U.S. flag

An official website of the United States government, Department of Justice.

Preventing Alcohol Use with a Voluntary After-School Program for Middle School Students: Results from a Cluster Randomized Controlled Trial of CHOICE

NCJ Number
Prevention Science Volume: 13 Dated: 2012 Pages: 415-425
Elizabeth J. D’Amico; Joan S. Tucker; Jeremy N. V. Mile; Annie J. Zhou; Regina A. Shih; Harold D. Green Jr.
Date Published
11 pages

This paper examines the effects of an after-school program aimed at preventing younger adolescent alcohol and drug use, specifically, middle school students.


There are many mandated school-based programs to prevent adolescent alcohol and drug (AOD) use, but few are voluntary and take place outside of class time. This cluster randomized controlled trial evaluates CHOICE, a voluntary after-school program for younger adolescents, which reduced both individual- and school-level alcohol use in a previous pilot study. The authors evaluated CHOICE with 9,528 students from 16 middle schools. The sample was 51 percent female; 54 percent Hispanic, 17 percent Asian, 15 percent white, 9 percent multiethnic and 3 percent African American. Fifteen percent of students attended CHOICE. All students completed surveys on alcohol beliefs and use at baseline and six-to-seven months later. The authors conducted intention-to-treat (ITT) school-level analyses and propensity-matched attender analyses. Lifetime alcohol use in the ITT analysis (i.e., school level) achieved statistical significance, with an odds ratio (OR) of 0.70 and a NNT of 14.8. The NNT suggests that in a school where CHOICE was offered, one adolescent out of 15 was prevented from initiating alcohol use during this time period. Although not statistically significant, results indicate that past month alcohol use was also lower in CHOICE schools. Comparisons of attenders versus matched controls yielded results for lifetime use similar to school-wide effects. The authors conclude that initial results are promising and suggest that a voluntary after-school program that focuses specifically on AOD may be effective in deterring alcohol use among early adolescents; however, further research is needed as program effects were modest. Publisher Abstract Provided