1. PRACTICES AND INTERVENTIONS FOR PREVENTION OF ALCOHOL USE AMONG YOUNG PEOPLE IN EUROPE Presented by: Anna Markina University of Tartu

2. Authors: Gabriele Rocca, Alfredo Verde and Uberto Gatti University of Genoa Anna Markina and Kristjan Kask Universty of Tartu

3. Our task: To identify and select programs and interventions that have been evaluated and of which the effectiveness has been proved, with the intent of enabling politicians and policy-makers to discern which interventions are effective or promising in the field of prevention.

4. Definitions: Intervention is a goal-directed and systematic approach toward the prevention of alcohol carried out by various providers.

5. Definitions: Best practices in health promotion: “those sets of processes and actions that are consistent with health promotion values, theories, evidence and understanding of the environment, that are most likely to prevent alcohol use among juveniles.” Kahan & Goodstadt (2001)

6. Classification of preventionprograms (Mrazek & Haggerty 1994): Universal Selective Indicated

7. Focusing on the contexts and actors involved: Individual; Family; School; Community; Multi-component.

8. Methodology Step 1: partners from 25 European countries were required to make an inventory of meso (school and community) and micro (family and individual) initiatives in the field of prevention of alcohol use among juveniles in their countries.

9. Methodology Step 2: we asked national experts to propose two (or more, if available) “good” programs or interventions in their country as “best practice models” according to their competence and experience to be evaluated.

10. Methodology Step 3: three teams of the AAA- Prevent project (Italian, Estonian and Dutch team) independently evaluated these programs selected by national experts.

11. Inclusion criteria for the best practices: The interventions’ focus is primary and/or secondary level prevention; The interventions have been implemented and evaluated with positive outcomes and are described in published literature; Interventions show evidence of effectiveness in eliciting desired changes;

12. Inclusion criteria for the best practices: The intervention addresses alcohol use prevention among children under the age of 18; The intervention addresses one or more of the following domains: individual, school, family, community, multi-component.

13. Clustering of countries: Central Europe: Germany, Belgium, Netherlands, Austria and Switzerland; Nordic: Ireland, Finland, Sweden, Norway, Denmark and Iceland; Mediterranean: France, Spain, Italy, Portugal and Cyprus; Eastern European: Czech Republic, Poland, Hungary, Estonia, Lithuania, Slovenia, Bosnia, Armenia and Russia.

14. Evaluation of programs: 1 Theoretical background 1 (meets the criteria) 0 (does not meet the criteria) 2 Implementation 1 (meets the criteria) 0 (does not meet the criteria) 3 Outcome 1 (meets the criteria) 0 (does not meet the criteria)

15. Overall score 0..3 3 (meets our criteria) 2 (moderately meets our criteria) 1 (minimally meets our criteria) 0 (does not meet the criteria)

17. 391 programs among 24 European countries were evaluated

18. Individual level Program Risk factor/s targeted* Overal l score Country Skoll (Self- control training) Individual, peers 3Germany Supra-fIndividual, peers 3Switzerland

19. Family level Program Risk factor/s targeted* Overal l score Country Strengthening Families Program (SFP) Individual, family, peers 2Ireland Slovenia Triple Pfamily3 The Netherlands Örebro preventionsprogram (ÖPP) Family3Norway Sweden DedaloFamily2Spain

20. School level Program Risk factor/s targeted* Overal l score Country UnpluggedIndividual, family, peers3 Belgium, Italy, Lithuania, Slovenia To prevent is to live Individual, peers, school 2Spain Drug-Reason-Impact Individual, peers, school 3Czech R. Life Skills and Knowledge Individual, school, peers 2Hungary PDD-FM Individual, peers, school, family 3Poland KurzinterventionIndividual, peers3Swizerland I am OK when I say NO WAY Individual, peers3Denmark PAS Individual, family, school 3The Netherlands Social Skills TrainingIndividual, family, peers2Estonia

21. Community level Program Risk factor/s targeted* Overall score Country Prague 6 District Individual, peers, school, family 3Czech R. HaLT Individual, family, peers, neighbourhood 3Germany Don’t start too early Individual, family, peers 2Belgium Local Alcohol Policy (PAKKA) Peers, neighbourhood 3Finland Responsible alcohol handling Peers, neighbourhood 3Norway STADs Responsible Beverage Service Peers, neighbourhood 3Sweden

22. Multi-component Program Risk factor/s targeted* Overall score Country PES´P Andar (Feet for Walking) Individual, peers2Portugal Searching for Family Treasure Individual, family2 ODLOT Individual, family, peers, neighbourhood 2Poland Drug Policy at School Individual, school, peers 3Belgium A cool worldindividual2 ADSUME and EIindividual2Finland SnowballIndividual, peers2Lithuania

23. Conclusions The main aims the prevention are the delay of onset, consumption decrease and harm reduction. Prevention in school level is considered most frequently effective compared to other domains. It is therefore important to define school as an educative alcohol-free environment.

24. Conclusions Interaction between families (parents) and the youth seems to be a successful approach. Community organization can play an important role in alcohol prevention. It is recommended that local communities should be more actively integrated in the alcohol prevention.

25. Conclusions There is a lack of evidence in evaluation, so there is a need for increasing scientific research in the area of alcohol prevention methods. Limitation of funding for developing new alcohol prevention programs. Importance of networking in application of the programs.

26. Thank you for your attention! http://www.aaaprevent.eu/strategies