Sunday, May 5, 2013

D.A.R.E.’s Failure And Its Lack Of Integrating Social-Behavioral Theories Into Its Practice-Corey Benedum

If you were to do simple word association game with today’s twenty-somethings and were to use the word “D.A.R.E.” you would get a number of different responses. These responses would include “police officers,” “elementary school,” “drugs,” “the lion mascot,” and “just say no” among many other words. Now if you do the same word association game with researchers who investigated the efficacy of the program the words that would be associated would be quite different. The words associated would be “failure,” “no effect,” “flawed,” and “increased drug use.
Standing for Drug Abuse Resistance Education, the D.A.R.E. program was founded in 1983 in Los Angeles and has been implemented in 75 percent of the United States’ school districts as well as 43 other countries worldwide (1). The program was formed with the vision of joining local law enforcement and local schools together to educate students about the personal and social consequences of substance abuse and violence (1). D.A.R.E.’s objective is to present curricula for students k-12th grade with the central tenets being a “strong ‘NO USE’ message” (1).    
The program has further been touted as “successful” however, this is by its own website, and scientific research on the other hand, would politely disagree with this claim (1). In August of 1994, the journal Social Problems published an article critiquing the D.A.R.E. program, the first of many to come. This study examined the long-term effects of the program and came to the conclusion that “[their] quantitative and qualitative data both point in the direction of no long-term effect for the program in preventing or reducing adolescent drug use” (2). In the grand scheme of things, what does one study reveal about a program? There are plenty of explanations that could be called in to critique the study such as possible biases, poor study design, or even just an incorrect conclusion. Unfortunately for the D.A.R.E. program, this was just the beginning.
In 1999 in the Journal of Consulting and Clinical published another blow to the D.A.R.E. program. In their manuscript titled “Project D.A.R.E: No Effects at 10-year Follow Up,” Dr. Lynam and colleagues examined the impact of Project D.A.R.E 10 years post administration. According to their study, they determined that there were no beneficial effects associated with the D.A.R.E. program for measurement outcomes of actual drug use or attitudes toward drug use (3).
D.A.R.E. reached a point of such ineffectiveness that in 2001, the Office of the Surgeon General placed the program under the “Ineffective Prevention Program” list. Despite its popularity and what would seem like its ability to succeed why does this program continue to be found ineffective? Is it due to not enough money being spent on the program? Is it due kids just want to do drugs and cannot resist the appeal? Perhaps the officers who train the children within the program have no idea what they are doing? Despite some people most likely wanting to claim these as the true cause of the ineffectiveness, they are not. The reason that the program cannot succeed is quite simple, it’s flawed. D.A.R.E. fails to utilize theories from the social behavioral sciences.
The Flaws:
The Wrong Message by the Wrong People
            A characteristic of the D.A.R.E. program is a pledge taken by all of the participants. In this pledge the students proclaim that they will “just say no” (1). Though this may look great at first glance, who is truly making this decision? Are the students coming to the realization that they do not need nor want to take drugs, or are they having this message of “Do not do drugs” forced upon them?  According to the psychological reactance theory, when an instruction is viewed as a threat to one’s freedom, the individual will react in a manner of rebellion against that instruction (4). Unfortunately, this program instructs kids on what to do and how to behave through their core concepts of “just say no” and “don’t do drugs” which psychologically removes an aspect of freedom from these kids. The psychological reactance theory further implies that the person being instructed on what to do will not just flatly rebel but will rebel by doing the opposite of what they are being instructed to do (4). This also explains the increase in drug and tobacco use in a study performed by the state of texas (14). By analyzing the D.A.R.E. program strictly through the psychological reactance theory, the program is in reality pushing students to do drugs since the student’s freedom is being challenged. Furthermore, children are curious about what they are banned from doing and will attempt to seek it out. Due to being at a developmental stage in their life, they are not fully capable to consider and potentially understand the magnitude of the consequence of the choice that is being banned. Based upon the core values and beliefs of D.A.R.E., the psychological reactance theory is violated terribly, which helps explain the scientific evidence showing how drug use has increased among this population (5).
            Another issue stemming from not accounting for the psychological reactance theory is the use of police officers as leaders of the program. The use of police officers as leaders cause yet another threat to the student’s perceived sense of freedom. This is due to the fact that the officer may be viewed as someone who aside from telling them what to do and “taking away their choice,” the officer can actually arrest the student, potentially resulting in a complete loss of freedom (4). Furthermore, the stronger the message, the stronger the rebellion will typically be, and a message from a police officer is a very strong message (6). 
Framing the Wrong Way
A second flaw of the D.A.R.E. program is in the way that it frames its argument and attempts to sell its message in a way that does not yield results. D.A.R.E. developed their fundamental cores using the Health Belief Model Theory. This theory states that a person will adopt a health behavior when the person believes that they are susceptible to the outcome, and the outcome will have an impact upon their life (7). By applying this method of thought, D.A.R.E. attempts to sell the idea that youth are susceptible to drug use and abuse and this will have a significant negative impact on their lives. Despite sounding like a good idea, it truly is not, and here is why. The program is attempting to “sell health” when their friends and others, who are trying to get them to try drugs or alcohol, are selling “freedom,” “acceptance,” and “rebellion.” When presented with different frames, a person is then left to decide between the two, in this case, the youth must decide between these frames and unfortunately health does not sell based upon its rather weak strength as a frame (8).
Additionally, according to Marketing Theory the needs and wants of the consumer must be considered over what the consumer should want or what the consumer is believed to want (9, 10). What the youth want needs to be the driving factor behind the intervention as oppose to “do this because it is good for you.” Based upon this, D.A.R.E. is attempting to use health to win over youth when health is not their main priority. Rather youth are more concerned with “acceptance,” “cool,” “friendship,” and “freedom” which all of these they believe can be found through taking drugs and alcohol.
Overly Optimistic
            A final flaw within the D.A.R.E. program is its failure to account for optimistic bias within students. The Optimistic Bias Theory is defined as “the mistaken belief that one’s chances of experiencing a negative event are lower than that of one’s peers” (11). Based upon this theory, the students who are in the D.A.R.E. program, despite knowing that “drugs are bad” or “alcohol is bad” will believe that they are not as likely to happen to this. Therefore the statistics on addiction and other negative outcomes associated with drugs and alcohol will be brushed away since these children believe that they are immune to this outcomes. Furthermore, these students will believe that their own individual risk of having a negative outcome will be lower than the true risk is (12).

The Solutions:
Someone to relate too
            As mentioned earlier, a flaw within the program is that the message is being relayed to the students by the wrong type of person. Since officers inadvertently elicit a high level of reactance stemming from their power of authority a better person to communicate the message of the program would be someone that is relatable and who does not elicit reactance. In order to be relatable, the new speaker must have similarity with the students who are being taught. Additionally, similarity as well as not being an imposing authority figure will help decrease any reactance that the students may feel. Additionally, when students feel that they can relate to the speaker, they will be more open to discussing these sensitive subjects and feel more able to go to them for help (6). Based upon these criteria, the best candidate to be the mentor of this program will be other teenagers who are just a few years older. Another benefit of this is that teen speakers will be more able to convey the message that they were there and have gone through the pressure to use drugs and alcohol, as well as being able to offer the opinion that they didn’t use drugs and it worked out great for them and that they were accepted by their friends. Mentors who have used drugs and/or alcohol in the past can also be a useful tool. They can discuss their experience with it and communicate how bad this decision was for them. The use of teens will also address other issues within the program, the issue of optimistic bias. Since the story of the peer mentors will be more relatable than the message of an officer, it will be able to strike closer to home as opposed to just using statistics to try and “convince” students to not do drugs or alcohol. The stories that will be shared will be frank and demonstrate how drugs and alcohol either directly affected them or perhaps a friend or family member.
After fixing the delivery mechanism for the D.A.R.E. program, the next step would be to develop a message that is worthy of being delivered. The program needs to move away from the original message which creates reactance through the “stealing” of a perceived freedom and gravitate to a message of choosing to be drug free. This message should be focused on helping students choose for themselves that they will be drug and alcohol free. There are two reasons that this is optimal to outright telling the students “don’t do drugs.” The first is that this will minimize the formation of reactance on behalf of the students. This is achieved by guiding the student to the choice that they will be drug free as opposed to “taking away” that choice and telling the student what to do which results in reactance. The second is that this will create ownership between the students and their choice. Ownership is important because having made their own choice about drugs and alcohol, opposed to having it forced on them, they are more likely to choose to not do drugs and alcohol when they are in a situation when one or the other is being offered (9).
Sell Teens What They Want
            Using a health frame to counter frames of freedom and rebellion as mentioned previously is utterly pointless. The D.A.R.E. program must also focus meeting the needs of what students want. When considering these two aspects the primary words that come to mind are the following: “friends,” “acceptance,” “future,” “freedom,” and “rebellion.” Luckily, there are strong ties between most of these words and can thus meet the needs and wants of the students if framing is used correctly. By using a freedom frame D.A.R.E. can also address the desire for a level of rebellion that most youth want. By using this frame in a way to say get freedom from addiction and poor life choices the program will be on the way to winning them over. The next step would to then utilize the desire to be rebellious by directing that nature against drug dealers and put them in a light of only using youth to make money off them. The next step is to show that when you choose to not take drugs or drink, that you will be accepted and will continue to have friends. A way to do this is to develop friendship ties among the youth in the program who are choosing to not do drugs and alcohol. A similar program which has seen success is “The 84.” This Massachusetts anti-smoking program utilizes similar tactics that were previously outlined. The program focuses on rebelling against tobacco companies and then providing an environment of acceptance and friendship among those who are making a similar choice (13). Though this would call for a complete change in curriculum design for D.A.R.E. it would be changing to a format which has already been demonstrated to be a huge success.
Don’t Just tell Them, Show Them
            Since people tend to be overly optimistic about their own personal risk, it does not help to present people general statistics (14). Because of this, it is imperative for the improved D.A.R.E. program to not focus on the numbers but to find an alternative to reaching these youths. This alternative should be focused on telling stories which the students will be able to relate to, and the program should strive to get these story shares from similar backgrounds as the students to help maintain similarity, which as mentioned previously will increase relatability. For the stories that will be shared with the students, they should encompass a broad range of outcomes as well as maintain the core ideas from the improved message of rebelling against drugs, maintaining your freedom for your future and acceptance. These stories will show to the students that; yes addiction is possible no matter who you are or where you’re from, the consequences that can come from drug and alcohol abuse, and also the bad effects that it can have on your academic, personal, professional life, goals, and future. However, the stories should not focus on the negative consequences of drugs and alcohol, but also of the successes and benefits of being drug and alcohol free. These stories need to convey the idea that it’s ok to say no and that you will still maintain your friendships if that is the decision you make. By giving both the positive end of saying being drug free and the negative end of using drugs and alcohol, the students will feel more comfortable and happy in their choice to not use and abuse drugs and alcohol.
            Despite all the good will, helpful intensions, and hard work that has come out of the D.A.R.E. program it is quite evident that it has failed our youth. By not utilizing alternative theories of the social and behavioral sciences, D.A.R.E. has failed on three different planes, its message and the way it’s delivered, addressing what youth want, and making the message more relatable. D.A.R.E. must change the message change their message of “don’t” which elicits reactance by challenging someone’s freedom to one of helping students reach the conclusion not to abuse drugs and alcohol on their own. Since students will be making their own choice on the matter, they will take ownership over this choice and have a stronger foundation to handle peer pressure. In order to help students reach this decision, the message deliverer must also be changed from police officers to youth who are slightly older that the students can relate to. This will help create a dialogue between students and leaders in which an honest discussion about the benefits of being drug and alcohol free and how it compares to the dangers and consequences of not being so. Lastly, the message needs to move away from numbers and statistics to stories that hit closer to home to youth. Framing the message properly as well as sharing stories of success and failure will put a human face to what can happen as well. By integrating the principles and ideas behind marketing theory, psychological reactance theory, ownership and optimistic bias, D.A.R.E. can make significant strides in turning this failure of a program into one of success warranting of being modeled in other areas. Finally, despite having all these flaws the war for youth of this world is not over, but perhaps the tide of who is in control will change by utilizing these concepts.

1.    D.A.R.E. America. About D.A.R.E. Los Angeles. D.A.R.E. America
2.   Wysong, E., Aniskiewicz, R., & Wright, D. (1994). Truth and DARE: Tracking drug education to graduation and as symbolic politics. Social Problems, 41, 448–472Lynam, Donald R.; Milich, Richard; Zimmerman, Rick; Novak, Scott P.; Logan, T. K.; Martin, Catherine; Leukefeld, Carl; Clayton, Richard Journal of Consulting and Clinical Psychology, Vol 67(4), Aug 1999, 590-593. doi: 10.1037/0022-006X.67.4.590
3.   Burgoon, M., Alvaro, E., Grandpre, J. et al. Revisiting the Theory of Psychological Reactance (pp. 213-232). In: Dillard, JP. & Pfau, M. The Persuasion Handbook. Developments in Theory and Practice. Thousand Oaks, CA: Sage Publications, Inc., 2002.
4.   Marlatt, GA. & Witkiewitz, K. Harm reduction approaches to alcohol use: health promotion, prevention, and treatment. Addictive Behaviors 2000; 27:867-886.
5.    Siegel, M. Class Lecture. Social and Behavioral Sciences in Public Health. Boston University, Boston MA. April, 11 2013.
6.   Siegel, M. Class Lecture. Social and Behavioral Sciences in Public Health. Boston University, Boston MA. February 21, 2013.
7.   Siegel, M. Class Lecture. Social and Behavioral Sciences in Public Health. Boston University, Boston MA. January, 24 2013.
8.   Siegel, M. Class Lecture. Social and Behavioral Sciences in Public Health. Boston University, Boston MA. March, 7  & 21 2013.
9.   Grier S. and C. A. Bryant. Social Marketing in Public Health. Annual Review of Public Health 2005; 26:319-339.
10.       Klein. W. M. P.  Optimistic Bias National Cancer Institute
11.Weinstein article in reader
12.       The 84. Join the 84 Massachusetts The 84
13.       Siegel, M. Class Lecture. Social and Behavioral Sciences in Public Health. Boston University, Boston MA. April 25, 2013.
14.       Window on State Government. Evaluate State-Funded Drug Prevention Programs. State of Texas.

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