EFFECTIVENESS OF DRUG AND SUBSTANCE ABUSE PREVENTION

PROGRAMS IN SELECTED PUBLIC AND PRIVATE UNIVERSITIES IN

KENYA.

BY

KEMEI C. RONOH, (MA)

C82/11040/08

A THESIS SUBMITTED TO THE SCHOOL OF HUMANITIES AND SOCIAL

SCIENCES IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE
AWARD OF THE DEGREE OF DOCTOR OF PHILOSOPHY IN COUNSELING
PSYCHOLOGY OF KENYATTA UNIVERSITY.

October, 2014
 i

DECLARATION
This Thesis is my original work and has not been presented for any examination in any
university or any other award

Signature: __________________________________ Date____________________

Kemei C. Ronoh (C82/11040/08)

Department of Psychology

Supervisors:

We confirm that the work reported in this thesis was carried out by the candidate under
our supervision

Signature: ___________________ Date____________________________

Margaret K. Mwenje (PhD)

Department of Psychology
Karatina University

Signature: _________________ Date____________________________

Wilson A. P. Otengah (PhD)

Department of Sociology and Psychology
Rongo University College
 ii

DEDICATION
Children, Youth, Adults, Parents and Researchers whom we together should see the need

to defend our great potential through a reasoned fight against

Drug Abuse in our society.

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ACKNOWLEDGEMENTS
I wish to express my special gratitude to my Supervisors, Dr. Margaret Mwenje and Dr.

Wilson Otengah for their candid supervision, insight, timely response to my inquiries,

guidance, unchallenged support and commitment. I have a message to them in form of a

quote „“We are like dwarfs on the shoulders of giants, so that we can see more than they,

and things at a greater distance, not by virtue of any sharpness on sight on our part, or

any physical distinction, but because we are carried high and raised up by their giant

size." (Bernard of Chartres, 1130 AD). The Corrections‟ Supervisor, Dr. Christine

Wasanga did fantastic job to make it possible for the thesis to obtain professional

structure. I greatly appreciate her great effort and commitment.

I appreciate the Vice- Chancellors of the Universities under study for the permits and

support. It is through this that comparison of valuable information was obtained.

I thank my Colleagues in the PhD Pioneer class for the cordial relationship, insights and

support we shared together during the Course Work, Practicum and Thesis Research.

To my Family; my husband, David Ronoh and our children, I sincerely thank them very

much for their continuous love, understanding and support. Definitely, without this kind

of a family, I wouldn‟t have carried out my studies. I treasure them greatly.

Sr. Nganda, a very special friend, I heartily appreciate her generous provision of love

encouragement and support always and particularly at the beginning of my study.

Many other people also in big or small ways contributed to the completion of this study.

To all these great people, may our Almighty God, love, keep and increase them.
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Table of Contents

DECLARATION ................................................................................................................. i

DEDICATION .................................................................................................................... ii

ACKNOWLEDGEMENTS ............................................................................................... iii

Table of Contents ............................................................................................................... iv

List of Tables……………………………………………………………………………..ix

List of Figures …………………………………………………………………………….x

Operational Definition of Terms………………………………………………………...xii

Abbreviations and Acronyms .......................................................................................... xiv

ABSTRACT……………………………………………………………………………...xv

CHAPTER ONE: INTRODUCTION ..............................................................................1

1.1 Background to the study ................................................................................................1

1.2 Statement of the problem .............................................................................................10

1.3 The Purpose of the study..............................................................................................12

The purpose of this study was ............................................................................................12

1.4 Specific objectives: ......................................................................................................12

1.5 Research questions .......................................................................................................13

1.6 Hypotheses of the study ...............................................................................................13

1.7 Justification of the study ..............................................................................................14

1.8 Significance of the study..............................................................................................16

1.9 Assumptions.................................................................................................................17

1.1Scope and delimitation ..................................................................................................17

CHAPTER TWO: LITERATURE REVIEW ...............................................................19

2.0 Introduction ..................................................................................................................19

2.1 Theoretical Framework ................................................................................................19

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2.1.1 Self-Efficacy Theory (Bandura, 1986) .....................................................................19

2.1.2 Ecological Systems Theory (Bronfenbrenner, 1944)................................................22

2.2 Review of literature......................................................................................................27

2.2.1 Objectives, Levels and Principles of Prevention Programs ......................................27

2.2.2 Drug and Substance Abuse Prevention Programs…………………………………39

2.2.2.1 Drug and Substance Abuse Prevention Programs in the US Universities ............39

2.2.2 Drug Abuse prevention programs in Universities…………………………………39

2.2.2.2 Drug and Substance Abuse Prevention Programs in European Universities .........47

2.2.2.3 Drug and Substance Abuse Prevention Programs in Asian Universities ...............50

2.2.2.4 Drug and Substance Abuse Prevention Programs in African Universities ...........51

2.2.2.5 Substance Abuse Prevention programs in Kenyan Universities ............................53

2.4 Conceptual framework .................................................................................................58

CHAPTER THREE: RESEARCH METHODOLOGY ..............................................61

3.0 Introduction ..................................................................................................................61

3.1 Research design ...........................................................................................................61

3.2 Variables ......................................................................................................................61

3.3 Site of study .................................................................................................................62

3.4 Target Population. ........................................................................................................63

3.5 Sample size and sampling techniques ..........................................................................63

3.6 Research Instruments ...................................................................................................65

3.7 Pilot study ....................................................................................................................68

3.8 Data collection Procedures ..........................................................................................69

3.9 Validity and Reliability ................................................................................................69

3.10 Data analysis techniques ............................................................................................70

3.11 Data Management and Ethical Considerations ..........................................................72

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CHAPTER FOUR: DATA ANALYSIS, PRESENTATION AND DISCUSSION ....73

4.0 Introduction ..................................................................................................................73

4.1 Demographic information of Respondents ..................................................................74

4.1.1 Respondents‟ Gender distribution.............................................................................74

4.1.2 University Faculties ..................................................................................................76

4.1.3 Respondents‟ Year of Study .....................................................................................77

4.1.4 Respondents‟ residence .............................................................................................78

4.2 Findings of the study....................................................................................................81

4.2.1 Prevention programs and activities currently at work in the university ...................81

4.2.1.1 Objectives of Prevention Programs .......................................................................89

4.2.2 Methods of Program Implementation .......................................................................92

4.2.2.1 Availability of Resources .......................................................................................92

4.2.2.2 Display of DSAPP activities .................................................................................95

4.2.2.3 Coordination amongst prevention providers ........................................................100

4.2.2.4. Departmental Involvement..................................................................................101

4.2.2.5 DSAPP impact on drug abuse prevention ............................................................108

4.2.2.6 Rating on DSAPP implementation methods ........................................................111

4.2.2.7 Suggestions on more popular and useful DSAPP methods .................................113

4.2.Student participation in and utilization of prevention programs ...............................115

4.2.3.1 Student Drug and Substance Abuse Prevention programs……………………..115

4.2.3.2 Student Participation ............................................................................................119

4.2.3.3 Strategies which enhance Students‟ utilization of DSAPP ..................................128

4.2Challenges to effective implementation of DSAPP ....................................................132

4.2.4.1 DSAPP Challenges ..............................................................................................133

4.2.5. Target of factors which sustain Drug and substance abuse ...............................140
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4.2.5.1 Aspects of drug abuse sustaining factors .............................................................141

4.2.5.2 Youth Drug Culture .............................................................................................151

4.2.6. Suggestions on effective drug abuse mitigation ....................................................154

4.3 Summary of the findings ............................................................................................157

CHAPTER FIVE: SUMMARY, CONCLUSIONS AND

RCOMMENDATIONS….............................................................................................159

5.0 Introduction ................................................................................................................159

5.1 Summary ....................................................................................................................159

5.1.1 Demographic information of research respondents ................................................159

5.1.2. Objectives of prevention programs currently at work in universities ....................160

5.1.3 Program implementation .........................................................................................161

5.1.4. Student participation and utilization of prevention programs...............................164

5.1.5 Challenges to effective implementation of DSAPP ................................................166

5.1.6. Drug abuse sustaining factors ................................................................................166

5.2 Conclusion .................................................................................................................169

5.2.1 Demographic Characteristics of respondents..........................................................169

5.2.2 Prevention levels and objectives .............................................................................170

5.2.3 Program implementation .........................................................................................170

5.2.4 Student responsiveness to prevention programs .....................................................171

5.2.5 Challenges facing DSAPP ......................................................................................171

5.2.6 Drug abuse sustaining factors .................................................................................171

5.3 Recommendations ......................................................................................................172

5.4 Suggestions for further research ................................................................................175

Appendix A: Introduction Letter and Consent Form .......................................................192

Appendix B: Questionnaire for Students. ........................................................................193

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Appendix C: Focus Group Discussion Guide ..................................................................198

Appendix D: Qualitative Interview Schedule ..................................................................199

Appendix E: Structured Observation Guide ....................................................................202

Appendix F: Study Process Framework ..........................................................................203

Appendix G: Reasons for lack of DSAPP awareness ......................................................204

Appendix H: Prevention activities and services ..............................................................208

Appendix I: Suggestions on effective communication of DSAPP messages ..................210

Appendix J: Suggestions on more popular and effective methods ..................................212

Appendix K: Reasons for rating on student participation ................................................215

Appendix L: Challenges facing DSAPP ..........................................................................217

Appendix M: Drug abuse sustaining factors ....................................................................219

Appendix N: Suggestions on effective ways to address ADA………………………...221

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List of Tables

Table 2.1 Prevention levels and interventions ...................................................................35

Table 3.1 Sample size and sampling techniques ...............................................................59

Table 3.2 Schedules of Research Tools‟ administration…………………………………62

Table 4.1 Student enrolment in universities by sex ...........................................................69

Table 4.2 Mean scores for drug abuse prevalence in universities .....................................73

Table 4.3 Demographic information of respondents ................................................…….74

Table 4.4 Programs‟ objectives..........................................................................................83

Table 4.5 Chi-square Test…………………………..……………………………………94

Table 4.6 Reasons why DSAPP had actively involved their departments………………95

Table 4.7 Chi-square Tests……………………………………………………………..102

Table 4.8 Student groups which carry out DSAPP activities ..........................................108

Table 4.9 Rating of student participation .........................................................................110

Table 4.10 ANOVA tests on rating……………………………………………………..111

Table 4.11 Reasons for students‟ rating on participation ................................................113

Table 4.12 Chi-square Tests……………………………………………………………117

Table 4.13 DSAPP strategies that could enhance students' utilization ............................118

Table 4.14 ANOVA Tests………………………………………………………………121

Table 4.15 Reasons why students think DSAPP do not face challenges……………….125

Table 4.16 Suggestions on how to address challenges facing DSAPP ............................137

Table 4.17 Ranking of social, economic, psychological and youth culture ....................141

Table 4.18 Means of factors sustaining drug abuse…………………………………….135

Table 4.19 ANOVA tests on rating of causes of drug abuse ...........................................147

Table 4.20 Factors of drug abuse that have not been adequately addressed....................150

Table 4.21 Understanding of drug youth culture .............................................................152

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List of Figures

Figure 2.1: Conceptual Framework ...................................................................................60

Figure 3.1: Data analysis process.......................................................................................71

Figure 4.1. Distribution by Gender ....................................................................................68

Figure 4.2: Year of study by universities ...........................................................................71

Figure 4.3: Students‟ residence by universities .................................................................72

Figure 4.4: Ways DSAPP carry out their activities ...........................................................75

Figure 4.5: The Precede-Proceed Model ...........................................................................78

Figure 4.6 Awareness of DSAPP………………………………………………………...79

Figure 4.7 Reasons why students were not aware of DSAPP……………………………81

Figure 4.8: DSAPP messages display ..........................................................................…..87

Figure 4.9: Suggested communication avenues .................................................................97

Figure 4.10: Berlos SMCR model of communication .......................................................99

Figure 4.11: DSAPP Involvement with other departments ...............................................94

Figure 4.12: Reasons for departmental involvement .........................................................98

Figure 4.13: Reasons for lack of departmental involvement ...........................................107

Figure 4.14: DSAPP impact on substance abuse prevention ...........................................109

Figure 4.15: Rating of implementation methods .............................................................112

Figure 4.16: Methods which could be more popular and useful......................................113

Figure 4.17: Ways DSAPP could improve their services ................................................114

Figure 4.18: Awareness on DSAPP Student groups ........................................................116

Figure 4.19: Knowledge of student groups that carry out DSAPP activities...................117

Figure 4.20: Ratings on whether students should be used as agents of DSA ..................125

Figure 4.21: DSAPP strategies that can enhance students' utilization ............................130
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Figure 4.22: Knowledge on whether DSAPP face challenges .........................................133

Figure 4.23: Challenges facing DSAPP...........................................................................134

Figure 4.24: Suggestions on how to address DSAPP challenges ....................................139

Figure 4.25: Other aspects in students‟ lives causing drug abuse....................................149

Figure 4.26: Youth Drug Culture.....................................................................................151

Figure 4.27: Suggestions on effective ways to deal with drug abuse ..............................156
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Operational definitions of terms

Assessment refers to a detailed way of gathering information about how prevention

programs at the university meet the criteria for effectiveness

Drug and Substance Abuse refers to inappropriate use of intoxicating drugs to an extent

that personal, academic, social and spiritual functioning is disrupted.

Effectiveness refers to the presence, usefulness and capacity of drug and substance abuse

Prevention Programs and activities to encourage university members to promote

constructive lifestyles and avoid drug and substance abuse.

Levels of prevention programs refer to different categories of prevention activities

targeting drug users and abusers at different stages of drug use and abuse.

Lifestyle is an inclined mode of living which is influenced by specific attitudes, interests,

habits, preferences and behaviors which arise spontaneously in most cases.

Prevention refers to the diverse approaches through which the university community

promotes constructive attitudes, norms, beliefs, values, practices and life choices

to build against substance abuse. It refers to all the activities in addiction

continuum employed by the university to help its community members from

engaging, progressing and staying in drug addiction.

Student Responsiveness is students‟ awareness, receptiveness and attitude towards

 xiii

prevention activities including their participation in drug abuse prevention

programs.

System refers to a complex of interacting components together with the relationships

which contribute to various webs and hubs of reactions and behaviors

 xiv

Abbreviations and Acronyms

AA Alcoholics Anonymous

ADA Alcohol and Drug Abuse

ADCU Aids and Drug Control Unit

DSAPP Drug and Substance Abuse Prevention Programs

FGD Focus Group Discussion

GOK Government of Kenya

ICL I Chose Life

LST Life Skills Training

NA Narcotics Anonymous

NACADAA National Campaign Against Drug Abuse Authority

NIDA National Institute on Drug Abuse

PUU1 Public University 1

PUU2 Public University 2

PRU1 Private University 1

PRU2 Private University 2

QIS Qualitative Interview Schedule

SCAD Student Campaign Against drugs

SHED See, How, Empower, Do

SOG Structured Observation Guide

SPSS Statistical Package for Social Sciences

SSSP Social Support Service Providers

WHO World Health Organization

 xv

ABSTRACT
Substantial outcry about the problem of drug and substance abuse and its rippling effects
echoes from many sectors of the society today. Families, learning institutions and places
of work undergo agonizing consequences of drug abuse. In the university, the problem is
rampant aggravated by many factors such as personal independence, a lot of free time, a
wide range of demands on the individual student, psychosocial impact of interpersonal
interactions, transition to university life and making new peers. Drug and substance abuse
impacts negatively not only on student abusers and the university goal attainment but also
causes problems to students who don‟t abuse drugs, their families and care providers. In
response to this problem, universities have established prevention programs and Social
Support Services to implement interventions. Information from the literature review
demonstrates that some prevention programs can be effective whereas others may not be.
This study sought to assess effectiveness of drug abuse prevention programs in selected
Public and Private Universities in Kenya with specific objectives which were to establish;
objectives of various levels of prevention programs and activities, implementation
methods, student utilization of prevention activities, challenges facing prevention
services and factors which sustain drug abuse in the universities. Self-efficacy and
Ecological Systems Theories including principles for effective prevention programs
endowed insight into this study. It was a cross-sectional survey applying both qualitative
and quantitative techniques to benefit from their complementary nature. This study was
carried out in 2 Public and 2 Private Universities in Kenya. Multi-stage sampling
techniques were employed in selection of 499 respondents consisting of 395 students and
104 Social Service Providers. Four data collection tools consisting of Student
Questionnaire, Focus Group Discussions, Qualitative Interview Schedule and Structured
Observation Guide were used. Data analysis was done with the aid of SPSS and NVIVO
10. Findings revealed homogeneity in respondents‟ characteristics and use of drug abuse
(Chi-square P-value, 0.145) amongst universities under study. Findings demonstrated that
primary prevention level was the predominant intervention activity with low rate (30.8%)
student awareness of prevention programs and activities. It also showed poor student
participation (14.1%), inadequate resources, poor implementation methods and negative
student attitude being the major challenges to effective implementation. Study findings
revealed that drug abuse is sustained by factors related to social, psychological, economic
and cultural. The study recommended to DSAPP to apply scientifically based approaches.
It recommended to the University Management provision of comprehensive support to
DSAPP. It was recommended to NACADA to strengthen personnel training and
dissemination of information at all educational levels and in all counties. This study also
recommended to the Ministry of Education to integrate Drug abuse courses in the
curriculum in all education levels from Primary to the university. Suggestion for further
research should target specific drugs and prevention models which are contextual to
universities in Kenya.
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CHAPTER ONE

INTRODUCTION

1.1 Background to the study

The problem of substance abuse is considerably rampant in universities with increasing

trend for the last over a decade as evidenced by a study carried out in one of Kenya‟s

private universities which revealed percentages of lifetime rates of commonly used

substances at; tobacco 54.7%, alcohol 84.2 %, cannabis 19.7% and inhalants 7.2%

(Ogunde, & Leak, 1999; Atwoli et al.(2011). In a 2013 study in public universities, this

trend is persistent with tobacco rising to 69.5 % (Magu, Mutugi, Ndahi & Wanzala,

2013). Evidence (Mwenesi, 1996, Lutomia & Skolia, 2002, NACADA, 2002, 2004)

demonstrates that majority of drug abusers in Kenya are students in schools and

universities especially in the cities of Nairobi, Mombasa and Kisumu. Oteyo & Karuiki

(2009) echo out use of alcohol which has evolved over time into a problem of

dependence and addiction with the youth getting more and more involved in consumption

of illicit drugs. NACADA (2009) survey revealed that 10.6% respondents smoke bang,

while over 11% of Kenyan youth use Miraa.

Adverse impact of drug abuse is great as UNDCP (2002) sums up that, „Drugs destroy

lives and communities, undermine sustainable human development and generate crime.

Further, drugs affect all sectors of society in all countries and in particular; drug abuse

affects freedom and development of young people, the world‟s most valuable asset.

Further, drugs are a grave threat to the health of all mankind, the independence of states,

democracy, the stability of nations, the structure of all societies and the dignity and hope
 2

of millions of people and their families‟. Ray & Ksir (2002) strongly support this fact that

alcohol and other drug use is a factor in many accidents, injuries, vandalism, and crime

on campuses and is frequently a key factor when students encounter problems with their

coursework. Ironically, even college students who avoid the unsafe use of alcohol and

other drugs still suffer the effects of the high-risk behaviors of their peers such as

conflicts or having to take care of their drunken colleagues. The World Health

Organization (WHO) have stated that by the year 2020 mental and substance use

disorders will surpass all physical diseases as a major cause of disability worldwide

(WHO, 2008). WHO (2013) further emphasizes that at least 15.3 million individuals have

drug use disorders and drug abuse are associated with significant health and social

problems. NACADA (2012) views many risks associated with the problem of drug abuse

including; dependent young adults, increased health care needs amongst the youth

abusing alcohol and drugs and crimes resultant from idleness and the youth‟s drinking

habits.

Several psychosocial and environmental factors combine to aggravate and sustain

habitual drug and substance abuse at the university. These include personal

independence, a lot of free time, a wide range of demands on individual student,

psychosocial impact of interpersonal interactions, academic demands and societal

transitions such as leaving home, developing autonomy, making new friends and peers

(Larimer et al., 2005; University of Nairobi, 2010). These factors also have an

interlocking impact in determining student efficacious response to substance abuse

prevention programs in the university.

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Drug Abuse Prevention Programs are tools designed to enable users avoid or decrease

unhealthy drug use through focusing on different motivations individuals have for using

and abusing specific drugs at different ages (Insel, Roth, Rollins & Petersen, 2012).

UNDCP (2002) define prevention as an intervention designed to change the social and

environmental determinants of drug and alcohol abuse including discouraging the

initiation of drug use and preventing progression into more regular use among at-risk

populations. Prevention is one of the positive health behaviors (Mrazek & Haggerty,

1994). Prevention in this study refers to the diverse approaches through which the

university community promotes constructive attitudes, norms, beliefs, values, practices

and life choices to impede drug abuse. It refers to all the activities in addiction continuum

employed by the university to help its community members from engaging, progressing

and staying in drug addiction. Public Health Model (Mrazek & Haggerty, 1994; Ayah,

2011; Kloos, et.al, 2012) on prevention delineates three levels and characteristics of

prevention which this study examined for their presence in the programs of the

universities under study.

The beginning of drug abuse prevention programs in institutions and communities dates

back to Shanghai Opium Commission in 1909 when the groundwork for the first

International Drug Control Treaty was established. This was followed by the

International Opium Convention of The Hague, 1912 which laid the ground for various

studies that came up with recommendations for prevention.

This study considers assessment of effectiveness of drug abuse prevention programs a

strong rejoinder which provides an avenue for bridging the gap between the existing
 4

knowledge about prevention and the practical implementation as well as grasping the

demarcation between effective and non-effective prevention programs in Kenyan

universities. Laurie (1984) delineates that the goal of research is to expand knowledge

about how existing prevention programs actually operate, which programs have been

effective and why and whether these programs are transferrable to other settings.

Evidence from epidemiology according to a survey done by (NIDA, 2009) suggests

continuous shifts between periods of increasing and decreasing abuse of substances

because prevention can modify the trend, generate or reinforce the downward shift, or

help diminish the rising trend. This fact is reiterated by results of a comparative study

carried out at Gaza strip in 2004 and 2008 demonstrating changes in drug use prevalence

found reduced as follows: marijuana, 2.5 percent of males and 0.8 percent of females

compared with 4.6 percent and 1.2 percent, respectively, in 2004; alcohol, 3 percent of

males and 5 percent of females compared with 7.1 percent and 2.6 percent, respectively;

powder (heroin and cocaine), 1.2 percent of males and 0.3 percent of females instead of

2.8 percent and 1.6 percent, respectively. However, tablets were reported to increase and

new tablets were reported: Tramadol, 7.8 percent for males and 2.5 percent for females;

central nervous system stimulants, 5 percent for males and 1.5 percent for females

compared with 5.4 percent and 1.3 percent, respectively (AlAfifi, &. AlSakka, 2010).

(AlAfifi, &. AlSakka, 2010) argue that changes in substance abuse trends are due to

reduced amounts of planted marijuana due to improved control on planting and the

increased supply of smuggled Tramadol tablets, which has increased demand for this

medication that is used by young people of both sexes without prescription. Hawkins et
 5

al. (2002) suggest utilizing an empirically sound diagnostic tool for assessing risk and

protective factors in order to identify factors for prioritization to be harmonized with

effective prevention efforts.

Assessment of effectiveness of prevention programs in Kenyan universities would offer

a reflection necessary in reducing substance abuse which in turn positively impact on

accomplishment of universities‟ vision through improved academic performance, reduced

student indiscipline and dropout cases, improved relational dynamics and enhancement of

student participation in extra-curricular activities. A paradigm shift of this nature can

only be achieved through articulate consideration on how prevention programs operate

including looking at factors responsible for effective and non-effective prevention

programs.

Scientific evidence demonstrates effective prevention programs as those with multiple

approaches and attributes such as; placing emphasis on socio-cultural relevance to users,

aiming at modifying risk and protective factors, are developmentally relevant in getting

to the intellectual, cognitive and social levels of participants, employing comprehensive

life skills, have interpersonal skills and interactive activities amongst users and

implementers, and are theory driven (Dusenbury & Falco, 1995, Tobler 2000, Riggs,

2003, Nation, et.al, 2003).

Riggs (2003) proposes intervention measures such as; strengthening academic

requirements, restricting alcohol promotions and advertising on campus, providing a wide

range of alcohol-free social and recreational activities. Research also suggests matching

individual characteristics with a specific approach and those approaches that will attract
 6

university students to see the need to mitigate the problem of drug abuse (Battjes & Bell,

1985, Jones 1990, Ghodse, 2005). Bukoski (2006) recommends that prevention programs

for students should include integrative methods such as peer discussion groups and not

just didactic teaching techniques. He supports programs that integrate skills which enable

students resist drugs when offered, strengthen personal commitment against drug use and

increase social competency of assertiveness and self-efficacy. Research vividly shows

further that strategies designed to mitigate substance abuse problem are geared towards

targeting psychological, social, cognitive and behavioral components of student

interactions. These constitute good suggestions on methods of delivery and fundamental

areas to focus on in order to ensure effectiveness of prevention programs.

In America, The Higher Education Center for Alcohol and Other drugs and Violence

Prevention was established to spearhead prevention through programs like Drug Abuse

Resistance Education (DARE), Alcohol and Drug Abuse Prevention Team (ADAPT) and

Students Taught Awareness and Resistance (STAR). These programs disseminate

information and address student psychosocial behavior at multiple levels such as

personal, peer, institutional and community. They include provision of mutual counsel,

encouragement and mentorship. Through these programs, some students have abstained

from abusing drugs (Stubbs, 2008). Assessment of prevention programs in Kenyan

universities to establish ability and viability of targeting prevention epitome through

accessibility and modification of drug taking behaviors of students is paramount in

determining the effectiveness of student utilization of prevention services drug abuse

reduction.
 7

Utilization of extracurricular activities to prevent risky behaviors including alcohol and

drug use among adolescents, university students and adults prove effective in reducing

drug abuse cases. Incorporation of Games and Sporting activities in prevention programs

may augment effectiveness. It also encourages students to participate in antidrug abuse

campaigns in UK universities (Larson, 2000, Eccles et al., 2003, Murphy et al., 2005).

In Chinese universities prevention of drug and substance abuse aims at replacing attitudes

of reckless socialization with a sense of responsibility in social relationships. This

enhances collaboration among students in working against drug abuse (Abdullah,

Fielding Hedley, 2010). Promotion of positive attitudes for concerted effort towards drug

abuse reduction among university students would be crucial in instigating effectiveness

of substance abuse prevention programs.

At the University of Deakin in Australia, student drug and substance prevention activities

reinforce the government‟s prevention effort through integration of a unit which tackles

drug abuse information in academic programs. This has increased positive responsiveness

to drug abuse prevention amongst students (Lewis, 2010). Integrating drug and substance

abuse prevention programs with academic activities has proven effective in the fight

against drug abuse. Kenya universities‟ integration of prevention activities in academic

programs would expand the scope of recipient information hence augment prevention

effectiveness.

In Rwandan universities, students and staff utilize a radio program to disseminate

information on drug abuse prevention. Other strategies include anti-drug campaign weeks

(Ngabonziza, 2011). In Uganda, the Prevention of Alcohol and Drug abuse (PADA)
 8

founded by Makerere University, students with support from other agencies such as the

Ministries of Gender, Health and Education spearhead. Drug abuse prevention activities

include empowerment on psychosocial skills for drug abuse prevention, advocacy and

research for social change (Henning, 2011). PADA has encouraged university students to

participate in reduction of drug abuse amongst their colleagues. This kind of program has

been more effective than the ones that don‟t encourage students‟ participation since

participation makes them own the programs. This would provide a good example to

Kenyan universities‟ prevention programs in emphasizing social change for support and

involvement in prevention programs amongst students.

In Kenya, The National Agency for Campaign Against Drug Abuse (NACADA) founded

in 2001 with a mandate to prevent substance abuse collaborates and partners with

universities. It has provided empowerment to youth and general public on how to counter

drug abuse in learning institutions including universities. NACADA carries out training

of counselors to help in the prevention of substance abuse. Other programs are offered by

the media, Non-Governmental Organizations (NGOS) and spiritual leaders, all of which

make attempts to prevent substance abuse in Kenyan institutions including universities

through provision of life skills, dissemination of information and skill development. Most

strategies entail dissemination of information about drug abuse and its consequences and

empowerment on social skills for resisting drug use and abuse. Through these trainings,

production of materials for dissemination of information and other activities, substance

abuse prevention in Kenyan universities is undergoing prevention.

 9

Foregoing information depicts various universities‟ efforts to address substance abuse

problem. These efforts entail huge financial investment through production of materials,

implementation procedures and employment of counselors and other social support

providers. A fundamental question that inevitably emerges is the state of discrepancies in

prevention programs to an extent of still a rising prevalence rate despite all these

exertions in Kenyan Universities. In response to this inquiry, this study embarked on

assessment of effectiveness of substance abuse prevention programs in selected Public

and Private Kenya universities. Apparently, measures of effectiveness of drug abuse

prevention programs are multifaceted, but this study adopted two strategies to address it.

First, it identified principles of effective prevention programs which have been

established after several years of research from renowned drug abuse prevention bodies

namely, US National Institute on drugs (NIDA) and The Mentor Foundation, UK and

individual research scholars. Representation of different regions of the world was put into

consideration while selecting these researches to gain from divergent contexts, a strong

factor influencing effectiveness of substance abuse prevention programs. These

researches spanning over several research years offer scientific-based findings on

effective principles for fundamental ideals in establishing workable prevention programs.

Secondly, elements assumed relevant and worthy examining were operationalized in

order to obtain a clear picture of how prevention programs in Kenyan universities combat

drug abuse. These consist of; objectives of various prevention programs present ,

methods of service delivery, material and human resources, suitability of prevention

programs to users‟ psychosocial and socio-cultural attributes, availability of prevention

services to users, synchronization of prevention programs to other university academic

 10

and non-academic programs, student responsiveness, challenges encountered by

prevention programs and factors sustaining drug abuse. Study process framework based

on these parameters to aid in expedition of prevention programs in Kenyan Universities

was purposefully developed to guide in examining variables deemed essential (Appendix

F). Each parameter has details of program expectations which according to this study

deserved to be investigated as portrayed in research findings that capacity of drug abuse

prevention programs to infiltrate and implement these parameters constituted an

indication of effectiveness (Naidoo & Wills, 2011, Kloos et.al 2012).

1.2 Statement of the problem

Attempts to address substance abuse dates decades back in Kenya as demonstrated by the

following series of steps; The Kenya Ministry of Education in its reports (Ominde, 1964,

Gachathi, 1976, Koech, 1994); establishment of NACADA in 2001; legislation

overseeing the cultivation, trafficking and abuse of legal and illegal drugs in Kenya

(NACADA 2002). Contracting performance of State Corporations (GoK 2003) which

saw recommendation of prevention of drug abuse in universities resulting in strategy

which has since ensured employment of counsellors, training of drug and substance abuse

trainer of trainers (TOTs) and establishment of workplace drug abuse policy; the

government implementation of United Nations Millennium Development Goals and the

Vision 2030 (GoK 2007) all depict measures to curb drug abuse in Kenya through

various prevention programs.

In universities in Kenya, substance abuse prevention programs are provided by social

support systems such as counselling, chaplaincy, coaching, and mentorship who closely

work with students in providing life skills education, support and coping strategies.
 11

Through academic programs and auxiliary services, the university endeavors to keep

students on academic agenda and make the university the serene world of academia with

goals of teaching, learning, and research and community outreach services. Furthermore,

universities incur a lot of financial expenses through prevention programs. The strategic

plans covering five years for NACADA (2009) and the Ministry of State for Youth

Affairs (GoK, 2007) on budgets for drug abuse prevention which is estimated at Ksh

820,860,308 and 160,000.000 respectively demonstrate huge amounts of money spent on

drug abuse prevention programs.

However, information on the status of drug abuse shows a rising trend. National Baseline

survey on Alcohol and substance abuse in learning Institutions (2009) illustrates an

increased use as education level advances. At primary school level, alcohol consumption

is at 10.3% whereas at secondary school level it shoots to 29.5%. Cigarette smoking at

primary school level was 10.2% whereas secondary school was 17.9%. A baseline survey

carried out by Kenyatta University (2009) demonstrated that 24% of students use alcohol

while other drugs‟ consumption is above 10%. Atwoli, Mungla, Ndungu, Kinoti & Ogot,

(2011) quotes a lifetime prevalence rate of 69.8 %. College of Health Sciences at

University of Nairobi demonstrates 52.6% of students use alcohol and 14.6% showed

symptoms of dependence (UoN, 2010). Squirting trend and repercussions of university

students‟ drug abuse is further evidenced by Kenya Police department reports. A few

cases from Nairobi Central Police Station in their daily occurrence books reveal that in

February 2002, students of University of Nairobi after drinking at club Heatz at Moi

Avenue beat up customers, in 2006, students of Kenya polytechnic caused chaos after

drinking at Juzz club, in 2009, students from Jomo Kenyatta University of Agriculture
 12

and Technology caused problems after drinking at Black Diamond club, in 2011,students

of United states International University went on rampage after drinking at club Beltz and

in January 2012, university of Nairobi students were arrested at Cocoa lounge after being

found smoking cigarettes.

The above information substantiates a contest between drug abuse prevention efforts

stretching from 1960s to the present involving weighty human and financial investment

and drug abuse rising trend. Hence it is in the light of the above premises that this study

seeks to assess the effectiveness of substance abuse prevention programs and activities in

selected Public and Private Universities in Kenya.

1.3 The Purpose of the study.

The purpose of this study was to assess effectiveness of drug and substance abuse

prevention programs in selected Kenyan Public and Private Universities.

1.4 Specific objectives:

The specific objectives were:

1) To establish objectives, levels and principles of drug abuse prevention programs‟

and activities‟ currently in existence in universities.

2) To establish methods of implementation of drug abuse prevention programs in

universities.

3) To determine student utilization of and participation in drug abuse prevention

programs and activities in universities

 13

4) To establish challenges to effective implementation of drug abuse prevention

programs in universities.

5) To find out if prevention programs and activities target factors which sustain drug

abuse in universities.

1.5 Research questions

The research questions which guided this study were:

1) What are objectives, levels and principles of drug abuse prevention programs in

existence in the universities?

2) What are the implementation methods of drug abuse programs in the universities?

3) Do students utilize and participate in drug abuse prevention programs and

activities in the universities?

4) What are the major challenges facing effective implementation of drug abuse

prevention programs in the universities?

5) Do prevention programs and activities target factors which sustain drug use and

abuse in universities

1.6 Hypotheses of the study

This study employed Hypothesis testing on research sections which needed clarification

and comparison of findings amongst universities and between public and private

universities under study which included:

1. H0: There is no significant relationship between students‟ awareness of

DSAPP and their residence.

 14

2. Hα: „There is no significant difference in use of drugs amongst students in Private

and Public Universities‟

3. Ho: There is no significant difference in DSAPP departmental involvement in

Public and Private Universities

4. Ho: There is no significant difference in opinion about the impact of DSAPP on

drug abuse prevention amongst respondents in universities under study.

5. Ho „There is no significant difference between ratings on student participation in

selected universities‟

6. Ho: There is no significant statistical difference in students being used as agents

of prevention in Public and Private Universities under study‟

7. Ho: There is no significant difference in strategies suggested for greater

utilization of prevention programs in selected Public and Private universities‟

8. Ho: There is no significant difference in the rating of social, cultural,

psychological and economic as factors sustaining drug abuse in selected

universities.

1.7 Justification of the study

Assessment of effectiveness of prevention programs could help identify benefits and

challenges for prevention programs‟ appropriate adjustment. Drug abuse has agonizing

social, physical, spiritual, emotional and financial consequences on the abuser, their

families and the university‟s vision and mission. Substance abuse continues to impact

negatively on academic performance, making the victims frustrate their roommates and
 15

caretakers. Students who abuse drugs take longer periods of study or even drop out of the

university. Assessment of effectiveness of prevention programs is crucial in unveiling

workable strategies which the university stakeholders could apply to avert substance

abuse and its adverse impact.

Recovery from drug addiction is costly for families, the university and the government as

Sloboda & Bukoski (2006) evidently put it that effective prevention program is cost-

effective since for every dollar spent on drug use; communities can save 4 to 5 dollars in

costs for drug abuse treatment and counselling. NIDA (2009) measured the cost-

effectiveness and benefit-cost of two long-term, effective intervention programs known

as Strengthening Families Program: For Parents and Youth 10–14 (SFP 10–14) and

Guiding Good Choices (GGC) program. For every dollar spent on SFP, a $10 benefit was

measured, and for every dollar spent on GGC, a $6 benefit was measured. Earlier studies

also reported that for every dollar spent on drug abuse prevention programs in general,

communities saved from $4 to $5 in costs for treatment and counselling programs.

Preventing drug use before it begins is a cost-effective, common-sense approach to

promoting safe and healthy communities (UNODCP). Obot (1993) retorts that economic

cost of drug abuse are enormous with Egypt spending 6.6 billion US dollars annually on

efforts to combat them through cost of treatment, loss of productivity and the social and

health complications. The Ministry of State for Youth Affairs and NACADA in Kenya

collectively spend approximately Ksh 180 Million annually on drug abuse prevention. It

is on the basis of the above detrimental financial and psychological incurrence that this
 16

study sought to assess the effectiveness of substance abuse prevention programs in

selected Public and Private Kenyan universities.

1.8 Significance of the study

Through effective prevention programs, the university being a nurturing institution for

highly qualified scholars and as the point of departure for students to the world of work,

it is ably suited to inoculate a drug abuse-free culture. The university setting provides an

opportunity for reaching a large number of young people and equipping them with

knowledge, skills and attitudes to enhance not only their personal health but also that of

the families they will establish and the communities in which they will live and interact

with (Kupchella, 2009 in Fertman & Allensworth, 2010). Assessment of effectiveness of

prevention programs enables adequate understanding of variables surrounding drug abuse

dynamics. This is quite significant for formulation and amendments of drug abuse

policies for improvement in universities. In the perspective of this study, it is only

effective prevention programs that have the capacity to accurately trace the nub of drug

and substance abuse prevention. Assessment of effectiveness was therefore found

necessary to create room for refinement and depict prevention hallmarks. It was

envisaged that through the findings of this study, prevention program implementers

would be able to pay adequate attention to relevant environmental, social and personal

predispositions which play a key role in drug and substance abuse prevention. The

findings of this study on what constitutes effective prevention programs could greatly

contribute a positive change in the practice of substance abuse prevention which could be
 17

replicated in other learning institutions. Effective interventions may help prevention

practitioners select, modify or create more effective programs.

1.9 Assumptions
This study was based on the assumptions that:

1. Substance abuse is a phenomenon entrenched in student lifestyle dynamics with

universities responding by establishing drug abuse prevention programs whose

comprehensive and integrated approaches are required for effectiveness.

2. Drug abuse prevention in the university is not a statutory requirement because they do

not constitute the core functions. Support of prevention programs hence are

dependent mainly on the will of the university as alluded to by (Polymerou, 2007).

3. The triangulation of data collection methods was strategic to an enriched study.

1.10 Scope and delimitation

This study was carried out in two Public and two Private universities in Kenya. It

integrated students and social support providers consisting of counsellors, chaplains,

wardens, security officers and Housekeepers working. Four tools of data collection

consisting of Student Questionnaire, Focus Group Discussions and Qualitative Interview

Schedule. In all these research tools, synthesis of information targeted operationalized

parameters which were considered indicators of effectiveness as derived from the

literature review namely; programs and activities present in universities including their

levels, objectives and principles. Other parameters were, methods of implementation,

resources, student utilization of and participation in prevention programs, suitability of

prevention programs to users‟ psychosocial and socio-cultural attributes and challenges

encountered by prevention programs.

 18

However, prevention activities targeting specific drugs of abuse such as heroin, cocaine

and emerging drugs were not done to avoid too much breadth and allow for adequate

attention to major domains identified in the objectives of this study. It is for the same

reasons that assessment of specific prevention programs such as NACADA, ADCU,

SCAD, NGOS, FBOS or any other organizations related directly or indirectly to

prevention efforts in universities was not done.

 19

CHAPTER TWO

LITERATURE REVIEW

2.0 Introduction
The purpose of this study was to assess effectiveness of drug abuse prevention programs

in selected Public and Private Universities in Kenya. This chapter presents theoretical

framework of the study based on Self-Efficacy Theory (Bandura, 1986) and Ecological

Systems Theory (Brofenbrenner 1944) and other augmenting theoretical frameworks and

concepts. It discusses literature review, on researchers‟ findings on drug abuse prevention

programs over time in World, African and Kenyan universities. These prevention

programs discuss their effectiveness in reducing drug abuse behaviors. Principles for

effective prevention programs emanating from Dusenbury & Falco‟s (1995) evaluation of

several drug abuse prevention programs provide basis to discourses in this section. The

Conceptual framework of the study comes at the end of the chapter delaminating major

features of consideration in any effective drug abuse prevention program.

2.1 Theoretical Framework

This study specifically made use of two theories namely, Self-efficacy theory (Bamdura,

1986) and Ecological systems theory (Bronfenbrenner, 1944) because their tenets

demonstrated relevant relationship to the parameters measuring effectiveness and

objectives of the study.

2.1.1 Self-Efficacy Theory (Bandura, 1986)

This theory was proposed by Albert Bandura, a Psychologist born in 1925 at Alberta,

Canada. Bandura (1995, 2004) perceived self-efficacy as beliefs in one‟s capacity to

 20

organize and execute the courses of action required to manage prospective situations.

Other researchers advance this point that, Self–efficacy, or the confidence in personal

ability, has been shown to predict a variety of health behavior outcomes (Ormrod, 2003;

Margolis & McCabe, 2006; Conner & Norman, 2009). Bandura (1977) states that

people‟s level of motivation affective states and actions are based more on what they

believe than what is objectively true and for this reason, how people behave can often be

better predicted by the beliefs they hold about their capacities than by what they are

actually capable of accomplishing. According to him therefore, self-efficacy perceptions

help determine what individuals do with the knowledge and skills they have.

Bandura‟s theory is a pointer to an important situation that could emerge in universities in

which established prevention programs may either be utilized by students or not. This

dichotomous position is determined by the beliefs and attitudes they hold about the

impact prevention programs create in their lives. Theory of Planned Behaviors (Fishbein

& Ajzen, 2010) describes attitude as a disposition to respond favorably or unfavorably to

an object, behavior, person, institution or event. Zimmermann (2008) argues that an

elemental support of the effect of attitude on self-regulation is a dynamic process in

which the individual engages as he or she works toward a goal. Without feedback or

reflection, adjustments cannot be made and regulation of behaviors does not take place.

He views the environment as an influencer to self-regulation in either a positive or

negative direction. If the environment provides no feedback or social cues, it is difficult

for effective self-regulation to take place.

 21

This assertion indicates a complementary relationship between attitude and factors

within the environment. If students positively appraise prevention programs, they are

most likely to utilize them for their benefit. Conceptualization of student self-efficacy

dynamics plays a big role in student positive responsiveness and participation in

prevention activities. In this regard, student participation plays a key role in the

implementation and effectiveness of prevention programs.

Self-efficacy theory further postulates that, virtually all people can identify goals they

want to accomplish, things they would like to change, and things they would like to

achieve. However, most people also realize that putting these plans into action is not

quite so simple. Bandura (1977, 2004) found that an individual‟s self-efficacy plays a

major role in how goals, tasks, and challenges are approached. He argues that people with

a strong sense of self-efficacy form a stronger sense of commitment to their interests and

activities. Bird, Conrad, Fremont & Timmermans (2010) argue that personal control

depends on one‟s choices and actions that they can master, control or effectively alter the

environment. Luszczynska, & Schwarzer (2005) assert that choices affecting health are

dependent on self-efficacy which determine whether health behavior change will be

initiated, how much effort will be expended, and how long it will be sustained in the face

of obstacles and failures. West (2006) in his cognitive bias theories argues that addiction

is maintained by biases in the cognitive system, including beliefs, expectancies, self-

efficacy, attributions and attention. Batholomew et al. (2006) argue that behavior change

occurs in capability to perform the behavior or under a number of different circumstances

like perceived self-efficiency and perceived behavioral control. The presuppositions

 22

provide insight to prevention programs on the crucial need to develop self-efficacy

among students.

In universities, the success of prevention programs‟ implementation is regulated by self-

efficacy of individual students who are users of these programs. It is essential for

prevention programs to access student cognitive dynamics for synchronization with

techniques and strategies being used as this could contribute to effectiveness of substance

abuse prevention.

2.1.2 Ecological Systems Theory (Bronfenbrenner, 1944)

The proponent of Ecological theory is Urie Bronfenbrenner, a Russian American

Psychologist born in 1917. Ecological systems theory provides a behavioral,

environmental and socio-ecological approach to health promotion and prevention. This

theory postulates that individuals, families and communities are not isolated entities but

rather are an interrelated ecological system with each adapting to change that occurs in

other parts of the organization (Guttmacher, Kelly, & Ruiz-Janecko, 2010).

Bronfenbrenner (1944) proposes five systems which contain roles, norms and rules which

play a big role in shaping individual development namely, Microsystems, Mesosystem,

Exosystem, Macro system and Chronosystem.

Microsystem refers to the immediate environment the individual comes from such as the

peers, family and the neighborhood. A person's closest social circle consisting of peers,

partners and family members do influence their behavior and contributes to their range of

experience. Prevention strategies at this level may include mentoring and peer programs

designed to reduce conflict, foster problem solving skills, and promote healthy
 23

relationships. Mesosystem refers to the interactions between and among different

Microsystems and the contexts that form them such as relationships among university

prevention programs and the neighboring community. Exosystem demonstrates

connection between social settings and the individual‟s immediate context. Individual

Prevention strategies at this level are often designed to promote attitudes, beliefs, and

behaviors that ultimately prevent substance abuse. Specific approaches may include

education and life skills training. At macro system level, culture plays a crucial role in

determining the way people exchange their relationships. Prevention strategies at this

level are typically designed to impact the climate, processes, and policies in a given

system. Social norm and social marketing campaigns are often used to foster community

climates that promote healthy relationships.

Chronosystem refers to the patterning of environmental events and transitions over the

life of an individual. These factors include social and cultural norms. Other large societal

factors include the health, economic, educational and social policies that help to maintain

economic or social inequalities between groups in society.

In a university setting, interactions exit at all the diverse levels mentioned by

Brofenbenner (1944). Relationships exist among individual students, neighboring

communities and the members of the entire university community. These relationships

are determined by values, practices, beliefs, norms and regulations that deter or

encourage drug use. It is necessary to approach substance abuse prevention from all these

interacting factors so that thoroughness is achieved in reducing abuse. Botvin and Griffin

(2007) summarizes this concept concerning campus environment that, perceptions of

 24

campus use, campus climate, substance availability, awareness of campus policies and

enforcement and students‟ family histories of substance abuse impact the extent of drug

use and abuse on any given campus. He emphasizes that the campus and surrounding

community exert profound influence on innumerable facets of student life. Recognition

of the environment in shaping and maintaining individuals' behavior is important in

addressing individuals and the policies, practices, and social norms that affect them on

campus or in the community. This is in line with (Margolis & McCabe, 2006; Conner &

Norman, 2009) postulation of complementary interaction of aspects in ecological system.

They enlist these factors as; intrapersonal factors consisting of characteristics of

individuals themselves, such as knowledge, attitudes, behavior, self-concept, learning

history, and skills; interpersonal processes and primary groups which constitute formal

and informal social network and social support systems, including family, work group,

living group, and friendship networks; institutional factors composing of social

institutions to which individuals belong with particular organizational characteristics and

formal and informal rules and regulations for operation; community factors which entail

relationships among organizations, institutions, and formal and informal networks within

defined boundaries and lastly, public policy on levels of local, state, and national laws

and policies.

Coreil (2010) suggests analysis within a social ecological framework at intrapersonal

level which includes characteristics of individual such as knowledge, attitudes, behavior

perceptions of risk and self-concept. He further advances that adolescent peer culture

plays a key role in the development and maintenance of health risk behaviors.
 25

Proponents of systems theory (Ludwig Von Bertallanfy, 1968, Bronfenbrenner, 1944,)

advance several ideas through their basic concepts namely; that, a system interfaces with

other systems that may be of a similar or different type., the functioning of a system

affects multiple other systems and is effected by multiple other systems and that there is a

constant interaction between systems resulting in a constant state of change. They

contend further that time is a significant dimension and different effects occur over time.

This is relevant to a typical university setting which goes through several changes as

social and intellectual demands dictate.

Ecological systems theory suggests fundamental principles underpinning multifaceted

person-focused and environmentally based components in establishing prevention

programs. In view of ecological systems theory, prevention programs need perceive high-

impact leverage points and intermediaries that can facilitate successful implementation of

prevention programs. It is essential as well for prevention programs to measure the scope,

key players and sustainability of the outcome of prevention programs due to societal

interactionism and functionalism (Weiss & Lonnquist, 2012). Rogers (2006) in support of

these facts argues that when assessing and developing an intervention, there is need to

consider all the factors that fall in the individual‟s life at all levels. The concept of

individualism and collectivism hold relevance in community interaction (Myers, 2010).

These precepts suggest that prevention programs need to consider various student

psychosocial, behavioral and environmental characteristics which influence different

levels of drug abuse prevention from the onset of drug use to addiction and recovery on

individual and social basis at the university since individual health and behavior are

influenced by their social and physical environment (Issel, 2004). It is relevant as well to
 26

consider various changes that occur in availability, course and use of drugs of abuse at

the university.

Prevention strategies ought to give adequate consideration to the impact being created by

drug abuse dynamism. This is practically possible if all the above mentioned concepts of

interacting systems are examined to comprehend their role in drug abuse correlates.

Changes take place in terms of entry, course and outcome of drug use. Attention on new

ways in which drugs get accessed, used and camouflaged by students is important in

determining prevention approaches useful to students who have not started using, or

those already in use and those addicted to the problem. Attention needs to focus on new

factors that sustain drug abuse in the university.

Other researchers‟ perspective strongly augment this theory attesting that prevention

strategies should include dissemination of drug information, cognitive and behavioral

skills training for youth, parents, and professionals among others(Coreil,2010;

Frost,2008; Ghodse,2005; Bandura,2004). Dusenbury & Falco, (1995); Riggs, (2003),

contend that treatment and prevention for adolescents is most effective when multimodal

treatment services are provided and integrated.

Assessment of effectiveness of prevention programs should place special credence to

levels of relationships, risk and protective factors present in the campuses in which

students stay and carry out most of their formal, informal, academic and non-academic

activities.
 27

2.2 Review of literature

The review of literature covered prevention levels, principles of prevention programs and

prevention activities in World, African and Kenyan universities.

2.2.1 Objectives, Levels and Principles of Prevention Programs

In various universities and drug abuse research centers such as National Institute on Drug

Abuse (NIDA), Narconon International and Substance abuse Research Center at Jazan

University, objectives of drug abuse prevention programs include but not limited to the

following:

1. To reduce drug abuse in campuses and encourage a healthy lifestyle

2. To identify the characteristics and patterns of drug abuse.

3. To understand how, environment, and development influence the various risk and

protective factors for drug abuse.

4. To develop and promote more effective strategies to prevent people from taking

drugs and from progressing to addiction if they do

5. To support research to better understand the spread and risk factors among drug

abusing populations.

6. To support participation of all stakeholders in prevention

7. To help in primary and secondary preventions of psychiatric and other medical

diseases among drug abusers.

 28

8. To improve substance and drug abuse prevention and outcomes in drug abusers

through a better understanding of processes, risky behaviors and mental problems

associated with drug abuse

9. To study and assess the adverse effects of substance abuse and related social,

medical, and health consequences within vulnerable populations

10. To enhance methods for campus conduct and policy compliance

Objectives of programs show that prevention programs should inform users about

availability of prevention activities and policies guiding its use and abuse, educate the

users on the causes, course and effect of drug abuse, support the students who are

affected by drug abuse at all stages of the drug abuse continuum and maintain activities

which promote a good lifestyle without drug abuse. Prevention programs in universities

in Kenya need have specific objectives targeting specific outcomes for prevention to be

effective.

Medina-Mora (2005) acknowledges prevention as any activity designed to avoid

substance abuse and reduce its health and social consequences. He argues that effective

approaches are required before and after symptoms develop. Prevention is a

complementary approach in which services are offered to the general population or to

people who are identified as being at risk for a disorder and they receive services with the

expectation that the likelihood of a future disorder will be reduced. Prevention seeks to

reduce incidence, prevalence, recurrence and time spent with symptoms. Decreasing the

impact of illness on the person, family and society are considered part of prevention.

Stevens & Smith (2005) contend that once there is a perceived need for prevention, initial
 29

questions should involve who should be targeted and goals to be set. Substance Abuse

Mental Health Service Administration (SAMHSA) and National Institute of Mental

Health (NIMH) state that prevention is different from intervention and treatment in that it

is aimed at general population groups with various levels of risk for any problem with the

goal of reducing risk factors and enhancing protective factors. They further argue that the

framework can be used to match interventions to needs of a targeted population.

However, it is sometimes confusing to demarcate prevention levels from interventions.

Intervention levels refer to the focus for the strategy, whether programs are targeted at

community or systems or individuals; interventions refer to the audiences of target.

Institute of Medicine (Mrazek & Haggerty, 1994; Ayah, 2011; Kloos, et.al, 2012)

categorize as these intervention levels into three types. The first is Universal programs

which are programs designed for the general population, such as all students in a

university. The mission of universal prevention is to deter the onset of drug abuse by

providing all individuals in a population with the information and skills necessary to

prevent the problem. Further research on these programs demonstrates that these

programs might encourage complete abstinence from drug use (Issel, 2004). The main

strategies being employed at this level of intervention is teaching people how to view

drugs and the potential impact on their lives (Ray & Ksir, 2002). It also includes building

public health policies which create a safe and supportive environment for development of

personal skills among students. Persons at elevated risk are less amenable to universal

preventions. Hence, despite widespread knowledge dissemination, public relations

campaigns and educational programming, a large proportion of the population engages in

risky sex, has an unhealthy lifestyle, exercises poor nutrition, uses illegal drugs, as well
 30

as engages in injury-prone behaviors (e.g. driving without seatbelt fastened). For these

individuals, intensive individualized prevention is required to effectively reduce or more

hopefully ameliorate the risk. Toward this end, selective and indicated prevention

interventions are required. Their objective is to attenuate the likelihood of adverse

outcome by directly modifying the factors causing the heightened risk status. An example

of universal program is project Adolescent Learning Experiences in Resistance Training

(ALERT), which targets alcohol, marijuana and cigarette use and is designed to help

students identify and resist pro-drug pressures and understand the social, emotional and

physical consequences of harmful substances. It aims to motivate students against using

drugs and give them the skills they need to translate that motivation into effective

resistance behavior, an approach that is widely viewed as the state of the art in drug-use

prevention (Rand, 2004). ALERT is a science-based exemplary model program which

addresses substance misuse rather than simply use, because of the widespread acceptance

of these substances amongst youth. ALERT and many other school-based drug

prevention programs draw on the tenets of social learning theory. Social learning theory

focuses on the learning that occurs within a social context, and considers that people

learn from one another through observation, imitation and modeling. Basically, social

learning theory says that people can learn by observing others‟ behavior and the

outcomes of those behaviors; that learning may or may not result in a behavior change;

and that cognition plays a role in learning. Accordingly, awareness and expectations of

future reinforcements and punishments can have a major effect on the person‟s behaviors.

Selective prevention strategies target subgroups of the general population that are at risk

for substance abuse. Numerous risk factors have been identified in youth at risk for the
 31

development of a variety of adverse outcomes (NIDA, 2003; Cleveland et. al.2008). First

is genetic risk factor where a family history of a substance use disorder or psychiatric

disorder is associated with increased risk for a disorder in offspring. Research literature

shows that paternal substance use disorder or antisocial behavior transmits risk for these

disorders in male offspring. Another factor is biological mechanisms of risk which

according these authors augment the risk for an adverse outcome in children. For

example, children who mature or reach puberty at a young age are at elevated risk. This

appears to be caused by their heightened physical appearance of maturity, combined with

lack of intellectual and social maturity which puts them at risk through association with

older peers who expose them to risky situations.

Behavioral risk factors are associated with substance abuse and other outcomes (NIDA,

2003; Cleveland, et. al.2008).Temperament, for example, is a well-established risk factor,

particularly where the child demonstrates the so-called "difficult temperament". This

disposition is featured by high behavioral activity level, difficulty in socializing, low task

persistence, high emotionality or irritability, and irregular sleep-wake cycles. Children

with difficult temperaments, particularly where extreme, often manifest maladjustment at

an early age which sets the trajectory for behavioral problems during childhood and

ultimately early age exposure to alcohol and drugs. Along with these dispositional

characteristics are impulsivity, sensation seeking, and aggressively.

Cognitive Risk Factors influence individual‟s beliefs about whether to engage in alcohol

or drugs or not. Those who believe that these compounds are personally enhancing are

more likely to use, and consequently a continued pattern of consumption puts that person
 32

at risk for developing an addictive disorder. Many misattributions are made by

individuals regarding the risk associated with their own behavior. This has been

demonstrated by the fact that youth typically underestimate the risk of unprotected sex or

not using seatbelts. They also underestimate the risk, or have misattributions, regarding

the hazards associated with alcohol or drug use. Neuropsychological processes which

refer to the capacity to strategically plan behavior, monitor behavior during goal directed

motivation play an important role in determining drug use. It has been shown that youth

at high risk for substance use are deficient in executive cognitive functions. Low

executive cognitive capacity is also associated with high aggressiveness. As a result of

this reduced capacity, high risk youth lack the ability to preview their behavior, or exhibit

foresight with the same capability as normal youth. These neurobehavioral factors

contribute to the risk for substance use in youth which are manifest especially in the form

of lower executive cognitive functions.

Prevention programs have a task of considering all the factors that expose university

students to risks. However, some of these risk factors can be identified using

psychological tests. This could present another challenge for those prevention programs

that are not adequately prepared with tools for psychological testing. Apparently, this is a

requirement that would enhance the effectiveness of prevention programs at all

intervention levels.

Indicated prevention interventions identify individuals who are experiencing signs of

substance abuse and other related problem behaviors associated with substance abuse and

target them with special programs. These programs are even more extensive, longer and
 33

are effective in preventing the developmental progression from one disorder to another.

They require greater effort on the part of participants than do selective or universal

programs. Programs require highly skilled staffs that have clinical training, counseling

and other skills. In the field of substance abuse, an indicated prevention intervention

would be a substance abuse program for students who are experiencing a number of

problem behaviors, including truancy, failing academic grades, juvenile depression,

suicidal ideation, and early signs of substance abuse. Examples of indicated programs are

Project Towards No Drug Abuse (TND) and Reconnecting Youth Program (RY) whose

main activities entail equipping youth with skills to defy drug abusing activities. They are

also trained to value their personal development.

Levels of prevention refer to the stage at which drug abuse problem is addressed. It indicates

whether the problem is handled before it starts, as it develops, or after it has developed as a

problem. The Public Health Model identifies three levels of prevention programs as

Primary, Secondary and Tertiary prevention. Primary prevention refers to programs

aimed mainly at young people who have not tried substances and drugs. These programs

presuppose an adequate knowledge of causal mechanisms and calls for development of

procedures capable of influencing them at an early stage (Perkins, Haines & Rice (2005).

Primary prevention programs would be helpful to university students in avoiding initial

use of drugs amongst students who have not started using them. Studies demonstrate an

increasing rate of drug abuse with the year of study (West, 2006) .It is thus necessary to

equip college freshmen who have a lot of free time and high social interactions with

information on how to avoid drug using behaviors to equip them with protecting

strategies.
 34

Secondary prevention entails programs designed for people who have tried drugs. These

programs are thus aimed at stopping development of drug use into addiction. This

category of prevention is equivalent to selective programs which target groups at risk or

subsets of the general population, such as poor school achievers or children of drug

abusers according to Institute of Medicine (Mrazek & Haggerty, 1994). Prevention

Programs need carry out early screening to identify those who fall under addiction

dispositions. At the university, a sizable number of students fall into this stage of drug

use and effective prevention programs should be able to identify and place students

falling in different categories in order to reduce the degree of individual and social

damage (Ghodse, 2005).

The third level of prevention is Tertiary prevention which corresponds with indicated

programs according to prevention classification of Institute of Medicine. It helps people

to manage health problems that have long term consequences such as addiction and

relapse to drug use (Ray & Ksir, 2002). Activities which may be included at this stage are

follow up programs such as Inpatient and Outpatient programs, Alcoholics Anonymous

(AA), Narcotics Anonymous (NA) and After Care Services. Rehabilitation services

which provide emotional support as well as psychotherapy towards psychological change

along with growth of the individual‟s self-actualization also fall in this category of

prevention. University setting encompasses students who are already addicted to drugs

and they require help in order to obtain sobriety hence tertiary prevention programs

would be effective in meeting the needs of this group of university community. Table 2.1

provides description of Prevention and Intervention levels.

 35

Table 2.1

Prevention levels and interventions

Prevention Intervention Target of Prevention activities

Level Level

Primary Universal Targeting the general public or whole population or group

before the problem starts

Secondary selective Target sub-groups of the population whose risk of

developing the disorder is higher than average when the
problem has already started but has not progressed to
addiction

Tertiary Indicated Targeting high-risk individuals whose drug problems are in

addiction or relapse

University population composes of students and staff with substance abuse psychosocial

facets in all the above categorical levels of prevention and interventions. Prevention

programs which are comprehensive in availing appropriate programs to diverse university

community groups stand better chances of effectiveness. Medina Mora, (2005) supports

this strategy that in the past, there was a tendency to regard primary prevention as the

only true form of prevention but effective prevention approaches are required before and

after symptoms become apparent. In his view, prevention of recurrence and relapse,

including relapse after successful treatment is an essential aspect of a public health

strategy to reduce prevalence. In this case, programs that comprehensively deal with all

levels of prevention are effective in addressing drug abuse cases falling in the drug

addiction continuum, a phenomenon present amongst university students. Galanter &

Kleber, (2008) in concurrence of this fact discuss on third taxonomy of prevention which

involves downstream interventions in which focus is on the individual and his or her
 36

lifestyle or behavior. According to them, Midstream intervention in which the focus is on

the communities and upstream interventions involving policies that support prevention

are all important in prevention strategies (Mc Kinlay & Marceau, 2000).

The discussion on the concept of prevention suggests that, all forms of prevention

practice must necessarily involve the conjoint application of universal, selected and

indicated interventions as well as primary, secondary and tertiary prevention levels. As a

nifty gritty procedure, two significant steps should be taken. First is about the social

contexts in which those individual students live and stay in campus and at home within

the community ought to be considered during planning of prevention programs if

effectiveness is to be realized. Secondly, prevention interventions must consider the

developmental stage of the individual in gauging the extent to which the person is at

elevated risk. This provides the opportunity to project the child‟s future developmental

trajectory. The premise behind all prevention is that the direction of the developmental

trajectory can be re-oriented to positive outcomes following the implementation of an

effective intervention (Trudeau, et. al.2003).

Research demonstrates (NIDA 2009, The Mentor Foundation, Schinke, Brounstein &

Stephen, 2002) that any successful prevention program ought to be guided by principles.

Dusenbury & Falco (1995) conducted a literature review of research on substance abuse

prevention programs and interviewed 15 experts in prevention research to determine the

components of effective drug abuse prevention programs. This resulted in identification

of 11 key components deemed essential principles for prevention programs as follows;

 37

1. They should be research-based and theory-driven. Curricula should be based on

research and supported by rigorous theoretical underpinnings that address both the

risk and protective factors associated with substance use.

2. They should possess developmentally appropriate information. The programs should

provide accurate and developmentally appropriate information that focuses on the

current reality for children. Information that exaggerates the consequences of

substance use or highlights risks that may affect children in the future are less likely

to be effective.

3. Social resistance skills training need to be included. Programs should help students

identify and resist the social pressures to use drugs that they are likely to encounter.

4. Normative education is part of prevention. These programs should help students

understand that most people do not use drugs and that substance abuse is not a

normative behavior.

5. Should include broader-based skills training and comprehensive health education.

Programs should help students develop strong decision-making skills, goal-setting

abilities, stress management techniques, communication skills, social skills, and

assertive skills so that they can make and defend their sobriety decisions.

6. Interactive teaching techniques are important. Programs should be based, at least in

part, on interactive teaching techniques (such as role-playing or small-group

activities).

7. Teacher training and support is a necessary part. Because these programs should be

interactive, teachers need to be trained in interactive teaching techniques. Success of

 38

prevention programs is based on the ability of participants to adequately implement

the components of the program. Riggs (2003) supports this point emphasizing focus

on adequate training and ongoing staff development activities for counselors and

program specialists.

8. Should have adequate coverage and sufficient follow-up. To help mitigate the

tendency of program effects to decay over time, interventions should be sustained

and offered periodically.

9. Cultural Sensitivity needs considered. Because of the focus on social resistance and

normative behaviors, prevention programs should be culturally relevant to the

participants.

10. Additional components should be incorporated. Within a prevention program,

family, community, and media components that support the goals of reduced

substance use can add additional support for students.

11. Evaluation is an important component. An independent evaluator should assess these

programs for effectiveness. Many programs have been rigorously evaluated.

Decision makers should request such information before they adopt a curriculum or

program. Riggs (2003) supports this fact that systematic evaluation to identify

problems and treatment needs in multiple domains including psychiatric co

morbidity is important.

Precepts from the above principles generate paramount prototypes of ideals for

effectiveness in drug abuse prevention which universities in Kenya could model.

 39

2.2.2 Drug and Substance Abuse Prevention Programs in Universities

2.2.2.1 Drug and Substance Abuse Prevention Programs in the US Universities

The US launched the Higher Education Center for Alcohol and other drug abuse and

violence prevention to help campuses and communities develop strategies for changing

campus culture; foster environments that promote healthy lifestyles and prevent high risk

alcohol and other drug use and violence among students. This center has encouraged

Colleges and universities to initiate a number of activities which are aimed at helping

students successfully transition into campus life and at reducing a range of problems

related to student drinking. In universities where programs have been established, drug

abuse cases and consequences associated with it have lessened. Criteria used by US

department of Education (NIDA, 2008) on award-winning prevention programs have

helped identify some of the campuses whose prevention programs have demonstrated

effectiveness. Examination of these programs would be important for benchmarking in

Kenyan universities.

Vicary & Karshin, (2002) observed that Social marketing campaigns are popular

interventions in reducing binge drinking in US universities and seems to have some

effectiveness in influencing students‟ beliefs and behavior towards drug abuse. Western

Washington University has incorporated several programs such as Social Marketing

Campaign, Health Opinion Leaders, and Community-Health Service Learning Program.

It would help universities in Kenya if students are engaged in campaigning against drug

abuse so that they may persuade their colleagues who may otherwise be using drugs.
 40

At the Auburn University, the program being used is Brief Alcohol Screening and

Intervention for College Students (BASICS) founded in 1997. It is a supportive program

to enhance motivation and make students learn how they might benefit from not engaging

in drug abusing behaviors. This has reduced enthusiasm among some students to avoid

taking drugs. However, this needs to be applied in Kenyan Universities with caution

through amiable approaches to avoid misinterpretation that they are being compelled and

for students to see the beneficial effect it has on them.

University of Boston employs a comprehensive community-based program involving

encouragement and law enforcement on drug abuse prevention. This is done through a

Task Force which ensures students make healthy decisions and exercise a sense of

responsibility with use of drugs. Feedback on what students think about alcohol is

through e-checkup which enables students to develop self-awareness on their drug status.

Other programs in this university include e-TOKE, CHOICES and BASICS (Retrieved

from www.bu.edu/shs/about/). An enhanced involvement of students is likely to

contribute to effectiveness hence these programs offer a good example to universities in

Kenya

Prevention program at Bowling Green State University is called Bowling Green State

University Peer-Based Alcohol prevention. It targets misperceptions, attitudes and

behaviors that discourage drug abuse. It was based on study findings that perceived

drinking norms and the actual norms do not tally therefore the programs were established

to address this gap. The Program at Rutgers University applies a similar strategy of

targeting misperceptions though their RU SURE program which encourages students to

 41

review their behaviors (D‟Amico & Edelen (2007). This is a strategy geared towards

introspection which ideal for encouraging individual ownership of prevention amongst

students. Based on the theoretical framework highlights above, these programs have

strong lessons to offer Kenyan universities on the crucial role individual initiative plays

in comprehending accurate norms to be encouraged in the university.

At the university of Virginia, a student body called Alcohol and Drug Abuse Prevention

Team (ADAPT) promotes awareness, provides educational outreach, and serves as

accessible resources for their fellow students. These are meant to encourage the students,

faculty and staff involvement in environmental change and community collaboration.

Tarter (2006) reiterates the significance of these practices that intensive individualized

prevention is required to effectively reduce or more expectantly ameliorate the risk of

abuse. Social marketing has shown great promise in addressing a wide range of problems

including adolescent substance abuse (Denniston, 2004 in Coreil, 2010). In general,

multiple-component programs which include school, family and community prove to be

the most effective. Kenyan universities require family involvement in prevention

activities to ensure complementarity of efforts and whole roundedness of drug source.

At Berkshire Community College, a program called Leadership in education about

alcohol and drugs (LEAD) operates a range of activities mainly to create positive

reinforcement and Peer leadership, with emphasis on civic and individual values and

responsibilities. The programs assess the environment and contribute to written policies

and procedures for the college community; promote education, prevention, and

intervention efforts that include curriculum adaptations, student-peer participation, staff

 42

orientation, and training; and provide activities to motivate students and generate positive

publicity. These programs are supported as good approaches to drug treatment due to

their ability to address certain aspects of drug addiction and its consequences for the

individual, family and society (Medina-Mora, 2005, NIDA, 2009).

Health Entrepreneurship is a program started at the Montana State University to redefine

drug and alcohol norms on campus through the development of autonomous "micro-

businesses" that focuses on health. Thus, the role of the Health Promotion staff becomes

that of health entrepreneurs who teach students to apply environmental strategies into

their daily operations. A similar program is in George Mason University where

transformation of campus cultures is done through healthy expectations program which

promotes positive expectations, norms, skills and proactive life healthy planning. The

healthy life planning is founded on seven principles namely; optimism, values, self- care,

relationships, community, nature and service. These principles have been integrated in an

initiative dubbed COMPASS which handles topics appropriate for healthy life planning

on many aspects of life. They are distributed to first year students so that a culture of

healthy living may be established. Retrieved from www.healthyexpectations.gmu.edu

Attesting to these practices, (NIDA, 2003; Ghodse, 2005) argue that if prevention

programs are incorporated into a wider perspective of healthy lifestyles rather than

emphasizing what is forbidden or dangerous, they become more effective. COMPASS

program spreads tentacles of dissemination on drug abuse so that students may view from

the perspective of health benefits. This program sets a good example which can be
 43

embraced by university students without necessarily feeling being coerced into not using

substances. It could lead to prevention effectiveness if implemented.

At the University of Scranton, The Drug and Alcohol Information Center and Educators

(D.I.C.E) is a program geared towards encouraging students to consume alcohol in legal,

low-risk ways, and in ways which abstinence from the use of drugs and alcohol is

acceptable. Students are encouraged to make informed decisions supporting responsible

alcohol use and make it a habit to participate in organized activities emphasizing

responsible use of alcohol and non-use of illegal drugs. In support of these programs

(Dusenbury & Falco, 1995; Botvin, 2005) contend that Life Skills Training is the most

effective and rigorously tested school-based prevention program which has been proven

to cut alcohol, tobacco and drug use by up to 87 percent. They recommend programs

which help students develop strong decision-making skills, goal-setting abilities, stress

management techniques, communication skills, social skills, and assertive skills so that

they can make and defend their sobriety decisions. These skills enhance student efficacy

in drug abuse prevention which has demonstrated its crucial significance for effective

implementation.

On examining these programs, one realizes that most universities have established

programs based on research findings (Deas, et.al. 2000; Winters et al.2007) who argue

that, behavioral and psychosocial interventions can be effective in treating adolescent

drug abuse and other associated problems. On the same note, (Riggs, 2003, Barry, 2003;

Epstein & Mc Crady, 2009) postulate that, cognitive-behavioral and behavioral therapy

approaches are based on operant behavioral principles such as, rewarding behaviors
 44

because they provide a constructive reinforcement system for the students. Social

learning-based drug prevention programs have positive long-term effects on tobacco,

alcohol, and marijuana use (Botvin & Griffin, 2007; Teesson, Newton & Barrett, 2012).

Additionally, programs mentioned above produce similar improvements in substance-

related behavior, such as reductions in antisocial behavior and school behavior problems,

and in areas of social functioning, such as improvements in academic skills, greater

commitment to school, improved drug refusal skills, and reduced affiliation with deviant

peers (Riggs, 2003, Barry, 2003; Epstein & Mc Crady, 2009). Student psychosocial

operations may influence their responsiveness to prevention programs and judicious

effectiveness.

Target areas for prevention programs are on development of individual skills to protect

from being influenced to using drugs. These include; decision-making skills, sports

nutrition knowledge, perception of personal athletic competence, athletic self-efficacy,

exercise skills, reasons for not using drugs, proper nutrition and eating behaviors,

perception of drug risks, knowledge about steroids, alcohol, and other substances of

abuse. Peers are also prepared to offer correct information about drugs. Protective factors

should be enhanced in the school as well in order to coaching staff intolerance to

substance use.

Brief alcohol and screening Intervention for colleges students combines both selective

and indicated levels of prevention to reduce on the problem of alcoholism is conducted

over the course of only two interviews, and these brief, limited interventions prompt

students to change their drinking patterns. Through this program, post-intervention

 45

students often comment that they respond differently to friends as a result of participation

(Hanson, 2013).

Prevention strategies at the university of Albany has made use of a program called

STEPS which focuses on University comprehensive Screening and Brief Intervention

(SBI) strategy based on the Brief Alcohol Screening and Intervention for College

Students (BASICS) of 18-24 years of age. The intervention is aimed at students who

drink alcohol heavily and have experienced or are at risk for alcohol-related negative

consequences. The STEPS model is designed to reduce alcohol use, frequency and

quantity. Secondly is to reduce associated negative consequences by adapting

interventions to meet the distinct and complex needs of the three target populations of

high-risk drinkers namely, first-year students, student-athletes, and students seeking

primary health and mental health care on campus. This demonstrates that effective

programs need to have all the three levels of prevention.

A universal program founded by Botvin & Griffin (2007) is an evidence-based

prevention program which concentrates on a variety of risk and protective factors to teach

personal and social skills. It is designed to impart to students the necessary skills to

resist social pressures to smoke, drink and use drugs and improve cognitive and

behavioral competence and to prevent a variety of health risk behaviors. A study by

(NIDA, 2003) found that Life Skills Training (LST), a thoroughly tested, school-based,

universal prevention program, significantly reduced initiation of drug use among urban,

minority middle school students who were doing poorly academically and had substance-

abusing friends. Previous research has linked these academic and social factors to
 46

increased risk of subsequent substance abuse. Yet one year after the LST program, these

high-risk youths reported lower rates of cigarette, alcohol, and inhalant use than a

comparable group of nonparticipating students. Moreover, LST participants who reported

using these substances used them in lower amounts than nonparticipants. Resistance

skills programs as a whole have generally been successful. Botvin (2000) states that a

comprehensive review of resistance skills studies published from 1980 to 1990 reported

that the majority of prevention studies (63%) had positive effects on drug use behavior,

with fewer studies having neutral (26%) or negative effects on behavior (11%) with

several in the neutral category having inadequate statistical power to detect program

effects. Furthermore, several follow-up studies of resistance skills interventions have

reported positive behavioral effects lasting for up to three years, although longer term

follow-up studies have shown that these effects gradually decay over time, suggesting the

need for ongoing intervention or booster sessions.

Mihalic, Fagan, & Argamaso, (2008) in their appraisal of this program argue that

although most sites faced common barriers, such as finding room in the school schedule

for the program, gaining full support from key participants, ensuring teacher participation

in training workshops, and classroom management difficulties, most schools involved in

the project implemented LST with very high levels of fidelity. Life Skills Training should

be promoted amongst students to teach them resistance techniques.

Evaluation studies of DARE by Dennis Rosenbaum and Gordon Hanson examined the

most scientifically rigorous published evaluations of DARE and concluded that DARE

has little or no impact on drug use behavior, particularly beyond the initial posttest
 47

assessment. Some of the possible reasons why DARE is ineffective may be that the

program is targeting the wrong mediating processes, that the instructional methods are

less interactive than more successful prevention programs, and that teenagers may simply

"tune out" what may be perceived as an expected message from an ultimate authority.

This raises a cautionary note to Universities in Kenya to dissuade programs which may

appear fanciful but may not appeal to users as evidenced by Botvin & Griffin (2005) who

argue that the etiology of drug and alcohol abuse is complex and prevention strategies

that rely primarily on information dissemination are not effective in changing behavior.

2.2.2.2 Drug and Substance Abuse Prevention Programs in European Universities

In the UK, colleges are using a variety of methods to educate students around drugs and

to challenge their perceptions and attitudes (Polymerou, 2007) and is organized and

delivered in a wide health promotion network (Dunne & Summerset, 2004).

McCambridge & Strang (2004) examined ten education colleges across inner London and

observed that students that received the Motivational Interviewing intervention reduced

the use of alcohol, cannabis, other drugs and cigarettes at three months follow up

compared to students who received „education as usual‟. Miller and others (NIDA, 2003;

Miller at al., 2005) reported that older youth at university or entering the working world

often continue a pattern of heavy substance use begun in secondary school. Their

reported use of substances to cope with pressure is a concern, as is using to the point of

intoxication and thereby risking accidents or, particularly in the case of alcohol, violence.

Motivational and skills-training approaches are proving effective in reducing substance

use problems in university settings.

 48

Another most well-known campaign in London was 'Study Safely'. This campaign was

targeted at further and higher education students aged over 18 across London and was run

jointly by 26 London Drug Action Teams (DATs). It was based on a non-judgmental,

harm-minimization strategy. The materials produced were received very positively and

the National Union of Students (NUS) encouraged their Alcohol and Drug Prevention in

Colleges and Universities making a positive impact (Branigan & Wellings, 1998). The

role of students‟ active participation and dissemination of information on drug abuse

prevention enhances effectiveness as they embrace drug abuse prevention programs.

Social norms interventions are strategies targeting students‟ misperceptions about drug

abuse and its consequences. Research demonstrates that students don‟t accurately

perceive the nature and use of alcohol and drugs amongst their peers (Hollands & Myer,

2006).

Polymerou (2007) reports effectiveness of extracurricular activities as part of drug abuse

prevention programs for adolescents (Stigler et al., 2006) and the findings about the role

of extracurricular substance free activities among college and university students

(Murphy et al., 2005) have potential implications for prevention programs in universities

and colleges. Adolescents that participate in extracurricular activities such as pro-social

activities, team sports and performing arts have better academic performance and college

attendance as well as a lower risk of dropping out. Participation also predicts reduced

involvement of risk taking behaviors, including alcohol and drugs and better self-esteem

(Eccles et al., 2003). Different types of activities are related with different types of

outcomes. For example, prosocial and performance activities predict lower increase in
 49

alcohol use while participation in sports has produced mixed results in youth substance

use (Fredricks & Eccles, 2006; Eccles et al., 2003).

Additional support for the role of sport in drug prevention comes from the Positive Future

Programme, a social inclusion programmer in England that engages young people in

sport activities. There is evidence that the programme may have a positive influence on

participants‟ substance misuse, physical activity and offending behavior (Eccles et al.,

2003).Beneficial role of extracurricular activities in students attending university is

supported by research that shows the important reinforcing role that student activities

have on reducing drinking in the campus. Murphy et al. (2005) found that students who

decreased their drinking showed increased reinforcement from substance free activities.

The FRANK campaign is a partnership program amongst department of Health and

education units in the UK which provides information on drug abuse risks as an endeavor

to discourage young people from engaging in drug taking behaviors. It has helped in

reducing drug abuse cases amongst young people. Retrieved from

(http://www.talktofrank.com/

In Germany, a program called Information and Psychosocial Competence (IPSY)

established by psychologists and psychiatrists in the university of Jena teaches students

life skills making them less susceptible to peer pressure and drug abuse habits,

(Weichold, 2011) This is supported by a study conducted earlier by the Global Youth

Network that positive peer pressure should be encouraged through art, music and sports

in order to encourage self-esteem and self-confidence (UN 2002). In Romania, a program

called our „Measure Your Lifestyle‟ encourages students to enjoy alcohol in moderation
 50

and so avoid personal, social and health costs to themselves, their families and society as

a whole (Retrieved from www.sabmiller.com/index.asp?pageid=599-

12.09.11).Establishment of personal values can be an effective strategy to preventing

drug abuse amongst university students since art and sporting activities are popular.

2.2.2.3 Drug and Substance Abuse Prevention Programs in Asian Universities

A study done in the University of Wuhan in China suggests that prevention places

attention among young internet users, Jenaro, et.al (2007). Shakeshaft,et.al. (2005)

reported that, educating students about the dangers of drug intake as well as its moral and

religious implications is likely to be more effective than increased policing. They further

emphasize integration of addiction medicine into the undergraduate medical curriculum.

Integration of addiction medicine in the university curriculum has been more effective in

reaching out to students. Social Media such as Tweeter and Face Book could be used to

communicate ADA messages to students as they communicate amongst themselves.

In the Philippines, the Youth Life Enrichment Program (YLEP) was implemented in the

college level through the psychological societies of the different colleges and universities

in Metro Manila (Cornelio, Banaag, & Jesus, 2000). The program is committed to

providing education and advocacy activities on drug abuse prevention among the youth.

These programs have contributed to drug abuse reduction. At the Philippine Women‟s

University, The University‟s Drug Prevention, Recovery and Post-Recovery Care

Program consists of three components of prevention, recovery and post-recovery care

which all aim at helping students not to abuse drugs. At Trinity University of Asia, a

project called HEALS encourages student volunteers and community clients to observe

wellness and busy themselves with worthwhile social activities or services to prevent
 51

them from engaging in drug and substance abuse (Ebuen, 2008). These projects have

helped students participate in preventing drug abuse amongst their colleagues through

dissemination of information and an inclination to prevent drug abuse. Participation of

students in positive various activities makes them meaningfully occupy their time and

plays a big role in making prevention programs effective.

A study carried out in Japanese universities indicated that substance abuse prevention

programs for college students address the health effects of risky drinking behaviors and

train students on how to avoid submission to peer pressure, (Shimane et al., 2009). In

Australia, response to the drug problem is an integrated approach, involving law

enforcement, health, prevention, education and treatment services. In universities, Peer

educator program, Youth sport and recreation program play an important role in

prevention. From a law enforcement perspective, the focus is on prevention and

partnerships with colleagues nationally and internationally (Lockwood & Saunders,

1991). Strengthening policy implementation is an important value addition to prevention

programs‟ effectiveness.

2.2.2.4 Drug and Substance Abuse Prevention Programs in African Universities

Most of the prevention programs in African Universities entail those offered by Non-

Governmental and Governmental organizations whose fundamental objective is to

empower students on prevention of substance abuse. Drug control strategy in the sub

region of West Africa hinges on a combination of supply control and demand reduction

programs (Adelekan, 1996). Through these programs, dissemination on drug abuse

causes, course and effects has been done to enable students acquire appropriate

information necessary for effective prevention of drug abuse.

 52

Burnhams, Myers, & Parry, (2009) in their study in learning institutions in South Africa

reported that Prevention programs in Cape Town mostly take the form of educational

programs (91%) which aim to raise awareness by providing knowledge about drug abuse

and their consequences. It encompasses Comprehensive survey of substance abuse to

identify those with the most serious drug and alcohol problems in order to offer

psychosocial support, over and above awareness and education, (McDonald, 2010).

Another program established under the partnerships of students, university authority and

Miller Company used three educational channels consisting of poster positioned on

campus pubs, banners with taxi information displayed during orientation week events

encouraging drinkers not to drive drunk and disposable breathalyzers carrying a

responsible message given out at various events.

The Global Initiative on Primary Prevention of Substance Abuse by World Health

Organization and United Nations on Drug and Crime (2003) initiated comprehensive

substance abuse prevention programs involving various projects in South Africa, Zambia

and Bagamoyo, Tanzania for young people in schools and universities. Activities include

broad-based interventions that give equal weight to supply and demand reduction;

improve young people‟s living conditions; and ensure that community agencies are

mobilized towards preventive action. Comprehensiveness of prevention programs to

include individual and environmental related approach is significant in adequately

addressing drug and substance abuse.

In Namibia, The Suzie and Shafa Show is a lifestyle‟s variety show created by youth for

youth between the ages of 15 and 24. The radio program airs on the University of
 53

Namibia (UNAM) Radio 97.4 FM. The programs address different types of lifestyle

issues youth face, including; alcohol and drug abuse, dating, date rape, staying healthy

and avoiding and preventing sexually transmitted infections (STIs), and HIV infection. A

radio program that accurately targets youth oriented activities would be a strong avenue

through which drug abuse information is effectively passed to them.

2.2.2.5 Substance Abuse Prevention programs in Kenyan Universities

The Ministry of Education in Kenya (GoK, 2003) mandated universities in the

performance contracting to initiate drug abuse prevention. This resulted in universities‟

networking and linkages with the Ministry of Education, Science and Technology, and

NACADA (Hagembe, & Simiyu, 2006). Through this, surveys, dissemination of

information and training of trainer of trainers (TOTs) on drug abuse has been carried out.

These are important processes that unveil pillar themes to target in order to upgrade drug

abuse prevention effectiveness.

At Kenyatta University, Kamanja, (2010) reports that the peer education program aims to

reduce irresponsible sexual behavior, unwanted pregnancies, sexually transmitted

infections (STIs) including HIV/AIDS and drug abuse by enhancing the quality of

counseling and service delivery for students. He says that peer outreach and extension

program trains university students to promote responsible behavior among their peers.

Through peer counseling program, students obtain information on drugs and referrals for

better help from trained counselors are done for students with complicated drug abuse

cases. Other drug abuse prevention programs are done through dissemination of

information about the onset, course, effects and intervention approaches to drug abuse

through University Newsletter and radio station (99.9 FM). Student clubs such as
 54

Kenyatta University Youth Against Drug Abuse (KUYADA) spearhead drug abuse

prevention activities through talk shows, (Oral interview, 2010). This student body caries

out dissemination activities amongst the students. Participation of many student bodies in

prevention promotes effectiveness through positive student responsiveness.

At The University of Nairobi, a program called Students Campaign Against Drugs

(SCAD) discourage students from using drugs in the campus. Peer counselor program has

been active through the assistance of Pathfinder International. A survey carried out by

Ndetei (2001) established that Nairobi University Association for a drug- free society

(NUADS) had done some advocacy work and was planning to extend it through

cooperation with students in other Kenyan public and private universities. Through these

student organizations, networking links within and outside the university has been made

possible hence improving effectiveness through diversification of approaches to

prevention.

At Jomo Kenyatta University of Agriculture, REPACTED in collaboration with other

Nongovernmental organizations such as, the MTV Staying Alive Foundation, the Raising

Global Voices Online, the Nakuru Players Theatre, APHIA II Rift Valley, Partners for

Progress, Act Alive, Vices of Roses, National Organization of Peer Educators, Kenya and

the National AIDS Control Council provide information on drug abuse causes and

prevention. Retrieved from

http://rising.globalvoicesonline.org/repacted/page/2/.Complementary approach amongst

university service providers and outside agencies to drug and substance abuse prevention

could enhance effectiveness due to joint material, human and financial resources.
 55

Daystar University was one of the first universities to involve NACADA in their drug

and substance abuse prevention campaigns against smoking, gambling, use of

intoxicating liquor, use of illegal drugs, and use of obscene or pornographic materials in

September 2005 leading to declaration of Daystar University as a drug abuse free

institution in February 2006, (Retrieved, June 13, 2010 from

http://www.nacada.go.ke/about /partnerships). Kenya Methodist university prevention

programs are implemented through Kenya Methodist University Campaign Against Drug

Abuse (KEMUCADA). It disseminates information on the effects of drug abuse amongst

students and staff. It also carries out campaigns against drug abuse in the neighboring

communities of the campus to counteract drug abuse.

From the above literature review on universities of the world, Africa and Kenya, it

becomes patently clear that various universities apply diverse approaches depending on

their contextual orientation. However, models shown to be predominant in drug abuse

prevention practice include; Awareness model, Attitude change model, Social influences

model and the most recent and seemingly preferred, Ecological model. Hansen,

Dusenbery, Bishop & Dersen (2007) further clarify this in their summary of seven

distinguishable approaches including; changing access within the environment,

promoting the development of personal and social skills, promoting positive affiliation,

addressing social influences, providing social support and helping participants develop

goals and alternatives, developing positive schools and enhancing motivation to avoid

substance use. The emphasis is that programs operate by changing characteristics of the

individual, the social group or the social or physical environment that subsequently

influence behavior. Their findings too suggested that program developers borrow across
 56

theories to construct effective prevention programs. Stevens& Smith (2005) advocate a

comprehensive approach which has the following characteristics; multiple levels of

intervention and populations multiple strategies, networks of resources sensitivity to

development and diversity factors, multiple effects and consequences of substance use

and abuse and need for long term effort. Botvin and Griffin (2005) classify prevention

approaches into five categories, namely information dissemination, affective education

approaches, alternatives approaches, social resistance skills approaches and competency

enhancement approaches. These approaches have been shown to work in various

universities and are in line with the theoretical framework of the study vividly pointing to

ardent consideration of factors surrounding the individual and the environment they live

in.

2.3. Summary of the Literature Review

The literature review reveals that understanding major principles which govern the

practice of prevention and need for all levels and interventions is crucial as delineated

clearly (Ries, Fielin, Miler& Saitz (2009). Objectives of most programs aim to

disseminate information on causes, course and effects of drug abuse while promoting a

healthy lifestyle. Other objectives target the source of drugs in the campus and how they

are permeated into the student population. Universities in Kenya aim at reducing drug

abuse and creating a drug free culture. The main principles portrayed in the literature

review includes: involvement of all stakeholders, carrying out research to identify viable

programs, engaging all levels of prevention and enhance protective factors and reduce
 57

risk factors. It also showed that prevention programs can be effective when they employ

interactive techniques and active participation.

Universities in the US and the make use of approaches such as life Skills, social

marketing, screening, e-communication, student involvement, peer-based programs,

involvement of all stakeholders, establishment of drug free culture, resistance skills and

behavioral and psychosocial interventions. Other main approaches and activities include;

motivational interviewing and skills training, student involvement, dissemination of

information, prosocial skills, sporting activities, and personal values. In Asian

universities, approaches include but are not limited to targeting internet users, integration

of prevention programs into the formal program of the university, education and

advocacy, student involvement, peer-education and sporting and recreational activities. In

the African continent, use of empowerment and sensitization of information, surveys to

identify those who require a specialized attention, supply and demand reduction

strategies, mobilization of community agencies and dissemination of information to every

member of the university community. Universities in Kenya employ dissemination of

information, training of Peer counselors, declarations of the university premise as a drug

free zone as the main strategies.

Counseling department and other social support providers such as chaplains were

depicted as the main implementers of prevention. However, many organizations dealing

with prevention and research prevention were also shown to be taking an active role in

prevention. Examples include, NIDA, Mentor Foundation and Narconon International.

Student participation and utilization of prevention programs was enhanced when

 58

programs were administered formally to a selected group of students under clear

supervision by program implementers.

Literature showed that universities face challenges of implementation and lack of support

from some stakeholders. Overwhelming student socialization places a stiff completion

between sustaining a healthy lifestyle and using drugs to binge levels. It also showed that

being able to identify programs which work well required time to test before

implementing. For instance, some of the programs like DARE were shown to be effective

but not many universities had applied them. Lack of adequate time and resources were

other limitations which were faced by prevention programs. The literature revealed that

developmental and intellectual levels of the users should be targeted so that activities

may be geared at addressing drug abuse issues which are applicable to the various

categories of students.

In summary hence, the literature review of this study demonstrates that, there is no single

approach that has been found to work similarly in all populations and environments.

Perhaps a combination of a variety of methods, strategies and models may work

effectively. However, fundamental principles of implementation must be laid down for

any prevention program to succeed. It is on this premise that this study found it most

fitting to assess effectiveness of substance abuse prevention programs in selected Public

and Private universities in Kenya.

2.4 Conceptual framework

Literature review in this study illuminates effective prevention programs as those with

multimodal approach not withstanding environmental variance. Such programs put into
 59

consideration factors such as: developmental appropriateness (Galanter & Kleber,2008),

interactive nature of prevention programs and the users, socio-cultural relevance, theory-

driven tenets, targets to personal and group values and norms, targets to risk and

protective factors, contact with consumer population, enhancement of positive

relationships amongst providers and users, self-efficacy and varying methods of service

delivery. These variables have an intense influence on prevention programs‟

effectiveness positively or negatively in several ways based on the context of application.

This study assumed that these factors should be found integrated in any prevention if it

has to be effective. Other parameters which indicate effectiveness if well-structured and

harmonized in any prevention activity or program are; Objectives of various levels of

prevention programs, methods of service delivery, accessibility of prevention programs to

users, synchronization of prevention programs to other university programs, keenness of

programs to target developmental stages of users, student participation and utilization of

prevention activities, challenges facing DSAPP and target of factors which sustain drug

abuse in the university. Whereas Prevention programs and can formulate activities

thoroughly, success to implement them relies on the support the university provides in

terms of policies, resources, curriculum flexibility and selectivity of student

entertainment joints. Outside agencies have a crucial role to play in enhancing

effectiveness through partnerships and collaborations for financial and material support.

Figure 2.1 demonstrates that interaction between social support providers with the

university management for consultation and provision while putting into consideration

multimodal approaches in prevention. The critical elements which DSAPP have to give
 60

articulate attention are parameters which run through a prevention program to ensure that

all the elements of a prevention program are captured.

Conceptual Framework of the study

Role of University
Social Support Service
Management:
Providers:
 Policies and
structures on DSA
 Counseling
 Financial support
 Chaplaincy
 Cultural dynamism
 Mentoring
 Status of resources
 Peer counseling
 Academic schedules
 Student
Organizations/Groups  Outside Agencies
 Security Department
 Outside groups

Multimodal: Psychosocial,
Effectiveness Parameters:
Behavioral and Environmental
factors:  Objectives Levels of
prevention and activities
 Developmentally appropriate  Principles of effective
 Interactive nature prevention programs
 Socio-culturally relevant  Resources: Material and
 Theory-driven Personnel
 Target personal and group  Interdepartmental
values and norms coordination
 Target risk and protective  Communication modes
factors  Student Participation and
 Contact with consumer utilization
population  DSAAP target on sustaining
 Enhance positive factors
relationships  Challenges facing DSAPP
 Promotes self-efficacy
 Varying methods of delivery

Effectiveness

Figure 2.1: Conceptual Framework

Source: Researcher, Kemei C. Ronoh, 2011

 61

CHAPTER THREE

RESEARCH METHODOLOGY

3.0 Introduction
This chapter provides methodological procedures explaining how assessment of

effectiveness of substance abuse prevention programs in selected Public and Private

Universities in Kenya was carried out. It includes description of the research design, the

target population, sample and sampling procedures, research instruments, data collection

and analysis procedures and data management ethical standards each with factors

validating their utility choice in this study.

3.1 Research design

It was a cross-sectional survey design which utilized both qualitative and quantitative

techniques with more emphasis on qualitative approach. This research design was found

appropriate to realizing epistemological, theoretical and methodological way of working

to serve research purpose (Saldana, 2011). It was cross-sectional involving students from

third year to fourth year because first and second year students were omitted due to their

short duration at the university. It also involved social support providers in various ranks

such as wardens, counselors, chaplains and students in the general population and student

leaders.

3.2 Variables
This study assessed effectiveness of prevention programs by operationalizing parameters

deemed necessary to identify effectiveness namely; objectives of various levels of

prevention programs, methods of service delivery, availability of human and material

 62

resources, synchronization and coordination of prevention programs into other university

programs, suitability of prevention programs to users psychosocial and socio-cultural

attributes, efficient accessibility of programs to users, student responsiveness, apt

response to challenges encountered by the programs and factors sustaining drug abuse in

the university. This research also plunked into consideration of confounding variables

such as university support, partnership with outside agencies and cultural dynamism. The

assumption was that prevention programs that enjoy strong support by the university

seem to perform more effectively whereas partnerships with outside agencies may create

easy accessibility to financial and material support. Cultural dynamism does not take the

same pace in all universities and has great influence on psychosocial factors for

prevention. These factors constituted fundamental areas which qualified for meticulous

attention during assessment of effectiveness of drug and substance abuse prevention

programs in universities.

3.3 Site of study

This study was carried out in two public and two private universities. The first university

coded PUU1 is the oldest established in 1970 and is situated near Nairobi city with

diverse intersectional influences from urban dynamics. The second public university

coded in this study PUU2, founded in 2007 and situated in a setting far from major towns

and cities was thought to might have much lesser urban influences. The two private

universities; coded PRU1 which was started in 1982 and PRU2 started in 2002

respectively are chosen because of their geographical situation and the period of

establishment with the same reasons as the two public universities. Apart from the above

variations in these four universities, there are other differences in regard to population
 63

size, quality of available resources and social value systems which have a variation in

public and private universities. All these factors were thought to have significant effect

on operations and effectiveness of substance abuse prevention programs.

3.4 Target Population.

The target population was undergraduate university students in third and fourth year in

selected Public and Private Universities in Kenya.

3.5 Sample size and sampling techniques

The first multistage sampling entailed cluster sampling to categorize Public and Private

Universities. The second stage was purposeful sampling techniques to enable selection of

2 universities from 7 public universities and 2 universities from about 24 private Kenyan

universities at the time of study. This study choose two in each category to enable

comparison due to variability in value system, management approaches and availability

of resources all of which, influence prevention programs‟ effectiveness. The third stage

was a random selection of the main respondents from each university and purposeful

sampling to identify 104 Social Support Service Providers composing of, leaders from

student government, Peer counselors, students recovering from substance abuse, Security

officers, Housekeepers, Wardens, Chaplains and Counselors to provide perceptive

experience on drug abuse prevention. At this stage also, purposeful sampling was used to

identify SSSP in Security departments and student leadership to provide an in-depth

perspective on how prevention is carried out and the challenges being encountered. The

subjects of the study consisted of 3rd and 4th year undergraduate students on regular mode

of study randomly selected from the faculties of Humanities and Social Sciences and

Pure Sciences. These faculties generally host the highest number of student population in
 64

most Kenyan universities hence the faculties were purposefully targeted to their

population popularities. However, samples from PRU1 were taken from the school of

communication for it hosts the largest number of students. School of Business at PRU2

university also has the largest number of students therefore it replaced the school of

sciences. Focus Group Discussion comprised between 7-12 Social Support Service

Providers (SSSP) consisting of counselors, chaplains, Housekeepers, security officers,

student leaders and Peer counselors for every session. They were purposively selected on

the basis of their perceptual experiences in drug abuse cases and provision of prevention

programs in the university.

Having employed purposeful sampling to select universities for study, it was necessary to

employ a proportional formula n=(p (1-p)/A2/Z2+p (1-p)/N/R (Watson & Jeff, 2001) to

obtain sample sizes for each of the selected universities. The sample size was determined

using confidence level of 95%, precision level of 5%, estimate variance of 5% and a

response rate of 0.8. The steps entailed in the formula suit the testing of the study

parameters. However, for data management purposes and to have just enough samples, a

further adjustment of 25% was accommodated. The main respondents of the study

consisted of 425 students and 104 Social Support Service Providers. The total sample size

was 499 respondents.

Table 3.1
Sample size and sampling techniques

Sampled Student Categories of respondents Total Sampling

Technique
Universities Population Stud Social S. Qualitative NO
ents Interview
Providers Schedule(
 65

(FGD) QIS)

PUU1 50,000 119 32 4 155 Cluster, Random,

Purposeful

PUU2 11,000 116 14 3 133 Cluster, Random,

Purposeful

PRU1 2,000 80 28 4 112 Cluster, Random

Purposeful

PRU2 2,000 80 16 3 99 Cluster, Random,

Purposeful

Total Number of respondents is 499

3.6 Research Instruments

Triangulation of research tools was found instrumental in cross-checking and

substantiating findings to increase validity. Several reasons for using multiple data

gathering methods are provided by Saldana (2011) Harris (2010) which comprise;

guaranteeing a wider spectrum of diverse perspectives for analysis and representation.

Harris (2010) argues that limitation of one data collection method can be addressed by an

additional method and that multiple data collection methods enhance credibility and

trustworthiness. Research tools therefore consisted of a questionnaire which was

developed specifically for students with the principal objective of perceiving a glimpse of

drug abuse prevention programs amongst students in the student population of the

university. The questionnaire was also meant to capture details on; prevention programs

in operation, programs‟ synchronization into academic and nonacademic programs,

delineation of student responsiveness to prevention programs and accessibility of

 66

prevention programs to users. It also inquired into student and university environmental

aspects deemed essential to target in prevention and the challenges faced by prevention

programs. In-depth interviews were administered to various groups of students to gather

information on strategies being used and students‟ responsiveness to them. Focus Group

Discussion was chosen to provide interactive information from the group as they share

their views and experiences (Hesse-Biber & Leavy (2011). They were hence conducted

separately on several groups encompassing social service providers consisting of

counselors, chaplains, wardens, Housekeepers and security officers. The second group

were students whose composition was purposively selected to include student leaders in

student governments and clubs due their direct knowledge on students‟ dynamics and

prevention activities. Qualitative interview schedule was administered to leaders of peer

counseling program, security officers and counselors to ensure confidentiality. Through

collaborative sense-making and participants‟ ideas, and opinions, understanding of

prevention programs was captured Breakwell (2004). Observation method which

Breackwell, et. al., (2008) describe as a research method in its own right as well as

being integrated into other kinds of research methods was employed in this study. Direct,

Non-participant structured observation guide was applied with the principal reason to

find out how prevention programs factually operate Flick (2006) and to countercheck

information that was obtained from other methods. It helped to establish viability of the

methods used by prevention programs to disseminate information (Harris, 2010;

Heppner, Wampold & Kivlinghan, 2008). To enhance the use of observation method, the

S.H.E.D techniques suggested by Harris (2010) were applied to students on two specific

posters on drug abuse which were found common in all the universities. These posters
 67

instructed that drug abuse is prohibited within university premises. S.H.E.D stands for

four important questions which provided an indication whether prevention programs have

these qualities or not and the meaning the posters impact on students. The questions were,

what do you see in the poster? How do the conditions in the poster relate to drug abuse

lifestyles in your university? How can we become more empowered by the new

understanding created by this poster? And what can we do to address these issues?

Observation method also included several props found in universities‟ students‟ strategic

places and those hypothesized to be main areas with frequent student traffic namely;

admissions and Dean of students‟ offices, student centers, computer centers, Library and

the main entrance into the university. In each of these places, research focused on

communication modes and props. It was also important to find out if there are

rehabilitation centers in universities.

The table 3.2 provides a summary of research tools and number of schedules as

administered in each of the four universities.

Table 3.2

Schedules of Research Tools’ administration

Tool PUU1 PRU1 PRU2 PUU2

FGD 5 5 1 1

QIG 3 3 3 3

SOG 1 1 1 1
 68

3.7 Pilot study

To ascertain validity and reliability of instruments, a pilot study involving three tools

initially suggested in the study was carried out at Kenyatta University being one of the

first public universities in Kenya to launch a drug abuse policy in September 2011. After

analyzing data from the pilot study, inevitable changes were made to replace the

projective test with Qualitative Interview Schedule which was seen fit being administered

separately to counselors, students in student governments and security departments

whose sections were regarded sensitive. It was also found fundamental to have a separate

focus group discussion with members of student governance due to their direct

connection to student population and prevention programs. Through the Pilot study,

discrepancies were discovered which enabled adjustment of questionnaire and qualitative

guide as new insights came in during the analysis of the data. Out of the pilot study, the

following valuable detections were made: Second years didn‟t have much information

about prevention programs perhaps due to their short period in the university. It became

necessary to administer questionnaires to 3rd and 4th years whose experience with

university culture, attitudes, lifestyles and practices spans over a longer period.

The pilot study revealed fundamental insinuation on acquisition of background

information about the selected study sites. Uniform respondents‟ selection criteria

proposed initially were not applied in all universities because responsiveness and

randomness would not have been achieved. For instance in PUU1, respondents were

selected from student clubs of major schools to enhance the chance of randomness due to

high number of schools and colleges in this university which would have closed out many

through random selection and hence bias randomness.

 69

3.8 Data collection Procedures

After obtaining research permit, from the National Council for Science and Technology

(NCST) and the universities under study, the researcher systematically observed the

necessary protocol and procedures to access the students and Social service providers.

Research Assistants who had undergone training administered and collected

questionnaires. They helped the investigator with recording of the proceedings FGDS.

For confidentiality purposes, the main investigator preferred to carry out in-depth

interviews with selected groups of the respondents.

3.9 Validity and Reliability

Validity of the study was ascertained through confining research tools and respondents

to variables stipulated in the research objectives. Use of four tools; student questionnaire,

Qualitative Interview Schedule, Focus Group Discussion and Structured Observation

Guide allowed for collection of a wider breadth of information which reinforced,

complemented and compared against each other. Direct structured or systematic

observation method particularly on visual cues such as modes of communication about

drug abuse prevention in universities is supported by Yin (2011) who attests that

unobtrusive measures complement the collection of interviews and other data within the

same qualitative study. Combination of all these research tools helped in not only

strengthening validity but also in determining whether data from two or more sources

converge or lead to the same finding Yin (2011). Research tools were arranged

systematically in such a way that research questions in each tool matches the theme of the

parameters under study. This aided in ensuring that no valid information was left out

during data collection and analysis. It also expanded the source of information, Creswell
 70

& Miller (2000). To further strengthen validity details, the researcher developed a study

process framework (Appendix F) which provided a vivid guideline on all the ten

indicators which were selected for examining effectiveness. Adjustments from piloting

entailed replacing projective test with qualitative interview schedule due to need to

enhance confidentiality and encourage openness of the discussions. During proposal

defense, examination team mentioned researcher‟s subjectivity which was rectified

through journal keeping on reflective thinking throughout research collection and

analysis process. Through pilot process, clarity of questions and discussions made easy

for respondents to contribute insight into the study area. Application of mix up of survey

questions helped in dealing with response acquiescence, Keegan (2009). Establishment of

variables to be included in the study was done through an earlier visit to the Dean of

students‟ Offices where information on the number of students in faculties and clubs was

obtained. The sampling formula was then used to identify the number of students in each

department to be randomly given questionnaires. Focus Group discussions were carried

out amongst counselor, Chaplain, warden, two house keepers, security man, peer

counselors and student leaders. This step helped in enhancing randomness and reducing

bias.

3.10 Data analysis techniques

Transcription, coding and theming was done to help organize and categorize non

numerical data such as students‟ and service providers‟ attitudes, behaviors, value

systems, concerns, perceptions, aspirations, and suggestions on the components of

effectiveness of prevention programs examined in this study. Stevens‟ taxonomy of

measurement (1946) was used in this process. Each research question and parameter
 71

falling under each question was divided into codes and themes with the aid of Computer

software, NVIVO 10 whereas Statistical Package for Social Sciences (SPSS) aided in the

analysis of demographic information of the respondents. Chi-square and ANOVA were

used in testing the hypotheses. Systemization of the four data collection instruments

namely; student questionnaire (SQ), Qualitative Interview Schedule (GIS), Focus Group
Analysis
Discussion (FGD) and Structured Observation Guide (SOG). Data analysis was

conceptualized as shown in figure 3.1.

Themes

Sub-themes

Synthesized Information

SQ FGD QIS SOG

Figure 3.1: Data analysis process

In the data analysis process, two different data analysts were engaged to ensure

complementarity of findings and to avert bias as suggested by Patton Quinn (2002). This

was particularly important in accommodating both quantitative and qualitative techniques

of data analysis.
 72

3.11 Data Management and Ethical Considerations

In line with general principle D of APA Ethics Code (1992) in Heppner, Wampold &

Kivlinghan (2008) Ethical standards of confidentiality and honesty guided this study in

collecting, keeping, discussing analyzing and releasing information obtained from the

study. For this reason, a letter of introduction and an informed consent was sought to duly

clarify the purpose of the study to all the respondents, Hesse-Biber & Leavy (2011)

before any research was undertaken. The researcher embraced adequate responsibility to

ensure that research purpose, instructions and expectations of the study were clarified to

participants and duly observed. Audio/video taped materials were put under strict custody

of the researcher during all the stages of the study process to avoid being tampered with.
 73

CHAPTER FOUR

DATA ANALYSIS, PRESENTATION AND DISCUSSION

4.0 Introduction
This chapter presents analysis, research findings and discussions guided by the objectives

of the study derived from the study purpose. The overriding purpose of this study was to

assess effectiveness of drug abuse prevention programs in Public and Private Kenyan

Universities. Mixed quantitative and qualitative data analysis procedures and techniques

were employed. Presentation of research findings encompassed use of summary displays,

diagrams, graphs and tables (Saldana, 2011; Scott & Mazhindu, 2005). Dissertation in

this chapter encompassed interplay and synthesis of information from theoretical

framework, research findings and researcher‟s experience in the field. Theoretical

framework of the study espoused two theories namely, Self-Efficacy Theory by Albert

Bandura (1986) and Ecological Systems Theory by Brofenbrenner (1944). Principles of

effective drug abuse prevention programs derived from evaluation and assessment of

Dusenbury, Hansen and NIDA (2009) on effective prevention programs are incorporated

in the analyses, presentation and discussion.

Section 1 provides the findings on demographic information and section two gives the

findings of the study based on objective one to five.

 74

4.1 Demographic information of Respondents

Demographic information of the respondents was important for identifying other

variables that may not have constituted the central objectives of the study but which were

credible for conceptualization of possible intervening and confounding factors in

substance abuse prevention. These include, age, gender, faculty, year of study and

residence status of respondents. The variable asking respondents‟ use of substance was

meant to gauge the state of drug use to other research questions related to substance

abuse prevention programs. Descriptive and inferential statistics were undertaken and

presented in tables and graphs.

4.1.1 Respondents’ Gender distribution

Information on gender distribution revealed that there were more males than females in

all universities. Males were; PUU1 (76.3%), PUU2 (67.5%), PRU1 (57.5%) and PRU2

(75.4) compared to their female counterparts 23.7 %, 32.5%, 42.5% and 24.6%

respectively as shown in figure 4.1.

80.0% 75.4 76.3

67.5

70.0%
57.5
60.0%
42.5
Percentage

50.0%
32.5

40.0%
24.6

23.7

30.0% Male
Female
20.0%
10.0%
.0%
PRU2

PUU1

PRU1

PUU2

University
 75

Figure 4.1. Distribution by Gender

Gender percentages in every university seem to have taken a proportionate correlation

with the number of gender representation in the clubs and schools from which

respondents were drawn. This could indicate that female students were fewer in the

respective clubs and departments; a trend which seems to share similarity with university

enrolment spanning from academic year 2003-2009 as shown in table 4.1.

Table 4.1

Student enrolment in universities by sex.

Academic year Male Female % Female

2003/4 47,088 25,462 35.10

2004/5 53,394 28,097 34.48

2005/6 53,737 27,940 34.21

2006/7 56,517 34,820 38.12

2007/8 60,504 36,603 37.69

20008/9 62,754 37,896 37.65

Source: GOK (2009b, 2007b).

Other studies NACADA (2012) with 54.4%; Atwoli et al. (2011) with 52.2%; Barasa,

Toili & China (2011) with 53% and Kyalo & Chumba, (2011 ) with 63%, Magu et

al.(2013) with 69% male respondents reveal the same trend in which female respondents

are fewer. Psiquiatr (2007) portrayed the same perspective.

Despite this slight gender disparity, FGD and GIS were carried on with respondents

participating actively in an equivalent adeptness. It was however paradoxical to discover

 76

that most of the students who participated in student DSAPP were more female than

male, using Peer Counseling program as an instance. This situation could hint out to

selection criteria of students who participate in prevention programs or female students‟

more interest in service provision in general. It could also indicate a higher number of

drug users amongst the male students hence making it ironical for them to participate in

prevention programs.

4.1.2 University Faculties

This study had acknowledgement of the fact that universities have different faculties with

varying student populations and course attributes which could influence correlates of

drug abuse. During data collection, representativeness of faculties was ensured through

selecting respondents from sciences and social science faculties or other faculties which

had larger student populations. This strategy was meant to ascertain randomness and

reliability of the study. It was important to know the faculties of respondents for

comparison of responses from various faculties on the use and abuse of substances and

operations of prevention programs in their faculties. However, this study did not note any

significant difference in drug use or abuse among respondents of various faculties.

Research findings revealed that drug abuse habits were generally same across faculties

except a few comments on the fact that faculties with heavy course work seemed to have

many students abusing drugs at stages of addiction. For instance, the Schools of

Medicine, Health Sciences and Engineering came out amongst respondents as schools

with drug abuse cases at addiction stage levels. FGD and GIS strongly contended that a

portion of students abusing drugs from these faculties display quiet personalities and in

most cases are brought to therapy when their drug taking habits have reached
 77

unmanageable levels. Attribution of faculty characteristics to drug abuse habits is an

important feature that deserves consideration particularly during planning stages of

programs to ensure that specific interventions are established for these populations. This

is the essence of selective and indicated prevention interventions, Galanter & Kleber

(2008) and as echoed out in systems theory (Ludwig Von Bertallanfy, 1968;

Bronfenbrenner, 1944; Coreil, 2010).

4.1.3 Respondents’ Year of Study

This study selected third and fourth year students to partake the study purposefully based

on the premise that their longer experience at the university holds more information than

that of first and second years. Student respondents in third year were as follows; PRU2

(47.4%), PUU1 (53.1%), PRU1 (54.3%), PUU2 (33.8%) whereas those in fourth year

were 52.3%, 46.9%, 45.2% and 66.2% respectively as displayed in figure 4.2.

70.0%
60.0%
50.0%
Percentages

40.0%
30.0% Third year
20.0% Fourth year
10.0%
.0%
PRU2 PUU1 PRU1 PUU2

Universities

Figure 4.2: Year of study by universities

However, there was no significant variation displayed between third and fourth year

respondents in their perspective to questions. This uniformity in response to questions

could be attributed to the fact that unit system in the university shrinks the vast variation
 78

that would exist if students in different academic years had independent classes and

experience. It could also indicate common application of DSAPP methods to all the

students making it possible for those in different years to access information as confirmed

by SOG observation of posters and fliers and student booklets. Coreil (2010); Medina

Mora, (2005) argue that all the populations in a community of drug abuse prevention

should be reached with appropriate programs. This hence presents a vivid indication that

DSAPP in Kenyan universities should integrate all components of prevention. DSAPP

spread of programs should reach all the students in all the academic years including first

years in order to zip possibilities of students influencing one another into drug abuse.

4.1.4 Respondents’ residence

It was found prudent to inquire whether respondents resided within or outside the

university in case their experience with drug abuse varied. Results indicated that majority

of respondents (90.7%) in PRU2, 90.8% from PUU1, 60.5% from PRU1 and 56.9 from

PUU2 were residing within the university as shown in figure 4.3.

100.0% 90.7 90.8

80.0%
60.5
Percentages

56.9
39.5

60.0%
43.1
40.0%
9.2
9.3

20.0%

.0%
PRU2 PUU1 PRU1 PUU2
Universities

Resident Non resident

 79

Figure 4.3: Students’ residence by universities

Responses to questions on awareness of DSAPP demonstrated no significant difference

between resident and non-resident students as demonstrated by a chi-square performed

with the following hypotheses.

H0: There is no significant relationship between students‟ awareness of

DSAPP and their residence.

Table 4.2

Chi-square tests

Chi-Square Tests

Value df P-Value

Pearson Chi- 2.284 1 0.131

Square

N of Valid Cases 295

Since the p-value (0.131) is greater than the level of significance (0.05), we do not reject

the null hypothesis and conclude that there is no statistical significant relationship

between students‟ awareness of DSAPP and their university residence status.

Conversely, discussions emanating from FGD and GIS insinuated the fact that students

who are non-resident at the university seem to miss out on some activities such as talk

shows and movies which are mainly scheduled for evenings or weekends. Pascarella and
 80

Terenzini, (2005) assert that living in the residence halls during one's college years

enhances effort and involvement in academic, social, and extracurricular activities and

enables more involvement with other students, faculty, and the institution as a whole.

This coincides with experience in other findings (Kloss, et.al 2012) showing that

programs are more effective when they involve all members of the community. It further

poses a question facing DSAPP on the best time to schedule their activities for the

activities to be student all- encompassing.

The sum of respondent demographic information in this study is provided in Table 4.3.

Table 4.3

Demographic information of respondents

Demographic variables Frequency %

Male 189 60.5
Gender:
Female 123 39.5

3rd Years 123 40.7

Year of study:
4th Years 179 59.3

Resident 225 75.0

Residence:
Non-resident 75 25.0

Most Frequently 13 4.5

Frequently 24 8.3
Use of drugs:
Rarely 74 25.7

Never 177 61.5

 81

4.2 Findings of the study

Findings of the study are provided in this section based on the study objectives.

4.2.1 Prevention programs and activities currently at work in the university

The task of this section was to find out levels and objectives of drug abuse prevention

programs currently in existence in universities with the research question to establish

objectives, levels and principles of drug abuse prevention programs‟ and activities‟

currently in existence in universities. The word programs in this section is used

interchangeably with the word activities because respondents listed activities and

programs without necessarily distinguishing them. The researcher however categorized

them.

This section gathered information on DSAPP programs and activities currently available

at the university which were subjected to Classification by Public Health Model (Mrazek

& Haggerty, 1994) to them to levels of prevention. Respondents listed posters, billboards,

movies, motivational speakers, electronic messages, counseling, peer education,

campaigns, seminars, training, music and sporting and games as the major activities

(Figure 4.4). FGD and QIS confirmed that additional activities such as drug abuse

prevention days, talk shows, door to door campaigns, brochures, university functions

such as culture week and Christian unions whose details are provided in Appendix H

were in existence.
 82

0.4%
5.2% 3.0% 2.6% 2.2%

12.3%

12.6% 61.7%

Dissemination of information Not aware Guidance and counselling

Lecturers involvement Peer education Drug abuse policy
Punishment on drug abusers Common unit on drug abuse

Figure 4.4: Ways DSAPP carry out their activities

There was no strong demonstration of secondary and tertiary levels of prevention in the

listed activities. The following excerpts from student respondents further illustrate this;

„Students who are addicted are admitted to the university sick bay where there is
no meaningful treatment apart from a Psychiatrist who occasionally visits them. I
wouldn‟t consider this as any attention to the addict at all‟. (Student Public
University)

„We hear there are rehabilitation centers in this country but students who are
addicted are never taken to these rehabs. Most of the cases have ended up
dropping out of the university‟. (Student, Private University)

„We liaise with university Psychiatrist who comes once a week on matters of
addiction but most students whom we refer to the rehabilitation centres do not
afford the charges because they are quite high‟. (Counselor, Public University)

„Rehabilitation centres have their own challenges apart from inflated financial
costs. Some students complain of lack of facilities and lack of compatibility in
terms of intellectual levels. Some have had to escape before serving full
rehabilitation terms due to such conditions‟. (Counselor, Public University)
 83

The conclusion derived from the above information reveals that there is a predominance

of primary level of prevention as defined by Public Health Model (Mrazek & Haggerty,

1994). There were dismal evidence of other components of prevention levels such as

outpatient services offered by counselling and chaplaincy services. Referral to

rehabilitation centers in the country is a measure used by many universities to deal with

cases of addictions because there is no university which had established their own drug

rehabilitation center by the time of this study. This is an indication that secondary and

tertiary levels of prevention are not well established in most universities. However, one

principle of effective prevention programs states that prevention programs should address

all forms of drug abuse, alone or in combination, including the underage use of legal

drugs (e.g., tobacco or alcohol); the use of illegal drugs (e.g., marijuana or heroin); and

the inappropriate use of legally obtained substances (e.g., inhalants), prescription

medications, or over-the-counter drugs (Johnston et al. 2002, in NIDA 2003). This

uncovers DSAPP insubstantiality in the area of policy establishment. At the time of

study, most universities did not have drug abuse policy in place whereas others were at

the verge of developing one. Drug abuse policy is crucial in guiding implementation

activities hence should be one of the structures to ensure effective prevention.

Considering the complexity web of drug abuse-causing factors such as social interactions,

drug availability and university comrade euphoria, it would be more imperative to put in

place all the levels of prevention in order to avoid the spiraling effect of emulation of

drug abuse behaviors. The theoretical framework (Self –efficacy and Ecological systems

theories) in this study clearly demonstrates this that, students‟ perceptions of peers‟
 84

alcohol consumption and cannabis use predicts and explains a significant amount of

variance in alcohol and cannabis use (Kilmer et al., 2006; Perkins et al., 2005). This

shows that it doesn‟t suffice to dwell on primary prevention services alone because it

would ignore other populations in secondary and tertiary levels resulting in them

permeating their drug taking habits to other members.

Further findings reveal that all the levels of prevention are required because drug abusers

fall in primary, secondary and tertiary categories and prevalence rate being high with all

sampled universities disposing with similar drug use as evidenced by FGD and GIS.

Sentiments from SSP respondents which were similar in all universities appear to send a

disconcerting fret on the state of drug abuse in universities with accompanying concerns

of whether DSAPP are employing the right prevention strategies on the right target or

not. However, from this study, information does not vividly provide an accurate

numerical picture of students in drug abuse. Foregrounding activities such as baseline

surveys and other factors such as drug abuse policy implementation which were missing

would not only reveal prevalence and incidence of drug abuse but also the type of drugs

being abused to form a good informational basis for establishment of efficient prevention

programs. This is vividly postulated by the Precede-Proceed Model (Green, L.W., &

Kreuter, M.W. (2005) in figure 4.5 which advocates that preceding activities in any

prevention program are those to be undertaken before any intervention takes off and they

include; predisposing, reinforcing and enabling constructs in educational and

environmental diagnosis and evaluation. Proceed refers to policy, regulation and

organizational constructs.
 85

Figure 4.5: The Precede-Proceed Model

Source: Green & Kreuter (2005).

DSAPP effectiveness could be enhanced through application of stages of program

implementation development. In this study, though primary prevention was found

common amongst the universities under study, it significantly lacked in interventions

specific to individuals, environmental and selectivity to drug types. Markwood (2011)

 86

supports this fact that principles of primary prevention are relevant to tobacco, alcohol

and marijuana but not post-gateway drug use because the factors influencing progression

beyond gateway drug use are as much defined by the effects of currently used drugs as by

pre-existing factors. Consequently, there is a great gap which requires keen and

systematic establishment of all the three prevention levels and interventions in respect to

drug addiction continuum as echoed out by Prochaska & DiClement (1984) in their

postulation that people pass through a series of stages when change occurs. Frost (2008)

postulates the same idea.

This study found it significant to gauge students‟ level of awareness of prevention

programs. Question on whether students were aware of prevention programs in their

universities revealed that ; PUU1 (33.7%), PRU1 (35.6%), PUU2 (40.3%) and PRU2

(50.0) were aware as compared to those who were not aware 66.3%, 64.4%, 59.7% and

50.0% respectively. Figure 4.6 displays this data.

70.0% 66.3 64.4 59.7

50.0
50.0

60.0%
40.3

50.0%
35.6
Percentage

33.7

40.0%

30.0%

20.0%

10.0%

.0%
PRU2 PUU1 PRU1 PUU2
Universities

Yes No

Figure 4.6: Awareness of DSAPP

 87

Findings show that in three universities, PUU1 (66.3%), PRU1 (64.4%) and PRU2 (50%)

above fifty percent students were not aware of prevention programs. The average

percentage of students who were not aware of prevention programs is 55.2 % hence an

indication that many students are not aware of prevention programs in their universities.

Fundamentally, lack of awareness has a chain effect on trends of drug abuse rates and

effectiveness of prevention programs. FGD and QIS projected a contradicting picture in

their assumption that, almost all the students in the university should be aware of

prevention programs. This scenario creates a gap that should be addressed by Social

Support Providers in universities if prevention effectiveness is to be realized. It was clear

that these assumptions were not based on any baseline surveys that have been undertaken,

placing DSAPP at the risk of blindly establishing programs which have no users‟ interest

and on flimsy assumptions.

Studies on the contrary document that when students are aware of programs and when

campaigns are effective, they are likely to either participate or support the activities

Henning (2011). Awareness should go beyond the simple of experience of noticing

advertised information to that of acquiring drug-related information and skills such as

knowledge, attitudes, normative expectations, and skills for resisting drug offers.

Unfortunately this seems to be missing in Kenyan universities based on this study‟s

findings. Pertinent on this issue of lack of awareness is necessity to develop

understanding of the factors responsible for lack of awareness. Not all studies however

agree on the effectiveness of awareness campaigns as evidenced by (Aveyard, 1999)

argument that although drug and alcohol awareness campaigns have been carried out in

universities, little is known about their effectiveness. A situation like this could arise if
 88

there is no calculated interest in selectivity of campaign methods as was projected by

findings of this study. Effective campaign methods are critical in degree of DSAPP

activities‟ utility.

Respondents were asked to provide reasons why they were not aware of prevention

programs. Appendix G gives details as listed by respondents and figure 4.7 provides a

summary.

Lack of information

poor DSAPP methods

5.6%
5.2% 4.8% Small number of drug
6.1%
6.5% abusers
Lack of participation
52.8%
Lack of time
19.0%
University managemnt,
attitude and rules
Lack of interest

Figure 4.7: Reasons why students were not aware of DSAPP

Lack of information is the principal factor (52.8%), poor dissemination methods (19.0%),

small number of drug abusers (6.5%), lack of student participation (6.1%), lack of time to

implement activities (5.6%), lack of seriousness of university management in supporting

DSAPP and lack of student interest in DSAPP (4.8%) are other factors for lack of

awareness.

The above factors responsible for lack of student awareness of DSAPP seem to

correspond to the high percentage (55.2%) of students who lack awareness as

 89

demonstrated in figure 4.7. In other universities, research shows that information

provision must be emphasized in effective prevention Polymerou (2007); Myers, B. &

Parr, C., (2006). The role of information in implementation of any activity forms the

basis of success for that activity. FGD and QIS clearly brought it up that lack of

information has contributed to reckless use of drugs because students find no valid reason

to abstain. They reported that,

„
Students use drugs sometimes not because they choose to engage in it but because
valuable reasons for not using them are not there. Many of us don‟t know why
adults lament about out use of drugs because there are those of us who have used
them since High school and nothing adversely major has happened to us‟
(Student Public University)
„
Actually we are in oblivion of drug abuse consequences because the messages we
get on posters or any avenue of communication is that drugs are bad. For us we
do not understand that such a blanket statement which doesn‟t mean much to
most of at the university. What I mean here is that there is no concrete
information supporting the fact that drugs should not be abused, students
sometimes think that parents or teachers or whoever adult is refusing them to take
drugs because they don‟t want them to compete with them or to spend money so
they ask for more or so that they don‟t go to church or so that they don‟t go on
strike. I mean there are a host of other factors that adults may be thinking
university students shouldn‟t take drugs‟. (Student Public University)
Consequently, DSAPP lack the core bedrock of prevention capacity by failing to access

true facts about drugs to their users in the right way and time. It is quite pertinent to curb

these weaknesses in order to achieve effectiveness.

4.2.1.1 Objectives of Prevention Programs

Information on objectives of prevention programs was solicited from FGD and QIS

because student were omitted from participating in this question by virtue of not being

the principal implementers of DSAPP. Both research tools revealed that most programs

have a primarily general objective which is to reduce ADA. This is evidenced by

 90

counselling and peer counselling programs whose activities chiefly entail helping

students avoid getting introduced to drugs. Main sub-objectives included in their

programs are; raising awareness on drug abuse, identifying students and staff who are

affected for DSAPP to select appropriate strategies, encouraging participation by students

and staff in the prevention of drug abuse, obtaining feedback from recipients of

prevention programs and undertaking trainings on drug abuse as a means of

disseminating information and equipping some students and staff to help in prevention.

Table 4.4 summarizes this information on objectives of different programs.

Table 4.4

Programs‟ objectives

Program OJECTIVES Prevention Timeframe

level

Counselling a. reduce on drug abuse through sensitization Primary Continuous

b. Help those already using drugs through
counselling therapies and referral to Secondary
rehabilitation centers
Tertiary

Chaplaincy a. 1.Reduce on drug abuse problem Primary Continuous

b. 2. Use of pastoral counselling approach to
help those already in drug use and abuse Secondary

Tertiary

Peer a. 1.Reduce on drug abuse Primary continuous

counselling b. 2. Refer drug abuse cases to counsellors and
program other professionals

I chose a. 1.Reduce drug abuse cases Primary continuous

Life(ICL) b. 2. Collaborate with other social support
providers in helping those already involved
Student a. 1.Reduce on drug abuse Primary Continuous
bodies such b. 2. Refer students in drug abuse to counsellors
and rehabilitation centers
 91

as SCAD

Results from FGD, QIS and SOG corroborated reduction of drug abuse as the main

objective found in DSAPP statements of objectives. However, counselling and

chaplaincy objectives related to components of secondary and tertiary prevention levels

in form of various counselling therapies and referrals. Objectives on comprehensive

tertiary prevention was lacking in most universities because the study did not find any

university that has established rehabilitation centers nor support groups such as

Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) within the university. It

became evident that the objectives of programs are not well formulated in terms of time

frame and measurable activities. Objectives appeared to be too general to define any

specific actions to be achieved within a specified period of time. Data from FGD and QIS

attested to this fact as demnstrated below;

„We aim at reducing the problem of drug abuse by disseminating information

about
drug abuse‟ (Chaplain Private University)
„In our department we plan to undertake campaign activities which we believe
will
change the problem of drug abuse in the university‟( Counselor, Private
University)
„Our main activities are to access one or two students with drug abuse problem
and
ensure they get one or two words that can help them stop using drugs‟.(Warden,
Public University‟

Lack of well formulated objectives poses a serious challenge of inefficient engraining

prevention activities due to failure to state personnel that discharge specific activities at a

specific time. Objectives should provide guidelines for accomplishment of goals which

have been identified for the target group and should state the expected outcome. This is
 92

supported by Maitthya, Muola, & Mwinzi, D. (2011) in their study that the aims and

objectives of preventive education should define its aims before decision is made on

content and instructional methods. Further, research reiterates the importance of program

objectives in defining the goals sought for (Round, Marshall & Horton, 2005). Execution

of well formulated objectives clearly aligned to the respective activities would enhance

effectiveness of prevention.

4.2.2 Methods of Program Implementation

This section addressed the second research objective whose research question was ‘What

are the implementation methods of substance abuse programs in the universities?’

Implementation in this study referred to ways in which activities are delivered to users.

This study understood methods of delivery as crucial in users‟ utility of the programs and

a determinant of effectiveness. Descriptive and inferential statistic was undertaken on

status of resources in the light of implementation effectiveness, ways in which DSAPP

carry out their activities, modes of communication and coordination of DSAPP among

departments. Rating of implementation methods and suggestions on their improvement

were also inquired into. Descriptive and inferential statistics were employed and

presented in tables and graphs.

4.2.2.1 Availability of Resources

The role of resources in implementation of prevention programs is crucial hence a

question was posed to FGD, QIS and SOG asking them to describe material and human

resources available for DSAPP utility. Findings revealed that books, pamphlets, and

internet are major ADA sources of information. Most universities seem to lack Drug

Abuse Policy to provide a framework for prevention. There was an indication that
 93

universities are in collaboration with NACADA which has supplied a number of

materials including T-shirts and reading materials to DSAPP in universities.

Results on the ratio of social support service providers to university student populations

revealed a shortage of personnel. It was demonstrated that even with increasing intake

particularly with the government policy on double intake, Ministry of Higher Education

Science and Technology (MOEST) (2011), it is not easy to carry out activities for

sensitization and therapy sessions at the same time. Approximately 80% of counselors

from all the universities said that work is quite overwhelming because of a high number

of clients they counsel per day. As a result of this, many students who come for

individual counseling are rescheduled to later dates despite the urgency of the matter at

hand. One of them retorted „It is a frustrating experience having to fail to attend to

emergency cases for the only and weak reason that numbers are overwhelming!‟

Findings also revealed that there are no counselors who are trained specifically in the area

of drug addiction counseling. Counselors hence have to utilize general knowledge,

techniques and skills which they employ in other counseling cases. This could negatively

affect effectiveness of drug abuse prevention programs.

The study discovered that both human and material resources which are currently

available are not adequate to raise a fortified prevention strategy. Fundamental role of

human resources in program implementation is candidly emphasized by research that

regardless of how effective a prevention program may be, it is not likely to produce the

desired results unless it is provided in full and by qualified and motivated staff (Botvin &

Griffin, 2007; Nation et al. (2003).

 94

Intellectual endowment and technological experience categorize DSAPP users in high

standards and expectations of any program and activity that goes on in the university.

Lack of resources definitely makes it difficult for DSAPP to establish activities with

selective suitability without which, number and frequency demand of programs is

hampered. Universities‟ DSAPP need to devise methods of overcoming these challenges

to enable them acquire resources which are needed for effective implementation

notwithstanding the university management need to support and allocate resources to

DSAPP. Sourcing for funds should be done through proposals for funding and adherence

to channeling of university funds in line with mandates, terms of reference and objectives

of DSAPP. Nation et al. (2003) emphasize crucial presence of well qualified practitioners

and administrators and the support of community leaders. This is a point found

fundamentally relevant by (Winters, Fawkes, Botzet, Fahnhorst & August (2005) in their

synthesis of program review on effective drug abuse prevention programs which

concluded that coordination of all key players in prevention is of great necessity. Training

of personnel in ADA specialization in this study was shown to rate lowly as respondents

said there are no universities training therapists in the area of drug abuse. SOG confirmed

this through establishment that counseling courses in most universities only have a unit

that deals with drug abuse but no specialized degree course. It came out that some

institutes in Kenya may be offering courses in drug abuse at Diploma levels. This

definitely does not suffice in regard to the level of clients to be handled and the quality of

programs which need to be developed. This is a great shortfall which has to be addressed

at the Ministry of education level through recommendations of DSAPP.

 95

4.2.2.2 Display of DSAPP activities

Communication plays a major role in conveying information about programs available

and ADA messages. To this effect, a question posed to respondents was „Do you find

DSAPP messages visibly displayed in your university?‟ Majority of the students as

displayed in figure 4.11, PRU2 (73.3%), PUU1, (66.7%) PRU1 (59.2%) and PUU2

(74.6%) reported that DSAPP messages were not visibly displayed in their Universities;

an average of (68.45%) from all universities.

80.0% 73.3 74.6

66.7
70.0% 59.2
60.0%
percentage

50.0% 40.8
40.0% 33.3
26.7 25.4
30.0%
20.0%
10.0%
.0%
PRU2 PUU1 PRU1 PUU2
Universities

Yes No

Figure 4.8: DSAPP messages display

Messages that are not sufficiently visible could impede efficient advertisement of

prevention activities making them futile even if they have been planned. FGD and QIS

unveiled that communication modes which are currently in place may not be attractive to

students because most of them do not directly attract nor appeal to individual students

based on technological advancement. Their verbatim responses were as follows;

 96

„Billboards, posters and fliers make students to think that they are meant for other
people not them. Students perhaps don‟t even take notice of them. In my opinion,
communication should involve electronic messages which students are fonder of
than what we are using at the moment‟ (Security Officer, PRU1)
„Communication modes are many. They include posters, billboards and banners
Whenever we have DSAPP functions which are distributed to many parts of the
university with heavy student populations. However, it is shocking to note that not
many students recognize these forms of communication. I don‟t know what could
be done because even during orientation when we directly address first year
students, they still don‟t take the messages seriously. It is most probable that
direct modes to their e-mail addresses might be better than modes which are
displayed for the general public‟ (Counselor, Public Universty)
„We need to style up in terms of communicating to students to ensure that we are
in tandem with new means of communication which are interesting to them. We
need be to be digital and our approach and sake off the analogue type of
approach‟ (Counselor .Public University)

Siegel, M., & Biener, L. (2000 ) are succinct about need of campaign practitioners to

develop messages that can elicit high levels of attention from the target audience and

disseminate the message through media channels actually used by audience members.

Conversely, .the findings above don‟t seem to comply with effective ways of conveying

messages as attested by Mayer (2001) in his cognitive theory of multimedia learning.

This theory states that people learn more deeply from words and pictures than from

words alone and that learning is an active process of filtering, selecting, organizing, and

integrating information based upon prior knowledge.

The study through SOG discovered that most universities did not have means by which

students communicated to DSAPP about drug abuse issues. This implies that they cannot

get feedback from the users‟ on their performance hence making it difficult for them to

improve on their programs.

 97

Efficient means of communication is quite crucial in marshalling effectiveness of DSAPP

through attracting students into their programs.

Respondents were requested to suggest better ways in which DSAPP messages could be

conveyed. This was deemed important for understanding effective accessibility of

DSAPP messages to users. Figure 4.9 and Appendix I provide this information.

25.0 24.1
20.6
20.0

15.0 13.6
Percentage

10.0 8.3 7.9 7.9

7.5

5.0 4.4 3.5

1.3 .4
.4
.0
DSA prevention day

Advocating for christian

DSA policy
Inclusion in the

Target highly populated

Talk shows

Social meadia
Peer counsellin
Open forums and

Sports and games

Rehabilitation centres
Bonchures and posters

Communication means

Figure 4.9: Suggested communication avenues

Descriptive statistic undertaken demonstrates talk shows (24.1%), open forums (20.6%),

peer counseling (13.6%), sports and games (8.3%) and DSA prevention day (7.9%) as

methods which could be favorable to students. Inclusion in the curriculum (7.9%),

brochures and posters (7.5%), social media (4.4 %), advocating for Christian values

(3.5%) and rehabilitation centers (1.3%) are other modes which respondents proposed.
 98

However, these suggestions corroborate most means of communication being employed

by DSAPP at the moment. It is most likely that the quality of these modes is poor or they

may not be enough. Nevertheless, articulate attention is required to enhance

communication to create change as proposed by The Yale Attitude Change Approach

whose argument is that people are likely to change their attitude in response to persuasive

messages focusing on „who said, what, to whom‟ referring to the source of

communication, the nature of communication and the nature of the audience (Aronson,

Wilson & Akert, 2010). More findings (Haines, Barker & Rice 2003) conducted at North

Illinois University regarding the believability of Alcohol and other drugs (AOD) and

other health information indicates that students rate print material more believable than

other media and health professionals more believable than peer educators, friends, or

other interpersonal sources. Fertman & Allen worth, (2010) argue further that

understanding the role and principles of effective communication enhances the chances

of program success.

Talk shows, open forums, peer counseling and counseling which were suggested by

respondents emerge with pertinent issues related to the characteristics of the users of

DSAPP and which ought to be considered while designing information messages. This is

crucial for meaningful connectivity without which, popularity of prevention activities

might be relegated to oblivion. A deeper incursion into the above suggested activities

reveal that these activities are interesting to students due to peer power and the fact that

it captures the culture, attitudes and leisure of students. This seems to agree with

proposals by Berlo in his SMCR model of communication as shown in figure 4.10 on

some qualities of successful communication.

 99

Figure 4.10: Berlos SMCR model of communication

Berlos‟s SMCR model suggests four major factors which matter in ensuring effective

communication and which orchestrate this study‟s findings to offer credible propositions

to DSAPP practice. Message construction, channeling and qualities of the receiver are

important factors to consider when conveying information. DSAPP as the source of DSA

messages need to provide facts based on tangible knowledge, positive attitudes and a

well-grounded culture of prevention. Channeling should be diversified to include

demonstrations with drugs of abuse and visual objects which project strong messages on

effects and prevention of drug abuse. Other studies reiterate handling communication as a

process which should depict delivery quality (Paul & Peter, 2013).

Suggestions from these studies create a pointer to investigating deeper into missing

trajectories in communication avenues being used by DSAPP to identify spheres of

ineffectiveness. For instance, it would be significant to find out from students which
 100

avenues of communications are popularly read in the university even during odd hours so

that drug abuse messages may be slotted in within such avenues.

4.2.2.3 Coordination amongst prevention providers

Implementation of DSAPP can be ensured in the presence of synchronization and

integration of activities, responsibilities, and action command to ensure that resources are

used most efficiently amongst departments. Respondents attested to the fact that most

sections function semi- autonomously with the mandates stipulated to them in the

university policy without necessarily indulging with other departments. Referral system

was the major means by which most prevention programs coordinated activities. FGD

and QIS reported that Peer counselors networked most of the times with the house

keepers, health unit, counselors, chaplains, community health workers and open forums.

However, there was an enormous consensus that every program dealt with their own

issues in their own way without necessarily consulting with other programs and

departments. It was evident that establishments of some dockets for social support

provision lacked mandate for drug abuse prevention. One respondent commented that,

„the university assumes that we shall use our discretion to include drug abuse prevention

activities in our daily tasks in our departments‟ These sentiments point to the inference

that, there is no strong networking and coordination amongst drug abuse prevention

providers. One respondent said „In most cases each department and program does their

own things except when they are referring students to other departments‟. There were

also concerns surrounding challenges in coordination due to university policies which

may not allow free flow of financial resources from one department to the other. One

respondent said in disappointment,

 101

„As DSAPP groups, we have no problem working together but the difficulty sets in
when
departments cannot manage financial logistics since the university controls the
finances and vote heads of every department. We have problems planning our
activities together because we cannot know who will be responsible amongst the
departments involved. The university ought to look at how financial independence
should be put in every department so that we may be flexible to operate as a
team‟.

A loophole is depicted from research findings on insufficient coordination among student

and staff DSAPP which could impinge on effectiveness due to lack of concerted effort,

shared resources and facilities. Coordination is significant in enhancing dissemination of

information, referrals and interdependence as demonstrated by ecological system‟s theory

(Bronfenbrenner, 1944).

4.2.2.4. Departmental Involvement

For further understanding of DSAPP implementation methods, respondents were asked

whether DSAPP actively involves various departments. Involvement in this study meant

participation in which departments were engaged in prevention activities such as talk

shows, drug abuse prevention days and training of personnel on ADA prevention skills.

Results showed that DSAPP did not actively involve other departments in prevention of

drug abuse. The bar chart below (figure 4.11) provides evidence of responses from

universities as follows; PRU2 (63.5%), PUU1 (64.9.0%), PRU1 (77.4%) and PUU2

(75.0%). Non-involvement of departments is a sign of weakness which could aggravate

drug abuse problem and make it more difficult for DSAPP to achieve effectiveness.
 102

77.4%
75.0%
80.0%
63.5% 64.9%
70.0%
60.0%

percentage
50.0%
40.0% 36.5% 35.1%
Yes
22.6% 25.0%
30.0% No
20.0%
10.0%
.0%
PRU2 PUU1 PRU1 PUU2
university

Figure 4.11: DSAPP Involvement with other departments

An average of 73.12% against 26.88 % thought that DSAPP did not involve their

departments in DSAPP activities. It is clear that departmental involvement is inadequate

in both Private and Public universities. It was necessary to find out if departmental

involvement in all universities is the same. A chi-square was carried out based on the

following hypothesis:

Ho: There is no significant difference in DSAPP departmental involvement in private and

public universities
 103

Table 4.5

Chi-Square Tests

Value df P value

Pearson Chi-Square 4.604 3 .203

Likelihood Ratio 4.666 3 .198

N of Valid Cases 275

The P-value (0.203) is greater than the level of significance (0.05) hence we do not reject

the null hypothesis that there was no significant difference in DSAPP departmental

involvement in the universities under study and conclude that DSAPP departmental

involvement is same in public and private universities.

The above trend can be attributed to presence of multiple academic programs and

modalities of studies which have compressed time schedules in all universities to an

extent that there is limited extra time to undertake extra-curricular activities at a common

time outside the timetabled lectures. It is most likely that DSAPP in all universities are

not flexible enough to engage other departments in their activities amidst their busy

schedules. The second most probable reason which is related to findings of this study in

other sections is university homogeneity in DSAPP lack of departmental involvement and

seems to display weaknesses of inefficiency and failure to be all inclusive in their

operations. Whatever factors are responsible, DSAPP have to devise efficient ways of
 104

involving other departments because interdepartmental input can yield moral, intellectual

and psychosocial positive impact in drug abuse prevention.

Table 4.6 below gives reasons why respondents thought their DSAPP involved their

departments.

Table 4.6

Reasons why students think DSAPP had actively involved their departments

Name of the university Total

Reasons PRU2 PUU1 PRU1 PUU2

A Christian ethics unit - 1.0% - - 3%

Allowing posters on drug abuse 1.8% 8.2% - 2.6% 3.5%

Involvement in the programme 3.5% - - - 6%

Being taught on negative effects 3.5% 5.1% - 2.6% 2.9%

Bible units taught 1.8% - - - 3%

Community development - - 2.5% 1.3% 1.0%

DSAPP is not active - 3.1% - - 1.0%

Lack of institutional cooperation - 1.0% - - 3%

lectures on healthy behavior - - 1.3% - 3%

Giving us lessons about drugs 3.5% - - 1.3% 1.0%

Holding talks on drug abuse 1.8% 6.1% - 2.6% 2.9%

I have never seen DSAPP - 1.0% 1.3% 1.3% 1.0%

Lack of Information - - 3.8% 2.6% 1.6%

It is illegal in the school - 2.0% - - 6%

It‟s so dormant in case it exists - 1.0% 5.0% 3.9% 2.6%

 105

Lack of commitment 7.0% - - - 1.3%

Lecturers incorporate DSAPP - - 2.5% - 6%

Make members as a role model 1.8% - - 1.3% 6%

Organizers not from the students - 1.0% 1.3% 1.3% 1.0%

Never heard of DSAPP 28.1% 37.8% 23.8% 26.0% 29.5%

No evidence of any activity - 2.0% - - 6%

No measures for culprits 3.5% 4.1% - 2.6% 2.6%

No response 29.8% 4.1% 45.0% 36.4% 27.2%

lecturers emphasize on effects - - -1.3% - 3%

rarely talk about drug abuse 1.8% - - 2.6% 1.0%

No any unit related to drugs - 2.0% 2.5% 1.3% 1.6%

The dean gives out brochures - 1.0% - - 3%

The school is uninterested - - 6.3% 2.6% 2.2%

Student department is neglected - 1.0% 1.3% 1.3% 1.0%

There are very rare cases - 2.0% - - 6%

There is a unit on drug abuse 1.8% 1.0% - - 6%

They have never told us - 1.0% 1.3% 1.3% 1.0%

Through relevant clubs - - 1.3% - 3%

Use of student's counsellors 10.5% 14.3% - 5.2% 7.7%

Total 100.0% 100.0% 100% 100.0% 100.%

Figure 4.12 Summarizes information in Table 4.6 above giving a high implication that

dissemination of information methods (78.6%) such as posters, talk shows, billboards and

brochures is evidence of DSAPP departmental involvement. Other students also felt that
 106

they were engaged in activities (14.3%). Other students still found some units such as

Bible units with elements of drug abuse prevention being helpful in enabling departments

to get engaged in prevention. A small percentage of students thought that university rules

and regulations which were explained in the department were other measures which

assisted students to avoid drug abuse and were expressed in the department.

5.7% 1.4%
14.3%

78.6%

Presence of dissemination methods

Involvement of departments
Bible unit is taught
University rules

Figure 4.12: Reasons for departmental involvement

The presence of methods in the departments are important in strengthening DSAPP

effectiveness as supported by Riggs, (2003) in his contention that treatment and

prevention for adolescents is most effective when multimodal treatment services are

provided and integrated. The fact that some respondents have recognized presence of

dissemination methods in the departments is a positive trend which requires more

exhilaration in order for DSAPP to realize effectiveness. However, percentage indicating

departmental involvement is small and could be beefed up to promote more participation.

Students‟ recognition of DSAPP in their departments creates an impression that at least

 107

there are students who are interested in DSAPP activities. If this is the case, these

students need more vibrancy for them to get attracted to and actively support prevention

activities.

However, other respondents thought DSAPP did not involve their departments. Figure

4.13 provides information on factors why respondents thought departments were not

involved.

1.3%
2.0% 0.7%
7.2%

20.3%

68.6%

Lack of information Dormancy of DSAPP

Lack coopertion among departments DSAPP not from students body
Rare cases of drug abuse DSA is illegal in the University

Figure 4.13: Reasons for lack of departmental involvement

Factors justifying why respondents thought DSAPP did not involve their departments

were; lack of information (68.6%) about what DSAPP entailed, DSAPP were quite

dormant (20.3%) that they could not initiate any activities which departments could carry

out., lack of cooperation amongst departments (7.2%), failure of DSAPP to include

student body (2.0%), rare cases of drug abuse and university stance on drug abuse as

illegal were some of the substantial factors mentioned for lack of departmental
 108

involvement. SOG confirmed these claims of lack of departmental involvement through

observation that most departments in all universities did not have any mode of

communication on ADA except one or two posters in the departments of DSAPP. This

could adversely affect effectiveness due to fragmented approach. However

demonstrations from research (SAMHSA, 2002) reveal crucial necessity for

interdepartmental involvement in program implementation in their contention that

programs that involved participants interactively were more effective in reducing

substance abuse than programs that relied on passive classroom-style teaching. Programs

that combine life skills, interactive delivery, intensive participation, and strong

implementation consistently produced stronger and longer-lasting positive effects on

substance use. These proposals are worthy for application by DSAPP since this study

discovered a serious shortfall in all of them. Further proposal from (SAMHSA,2002) is

that Successful programs work through naturally occurring social networks and services

are delivered via the school, community-based agencies, or other networks already in

place (e.g., the sports team setting). It was evident during data collection that this

approach could lead to effectiveness so that it may counteract challenges of accessing

large populations in most universities.

4.2.2.5 DSAPP impact on drug abuse prevention

In order to gauge implementation effectiveness, a question was given to student

respondents on whether DSAPP had any impact on prevention. More than half of

students from three universities attested to the fact that DSAPP had an impact on drug

abuse PRU2, (75.0%), PRU1 (63.6%) and PUU1 (56.1%. At PUU2, students who
 109

thought DSAPP had impact were equal in percentage to those who thought it didn‟t have

any impact.

80.0% 75.0
70.0% 63.6
60.0% 56.1
50.0 50.0
43.9
Percentage

50.0%
40.0% 36.4

30.0% 25.0

20.0%
10.0%
.0%
PRU2 PUU1 PRU1 PUU2

Yes No

Figure 4.14: DSAPP impact on substance abuse prevention

PRU2 gave the highest percentage on the opinion that DSAPP has impact on prevention.

Information from FGD and QIG in this university revealed that this university is very

strict with penalties netted on the culprits of drug abuse. Discussion also raised issues on

how the university engages spiritual approach exclusively to address drug abuse.

Information further revealed that support by the management on DSAPP was poor

because management thinks that rules will deal with the problem. Stringent rules have

been stipulated to reduce the number of students who abuse drugs. This mentality is

based on the assumption that students are expected to practice Christian ideals and

therefore no one is expected to be using drugs at all. Their argument was that DSAPP

would implement drug abuse prevention far much better than the stringent rules which

seem to have no concern for those abusing drugs based on what they thought was
 110

evidence from students who used drugs despite the rules but who had positively

responded to stopping whenever they sought help from DSAPP. Other universities are in

agreement as well that DSAPP makes an impact on prevention because some students

seek help from prevention programs. According to them, seeking help justifies DSAPP

effectiveness without which, students wouldn‟t be going for them.

FGD and QIG strongly supported the fact that DSAPP are effective tools to deal with the

problem of drug abuse. Their argument demonstrated a good number of students whose

academic performance, relationships and drug abuse prevention had been restored due to

counselling services.

The above arguments alluded to research findings that prevention programs have impact

on drug abuse prevention. Evidence from controlled studies, national cross-site

evaluations, and Centre for Substance Abuse Prevention (CSAP) grantee evaluations in

the US demonstrate that prevention programs work. For instance, an assessment of

Project STAR found that forty-two participating schools in Kansas City, Missouri

reported less student use of alcohol, tobacco, and marijuana than control sites (Project

Star, 2000, 2003, 2013, Project BASICS 2013).

It was relevant to find out the parity or disparity in responses to the question on impact of

DSAPP amongst universities. A chi-square was carried out with the following

hypotheses: HO: There is no significant difference in opinion about the impact of DSAPP

on drug abuse prevention amongst universities under study.

 111

Table 4.7

Chi-Square Tests

Value df P-value

Pearson Chi-Square 4.543 3 .208

Likelihood Ratio 4.676 3 .197

N of Valid Cases 180

The P- value is greater (0.208) than the level of significance (0.05) therefore we do not

reject the null hypothesis that there was no significant difference in opinion about the

impact of DSAPP on drug abuse prevention amongst universities.

Agreement to the fact that DSAPP have impact on drug abuse is a great impetus which

requires a closer look into the tangible areas of impact. Documented research findings

argue that through drug abuse prevention programs, some students have abstained from

abusing drugs (Abdullah, Fielding Hedley, 2010; Stubbs, 2008; Botvin & Griffin, 2007).

A close examination into characteristics of these programs reveals that they must meet

certain threshold which seems to be absent amongst DSAPP in Kenyan universities.

These are principles which have been appraised to work for individuals and groups as

outlined by (Dusenbury & Falco, 1995 and NIDA, 2009).

4.2.2.6 Rating on DSAPP implementation methods

Methods of implementation are critical in determining the success and effectiveness of

prevention programs. It was found relevant for respondents who are beneficiaries of these
 112

methods to provide a view on how DSAPP rate in implementation of their programs.

Figure 4.15 below presents the findings.

48.6
50.0%

37.3

36.4
45.0%

36.4

32.7
33.0

32.2
40.0%

30.7

30.9
30.5
35.0%

24.3
27.0
Percentage

30.0%
25.0%
20.0%
15.0%
10.0%
5.0%
.0%
PRU2 PUU1 PRU1 PUU2
Universities

Good Poor V.poor

Figure 4.15: Rating of implementation methods

Three scales were considered useful in the rating; good, poor and v poor. Ratings as good

were follows; PRU2 (48.6%), PUU1 (33.0%), PRU1 (30.5%) and PUU2 (30.9%); rating

as poor were; 32.7, 24.3%, 30.7% and 37.3%; ratings as very poor were 27.0%, 36.4%,

32.2% and 36.4%. Total percentages rated poor and very poor were as follows; PRU2

(50.3%), PUU1 (67.1%), PRU1 (69.5%), PUU2 (69.1%). This depicts a consistent

agreement in all universities that methods being used in prevention rate poorly if not very

poorly. This trend could be attributed to the fact that students are not aware of prevention

programs (55.2%), resources are inadequate and means of communication is poor

(68.5%) as attested by respondents in sections 4.2.1, 4.3.1 and 4.3.2 above. The fact that
 113

drug problem is a dynamic phenomenon could explain a paradigm shift in drug

complexities which are not commensurate to implementation efforts and approaches.

4.2.2.7 Suggestions on more popular and useful DSAPP methods

A two-tier question was posed to respondents asking them to suggest methods they

thought could be more popular and useful to students and secondly, asking them to

suggest how DSAPP could improve their implementations. Descriptive statistics were

used to analyze their answers. Appendix J, Figure 4.16 and 4. 17 provide this

information.

Dissemination of
information
3.7% 3.4% 2.7%
5.1% DSAPP to be more
5.1% 41.0% effective
6.1% Guidance and
cuonselling
Conferences
9.8%
Clubs and associations

Rules and regulations

10.5% 12.5%
Social media

Include in academic
curriculum
Avid students iddlness

Inhouse rehabiitation
centres

Figure 4.16: Methods which could be more popular and useful

 114

45.0 40.6%
40.0
35.0

Percentage
30.0 24.9%
25.0
20.0 16.6%
15.0 7.4% 5.5%
10.0
5.0 3.2%0.9%0.9%
.0

Involvet of staff &students

DSAPP to be more active
Reach out many students

Training & counseling

Source for funds

Rules & regulations

Rehabilitation centres

Engage departments
Improvements of DSAPP methods

Figure 4.17: Ways DSAPP could improve their services

Results of the bicameral question depict a systematic concurrence with the first two

strong suggestions retaining their positions as, dissemination of information (41.0% and

40.0% ) and DSAPP to be more effective (12,5% and 24.9%) respectively. Other

suggestions presented included; involving lecturers and students (16.6%), guidance and

counselling (10.5%), Conferences (9.80%), clubs and associations (6.1%) rules and

regulations (5.1%) social media(5.1%)., include in academic curriculum(3.7%) avoid

student idleness(3.4%) and in-house rehabilitation centers (2.7%).

The above suggestions on improvement of DSAPP provide more clarification on the

current state of DSAPP operations which seem to strongly display defective execution

and instrumental structures. To this end, they fall short of one of the principles of model

programs as explained by clay (2003) and perhaps meet the standards of promising
 115

programs which she says are programs which require strong evidence of scientific rigor

and positive results, but to a lesser degree than that required of an effective program.

DSAPP in their endeavor nevertheless, need to strive for the standards of model programs

in which one principle reveals that when communities adapt programs to match their

needs, community norms, or differing cultural requirements, they should retain core

elements of the original research-based intervention which include: structure (how the

program is organized and constructed); content (the information, skills, and strategies of

the program); and delivery (how the program is adapted, implemented, and evaluated

(NIDA,2003).

4.2.3 Student participation in and utilization of prevention programs

This section of the study inquired objective three which investigated into DSAPP users‟

feedback as an indicator of effectiveness with the research question, ‘What is the

participation and utilization of students to substance abuse prevention programs in

the universities?’

Descriptive and inferential statistic processes were applied and presented in tabular, bar

and pie charts giving results on; awareness of student groups who participate in DSAPP,

rating and reasons on students‟ participation, views on using students as agents of

prevention, and strategies which enhance student utilization of DSAPP.

4.2.3.1 Student Drug and Substance Abuse Prevention programs

It was primarily important to establish whether there were students who actively take part

in prevention activities. When asked whether they were aware of such student groups,
 116

majority of the respondents (90.3%), PUU2, (88.8%), PUU1, (84.8%), PRU2 and

(78.5%) PRU1 said they were not aware.

100.0% 88.8 90.3

84.8
90.0% 78.5
80.0%
70.0%
Percentage

60.0%
50.0%
40.0%
30.0% 21.5
20.0% 15.2 11.2 9.7
10.0%
.0%
PRU2 PUU1 PRU1 PUU2
Universities

Yes No

Figure 4.18: Awareness on DSAPP Student groups

An average of 85.6% in all universities reported not being aware of student groups who

participate in drug abuse prevention activities whereas only 14.4% agreed to have

awareness about student groups who undertake prevention programs in the university.
 117

14.1%

Yes
No

85.9%

Figure 4.19: Knowledge of student groups that carry out DSAPP activities

Information obtained from FGD and QIG attested to this fact that not many students do

have their own initiatives but in most cases participate in prevention programs already

established by other groups from outside like ICL or as part of DSAPP. However, peer

counselling is a program in which students actively participate in. FGD expressed

concern that peer counsellors consisted of a small fraction of students who could not

adequately permeate the larger university student population. FGD and QIS also alluded

to the fact that not many student groups participate in prevention.

However, there are a small exceptional number of students who participate through

various groups like ADCU in the case of PRU1. From PRU2 (33.3%) named ADCU;

from PUU1 students (42.9%) named student government. Outside groups which were

listed were St. Johns ambulance Volunteer group (37.7%). I chose Life (ICL); PRU1

(37.5%), PUU2 (25.0%), PUU1 (14.3%), PRU2 (11.1%). Psychology club was also

mentioned in some universities.

 118

Table 4.8

Student groups which carry out DSAPP activities

Name of the university Total

Students Groups PRU2 PUU1 PRU1 PUU2

ADCU 18.8% - 33.3% 12.5% 14.9%

Alcohol and drug abuse club 11.1% - - - 2.1%

AYS 11.1% - - 12.5% 4.3%

Christian organization groups - - - 12.5% 2.1%

ICL 11.1% 14.3% 37.5% 25.0% 23.4%

National youth % counselling club - - 18.8% 12.5% 8.5%

Peer educators 11.1% - - - 2.1%

Psychology club - 7.1% 12.5% 12.5% 8.5%

Red cross student group - - 12.5% - 4.3%

Student government - 42.9% - - 12.8%

St John‟s Ambulance volunteer group 11.1% 35.7% - - 12.8%

YCS 11.1% - - 12.5% 4.3%

Total 100.0% 100.0% 100.0% 100.0% 100.0%

The above findings tend to imply that students do not play an active participatory role in

prevention, a situation which could weaken usability of DSAPP due to lack of ownership

of programs. Research shows the role of users‟ active engagement in embracing and

popularizing prevention activities amongst their colleagues hence promoting

effectiveness (Kloss,et.al 2012 ). Another example is be-WISE-er”, a student program

referred to SNAP at the University of Minnesota which encourages peers to "be-WISE-

er" when making choices about alcohol through an interactive and educational program.
 119

Its goals and objectives include; debunking myths about booze, emphasizing alcohol

serving sizes through bartending 101 activities, training students to recognize and take

action during problem situations involving alcohol, instead of being a bystander and

showing students how alcohol impairs their vision. These activities won the program an

award. This presents a classic example of the crucial role that student participation would

equip prevention with more success.

4.2.3.2 Student Participation

Student participation in this study was subjected to four aspects which were deemed

indicative of student activities and attitudes depicting participation. Respondents were

asked to rate student participation in four aspects; acceptance, support, involvement and

readiness. Acceptance in this study referred to a positive attitude towards DSAPP

programs and activities. Descriptive and inferential were used in analyzing universities‟

ratings and comparisons. Presentations are given in tables.

Rating of students’ participation in DSAPP acceptance, support, involvement and

readiness
Table 4.9

Rating of student participation: Acceptance, support, involvement, readiness

University Acceptance Support Involvement Readiness

PRU2 Mean 2.90 3.10 3.10 2.64

N 41 41 40 47

PUU1 Mean 2.96 3.16 3.34 2.55

N 81 81 83 82

PRU1 Mean 2.98 3.04 3.39 2.64

 120

N 54 54 54 53

PUU2 Mean 3.18 3.25 3.49 2.50

N 51 51 51 52

Total Mean 3.00 3.14 3.34 2.58

N 227 227 228 234

The means as used in table 4.9 above were taken to indicate that any mean which is

below 2.5 was a high rate of students‟ DSAPP participation whereas any mean above 2.5

indicates a low rating. It was observed that students‟ acceptance, support and

involvement were low in all universities whereas readiness was incidentally moderate in

all universities. The aspect of readiness is a positive feature which could be taken

advantage of by DSAPP to enhance student participation. On the other hand, the low

rating in the three aspects raises a lot of questions surrounding the nature and capacity of

DSAPP to initiate and reinforce participation of students.

A statistical procedure was necessary to establish variability (Boddy & Smith, 2009)

hence an ANOVA test was undertaken to find out if there was any significant difference

between ratings in various universities with the hypothesis Ho: „There is no significant

difference between ratings in various universities‟. The results were as shown in the

ANOVA table 4.10 below.

 121

Table 4.10

ANOVA tests on rating

Mean P
Sum of
df Squa F value
Squares
re .

Acceptance of Between 2.104 3 .701 .948 .418

DSAPP Groups

Total 166.996 226

Support of DSAPP Between 1.353 3 .451 .881 .451

Groups

Total 115.489 226

Involvement in Between 3.583 3 1.194 2.09 .102

DSAPP Groups 5

Total 131.316 227

Readiness to Between .771 3 .257 .286 .835

preventing DSA Groups

Total 207.115 233

The ANOVA table 4.10 above shows that the P-value in students‟ acceptance of DSAPP

(0.418), support of DSAPP (0.451), and students‟ readiness to (0.835) prevent drug abuse

was greater than the level of significance (0.05), hence we do not reject the null

hypothesis that there was no significant difference and conclude that there was no

significance difference on students‟ rating of support, acceptance and readiness whereas

involvement had a difference (0.012).This variation could be associated to the fact that

universities may not be having the same activities which involve students. For instance
 122

during data collection, it was noted in one private university that students had a lot of

student initiated activities which carried out prevention activities.

It was observed that participation in prevention programs by majority of the students was

very low, contradicting research findings on the role of student participation (Weiner,

2009). Global Youth Network, (2003) indicates that peer educator model is important as

a good way of communicating information in different ways suitable for their peers and

that it increases credibility of what is being shared through experience. Their research as

well reveals that student participation can enhance sharing of information amongst them.

Involving young people can make a difference in program success. One example is the

Project Northland Peer Participation Program, implemented in Northeastern Minnesota

(Perry et al 2009). The program involved students in the planning and promotion of

alcohol-free social activities in order to determine whether such participation is

associated with reduced alcohol use among students. Evaluation demonstrated a positive

correlation between student involvement in planning the activities and a lower rate of

alcohol use among involved students as compared with uninvolved students. In addition,

evaluation showed increased acceptance of alcohol-free events by the student population

as a whole.

In the universities under study, this study unveiled that peer counselling programs

participate in DSAPP but these peer counsellors have other roles which they play in the

university. The peer counselors are also paraprofessionals who lack specialized training

in the area of drug abuse prevention. Students who participate in activities that are

specific to drug abuse prevention like SCAD and ADCU require well planned activities
 123

and time for these students to acquire the right empowerment so that they manage to

handle drug abuse cases amongst their colleagues.

It was important to find out factors for low student participation to provide reflection on

DSAPP‟s effectiveness on users‟ participation as presented in Appendix K and Table

4.11 below.

Table 4.11

Reasons for students‟ rating on participation

Reasons Rating

High Low Total

Many students abuse drugs 6.7% 8.6% 8.5%

Lack of prevention - 13.6% 12.4%

knowhow

Students' negative attitude - 11.1% 10.2%

Students commitment 13.3% 3.1% 4.0%

DSA consequences - .6% .6%

DSAPP positive impact 80.0% - 6.8%

DSAPP dormancy - 54.3% 49.7%

DSAPP challenges - 8.6% 7.9%

Total 100.0% 100.0% 100.0%

The study revealed that DSAPP dormancy (49.7), lack of knowledge on prevention (12,

4%), students negative attitude (10.2%) and many students who abuse drugs (8.5%) were
 124

the main draw backs for students‟ participation in prevention programs. Information from

FGD and QIG strongly supported these reasons as demonstrated in their excerpts:

„Many students have a negative attitude towards prevention programs. Many a

times when we arrange for DSA programs, a small percentage of students show
up and sometimes none turn up!‟(Counselor Private University)

„Student participation is a serious issue that has to be addressed because

prevention programs cannot take off without their participation. In my opinion,
students don‟t take part because our programs don‟t meet their expectation and
standard. Many of them don‟t find anything new about them apart from the usual
negative effects of drugs. Many students say DSAPP show no difference to the
problem of drug abuse in the university because they have never been able to
target the real issues‟ (Counselor, Private University)

„Students don‟t participate in prevention programs because drug abuse is the

order of the day in the university and they have no reason to eliminate it‟.
(Student Public University

Attitude is a very crucial ingredient in implementation of programs and task

accomplishment as illustrated by the theory of planned behavior which postulates that the

best predictors of a person‟s planned, deliberate behavior are the person‟s attitude

towards specific behaviors, subjective norms and perceived behavioral control (Aronson,

Wilson & Akert, 2010). Lack of knowledge in ADA as reason for not participating is a

very justified factor because ADA is a technical area which requires specialized skills. It

is most probable that students do not want to participate because they don‟t feel confident

to handle ADA cases.

Students were requested to give their view on need of students being used as agents of

prevention to find out if it is a parameter for implementation effectiveness. Data

demonstrated clearly that, students should be used as agents of drug abuse prevention.
 125

Respondents from PRU2 (51.4%) PUU1 (56.8%), PRU1 (41.8%) and PUU2 (62.0%),

agreed that students should be used as agents of drug abuse prevention. Public

universities had stronger agreement to students being used as agents of prevention as

compared to private universities.

70.0%
62.0
56.8
60.0%
51.4
48.6 48.1
50.0%
42.0
Percentage

40.0% 37.0
28.0
30.0%

20.0%

9.3

8.0
5.6

2.0
1.2
10.0%

.0%
PRU2 PUU1 PRU1 PUU2
Universities

Strongly agree Agree Disagree Strongly disagree

Figure 4.20: Ratings on whether students should be used as agents of DSA

This fact is strongly supported by FGD and QIG (80%) that, using students as agents of

prevention makes them to own up the activities and actively participate in them. They

further argued that students who have been participating have been able to demonstrate a

lot of passion for prevention. Further information reveals that students know the causes of

drug abuse including student preferences on methods to be employed in dealing with it.

They argued that students can form a „chain reaction‟ to change their attitudes as regard

use of drugs. Chain reaction according to them is an approach where students with a

popular idea influence others in a snowballing kind of a pattern. This point was strongly
 126

supported by students in the Focus group discussion that since students believe in one

another, they should be used as inoculations against one another on aspects of drugs.

They contended that student to student campaigns against drugs work far much better

than campaigns carried out by senior adult officers of the university. It would be easier

for other students to permeate the others with new information than for DSAPP. They

said „comrade power‟ works even in drug abuse matters. This idea is strongly supported

by research (Mara, 2000) that student participation not only improved a school's policy,

but also increased campus-wide "ownership" of the prevention efforts emanating from it

including participation in Campus-based task forces to direct prevention program efforts

and develop specific strategies for promoting change in student organizations and joint

campus and community coalitions.

Involving young people is associated with a number of benefits such as more effective

outreach that provides important information peer to peer, greater acceptance of

messages, services, and decisions because youth were involved in shaping them,

increased self-discipline and schedule management source (Pentz et al., 2009).

These arguments show that involving students in planning their own activities may have

a double benefit of preventing or reducing drug taking habits among involved students

and in modifying attitudes of their colleagues who may not necessarily be involved in

drug abuse. Student participation should adopt the rationale of peer educator program

which is founded on the premise that young people have the power to influence and

positively change others‟ attitudes and social values and ultimately the behavior of

colleagues.
 127

A chi-square was undertaken, Ho: There is no any significant statistical difference in

students being used as agents of prevention among universities‟ The chi-square results

gave a P-value of (0.038) is lower than the significant level of (0.05) hence the null

hypothesis that there is no significant difference amongst universities in their view of

students being used as agents of prevention was rejected.

Table 4.12

Chi-Square Tests

Asymp. Sig. (2-

Value df sided)

Pearson Chi-Square 17.746 9 .038

Likelihood Ratio 19.994 9 .018

N of Valid Cases 222

The difference in view of using students as agents of prevention could be associated to

the ratings of students‟ participation in which acceptance, involvement and support rate

low. This low rating may be depicting DSAPP‟s inability to target the epitome of

acceptability of implementation methods. It could also be ascribed to the challenges

DSAPP face in implementing activities which involve use of money which was

mentioned as really inadequate. This was evident in FGD and QIS discussions which

revealed that students are not readily willing to engage themselves in activities because

they lack financial support from university management. One student FGD said,

„It is not possible for students to sacrifice their time to do activities for the
university yet they don‟t get any support nor reinforcement from the university.
 128

The worse situation is where students have to raise tier own money if they have to
go out on outreaches to the community‟.

Another strong factor that could be attributed to this difference is lack of proper

supervision of activities being carried out by students which could jeopardize the quality

of service on issues of confidentiality and competence. This opinion may reflect a

genuine concern in consideration of the fact that drug abuse is sensitive issue which

requires high levels of professionalism and confidentiality. Variation can also be

attributed to disproportions in population sizes of the university which are overwhelming

in one university but may be manageable in another.

4.2.3.3 Strategies which enhance Students’ utilization of DSAPP

Utilization of services offered by DSAPP is important in determining its success hence it

was found prudent to comprehend the kind of strategies which could appeal to students to

enhance their utilization. Descriptive statistic was used to analyze suggested strategies

and presented in tables and pie chart. Table 4.13 below shows suggested DSAPP

strategies that could enhance student‟s utilization of DSAPP.

Table 4.13

DSAPP strategies that could enhance students' utilization

Name of the university Total

Strategies PRU2 PUU1 PRU1 PUU2

Academic provisions 4.0% 10.7% 4.0% 10.3% 8.4%

Brochures 12.0% 6.7% - 6.9% 6.5%

Building networks - - 8.0% 6.9% 2.6%

Counselling services 8.0% 2.7% - 6.9% 3.9%

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Create awareness 4.0% - 4.0% 6.9% 2.6%

DSAPP campaign 2.7% - - 1.3%

Encourage students to 16.0% 9.3% - - 7.1%

Entertainment - 4.0% - - 1.9%

Forums 4.0% 10.7% 4.0% 10.3% 8.4%

Group session - 1.3% 4.0% - 1.3%

Hand-outs - 6.7% 8.0% - 4.5%

Students easy access to offices 4.0% - - - 6%

Helping students recognize 4.0% 8.0% - 6.9% 5.8%

High interaction 4.0% 4.0% 4.0% 3.4% 3.9%

Improve their accessibility - - 20.0% 6.9% 4.5%

Increase DSAPP school events 4.0% - - 6.9% 1.9%

Personal session - 1.3% 4.0% 1.3%

Proactive approaches - - 8.0% 6.9% 2.6%

Public notice 8.0% 6.7% - 6.9% 5.8%

Seminars 8.0% - - - 1.3%

Setting time bound goals - - 24.0% 6.9% 5.2%

Sports 4.0% - - - 6%

Students involvement - 6.7% 8.0% - 4.5%

Talk during 1st yr. orientation - 5.3% - - 2.6%

Talk show 4.0% 5.3% - - 3.2%

Use of posters 8.0% 8.0% - 3.4% 5.8%

Proper learning materials 4.0% - - 3.4% 1.3%

Total 100.0% 100.0% 100.0% 100.0% 100.0%

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2.6% 2.6%
5.2%

15.6%

56.5%
17.5%

Awareness promotion Make DSAPP accessible to students

Encourage student participation Setting goals
Sporting activities Networking

Figure 4.21: DSAPP strategies that can enhance students' utilization

Six major suggestions on strategies emerged from synthesized data in table 4.13 and
shown in figure 4.21. These include awareness promotion (56.5%), make DSAPP
accessible to students (17.5%) Encouraging student participation (15.6%), setting goals
(5.2%), sporting activities (2.6%) and networking (2.6%). These factors could enhance
students‟ utilization of prevention services if considered for implementation because they
appear to be pillars of program implementation. Taking just three of eight aspects
identified by Durlak & Dupre in Khloos et al. (2012) as aspects of implementation
including related questions provides evidence of validity of aspects mentioned above by
respondents. These include; Program Reach referring to how many of the intended
participants were actually enrolled in the program. The second is Participant
Responsiveness referring to how engaged the participants are and thirdly, Adaptation
referring to the aspects of the program which were adapted to fit the specific setting.

ANOVA tests were undertaken, Ho: There is no significant difference amongst strategies

suggested for greater utilization of prevention programs in various universities‟.

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Table 4.14

ANOVA tests on utilization of prevention programs

DSAPP strategies that can enhance students' utilization of DSAPP

Sum of
Squares df Mean Square F Sig.

Between Groups 278.891 3 92.964 2.380 .070

Within Groups 12030.070 308 39.059

Total 12308.962 311

Since the p-value (0.070) is greater than the level of significance (0.05), we do not reject

the null hypothesis and conclude that there is no statistic significant difference amongst

strategies suggested for greater utilization in various universities. These results allude to

the fact that DSAPP in all universities generally rate the same in their implementation

strategies and probably experiencing the same incomprehensibility and challenges.

Information from FGD and QIS depicts a strong correlation with information elicited

from the questionnaire and strongly supports suggestions on strategies that could enhance

students‟ utilization of DSAPP. FGD and QIS argued that most students may not be

aware of prevention programs because during activities‟ planning stages, students are not

usually involved resulting in inadequate conceptualization and awareness of activities.

Further discourse on this revealed that materials being used for advertisement are not

appealing to the students or those engaging enticing activities like Mr. and Ms. Campus
 132

pageant forums which could yield better success. They suggested activities which

actively engage student participation so that they can know and own the activities. FGD

and QIS portrayed a picture of conformity in regard to making DSAPP accessible to

students. One respondent commented that,

„Our methods of dissemination could be obsolete in the light of the era we are in.
Many students rarely get attracted to hard data that we put on our walls as
information for them to see. Students spend their free time in the internet and
have no time reading banners we hang on our areas. We should therefore change
our mode of communication to ensure that we reach as many students as possible‟

The general idea arising from the premise of these discussions is that users‟ readiness

appears to be robust and hence a fundamental role is left for DSAPP to raise the edge of

implementation. A manifestation vividly pops out that awareness promotion entails many

dimensions which necessitate adjustment to modern means of information dissemination

to ensure that users are accessed with the right information with appealing methods so

that students may utilize the programs. NIAAA (2O02) provide authenticity to this

argument in their realization of need for adequate research to inform formation of

prevention activities.

4.2.4 Challenges to effective implementation of DSAPP

Effectiveness of prevention programs can be slowed down or even derailed in the

presence of challenges. Consequently, one objective of this study was to establish

challenges to effective implementation of substance abuse prevention programs in

universities with the research question ‘What are the major challenges facing effective

implementation of drug abuse prevention programs in the universities?’ Descriptive

Statistics were used to analyze challenges facing DSAPP and suggestions provided for
 133

trying to address these challenges. Results were presented in bar graphs, pie charts and

tables.

4.2.4.1 DSAPP Challenges

This study envisaged challenges which could be known in the domain of the respondents

who then were given the question, „Do you agree that DSAPP face challenges in

providing drug abuse prevention services to students in your University?‟ Figure 4.23

shows that over seventy percent of students in two universities, PRU1 (75.6%), PUU2

(73.5%) agreed that DSAPP face challenges in providing prevention services whereas

PUU1 (61%) and PRU2 (52.6%) had slightly lower percentage agreement. However,

there was above 50% concurrence in all universities that DSAPP face challenges.

80.0% 75.6 73.5

70.0% 61.7
60.0% 52.6
47.4
50.0%
Percentage

38.3
40.0%
24.4 26.5
30.0%
20.0%
10.0%
.0%
PRU2 PUU1 PRU1 PUU2
Universities

Yes No

Figure 4.22: Knowledge on whether DSAPP face challenges

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Respondents were asked to enumerate challenges facing DSAPP. Figure 4.26 below

illustrates that; inadequate information about DSAPP(30.0%), negative attitude by

students(26.4%), lack of funds(20.9%), DSAPP inability to access students(13.6%) and

lack of university administration support of DSAPP(9.1%) are the major challenges .

30.0
30.0 26.4

25.0
20.9
20.0
Percentages

13.6
15.0

9.1
10.0

5.0

.0
Negative
Inadequate

information

students'

resources &

management
inaccessibility
attitude

to students
DSAPP

Lack of

Lack of

support
DSAPP
funds

Challenges

Figure 4.23: Challenges facing DSAPP

Outcome of FGD and QIS on challenges being faced by DSAPP was in agreement with

information on figure 4.23. They argued that lack of support from management resulted

in poor facilities and poor implementation because of lack of finances to purchase

resources. Some of the excerpts from FGD are;

„You do not expect students to get enticed into our services when the offices we operate
from are not different from other offices with blocking structures which speak aloud
about segregation between the client and the counselor. I mean our offices are so poorly
furnished that it is a shame to claim we are doing counseling in them. It poses serious
 135

sense of unprofessionalism and ineffectiveness‟ (mentioned in disappointment)

(Counselor, Public University).

„We have many challenges including too much work. Students seem to have no common
free time to enable us much present our activities to them no wonder we get few or lack
of quorum whenever we organize our activities. We end up addressing students who
voluntarily participate in our programs or those few who for reasons known to then are
interested in our activities. Many of students who abuse drugs and who should be our
target miss out altogether‟. (Counselor, Public University)
„The administration and student governments are a great challenge because
administration doesn‟t act immediately drug abuse culprits are taken to them.
Disciplinary cases take too long until they are overtaken by events. Student
government, to say the truth, is an enemy of drug abuse prevention. I say so
because they defend students who are found guilty of trafficking drugs. They even
threaten to go on strike if their student colleagues who abuse drugs are reported
to the police or administration. Such behaviors make us to watch helplessly even
when we know the culprits. Unless these two bodies (referring to university
management and the student government) change, the problem of drug abuse will
increase a hundred times in the next few years‟. (Security Officer, Public
University)
„Challenges are multiple. Counselors are few; they are not specifically trained in
the area of drug abuse. Student population is overwhelming considering that we
are expected to undertake other duties but more importantly the fact society
including management seem to underestimate the magnitude of drug abuse
problem‟ (Chaplain Private University)
„With due respect for service providers who are here, one challenge is poor
student mobilization into DSAPP. There seems to be a gap between students and
program providers in the way they mobilize students. Something is not right. As
in, many students find no reason to attend DSAPP outlined for them since there is
nothing new apart from don‟t abuse drugs , they will ruin you… same song same
chorus. I think service providers are failing to appeal to students in the way they
approach them‟. (Student, Private University)

Challenges raised can be categorized into factors related to inadequate resources,

inefficient DSAPP methods, lack of support by university management and negative

student attitude. Analysis of these four factors reveals a revolving nature of one factor to

the other in which failure to resolve one sustains the other. On attitude,

Pylkanen,Viitanen, & Veuhelainen (2010) argue that substance abuse information may

not interest those at risk or everybody in the population being targeted. This suggests that
 136

ADA messages ought to be given a seasoned manifesto to make it appealing to those who

use drugs without necessarily distorting the content.

Amongst student respondents some maintained the position that DSAPP did not face any
challenges at all and they prevented their justifications in table 4.15.

Table 4.15

Reasons why students think that DSAPP do not face any challenge

Name of the university Total

PRU2 PUU1 PRU1 PUU2

Because it is
sponsored by 11.1% - - - 4.0% The
government
stron
Don't exist 55.6% 25.0% - 33.3% 36.0%
gest
Lack of - - -
11.1% 4.0% reas
commitment

Not aware - - 100.0% - 4.0% on

Not fully give

supported by 11.1% 66.7% - 66.7% 44.0%
n as
University

They are not active to

11.1% 8.3% - - 8.0%
so few challenges
why
Total 100.0% 100.0% 100.0% 100.0% 100.0%
resp

ondents think DSAPP did not face any challenge is that DSAPP don‟t exist in the first

place. This presents a high indication that DSAPP have not managed to make themselves

known to users. It also reiterates earlier responses that many students are not aware of

DSAPP because of lack of information and poor implementation methods. Research

 137

studies endorse effective implementation of any program once articulate attention is

positioned to curb any hindrance that may arise as demonstrated by SAMHSA (2009)

argument on appropriateness that if the prevention program, policy, or practice does not

fit the community‟s capacity, resources, or readiness to act, then the community is

unlikely to implement the intervention effectively.

It appears from the findings that DSAPP have not met the threshold of implementation

because in every component of implementation spanning from planning to evaluation

stages of the program, there are conspicuous weaknesses. Prevention effectiveness cannot

be achieved if implementation strategies are feeble.

It was important to find out from the respondents as consumers of DSAPP what they

thought would mitigate the challenges facing DSAPP to enhance their effectiveness.

Their suggestions are provided in table 4.16

Table 4.16
Suggestions on how to address challenges facing DSAPP

Name of the university Total

PRU1 PUU1 PRU2 PUU2

Adequate resources should be availed - - 3.8% - 9%

Administration should introduce and 6.3% - - 3.2% .8%

support DSAPP

Aggressive awareness campaigns to 6.3% 5.4% 30.8% 12.9% 3.6%

students

Approach them politely 5.4% .8%

Be more fun in expressing your ideas 6.3% - - - 9%

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Building students friendly networks - - 3.8% 6.5% .7%

Programs on how to get some funds - - - 3.2% 9%

Counseling 6.3% 10.8% 3.8% - 5.2%

Create support between concerned parties - - - 3.2% 9%

Acceptance of drug addicts among peers 6.3% - - - 9%

Educating students on drugs - 8.1% - - .7%

Ensure accountability and transparency - - 3.8% 6.5% .7%

share of experiences - - 3.8% - 9%

Activities that student like to open up - 10.8% - - .6%

Engage the students to actively identify - 2.7% 7.7% 3.2% .6%

the student affected by drug

Find better ways of approaching students 6.3% 18.9% - 3.2% .2%

Get ways of soliciting funds - - - 3.2% 9%

Get ways to attract audience - - - 3.2% 9%

Go to the students event e.g. birthdays - - - 3.2% 9%

Government should fund the programs 31.3% 18.9% - 12.9% 4.5%

Involve students directly - 2.7% 19.2% 6.5% .3%

Make it more informal - - - 3.2% 9%

Making administration aware of the - - 3.8% - 9%

importance of the programs

More peer educators should be involved 6.3% 5.4% 3.8% - 6%

Put posters everywhere - - - 3.2% 9%

Sensitize on DSAPP - - - 3.2% 9%

Should be made available 6.3% 5.4% - - .7%

Socialite funds 12.5% - - 6.5% .6%

 139

Support from university management 6.3% - - 3.2% .8%

Give addicts acceptance and healing - - - 3.2% 9%

They should be supported financially - - 11.5% 6.5% .5%

DSAPP should do their job - 5.4% - - .8%

Use of social media - - 3.8% - 9%

Total 100.0% 100.0% 100.0% 100.0% 100.%

Findings on how to deal with challenges demonstrated that DSAPP should employ good

approaches (58.2%), avail funds (20.9%), show acceptance and recognition of drug

abusers (6.4. %), management support of DSAPP (5.5%) counseling services (5.5%) and

use of peer educators (3.6%). This is represented in figure 4.24.

5.5% 3.6%
5.5%
6.4%

58.2%

20.9%

DSAPP to use good approaches Avail funds

Acceptance of drug abusers Management support of DSAPP
Counselling Use of peer educators

Figure 4.24: Suggestions on how to address DSAPP challenges

 140

FGD, QIS had considerable perspective on how to address challenges facing DSAPP.

They strongly advocated for greater support by management and collaboration amongst

prevention service providers so that they coordinate their activities within available

resources. It was strongly expressed that stopping drug abuse from permeating to

university community was really difficult if all the stakeholders did not cooperate and

support each other. They further suggested that availability of funds would enable the

programs to run effectively and efficiently since funds are avenues through which

purchasing of resources and running of programs is achieved.

Suggestions above convey a genuine note in regard to prevailing conditions in prevention

of drug abuse as per revelation of the study. Application of good approaches like

counseling and peer counseling as enumerated propels constructive responsiveness to

ADA which is needed for effectiveness. Availability of resources lays a good foundation

for successful mounting and implementations of programs as supported by research.

Looking into enmeshment of all the stakeholders composing of all the roles, functions

and mandates may help in resolving the challenges.

4.2.5. Target of factors which sustain Drug and substance abuse

Drug abuse sustaining factors are those factors which spontaneously and continually

encourage drug abuse without users‟ realization of its negative consequences.

Characteristics of DSAPP users such as age, culture, intellectual capacity and interest

require adequate consideration when developing and conveying DSAPP activities. This is

significant in determining what is enticing to students for easy adoptability. DSAPP have

to be amicable to their day to day activities. The fifth objective of the study was to find
 141

out factors which sustain drug abuse in universities with an endeavor to appraising

effectiveness of DSAPP in targeting these correlates. Research question was, ‘Do

prevention programs target factors which sustain drug and substance abuse in

universities?’ Descriptive and inferential statistical analysis techniques were carried out

on ratings of causes of drug abuse, drug culture and suggestions on how ADA can be

addressed effectively. Results are presented in tables, graphs and ANOVA tests.

4.2.5.1 Aspects of drug abuse sustaining factors

Four aspects which were assumed to contribute to drug abuse in the university were

subjected to four scales to compare their potencies as provided in table 4.17 below.

Table 4.17
Rating of social, economic, psychological and youth culture

PRU2 PUU1 PRU1 PUU2 Total

Ranking of social v.hig 54.2% 55.6% 72.9% 66.7% 62.5%

aspect as a cause of
drug abuse within the High 39.6% 32.1% 21.4% 26.7% 29.3%
university Low 4.2% 7.4% 2.9% 1.7% 4.2%

Low 2.1% 4.9% 2.9% 5.0% 3.9%

total 100.0% 100.0% 100.0% 100.0% 100.0%

Ranking of youth high 28.6% 36.8% 24.3% 25.8% 29.5%

culture as a cause of
drug abuse within the high 61.2% 49.4% 55.7% 56.5% 54.9%
university low 10.2% 9.2% 20.0% 14.5% 13.4%

Low - 4.6% - 3.2% 2.2%

total 100.0% 100.0% 100.0% 100.0% 100.0%

Ranking of high 18.8% 22.2% 1.5% 15.3% 14.5%

 142

Psychological as a high 50.0% 34.6% 33.8% 35.6% 37.5%

cause of drug abuse
low 25.0% 28.4% 58.8% 39.0% 38.3%
within the university
v.Lo 6.3% 14.8% 5.9% 10.2% 9.8%
w

total 100.0% 100.0% 100.0% 100.0% 100.0%

Ranking of economic high 40.8% 16.3% 16.2% 16.4% 20.8%

as a cause of drug
the high 22.4% 36.0% 35.3% 39.3% 34.1%
abuse within
university low 12.2% 22.1% 27.9% 21.3% 21.6%

vLow 24.5% 25.6% 20.6% 23.0% 23.5%

Total 100.0% 100.0% 100.0% 100.0% 100.0%

Findings depicted in the table 4.17 above revealed the rating of four aspects as follows;

„very high‟; Social (62.5%), Youth culture (54 %), Economic (20.8 %) and Psychological

(14.5%).The ratings on just „high‟ were; 29.3%, 54.9%, 34.1% and 37.5% respectively.

Findings reveal youth culture and social factors as major factors that blend to sustain drug

abuse. Apparently these two factors are intertwined in their interactional properties as

confirmed in several studies. Referring to the same theory and postulations of subcultural

model in his terms, Bruce Johnson (1980), and Denise Kandel who calls it the

socialization model, contend that potential drug users do not randomly “fall into” social

circles of users; they are attracted to certain individuals and circles in a subcultural setting

or subcultural groups because their own values and activities are compatible with those of

current users. Their view is that there is a dynamic element in use in which even before

someone uses a drug for the first time, he or she is “prepared for” or “initiated into” its

use or, in a sense, socialized in advance because his or her values are already somewhat
 143

consistent with those of the drug subculture. As a result, the individual chooses friends

who share these values and who are also likely to be attracted to use and to current users.

It is both a subcultural and a socialization perspective. In support of the arguments raised

in these theories, subcultural theory by Howard Becker (1963) argues that involvement in

a particular social group with attitudes favorable to drug use is the key factor in fostering

the individual‟s own drug use, whereas involvement in a group with negative attitudes

toward drug use tends to discourage such use. Pylkanen,Viitanen & Veuhelainen (2010)

on the same note maintain that the evaluation of young people‟s attitudes, life situation

and behavior from the angle of factors protecting from substance use and the risk factors

exposing one to them is essential.

In description of what goes on amongst students, student FGD provided information that

Youth culture is a major factor because students want to „SWAG‟ around and it

prominently features when it comes to drugs. They reported that youth culture and drugs

are one and the same thing. It is present in music and movies. They argued that student

functions such as parties and meetings don‟t take place without drugs. One major

example is campaigns for students‟ government positions. Any party in the university

must have drugs if it has to be meaningful to students. University students highly sustain

the mentality that students cannot interact well unless under some good drinking

conditions. To some, it is primitive behavior not to take alcohol or some other drug to

„relax and enjoy‟. Schaefer (2012) defines culture as the totality of learned, socially

transmitted customs, knowledge, material objects and behavior and a sub-culture is a

segment of society that shares a distinctive pattern of customs, rules and traditions that

differs from the rest of the society. He argues further that members of a subculture
 144

participate in the dominant culture while engaging in unique and distinctive forms of

behavior. These descriptions replicate the discussions provided in this study about the

contribution of youth culture to drug abuse through cliques and need for social

acceptance among students.

FGD and QIS were consistent on the fact that substance abuse is sustained in the

university because of factors related to students and factors related to university

management. Environmental dynamics arising from factors related to the urban or rural

siting universities plays an important role too. Amongst the factors related to the

university management were; lack of adequate support for prevention programs and

particularly slow implementation of punishments netted on drug abuse culprits. Lack of

finances was also mentioned as one factor that sustains drug abuse because lack of funds

renders DSAPP incapable to implement their activities effectively. Discussions from

FGD and QIS displayed strong arguments on what sustains drug abuse as exhibited by

the following excerpts;

„Drug abuse doesn‟t seem to get overturned because there are not enough
resources to
implement the beautiful programs that we plan. Making of T-shirts, posters, fliers,
banners and all materials for advertising activities require money which takes
centuries to be approved by management or sometimes not approved at all. Our
hands are tied and we often are left to watch things take their own course. I mean
it is that frustrating‟ (Counsellor Public University)
„Lack of liaison amongst DSAPP and university management continues to nurture
the
culture of drug abuse in the university. Without the university coming in to
develop and strengthen rules and regulations governing sale of drugs in the
university, it won‟t be easy to eradicate drug abuse. A good example is the center
that sells alcohol within university premises without any restrictions in terms of
time. Such practices tend to negate the efforts that DSAPP put in place.
(Counselor Public University)
 145

„Drug abuse might have to stay in the university because it is a complex habit
involving
highly hidden schemes of dealers right from the source to the user. As DSAPP, we
are not able to keep in tandem with these tricks which are so dynamic. This is
more exacerbated by the fact that universities are sophisticatedly cosmopolitan in
terms of member composition and purpose thus one won‟t get to identify what
they are doing whether their business is to sell drugs or not. For me, the problem
is bigger than the local university and it requires a broader approach which
engages even national and international governments in order to counteract
international traffickers‟ (Counselor Private University)
„Pillars that sustain drug abuse are money (lack of it and too much of it), stress,
drug availability, negative peer influence, desire for adventure and Youth
culture. The university has not given drug abuse grave attention it deserves. In my
view, DSAPP are not able to comprehensively handle all the complex causes of
drug abuse because they are knit together in a sophisticated way‟ (Student Public
University)
„The University is not near real areas of intervention. The most common way
through
which DSAPP get students is self- referral which doesn‟t stop the spread of
substance abuse. Students who come for help with drug abuse are those squeezed
by other challenges such as academic discos and obviously you cannot take this
for self-conviction against drug abuse. There are no serious approaches targeting
the real issues which cause drug abuse. There is serious need for DSAPP to get
back to the drawing board otherwise drug abuse is gaining momentum every day.
For instance, in our university there is no student who doesn‟t take bhang and
alcohol unless very serious Christians, if any!‟(Security Officer, Public
University)
„The debate should be whether DSAPP should target the source or the market.
Let
DSAPP evaluate factors for both of these because this is the center of drug abuse
sustenance in the university. In my own opinion, drug abuse is sustained because
drugs are available and students as well are in cliques who intimidate each other
into using drugs. I mean students in the same group have to sing the same tune of
drug taking otherwise they are understood as „traitors‟. (Warden Private
University)
 146

Table 4.18
Means on Factors which sustain drug abuse

University Social culture Psychological Economic

PRU2 Mean 1.54 1.82 2.19 2.20

N 48 49 49
48

PUU1 Mean 1.62 1.82 2.36 2.57

N 81 87 81 86

PRU1 Mean 1.36 1.96 2.69 2.53

N 70 70 68 68

PUU2 Mean 1.45 1.95 2.44 2.51

N 60 62 59 61

Total Mean 1.49 1.88 2.43 2.48

N 259 268 256 264

The means clearly demonstrated that there was no difference in means on factors

sustaining drug abuse in public and private universities. There was homogeneity showing

social and cultural as the leading factors whereas psychological and economic factors

have a significant impact as well.

ANOVA tests were carried out to find out if there was a statistical significant difference

in the rating of the four aspects above as causes of drug abuse in various universities with
 147

the hypothesis, Ho: There is no significant difference in the rating of social, cultural,

psychological and Economic as factors sustaining drug abuse in universities‟

Table 4.19
ANOVA tests on rating of causes of drug abuse

ANOVA Table

Sum of df Mean F Sig.

Squares Square

Social Between (Combined) 2.767 3 .922 1.634 .182

Groups

Within Groups 143.974 255 .565

Total 146.741 258

Psychological Between (Combined) 1.284 3 .428 .842 .472

Groups

Within Groups 134.131 264 .508

Total 135.414 267

Culture Between (Combined) 7.884 3 2.628 3.700 .012

Groups

Within Groups 178.987 252 .710

Total 186.871 255

Economic Between (Combined) 4.636 3 1.545 1.361 .255

Groups

Within Groups 295.228 260 1.135

Total 299.864 263

 148

According to the scoring system that was used in this study, 2.5 was taken as the

moderate mean hence any mean which was below 2.5 was a high rate of the aspect as a

cause of drug abuse whereas any mean above 2.5 indicated a low rating for the specific

aspect named. The study observed that the P-value for social (1.82) and culture (0.012),

psychological (0.472) and economic (0.255) were lower than the mean (2.5) hence

despite variation in strength all were rated high. It seems from the above findings

principally that drug abuse problem is displaying homogenous trend which could reflect

on the psychosocial nuances of the wider society. DSAPP practitioners need an in-depth

understanding of these typical characteristics of drug abuse to enable mounting of

comprehensive approaches targeting all the aspects and drug abuse correlates. DSAPP

integration of all activities itemizing prevention levels and interventions in the drug

addiction continuum may offer a promising approach. Bio psychosocial theory of

addiction Engel (1977) seems to support these explanations that addiction is a disease,

but also includes perspectives of psychological, cognitive, social, developmental,

environmental and cultural nature related to substance addiction. It recognizes the fact

that substance addiction is more than a mere disease and that the use of drugs is induced

as a result of factors existing in the society, the peer group, a cultural tendency for

substance abuse. DSAPP effectiveness might be enhanced when if all the components are

targeted in the lives of program users and particularly students because they are specific

in their approach to issues.

In an endeavor to catch a glimpse of respondents‟ perspective on factors other than

social, youth cultural, economic and psychological responsible for drug abuse in the

university, a question was posed to them on what other factors they thought caused drug
 149

abuse. Appendix M and figure 4.25 below shows other aspects in students‟ lives which

sustain drug abuse and which could be necessary for DSAPP to target in their prevention

activities.

Lack of 5.0%
awareness/ignorance
6.5%
Media
Other causes of drug abuse

Availability of extra 9.0%

money 10.4%
Availlability of drugs
Family background 11.9%

Stress 17.4%
Relationships & peer 19.4%
pressure
20.4%
Identity crissis

.0 5.0 10.0 15.0 20.0 25.0

Percentage

Figure 4.25: Other aspects in students’ lives causing drug abuse

The factors listed include; Identity crisis (20.4%), relationships and peer pressure

(19.4%), stress (17.4%), family background (11.9%), availability of drugs (10.4%),

availability of extra money (9.0%) media (6.5%), and lack of awareness/ignorance of

DSAPP(5.0%). Information from FGD and QIS reveals inability of DSAPP to target core

areas of drug abuse problem such as visiting rooms or parties where drug abuse takes

place. This makes scrutiny of causes elusive resulting in shallow approaches to ADA.

One FGD student member commented that,

„The university is not near the real areas of drug abuse intervention since they
simply wait for students who take themselves to counseling thus no serous
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approach targeting real causes of drug abuse in the university. I mean the
problem of drug abuse is more complex than the social providers understand it‟.
Psychological issues such as identity crisis affect self-concept and capacity for making

decisions for or against drug abuse as illustrated in earlier studies (Bird, Conrad, Fremont

& Timmermans, 2010; Bandura, 2004). Effectiveness of DSAPP in targeting

psychosocial factors would equip users with skills to resist drug abuse.

This study findings showed that amongst the factors which were mentioned by

respondents as sustaining drug abuse, in their view, there were those that had not been

adequately addressed. Table 4.20 provides this information. Majority of the students felt

that economic (24.7%), psychological (24.1%), social (18.7%) and youth culture (16.3%)

factors had not been addressed.

Table 4.20
Factors of drug abuse that have not been adequately addressed

PRU2 PUU1 PRU1 PUU2 Total

All 21.9% 9.4% 13.9% 20.6% 15.1%

Economic 28.1% 31.3% 13.9% 20.6% 24.7%

Politics - - 5.6% - 1.2%

Psyc‟l 12.5% 26.6% 27.8% 26.5% 24.1%

Social 18.8% 25.0% 13.9% 11.8% 18.7%

Y. culture 18.8% 7.8% 25.0% 20.6% 16.3%

Total 100.0% 100.0% 100.0% 100.0% 100.0%

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According to respondents, economic and psychological aspects rank equally high as those

that have not been adequately addressed. Perhaps in view of respondents, there are no

interventions addressing economic and psychological factors. This information appears

consistent with studies (Insel, Roth, Rollins & Petersen, 2012) attesting that prevention

programs are meant to focus on factors that motivate individuals into drug use.

4.2.5.2 Youth Drug Culture

This study viewed youth culture as an aspect that deserved further attention to understand

how it relates to factors sustaining drug abuse hence effectiveness of DSAPP.

Respondents were given a question, „Have you heard of youth drug culture?‟ It was

observed that majority of the students PRU2 (66.7%), PUU1 (66.3%), PRU1 (73.2%) and

PUU2 (75.0%) reported that they were not aware of youth drug culture neither had they

heard of it. A small proportion of the students 33.3%, 33.8%, 6.8% and 25.0%

respectively said that they had heard of the Youth drug Culture.

73.2% 75.0%
80.0%
66.7% 66.3%
70.0%

60.0%
percentages

33.8%
33.3%

50.0%
25.0%
26.8%

40.0%

30.0%

20.0%

10.0%

.0%
PRU2 PUU1 PRU1 PUU2

Yes No

Figure 4.26: Youth Drug Culture

 152

Questionnaire respondents didn‟t appear to know much about youth drug culture

however, student respondents in FGD emphasized that youth and drug culture cannot be

separated. They said that students find drug using habits a normal activity within their

interactions that they cannot see it as a separate entity from what they usually do. Perhaps

it is this students‟ perception which contributes to students not being familiar with youth

drug culture. Implication of their responses seems to designate nothing unusual as

opposed to the understanding that youth drug culture is an abnormally. This gap about the

extent a youth culture would be normal or abnormal deserves further investigation

because it seems to sustain the use of drugs and hence challenge effectiveness of DSAPP.

Respondents were asked to provide their understanding on youth drug culture at the
university. Table 4.21 shows information on youth drug culture as provided by students
in different universities.

Table 4.21

Understanding of drug youth culture

Name of the university Total

PRU2 PUU1 PRU1 PUU1

Alcohol is applauded and getting too - 2.5% 20.0% 7.7% 5.6%

masculinity or a sign of having good time
- - - -

Censored strongly 11.1% 20.0% - 15.4% 15.3%

I don't know 11.1% 17.5% - 15.4% 13.9%

It is a lifestyle of youths private time - 12.5% 10.0% 7.7% 9.7%

Its normal for youth to use drugs - 12.5% 20.0% - 9.7%

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No information 44.4% 17.5% - - 15.3%

Peer influence and the notion that every - 2.5% 20.0% 7.7% 5.6%
youth should use drugs

Feeling of belonging and being well off 11.1% - - 7.7% 2.8%

Students who have money spend their 22.2% 12.5% - 15.4% 12.5%
weekends on alcohol

They should avoid drug abuse - 2.5% 10.0% 7.7% 4.2%

Very prevalent - - 20.0% 15.4% 5.6%

Total 100.0% 100.0% 100.0% 100.0% 100.0%

Conceptualization of youth drug culture as provided by respondents shows that youth

drug culture is intermingled in drug taking activities with many students understanding it

as; a way of spending free time (30.7%), a way of displaying economic power (15.4%)

and as a normal leisure activity to undertake whenever students want to do as a form of

relaxation (15.3%) and others (28.6%). This conceptualization is important in identifying

youth behaviours which should to be avoided or encouraged in order to put in place

measures which are in line with these youth cultural needs.

Definition of youth popular culture clarifies further these explanations. It refers to that

which is "in," contemporary, and has the stamp of approval of young people. It is that

which has mass appeal; it is nonlinear and eclectic. The culture dictates what defines the

shared norms that provide young people "with a deep sense of belonging and often with a

strong preference for behaving in certain ways." It is "psycho-socio-cultural" in that its

primary elements involve the reciprocal interaction of individual, social, and cultural

forces. These definitions lucidly describes what (Oxford, 2001, in West, 2006) advances
 154

in his theory of Appetites viewing addition or drug abuse as appetitive behaviors that

have the potential to become so excessive as to spoil lives, appearing at the skewed end

of the norm of consumption of the population. It arises from ecological, socio-economic

or cultural factors interacting with features of the behavior and the individual. Culture

therefore cannot be underestimated on the influence it can make to students who have or

have not used drugs towards maintaining their drug-taking behaviors. It is thus

imperative for DSAPP to target ecological, socio-economic and cultural dispositions

amongst students.

4.2.6. Suggestions on effective drug abuse mitigation

The understanding of demarcation between effective and non-effective methods can be

obtained from Users‟ perspective or scientifically- based evaluations (Hawkins et al.

2002, Young & Klerk, 2008). To pursue this endeavor of effectiveness, a question was

hence given to respondents on what they considered to be most effective ways to address

the problem of drug abuse. Answers proposed the following; to ensure adequate

information on drug abuse is availed (35.5%), Utilization of counselling services in

prevention(11.9%), DSAPP to use more effective methods and to increase frequency and

intensity (6.1%), to engage all the stakeholders in DSAPP activities (5.1%), to encourage

sporting activities to be integrated in DSAPP (4.8%), to encourage Peer educators to play

a big role in DSAPP(4.4) identification of appropriate activities for students‟ leisure time,

Security to strengthen rules and regulations such as security check-ups (4.1%),

establishment of rehabilitation centers (3.4%) and others 24.7%. These findings were

confirmed by FGD and QIS who stated several ways in which prevention strategies could

yield better prevention outcome. Some of the major excerpts are;

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„Make connections with students so that they may get information about drugs. I
mean
social support providers have to show concern and teach students all about drugs
without appearing like they are at a higher level from the students‟. (Student
Public University)
„Avoid lectures and get smart in dealing with students. For instance get creative
and
introduce bonfires during dissemination of information‟( Student Public
University)
„Get back to high school and address the problem from there since not a small
percentage of students start experimenting with drugs when they are in high
schools. This will help in peer influence on hose ignorant students who have
never used drugs before coming to campus. (Student Private University)
„You can never get it right until you engage students in DSAPP. Unless students
actively participate in prevention programs they will always think they are meant
for those who are addicted to drugs. Let the university too take up an active role
instead of passivity‟ (Student Private University)
„For me, drug abuse prevention starts with handling challenges facing them. Top
on
the list is student attitude which determines whether programs set out for them
are utilized or not. I also feel Capacity building is important so that students and
staff can support one another even if it means incorporate them in lectures. For
example class representatives should be trained on drug abuse so that they
disseminate information in close proximity to students. Finally, I find social
networks effective in passing messages amongst students and it might help
DSAPP access students at an interesting and appealing level‟.( Student Public
University)
„NACADA should show us their passionate interest to stop drug abuse by being
more
active. We hear of NACADA but we don‟t see them often except for a few
occasional t-shirts that few students wear once in a while. It is like a drop in the
ocean‟. (Student, Private University).

A synthesis of information from all the research tools on effective ways to prevent drug
abuse is presented in the graph below (Figure 4.27).
 156

Use leisure time .6%

Rehabilitation centres 2.3%

Suggested effective ways

Peer educators 3.4%
Students involvement 4.5%
Strengthen security measures 5.6%
Sporting activities 5.6%
Engage all stakeholders 10.7%
Counselling service 14.1%
More effective DSAPP methods 22.6%
Avail adequate information 30.5%

.0 5.0 10. 15. 20. 25. 30. 35.

0 0 0 0 0 0
Percentage

Figure 4.27: Suggestions on effective ways to deal with drug abuse

The suggestions proposed are very much in line with what the findings in the other

sections above alluded to. Specifically in objective two, there was a question asking

respondents what their view was on the way messages are displayed at the university, the

response to this question was that messages are not well displayed. Equally when

students were asked whether they have heard of DSAPP, majority of them replied that

they had not heard about them. It is therefore logical for respondents to suggest that

dissemination of information needs to be promoted because it appears to be in line with

the real experience of DSAPP users. Information entails providing facts about drugs,

programs available for dealing with drug problem and also facts about activities of

DSAPP when the activities are provided and who is to be involved in those activities.

This implies that DSAPP have to be very accurate in planning these activities to ensure

that activities enticing to students are provided. This is strongly advocated by research

(Pylkanen,Viitanen & Veuhelainen, 2010) that attitudes and behavior cannot be changed

quickly nor with a single lesson of substance abuse but should be a process enabling
 157

students to recognize the subject, process it, get interested and eventually decide on the

right direction

Suggestions (Buddy, 2011) at Columbia University include setting clear substance use

policies and consequences of violations, screening all students for substance abuse

problems to be able to target high-risk students and provide needed interventions and

treatment. They also advocate for educating faculty, staff, students, parents and alumni

about substance abuse and involving them in prevention activities and including

information about substance abuse and addiction in the academic curricula.

One fundamental area that must be reiterated is need for development of drug abuse

policies in universities to guide the students, staff and management in their response to

ADA because the study showed that it was absent in most universities.

Respondents have persistently recommended that DSAPP should apply more effective

methods, a suggestion that the methods being employed at the moment are not meeting

the standards of users neither are they achieving objectives of prevention.

4.3 Summary of the findings

In sum, research findings and discussions in chapter four engender several fundamental

insights emanating from each research objective. Lack of provision of adequate

information on DSAPP activities, availability and type of services including predominant

provision of primary level prevention programs with selective and indicated being

inadequate or even inexplicit were noteworthy points under objective one. Under

objective two, inadequate human and material resources, inadequate networking and

collaboration amongst prevention service providers within and outside the university and
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ineffective DSAPP implementation methods resounded greatly. The third objective on

student responsiveness showed clearly that there is insufficient user participation in

DSAPP. This study unveiled presence of several challenges facing DSAPP but which

have not been resolved. The fifth objective revealed that DSAPP have not been able to

target core factors and correlates of drug abuse which sustain it. These factors which

sustain drug abuse have not received adequate attention by DSAPP and the University

Management. Proposals on effective strategies to the problem of drug abuse provided by

respondents according to their perspective evoke a strong antithesis of the above findings

and hence confirm the fact that there is a lot of ineffectiveness in provision of DSAPP

programs and activities in all the areas covered by the objectives of this study.

Summaries, conclusions and recommendations of the study are provided in chapter five.
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CHAPTER FIVE

SUMMARY, CONCLUSIONS AND RECOMMENDATIONS

5.0 Introduction
The purpose of this study was to assess effectiveness of drug abuse prevention programs

in selected Public and Private Universities in Kenya. Research findings and discussions

in chapter four unveiled several trajectories which set the basis for summaries,

conclusions and recommendations presented in this chapter.

5.1 Summary

5.1.1 Demographic information of research respondents

Demographic characteristics of respondents which consisted of gender, faculty, year of

study, residence and use of drugs displayed a homogenous trend in domains and

responses to questions and discussions in the FGD and QIS in all universities under

study. This study found out that there were more male than female respondents; a picture

that was consistent with Kenyan universities‟ enrolments with more male for six years

from 2003 to 2009 as shown in table 4.1. Other studies sustain this trend with higher

percentages for male respondents than female (NACADA, (2012) 54.4%; Atwoli et al.

(2011) 52.2%; Barasa, Toili & China (2011) 53% and Kyalo & Rose, (2011) 63%.

However, this study did not establish other factors associated to this male dominated

sample sizes. Despite this gender variation, no significant respondents‟ views divergence

was noted.
 160

Results on drug use and abuse indicated presence of drug abuse cases falling under all the

three levels of prevention (Public Health model, Mrazek & Haggerty, 1994; Ayah, 2011,

Kloos, et.al, 2012) However, current practices in universities as demonstrated by findings

showed predominant presence of primary level of prevention. It further showed that this

primary level as implemented at the universities at the time of study does not meet the

basic elements of effective primary level prevention as recommended by prevention

principles (Dusenbury & Falco (1995).

Despite the fact that resident and nonresident students had similar information, it was

clear that resident students benefit from programs planned within evening hours and

weekends. Faculties showed varying correlates of drug abuse which DSAPP need to

identify and attend to in their programs.

5.1.2. Objectives of prevention programs currently at work in universities

This study found a symmetrical trend in lack of specific objectives which guide

operations of activities. There were instead general objectives without specified time and

personnel to undertake the actions planned. The general objective consistently common

in all universities was reduction of drug abuse but without how to do it nor specific

implementers. This was found to be a good goal but too broad to propel implementable

activities. This could lead to failure in planning, implementation and evaluation of the

progress of these programs. Studies (Berkowitz, & Schultz, J(2013); Dusenbury,

Brannigon, Falco & Hansen (1990b) state that setting objectives enable programs to

structure for prioritization, remove ambivalences, focus resources to drive performance

and efficiency, identify areas for improvement and set stage for completeness check. It is
 161

inevitably a weakness therefore for DSAPP to operate prevention activities without well

aligned objectives.

Results in all universities revealed presence of activities in all levels of prevention with

predominance of primary prevention. Staff and students with integrated help of outside

agencies undertake activities in complementary working or independently. However,

results showed a strong skewedness in coordination. Activities mainly entailed

dissemination of information through talk shows, posters, radio programs and trainings.

However, there was homogeneity in universities on findings showing that a large

percentage of students (55.2%) indicated not being aware of prevention programs due to

lack of adequate information.

5.1.3 Program implementation

This study discovered a derisory state of financial and material resources with few

personnel and scanty specialization in the area of drug abuse. Funds for training materials

and facilitation of anti-drug abuse campaigns were reported missing in most cases.

Harnessing of resources was shown to be a challenge because of university financial

control systems which are procedural and policy-based, causing serious delays in

implementation. Inversely, resources play a crucial role in effective implementation of

any program (Durlak, 2013; Bartholomew, Parcel, Kok & Gottlieb, 2006; Mihalic et al.,

2004).

This study unveiled a robust mismatch between students‟ characteristics and methods of

conveying information which according to respondents was the major reason why

students were not making use of DSAPP activities. Findings revealed that many
 162

respondents (68.5%) appraised information display unfavorably. Interesting information

from the findings was the suggestion for DSAPP to style up to digital approach as

opposed to analogue approach in communicating to students. Further findings showed

that analogue approach is weak in conveyance efficiency as opposed to digital which is

the ability to create persuasive communications in different media, be it websites, video,

audio, text, or animated multimedia (Chitode, 2008). DSAPP could institute appropriate

modes of communication such as electronic messages for students to get information in

less formalized settings such as their waiting benches where attitudinal dispositions might

not negatively affect reception of messages.

Research findings revealed that coordination amongst DSAPP is quite poor and is only

limited to referral processes which are few and occasional consultations that members of

different departments carry out amongst themselves. Factors attributed to poor

coordination are, poor streamlining of DSAPP in the university system on policy

structures hence inadequate demarcation and uptake of roles and functions. This situation

leads to confusion, superficial service delivery and duplication of activities without

accountability.

Academic and non-academic departments which are hubs of student activities including

those which are not purposefully involved in ADA prevention play a key role in effective

implementation of DSAPP. They are the joints for students who may not be reaching out

to prevention programs from where they are offered. Research findings demonstrated that

a large percentage (73.12%) of respondents felt that their departments were not involved
 163

in DSAPP activities. This may imply DSAPP inability to inclusively advance their

activities to many students which in turn negatively affects successful implementation.

Respondents who felt DSAPP involved their departments cited presence of dissemination

methods in their departments as reasons why they thought DSAPP involved their

departments. This may indicate positive outcomes although it doesn‟t stipulate

effectiveness since there should be more activities than just presence of dissemination

methods. Departments can be involved in planning of DSAPP and in baseline surveys

and outreaches to high schools or community.to bring about a congruous achievement of

university mission and vision. Other studies (Insel et al., .2012; Kloos, 2012; NIDA,

2009) show benefits accrued from interdepartmental collaboration in approaches to drug

abuse prevention.

All universities alluded to the fact that DSAPP has impact in DSA prevention. Great

emphasis in this study came out that DSAPP has a lot of impact in cases of; bereavement;

traumatic events, relationships; reduced, student rowdiness and outreach activities

particularly to high schools on issues of academic performance, drug abuse and early

pregnancy prevention which are all factors related to drug abuse. This raised one big

question as to factors leading to a rising trend (Magu, Mutugi, Ndahi & Wanzala, 2013)

in DSA yet respondents claimed positive impact of DSAPP. Spoth (2013) in his six-year

study finding out outcomes of PROSPER project, concluded that „We think the programs

work well because they reduce behaviors that lace youth at higher risk for substance

misuse and conduct problems‟. In the PROSPER Project, there were significant reduction

rates for amphetamine, marijuana, alcohol, cigarette and inhalant use. On the same note,
 164

Larmer, Kilmer & lee (2005) argue that interventions are shown to be efficacious in drug

prevention and treatment.

Results depicted a poor rating (64%) on DSAPP performance with reasons that there is

no adequate information; there are no vibrant resources and poor implementation

strategy. It is most likely that implementation strategies being employed are not matching

with socio-cultural, developmental and intellectual levels of students. Program to

program evaluation which could help in identification of components which require

modification to suit characteristic factors of users was missing in all universities.

Three strong suggestions on more popular methods are dissemination of information,

bolstering more effective methods and involvement of students and lecturers in DSAPP.

These suggestions are in line with other studies (Rogers, 1995 in Larimer Kilmer & lee

(2005). Feldestein & Glasgow (2008) on their model called the Practical, Robust

Implementation and Sustainability (PRISM) Model argue that for the organization,

organizational component will influence adoption, implementation and maintenance of

the program whereas patients‟ characteristics on the other hand will influence patient

recipient attitudes which influence in turn implementation success. University situational

analysis on factors related to users‟ characteristics in comparison to DSAPP activities as

suggested by Ecological Systems Theory (Bronfenbrenner, 1944) is a factor which was

demonstrated being essential for prevention effectiveness.

5.1.4. Student participation and utilization of prevention programs

Results revealed a high percentage (85.9%) of students who reported not being aware of

any student groups who participate in prevention programs. This is indicative of a

 165

situation in which students tend to play a more passive role than active participation, a

condition which may not encourage effectiveness. Nevertheless, student active

participation is a critical ingredient for success (Larimer, Kilmer & lee (2005) but this

study did not substantial work needs to be carried out to find out the factors attributed to

student detachment.

An investigation into four aspects of participation namely acceptance, support,

involvement and readiness exhibited a homogenous rating indicating low student

participation (P Value above 0.05) although involvement of students in activities is

shown to enhance their support of the programs (Murphy et al., 2005; Eccles et al., 2003).

A good example are the Peer Programs which have been designed to encourage attitudes,

knowledge, behaviors and outcomes that the community considers desirable and to

discourage attitudes, behaviors and outcomes that a community considers undesirable

(Hansen et al.2007). This study concurred with this research that peer counseling

program seems to achieve better than other programs because students understand their

peers through commonality in experiences and have no authority barrier found in most

social providers consisting of counselors in the Dean of Students Office. One respondent

commented „Who would dare go for counseling whose office is in the Dean of students

Office which is The Hague of the university with so many Ocampos‟. This reflects

inability of students to separate roles of the counselors from those of other personnel in

the office of Dean of Students. It also reflects on lack of trust in social support providers.

DSAPP dormancy, students‟ lack of ADA knowledge and student negative attitude due to

economic and socio-cultural factors cause ineffectiveness but (Henning, 2011; Lewis,

2010) appeal for keen attention to socio-cultural factors.

 166

Results provided a significant agreement (80%) that students should be used as agents of

ADA prevention for students to own up programs as SAMHSA (2002) attests that

programs which engaged participants actively were more effective in reducing substance

abuse than other programs that emphasized other content.

5.1.5 Challenges to effective implementation of DSAPP

Although some respondents thought DSAPP did not face any challenges because DSAPP

did not exist in the first place, there was (65.7%) agreement that DSAPP face challenges

such as lack of information, student negative attitude, lack of funds, DSAPP

inaccessibility to students and lack of university management support. In consideration of

the knotty schemes of drug dealers, it can be observed that these weaknesses only fortify

ADA situation since such limitations rule out commensuration of the efforts and ADA

maneuvers yet loopholes is among the first steps that any drug abuse prevention program

should address (NACADA, 2012).

Findings demonstrated suggestions for DSAPP to address these challenges by employing

good approaches (58.2%), availing funds (20.9%), acceptance of drug abusers (6.4. %),

university management support of DSAPP (5.5%) counseling services (5.5%) and use of

peer educators (3.6%).

5.1.6. Drug abuse sustaining factors

Results revealed a correspondent picture of dynamics that sustain drug abuse in all

universities with social factor being more resolute. Social factor was seen to be multi-

dimensional including but not limited to peer pressure, emulation from family members,

social activities such as parties and doing drugs to be able to fit in the clique. Mutiso et al.

(2012) in their study of youth between 15-35 years at Bamburi Location, Kenya, found
 167

that influence from friends was the first factor for abusing drugs. Other studies show pads

and fashion (Schaefer, 2012), family influence, socialization activities and to fit in the

group as major social factors sustaining drug abuse.

Psychological factors play a key role as well in drug use which begins as a means to deal

with trauma, anger, depression or boredom. Other factors are personality patterns, learned

behaviors, coping abilities and denial of not only drug abuse but also issues which ought

to be practically addressed. In this study, denial came out strongly amongst the female

drug users. These psychological factors when not dealt with have capacity to sustain drug

abuse because they influence cognitive capabilities of students hence behavior. Hall and

Queener (2007) reinforce self-medication theory that young people use drugs in order to

escape painful feelings and that some individuals are not able to cope with problems till

they use drugs. Individual‟s behavioral, emotional and cognitive dispositions such as low

self- esteem play an important role in the use of drug abuse or impulsivity as explained in

Self-derogatory theory by Kaplan (Volkow et al., 2009; Walston & Roberrts, 2007).

Psychological factors with variables like identity crisis, stress, anger, bitterness low self-

esteem self-confidence and impulsivity influence behavior and determine to a large

extent the individual‟s response to stimuli (Kottlier & Shepard, 2011; Myers, 2010;

Natarajan, 2010).

Studies (Best, Rome, Hanning, White, Gossop, Taylor & Perkins, (2010) report that the

problem of drug abuse is strongly linked to socio-economic disadvantage which, besides

deprivation, there are other routes into drug misuse such as enjoyment, escapism and peer
 168

support. This is illustrated by Mutiso et al. (2012) on affordability of drugs as a major

factor in youth drug use. This study‟s findings further corroborate that university students

may not afford food but will afford drugs at Ksh 10 which give them preference for

dealing with stressful situations and enjoying themselves.

It became evident that social providers‟ efforts were being seriously frustrated by

continuous accessibility to drugs from the surrounding trading centers of the universities

called in various universities by such names as („KBC‟, „Masingo‟, „Kampi ya moto‟,

„DC‟ ,‟West Mall‟ „KM‟) and identified for favorable drugs of choice for student drug

abusers. To counter this frustration, it was suggested that the sources of drugs should be

blocked. One student respondent remarked,

„If you approach the problem of drug abuse from the source, then drug abuse will
be a problem of the past because students use drugs due to its plentiful
availability not because they go looking for them. Drugs are at our doorsteps in
our hostels or whatever area of residence for students.‟
From the arguments of these studies therefore, DSAPP ought to get deep into students‟

psychosocial experiences at the university to enable them formulate programs which are

commensurate to the challenges students go through. Resistance skills which were

missing according to the study findings would help in the mitigation the challenges of

drug availability.

Results revealed that youth drug culture is a major factor sustaining drug abuse due to

students‟ understanding that drug use and youth activities must go together. According to

them, all youth activities must have the component of drugs of choice. This trend was

unveiled by Gurtavich et al., 2005 in Tsvetkova & Antonova, 2013) in Russian

Universities. In this study, enumeration of youth activities included; partying, spending

 169

time on Fridays and Weekends, celebrating the end of exams, campaigns during student

leaders‟ elections and forming cliques for enterprising activities. Youth drug culture plays

a significant role in sustaining drug abuse in the university because of what appears to be

a misconception among them about drugs as an entertaining icon.

Respondents mentioned economic and psychological aspects as those that have not been

given adequate attention by DSAPP. Most universities in Kenya at the moment face

challenges of accommodation for students within the university giving them financial

difficulties for having to rent hostels outside the university. Effectual situation is lack of

food from university catering services which are better in prices and time spent.

Economic factors also cause drug abuse due to availability of extra money on the part of

students who have a lot of money but cannot effectively plan for constructive use and end

up spending the money on drugs.

This insinuates that failure to attend to these factors can contribute to drug abuse

sustenance in the university. Liaising amongst social support programs like Mentoring

may aid early identification of psychological issues as FGD and GIS suggested.

5.2 Conclusion

5.2.1 Demographic Characteristics of respondents

Universities displayed homogeneity in demographic characteristics with more male

participants. It was clear that drug abuse variations existed from faculty to faculty with

presuppositions that certain factors exacerbate drug abusing habits than others. There was

thus an implication that universities ascribe resemblance in their demographic

characteristics and drug abuse inclinations. Findings in both this study and literature
 170

review point to a high prevalence and incidence rate of drug abuse in Public and Private

Universities in Kenya (Atwoli et al. 2011; Magu et al.2013).

5.2.2 Prevention levels and objectives

Objectives of programs were general and many respondents were not aware of

prevention programs resulting in relative tolerance of drug abuse (NIDA, 2003).

Consequently, DSAPP lacked the core bedrock of effectiveness by failing to access

information to their users in the right way and the right time. Definitely the role of

information in implementation of any activity forms the basis for success of that activity.

Clear-cut objectives lacked in most programs hence jeopardized the goals being sought

for (Round, Marshall & Horton, 2005). DSAPP is weak without objectives to direct

their operations.

Universal intervention was the chief prevention activity. However, the essence of

selective and indicated prevention interventions as echoed out in systems theory (Ludwig

Von Bertallanfy, 1968, Bronfenbrenner, 1944, Coreil, 2010 and Galanter & Kleber,

2008) is to place considerable thoughtfulness during planning stages of programs to

ensure that specific interventions are established for each category of populations.

Predominance of primary prevention level does not suffice to realize prevention

effectiveness.

5.2.3 Program implementation

DSAPP lacked essentials of standards of model programs in which program adaptation

matches users‟ needs, community norms, or differing cultural requirements. Core

elements of research-based interventions which include: structure (how the program is

organized and constructed); content (the information, skills, and strategies of the
 171

program); and delivery (how the program is adapted, implemented, and evaluated (Insel,

2004) were lacking in all universities under study.

Coordination, collaboration and networking amongst programs dealing with students‟

needs were weak and should be strengthened as postulated by (Riggs, 2003, Barry, 2003;

Epstein & Mc Crady, 2009).

5.2.4 Student responsiveness to prevention programs

There was utility disconnect between the students who are the users of prevention

programs and DSAPP hence it is important for DSAPP to do more dissemination of

information and involve students. Poor participation of students was attributed to lack of

resources which should be provided by the university based on recommendations by

DSAPP. Peer counselling program was shown as the principal student body which

actively participates in prevention. However, this is not enough.

5.2.5 Challenges facing DSAPP

Factors responsible for challenges facing DSAPP were being contributed to by all the

stakeholders; students, DSAPP, and university management. It was evident that these

problems were not being addressed yet in many exemplary programs, pronging problems

are sorted out as implementation goes on (Coreil, 2010). Practical approach to challenges

was lacking in all universities under study hindering effectiveness.

5.2.6 Drug abuse sustaining factors

Most of the activities were about dissemination of information about drugs but skills to

help students deal with demanding socio-economic and psychosocial situations were

missing. Understanding of factors related to users‟ characteristics particularly, social,

cultural, economic and psychological factors is part of steps to enable alignment of

 172

DSAPP activities to meet users‟ expectations and standards. Bandura‟s theory (1986)

proposes social modeling, social persuasion, mastery experience and psychological

responses as strategies to modify behavior and enhance self-efficacy.

Development of culture is a process which is influenced by several environmental factors

Coreil, (2010). Cultivating a youth culture that is drug free is critical in prevention. This

however requires formulation of good alternative activities which will engage the youth

in a culture of innovation as Frost (2008) in one of his eight components of behavior

change puts it that the person has to perceive that performing the behavior is more

consistent than inconsistent with his or her own personal norms and standards.

Economic factors dispose with protective and risk factors hence can encourage or

discourage drug taking habits. Communities around universities exacerbate these

conditions through drug availability and factors related to stressors. Prevention projects

targeting the communities around the universities were missing. Effectiveness can be

enhanced if such projects are established to address the factors within the process of drug

abuse.

5.3 Recommendations
1. DSAPPs to undertake the following:

a. Engage in robust action plans during the initial stages of prevention which

include; baseline surveys and research on workable strategies to reflect

faculty course characteristics; infusion of activities to all departments and

sections of the university

 173

b. Do a proposal for integration of DSAPP in curriculum especially in

university common units and important functions such as Culture Week or

during any function involving larger members of university community.

Involvement of gender in an equal proportion amongst staff and students

both in sample sizes and participation in prevention programs to enable

adequate scope and planning.

c. Develop a portfolio of all DSAPP groups within campus and streamline

their mandates and terms of references. It is through this that they will be

able to foster harmonization and integration of all the three levels of

prevention while paying articulate attention to multidimensional factors in

all stages in drug addiction continuum.

d. Ensure representativeness amongst staff and students equipped with skills

ADA to help in achieving efficiency. Make use of available resources to

carry out activities that are possible (Conservation of Resource Theory,

Hobfoll, 1989). Diversify communication of DSAPP messages amongst

university units of common avenues of communication such as University

Newsletter, Radio programs. Electronic messages on waiting bays, group

email addresses, culture week to foster greater favorability based on

characteristics of the target groups at the university and find out gaps in

current communication means with a view to establishing most attractive

ones amongst students. Use of recovering addicts from among the student

population to disseminate information during first year orientations and

 174

other student forums like culture week which have a large number of

students.

e. Create and support an atmosphere conducive for students to initiate their

own activities based on their experience with their peers. Peer Counselling

Model could be used in drug abuse prevention hence develop

comprehensive training for both staff and students to acquire specialization

in ADA helping skills.

2. This study strongly recommends to University Management to offer necessary

and adequate support to DSAPP in their universities without which DSAPP

cannot get to the epitome of factors such as Socio-cultural, Psychological and

Socio-economic dispositions which sustain drug abuse in the university. Such a

support would resolve issues like DSAPP dormancy due to lack of information

provision, negative student attitude and poor implementation strategies. Higher

Education Loans Board (HELB) in liaison with university to employ rigorous

selection criteria which would ensure that students who are needy access loans to

minimize stressors causing drug abuse amongst them.

3. This study strongly recommends to the Ministries of Interior Coordination of

National Government, Ministry of Education, Ministry of Health and, Ministry of

Sports, Culture and Arts to appreciate the huge magnitude of drug abuse in our

society today going beyond efforts of a single community like a university and for

every stakeholder to streamline their roles, functions and mandates to avoid log

jamming execution.
 175

5.4 Suggestions for further research

1. Intervention research designs such as Longitudinal and control studies on drug

abuse and prevention programs.

2. Prevention research specific to drug types particularly Miraa, Bhang, alcohol and

emerging drugs such as shisha

3. Models of drug abuse prevention which are contextual to universities in Kenya.

 176

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 192

Appendix A: Introduction Letter and Consent Form

University............................................

Department..........................................

Good Morning/ Afternoon,

My name is Kemei Ronoh, a student at Kenyatta University undertaking a postgraduate

degree. I am carrying out a survey on drug abuse prevention programs in Kenyan
Universities to establish their effectiveness.

Research tools; a questionnaire, Focus Group Discussion, Qualitative Interview Schedule

and Structured Observation Guide are significant instruments for gathering information
about drug abuse prevention programs in the universities. I request that you carefully read
the instructions to understand what each is expecting of you. I sincerely appreciate your
sacrifice to respond to these tools. I wish to kindly bring to your attention the following:

i. The information you provide will help me recommend strategies to be applied in

enhancing effectiveness of drug abuse prevention programs in Kenyan
Universities. This is quite essential because drug abuse has economic, social,
emotional and academic burden to the user, their friends, families and the
university.
ii. The information you provide will be used for research purposes only and will be
given utmost custody and confidentiality it deserves.
iii. To the best of my knowledge, your participation does not involve any risk.
However, if for unavoidable circumstances known to you it becomes necessary to
decline from participation, you are free to do so without any fear of any
consequence.

If you readily accept to provide your valuable participation in this research, please sign
below or give an oral consent.

Sign..............................................................Date................................................................

Thank you very much for accepting to participate.

 193

Appendix B: Questionnaire for Students.

Introduction

Substance abuse refers to persistent inappropriate non-medical use of drugs and

substances despite its negative consequences. This questionnaire seeks information on
substance abuse prevention programs in selected Kenyan Universities. Your readiness to
spend your valuable time in genuinely providing significant information as much as you
can is highly appreciated. Strict confidentiality will be observed. Do not indicate your
name anywhere in this questionnaire. It consists of section 1 and 2.

Section 1: Background Information

Please give the following information by ticking the alternative that applies to you or by
writing in the spaces provided.

a) Gender: Male [ ] Female [ ] b) Faculty/School ………… c) Course of

study………………………d) Year of study………………. e) Resident [ ] Non-
Resident [ ]

h) Use of drug and substances: Most frequently [ ] frequently [ ] Rarely [ ]

Never [ ]

Section 2: Drug and Substance abuse prevention programs (DSAPP)

Levels and objectives of DSAPP

1 i) Are you aware of DSAPP in your university? Yes [ ] No [ ]

ii) If yes, kindly list them

i……………………………………….

ii…………………………………........

iii……………………………………..

iv……………………………………

.2.i) Do you know prevention activities which DSAPP offer at your university? Yes [ ]
No [ ]

ii) If yes, please tick from the following the ones being carried out in your university
Counseling services [ ]
i. Drug Abuse Prevention Campaigns [ ]
ii. Talk show [ ]
 194

iii.
Posters [ ]
iv.
Drug Abuse Prevention Day [ ]
v.
Brochures [ ]
vi.
Drug Abuse Prevention Walk [ ]
vii.
Talk during First Year Orientation [ ]
viii.
Billboards [ ]
ix.
Drug abuse prevention Plaque [ ]
x.
Drug abuse policy [ ]
xi.
Drug abuse prevention messages in students booklets [ ]
xii.
Chaplaincy [ ]
Wardens‟ and Housekeepers‟ services [ ]
xiii.
xiv.
Electronic messages on drug abuse prevention [ ]
Other…………………………………………………………………………
xv.
……….………………………………………………………………………
………………..iii) If you are not aware of prevention programs in your
university please provide possible reasons
i………………………………………..
ii…………………………………………..

DSAPP Implementation methods

3 i) In which ways do DSAPP carry out their prevention services in your university?
i………………………………………..
ii……………………………………….
iii………………………………………
iv………………………………………
ii) Do you find DSAPP messages visibly displayed in your university? Yes [ ] No [ ]

iii) In which other ways would DSAPP successfully give information on drug abuse at
the university?
i………………………………………….
ii………………………………………….
iv) Kindly provide information on how DSAPP works with the following university
programs
a. Academic...................................................................................................................
...........
………………………………………………………………………………………
……..
b. Non-academic
…………………………………………………………………………….
………………………………………………………………………………………
…….
4 i) In your view, do DSAPP actively involve your department in prevention of drug
abuse in the
 195

university? Yes [ ] No [ ]
ii) Please give reasons for your answer:
i…………………………………………
ii………………………………………..
5 i) DO DSAPP in your view, have impact on substance abuse prevention? Yes [ ] No [
]
ii) Suggest DSAPP methods which could be more popular and useful to students in the
prevention of drug abuse at the university
i…………………………………………
ii………………………………………. .
iii………………………………………..
iv………………………………………
iii) What is your rating of the methods used in the prevention of drug abuse in your
university?
v. good [ ] good [ ] poor [ ] v. poor [ ]
iv) How can DSAPP further improve their activities?
i………………………………………...
ii………………………………………..

Student responsiveness to DSAPP

6) i) Are you aware of student groups which carry out DSAPP activities? Yes [ ] No [
]
ii) If yes, please name them
i…………………………………………… iii…………………………………
iii) Kindly rate students‟ participation in prevention programs at the university according
to these four aspects:

Aspect Rating

V. High High Low V. Low

Acceptance of DSAPP

Support of DSAPP

Involvement in DSAPP

Readiness to prevent drug abuse

iv) Please provide the reasons for your rating

i………………………………………... ii ……………………………………
 196

v) To what extent do you agree that students should be used as agents of drug abuse
prevention?

in your university? Strongly agree [ ] Agree [ ] Disagree [ ] strongly disagree [

]

vi) List activities which actively engage students in prevention of drug abuse at the
university?

i…………………………………… ii…………………………………

vii) In your view, which DSAPP strategies could enhance students‟ utilization of
DSAPP? i………………………………………
ii…………………………………………

Challenges facing DSAPP

7i) Do you agree that DSAPP face challenges in providing prevention services to students
in your university? Yes [ ] No [ ]

ii) If yes, indicate in this table the challenge and how it can be addressed

Challenge How it can be addressed

ii

iii

iv

iii) If your answer to Q 8i) above is No, give reasons

i……………………………………
ii………………………………………………………

Factors that sustain drug abuse at the university

8 i) Please rank the following aspects as causes of drug abuse within the university
Aspect Rank

v. High High Low V. Low

Social
 197

Youth Culture

Psychological

Economic

ii) Which other aspects in student lives should DSAPP target as causes of drug abuse?
i…………………………………………
ii………………………………………..
iii) Which of the above factors in your view, have NOT been adequately addressed by
DSAPP in your university?
i………………………………………..
ii……………………………………….
iv) Have you heard of „youth drug culture‟ in your university? Yes [ ] No [ ]
v) Please provide information on youth „drug culture‟ in your university
……………………………………………...……………………………………
……………………………………………………………………………………
………………
9 What, in your view, would be most effective ways to address the problem of drug abuse
in the university?
i. ………………………………………………………………………………………
……
ii. ………………………………………………………………………………………
……
iii. ………………………………………………………………………………………
……
iv. ………………………………………………………………………………………
……
v. ………………………………………………………………………………………
……
vi. ………………………………………………………………………………………
……
vii. ………………………………………………………………………………………
……
viii. ………………………………………………………………………………………
……
ix. ………………………………………………………………………………………
……
x. ………………………………………………………………………………………

Thank you very much for sparing your valuable time to participate in this important
study.
 198

Appendix C: Focus Group Discussion Guide

I take this opportunity to sincerely thank each one of you for accepting to participate in
this important study. This study is interested in understanding how drug abuse prevention
programs in our university undertake their activities. The sole purpose of this is to enable
improvement of effectiveness through recommendations which will be made.

The information you will provide will be treated with confidentiality and we will not
associate your name with anything you say in this focus group discussion. In the same
way we expect every member here to keep confidential any material that is shared in this
meeting. We also request every member to respect the opinions provided and to give
chance to the person talking till they finish. I am too requesting to tape the focus group
discussion to ensure we capture the thoughts, opinions, and ideas from each of the group
members. In this regard, we encourage you to provide your personal perspective on this
subject matter without necessarily being influenced by others or fearing to express
yourself.

Our discussion will be guided by the following five areas from which several questions in
each have been formulated to provide information.

1) The objectives of the various levels of drug abuse prevention programs which are

in existence in the university

2) The implementation methods of drug abuse prevention programs in the university

3) The responsiveness of students to drug abuse prevention programs in the

university

4) The major challenges facing effective implementation of drug abuse prevention

programs in the university

5) The factors which sustain drug and substance abuse in university

Thank you very much for your contribution in this focus group discussion.
 199

Appendix D: Qualitative Interview Schedule

This is a research tool seeking information on drug abuse prevention in Kenyan Public
and Private Universities. Your readiness to spend your valuable time in genuinely
providing significant information as much as you can is highly appreciated. Strict
confidentiality will be observed. You are not required to indicate your name anywhere
in this discussion Guide. It consists of two sections.

Section 1: Background information

Please give the following information by ticking or by writing in the spaces provided the
alternative that applies to you.

a) Gender Male [ ] Female [ ] b)

Nationality.........................................

c) Faculty/School/department …………… d) Course of

study…………………….

e) Year of study/work.……………...…… f) Resident [ ] Non-Resident [ ]

g) Religious Affiliation..............................

h) Use of drug and substance: Most frequently [ ] Frequent [ ] rarely [ ] Never [ ]

Section 2: Prevention programs

Prevention programs and Methods of implementation-

Levels and objectives of prevention programs

1. Which substance abuse prevention programs are at work in your university?

2. What objectives do the programs offered by the following departments/ groups
have?
 Peer counselors
 Student leaders
 Wardens
 House keepers
 Security personnel
 Chaplains
 Counselors
3. What constitutes major activities of prevention programs in your university?
4. How do these various prevention programs offered by groups in Q2 above
coordinate their activities?
5. What roles do the following play in prevention of drug abuse in the university?
 Students
 200

 University Management
6. Which programs target the students and staff of the university?
7. How are programs integrated in academic and non-academic programs in the
university?
Resources:

1. What material resources are available to aid prevention activities in your

university?
2. How does the number of personnel dealing with prevention match with the needs
of drug abuse and university population?
3. How does availability of resources in our university affect provision of prevention
services in your view?
4. If the university has a drug abuse policy, how is it implemented?
5. What material resources do DASAPP require in order to be effective in
implementation of drug abuse prevention?
Student responsiveness

1. In what ways are students involved in prevention programs?

2. List activities which actively engage students in prevention of drug abuse at the
university?
3. How best could drug abuse prevention programs and activities be increased for
students‟ optimal utilization?
4. How can factors that prevent students from utilizing services be addressed?

Prevention programs’ Suitability to User’s psychosocial and socio-cultural

attributes

1. How do prevention programs suit in the psychosocial and socio-cultural attributes

of Users?
2. To what extent is drug abuse a social influence amongst students in the
university?
3. Which other factors aggravate drug abuse in the university?
4. How are drug and substance abuse prevention programs geared towards targeting
factors in Q1 and 2 above?
Challenges facing Prevention programs

1. What major Challenges do prevention programs face in the implementation of

prevention services?
2. How are these challenges addressed?

Factors sustaining drug abuse in the university

How do the following dimensions of student lives within the university rank in their
cause of drug abuse
 201

Dimension Rank

v. High High Low V. Low

Social

Youth Cultural

Psychological

Economic

iv) Which other dimensions in student lives should DSAPP target as aggravators of drug
abuse?
iii) Which of the above factors have NOT been adequately addressed by DSAPP in your
university?
 202

Appendix E: Structured Observation Guide

Observation on Modes of communication was the main strategy employed. The
researcher went out during data collection times looking for the following modes of
communication and props in strategic students‟ points at the university‟s Notice boards of
in the following main areas:

1. The dean of students‟ office

2. Admissions office
3. Students‟ Centre
4. Library
5. Computer lab
6. Gate
Major modes of communication:
1. Plaques
2. Brochures
3. Posters
4. Drug abuse policy
5. Flyers
6. Billboards
7. Electronic messages
8. ADA messages on Notice Boards
9. Psychological Tests and drug use assessment Tools

Uni Modes of communication and props

Posters Brochure ADA Plaque Billboards Flyers e-msges N.Brd

/Stdt Bklt Policy
 203

Appendix F: Study Process Framework

Prevention: Prevention levels and Activities

Primary Secondary Tertiary

Objectives

Resources
Personnel Material

Implementation Activities

Student SSSP University Management Outside

Groups Agencies
Synchronization Material

Academic Non-academic

Developmental suitability

Intellectual Social Psychological Cultural

Student Participation
Responsiveness

Support Acceptance Readiness Involvement

Challenges

Factors sustaining drug abuse

Psychologic Social Cultural Economic

al

Source: Kemei C. Ronoh 2011

 204

Appendix G: Reasons for lack of DSAPP awareness

PRU2 PUU1 PRU1 PUU2

Reasons % Reasons % Reasons % Reasons %

Lack of
No response 19.3 No response 19.4 awareness 10.0 No response 48.1
programs

Methods used
Am not to create I have never Poor
1.8 7.1 13.8 3.9
involved in it awareness are heard of it communication
poor

I have no Lack of
Crash program 1.8 6.1 No response 8.8 3.9
information advertisement

I don't use I have never They are very I have never

7.0 5.1 7.5 7.8
drugs heard of it dormant heard of it

Lack of
I have never Lack of No students
5.3 5.1 5.0 awareness 6.5
heard of it advertisement involved
programs

No information
I have no They are very
1.8 5.1 provided by 3.8 Ignorance 2.6
information dormant
administration

Lack of We are not

Am rarely in
Ignorance 1.8 guidance on 4.1 3.8 informed about 1.3
the campus
the addicts it

Lack of No awareness There is no Time

5.3 4.1 2.5 1.3
advertisement campaign sensitization limitation

There is little
Lack of Not keen on public They are very
awareness 12.3 them 4.1 2.5 1.3
awareness of dormant
programs these programs

Lack of There is no The university

4.1 The programs 2.5
concern from 1.8 sensitization only relies on 1.3
may not be
the its stipulated
 205

management popular rules and

regulations

Lack of The programs

No awareness
guidance on 1.8 Doesn't exist 3.1 5.0 may not be 1.3
campaign
the addicts popular

Lack of
No enough Lack of
1.8 awareness 3.1 Students Lack
publicity advertisement
programs 2.5 interest 1.3

There is little
public Bottom up
No posters 3.5 3.1
awareness of strategy Rarely am in
these programs 2.5 school 1.3

No Attitude
1.8 Crash program 2.0
sensitization problem 2.5 No reasons 1.3

Lack of
Poor concern from Am just a first Lack of
5.3 2.0
communication the year guidance on
management 2.5 the addicts 1.3

Suspension Lack of
Lack of We are not
and expulsion concern from
3.5 interest from 2.0 informed about
is the key of the
the students it
everything 1.3 management 1.3

They don't
address
Terrible No everyone nor
1.8 2.0
advertisement sensitization carry out
interaction It may not be
session 1.3 existing 1.3

They don't
The university address
is a Christian everyone or There are no
10.5 carry 2.0
based out drug users
institution interaction I have not paid
session 1.3 any attention 1.3
 206

The university Am not active

only relies on in clubs or any
Poor
its stipulated 1.8 other 1.0
communication
rules and extracurricular I have not been
regulations activities 2.6 here for long 1.3

There is no
strict drug Am too busy in Not well
3.5 1.0
awareness school work displayed I have never
program 1.3 been involved 1.3

I have never
They are not Bottom up No proper
1.8 1.0 asked of such a
vibrant strategy advertisement
1.3 program 1.3

We are not DSAPP has

Guidance and Never bothered
informed about 5.3 1.0 not been fully
counseling to look
it 1.3 advertised 1.3

Methods used
I am really in to create
1.0
school awareness are
poor 1.3 Apathy 1.3

Maybe the
I don't use
1.0 organization Am rarely in
drugs
isn‟t that active 1.3 the campus 1.3

Lack of Lack of
seriousness by 1.0 seriousness by Am not very
administration administration 1.3 observant 1.3

Maybe the Lack of

organization 1.0 interest from Am not very
isn‟t that active the students 1.3 interactive 1.3

I have not
participated in
Never heard of
1.0 drugs 1.3
it
prevention
program
 207

I don't use
No activities 1.0 1.3
drugs

No Few abuse
1.0 1.3
communication drugs

Drug abuse is
not allowed in
No posters 1.0 1.3
the university
premises

No students Course too

1.0 1.3
involved demanding

The university
Compact
is a Christian
1.0 programs of 1.3
based
study
institution

Am not active
in clubs or any
They are not
1.0 other 1.3
vibrant
extracurricular
activities
 208

Appendix H: Prevention activities and services

Name of the university

PRU2 PUU1 PRU1 PUU2

No response - 4.1% 11.3% 39.0%

Active clubs - - 2.5% -

Awareness 3.5% 2.0% 2.5% 2.6%

Billboards 7.0% - - 1.3%

Bringing musician - - 2.5% 2.6%

Brochures - - 8.8% 5.2%

Organizing seminars 1.8% - - 1.3%

Anti-drug Campaigns 3.5% 2.0% - 2.6%

Sporting activities 5.3% 16.3% - 6.5%

Boards on DSAPP - - 1.3% -

Door to door visits 1.8% - - -

Drama and music - - - 2.6%

Drug abuse policy - 1.0% 5.0% 2.6%

Electronic messages 3.5% - 3.8% 2.6%

First year orientation 1.8% - - -

Frequent workshops - - 1.3% -

Counseling 8.8% 10.2% 11.3% 11.7%

DSAPP common unit - - 1.3% -

motivation speakers - - 2.5% -

Involve lecturers 3.5% 6.1% 3.8% 3.9%

 209

No measures taken 1.8% 2.0% - -

Not aware of them 17.5% 19.4% - 2.6%

Peer education 10.5% - 1.3% -

Penalties - 4.1% - -

Prevention campaign - 2.0% - -

Public lectures 3.5% - 5.0% 1.3%

Road shows 3.5% - - -

Strict laws - 2.0% - -

Student forums - - 1.3% -

Talk shows 10.5% 8.2% 6.3% 6.5%

Through Bible study - - 2.5% -

Through campaign - - 1.3% -

Through clinics 1.8% - - -

Interested students 1.8% - - -

Through seminars 1.8% - - -

Through sensitization - 5.1% 7.5% 2.6%

Training students how - - 1.3% -

to counsel their peers

Use of posters 5.3% 15.3% 10.0% 2.6%

Watching movies 1.8% - 6.3% -

Total 100.0% 100.0% 100.0% 100.0%

 210

Appendix I: Suggestions on effective communication of DSAPP messages

Name of the university

PRU2 PUU1 PRU1 PUU2 Total

No response 36.8% 10.2% 41.3% 26.0% 26.9%

Advocating for Christian values - - 1.3% - 3%

Airing the negative effects of drugs - 2.0% 1.3% - 1.0%

Be included in the curriculum - - 1.3% - 3%

Bringing drug victims - 1.0% - - 3%

Brochures 1.8% - - - 3%

Busy pathways - - 1.3% - 3%

Carrying out a faculty awareness day - 1.0% 1.3% 1.3% 1.0%

Chapel 1.8% - - - 3%

Debates - - - 1.3% 3%

Door to door campaigns 1.8% 1.0% 2.5% 5.2% 2.6%

Encouraging peer counselling 7.0% 7.1% 3.8% 7.8% 6.4%

Engaging more students - 2.0% - - 6%

Gospel - 1.0% - - 3%

Holding conferences - 1.0% - 1.3% 6%

Holding drug prevention day - - - 2.6% 6%

Increasing the sensitization programs - - 1.3% - 3%

Introducing as a unit of study 1.8% 9.2% 6.3% 2.6% 5.4%

Mass - 5.1% - - 1.6%

Meeting and open forums 5.3% 6.1% 7.5% 9.1% 7.1%

Awareness students Mobilization 5.3% 1.0% - 2.6% 1.9%

 211

Frequent events e.g. sports, concerts, 5.3% 5.1% 6.3% 7.8% 6.1%

Orientation during first year 3.5% 6.1% - 2.6% 3.2%

Regular drug awareness campaign - 4.1% 1.3% 2.6% 2.2%

Regulating the policy - 1.0% - - 3%

Rehabilitation centers and programs - 1.0% 1.3% 1.3% 1.0%

Seminars and workshops 1.8% 9.2% 7.5% 6.5% 6.7%

Talk shows 7.0% 14.3% 1.3% 7.8% 8.0%

Through class representative - - 1.3% - 3%

Through orientation of first years 15.8% 7.1% - - 5.1%

Through the billboards 1.8% 1.0% - - 6%

Through video watching - - 2.5% - .6%

Use of posters 3.5% 3.1% 3.8% 5.2% 3.8%

Use of social media like face books - - 6.3% 6.5% 3.2%

Total 100.0% 100.0% 100.0% 100.0% 100.0%

 212

Appendix J: Suggestions on more popular and effective methods

PRU2 PUU1 PRU1 PUU2 Total

Advertisements 3.5% 5.1% - 2.6% 2.9%

Airing negative effects of drug - 2.0% - - 6%

abuse

Be more vibrant - 1.0% 1.3% 1.3% 1.0%

Billboards - - 6.3% 2.6% 2.2%

Bonding session like team building - - 1.3% - 3%

Bring artist to address drug issues - - 1.3% 1.3% 6%

Brochures 1.8% 3.1% 5.0% 2.6% 3.2%

By demonstration 1.8% 2.0% - - 1.0%

By showing practically victims 1.8% - - - 3%

who have been affected before

Can do concerts and talk about - 3.1% - - 1.0%

drugs

Cinemas - - 2.5% - 6%

Co-curriculum activities 1.8% - - - 3%

Creating social activities - - 1.3% 1.3% 6%

Cubs and association 3.5% 1.0% - - 1.0%

Drug abuse awareness 1.8% - - - 3%

Drug abuse prevention days 3.5% 5.1% 2.5% 3.9% 3.8%

Entertainment so that students 1.8% - - - 3%

don't have much free time

Events organized - 1.0% 5.0% 3.9% 2.6%

Fashion shows to fight abuse 3.5% 2.0% - - 1.3%

 213

Giving reading materials 1.8% 1.0% 3.8% 2.6% 2.2%

Giving rules and regulations - 9.2% - - 2.9%

Guidance and counselling 1.8% 10.2% 10.0% 6.5% 7.7%

Incorporate the program in the 3.5-% 6.1% 1.3% 2.6% 3.5%

academic curriculum

In house rehabilitation services 1.8% 5.1% 1.3% 1.3% 2.6%

Invite victims of drug abuse - 2.0% 7.5% 6.5% 4.2%

Involve speakers with personal 1.8% - - - 3%

experience on drug abuse

Involve students directly - 2.0% 5.0% 5.2% 3.2%

Meeting and conferences 3.5% - - - 6%

More drugs sch/ class awareness - - 1.3% - 3%

Motivates victims to avoid drugs 1.8% - - - 3%

Music concerts 5.3% - - - 1.0%

No response - 1.0% 5.0% 15.6% 5.4%

Organizing a movie evening - 1.0% 3%

Organizing seminars on drug abuse 14.0% 3.1% 2.5% 3.9% 5.1%

Organizing sports - 2.0% 2.5% 2.6% 1.9%

Provide options for leisure time - - 1.3% - 3%

Rules and regulations policies 3.5% - - - 6%

Setting counseling center - - 2.5% 2.6% 1.3%

Supply of magazines 1.8% 2.0% - - 1.0%

Talk shows 12.3% 7.1% 2.5% 5.2% 6.4%

Talks from former addicts - - 1.3% - 3%

Those involved to be penalized - - 2.5% 2.6% 1.3%

 214

open discussion forums 5.3% 3.1% - - 1.9%

Use of posters 8.8% 9.2% 3.8% 1.3% 5.8%

Social forums and conferences 1.8% - 5.2% 1.6%

Use of social media 1.8% 4.1% 7.5% 5.2% 4.8%

Use students as ambassadors - - 2.5% 3.9% 1.6%

Using campaigns 5.3% 5.1% 7.5% 6.5% 6.1%

Video clips - - 1.3% - 3%

Youth orientation and mentorship - 1.0% 1.3% 1.3% 1.0%

Total 100.0% 100.0% 100.0% 100.0% 100.0

%
 215

Appendix K: Reasons for rating on student participation

Name of the university Total

PRU2 PUU1 PRU1 PUU2

Almost everyone abuses drugs 3.0% - - - 5%

Want to help but don‟t know - 1.4% 3.0% 2.4% 1.6%

Students attitude problems - 8.1% 6.1% - 4.4%

commitment from the students 3.0% - - 2.4% 1.1%

Can change their habits - 4.1% 6.1% - 2.7%

Crimes emerging from it 3.0% - - - 5%

discourage drug abuse - 1.4% 3.0% 2.4% 1.6%

Peer pressure causes DSA 3.0% 1.4% 3.0% 2.4% 2.2%

DSAPP doesn't exist/inactive - 1.4% 6.1% 4.8% 2.7%

Everyone is a victim 3.0% 6.8% - - 3.3%

Few are willing - - - 2.4% 5%

Good education program 3.0% - - 2.4% 1.1%

Not been highly advertised - - - 2.4% 5%

Not popular for the students - 1.4% 18.2% 7.1% 5.5%

Student Lack of interest - 1.4% 9.1% 2.4% 2.7%

Lack of counseling session - 1.4% - - 5%

Lack of support 9.1% - - - 1.6%

Lack of time 1.4% 3.0% - 1.1%

Management attitude on drugs 3.0% - - 2.4% 1.1%

Many willing to accept DSAPP 2.7% - 1.1%

Most are ignorant about 3.0% 4.1% 9.1% 7.1% 5.5%

 216

DSAPP

Most students don't use drugs 3.0% - - 2.4% 1.1%

Most students fear drug abuse - 2.7% - - 1.1%

Never heard of DSAPP - 1.4% - - 5%

No awareness among students 24.2% 16.2% 12.1% 16.7% 17.0%

No clear forums on DSAPP - 1.4% 3.0% - 1.1%

No display of DSAPP - 1.4% - - 5%

Lack of drug abuse prevention 3.0% 8.1% - 4.8% 4.9%

No reason 3.0% 5.4% - 4.8% 3.8%

Nobody want to be participate 3.0% - - - 5%

Not aware of DSAPP 9.1% 2.7% 9.1% 9.5% 6.6%

students who read about drugs 3.0% 2.7% - 2.4% 2.2%

People abuse drugs in school 3.0% - - 4.8% 1.6%

Publicity is low - - 3.0% - 5%

Rare drug activities in campus - 1.4% - - 5%

Student assume to know much - 1.4% - - 5%

Students readiness to DSAPP - 1.4% 3.0% 2.4% 1.6%

Students willing but no support 3.0% - - 2.4% 1.1%

The reformed can influence 3.0% - - 4.8% 1.6%

Too much academic work 3.0% 8.1% - 4.8% 4.9%

Truth be told - - 3.0% - 5%

Very few people know DSAPP 3.0% 6.8% - - 3.3%

We have not seen them 3.0% 2.7% - - 1.6%

Total 100.0% 100.0% 100.% 100.0% 100.%

 217

Appendix L: Challenges facing DSAPP

Name of the university Total

Challenges PRU2 PUU1 PRU1 PUU2

Student attitude - 7.1% 2.5% - 3.0%

Corruption - - 2.5% 4.5% 1.8%

Doesn't exist 4.2% 3.6% - - 1.8%

Dormancy - 1.8% 5.0% 2.3% 2.4%

Hard to get students - - - 2.3% .6%

Hostility - 3.6% - - 1.2%

Ignorance - 7.1% 2.5% 2.3% 3.7%

Implementation - - 7.5% 2.3% 2.4%

Inactiveness - - 2.5% - 6%

Inadequate resources 8.3% - 10.0% 4.5% 4.9%

Information - - 2.5% - 6%

Insecurity - 3.6% - - 1.2%

Lack of administration support - - 2.5% - 6%

Lack of audience - - - 2.3% 6%

Lack of awareness by the students - 1.8% 22.5% 11.4% 9.1%

Lack of commitment - - 5.0% - 1.2%

Lack of cooperation - - - 2.3% 6%

Lack of funds 25.0% 12.5% - 13.6% 11.6%

Lack of information - 7.1% 5.0% - 3.7%

Lack of interest from the students - - - 2.3% 6%

 218

Lack of publicity 4.2% 1.8% 7.5% 6.8% 4.9%

Lack of self -acceptance 12.5% 7.1% 2.5% 9.1% 7.3%

Lack of students involvement - 1.8% - - 6%

Lack of support 12.5% - 2.5% 9.1% 4.9%

No follow ups - 1.8% 5.0% 2.3% 2.4%

No relevant people to share 4.2% 3.6% 2.5% - 2.4%

People are not aware - - - 2.3% 6%

Poor health 4.2% - - - 6%

Poor performance 4.2% - - - 6%

Poor strategies 8.3% - - 2.3% 1.8%

Poor target group 1.8% 5.0% 2.3% 2.4%

Popularity 8.3% 12.5% - 2.3% 6.1%

Relationship with students - - 2.5% 4.5% 1.8%

Reluctant students - 7.1% - - 2.4%

Sensitization - - - 2.3% 6%

Student socialization 4.2% 12.5% - 2.3% 5.5%

They feel attacked - - 2.3% 6%

Vandalism - 1.8% 2.5% 2.3% 1.8%

Total 100.0% 100.0% 100.% 100.0% 100.0%

 219

Appendix M: Drug abuse sustaining factors

Name of the university Total

PRU2 PUU1 PRU1 PUU2

Allow students to have - -

2.5% 4.1% 1.5%
some freedom

Availability of drugs - - 3.9% 4.1% 2.0%

Bewitching - 6.6% - 2.0%

Courage gain - - 9.8% 2.0% 3.0%

Depression 2.5% 1.6% - - 1.0%

Economic status 2.5% - - 2.0% 1.0%

Entertainment 2.5% - - - 5%

Extra money 7.5% 1.6% 9.8% 6.1% 6.0%

Family background 2.5% - 19.6% 14.3% 9.0%

Harsh regulations lead

7.5% 13.1% - 8.2% 7.5%
to reluctance

Identity crisis 2.5% - - - 5%

Idleness 27.5% 9.8% 11.8% 12.2% 14.4%

awareness/ignorance - 1.6% 2.0% 2.0% 1.5%

Lack of mentors 5.0% - - 6.1% 2.5%

Living environment - 6.6% - - 2.0%

Media 5.0% 11.5% 2.0% 6.1% 6.5%

No information 2.5% - - 2.0% 1.0%

Peer pressure 12.5% 24.6% 11.8% 14.3% 16.4%

Person upbringing 2.5% - - - 5%

 220

Poor performance in - - -
6.6% 2.0%
class

Poverty 7.5% - - 2.0% 2.0%

Proximity to drugs 1.6% 19.6% 12.2% 8.5%

Religion 2.5% - - - 5%

Social relation ships 1.6% - - 5%

Stress 5.0% 6.6% 9.8% 2.0% 6.0%

Workload - 6.6% - - 2.0%

Total 100.0% 100.0% 100.0% 100.0% 100.0%

 221

Appendix N: Suggestions on effective ways to address ADA

Name of University

suggestion

PRU2 PUU1 PRU1 PUU2

Accepting the drug users 1.8% .3%

before judging them and
offering counsel

Appoint student agents 1.0% .3%

who can easily mingle
with the student

Availability of 1.3% 3%
information on DSAPP

Banning clubs and 1.0% .3%

alcohol retails within the
institution

BCC should carry out 1.0% .3%

their activities intensively

Billboards 1.0% 1.6% .7%

Brochures every now and 1.0% .3%

then

Campaign against drug 1.6% .3%

abuse

Celebrity talks 1.0% 3%

 222

Chaplaincy 1.0% .3%

Choose good friends 1.3% .3%

Close the bar at the 1.0% 1.6% .7%

student center

Come up with drug 1.6% .3%

rehabs to enable the
affected to come back to
normal life

Concert that are fun on 1.8% .3%

drug abuse

Counseling services 8.8% 5.1% 3.2% 13.0% 7.5%

Create awareness on the 1.8% 6.1% 9.7% 1.3% 4.8%

effects of drug abuse

Deal with the suppliers 1.0% 1.6% .7%

first

Discussing the effects of 7.0% 1.4%

drug abuse with students

Door to door campaign 1.0% 1.6% .7%

Draw diagrams and 1.6% .3%

pictures for the effect of
these drugs

Drug abuse prevention 8.8% 3.2% 1.3% 2.7%

day

Drug peddlers should not 1.0% .3%

be allowed to access
school facilities

Drugs reforms should be 1.3% .3%

accepted back
 223

Encourage seminars on 1.6% .3%

drug abuse

Encouraging students to 1.0% .3%

make proper use of their
leisure time

Engage students in 2.0% 1.6% 6.5% 2.7%

extracurricular activities

Engaging the concerned 1.3% .3%

stake holders

Enhancing alternative 1.6% 1.3% .7%

means of recreation in the
university

Entertainment through 1.3% .3%

mass media

First years should be well 1.8% 1.3% .7%

oriented

Formation of association 1.6% .3%

and organization to deal
with the drug abuse

Forming constructive 1.6% .3%

groups to address the
issue of drugs

Get to know the root 1.3% .3%

Give addicts time to 1.3% .3%

explain themselves

Give alternative ways of 1.0% .3%

stress management other
than using drugs
 224

Give incentives for 2.0% .7%

students to engage in
activities in the campus

Group sharing 1.8% 1.0% 1.6% 1.0%

Have open talks 1.8% .3%

frequently

Holding seminars 1.3% .3%

concerning drug abuse
and its consequence

Holding seminars to 1.3% .3%

engage university
students

Holding seminars to 1.6% .3%

engage university
students

Holding talk shows 1.8% .3%

Identifying the students 1.6% .3%

affected then provide
counseling to them

Impose harsh penalties on 1.6% .3%

drug sellers

Information 1.0% .3%

dissemination through
posters

Initiatives by students 1.0% .3%

engineered solely by
themselves

Instituting strong 3.2% 1.3% 1.0%

leadership who will create
links with students
 225

Interacting freely with the 1.3% .3%

abusers

Interacting with students 2.0% 3.2% 1.3% 1.7%

on social media by
creating a DSAPP page or
group

Internet 4.1% 1.4%

Introduce rehabilitation 1.8% 2.6% 1.0%

programs to the addicts
Support socially,
economically and morally
the addicts

Introduction of drug 7.0% 3.1% 1.6% 2.7%

abuse policy

Involve everyone 1.8% 3.1% 1.6% 1.7%

Knowing the root causes 1.3% .3%

of drug abuse

Legal actions on drug 1.0% .3%

abusers

Legal enforcement from 1.0% .3%

the student body up to
government

Linking the university to 1.0% .3%

the public in fighting
drugs

Love and concern work 1.8% 2.0% 1.3% 1.4%

better than harsh rule

Management to facilitate 5.3% 1.3% 1.4%

the new preventive
measures of drug abuse
 226

Meeting with students 1.3% .3%

Mentors 1.8% 2.0% 1.0%

More information ought 1.0% .3%

to be provided to
enlighten students

Motivating youths to 1.0% .3%

focus on their careers

Non-discrimination 1.3% .3%

approach

Offering rehabilitation 1.3% .3%

services to the addicted
students

Organize drug abuse 2.0% .7%

prevention campaign

Organize Drugs 1.8% .3%

awareness week

Posters placed all over the 1.8% .3%

University

Promoting Christian 1.0% .3%

values

Promotion of anti-drug 4.8% 1.3% 1.4%

abuse campaign

Proper security 1.0% .3%

Provide enough 3.2% 1.3% 1.0%

counseling support to
students and reduce
stigma
 227

Provide written materials 1.6% .3%

dealing with prevention
ways

Providing alternative 1.8% .3%

activities that can engage
student leisure

providing clear 1.8% 1.0% 2.6% 1.4%

information about drug
abuse

Providing information 1.6% .3%

about the effects of drug
abuse to students

Public education through 1.0% .3%

forums, debates and plays

Reach out to every 1.0% .3%

student and teach them
the effects of drug abuse

Recreation time for 1.3% .3%

students

Reshuffling of security 1.6% .3%

guards to prevent
collusion

Rigorous campaign to 1.0% .3%

fight drug abuse

Routine checkups of 1.6% 1.3% .7%

students hostels

Seminars and open 10.5% 6.1% 8.1% 3.9% 6.8%

forums

Sensitization on the 1.6% 1.3% .7%

dangers of drug abuse
 228

Stop suspension and 1.3% .3%

expulsion

Strict rules and 3.2% 1.3% 1.0%

regulations for drug users

Students should be 1.8% 2.0% 2.6% 1.7%

encouraged to participate

Students who are addicted 7.0% 3.1% 3.9% 3.4%

should be counselled and
rehabilitated

Supporting each other 1.6% .3%

Talk shows 2.0% 3.2% 5.2% 2.7%

Teach it as a course 1.0% .3%

Teach on the side effects 1.3% .3%

of drugs

Teaching about the 1.3% .3%

consequences of drug
abuse

There should be more 3.5% 3.1% 3.2% 1.3% 2.7%

activities from DSAPP

To find out those selling 1.0% .3%

illegal drugs and arrest
them

To hold campaigns in 1.0% .3%

hostels

To involve students in 3.5% 6.1% 3.2% 5.2% 4.8%

more extra curriculum
activities to spend time
wisely
 229

To provide social talks 1.8% 2.0% 1.6% 1.4%

Tough measures on drug 1.0% .3%

peddlers

Treat people like adults 1.3% .3%

True stories from 1.8% .3%

recovered addicts

Understanding students 1.0% .3%

University should support 1.8% 1.0% 2.6% 1.4%

campaign fully

Use of peer educators 3.5% 5.1% 4.8% 3.9% 4.4%

Use of posters 2.0% 3.2% 2.6% 2.0%

Use of rehabilitation 1.3% .3%

centers

Use of social media to 1.8% .3%

capture more students

Using ex addicts to teach 1.3% .3%

about its effects

Youth discussions forums 1.0% .3%

Total 100.0 100.0% 100.0% 100.0% 100.0%

%