proposal

Research proposal
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Introduction

Purpose:

The purpose of this research project is to determine the most effective intervention for

adolescent drug and alcohol abuse in the United States. The research project will provide

information including statistics about drug and alcohol consumption among children in rural

areas verses the drug and alcohol consumption of children the inner cities of the United States.

This research project will determine the effectiveness of various alcohol prevention programs for

adolescents, and if there is a correlation between the quality of services that are offered in the

inner cities of the United States compared to those that reside in the rural areas of the nation.

This study involves children in the United States from the age of twelve through twenty. The

benefits of this research is to provide information that proves that the adolescents that live in

inner cities across the United States are more likely to abuse drugs and alcohol than adolescents

the live in rural areas across the nation. According to Clark, "Wilson and Donnermeyer (2006)

found that peer influence was a stronger influence on drug use among urban-located youths but

did not find any differences for family factors (Clark, 2011, p. 208)." This implies that there is

more drug and alcohol abuse for inner city adolescents.

Another purpose for this research is to determine if more drug and alcohol prevention

programs are needed in the inner cities of the United States verses the rural areas. Should inner

cities receive more funding than rural areas? This research project will also examine different

drug and alcohol prevention programs of methods available for adolescents in the United States.

We will measure our findings with the CRAFFT screening tool which is used to measure drug

and alcohol abuse for those that are 21 and under.

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Significance:

The social work profession seeks to determine vulnerable and/or oppressed populations

and help alleviate the symptoms of oppression for all individuals (NASW, 2008). The research

question presented in this paper seeks to determine a specific group of people suffering from

alcohol and drug abuse in South Carolina in the hopes that they may be better served and

understood. It is important to correctly determine a specific population that is at risk in order to

provide necessary services to them. This research question is relevant to the social work

profession in that it will determine a specific group of individuals, based on their environment,

that are potentially in need of an intervention and social services.

This topic is significant due to the fact that alcohol and drug abuse is a growing trend

among adolescents in America that poses serious health risks to themselves and those around

them. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), "more

than 190,000 people under the age of 21 visited the emergency room for alcohol related injuries

in 2008 alone" and the NIAAA also states that "every year in the United States, about 5,000

young people under the age of 21 die as a result of underage drinking" (NIAAA, 2013, p. 1-2). It

is crucial to determine specific areas where alcohol and drug abuse is prevalent among

adolescents so that we may better address their environment and potential causes for the abuse of

alcohol and drugs. If we can determine specific factors that contribute to the consumption of

alcohol and use of drugs among underage citizens then we can possess a better understanding of

how to address this issue.

The scope of this issue in our nation is very large. For this reason, we have narrowed our

research down to findings in South Carolina so that we may better address the issue in our local
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community. According to data from the Pacific Institute for Research and Evaluation (PIRE)

"approximately 169,000 underage customers in South Carolina drink each year" (PIRE, 2011, p.

1-2). It later states in this same data document that this rate of underage drinking in South

Carolina "leads to substantial harm due to traffic crashes, violent crime, property crime,

unintentional injury and risky sex" (PIRE, 2011, p. 2). The consumption of alcohol and use of

drugs among adolescents in South Carolina is a vast issue that affects the adolescents consuming

alcohol and using drugs and the people around them.

By addressing this issue in South Carolina and determining the environment that

contributes to the abuse of alcohol and drugs among adolescents, we may be able to better

provide necessary services to the environments at risk that can help to prevent this problem. By

answering this research question, we will have a better understanding of where to start when

determining who is most at risk for underage drinking and use of illegal substances in our state.

Once we know the areas that are most affected by this epidemic, proper social services can be

initiated or improved in order to correctly address this issue.

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Research Design ·

Description of the research design:

Research Question: Does the duration of adolescents living in an urban community in South

Carolina predict substance abuse scores on the T-ASI scale among adolescents?

Independent Variable: The duration of adolescents living in an urban community in South

Carolina. Meaning the number of adolescents that reside in an urban setting as opposed to a rural

setting. We will measure the independent variable by distributing the T-ASI survey to 50

adolescent in each of the 46 counties in South Carolina. The survey will include an indication of

the participant’s geographic environment – this will determine whether the fact that they are

living in an urban or rural setting has anything to do with the results of the survey.

Dependent Variable: The scores that indicate substance abuse on the T-ASI scale. These scores

will give s a clearer picture of whether adolescents are using illegal substances. We will

determine the dependent variable by the answers that the participant’s provide on the T-ASI

scale, which is an indicator of substance abuse for adolescents.

Hypothesis: The duration of urban residential status of adolescents in South Carolina

significantly predicts positive substance abuse scores on the T-ASI scale.

Sampling Technique: The sampling technique for this research is a stratified random sample of

2,300 adolescents from each of the 46 counties in South Carolina since the population that s to be

tested will be separated into different strata and random samples will be taken from each

subpopulation. Twenty-five adolescents in a urban community and twenty-five within a rural

community will be selected from each county making each county have 50 adolescents as
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representation. With this sampling method we would randomly select adolescents from urban

and rural public schools.

Method of Data Analysis: The method for data analysis in this research design is regression

since we are trying to identify the relationship between the residential status of adolescents and

the scores of adolescents on the ADI scale in order to make predictions.

Tool: A survey would be administered to the adolescents and include the question of how long

they were a resident of their location at the time of the survey. This survey would also determine

whether the adolescent’s location is urban or rural. To measure the dependent variable of

substance abuse the Adolescent Diagnostic Interview would be used. “The T-ASI systematically

assesses psychoactive substance use disorders in 12- to 18-year-olds. Based on DSM-III-R

criteria, this convenient structured interview also evaluates psychosocial stressors, school and

interpersonal functioning, and cognitive impairment. In addition, it screens for specific problems

commonly associated with substance abuse" (Kaminer, Y., Burkstein, O.G. & Tarter, R.E.,

1991).

Method of Data Collection: We will distribute this survey to public schools in South Carolina

in person. All persons distributing the survey will be IRB certified in order to conduct proper

research. The participants and their parents will be informed that everything on the survey will

remain completely confidential and only used for the purposes of research. Participants may also

choose to stop the survey at any time or keep their results from being used in research if they

change their minds.

Cultural Sensitivity: We will be distributing this survey to all adolescents (ages 12-20) willing

to participate regardless of their race, class, or gender. Being IRB certified, we are fully aware,
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as researchers, the need to be culturally sensitive and respectful of every participant’s

background in order to obtain unbiased research.

Reliability and Validity: The T-ASI scale itself has been tested for reliability and validity.

According to Kaminer, Y., Burkstein, O.G. & Tarter, R.E. (1991), the measures of reliability that

were used for this scale are test-retest and interrator agreement and internal consistency. The

measures of validity of this scale are content and construct.

Strengths and weaknesses including threats to internal validity:

A threat to the internal validity of this design is the fact that adolescents can be dishonest

about the use of drugs and alcohol out of fear of getting in trouble. In an attempt to eliminate this

weakness, a strength of this survey is that it will remain confidential and will only taken for the

purposes of research. The participants will be informed of their confidentiality when completing

this assessment.

Another threat to the validity of this scale is that it is dated since it was published in

19931 The reliability of this measure will increase if it is given on a yearly basis so that it may be

sensitive to time changes.

A strength of this assessment that reduces this threat to validity is that it can be repeated

or expanded as necessary. For example, you can test up to as many random participants as

necessary between any urban or rural location in South Carolina in order to obtain a better

knowledge of the use of illegal substances among adolescents across the whole state.

Explain why this research design is the best option:

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We feel that this research design will be the best option due to the fact that we will be

able to proportionately observe the amount of substance abuse that is taking place between two

distinct geographic environments in order to predict the relationship between environment and

substance abuse among adolescents living in the state of South Carolina.

Conceptual Model:

SEE APPENDIX A

This logic model is the theoretical framework for our research design. Obviously there

are many factors that can contribute to the use of alcohol and drugs among adolescents other than

geographic location, and it is important to look into the bigger picture of what is happening. This

is why we have designed a logic model in order to observe the different factors that contribute to

our dependent variable. Once we are able to observe the flow of factors contributing to the

problem that we are observing, we can design and observe programs that will better fit the

situation and gain a broader and clearer perspective of the use of drugs and alcohol among

adolescents living in South Carolina.

Literature Review

The goal of the literature review is to summarize research findings on adolescent alcohol

and drug use in rural and urban communities. Another goal is to apply theories to the research

findings to give a frame of reference. The effort to divide the literature into sections will show

recognition of the different key concepts that are present and should be acknowledged in a study

that focuses both on adolescent substance abuse and the adolescents’ environment. The

independent variable in the research is the duration of time of where the adolescent is residing is

defined as being either urban or rural. Theories applied from our research are the social

disorganization theory and social learning theory. “Social disorganization theory asserts that
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negative behavior is more likely in environments that lack structure and social control (Nasim,

A., Fernander, A., Townsend, T. G., Corona, R., & Belgrave, F. Z., 2011).” Social learning

theory is the concept of learning a certain behavior by observing others and was created by

Albert Bandura.

Adolescent Drug and Alcohol Abuse/Dependent Variable

In our research the life stage of adolescent is defined as anyone ranging from age twelve

to twenty-one. The independent variable of substance abuse is defined by the National Institute

on Drug Abuse as any illicit use of a substance as drug abuse. Drug abuse also includes the

nonmedical use of prescription drugs. Social risk factors are the most prevalent causes of

adolescent substance abuse according to authors Kaylen and Pridemore. “Factors such as

poverty, economic and residential instability, family disruption, and community violence leave

youth vulnerable for engaging in risky behaviors, including substance use and abuse (Kaylen, M.

T., & Pridemore, W.,2011).” Family conflict and the relationship between the parent and

adolescent are key factors resulting in involvement in substance abuse. “Family risk factors

include inadequate parental supervision, poor communication, family tension and conflicts,

inconsistent or unduly severe parental discipline, broken homes, and family history of parental

alcohol or drug abuse (Kaylen, 2011).” One author stated that families might differ in

communication, sanctions, and involvement based on their geographic location. For example

families in more rural areas my be more involved with their adolescent children and concerned

about staying within the normative bounds of behavior as prescribed by their specific community

(Rioux, A. R., & Hollist, D. R. 2010). According to the literature parents do not know how

common substance abuse is among adolescents. Family structure, such as a two parents or single

parent seem to have strong influences on whether an adolescent engages in substance abuse as
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well. Those who had two parents were less likely abuse alcohol or drugs according to the

research.

Individual risk factors are also predominant when determining why adolescents involve

themselves in risky behaviors. Some of these factors include history aggressive behavior; history

of physical or sexual abuse, emotional, social, or academic difficulties, impulsivity, unstable

emotions, and low perception of the dangers inherent in drug use (Ali, S., Mouton, C. P., Jabeen,

S., Ofoemezie, E., Bailey, R. K., Shahid, M., & Zeng, Q. 2011). Other important risk factors

include low socioeconomic status, living in a high crime and drug-use neighborhood, drug

availability, peer pressure, level of education and history of mental illness.

Adolescent Substance Abuse and Theory

Peer influence was also a predominant factor for adolescent substance abuse within the

literature. “Social learning theory suggests that the likelihood of substance use will be high in

those situations where the perceived rewards associated with the practice are high and the costs

associated with substance use are low. Thus, substance use is part of a learning process where

youths learn the benefits and punishments both indirectly through observing the reactions to the

use of others and directly through their interactions with others and others favorable or

unfavorable reactions to their own use (Rioux, 2010).” This theory is related back to dependent

variable of substance because based on the adolescents community they will learn certain norms

including drug use. The literature emphasized how positive adult influences decreased the

chances of adolescence being involved in risky behaviors.

To relate back to the independent variable of location in our research we used the social

disorganization theory. In a study with social disorganization theory it stated that more affluent
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areas, neighborhoods with high rates of poverty are likely to have higher rates of violence, more

unemployed residents, more visible displays of crime, cultural norms more favorable to deviance

and more commercial access to alcohol and tobacco. “Social disorganization theories emphasize

that youth delinquency is not equally distributed across communities but rather is clustered in

more disadvantaged areas (Pinchevsky, G. M., Fagan, A., & Wright, E., 2010).”

Environmental Influences: Rural vs. Urban/ Independent Variable

The most widely debated factor in the literature was whether living in a rural community

or urban community influenced adolescents to engage in substance abuse. According to the

National Center on Addiction and Substance Abuse, the rate of drug, alcohol and nicotine use

among teens in rural America is now higher than in the nation’s larger centers. “Adjacency of

rural to urban areas is important because of the influence that urban areas may have on rural

areas in terms of increasing the supply of drugs, providing educational and economic

opportunities, and promoting cultural influences (Lambert, D., Gale, J. A., & Hartley, D. 2008).”

Discussion:

Program Description:

The proposed program preceding our study will be a drug and alcohol educational

program for South Carolinas public schools.

The services provided in the proposed program are to include alcohol and substance

abuse prevention programming for adolescents in the communities found to be most at risk in

South Carolina. This will take the form of classes/seminars provided for grade schools and in

local community centers, and maybe even a designated alcohol and drug type counselor/social
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worker placed in each school in at-risk areas that are accessible for children living in at-risk

environments. A primary factor of the use of alcohol and drugs among adolescents is a lack of

substance abuse education or support in certain areas of South Carolina. By eliminating this

factor, we will be able to, hopefully, greatly decrease the effects of this issue.

The characteristics of clients served will include the characteristics of the population

addressed in the research question: between the ages of 12 and 20, living in South Carolina, and

residing in the environment which proves to promote a higher use of alcohol and drug abuse

(either rural or inner-city areas. Basically, this means that programming will be promoted in the

area that turns out to need it the most for adolescents in South Carolina who are both abusing

alcohol and drugs or at risk for abusing alcohol and drugs.

Ideally, these services will be provided through government funding. The funding will be

a part of public education funding. If this is not substantial funding then more money can be

obtained through grants. The services will be free for students who are attending public schools,

it will be worked in as a part of their school curriculum or education.

There is a program similar to the one laid out in our program description called

"D.A.R.E". Ideally, our program proposal would be similar to this program, but mandated for all

schools in South Carolina. The long-term goal for this program will be to increase awareness and

education about the use of drugs and alcohol for all of South Carolina's youth in the hopes of the

prevention of drug and alcohol abuse and relief from the use of drugs and alcohol use.

Sampling Design:

As mentioned in the research design, we will sample 2,300 random participants who meet

the criteria of our target population; ages 12-20 and residents of South Carolina. They will be

both male and female, and between the ages 12 and 20. The reason we have chosen these ages is
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that they must be at least 12 years old but not older than 21 to be considered an adolescent. We

will be using the stratified random sampling method. “ Stratification is the process of grouping

members of the population into relatively homogeneous subgroups before sampling.” (Princeton

University) This just means that since were are sampling from different geographical locations

such as urban and rural areas, that we are dividing them into subgroups to make the process more

reliable.

One of the strengths of stratified sampling is its organization. Keeping the different

groups separated will help everything stay organized and easy to understand, which will

ultimately lead to less mistakes on our part. Also, since it will be randomly distributed, it will be

unbiased. Another strength is representativeness, because it will be easy to determine whether or

not the participants represent a certain population as long as we know their residence. However,

there are some weaknesses that come along with this sampling method. Probably the greatest

weakness is validity. As also stated in the research design portion, we cannot guarantee that all

the participants will take our survey seriously and answer the questions honestly. They may also

be hesitant to answer the questions because they will be asked about certain illegal behaviors

concerning alcohol and drug use, and they may be afraid of getting into legal trouble.

Protection of Research Subjects:

For the protection of our research subjects, we will emphasize the voluntary

participation principle. In other words, well will explain to our subjects that they are not

required or mandated to participate and have the choice to refuse to in this research project. Our

participants will be aware of the fact that the nine-item questionnaire given will be administered

to them on their approval. As far as informed consent, we will make sure that our subjects are

aware of the actions that will be conducted during the process of which they participate. We will
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ensure that our subjects realize that the information that we gain from the data collected will be

used solely for the purpose of measuring the level of substance abuse in rural Orangeburg

County vs. urban Richland County. This involves educating our subjects on the likely risks that

could very well occur given the fact that they participate. Benefits that may result from

protecting our research subjects are that the subjects may be more likely to give accurate data. If

our participants feel as though we are not going to protect them and keep the data confidential,

then they may not answer the questions honestly in fear of some form of penalty for using

alcohol or illegal drugs, especially since all participants are under the age of 21. Confidentiality

is very important when regarding human subjects because if they feel as though the data you are

recording will be shared with an outside party, their choice to give false information/answers can

sabotage the results of your study.

Further Research in the Future:

This research design is ideal because it can be redistributed on a regular basis. The survey

can be administered every year in order to compare results across time and see if the proposed

program design has had any affect on the dependent variable. This research design could also be

applicable in any state that one is wishing to study the correlation of an urban setting and

adolescent’s scores on the T-ASI scale. Ideas for further research would include redistributing

this research design every year to a different pool of random participants in order to increase the

reliability of the study across time. This survey can also be administered in a different state and

work just as effectively.

References
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Ali, S., Mouton, C. P., Jabeen, S., Ofoemezie, E., Bailey, R. K., Shahid, M., & Zeng, Q. (2011).

Early detection of illicit drug use in teenagers. Innovations In Clinical Neuroscience,

8(12), 24-28.

Kaminer, Y., Burkstein, O.G. & Tarter, R.E. (1991). The Teen Addiction Severity

Index: Rationale and reliability. The International Journal of the Addictions,

26, 219-226.

Kaylen, M. T., & Pridemore, W. (2011). A Reassessment of the Association Between Social

Disorganization and Youth Violence in Rural Areas. Social Science Quarterly (Wiley-

Blackwell), 92(4), 978-1001. doi:10.1111/j.1540-6237.2011.00808.x

Lambert, D., Gale, J. A., & Hartley, D. (2008). Substance abuse by youth and young adults in

rural America. The Journal Of Rural Health, 24(3), 221-228. doi:10.1111/j.1748-

0361.2008.00162.x

Nasim, A., Fernander, A., Townsend, T. G., Corona, R., & Belgrave, F. Z. (2011). Cultural

protective factors for community risks and substance use among rural African American

adolescents. Journal Of Ethnicity In Substance Abuse, 10(4), 316-336.

doi:10.1080/15332640.2011.623510

Pinchevsky, G. M., Fagan, A., & Wright, E. (2010). Racial/Ethnic Differences in the

Relationship Between Neighborhood Disadvantage and Adolescent Substance

Use.Journal of Drug Issues, 69-84.

Rioux, A. R., & Hollist, D. R. (2010). Community, family, and peer influences on alcohol,

marijuana, and illicit drug use among a sample of Native American youth: An analysis of

predictive factors. Journal Of Ethnicity In Substance Abuse, 9(4), 260-283.

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Children's Hospital Boston. 2009. The CRAFFT Screening Interview. Retrieved from

www.caesar-boston.org/CRAFFT/pdf/CRAFFT_English.pdf

National Institute on Alcohol Abuse and Alcoholism. July (2013). Underage Drinking [Data

file]. Retrieved from

pubs.niaaa.nih.gov/publications/UnderageDrinking/Underage_Fact.pdf

Pacific Institute for Research and Evaluation. September (2011). Underage Drinking in South

Carolina: The Facts [Data file]. Retrieved from www.udetc.org/factsheets/SC.pdf

STORY:. (n.d.). Princeton University. Retrieved April 29, 2014, from http://www.princeton.edu

Winters, K. & Henly, G. Adolescent Diagnostic Interview (ADI) Manual. Los Angeles, CA:

Western Psychological Services, 1993.

Workers, N. A. (2008). NASW Code of Ethics (Guide to the Everyday Professional Conduct of

Social Workers). Washington, DC: NASW.

Clark, Trenette T.; Nguyen, Anh B.; Faye Z (2011). Journal of Child & Adolescent Substance

Abuse. Risk and Protective Factors for Alcohol and Marijuana Use Among African-

American Rural and Urban Adolescents. Vol. 20 Issue 3, P 205-220. 4 Charts.

Appendices:

Appendix A: Conceptual Model

Gang Peer Pressure

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Appendix B

SCALE USED FOR MEASUREMENT

A copy of the T-ASI can be accessed at this link:

http://www.emcdda.europa.eu/attachements.cfm/att_4008_EN_tt-asi.pdf