the 24 pretest items and 2 additional items). Response options include multiple-choice, true-false, and yes-no formats.
Key Findings In year 1 of the study, 6th- through 8th-grade classrooms in six schools were randomized to the intervention group, which received PALS, or the control group, which received the school's traditional prevention program (i.e., information on decisionmaking, illegal drugs, environmental health, keyboarding, and food). At baseline, there were no significant differences between groups in regard to knowledge of ATOD. At posttest, compared with students in the control group, those in the intervention group had greater knowledge of alcohol (p < .001), tobacco (p < .001), and other drugs (p = .003).

In year 2 of the study, all 6th- through 8th-grade students from five of the six original schools were offered PALS. From pre- to posttest, these students had an increase in their knowledge of alcohol (p < .001), tobacco (p < .001), and other drugs (p < .002).
Studies Measuring Outcome Study 1
Study Designs Quasi-experimental
Quality of Research Rating 2.4 (0.0-4.0 scale)
Outcome 3: Knowledge of peer pressure and healthy choices
Description of Measures Knowledge of peer pressure and healthy choices was assessed using the PALS Questionnaire, a self-report survey that was modeled after the NHSDA. Survey items were read out loud to students, who completed the survey before and after the intervention. The pretest survey contains 24 items (e.g., "Advertisers on TV must tell everything about their products," "Some alcohol and tobacco advertisements are designed for children," "Which of the following is a healthy lifestyle choice?"), and the posttest survey contains 26 items (the 24 pretest items and 2 additional items). Response options include multiple-choice, true-false, and yes-no formats.
Key Findings In year 1 of the study, 6th- through 8th-grade classrooms in six schools were randomized to the intervention group, which received PALS, or the control group, which received the school's traditional prevention program (i.e., information on decisionmaking, illegal drugs, environmental health, keyboarding, and food). At baseline, there were no significant differences between groups in regard to knowledge of peer pressure and healthy choices. At posttest, compared with students in the control group, those in the intervention group had greater knowledge of peer pressure and healthy choices (p < .002).

In year 2 of the study, all 6th- through 8th-grade students from five of the six original schools were offered PALS. From pre- to posttest, these students had an increase in their knowledge of peer pressure and healthy choices (p < .001).
Studies Measuring Outcome Study 1
Study Designs Quasi-experimental
Quality of Research Rating 2.4 (0.0-4.0 scale)
Outcome 4: Knowledge of learning styles
Description of Measures Knowledge of learning styles was assessed using the PALS Questionnaire, a self-report survey that was modeled after the NHSDA. Survey items were read out loud to students, who completed the survey before and after the intervention. The pretest survey contains 24 items (e.g., "People with disabilities can have successful jobs, relationships, and a happy life," "There is more than one type of intelligence," "Some disabilities are hidden"), and the posttest survey contains 26 items (the 24 pretest items and 2 additional items). Response options include multiple-choice, true-false, and yes-no formats.
Key Findings In year 1 of the study, 6th- through 8th-grade classrooms in six schools were randomized to the intervention group, which received PALS, or the control group, which received the school's traditional prevention program (i.e., information on decisionmaking, illegal drugs, environmental health, keyboarding, and food). At baseline, there were no significant differences between groups in regard to knowledge of learning styles. At posttest, compared with students in the control group, those in the intervention group had greater knowledge of learning styles (p < .001).

In year 2 of the study, all 6th- through 8th-grade students from five of the six original schools were offered PALS. From pre- to posttest, these students had an increase in their knowledge of learning styles (p < .002).
Studies Measuring Outcome Study 1
Study Designs Quasi-experimental
Quality of Research Rating 2.4 (0.0-4.0 scale)

Study Populations

The following populations were identified in the studies reviewed for Quality of Research.

Study Age Gender Race/Ethnicity
Study 1 6-12 (Childhood)
13-17 (Adolescent)
52% Male
48% Female
65% White
17% Black or African American
12% Race/ethnicity unspecified
3% Asian
2% Hispanic or Latino
1% American Indian or Alaska Native

Quality of Research Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the Quality of Research for an intervention's reported results using six criteria:

  1. Reliability of measures
  2. Validity of measures
  3. Intervention fidelity
  4. Missing data and attrition
  5. Potential confounding variables
  6. Appropriateness of analysis

For more information about these criteria and the meaning of the ratings, see Quality of Research.

Outcome Reliability
of Measures
Validity
of Measures
Fidelity Missing
Data/Attrition
Confounding
Variables
Data
Analysis
Overall
Rating
1: Intentions to use ATOD 2.3 2.3 2.3 3.3 2.0 2.5 2.4
2: Knowledge of ATOD 2.3 2.3 2.3 3.3 2.0 2.5 2.4
3: Knowledge of peer pressure and healthy choices 2.3 2.3 2.3 3.3 2.0 2.5 2.4
4: Knowledge of learning styles 2.3 2.3 2.3 3.3 2.0 2.5 2.4

Study Strengths

The PALS Questionnaire has face validity. Teachers received initial and booster trainings to learn procedures for delivering PALS, followed a curriculum, and kept daily lesson logs to track the completion of each unit. Research staff visited classrooms and performed in-class monitoring to determine whether the materials were being presented as intended. Missing data were negligible for both years of the study. A quasi-experimental design was used during the first year of the study. The sample sizes for both years of the study were large, providing good statistical power.

Study Weaknesses

Despite the use of correlational analysis, evidence of the evaluation instrument's reliability is limited. Neither criterion validity nor construct validity was documented. Although there were strong efforts to establish and maintain intervention fidelity, there was a lack of a psychometrically sound fidelity instrument to monitor the quality of intervention delivery. The study did not adequately address threats to internal validity, including the possibility of selection bias and contamination. In year 2 of the study, no control group was used for comparison with the intervention group. For analyses of data from year 1 of the study, which compared intervention and control groups, the use of t-tests alone is limiting.

Readiness for Dissemination
Review Date: April 2011

Materials Reviewed

The materials below were reviewed for Readiness for Dissemination. The implementation point of contact can provide information regarding implementation of the intervention and the availability of additional, updated, or new materials.

PALS: Prevention through Alternative Learning Styles curriculum binder (2011)

Program Web site, http://pals.wright.edu/

Quality assurance tools:

  • Evaluating the PALS Program
  • Implementer Daily Lesson Log (PALS 2011) Units 1-5
  • Lesson Observation Forms (PALS 2011) Units 1-5
  • PALS Follow-Up Survey (2010-2011)
  • PALS Post-Survey (2010-2011)
  • PALS Pre-Survey (2010-2011)
  • Unit quizzes (five total; one per unit)

Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the intervention's Readiness for Dissemination using three criteria:

  1. Availability of implementation materials
  2. Availability of training and support resources
  3. Availability of quality assurance procedures

For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.

Implementation
Materials
Training and Support
Resources
Quality Assurance
Procedures
Overall
Rating
3.5 3.0 3.0 3.2

Dissemination Strengths

The PALS curriculum binder is well written, comprehensive, and easy to follow. The binder includes handouts for participants, supplementary videos, and PowerPoint presentations that assist with implementation. The program Web site provides electronic versions of the curriculum and other implementation materials, as well as activities for students and peer mentors. Training materials are comprehensive and well organized, and PALS staff are available for consultation and technical assistance. The implementer daily lesson logs include checklists to help ensure that all topics have been covered, key points have been addressed, and objectives have been met. Quality assurance is supported by pre- and posttests and follow-up surveys, which are accompanied by clear instructions on how measures should be administered and by whom.

Dissemination Weaknesses

Assistance is not provided for determining organizational readiness to implement the program. Detailed guidance is not provided for using the student and peer mentoring sections of the program Web site during implementation. Although PALS staff offer technical assistance, the program Web site and implementation materials do not include information on the availability of this technical assistance. Criteria for interpreting the implementer daily lesson logs are not provided. Little guidance is provided on what to do if program goals are not met or how to use data to improve program delivery.

Costs

The cost information below was provided by the developer. Although this cost information may have been updated by the developer since the time of review, it may not reflect the current costs or availability of items (including newly developed or discontinued items). The implementation point of contact can provide current information and discuss implementation requirements.

Item Description Cost Required by Developer
PALS curriculum binder (includes teacher scripts, lesson outlines, supply lists, unit quizzes, CD-ROM with PALS PowerPoint presentations, Smoking Lung and Mr. Grossmouth DVDs, implementer fact sheets and background information, quality assurance tools, and information for accessing the PALS Place Web site) $300 per binder Yes
PALS storybooks (Tommy Types Tips on Alcohol, A Little Mouse Told Me, and Tommy Digs Up the Dirt on Drugs) $5 per storybook or $125 for a set of 30 storybooks (10 of each storybook title or 30 of the same title) No
1-day, on-site training $3,000 for up to 20 people, plus travel expenses Yes
Booster training Cost varies depending on site needs No
Online training videos Included in cost of training No
Email assistance Included in cost of binder No
Telephone consultation Cost varies depending on site needs No
1-day, on-site consultation $1,500 plus travel expenses No
Replications

No replications were identified by the developer.

Contact Information

To learn more about implementation or research, contact:
Jo Ann Ford, M.R.C.
(937) 775-1452
jo.ford@wright.edu

Judson W. Workman, M.A., OCPS-I
(937) 775-1481
judson.workman@wright.edu

Consider these Questions to Ask (PDF, 54KB) as you explore the possible use of this intervention.

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