Defense Date


Graduation Date

Summer 2008


Immediate Access

Submission Type


Degree Name





School of Nursing

Committee Chair

L. Kathleen Sekula

Committee Member

John Kern

Committee Member

Kathryn Puskar

Committee Member

David Brent

Committee Member

Mary Ann Thurkettle


academic performance, attendance, drug and alcohol use, promotion/graduation, suspensions, adolescence


The purpose of the study was to examine relationships between participation in Pennsylvania's Student Assistance Program (SAP) and educational outcomes (academic performance, promotion/graduation status, attendance, suspension, and policy violations) of students at risk for suicide. The methodology was based on the Framework for Program Evaluation in Public Health, while the theoretical framework was Jessor's Protection-Risk Model. A retrospective analysis was performed using existing SAP data maintained by Pennsylvania's Department of Education. Binomial and multinomial logistic regressions were performed.

Being referred and participating in the SAP due to suicidal ideation, gesture, or attempt predicted fewer drug and alcohol policy violations and fewer suspensions since first being referred to the SAP. However, being referred and participating in the SAP for suicidality and problems that they reported themselves predicted continued violations of drug and alcohol policies. Perhaps these students used drugs and alcohol to self-medicate. The service that was the most statistically significant in predicting decreased drug and alcohol policy violations and decreased suspensions for students at risk for suicide was assessment by a licensed drug and alcohol provider. Placement in an alternative school, such as a school for youth with disciplinary problems, and children and youth services provided by community agencies (investigation of alleged abuse, foster care, etc.) were also highly associated with fewer drug and alcohol policy violations. Outpatient drug and alcohol treatment predicted promotion to the next grade or graduation from high school for these students.

The results of this study must be communicated to school personnel and other key stakeholders, including service providers, since money continues to be spent on the SAP. Future analyses at the county level based on metropolitan and economic status, as well as gender and ethnicity, must be performed. Intervention studies of services are also needed. Furthermore, outcomes for students who participated in the SAP must be compared to those of students who did not need to be referred to the SAP. The ultimate goal is for the SAP to become an evidence-based prevention program.