PRINCIPLES OF PREVENTION (PowerPoint) by ert554898



Dr. Charles Davis
Department of Health, Wellness & Recreation
Fredonia State University
   The goal of prevention is to delay, reduce or eliminate substance use among
    children and adolescents.
   Targeting developmentally appropriate risk and protective factors.
   Through key community channels such as the family, peer networks,
    schools, and other community and environmental structures.
   Three types of Prevention: Primary, Secondary, Tertiary.
   Public school’s roles: Primary and Secondary.
         What do we know about the
         initiation of substance use?
   Most children initiate tobacco, alcohol and illicit drug use between the ages
    of 13 and 16?
   There is about a 200% increase in the use of tobacco, alcohol and other
    drugs between grades 8 and 10.
   Risk to move on to marijuana is 65 times greater for persons who smoke or
   Risk to move on to cocaine is 104 times greater for persons who used
   The more risk factors someone has the greater likelihood to use substances.
   The lack of perceived power and control over their lives leads to boredom in
    and a search for freedom from that boredom.
   In undeveloped countries the main reasons for drug use as stated by youth
    included lack of rights, food, health, education and a chance to earn a living.

What are Risk and Protective factors
   Associated with drug use?
   Longitudinal studies that follow children into adolescence and early
    adulthood have differentiated the pathways of those who initiate and
    continue to use substances from those who do not initiate or who
    discontinue the use of substances.
   Factors associated with greater potential to use substances are called “risk
   Factors associated with reduced potential to use substances are called
    “protective factors.”

                      Early Childhood
Early Childhood Factors have the longest potential
  impact as they may interfere with normal and
  successful development. These factors are
  Personal and Environmental.
Personal risk factors include:
   Being a man vs. being a woman. (Being male is a higher risk factor).
 Being young (many physical and emotional changes encourage
   Mental problems.
   Poor personal skills (decision making, expressing self, asserting self,
    problem solving and coping skills.
   Personality, behavior patterns, belief system (locus of control).
Interpersonal- include family and peer relations.
Environmental risk factors include:- school, work and
Chaotic home environments; parents do not know how to look after
him/her emotionally, physically, or providing support and guidance.
Person    who does not have a family.
Person    who is being abused.
Parents,   brothers or sisters who use drugs (availability).
Ineffective   parenting.
Lack   of mutual attachments and nurturing.
A great deal of unstructured time with limited or no constructive,
imaginative and challenging activities to take part in.
No job opportunities.
The society’s values encourage substance abuse.
     i.e. Widespread availability & limited or no enforcement of laws
          resulting in perceptions of approval of drug-using behaviors.
   Limited opportunities for education.
   Inappropriate shy and aggressive behavior in the classroom.
   Failure in school performance and school bonding.
   Affiliation with deviant peers. (Peer groups teach acceptance of certain
   Establishing identity, and achieving within this environment.

        WHAT ARE THEY?
   Strong bonds; family, friends, pets that encourage caring, sharing).
   Well-developed personal skills ( analyzing situations, making quick
    decisions, communicate with others, relax, negotiate, compromise).
   Parental monitoring—clear rules of conduct and involvement of parents in
    lives of children.
 Success   in school performance
 Strongbonds with prosocial institutions that meet physical and
 emotional needs ( social centers, intramurals, sports, employment)
 Adoptionof conventional norms about substance use ( tradition of
 temperance, moderation, abstinence)
 Laws that regulate substance abuse are stringent and well enforced
 and access to drugs is limited or difficult
Other Factors Influencing Drug Use

   Availability of alcohol, tobacco and drugs

   Trafficking patterns

   Beliefs that drug use is generally tolerated
         Progress in Prevention Science:
        Influences on the development of
          effective prevention programs
   Epidemiology of substance use
    _ Establishment of Drug Schedules- 1972
    –   Establishment of the National Institute on Drug Abuse-1974
    –   National Household Survey on Drug Abuse: 1975
    –   Monitoring the Future Study: 1975
    –   Longitudinal Studies on Factors Associated with Initiation of
        Drug Use: 1975
   Behavior Theory
   First Effective Smoking Prevention
    Program: Late 1970s
     Progress in Prevention Science
   National Institute on Drug Abuse funds 85% of prevention research in
   Reports of effective prevention programming in late 1980s:
           - Values, resistance, self esteem models.
   First National Conference on Drug Abuse Prevention Research: Putting
    Research to Work for the Community: September 1996.
Prevention Program Approaches
   UNIVERSAL programs reach the general population.

   SELECTIVE programs target groups at risk or subsets of the general
    population (e.g., children of drug users or poor school achievers).

   INDICATED programs are designed for groups who are already using
    substances or who exhibit other risk-related behaviors.
How to Use Risk and Protective Factors
  to Develop Prevention Programs
    when you go into a community and establish a drug prevention program, keep these risk and protective factors in mind while
                                                  deciding what action to take.
      Family Relationships: Teach parents skills for better family communications, discipline,
       firm and consistent rule making, get to know friends, understand problems and
      Peer Relationships: Develop social competency skills for improved communications,
       enhancement of positive peer relationships and social behaviors and resistance skills to
       refuse substances.
      School Environment: Enhance academic performance and strengthen school bonding;
       foster a substance-free environment with support for those who initiate use.
      The Community Environment: Enhance anti-substance use norms and pro-social
       behavior through policy or regulations, mass media efforts, community-wide awareness
       programs; new laws and enforcement, advertising restrictions; drug free school zones.
       Involve the whole community if possible.
      Negative effects of substances on children and adolescents health and activities.
      Establish a broad based program looking at many drug, not just one.
      Encourage positive alternatives.
      Involve the media to reinforce positive values (learning, exposure, potential traps).

   Be long-term and extend over the school career with repeated
    booster interventions.
   Focus on the family; this creates a greater impact than focusing
    exclusively on parents or children.
   Accompany community programs that include media campaigns
    and policy changes with school and/or family interventions.
   Strengthen anti-drug norms in all prevention settings.
   Enhance protective factors; reduce or reverse risk factors
   Target all forms of drug use: tobacco, alcohol, marijuana, inhalants
    and other drugs.
   Teach skills to refuse drugs when offered, strengthen personal
    commitments against use and increase social competency,
    reinforce anti-drug use attitudes.
   Include a parents’ or caregivers component to reinforce what child
    is learning and opens discussion.
   Incorporate interactive methods for adolescents
   Utilize opportunities that schools offer to reach diverse populations
   Adapt prevention programming to address the specific nature of
    problem in the local community
   Address the level of risk of the target population: populations at
    higher risk require earlier and more intensive prevention efforts
   Be age-specific, developmentally appropriate and culturally
    sensitive. Encourage social interaction.
   Create healthy alternatives- leisure, supportive attitudes.
Steps for Effective Implementation

   Problem Identification
   Needs Assessments
   Linking Prevention Strategies to Need
   Program Implementation
   Program Evaluation
    Dimensions Of Prevention Need
   Prevalence--who is using what drugs.

   Incidence--who begins the use of what drugs.

   Service need--what types of prevention services are needed.

   Quality of services delivered--are services appropriate and adequate?
    Prevention Principles for School-
            Based Programs
 Do the programs reach children from elementary through high school? If
  not, do they at least reach children during the critical middle or junior high
  school years?
 Do the programs contain multiple years of intervention?
 Do the programs use a well-tested, standardized intervention with detailed
  lesson plans and student materials?
 Do the programs teach drug-resistance skills through interactive methods
  with reinforcement and extended practice?
   Do the programs foster pro-social bonding to the school?
    To the community?
School-Based Programs Cont.
   Do the programs:
         teach social competence and drug resistance skills
         promote positive peer influence
         promote anti-drug social norms
         emphasize skills-training teaching methods
         Include an adequate dosage (10-15 sessions in year 1 with 10 or
         more boosters in subsequent years)
   To maximize benefits, do the programs retain core elements of
    effective intervention design?
   Is there periodic evaluation to determine whether the programs are
   Are they implemented with fidelity?
    Prevention Principles for Family-
            Based Programs
   Do the family-based programs reach families of children at each stage of
   Do the programs train parents in behavioral skills to:
        reduce conduct problems in children
        improve parent-child relations, including positive reinforcement,
        listening and communications skills, and problem-solving
        provide consistent discipline and rulemaking
        monitor children’s activities during adolescence
   Do the programs include an educational component for parents with drug
    information for them and their children?

   Are the programs directed to families whose children are in elementary
          through high school to enhance protective factors?
   Do the programs provide access to counseling services for families at risk?
                          Prevention Principles for
                          Community Programs
    To be comprehensive, does the program have components for the individual,
     the family, the school, the media, community organizations and, health
     providers? Are they well integrated in theme and content?
    Does the prevention program use media and community education
     strategies to increase public awareness, attract community support,
     reinforce the school-based curriculum for students and parents, and keep
     the public informed of the program’s progress?
    Can program components be coordinated with other community efforts to
     reinforce prevention messages?
    Are interventions carefully designed to reach different populations at risk
     and are they of sufficient duration to make a difference?
   Does the program follow a structured organizational plan that progresses
           from needs assessment through planning, implementation, and review
           to refinement with feedback?
   Are the objectives and activities specific, time limited, feasible, and
           integrated so that they work together across program components
           and can be evaluated?
                Evaluation Process
   What was done in the program?
   How was the program carried out?
   Who participated in it?
   Was the program implemented as intended?
   Did the program achieve what was expected?
   Did the program produce the desired long-term effects?
                     Marketing Prevention
                                    Remember …..
   No particular approach or strategy has been proven through rigorous scientific study to be consistently
    effective over the long term in reducing drug abuse. However, there is some consensus among experts,
    practitioners and youth themselves on what kinds of elements need to be taken into consideration when
    designing a prevention program.
   Not all young people are the same and they are not all equally vulnerable. Strategies should be carefully
    tailored to clearly defined target groups.
   Ideally programs should combine knowledge/attitude/behavior with health promotion, and the building of self-
    esteem and resistance skills.
   The strategies should encourage individual strengths and those things that protect individuals in stressful
    situations and environments, and should give youth a set of specific skills for resisting peer pressure to use
    drugs, for example in communications and relationships with peers. Opportunities to meet together, play, and
    take part in activities that develop self-confidence.
   Scare tactics reduce the trust that youth may have in the advice of adults, and in some cases actually
    encourage drug use.

        For every $1 spent on prevention, saves $4 to $5 in drug
                     abuse treatment and counseling

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