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2.0 LITERATURE REVIEW

2.1 Aims

The literature review aims were to:

• Identify and review published research evidence regarding the effectiveness of drug education in schools.
• Identify recommendations regarding the theoretical bases, approaches, content, methods, format and curricula associated with effective drug education in schools.
• Summarise indicators which can be used to evaluate the effectiveness of current drug education in schools.

2.2 Methods

The search and review methods were thorough and comprehensive but not systematic, as time and resource constraints did not permit the use of systematic review procedures.

A series of preliminary searches were carried out to give an insight into the types of literature available and to help refine the searching strategy. Following these preliminary searches, a systematic search method was adopted for all the electronic databases (see Table A2.1 below).

Table A2.1: Electronic Databases Searched

The original evaluation plan also proposed searching CINAHL, a database of nursing and allied health literature. However, we were not able to gain access rights to the database through local universities' libraries or through the National Library of Scotland. From information available about the CINAHL database, it covers twenty-one 'substance use disorders' journals, all but three of which are indexed in three of the databases listed above (Ingenta, PubMED, Sociological Abstracts). It also includes five 'school health' journals; four of which are indexed in several of the databases above. The small number of journals listed on CINAHL that are not covered by other databases do not appear to be peer-reviewed and are along the lines of weekly/quarterly newsletters. A brief search of the article titles and abstracts on the websites of these journals did not provide anything relevant to this review. Therefore it was felt justified not to search CINAHL.

Three tailored Boolean searches were carried out using the following search terms:

1. drug* AND school AND (education OR prevention)
2. "substance use" AND school AND (education OR prevention)
3. (alcohol OR tobacco) AND school AND (education OR prevention)

Where possible, limits to English Language and Human Subjects. were used in the databases to narrow the relevancy of the citations lists returned. The Cochrane Database of Systematic Reviews was also searched for other relevant literature reviews.

The returned citation list (in title and abstract form, or just title if abstracts not available) was printed for each search. This yielded over 800 citations containing the key terms. There was a huge amount of overlap in the results. As there is an obvious similarity between the three search strings (as well as overlap between the databases themselves) the same citation may appear in each of the three searches per database. A set of exclusion and inclusion criteria were then developed to help filter the citations. Citations were excluded:

• if the programme was not based in a primary or secondary school (or equivalent ages outside the UK);
• if the article only described the development, content or theoretical basis of the programme as opposed to reporting original research conducted to evaluate the programme;
• if no indication of sample size was provided, or the study had a weak methodology;
• if the article reported data from the intervention evaluation to explore something other than the impact of the intervention (eg. to explore the relationship between drug use or attitudinal variables but not to examine the impact of the programme);
• if the article was an opinion piece reporting no empirical research or containing no substantial review of the literature;
• if the article was published before 1980. This criterion was applied because it was judged that the bulk of relevant work has been conducted since 1980; pre-1980 studies are in any case covered thoroughly in early systematic reviews.

Dissertation abstracts were also excluded as time and resource constraints did not allow for their retrieval.

Included in the citation collection were:

• evaluations of drug education and prevention programmes based in schools or with a school-based component;
• systematic reviews and meta-analyses;
• non-systematic reviews of literature;
• discussion pieces and guides to good practice based on substantial reviews of the literature or empirical research (eg. studies of experts' views on effectiveness in drug education);

The inclusion/exclusion criteria detailed above were applied in order to sift out non-relevant citations. The remaining studies were then obtained in full text and read to assess their relevance to the review.

In addition to the electronic database searches, the bibliographies of retrieved studies were scanned for further relevant articles. Articles judged to be of relevance to the review were also retrieved from in-house files.

Grey literature, including evaluations and empirical studies, reviews and guidance documents, has been retrieved from the websites of organisations judged to be relevant to the review and from in-house files. Relevant organisations have included the Effective Interventions Unit, Learning and Teaching Scotland, Drugs Prevention Advisory Service (now part of Drugs.gov.uk), TACADE, HM Inspectorate of Education, and NIDA and SAMHSA in the USA.

In total, 302 studies, reports and other documents were included in the review.

Findings from the Literature Review have been reported separately and are not included in this document.

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