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Intervention Summary

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SODAS City

SODAS City, a self-instructional software program for preadolescents and adolescents, is designed to help prevent participants' current and future use of alcohol and other substances, as well as the problems associated with this use. The SODAS acronym reflects the five-step problem-solving sequence that composes the central element of the program:

  • Stop--stop and think about the problem you are facing
  • Options--generate options for solving the problem
  • Decide--decide on the best option
  • Act--act in accordance with your decision
  • Self-praise--give self-praise for acting correctly

The City component of the name reflects the urban context for the problem situations featured in the program. These situations are simulated through a series of adventures, games, and puzzles, which cover the topics of peer pressure, social norms and influences, self-efficacy, coping with pressure, assertiveness, refusal responses, stress reduction, relaxation, and social supports. The participant maneuvers through each situation by applying the five-step problem-solving sequence.

Based on social learning theory, SODAS City is delivered through 10 initial sessions (30-40 minutes each) and 5 optional annual booster sessions (20-30 minutes each) that review previously delivered material and introduce new, developmentally indexed material with topics such as dating situations, increased amounts of discretionary time, and alcohol use risks occasioned by college attendance, military service, and independent living. The software program is provided on CD-ROM, and the participant's parent, teacher, or counselor can implement the program with a computer at home, in school, or in a community center, respectively.

In the research reviewed for this summary, SODAS City was used by participants who were ages 10-12 at the start of the study and 17-19 at the end of the study.

Descriptive Information

Areas of Interest Mental health promotion
Substance abuse prevention
Outcomes Review Date: October 2012
1: Alcohol, cigarette, and marijuana use
2: Heavy or binge drinking
3: Refusal skills for drugs and alcohol
4: Number of friends who drank alcohol
5: Intentions to drink
Outcome Categories Alcohol
Drugs
Social functioning
Tobacco
Ages 6-12 (Childhood)
Genders Male
Female
Races/Ethnicities Black or African American
Hispanic or Latino
White
Race/ethnicity unspecified
Settings Home
School
Other community settings
Geographic Locations Urban
Suburban
Implementation History SODAS City was first implemented in 2001 in a group randomized trial conducted by investigators from Columbia University in New York City. It has been implemented once in Delaware, New Jersey, and New York, and approximately 370 children have received the program.
NIH Funding/CER Studies Partially/fully funded by National Institutes of Health: Yes
Evaluated in comparative effectiveness research studies: Yes
Adaptations No population- or culture-specific adaptations of the intervention were identified by the developer.
Adverse Effects No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories Selective
Indicated

Quality of Research
Review Date: October 2012

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

Schinke, S. P., Schwinn, T. M., Di Noia, J., & Cole, K. C. (2004). Reducing the risks of alcohol use among urban youth: Three-year effects of a computer-based intervention with and without parent involvement. Journal of Studies on Alcohol, 65(4), 443-449.  Pub Med icon

Schinke, S. P., Schwinn, T. M., & Fang, L. (2010). Longitudinal outcomes of an alcohol abuse prevention program for urban adolescents. Journal of Adolescent Health, 46(5), 451-457.  Pub Med icon

Schwinn, T. M., & Schinke, S. P. (2010). Preventing alcohol use among late adolescent urban youth: 6-year results from a computer-based intervention. Journal of Studies on Alcohol and Drugs, 71(4), 535-538.  Pub Med icon

Outcomes

Outcome 1: Alcohol, cigarette, and marijuana use
Description of Measures Alcohol, cigarette, and marijuana use was measured with questions adapted from the American Drug and Alcohol Survey, the Youth Risk Behavior Survey, and the Monitoring the Future survey. Each participant responded to questions regarding his or her use of alcohol, cigarettes, and marijuana in the past month (e.g., "In the past month, how many times have you had a drink of beer or alcohol?").
Key Findings Children were recruited by community-based agencies to participate in a long-term study. Sites were randomly assigned to one of three study conditions: (1) SODAS City, in which the participating children received the program on CD-ROM; (2) SODAS City plus parent, in which the participating children received the program on CD-ROM and their parents received printed materials and videos providing instruction on how they could enhance the program for their children; and (3) control, in which the participating children received assessments only. In addition, children in the SODAS City group or the SODAS City plus parent group also received the program's annual booster sessions, which consisted of additional program materials delivered by CD-ROM or online; parents who had received materials also received annual booster sessions. All participating children were assessed at pre- and posttest and at annual follow-ups beginning 1 year after the posttest; parents were not assessed. Pretest assessments occurred at the community-based agency, and posttest and follow-up assessments occurred by phone or online. Findings were reported from the pre- and posttest and the 3-, 6-, and 7-year follow-ups.

At pretest, past-month alcohol, cigarette, and marijuana use among children in the three study conditions did not differ significantly.

At posttest:

  • Compared with children in the control group, those in the SODAS City group and SODAS City plus parent group had lower past-month alcohol, cigarette, and marijuana use (p < .05 for each).
  • There were no significant differences in past-month alcohol, cigarette, and marijuana use between children in the SODAS City group and children in the SODAS City plus parent group.
At the 3-year follow-up:

  • Compared with children in the control group, those in the SODAS City group and SODAS City plus parent group had lower past-month alcohol, cigarette, and marijuana use (p < .05 for each).
  • Compared with children in the SODAS City group, those in the SODAS City plus parent group had lower past-month alcohol use (p < .05).
  • There were no significant differences in past-month cigarette and marijuana use between children in the SODAS City group and children in the SODAS City plus parent group.
At the 6-year follow-up:

  • Compared with children in the control group and children in the SODAS City group, those in the SODAS City plus parent group had lower past-month cigarette use (p < .05 for each).
  • There were no significant differences in past-month alcohol, cigarette, and marijuana use between children in the SODAS City group and children in the control group.
  • There were no significant differences in past-month alcohol and marijuana use between children in the SODAS City plus parent group and children in the control group.
  • There also were no significant differences in past-month alcohol and marijuana use between children in the SODAS City group and children in the SODAS City plus parent group.
At the 7-year follow-up:

  • Compared with children in the control group, those in the SODAS City group had lower past-month alcohol and cigarette use (p < .05 for each), and those in the SODAS City plus parent group had lower past-month alcohol use (p < .05).
  • There were no significant differences in past-month marijuana use between children in the SODAS City group or SODAS City plus parent group and children in the control group.
  • There were no significant differences in past-month alcohol, cigarette, and marijuana use between children in the SODAS City group and children in the SODAS City plus parent group.
Over the 7-year study period:

  • Past-month alcohol use increased in all groups, but the increase was largest for children in the control group and smallest for children in the SODAS City plus parent group (p < .001).
  • Past-month cigarette use increased in all groups, but the increase was largest for children in the control group and smallest for children in the SODAS City group (p < .001).
  • Past-month marijuana use increased in all groups, but the increase was largest for children in the SODAS City plus parent group and smallest for children in the SODAS City group (p < .001).
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.1 (0.0-4.0 scale)
Outcome 2: Heavy or binge drinking
Description of Measures Heavy or binge drinking in the past month (i.e., 30 days) was measured using a question adapted from the Youth Risk Behavior Survey and the Monitoring the Future survey: "During the past 30 days, on how many days did you have 5 or more drinks of alcohol in a row, that is, within a couple of hours?"
Key Findings Children were recruited by community-based agencies to participate in a long-term study. Sites were randomly assigned to one of three study conditions: (1) SODAS City, in which the participating children received the program on CD-ROM; (2) SODAS City plus parent, in which the participating children received the program on CD-ROM and their parents received printed materials and videos providing instruction on how they could enhance the program for their children; and (3) control, in which the participating children received assessments only. In addition, children in the SODAS City group or the SODAS City plus parent group also received the program's annual booster sessions, which consisted of additional program materials delivered by CD-ROM or online; parents who had received materials also received annual booster sessions. All participating children were assessed at pre- and posttest and at annual follow-ups beginning 1 year after the posttest; parents were not assessed. Pretest assessments occurred at the community-based agency, and posttest and follow-up assessments occurred by phone or online. Findings were reported from the pretest and the 6- and 7-year follow-ups.

Compared with children in the control group, those in the SODAS City group and SODAS City plus parent group had lower past-month heavy or binge drinking at the 6-year (p < .01) and 7-year (p < .05) follow-ups, after controlling for the past-month heavy or binge drinking reported at pretest and other potential confounding factors (i.e., gender, parent marital status, family income, parent education). There were no significant differences in past-month heavy or binge drinking between children in the SODAS City group and children in the SODAS City plus parent group at either the 6- or 7-year follow-up.

Over the 7-year study period, past-month heavy or binge drinking increased in all groups, but the increase was largest for children in the control group and smallest for children in the SODAS City plus parent group (p < .05).
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.1 (0.0-4.0 scale)
Outcome 3: Refusal skills for drugs and alcohol
Description of Measures Refusal skills for drugs and alcohol were assessed (1) with items that measured the ease with which the respondent thought he or she could refuse a close friend's offers to drink alcohol and use drugs and (2) with questions, adapted from the American Drug and Alcohol Survey and the Youth Risk Behavior Survey, that measured the extent to which the respondent's peers attempted to influence his or her drinking.
Key Findings Children were recruited by community-based agencies to participate in a long-term study. Sites were randomly assigned to one of three study conditions: (1) SODAS City, in which the participating children received the program on CD-ROM; (2) SODAS City plus parent, in which the participating children received the program on CD-ROM and their parents received printed materials and videos providing instruction on how they could enhance the program for their children; and (3) control, in which the participating children received assessments only. In addition, children in the SODAS City group or the SODAS City plus parent group also received the program's annual booster sessions, which consisted of additional program materials delivered by CD-ROM or online; parents who had received materials also received annual booster sessions. All participating children were assessed at pre- and posttest and at annual follow-ups beginning 1 year after the posttest; parents were not assessed. Pretest assessments occurred at the community-based agency, and posttest and follow-up assessments occurred by phone or online. Findings were reported from the pretest and the 6- and 7-year follow-ups.

Compared with children in the control group, those in the SODAS City group and SODAS City plus parent group had better refusal skills for drugs and alcohol at the 6-year (p < .05) and 7-year (p < .05) follow-ups, after controlling for pretest scores and other potential confounding factors (i.e., gender, parent marital status, family income, parent education). There were no significant differences in refusal skills for drugs and alcohol between children in the SODAS City group and children in the SODAS City plus parent group at either the 6- or 7-year follow-up.

Over the 7-year study period, refusal skills declined in all groups, but the decline was largest for children in the control group and smallest for children in the SODAS City group (p < .05).
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.1 (0.0-4.0 scale)
Outcome 4: Number of friends who drank alcohol
Description of Measures The number of friends who drank alcohol were assessed with two measures:

  • At pretest, participants responded to questions adapted from the Youth Risk Behavior Survey and the American Drug and Alcohol Survey regarding the number of their closest friends who drank alcohol.
  • At all other assessments, using a scale ranging from 1 (none) to 6 (all), participants responded to the Models for Drug Use Scale regarding how many of their friends used alcohol at least once per week.
Key Findings Children were recruited by community-based agencies to participate in a long-term study. Sites were randomly assigned to one of three study conditions: (1) SODAS City, in which the participating children received the program on CD-ROM; (2) SODAS City plus parent, in which the participating children received the program on CD-ROM and their parents received printed materials and videos providing instruction on how they could enhance the program for their children; and (3) control, in which the participating children received assessments only. In addition, children in the SODAS City group or the SODAS City plus parent group also received the program's annual booster sessions, which consisted of additional program materials delivered by CD-ROM or online; parents who had received materials also received annual booster sessions. All participating children were assessed at pre- and posttest and at annual follow-ups beginning 1 year after the posttest; parents were not assessed. Pretest assessments occurred at the community-based agency, and posttest and follow-up assessments occurred by phone or online. Findings were reported from the pretest and the 6- and 7-year follow-ups.

Compared with children in the control group, the number of friends who drank alcohol was lower among children in the SODAS City group and SODAS City plus parent group at the 7-year follow-up (p < .05), after controlling for pretest scores and other potential confounding factors (i.e., gender, parent marital status, family income, parent education). There were no significant differences in the number of friends who drank alcohol between children in the SODAS City group and children in the SODAS City plus parent group at either the 6- or 7-year follow-up. At the 6-year follow-up, there were no significant differences among any of the groups.

Over the 7-year study period, the number of friends who drank alcohol increased in all groups, but the increase was largest for children in the control group and smallest for children in the SODAS City group (p < .05).
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.1 (0.0-4.0 scale)
Outcome 5: Intentions to drink
Description of Measures Intentions to drink were assessed using 4 questions from the Commitment To Not Use Drugs Scale regarding the strength of the respondent's resolve to not use alcohol (e.g., "I have made a promise to myself that I will not drink alcohol," "I plan to get drunk sometime in the next year").
Key Findings Children were recruited by community-based agencies to participate in a long-term study. Sites were randomly assigned to one of three study conditions: (1) SODAS City, in which the participating children received the program on CD-ROM; (2) SODAS City plus parent, in which the participating children received the program on CD-ROM and their parents received printed materials and videos providing instruction on how they could enhance the program for their children; and (3) control, in which the participating children received assessments only. In addition, children in the SODAS City group or the SODAS City plus parent group also received the program's annual booster sessions, which consisted of additional program materials delivered by CD-ROM or online; parents who had received materials also received annual booster sessions. All participating children were assessed at pre- and posttest and at annual follow-ups beginning 1 year after the posttest; parents were not assessed. Pretest assessments occurred at the community-based agency, and posttest and follow-up assessments occurred by phone or online. Findings were reported from the pretest and the 7-year follow-up.

Compared with children in the control group, intentions to drink were lower for children in the SODAS City group and SODAS City plus parent group at the 7-year follow-up (p < .05), after controlling for pretest scores and other potential confounding factors (i.e., gender, parent marital status, family income, parent education). There was no significant difference in intentions to drink between children in the SODAS City group and children in the SODAS City plus parent group at the 7-year follow-up.

Over the 7-year study period, intentions to drink increased in all groups, but the increase was largest for children in the control group and smallest for children in the SODAS City group (p < .05).
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.1 (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) 51.4% Female
48.6% Male
54% Black or African American
30% Hispanic or Latino
11% White
5% Race/ethnicity unspecified

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: Alcohol, cigarette, and marijuana use 4.0 3.3 3.0 2.5 2.4 3.5 3.1
2: Heavy or binge drinking 4.0 3.3 3.0 2.4 2.4 3.5 3.1
3: Refusal skills for drugs and alcohol 4.0 3.3 3.0 2.4 2.4 3.5 3.1
4: Number of friends who drank alcohol 4.0 3.3 3.0 2.4 2.4 3.5 3.1
5: Intentions to drink 4.0 3.3 3.0 2.4 2.4 3.5 3.1

Study Strengths

The instruments were adapted from source materials with strong psychometric properties. The use of a computerized delivery system, which tracked what materials were accessed by participants and when, permitted the investigators to conduct careful assessments of intervention fidelity from a quantitative perspective. Random assignment and analytical adjustment provided some control for confounding factors. The analytical methods used were appropriate and well executed.

Study Weaknesses

Study instruments made up of portions of other questionnaires were not validated in the form in which they were used. Although the investigators were able to track participants' access of materials, they were not able to assess whether participants viewed all of the content of the materials or how long participants read the content. Attrition over the 7 years of follow-up assessments was moderate. The way in which the study population was recruited introduced the potential for confounding variables. Random assignment at the agency level, rather than from one central list, may have permitted variability across groups.

Readiness for Dissemination
Review Date: October 2012

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.

Columbia University School of Social Work. (n.d.). Assertiveness: A SODAS City booster [CD-ROM]. New York, NY: Static & Motion.

Columbia University School of Social Work. (n.d.). Mongoose's party: A review session [CD-ROM]. New York, NY: Static & Motion.

Indirect Pressures: A SODAS City Booster [CD-ROM]

Spinetta's Weekend [CD-ROM]

Thinking Not Drinking: A SODAS City Adventure. Episodes 0-9: Version 3.0 [CD-ROM]

What Is SODAS Anyway?: A SODAS City Booster [CD-ROM]

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
3.0 2.3 2.0 2.4

Dissemination Strengths

The content of the program is arranged in a logical order throughout the 10 computer-based sessions. The program engages participants through creative situations and tasks, and the characters in the program are appealing and represent the target population. Booster sessions are available, which introduce new age-appropriate material and reinforce previously delivered content. Although training is available for implementers, it is not required because of the program's automated nature. Brief participant quizzes are embedded at the end of each session and can be used to support quality assurance.

Dissemination Weaknesses

Loading the software from CD-ROM and navigating the program "city" may be difficult. Although the characters provide instructions to participants throughout the sessions, no written instructions or guidance is available to direct implementers. No materials are available to assess the format, content, or quality of the optional training. It is unclear how implementers access implementation materials or training services, as no online or written dissemination resource is available. No quality assurance materials or protocols are in place to support outcome or fidelity monitoring.

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
Thinking Not Drinking: A SODAS City Adventure (initial sessions software on CD-ROM) $20 per child Yes
Assertiveness, Mongoose's Party, What Is SODAS Anyway?, Indirect Pressures, and Spinetta's Weekend (booster sessions software on CD-ROM) Included in the initial sessions software cost No
4-hour, on-site training $1,000 plus travel expenses No
1-hour, online training Free No
Replications

No replications were identified by the developer.

Contact Information

To learn more about implementation, contact:
Jamison Monroe
(949) 887-0242
jamison@goodlife-learning.com

To learn more about research, contact:
Steven Schinke, Ph.D.
(212) 851-2276
schinke@columbia.edu

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