Intervention Summary

unique YOU®. – formerly known as "I'm Special"

I'm Special is a substance abuse prevention program for 3rd and 4th graders. The primary goal of the program is to develop and nurture each child's sense of uniqueness and self-worth. It further enhances the protective and resiliency factors of children by teaching them appropriate ways for dealing with feelings; steps for making decisions; and skills for healthy living, effective group interactions, and resisting drugs, as provided through the program's "no use" message. The program is administered by trained facilitators through eight 50- to 60-minute group sessions, which are designed to be enjoyable for children and include a variety of hands-on activities. To become a trained facilitator, an individual with group leadership experience (e.g., a teacher, youth leader, counselor, prevention specialist) must complete a 2-day training. I'm Special has been implemented with both universal and at-risk populations in school classrooms and in after-school settings as well as with youth groups (e.g., clubs, Scouts).

Descriptive Information

Areas of Interest	Substance use disorder prevention
Outcomes	1: Self-esteem 2: Communication skills 3: Teamwork/cooperation
Outcome Categories	Mental health Social functioning
Ages	6-12 (Childhood)
Genders	Male Female
Races/Ethnicities	Race/ethnicity unspecified
Settings	School Other community settings
Geographic Locations	Urban Suburban Rural and/or frontier
Implementation History	An estimated 300 sites across the United States have implemented I'm Special since the program's inception, reaching approximately 9,000 children. The program also has been implemented in American Samoa, the Bahamas, Bermuda, and Puerto Rico. I'm Special has been evaluated four times.
NIH Funding/CER Studies	Partially/fully funded by National Institutes of Health: No Evaluated in comparative effectiveness research studies: No
Adaptations	Program materials are available in both English and Spanish.
Adverse Effects	No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories	Universal Selective

Quality of Research

Documents Reviewed

The documents below were reviewed for Quality of Research. The research point of contact can provide information regarding the studies reviewed and the availability of additional materials, including those from more recent studies that may have been conducted.

Study 1

Stein-Seroussi, A., Stockton, L., & Brodish, P. Results of a randomized controlled trial of the I'm Special curriculum in three North Carolina school districts. Chapel Hill, NC: Pacific Institute for Research and Evaluation.

Outcomes

Outcome 1: Self-esteem
Description of Measures	Teachers assessed each student's self-esteem using an instrument developed for the study. The instrument included 2 items for each of the 6 constructs targeted by the program: communication skills, decisionmaking, expressing feelings, healthy choices, self-esteem, and teamwork/cooperation. For each construct, the 2 items asked teachers to indicate how many times in the past 30 days the student engaged in positive behavior related to the construct (e.g., "How often did the student make healthy choices?" and "How often was the student cooperative with other people?"). Response categories ranged from "never" to "all of the time." Higher scores on the 2-item self-esteem scale indicated greater self-esteem. Assessments occurred before and 30 days after the intervention.
Key Findings	A study compared students who received I'm Special with students who received no prevention services. Controlling for pretest scores on self-esteem, grade, gender, and type of setting (regular classrooms or programs for at-risk youth) and taking into account intraclass correlation, the study found that the students in the intervention group had significantly higher self-esteem scores than those in the control group at posttest (p < .05).
Studies Measuring Outcome	Study 1
Study Designs	Quasi-experimental
Quality of Research Rating	2.5 (0.0-4.0 scale)

Outcome 2: Communication skills
Description of Measures	Teachers assessed each student's communication skills using an instrument developed for the study. The instrument included 2 items for each of the 6 constructs targeted by the program: communication skills, decisionmaking, expressing feelings, healthy choices, self-esteem, and teamwork/cooperation. For each construct, the 2 items asked teachers to indicate how many times in the past 30 days the student engaged in positive behavior related to the construct (e.g., "How often did the student make healthy choices?" and "How often was the student cooperative with other people?"). Response categories ranged from "never" to "all of the time." Higher scores on the 2-item communication skills scale indicated greater communication skills. Assessments occurred before and 30 days after the intervention.
Key Findings	A study compared students who received I'm Special with students who received no prevention services. Controlling for pretest scores on communication skills, grade, gender, and type of setting (regular classrooms or programs for at-risk youth) and taking into account intraclass correlation, the study found that the students in the intervention group had significantly higher communication skills scores than those in the control group at posttest (p < .05).
Studies Measuring Outcome	Study 1
Study Designs	Quasi-experimental
Quality of Research Rating	2.6 (0.0-4.0 scale)

Outcome 3: Teamwork/cooperation
Description of Measures	Teachers assessed each student's teamwork/cooperation using an instrument developed for the study. The instrument included 2 items for each of the 6 constructs targeted by the program: communication skills, decisionmaking, expressing feelings, healthy choices, self-esteem, and teamwork/cooperation. For each construct, the 2 items asked teachers to indicate how many times in the past 30 days the student engaged in positive behavior related to the construct (e.g., "How often did the student make healthy choices?" and "How often was the student cooperative with other people?"). Response categories ranged from "never" to "all of the time." Higher scores on the 2-item teamwork/cooperation scale indicated better teamwork/cooperation. Assessments occurred before and 30 days after the intervention.
Key Findings	A study compared students who received I'm Special with students who received no prevention services. Controlling for pretest scores on teamwork/cooperation, grade, gender, and type of setting (regular classrooms or programs for at-risk youth) and taking into account intraclass correlation, the study found that the students in the intervention group had significantly higher teamwork/cooperation scores than those in the control group at posttest (p < .01).
Studies Measuring Outcome	Study 1
Study Designs	Quasi-experimental
Quality of Research Rating	2.5 (0.0-4.0 scale)

Study Populations

The following populations were identified in the studies reviewed for Quality of Research.

Study	Age	Gender	Race/Ethnicity
Study 1	6-12 (Childhood)	50.2% Male 49.8% Female	100% Race/ethnicity unspecified

Quality of Research Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the Quality of Research for an intervention's reported results using six criteria:

Reliability of measures
Validity of measures
Intervention fidelity
Missing data and attrition
Potential confounding variables
Appropriateness of analysis

For more information about these criteria and the meaning of the ratings, see Quality of Research.

Outcome	Reliability of Measures	Validity of Measures	Fidelity	Missing Data/Attrition	Confounding Variables	Data Analysis	Overall Rating
1: Self-esteem	2.0	2.0	2.5	2.3	2.3	4.0	2.5
2: Communication skills	2.0	2.5	2.5	2.3	2.3	4.0	2.6
3: Teamwork/cooperation	2.0	2.0	2.5	2.3	2.3	4.0	2.5

Study Strengths

The outcome measures have good internal reliability and face validity. Efforts were made to ensure fidelity; facilitators delivering I'm Special received 14 hours of training with a standardized protocol and were required to cofacilitate the curriculum with more experienced facilitators before implementing the program themselves. In addition, facilitators used standardized program materials and completed forms indicating which elements they had covered in each session; session fidelity scores were 94.8% or higher. Statistical analyses were used to adjust for data that were missing because of attrition. The sample size was large, and power appeared to be good.

Study Weaknesses

Information on internal reliability was the only type of reliability or validity information provided for the outcome measures. Although fidelity scores were good, fidelity assessments were provided for only 12 of the 31 intervention schools evaluated. The attrition rate was 34%, and the researchers did not explain whether this reflected the percentage of students or entire classrooms. The study included 31 intervention schools but only 19 control schools. Baseline differences were not adequately accounted for in the outcome analysis. Group assignments were not made in a consistent manner. At the beginning of the study, researchers made random group assignments at the classroom level; however, later in the study, these assignments were made at the school level, at the request of the schools.

Readiness for Dissemination

Materials Reviewed

The materials below were reviewed for Readiness for Dissemination. The implementation point of contact can provide information regarding implementation of the intervention and the availability of additional, updated, or new materials.

Lesesne, T. S. I'm Special: A program for third and fourth graders. Charlotte, NC: Substance Abuse Prevention Services.

Lesesne, T. S. I'm Special: A program for third and fourth graders, revised and expanded edition [CD-ROM]. Charlotte, NC: Substance Abuse Prevention Services.

Lesesne, T. S. I'm Special training folder. Charlotte, NC: Substance Abuse Prevention Services.

Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the intervention's Readiness for Dissemination using three criteria:

Availability of implementation materials
Availability of training and support resources
Availability of quality assurance procedures

For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.

Implementation Materials	Training and Support Resources	Quality Assurance Procedures	Overall Rating
3.4	3.2	3.5	3.3

Dissemination Strengths

A detailed manual provides clear instructions for implementing the program's eight sessions. The developer assesses the appropriateness of the program for prospective sites. A 2-day training, either on or off site, is available for potential facilitators and incorporates didactic and experiential methods. Ongoing technical support also is available. Program fidelity is emphasized with lesson-specific quality assurance tools, including pre- and posttests and fidelity checklists.

Dissemination Weaknesses

The reason behind the session sequencing is unclear, specifically in regard to whether the sessions are designed to build on one another. The materials lack sufficient guidance for selecting an appropriate program facilitator, and they do not address optimal class size or integration of the program into the school environment and curriculum. No standardized training materials are provided to accompany the slide presentation for the training. No guidance is given on how to use the information generated by the quality assurance tools.

Costs

The cost information below was provided by the developer. Although this cost information may have been updated by the developer since the time of review, it may not reflect the current costs or availability of items (including newly developed or discontinued items). The implementation point of contact can provide current information and discuss implementation requirements.

Item Description	Cost	Required by Developer
Unique YOU® manual (includes CD-ROM with student workbook)	$299 each	Yes
1 day Facilitator training	$4,000 plus trainer travel related expenses (10 person minimum, 24 maximum)	No, but recommended for strengthened fidelity
2 day Training of Trainers	$8,500 plus trainer travel related expenses (10 person minimum, 24 maximum)	No, but recommended for strengthened fidelity
Student Workbook	$19.99	Yes
Technical Assistance Available	Contact for Rates; Available at No Charge with Purchase of Training Options	No