Wagner 2000b.
Methods |
Study design: controlled before‐after study (independent samples) Sampling frame: ninth and twelfth graders from public and private schools where at least 50% of enrolled students resided in the community Sampling method: all available students from schools implementing the intervention Collection method: school‐based self administered questionnaire Description of the community coalition: The 11 grantees of the Community Health Promotion Grant Program were expected to establish coalitions that encompassed a broad spectrum of community agencies and organizations. Sponsoring agency for the coalition at this site (“Community I”) was a county mental health center; no further site‐specific information on coalition composition or structure is reported |
|
Participants |
Communities: Native American reservation Country: USA Ages included in assessment: adolescents (age range not provided) Reasons provided for selection of intervention community: not reported Intervention community (population size): Native American reservation (4149) Comparison community (population size): Native American reservation plus 2 other rural communities (population size not reported) |
|
Interventions |
Name of intervention: Henry J. Kaiser Family Foundation’s Community Health Promotion Grants Program Theory: not reported Aim: to address suicide and substance abuse among Native American teens Description of costs and resources: $150,000 per year from Kaiser Family Foundation plus any external funding or in‐kind donations the program could obtain (total funding not reported by community; overall average = $237,000 per year per site total) Components of the intervention: school‐based training; peer counseling programs; drug‐free activities; family resource center; community education activities; improvement in law enforcement Start date: 1987 Duration: 5 years |
|
Outcomes |
Outcomes and measures
Time points: baseline (1988) and follow‐up (1992) |
|
Notes | Because the 11 grantee communities had different populations, interventions, and evaluation study designs, and because the evaluation was stratified by site, the 2 communities with a minority target group and complete evaluation results are presented as separate studies (see Wagner 2000a) Funding source: Kaiser Foundation |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | High risk | Not randomized |
Allocation concealment (selection bias) | High risk | No allocation concealment |
Baseline outcome measurement similar | High risk | Baseline rates of substance abuse much higher in intervention community |
Baseline characteristics similar | Unclear risk | Baseline characteristics not presented |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | School‐based surveys in 9th and 12th grades |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Independent cross‐sectional samples imply no attrition; response rates not given by site or survey time |
Blinding of participants and personnel (performance bias) All outcomes | High risk | No blinding |
Protection against contamination | Unclear risk | Portion of control population drawn from same area as target population, but different ethnic group |
Selective reporting (reporting bias) | Unclear risk | Only 2 major substance abuse outcomes reported |