This article reports on a study of the long-term efficacy of the Adults in the Making (AIM) prevention program on deterring the escalation of alcohol use and development of substance use problems, particularly among rural African American emerging adults confronting high levels of contextual risk.
African American youths (M age, pretest - 17.7 years) were assigned randomly to the AIM (n - 174) or control (n - 173) group. Past 3-month alcohol use, past 6-month substance use problems, risk taking, and susceptibility cognitions were assessed at pretest and at 6.4, 16.6, and 27.5 months after pretest. Pretest assessments of parent-child conflict, affiliations with substance using companions, and perceived racial discrimination were used to construct a contextual risk factor index. A protective stabilizing hypothesis was supported. The long-term efficacy of AIM in preventing escalation of alcohol use and substance use problems was greater for youths with higher pretest contextual risk scores. Consistent with a mediation-moderation hypothesis, AIM induced reductions over time in risk taking and susceptibility cognitions were responsible for the AIM and contextual risk prevention effects on alcohol use and substance use problems. Training in developmentally appropriate protective parenting processes and self regulatory skills during the transition from adolescence to emerging adulthood for rural African Americans may contribute to a self-sustaining decreased interest in alcohol use and a lower likelihood of developing substance use problems. (publisher abstract modified)