PUTTING PREVENTION RESEARCH TO PRACTICE Prepared by: DMHAS Prevention, Intervention & Training Unit, 9/27/96 Karen Ohrenberger, Director Dianne Harnad, Prevention Program Supervisor Carol Meredith, Primary Prevention Services Coordinator Karen Charette, Health Program Assistant

PREVENTION Prevention promotes constructive lifestyles that discourage drug abuse and promotes development of social environments that facilitate drug-free lifestyles. Prevention is designed to prevent or delay the age of first use of alcohol, tobacco and other drugs and fosters the involvement among all segments of community and major societal systems. Prepared by Prevention, Intervention & Training Unit, 6/19/96

NIMH Prevention Continuum Universal Interventions - designed for reception by all segments of the population (PSA; school/parent curriculum; community awareness; alternative activities; known as primary prevention). Selected Interventions - directed towards populations characterized by epidemiologically established risk factors (high risk youth, children of substance abusers, etc.; early intervention). Indicated Interventions - strategies designed to reverse, in specific individuals, an already initiated pathogenic sequence (secondary prevention or intervention).

Best Practices in Prevention Research & Conceptual Framework Accuracy, Efficacy & Credibility of Approach Needs Assessment State-of-the-Art Goals & Objectives Outcome & Process Evaluation Comprehensive Approach Integrates Overall Health Promotion Community Involvement & Ownership Long-Term Commitment Replicability

Prevention Research Silver bullet, one size fits all, for prevention, does not work! Research indicates that drug use and abuse have multiple causes, pathways, and correlates (Jones & Battjes 1985). Risk factor research for drug use onset and progression to abuse has provided a theoretical basis for designing prevention programs.

Risk & Protective Factors Research has identified factors in each of these domains that increase the likelihood of someone developing a disorder (risk factors) as well as factors that decrease the likelihood (protective factors).

Risk Factors FAMILY Family Management Problems Family history/drug use SCHOOL Lack of student involvement Availability of drugs COMMUNITY Lack of social networks Lack of youth involvement PEERS Isolations Favorable attitudes toward drug use

Protective Factors FAMILY Close bond with child Clear expectations SCHOOL Goal setting & mastery Parental involvement COMMUNITY Laws supporting non-use Access to resources PEERS Drug free activities Respect authority

Prevention Research Findings Effective programs target all forms of drug use and are age appropriate and culturally appropriate. Long-term, enduring programs have more impact on those most at risk for drug use and abuse. More intensive, and earlier, prevention efforts must be used with the higher the level of risk target group.

Prevention Research Findings (continued) Community programs that include media campaigns and policy changes are strengthened with parallel school and family interventions. Communities need to assess and strengthen social norms against drug use in any interventions developed. School programs should include skills to resist drug offers, social competency skills (including communications and assertiveness), and normative education designed to correct students’ misperceptions about their peers’ drug use.

Prevention Research Findings (continued) Childrens’ programming should include parents’ or caregivers’ component. Family focused prevention efforts have a greater impact than parent-focused or child-focused strategies. Schools offer opportunities to reach all populations including children with behavior problems or learning disabilities.

Seven Components of Effective Prevention Program for High-Risk Youth Early & Sustained Intervention Over Time Individual Attention, Assuring Attachment of High-Risk Youth to a Responsible, Caring Adult Focus on the Acquisition of Basic Cognitive Skills Provision of Social & Life Skills Training to Promote Social Competency & Resistance to Peer Influence Involvement of Youth in Decision Making & Exposure to the World of Community & Work Involvement of Parents through Home Visits, Provision of Services & Concern for their Basic Needs Staff Development for all Levels of Care Takers (teachers, social workers, case aides, etc.) to Understand Child & Adolescent Development & Cultural Differences

Prevention Principles for Community Programs A comprehensive prevention program includes components for the individual, the family, the school, the media, community organizations, and health providers. Media & Public Education strategies are used to increase public awareness, attract community support, reinforce school-based curriculum, and keep the public informed. Program components should be coordinated with other community efforts to reinforce prevention messages. Interventions should be designed to reach different at-risk populations. Programs should follow a structured plan that progresses from needs assessment through planning, implementation, and review. Objectives and activities should be specific, time-limited, feasible, and integrated to work together across program components.