Evaluation of the Smart Talk: Cannabis Awareness and Prevention Curriculum

Stanford University, Stanford CA

Investigators

Linked publications, trials & patents

Abstract

Project Summary/Abstract Cannabis is the most widely used illicit drug among adolescents ages 14 -18 in the United States. Research demonstrates cannabis use is not harmless, especially given that the adolescent brain is particularly susceptible to dependence, and due to cannabis-related risks to the lungs, increased risk for depression, and decreased academic performance. Despite these health risks, since the mid-2000s, adolescents’ perceived risk of cannabis use has declined, and adolescents’ approval of cannabis use has increased. To date, very few comprehensive programs addressing adolescents’ misperceptions and knowledge about cannabis and preventing and reducing the use of all cannabis products have been developed, evaluated, or widely disseminated throughout the U.S. To address this gap, using a community-based participatory research approach in which we included a large group of adolescents and young adults, parents, educators, and healthcare providers with expertise in addiction medicine, we developed the “Smart Talk: Cannabis Prevention & Awareness” (Smart Talk) curriculum, which includes 5 lessons focused on health and environmental affects of cannabis, marketing, stress and coping, and refusal skills. Aligning with the NIH Stage Model for Behavioral Intervention Development, and through an NIH R34 grant in which we conducted a pilot randomized control trial with six schools, we have addressed 3 of the 6 stages needed to adequately develop, evaluate, refine, and fully implement and disseminate our Smart Talk curriculum. Our next step is to conduct a full evaluation to determine the real-world efficacy and effectiveness of the Curriculum (Stages III-IV), to determine for whom the Curriculum is most and least effective, and to further implement and disseminate the Curriculum (Stage V). As such, using a cluster-randomized trial, stepped-wedge design, with 30 middle and 30 high schools in California and New York (n=10,800 students), the Specific Aims of this proposed project are to: (1) Determine whether the Smart Talk Curriculum is effective in increasing adolescents’ knowledge of the different forms of cannabis and resistance to using and decreasing their positive attitudes towards and intentions to use cannabis products; (2) Determine whether the Smart Talk Curriculum is effective in changing adolescents’ actual use of different forms of cannabis (including preventing initiation, continuation, escalation; encouraging decreased use and cessation; and reducing co-use of cannabis and tobacco use); and (3) Examine the heterogenous treatment effects (HTE) of the intervention, identifying both those who benefit the most and those who do not benefit from the curriculum. The timing of this proposed research is extremely important given the rates of cannabis use in adolescence, legalization of cannabis across the country, and need for comprehensive cannabis education and prevention programs. Already we have hundreds of schools implementing Smart Talk, so determining the real-world effects of the curriculum and revising the curriculum as needed will further address the needs of schools and adolescents.