Benefits of community-based demonstration efforts: Knowledge gained in substance abuse prevention

Prospective studies document that preventive interventions can reduce the p revalence of substance abuse and antisocial behavior. In contrast, the just ification for community-based demonstrations in substance abuse prevention and mental health promotion assumes that communities have decided to invest in prevention and now wish to learn from the experience of others on how t he value of this investment can be maximized. The expectation has been that demonstration grants can be applied to improve substance abuse prevention efforts operated under State and community auspices. A review of selected K nowledge gains from community-based demonstration programs for substance ab use prevention provides evidence for the position that communities have bot h benefited from and contributed to this type of knowledge development proc ess on questions of the cost and effectiveness of specific categories of pr evention activities, the timing and duration of interventions, and factors affecting implementation. Of these, the most rigorously-confirmed findings are: (I) that the transmission of generic life skills is associated with sh ort-term reductions in substance abuse among adolescents; (2) that activiti es that improve self-esteem do not consistently affect adolescent substance abuse; and (3) that preventive interventions conducted among pregnant wome n motivated to participate produce net financial savings in hospital costs. (C) 2000 John Wiley & Sons, Inc.