Investigators: Wilkie Wilson, Desiree Murray, Leslie Babinski, Cindy Kuhn and Tim Strauman

Adolescent students face a myriad of opportunities and challenges that involve the brain.  Proper brain function is critical for academic accomplishment and extracurricular excellence.  However, schools rarely teach information specifically on the brain and the lifestyles and behaviors that enable optimal brain function.  Students are often unaware that the adolescent brain is still developing and that their behaviors, particularly use of alcohol and marijuana, can influence this development to produce life-long difficulties. We therefore are developing a high-school level course that would teach the role of the brain in supporting life and physical performance, the basic neuroscience of motivation and learning, the importance of brain health to brain function, and activities including substance use that degrade brain performance. In order to enhance the adoption and sustainability of such a course, intervention development will occur in local high schools and our curriculum will meet current national and North Carolina standards.  We are targeting 9th graders because developmentally they are at the peak of numerous risk behaviors and because a semester of health education is required for high school graduation, and is typically taken at this grade level.

The goals of the present project were to 1) evaluate pre-pilot data collected on 5 curriculum lessons administered in December, 2009, 2) revise these lessons based upon this experience, and 3) conduct a small, randomized controlled trial of the revised lessons to evaluate their feasibility and collect preliminary efficacy data with regard to student knowledge, beliefs and attitudes.

This pilot project addresses Aim 2 of the Administrative, Theory and Prevention Core in that it tests novel hypotheses about translating basic science to substance use prevention and the feasibility of conducting a larger study with strong potential for external funding.  It also has multi-disciplinary collaboration across basic neuroscientists, psychologists, and educators.

During this time period, we examined de-identified data collected by Wake County personnel during pre-piloting of five 90-minute curriculum lessons conducted with 3 ninth-grade classes (approximately 150 students) at Wakefield High School in December, 2009.  Data included student and teacher knowledge about brain function, risks, and development and student report on how their behavior might change as a result of participating in the curriculum.  Based upon this data as well as the experience of the teacher implementing the lessons, extensive revisions were made to the curriculum to enhance student engagement, acceptability, and the alignment of the lessons with desired outcomes.

We then conducted a randomized controlled trial of the 5 revised curriculum lessons in Lee County.  Four health education teachers from two high schools were trained to implement the lessons and delivered them to their classes randomized to intervention (vs. wait-list) during late May, 2011.  We collected written feedback from teachers evaluating the ½ day training they completed as well as their perceptions of each lesson’s feasibility, and completed semi-structured individual interviews with each teacher about the implementation and perceived impact of the lessons which were audio-recorded and transcribed.  Fidelity was assessed with 2 observations of each teacher conducting lessons, and observer ratings of student interest and engagement were collected.

We obtained written parent consent for 132 students to participate, reflecting a 68% consent rate which provides a very good representation of 9th graders in health education classes in the county.  Students completed questionnaires before and after the lessons assessing curriculum knowledge, theory of brain abilities, effort beliefs, and risk attitudes and beliefs.  They also participated in focus groups to assess their satisfaction and engagement in the curriculum and perceptions of how it may impact their beliefs and attitudes towards learning and substance use.  These groups were also audio-recorded and transcribed.  We also collected data on their implementation of a daily experiential activity (cup and ball catch) designed to enhance effort beliefs.  All quantitative data has been entered into a database that was developed with the assistance of staff from the Data Core.  Coding of qualitative data is ongoing.

The Wake county pre-pilot data analyzed had significant limitations that precluded meaningful interpretation of any benefits students may have gained. However, that experience did inform the design of the current pilot and curriculum revisions; namely, we reduced the difficulty level of some content, provided more visual and interactive learning activities, and provided instructional guidance to make the information more meaningful to students.

Given the brief time period of this project, outcome data are not yet analyzed.  However, strong evidence of feasibility is provided by 4 teachers with variable years of experience having successfully implemented the 5 day curriculum with largely positive feedback regarding its implementation.  Moreover, the lessons were considered by the teachers to have addressed the objectives well and to be related to other topics delivered in their health education classes.  Student engagement was variable across different parts of the curriculum and across different types of students and classes; this is an area we will continue to address.  In sum, valuable information was obtained regarding the content and methods of the curriculum that will inform expansion of the curriculum from 5 lessons to a full semester course.  Analysis of data collected will also allow us to refine our theoretical model, curriculum, and measures, and to evaluate the impact of the curriculum on students’ attitudes and beliefs related to substance use.

Results will be used to provide support for resubmission of a Goal 2 Development grant to the Institute of Educational Sciences in September, 2011. The primary goal of this grant will be to develop the curriculum into a full semester class after revising the 5 lessons in the curriculum based on pilot findings. We are also pursuing other sources of non-federal funding for this planned development work.

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