1. Opportunities for positive approaches to reducing underage drinking Dr Lisa Buckley

2. Overview Alcohol experiences among teenagers Protective factors Key design issues Example: a school-based program, Skills for Preventing Injury in Youth

3. Alcohol and underage use National picture

4. Alcohol and underage use Year 9s (n=661, mean age=13.6 years) in past 6 months –11% injured in a situation where they were also drinking Drunk alcohol (males - 41%, females – 38%) Drunk alcohol and vomited/ passed out (males - 6%, females – 5%)

5. Beliefs Family Friends Wider school & community Teachers

6. Skills for Preventing Injury in Youth (SPIY): Program goals  Reduce risk taking Interpersonal violence Transport related risks Alcohol use  Encourage adolescents to protect their friends  Increase first aid skills  Increase school connectedness

7. How is SPIY taught? Integrated with the curriculum Taught by teachers trained in program delivery and connectedness Year 9 Health Education approximately 1 school term Age-appropriate (research based 1 ) Personally, developmentally and culturally relevant Interactive discussions based on scenarios Practical exercises

8. 8 Why first aid? Emphasise that risk taking behaviour has serious injury consequences Make injury more realistic and meaningful Develop coping skills to minimise harm Emphasise the importance of getting help, even in risk-taking situations Integrate with Year 9 Health curriculum Provides job skills

9. Looking out for friends Prosocial behaviour is valued College students protect their friends from drink driving High school students intervene in their friend’s drinking, illegal drug use and smoking

10. Intervening Strategies: –“tell them the repercussions of it” –“you have to talk to your good friends” –“kind of watching the amount (he drinks)” –“take them away from the situation” –“go to the movies” Considerations: –“sometimes you have to be the bad guy. I get really nervous” –“you’ve gotta have a bit of confidence in yourself” –“you get a feeling that you get a bit more respect as well”

11. Parents Parental involvement General communication Parental modelling Limit access

12. Strategies used to encourage school connectedness among students ThemeExample quote Strength focus Everyone should have a little job, to teach that kid to do something, to get something positive out of them. Most kids disengaged from school are the kids who think they’re not worth anything. So try to engage them back into something Equity & fairness If a student has done something wrong, I would try to keep the relationship the same with them as it has always been and let them know that I still like them, it’s just their behaviour that I’m not keen on

13. Change in looking out for friends = significant change, baseline to follow up

14. Change in alcohol use

15. Change in injuries

16. Teachers comments: “The workbook was an attractive thing for us” “Kids like discussions, as I said, they like to bring their own experiences in” “They were quite happy to think oh yeah, probably not the world’s best move, so that was good” Student comments: Importance of getting an adult’s help, “if I was the only one there I would. But if there was someone older and more knowing about it, I'd leave it up to them and maybe go get help or something else” “To sacrifice 10 seconds of glory for, and like, say if you’ve broken your arm, you wouldn’t be able to do anything else that you wanted to do for a while.”

17. Key issues in intervention process design from the literature and focus groups with teachers... Interactive processes - needs to be engaging, interactive and non-traditional, employing a variety of stimulus Theory driven (e.g. cognitive-behavioural strategies) Teachers are appropriate with training - a “Professional Development” component is considered important including offering support ‘Dose’ – more than a single on-off lesson Must be integrated into the school curriculum. Some contents should be assessable. First aid may be appropriate. Socio-culturally and developmentally relevant (e.g., Botvin et al. 2003; Cuijpers, 2002; Ellickson, 2000; McBride, 2003; Perry et al., 2003; Sheehan et al., 1996; Shope et al., 2000) 1.5 Methodology and practical strategies

18. Any questions? Dr Lisa Buckley ld.buckley@qut.edu.au Ph. 3138 4638 Mark your Diaries! International Council on Alcohol, Drugs and Traffic Safety Conference (T2013) 26-29 August 2013, Brisbane