1. Promoting Positive Youth Development, Health, and Well-Being through Life Skills Training
Christopher Williams, Ph.D.
Pamela Werb, MEd
National Health Promotion Associates
This product is supported by Florida Department of Children and Families Substance Abuse and Mental Health Program Office funding.

2. Overview Background Theory and Description Effectiveness
Potential for Educational Outcomes
Botvin LifeSkills Training
Implementation Considerations
Q & A

3. Background

5. Priority Health-Risk Behaviors Monitored by CDC (YRBSS)
Behaviors that contribute to the leading causes of mortality and morbidity
Tobacco use
Alcohol and other drug use
Motor vehicle accidents
Other unintentional injuries
Violence (Suicide, Homicide)
Sexual behaviors
Unhealthy dietary behaviors
Inadequate physical activity
The YRBSS monitors priority health-risk behaviors that contribute to the leading causes of morbidity and mortality among youth and adults: unintentional injuries and violence, tobacco use, alcohol and other drug use, sexual behaviors, unhealthy dietary behaviors and, inadequate physical activity. The YRBSS also monitors two health outcomes: obesity and asthma. 5

6. Prevention Science Advances in Etiology and Prevention
Multiple health behaviors
Toward a unified field
Convergence
Similar etiologic factors and course
Shared methods and theories
Similar effective approaches

7. Institute Of Medicine Classification: Continuum of Care
Use of the term “prevention” is reserved for interventions occurring prior to the onset of a disorder. UNIVERSAL prevention focus on the general population. SELECTIVE prevention targets specific high risk groups or subsets of the general population. INDICATED prevention is for individuals showing early warning signs of a disorder.

8. Early Prevention Efforts: Ineffective
Health Information
Scare Tactics
School Assembly Programs
Ineffective
Drug information programs increased use in some studies
Ineffectiveness of information-based approaches: Elmquist, 1995; Hanson, 1992; Moskowitz, Results of some studies (e.g., Tobler, 1986) indicated that providing drug information can actually increase drug use.

9. Evidence-Based Approaches
Tested and Proven Effective
Well-Designed (Randomized Control Trials)
Carefully Executed
Rigorous Research Methods
Appropriate Data Analysis
Published in Peer-Reviewed Journal
One or More Replications

10. Substance Use Behavior
Etiology Studies Show Hypothesized Mediating Variables Associated with Adolescent Substance Use
Assertiveness
Refusal skills
Decision-making
Problem-solving skills _
Substance Use Behavior
Peer substance use
Perceived norms
Social anxiety
Risk-taking
Positive drug expectancies +

11. Intervention Effects Observed on Key Hypothesized Mediating Variables
Assertiveness
Refusal skills
Decision-making
Problem-solving skills
Locus of control +
Life Skills Training _
Peer substance use
Perceived norms
Social anxiety
Risk-taking
Positive drug expectancies

12. Life Skills Training: Conceptual Model and Brief Description

13. Model of Adolescent Drug Use and Focus of LST Program
Socio-
Cultural
Personal
Competence
Skills
Risk and
Protective
Factors
Family
Social
Competence
Skills
Drug Use
Social
Environment
Drug
Resistance
Skills/
Cognitions
Life
Skills
Training
Contextual
Factors
Individual
Factors

14. Life Skills Training Major Components
Personal Competence
Social Competence
Resistance Skills, Attitudes and Norms

15. Personal Competence Skills
Problem-Solving and Decision-Making
Personal Behavior Change Skills
Stress and Anxiety Management

16. Social Competence Skills
Communication Skills
Greetings and Brief Social Exchanges
Meeting New People
Conversational Skills
Complimenting Skills
Assertive Skills

17. Resistance Skills/Norms
Awareness of Drug Use Influences
Anti-Drug Use Norms
Resistance Skills
LST teaches the skills, attitudes, and norms necessary to resist pressures to engage in unhealthy behaviors such as tobacco, alcohol, or illicit drug use.

18. Effectiveness

19. Evidence of Effectiveness
Over 30 Peer-Reviewed Studies
Short, Intermediate, and Long-term
Majority and Minority Youth
Tobacco
Alcohol and Illicit Drug Use
Other Health Outcomes
Independent Replication
Cost Benefit of LST: Steve Aos, Washington State; Mark Greenberg, Penn State; Dick Spoth, U of Iowa 19

21. Methodological Issues
RCT: Cluster Randomization
Validity of Self Report
IDs for Tracking Individual Students
Pretest Equivalence
Differential Attrition/Data Loss
Appropriate Analysis (ICCs, Covariates)
GEE, Mixed Model GLM, GLM with School as Unit of Analysis

24. Short-Term Effects

25. Life Skills Training Short-Term Effects LST Control 30 25 20
Percent Using Monthly 15 10 5
Tobacco*
Alcohol**
Marijuana***
Source: *Botvin et al. (1982), ** Botvin, Baker et al. (1984), *** Botvin, Baker, Renick et al.(1984).

26. Source: *Botvin et al. (1983), ** Botvin et al. (1990)
Life Skills Training
Booster Effects
Source: *Botvin et al. (1983), ** Botvin et al. (1990) 5 10 15 20
Percent Using Weekly
Tobacco*
Marijuana**
LST + Booster
LST
Control

27. Long-Term Effects:
5 Years (Grade 12)

28. Life Skills Training Long-Term Effects: Smoking LST Control 30 25 20
28% Reduction
LST
Control 30 25
29% Reduction 20
20% Reduction
Percent Using
21% Reduction 15 10 5
Weekly Smoking*
Weekly Smoking**
Daily Smoking*
Daily Smoking**
(White Sample)
(Minority Sample)
(White Sample)
(Minority Sample)
Source: *Botvin et al. (1995), ** Botvin et al. (2004)

29. Life Skills Training
Long-Term Effects: Gateway Poly-drug Use & Illicit Drug Use
25% Reduction
LST
Control 30
38% Reduction 25 20
Percent Using 15
56% Reduction
50% Reduction 10 5
Polydrug Use*
Narcotics**
Hallucinogens**
Illicit Drug Use**
(Weekly)
(Lifetime)
(Lifetime)
(Lifetime)
Source: *Botvin et al. (1995), ** Botvin et al. (2000)

30. Life Skills Training Binge Drinking (Botvin et al., 2001)
Binge drinking – 5+ drinks in a row.
Reduced binge drinking by 50% or more.

31. Long-Term Effects:
5 Years (Grade 12)

32. Violence and Delinquency
Source: Botvin et al., Preventing youth violence and delinquency through a universal school-based prevention approach. Prevention Science, 2006

33. Long-Term Follow-Up:
12 Years (Young Adult)
Illicit Drug Use

34. Research Design Grade 7th 8th 9th 10th 12th Young Adult Follow-Up LST
O X O
X O O
Controls
O O
Note:
X = preventive intervention (LST)
O = observation point (self-report survey)
Mean age of sample = 24

35. Long-Term Follow-Up by Condition

36. Long-Term Follow-Up by Condition

37. Potential Educational Outcomes
Attendance, Engagement, and Commitment
Safe, Supportive Learning Environment
Ability to Handle Academic Pressures
Pro-social Engagement with Teachers and Peers
Promotion of Social and Emotional Learning
Better Choices In and Out of Classroom
By preventing problem behaviors and providing students with the skills needed to remain resilient and succeed in the face of new challenges, LST can contribute to a sense of mastery that enhances school bonding, engagement, commitment, and attendance.
When students feel safe, they can learn better and thrive. LST can help create and reinforce a safe and accepting school environment.
LST can help students handle school pressure by promoting greater self-esteem and self-confidence through goal-setting and self-monitoring, and by helping students learn the skills to effectively cope with stress and anxiety.
Students do not learn alone but rather in collaboration with their teachers and other students. Youth with good social skills are better prepared for learning, are able to ask their teachers for assistance with academic and personal problems, and can elicit and provide social support from peers. By promoting social skills, LST can enhance a student’s ability to interact with others in the process of learning, increasing academic competence over time.
Schools play an important role not only in teaching cognitive academic skills but also in fostering social and emotional development. However, schools have limited resources and are increasingly concerned with academic outcomes. LST can enhance social and emotional skills, in addition to preventing several problem behaviors. Thus, LST is an efficient way to teach students a variety of important skills, promote positive youth development, and decrease multiple problem behaviors.
LST teaches students the necessary skills to resist peer and media pressure to engage in unhealthy behaviors. Through in-class activities and behavioral homework assignments, LST can give students the skills to make better decisions and solve problems. Youth who learn these skills are likely to make more appropriate choices in and out of school which, in turn, supports academic success.

38. Q & A

39. Break

40. What is Botvin LifeSkills Training?

41. Self-Management Skills
Personal
Self-Management Skills
General
Social Skills
Resistance
Skills

42. Program Providers Health Educators Prevention Specialists Peer Leaders
Teachers

43. Teaching Methods Facilitate Discussion Teach Skills
Provide Reinforcement
Provide Opportunities for Skills Practice

44. What is the age range for LST?
Ages
The Botvin LifeSkills Training evidence-based approach spans multiple age groups. Materials are adapted for age and developmental appropriateness.

45. Sessions per Level Level Grade Level # of sessions Duration Elementary
3rd
8 sessions
45 – 50 mins
Level 2
4th
Level 3
5th
Middle School Level 1
6th
15 core + 3 optional
Middle School Level 2
7th
10 core + 2 optional
Middle School Level 3
8th
5 core + 4 optional
High School
9th or 10th
10 sessions
Transitions
11th or 12th
6 sessions

46. Elementary Program Content by Grade/Level
Topic
L1: 3rd/4th
L2: 4th/5th
L3: 5th/6th
Self-Esteem 1
Decision-Making
Smoking Information
Advertising
Dealing with Stress
Communication Skills
Social Skills
Assertiveness
Total Class Periods 8

47. Middle School Program Structure & Content By Grade/Level
Middle School UNITS
L1: 6th/7th
L2: 7th/8th
L3: 8th/9th
Self-Image & Self-Improvement 1
Decision-Making 2
Substance Use / Drug Abuse 4
Advertising/ Media Influences
Violence and the Media
Coping with Anxiety
Coping with Anger
Communication Skills
Social Skills
Conflict Resolution
Assertiveness
Resisting Peer Pressure
Total Class Periods
15/18
10/12
5/9

48. High School Program Content
Unit
Skills
# of Lessons
1. Understanding Prevention
Personal Self Management 1
2. Decision Making for Health
3. Drug Use and Risk Taking
Drug Resistance
4. Health in Media and Culture 2
5. Managing Stress and Anger
6. Family Communications
General Social
7. Building Healthy Relationships
Total Class Periods
7 Units / 10 Lessons

49. Transitions Program Content
UNIT
COMPETENCY DOMAIN
1. Goal Setting for Success
Personal Self Management Skill
2. Effective Communication
General Social / Social Environment Skill
3. Managing Stress
4. Decision Making and Risk
Personal Self Management / Social Environment Skill
5. Managing Time and Money
6. Building Relationships
Personal / General Social / Social Environment Skills
TRAINER NOTES
INSTRUCTIONS
Review the scope and sequence of the program.
Define fidelity as delivering the full scope and sequence of the program as it has been designed.
Ask for and respond to questions about scope, sequence, implementation and fidelity.
POINTS TO MAKE
Best outcomes of the program are achieved when it is delivered with fidelity to program scope and sequence, teaching methods and content.
PROGRAM FIDELITY:
Teach the lessons in order at least one time per week in consecutive weeks, allow 45 – 50 minutes per lesson and deliver all of the activities in the lesson. 49 49

50. Skills Training
Instruction Demonstration Behavior Rehearsal Feedback Reinforcement Extended Practice

51. Teaching Skills

52. What are the fidelity guidelines?
Best results are achieved with provider fidelity
Teach the full scope and sequence
Teach the units in order
Teach at least 1 X week. Can be taught more than one time per week if needed.
Use interactive teaching techniques
Teach the booster sessions
Optimum fidelity is achieved through planning with participation of stakeholders

53. Is implementation fidelity important?
YES!
There are different ways to monitor fidelity using checklists.
Peer observation and feedback
Self-monitoring and assessment
The LST fidelity checklists help providers:
Review key lesson points and instructional objectives during preparation
Identify areas that can be challenging
Focus on important lesson goals and objectives
Receive specific feedback on their ability to adhere to the lesson plan

54. Is there digital support for instruction?
Yes. There are digital support slides to help enrich learning and focus participants attention on key concepts, vocabulary, and lesson points.
The LST Digital Support Slides help providers:
Utilize available technology in the classroom
Highlight critical vocabulary and concepts prior to skills practice
Summarize essential information from each lesson
In addition, many of the program levels have optional CD ROMs or companion websites. These can aide to increase practice outside of the lesson and reinforce concepts when not in class.

55. LST Session Support Slides Each level and each unit
Designed to bring attention to:
Lesson goals and objectives
Key vocabulary and definitions
Important summary points
Available for Middle School
HS and Transitions (2014)

56. LST: Summary Over 30 Peer-Reviewed Studies
White, African-American, and Latino Youth
Sizeable and Sustained Effects
ATOD, Meth, Violence, Risky Driving
Replication by Other Researchers
$25 Benefit for Each $1 Spent
Potential Educational Outcomes

57. Recognition of Excellence
Recognized for excellence and quality by:
U.S. Department of Education
U.S. Justice Department, Office of Juvenile Justice Delinquency and Prevention (OJJDP)
Blueprints Model Program
National Institute on Drug Abuse
White House Office on National Drug Control Policy
DOJ Office of Justice Programs

58. Conclusions LST = strong and lasting effects Widely Used
All 50 States in US
32 Countries Worldwide
Approaches targeting school, family, and community offer greatest potential
Promote sustained use of proven approaches
Develop prevention infrastructure

59. Q & A

60. Contact us: National Health Promotion Associates
Botvin LifeSkills Training
TEL: (914)
IN FLORIDA
Mr. Andrew Martin (FL Regional Coordinator)
TEL: (786)

61. Thank You!