1. Enhancing School Prevention Partnerships by Micki Fuhrman, CPC, Regional School Health Coordinator
When you are seriously hungry, which do you want to use to most quickly and efficiently get the food into your mouth? You need something that will do the job!

2. Who’s in the room?
Name
Role

3. Comprehensive Prevention:
What comes to mind when you think of “Comprehensive”?
What would be the opposite?
What are the advantages and disadvantages fo each?

4. Adapted Health Belief Model Behaviors Knowledge Skills Self-Efficacy
The most important predictors of current and future health status
Adapted Health
Belief Model
Behaviors
Abilities to act in healthy way
Facts to make responsible decisions
Understanding severity
Risks and benefits
Knowledge
Skills
Belief that one can use the skills to change life
Self-Efficacy
There are many theories of behavior change, such as the Social Cognitive Theory, Social Influence Theory, and Social Behavioral Theory. Michigan model has merged several theories into the Adapted Health Belief Model, which consists of 4 factors which contribute to behavior change: knowledge, skills, self-efficacy and environmental support. Behavior change is more likely to occur if these four factors are included. Knowledge: must have information such as risks, facts, related problems. Skills: person must understand practice and be able to use skills to promote the behavior. Self efficacy: person must believe he or she has the ability to succeed in changing behavior to impact their life Environmental support: The home, the school, peer group must support and encourage the newly changed behaviors for a person to use the knowledge and skills.
Environmental Support
Peers, school, home, community support and reinforcement for healthy behaviors

5. Environmental Support
Typical Practice
Behaviors
Knowledge
Skills
Does knowledge always change behavior? Does it change YOUR behavior? What are some ways we give students “knowledge” alone?
Self-Efficacy
Environmental Support

6. Adapted Health Belief Model Behaviors Knowledge Skills Self-Efficacy
Speaker talks about risks of using drugs
Students know effects and consequences of use
Comprehensive health curriculum with knowledge and skills
No tobacco use
No substance use
Delay use of alcohol until 21
The most important predictors of current and future health status
Behaviors
Facts to make responsible decisions
Understanding severity
Risks and benefits
Abilities to act in healthy way
Refusal skills
Communication skills (expressing what bothers you, I messages, problem solving and decision making
Knowing and doing “3 D’s for telling”
Comprehensive health curriculum
Knowledge
Skills
Self-Efficacy
School works with substance abuse coalitions for Safe Prom
Students participate in “Most Teens Don’t” Social Norming project
Schools promote substance abuse prevention with parents and families
Parent resource sheets
Healthy alternatives
Schools have restorative policies for student caught using, and have referrals to assessment and treatment
Belief that one can use the skills to change life
Here are some examples of comprehensive prevention efforts. If our desired behavior is no tobacco or drug use, here are the supporting building blocks.
Environmental Support
Students’ social emotional knowledge & skills increase confidence
Students empowered to say no with social norm training
Peers, school, home, community support and reinforcement for healthy behaviors

7. Stop and Process What surprised you? What validated what you know?
What are you wondering?

8. Be thinking about a prevention program you know about as we go through the discussion of “Effective” vs. “Ineffective” prevention strategies.
See how it measures.
Remember our goal is to never do harm.

9. Building on the Health Belief Model
Think of it as a puzzle—what pieces do you need to add to make a complete and comprehensive puzzle?
What works in Prevention?
Remember, our goal is changing (or maintaining) behavior.
How do we build skills, knowledge, self efficacy, and environmental support?

10. Effective prevention:
Include parent/caregiver for family focus
Enhance protective factors & reduce risk factors
Provide continuity and repeated reinforcement
Use interactive methods with trained teachers
Target gateway drugs
Promote refusal skills, anti-drug commitments, social competency
Tailor age-specific, developmentally appropriate, & culturally sensitive programs
Enhance school & family interventions with community campaigns and policy changes & address community drug problems
Enhancing protective factors includes social skills to reduce early aggression, and increasing bonding to school, problem solving, academic support—reducing risk factors, such as

11. What doesn’t work and why?
Affective only programs (self-esteem)
Testimonies of ex-users
Inconsistent messages (e.g. school has no use policy, but a beer tent fundraiser)
One-Shot programs (e.g. assemblies) guest speakers
Pre-packaged curricula used in isolation
Non-promotion of students to the next grade
Scare tactics, mild threats, dead days, crash cars
Listing and describing a menu of drugs
Information only programs about the negative effects of drugs

12. Coordinated School Health: Whole School, Whole Community, Whole Child

13. Coordinated School Health: Whole School, Whole Community, Whole Child

14. Stop and Process What surprised you? What validated what you know?
What are you wondering?

15. For connection to the Regional School Health Coordinator in your area, please visit:

16. National Health Education Standards (NHES)16

18. About Michigan Model Addresses Six CDC Risk factors
Developed in the 80’s by a group of stakeholders
On the NREPP list: Only comprehensive PreK-12th grade comprehensive health curriculum
Proven effective at increasing attitudes against use of alcohol and tobacco and reduced intent to use alcohol and tobacco and in attitudes
Results showed that students who received the Michigan Model for Health™ curriculum showed significant, positive changes compared to a randomized control group of students who did not receive the program. Specifically, students who received the Michigan Model for Health™ had:
better interpersonal communication skills, social emotional skills, and self-management skills;
improved pro-safety attitudes;
stronger drug and tobacco refusal skills;
less reported alcohol and tobacco use in the past 30 days; and
enhanced knowledge and skills in physical activity and nutrition
Health standards: core concepts, Analyzing influences, Accessing Information, Interpersonal communication, decision making and goal setting, self management, and advocacy

19. Michigan Model for Health™: Comprehensive Health for Pre-K through 12

20. UNIT K 1st 2nd 3rd 4th 5th 6th Alcohol, Tobacco, & Other Drugs
How to safely use over-the-counter and prescription medicines
Household products that can be dangerous
Rules for avoiding poisons
Trustworthy sources of information
Illicit drugs
Harmful chemicals in tobacco products
Dangers of secondhand smoke and ways to avoid or reduce exposure
Caffeine
Staying away from nicotine and alcohol
Saying “No” to secondhand smoke
Medicines and poisons
Negative effects of tobacco use
Tobacco and media
Alcohol and alcoholism
Positive influences
Refusal skills
 Dangers of secondhand smoke and ways to avoid or reduce exposure
Reasons individuals choose to drink or not to drink
Decisions about alcohol and other drug use impact family and friends
Family and friends influence alcohol and other drug use decisions
Influence of advertising
Dangers of inhalant use and how to avoid exposure
Influence of family and peers on drug use
Rules for safety around dangerous or unknown products
Effects of smoking tobacco, secondhand smoke, and use of spit tobacco
Advocate for someone to avoid tobacco use or quit using
Analyze tobacco advertisements
Effects of alcohol, especially on driving a vehicle
Impact of alcohol and tobacco use on friends and family
Ways to avoid riding with a driver who has been drinking and what to do if it can’t be avoided
Possible reasons people use or don’t use drugs
Negative health effects of drug use
Analysis of drug use data
Persuasion skills for encouraging others to stay drug free
Influence of family, society and peers on drug use
Impact of drug use on goals
School rules and laws related to tobacco
Valid resources for drug problems
Benefits of remaining drug free and making a drug-free commitment

21. Middle School High School & Other Drugs
Units
Middle School
High School
Alcohol, Tobacco,
& Other Drugs
Understand and apply the rules and laws related to alcohol and other drugs including over-the-counter and prescription medications.
Understand internal and external influences on behavior and social norms related to alcohol and other drugs.
Understand the potential health, social, and legal consequences of alcohol and other drug use and exposure.
Apply verbal and nonverbal communication skills, including refusal skills, to avoid drug use and enhance health.
Analyze situations for risk of alcohol and other drug use.
Apply knowledge and skills to protect oneself and others from alcohol and other drug use and exposure and to support others who are abstaining from or trying to quit using drugs.
Identify and locate reliable sources of information and assistance regarding alcohol and other drugs.
Apply skills to advocate for changes in the school environment that would increase safety.
Describe the short-term and long-term health consequences of alcohol, tobacco, and other drug use.
Clarify myths regarding the scope of alcohol, tobacco, and other drug use among adolescents.
Locate resources in one’s community and on the Internet for information and services regarding alcohol and tobacco use prevention and cessation; and assess the validity of these resources.
Apply strategies to access and get help for self or others.
Demonstrate skills to avoid tobacco exposure and avoid or resist using alcohol, tobacco, and other drugs.
Describe financial, political, social, and legal influences regarding alcohol, tobacco, and other drugs.
Analyze internal and external pressures to use alcohol, tobacco, and other drugs.
Apply decision-making and problem-solving steps to hypothetical problems related to alcohol, tobacco, and other drug use.
Demonstrate ways to support others who want to stop using alcohol or tobacco.
Advocate for ways schools and communities can promote a tobacco-free environment.
Present a persuasive solution to the problem of alcohol, tobacco, and other drug use among youth.

22. Michigan Model is responsive:
New Tobacco Prevention Module: infused e-ciggs, hookah
Opioid Misuse Prevention Infusion coming soon

23. Making the most of effective prevention:
Parent and family involvement
Family Homework assignments
Teacher resources
Opportunities to make examples relevant to your audience
Skills-based instruction: Explain, model, guided practice, personalize
Professional development for teachers
(highly qualified teachers who are certified to teach health)

24. How can you use this information?
Educate other stakeholders about best practices in prevention programs and strategies
Advocate, explain and, persuade as to why certain programs/strategies
are more effective
Implement programs and interventions that are more likely to be effective
and provide desired behavior change
Use as a tool when choosing programs or interventions

25. What would you do if……..
The Superintendent of your local school wants an assembly on the dangers of drug use.
You want to follow the principles of the Adapted Health Belief Model, so what recommendations would you make to change the assembly from a “stand alone” to a part of an effective prevention program?

26. Behaviors
Knowledge
Skills
Self-Efficacy
Environment

27. Form a group of two or three:
Brainstorm three actions you can take to work with the Superintendent
Develop a short conversation starter to use
Report out

28. Prevention isn’t funded as well as the industries, so we need to be clear, concise and effective.
We are the experts and can advocate for effective prevention programming in our schools and communities.
Micki Fuhrman, Regional School Health Coordinator and Prevention Consultant