1. The Substance Abuse Prevention Specialist Training Prevention Research

2. Why study prevention research? “Evidence-based” prevention is the standard of accountability in the field Prevention theory assists in identifying what contributes to substance abuse and how it can be prevented Results depend on the quality of the research that guides prevention

3. What is “Evidence-based” Prevention? Based upon research meeting commonly agreed-upon criteria of rigor Guided by credible and substantiated research evaluation Principles, strategies and programs that are theory- driven, well implemented, and shown to have an effect on specific behaviors, or on specific risk factors that have been linked to them (SAMHSA’s Prevention Platform online glossary and CSAP’s Southwest CAPT Community Mobilization for Prevention online course glossary)

4. Why All the Concern Over Evidence-based Prevention? To use the most effective programs and strategies To improve existing programs To use limited resources wisely To ensure public accountability To meet requirements of federal and state agencies and private funders

5. What Should a Good Theory Do? Identify the factors that predict substance abuseIdentify the factors that predict substance abuse Explain the mechanisms through which they operateExplain the mechanisms through which they operate Identify the internal and external variables that influence these mechanisms, including cultural factorsIdentify the internal and external variables that influence these mechanisms, including cultural factors Predict points to interrupt the course leading to substance abusePredict points to interrupt the course leading to substance abuse Specify the interventions to prevent onset of substance abuseSpecify the interventions to prevent onset of substance abuse

6. Activity

7. Similar to public health model of disease prevention: focus on decreasing risk and increasing protectionSimilar to public health model of disease prevention: focus on decreasing risk and increasing protection Risk factors predict substance abuse and protective factors can buffer risk factorsRisk factors predict substance abuse and protective factors can buffer risk factors To prevent substance abuse, reduce risk factors and increase protective factors throughout an individual’s lifeTo prevent substance abuse, reduce risk factors and increase protective factors throughout an individual’s life Risk & Protective Factors Theory

8. Risk and protective factors: Can be influenced by individual, family, school, and environmental change strategiesCan be influenced by individual, family, school, and environmental change strategies Have a cumulative effectHave a cumulative effect Occur in communities, families, schools, and individuals and are subject to changeOccur in communities, families, schools, and individuals and are subject to change Risk & Protective Factors Theory

9. Different adolescent health and behavior problems share common risk factorsDifferent adolescent health and behavior problems share common risk factors –Substance Abuse –Delinquency –Teen Pregnancy –School Drop-out –Violence –Depression & Anxiety Risk & Protective Factors Theory

10. Multiple studiesMultiple studies LongitudinalLongitudinal PredictivePredictive Criteria for Inclusion as a Risk Factor

11. Community Risk Factors Availability of alcohol/other drugsAvailability of alcohol/other drugs Community laws and norms favorable toward drug useCommunity laws and norms favorable toward drug use Transitions and mobilityTransitions and mobility Low neighborhood attachment and community disorganizationLow neighborhood attachment and community disorganization Extreme economic deprivationExtreme economic deprivation

12. Risk Factors Adolescent Problem Behaviors Do- main Substance Abuse Depression & Anxiety Delin- quency Teen Preg. School Dropout Violence COMMUNITYCOMMUNITY Availability of alcohol/other drugs   Community laws and norms favorable to drug use    Transitions and mobility     Low neighborhood attachment and community disorganization   Extreme economic deprivation    

13. Family Risk Factors Family history of substance abuseFamily history of substance abuse Family management problemsFamily management problems Family conflictFamily conflict Parental attitudes and involvement in drug useParental attitudes and involvement in drug use

14. Risk Factors Adolescent Problem Behaviors Do- main Substance Abuse Depression & Anxiety Delin- quency Teen Preg. School Dropout Violence FAMILYFAMILY Family history of the problem behavior       Family management problems       Family conflict      Favorable parental attitudes and involvement in problem behaviors  

15. School Risk Factors Academic failure beginning in elementary schoolAcademic failure beginning in elementary school Lack of commitment to schoolLack of commitment to school

16. Risk Factors Adolescent Problem Behaviors Do- main Substance Abuse Depression & Anxiety Delin- quency Teen Preg. School Dropout Violence SCHOOLSCHOOL Academic failure beginning n late elementary school      Lack of commitment to school     

17. Individual/Peer Risk Factors Early and persistent antisocial behaviorEarly and persistent antisocial behavior RebelliousnessRebelliousness Friends who use drugsFriends who use drugs Favorable attitudes toward drugsFavorable attitudes toward drugs Early initiation of drug useEarly initiation of drug use Gang involvementGang involvement Constitutional factorsConstitutional factors

18. Risk Factors Adolescent Problem Behaviors Do- main Substance Abuse Depression & Anxiety Delin- quency Teen Preg. School Dropout Violence INDIVIDUALINDIVIDUAL Early and persistent antisocial behavior       Rebelliousness    Friends who engage in the problem behavior     Favorable attitudes toward the problem behavior  Gang involvement   Constitutional factors    

19. Protective Factors (community, family, school, peer) Individual characteristics Resilient temperament Positive social orientation Bonding Opportunities Skills Recognition Healthy beliefs and clear standards

20. The Social Development Strategy Healthy Beliefs & Clear Standards Bonding Attachment Commitment Healthy Behaviors Opportunities Skills Recognition Individual Characteristics

21. Activity Risk and Protective Factor Sculpture

22. Resiliency Approach Focuses on how children “bounce back” in the face of adversity Is based largely on the work of Emmy Werner Includes several factors which foster resilience in kids Is a “promising” approach

23. Developmental Assets Framework Emphasizes strengths in people Focuses on youth as resources, not problems Focuses on increasing the number of assets present in youths’ lives Is a “promising” framework

24. Community Family School Individual/Peer Other Adult Relationships Service to Others Creative Activities Youth Programs Youth as Resources Time at Home Parental Involvement Reading for Pleasure Homework Personal Power Cultural Competence Family Boundaries Interpersonal Competence Peaceful Conflict Resolution Planning & Decision Making Resistance Skills Community Values Youth Youth Given Useful Roles Caring School Climate High Expectations Neighborhood Boundaries Equality & Social Justice School Boundaries Integrity Honesty Responsibility Sense of Purpose Positive View of Personal Future Delays Gratification Overcomes Adversity Exhibits Leadership Resists Danger Succeeds in School Helps Others Values Diversity Maintains Good Health Caring Neighborhood Religious Community Adult Role Models Safety Family Support Positive Family Communication Bonding to School School Engagement Achievement Motivation Positive Peer Influence Personal Control Self-Esteem Restraint SkillsOpportunities Healthy Behaviors Healthy Beliefs & Clear Standards Individual Characteristics Recognition Bonding

25. Why study the media? The media play an important role in impacting people’s attitudes, perceptions, and behavior. The media can advance the prevention message by increasing awareness and helping gain support for prevention policies The Media and Prevention

26. The alcohol industry spends $1.5 billion on TV, radio and print advertising each year (Source: Children, Health and Advertising, 2002) The alcohol industry spends 3 times that much on collateral promotional advertising (Source: Federal Trade Commission) Annual tobacco industry marketing expenditures nationwide total $8.4 billion ($23 million per day!) (Source: Campaign for Tobacco Free Kids) The Big Business of Marketing

27. In 2002, 15 of the TV shows most popular with teens showed 5,085 alcohol ads at a cost of $53 million (Source: CAMY, 2002) Hispanic youth see 30% more alcohol advertising than non-Hispanic youth (Source: Exposure of Hispanic Youth to Alcohol Advertising Center on Alcohol Marketing and Youth, 2003) African-American youth see 60% more alcohol advertising than non-African-American youth (Source: Exposure of African-American Youth to Alcohol Advertising Center on Alcohol Marketing and Youth, 2003) Alcohol Advertising to Youth

28. Definition: The process of applying basic (commercial) marketing techniques to social issues in order to create behavior change (Kotler and Andreasen, 1987) Consumer-driven: The consumer (focus population) is the central focus for all steps of a social marketing campaign Social Marketing

29. Parents Empowered Campaign How did it come to be? –In response to the research collected from NIH about the devastating effects of alcohol on the developing brain. –A team of experts from around the state were invited to a national Summit on Underage Drinking to address the problem. In 2006 Utah State legislature appropriated funds to DABC to combat Underage Drinking.

30. Parents Empowered Campaign Partners Department of Education Utah Department of Public Safety Utah Council for Crime Prevention Utah Office of Ethnic Affairs Utah Attorney Generals Office Utah Juvenile Courts Valley Mental Health - Tooele Utah Substance Abuse and Anti-Violence Coalition Utah Parent Teacher Association Utah Department of Health Weber Human Services Salt Lake City Mayors Coalition Salt Lake City Police Department First Lady of Utah- Jeanette Herbert Four Corners Community Behavioral Health Northeastern Counseling Center Davis Helps Bear River Health Department ACE Disposal Inc. Associated Foods Stores (AFS) Fifty Studio Intermountain Healthcare Jerry Seiner: The GM Guy Larry H Miller Automotive (LHM) Mothers Against Drink Driving (MADD) O.C. Tanner The Power in You Time Dahle Automotive Utah Dental Association (UDA)

31. Parents Empowered Campaign

32. Three Case Studies in Prevention Select a facilitator, a timekeeper, and a recorder Read the case study assigned to your group Determine which risk factors and protective factors are at work in your case Report back to whole group

33. Case Studies Is there consensus on which risk factors were identified? Is there consensus on which protective factors were identified? How might our values and culture influence which factors we see present?

34. Caution! Purpose of this case study activity: –To begin using the risk factor and protective factor language –To see what risk and protective factors might look like in a community Risk and Protective Factors are identified in communities using a formal assessment –Section 3 presents a process for assessing the levels of risk and protective factors in communities –Data collection and analysis drives the process

35. QUESTIONS and DISCUSSION