Programs & Services

• Crisis Line - COSA-NCADD provides information and referral services through a toll-free hotline system, 1 - 800 - SOBER - 90
  (1 - 800 - 762 - 3790). Families and individuals seeking help for substance abuse problems or mental health services may call 24 hours per day, seven days per week, from any point in Alabama. Callers, many of whom are in crisis, receive current information on treatment centers, bed availability, and support groups. Treatment is secured, information dispensed, and data tabulated on a personal, confidential one-on-one basis.

• Advocacy - COSA-NCADD provides advocacy services to clients and their families and friends to ensure those in need of services receive them. If you, your familiy or friends have had problems accessing treatment, call 1 - 800 - 762 - 3790.

• National Intervention Network - The Johnson Institute will no longer be providing intervention services nationally. Dr. Vernon Johnson, founder of the Johnson Institute, as a network of central referral agencies to channel requests for interventions to appropriately trained individuals, created the National Intervention Network. As of October 1, 1998, COSA-NCADD became Alabama's point of contact for this national effort. Mental Health Center directors throughout Alabama have designated staff members who were trained to handle the interventions as they are funneled into Alabama through the Network.

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Advocacy

COSA-NCADD provides leadership in public policy concerned with alcohol and other drug related issues. Activities of the legislature, state, and local agencies are closely monitored by COSA-NCADD to ensure comprehensive resources are available in prevention, education, and treatment. If you, your familiy or friends have had problems accessing treatment or utilizing benefits for substance abuse or menthal health services provided by your insurance carrier, call 1 - 800 - 762 - 3790

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Prevention and Education

COSA-NCADD is funded in part by the Alabama Department of Mental Health and Mental Retardation, Division of Substance Abuse Services. The Alabama DMH/MR, Division of Substance Abuse Services is the only entity in the state of Alabama that requires the substance abuse prevention providers they fund to meet the standards set forth by the Alabama Alcohol and Drug Abuse Association, to provide outcome evaluations on all programs, to submit to an intensive program audit, as well as to furnish a financial audit consistent with the requirements delineated in the OMB Circular A-133. As of October 1, 1999, all agencies receiving prevention funds must be certified by the Alabama Department of Mental Health and Mental Retardation, Division of Substance Abuse Services.

POSITIVE ACTION:

The Council on Substance Abuse-NCADD has established a partnership with POSITIVE ACTION, a science-based curriculum recognized by the U.S. Department of Education and the Center for Substance Abuse Prevention. COSA-NCADD provides training in the use of this curriculum. Character education is an integral part of positive action.

Carol Gerber Allred, developed and taught Positive Action as a high-school social studies elective in Twin Falls, Idaho, from 1974 through 1977. From 1977 through 1982 she developed the program for elementary students. She founded Positive Action Company in 1982 (becoming Positive Action, Inc., in 1999). The program has been used in over 8,000 schools in every U.S. state and ~100 international schools. It is currently in about 2,500 schools.

• U.S. Department of Education, January, 1999: Listed in the Catalog of School Reform Models for Comprehensive School Reform Demonstration Modelsfor improving academic achievement.
• Education Commission of the States for Comprehensive School Reform, October, 1999: for improving academic achievement.
• U.S. Department of Education, January, 2001: Exemplary and Promising Programs for Safe Disciplined and Drug Free Schools Program. For substance abuse, violence and disruptive behavior prevention.
• Center for Substance Abuse Prevention, December, 2000:Exemplary Model Program for substance abuse prevention.
• Character Education Partnership, 2000: Resource Guide of Effective Character Education Programs, character education programs.
• Virginia Tobacco Settlement Foundation: 2002,Compendium for Tobacco Use Prevention Programs for Youth, tobacco prevention programs.
• Chicago Public Schools, 2000-2002, "Life Skills, Drug Prevention and Violence Prevention Curriculums, Training and Counseling Services," Chicago Public Schools mini-grants for Safe and Drug Free Schools program, substance abuse and violence prevention programs.
• New Jersey Character Education Partnership Initiative, July, 2000-2001: Listed in "Programs of Merit,"programs for character development.
• Illinois Center for Violence Prevention, September, 2001: Listed in "Peacing it Together," violence prevention programs.
• California Department of Education, 2000, California Healthy Kids, Program Dissemination Center to share information about programs that address alcohol, tobacco, other drugs, and violence prevention.

• Character Education Partnership, Dr. Marvin Berkowitz Templeton Foundation: Two lists of character education programs that (a) improve academics and (b)improve behavior. Positive Action is on both lists of character education programs.
• Collaboration for the Advancement of Social and Emotional Learning: University of Illinois at Chicago, 2002 List of programs for effective social and emotional learning.
• Channing Bete Company, 2003 Communities That Care Prevention Strategies: A Research Guide to What Works, A resource that identifies tested effective policies, programs and actions that address risk and protective factors identified through research.

Program Description

The Positive Action program (PA) consists of:

• A K-12 classroom curriculum with over 1,200 lessons. Using Teacher's Kits (manuals and materials for each grade), classroom teachers present 15-20-minute lessons in grades K-8. Drug-education supplement kits expand on drug-education lessons in grades 5-8. Positive Actions for Living is the text for grades 9-i 2 (42 lessons, 45 minutes each). All components are culturally sensitive, appropriate for diverse student populations. Lessons are developmentally appropriate, and scoped and sequenced. Curricula can also be used in after-school programs.
• A Principal's Kit, with directions for a school-climate program to promote the practice and reinforcement of positive actions in the school population. The Counselor's Kit (manual/materials) is used with high-risk students in the school, home, and community.
• A Family Kit contains weekly lessons paralleling the school program and parent-involvement activities.
• A Community Kit with manuals and materials encourages community involvement in schools and student/parent involvement in their community.

The program is adopted by a school which uses it school-wide. Training/staff development is conducted prior to beginning the program by the Positive Action staff or school personnel using the Positive Action workshop materials. PAI staff can provide training in the use of the program to all school staff (not only teachers) for one day before or at the beginning of the school year, one half day mid-year, and one half day at the end of the year.

Administratively, the program is guided by the principal with the assistance of a coordinator and a committee. The curriculum is taught by all the classroom teachers 15 minutes a day, four days a week, using a grade-appropriate kit containing a manual with all the lessons planned and all the materials prepared. The school climate program involves everyone in the school reinforcing positive actions they see throughout the day.

A Family Kit for parents contains lessons and materials that parallel the school curriculum and school climate program. It is also used for parenting classes. The Community Kit organizes a steering committee which links with the school to support the school's efforts and to provide opportunities for students to do positive actions in the community.

The school curriculum can also be used for an after-school program. The program offers an Implementation Plan to achieve fidelity of implementation. There is also a plan for program evaluation which schools are strongly encouraged to use to demonstrate and monitor program effects.

Evaluation Designs

The Positive Action program has been researched and evaluated in every kind of school and location by the program's developer, school districts and independent evaluators. During each of the five years she was developing the program, Dr. Allred used independent evaluators to evaluate the program. In 1982-83 she incorporated an evaluation of the program into her doctoral dissertation. Brian Flay, D.Phil. of the University of Illinois at Chicago has conducted recent evaluations. Evaluation designs have included experimental-control group, national comparison group (e.g., changes in percentile rankings), matched control, pre-post case, and comparison group studies.

Outcomes

Data from various comparison group designs involving over 100 elementary schools delivering the Positive Action program demonstrate consistent positive effects of the program on student behavior (discipline, suspensions, crime, violence, drug use), performance (attendance, achievement) and self-concept. See left-hand panel. These results were obtained from all sorts of schools (high and low minority representation, mobility rates, or poverty), in different states, at different times (1970's through 2000). Results were often better in more disadvantaged schools. Several thousand other schools have reported similar results from individual case studies. Below are selected findings in more detail.

Analyses of data from a matched case-control design in a large school district in Nevada found that:

• PA schools reported 85% fewer incidences of violence per 1000 students than non-PA schools;
• PA schools scored 14% better than non-PA schools in their percentile ranking of 4 grade achievement scores.

Similar matched control analyses of data from Hawaii found that PA schools reported:

• 28% better SAT scores than non-PA schools (3-year average of math and reading combined);
• 88% fewer disciplinary problems than non-PA schools;
• 20-32% lower daily absenteeism than non-PA schools.

In an intensive case study of effects of variations in implementation, some findings were that:

• Grade 4 and 5 students reported major changes in ever engaging in substance use and violence: among students without PA, 16% engaged in a negative behavior for the first time, compared with only 12% who received some of PA and 10% for students who received all of PA.
• Level of PA implementation had significant effects on parents, improving their already high readiness to take responsibility for their child's character and behavioral development, increasing the level of communication with their child, and improving their knowledge of their child's friends and their parents.

Complete implementation integrity can be ensured with staff training. In an evaluation of training, program effects were greater when teachers received PAI training than when they did not:

• 34% vs 20% fewer violence-related incidents (threats, fights, battery and weapons possession);
• 28% vs 5% improvements in percent scoring above the median on standardized achievement tests; and
• 20% vs 2% fewer chronic absentees.

In a large Florida school district, middle schools with a high percent of students coming from PA elementary schools (but who were not implementing PA themselves) reported (two to four years later):

• 15% fewer incidents of SU (tobacco, alcohol, illicit substances) in schools with 65-75% PA graduates, and 26% fewer incidents in schools with more than 75% of its students being PA graduates (see Figure 2);
• 20% more students scoring above the median on standardized grade 8 reading and math tests;
• 21% fewer violence-related incidents (threats, fights, battery and weapons possession);
• 21% fewer incidents of disrespect, disobedience or disorderly conduct; and
• 8% fewer out-of-school suspensions, with the effects being larger for high-minority schools.

Overall, there is a strong dose-response relationship, with stronger effects occurring in middle schools with greater numbers of PA graduates.

Overall, the Positive Action (PA) program has the comprehensive effects expected of it by its developer and predicted for it by current theory. Data from various comparison group designs involving over 300 elementary schools using PA demonstrate consistent positive effects of the program on school performance (attendance, achievement) and behavior (discipline, suspensions, crime, violence, drug use). Across studies, PA has produced the following results:

• Academic achievement improved by 12-75%
• Absenteeism reduced by six to 45%
• Self-concept improved up to 43%
• General discipline reduced by 23 to 90%
• Violence and drug use reduced by 26 to 63%
• Criminal bookings reduced by up to 94%

Several thousand other schools have reported similar results from individual case studies (simple pre-post comparisons or anecdotal reports). These results were obtained from all sorts of schools (urbanicity, high and low minority representation, mobility rates, or poverty), in different states, at different times (1970’s through 2001). Some of the above results are reported in a peer-reviewed research journal (Prevention Science, June 2001).

It is noteworthy that results were often better in more disadvantaged schools. Most effects were equally positive or better across ethnic groups, levels of poverty (usually indicated by percentage of students receiving free/reduced lunch), and levels of student mobility. Structural equation modeling shows that PA reduces the normally high correlation between poverty and achievement. These are exceptionally important findings, as intervention effects of other programs have often been found to be smaller in schools with high proportions of minority students, poverty or mobility. No other program has proven effects across so many academic and behavioral domains, and no other program demonstrates equal or superior effectiveness in the most needy of schools.

Results from long-term followup of students who received PA in elementary school demonstrate that the effects of PA can carry on once students graduate from elementary school. If most of the students come from elementary schools with PA, behavior and achievement was better than in middle- or high-schools with fewer or no PA graduates. Training of Principals, teachers and other school staff by Positive Action, Inc staff produced improved implementation and effectiveness.

• Alternative Education Program - COSA-NCADD presents Positive Action in alternative schools instituted by the local school systems to serve students who are academically at risk due to disruptive behavior. The agency melds this comprehensive program with the structural nature of the school and the critical needs of these students who are extremely at risk. Topics include conflict resolution, stress and anger control, peer pressure, as well as alcohol, tobacco and other drugs.

• Summer Alternative Programs - Provides high risk children with fun-filled, educational activities away from the school environment. The activities are designed to teach children a wide variety of lifetime skills, and to offer recreational activities emphasizing a drug-free lifestyle. Role models such as firemen, police officers, military cadets, and businessmen are introduced daily to show the children that a fine, fulfilling, and successful life can be obtained by staying in school and remaining drug free.

• Juvenile Justice Program - This was the first of its kind in Alabama, offering youth who are interred by the juvenile court a comprehensive, fifteen-part curriculum with an outcome component. The youth are administered a pre-test during intake and a post-test at release. COSA-NCADD's computer tracking system allows the agency to maintain outcome data showing changes in attitude, intention, and knowledge.

Workshops and Professional Training

Education and information is the key to overcoming obstacles. Expert trainers are available to provide a wide range of alcohol and other drug related topics. Workshops and professional training can be designed to meet each group's specific requirements.

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The Presentation of Symposia and Joint Sponsors

COSA-NCADD presents substance abuse symposia for specific professional fields, focusing on issues pertinent to those professions. Nationally known speakers are invited to share their expertise, and varied issues peripheral to substance abuse are addressed.

• Alabama Youth Symposium - The Youth Symposium focuses on teen smoking and underage drinking. Joint-sponsors include: Council on Substance Abuse-NCADD, Alliance Counteracting Alcohol and Tobacco Advertising Targeting Youth (ACATA), Alabama Department of Mental Health and Mental Retardation, Alabama Department of Mental Health and Mental Retardation-Division of Substance Abuse Services, Governor's Office on Disability, Governor's Office on Drug Abuse Policy, Alabama Department of Education, American Lung Association, Alabama Department of Youth Services, Alabama Independent School Association, Alabama Department of Children's Affairs, Alabama Congress of Parent Teacher's Association, Alabama Department of Public Safety, Alabama Army National Guard, Alabama Alcoholic Beverage and Control Board, State of Alabama Military Department, Alabama Department of Public Health, Medical Association of the State of Alabama, March of Dimes Birth Defects Foundation, American Cancer Society, American Heart Association, MADD-Mother's Against Drunk Driving, Alabama Center for Law and Civic Education, Alabama Department of Economic and Community Affairs, National Alliance for Model State Drug Laws, Region Eight ACATA Youth Advisory Board (representing all eleven regional ACATA Youth Advisory Boards), Partnership for a Drug-Free Community, Inc., Northwest Alabama Mental Health Center, Gateway, Linc Program, East Alabama Mental Health Retardation Center. The yearly conference for youth will be held focusing on issues critical to that age group. This conference is planned by the youth and is held annually.

• Positive Action - COSA-NCADD provides training in the use of the curriculum. Positive action is a science-based curriculum recognized by the U.S. Department of Education and the Center for Substance Abuse Prevention (CSAP).  

• Substance Abuse Symposium for Medical Professionals - Joint-sponsors include Nation Institute of Alcohol Abuse and Alcoholism (NIAAA); National Alliance for Model State Day Laws (NAMSDL); American Society of Addiction Medicine (ASAM); ASAM-Alabama; The Division of Continuing Education, University of Alabama School of Medicine; Medical Association of the State of Alabama; Alabama Physician Health Program; Alliance to the Medical Association of the State of Alabama; Alabama Board of Medical Examiners; Alabama Board of Nursing; Alabama State Nursing Association; Alabama Dental Association; Board of Dental Examiners of Alabama; Alabama Pharmacy Association; Alabama State Board of Pharmacy; Alabama Hospital Association; Alabama Nursing Home Association; Alabama Psychological Association; and Alabama Veterinary Medical Association. The Substance Abuse Symposium for Medical Professionals is held annually.

• Substance Abuse Symposium for Clergy - Joint-sponsors include Alabama Baptist State Board of Missions; Southeast Baptist Convention; Alabama District Council Assemblies of God; AME Zion Church: Alabama-Florida Episcopal District; Catholic Archdiocese of Mobile; Catholic Diocese of Birmingham in Alabama; The Episcopal Diocese of Alabama; The Episcopal Diocese of the Central Gulf Coast; The Fifth Episcopal District of the CME Church; The Ninth Episcopal District of the African Methodist Episcopal Church; Evangelical Lutheran Church in America: Southeastern Synod; Presbyterian Church of America-Gulf Coast Presbytery; Presbyterian Church of America-Warrior Presbytery; Presbyterian Church U.S.A., Presbytery of Sheppards and Lapsley; Southern District of the Lutheran Church: Missouri Synod; The Union of American Hebrew Congregations-Southeast Council; The United Methodist Church-Alabama-West Florida Episcopal Area; The United Methodist Church: North Alabama Conference; The Nation of Islam; and The Alliance Counteracting Alcohol and Tobacco Advertising Targeting Youth. The Substance Abuse Symposium for Clergy is held annually.

• Substance Abuse Symposium for the Legal Profession and Law Enforcement - Joint-sponsors include Alabama State Bar, State of Alabama Administrative Office of Courts, State of Alabama Judicial College, District Attorneys Association, Alabama Defense Lawyers Association, Alabama Trial Lawyers Association, Alabama Lawyers Association, Alabama Sheriffs' Association, Alabama Association of Chiefs of Police, Alabama State Trooper Association, Alabama Peace Officers' Association, Alabama Criminal Defense Lawyers Association, Alabama Beverage Control Enforcement Division, Alabama Department of Public Safety, and Alabama Bureau of Investigation. The Substance Abuse Symposium for the Legal Profession and Law Enforcement is held annually.

• Substance Abuse Symposium for the Workplace - The success and public support for the symposia for specific professions has prompted COSA-NCADD to begin planning for additional conferences. One will focus on drugs in the workplace and address costs in terms of health care costs, lost wages, decreased profits and human concerns.