LifeSkills Training is a substance abuse prevention program proven effective by over 30 research studies. The curriculum was created by Dr. Gilbert Botvin, a health behavior and prevention expert. Teachers follow the LST curriculum to provide teens the skills and knowledge needed on to handle changing situations.
The Johns Hopkins Center for Adolescent Health (CAH) is taking big strides to build on the efforts of the already effective LifeSkills Training program by expanding the middle school curriculum to include new modules on sexual risk reduction. The Center began implementing LST and the new modules (LST+) at six Baltimore City public schools in 2014.
“We thought a good way to reach an awful lot of young people in the city would be to work in Baltimore City Schools. One way you can do that is by finding or creating evidence-based programs that fit within a normal school day, while meeting the state and city standards for health education,” said Meghan, the Center for Adolescent Health’s senior research program coordinator.
CAH was awarded funding from the Centers for Disease Control and Prevention for 2014-2019 to implement LST as its core research project. This project was designed to build on City Schools’ and Behavioral Health Systems Baltimore’s Sixth-Grade Expanded School Behavioral Health Initiative, which targets sixth graders at risk of dropping out. The initiative supports implementation of LST in small groups of sixth graders at 35 Baltimore City schools. However, CAH’s strategy focuses on universal implementation. In the project’s third year, all students in 6th-8th grades at the five schools participate in LST and at 3 of the schools, students participate in additional modules focused on sexual and reproductive health.
The additional modules on sexual and reproductive health students receive in 7th and 8th grade follow the same pedagogy and decision making model that is the core of LST. Meghan said what often happens is that there are several health programs, each on a specific risk behavior like smoking or alcohol misuse, in one school. “So young people may be learning three different ways to say ‘no’ to something rather than learning one technique and framework to apply [in] a lot of different health situations,” she said.
LST and the Center’s new modules (LST+) equip young people with skills on how to handle difficult situations related to drugs, alcohol, smoking, violence, and sexual activity. “The school administration itself decides whether it's going to be taught and how, like during the PE class or some schools do it as a part of their science curriculum,” said Courtney, a research assistant at CAH.
Asari trained new teachers who will implement the modified curriculum earlier in the fall. Asari, now a doctoral student at Johns Hopkins Bloomberg School of Public Health, previously implemented LST in schools and community centers in New York City as a Children’s Aid Society prevention specialist. While working for Children’s Aid Society, Asari attended the LifeSkills Training-of-Trainers workshop through National Health Promotion Associates, a research and development firm founded by Botvin.
As an evidence-based program, LST was meant to be taught exactly how the curriculum was written. When taught with fidelity, it has positive results for young people. “We don't really know what happens if a lot of changes start happening. We don’t know if it would be more effective or if it would actually detrimental to young people so the safest bet is to implement as closely as we can to how it was tested,” Meghan said.
To ensure LST is implemented with fidelity, teachers complete fidelity logs after each lesson to track how much material they covered, changes they made and why. Teachers are also observed at least once by CAH staff.
“As our funding cycle winds down, we'll be thinking more about sustainability and being able to continue with the schools,” Meghan said. By the end of the research project, CAH hopes to provide information about feasibility, implementation quality, and feedback from teachers and administrators to staff at other schools who are considering implementing the program. “Part of the way it's set up right now is to look for just feasibility of implementing LifeSkills at a universal level and feasibility and acceptance of the new modules. So the next steps will be to look more into impact,” she said.