PRINCIPLES OF PREVENTION AND CURRICULUM DEVELOPEMNT FOR DRUG EDUCATION

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PRINCIPLES OF PREVENTION AND CURRICULUM
DEVELOPEMNT FOR DRUG EDUCATION

• Dr. Charles Davis
• Department of Health, Wellness Recreation
• Fredonia State University

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WHAT IS PREVENTION?

• 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 schools roles Primary and Secondary.

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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 drink
• Risk to move on to cocaine is 104 times greater
  for persons who used marijuana
• 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.

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MODIFIED SOCIAL STRESS MODEL 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.
• Factors associated with reduced potential to use
  substances are called protective factors.

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RISK FACTORS

• WHAT ARE THEY?

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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 experimentation).
• 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.

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• Environmental risk factors include- school, work
  and community.
• 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 societys values encourage substance abuse.
• i.e. Widespread availability limited
  or no enforcement of laws
• resulting in perceptions of
  approval of drug-using behaviors.

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ENVIRONMENTAL RISK FACTORS SPECIFIC TO THE
SCHOOL ENVIRONMENT

• Include
• 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 behaviors).
• Establishing identity, and achieving within this
  environment.

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PROTECTIVE FACTORS

• WHAT ARE THEY?

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Personal

• 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 monitoringclear rules of conduct and
  involvement of parents in lives of children.

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Environmental

• Success in school performance
• Strong bonds with prosocial institutions that
  meet physical and emotional needs ( social
  centers, intramurals, sports, employment)
• Adoption of 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

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Other Factors Influencing Drug Use

• Availability of alcohol, tobacco and drugs
• Trafficking patterns
• Beliefs that drug use is generally tolerated

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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

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Progress in Prevention Science

• National Institute on Drug Abuse funds 85 of
  prevention research in country.
• 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.

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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.

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How to Use Risk and Protective Factors to Develop
Prevention Programswhen 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 concerns.
• 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).

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PRINCIPLES OF PREVENTION

• STRUCTURE
• CONTENT
• DELIVERY

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Structure

• 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.

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Content

• 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.

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Delivery

• 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.

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Steps for Effective Implementation

• Problem Identification
• Needs Assessments
• Linking Prevention Strategies to Need
• Program Implementation
• Program Evaluation

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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?

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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?

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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 effective?
• Are they implemented with fidelity?

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Prevention Principles for Family-Based Programs

• Do the family-based programs reach families of
  children at each stage of development?
• 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 childrens 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?

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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
  programs 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?

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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?

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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