Lack of recreational and educational opportunities are often reported as risk factors for early involvement in substance use among rural youth. After a comprehensive needs assessment in two rural communities in southeast Missouri, the One Life: Choose to Live Free after-school program was developed to provide an environment conducive to positive behavior change. The program emphasized healthy behaviors, increasing protective factors, and decreasing risk factors for substance use. High-risk students were identified by school administrators at two high schools in rural Missouri. A total of 55 students participated in this after-school program which met bi-weekly for a total of 12 sessions during the academic year. This bi-weekly meeting followed a Lighted Schoolhouse model. Activities at the Schoolhouse focused on enhancing life skills and reinforcing positive influences on behavior, in addition to recreational activities. A pre-test/post-test design was used to measure changes among participants' attitudes and behavior using a validated instrument. Thirty-day smokeless tobacco use was reduced from 5.1% of participants reporting use to 2.6% (p=.041). Similarly, 30-day cigarette use was reduced from 11.1% of participants reporting use to 7.7% (p=.036). Reduction of 30-day alcohol use was also seen as use decreased from 18.2% of participants to 10.3% (p<.001). In addition to the decrease in 30-day substance use, other positive results of the program included an increased interest in higher education among participants. Historically, the two communities involved in this program have very low rates of high school completion (72.9% and 61.1% compared to 81.3% statewide) and college completion (10.6% and 9.6% compared to 21.6% statewide). Another objective of this program was to increase the participant interest in higher education. Only 37.5% of participants had any interest in attending college at pre-test, but this increased to 41.8% after the program(p=.029). Likewise, only 18.2% of participants had any interest in vocational training at pre-test, but this increased to 30.9% (p=.046). The One Life: Choose to Live Free program proved to be a moderately effective program to reduce substance use and increase interest in academics, thereby reducing risk factors and increasing protective factors among rural youth.
Learning Objectives
As a result of this presentation, the learner will:
1. Understand the design and implementation of a health promotion program designed to increase healthy activity and decrease risk factors among rural youth.
2. Recognize the benefit of emphasizing recreational and educational interventions for high-risk youth.