1. Promoting the bilateral relations and analyzing the Icelandic model for prevention Contract № BG 01-002/12.06.2015 Supported by the Fund for Bilateral Relations at National Level for Bulgaria under the EEA FM and NFM 2009-2014 www.eeagrants.org Conference Analyzing the Icelandic model for prevention addictions among children and adolescents and promoting the bilateral relations 02.02.2016 Grand Hotel Bulgaria

2. Promoting the bilateral relations and analyzing the Icelandic model for prevention Contract № BG 01-002/12.06.2015 Supported by the Fund for Bilateral Relations at National Level for Bulgaria under the EEA FM and NFM 2009-2014 www.eeagrants.org “Evidence Based Primary Prevention – The Icelandic Model” Jón Sigfússon 02.02.2016 Grand Hotel Bulgaria

3. Substance use decrease amongst 15-16 year old adolescents

4. Substance Use Amongst European Youth (ESPAD, 2011)

5. Structure of presentation 1.The role of research in prevention work 2.Background of the prevention model 3.Methodology, characteristics and emphasis 4.Actions in regard to primary prevention

6. The role of research

7. Prevention work must be evidence based! If we do not than we are steering blind!

8. ICSRA specialization Research in three age groups: 10 to 13 year old in primary school 14 to 16 year old in primary school 16 to 20 year old in high school / junior college

9. ICSRA database 1992 - 2015 Twenty two data collections amongst 15-16 year old pupils since 1992

10. Indicators Health status indicators, anxiety, depressive symptoms, physical health status, lifestyle and leisure time activities, local community networks, negative life events and strain, parents and family, peer group economic and psychological issues, studies and school, substance use, values and attitudes, violence and delinquency, and more…

11. The twofold use of research 1. Scientific 2. Practical

12. The scientific role of research 1.In depth analysis of the data 2.50 peer reviewed papers past 5 years 3.Publications in journals in Europe and USA 4.Science forms the platform for practice

13. The practical role of research 1.Data collections on substance use every year 2.Practical descriptive reports within 2-3 months of each data collection to the municipalities 3.School reports to the schools 4.Local information INTO all levels of prevention work is a KEY issue

14. Importance of frequent measuring Every school, every parent, every prevention worker can see the current situation in their close community and can act accordingly. Not 2-3 years later but almost immediately

15. Children's rights 1.Children have the right to have a say about what they want, what they do and how they feel 2.We have the obligation to make good use of what they tell us, react and constantly try to make their lives better.

16. Prevention approach background

17. Upward trend 1992 - 1998

18. 1998 At this point of time research had already showed us that certain circumstances and behaviour in the lives of adolescents were strongly connected with use We tried to establish the risk and protective factors

19. The main risk and protective factors Family factors Peer group effect General well being Extracurricular activities, sports

20. And analysing deeper Family factors Peer group effect General well being Extracurricular activities, sports Time spent with parents Support Monitoring Control Positive and negative effects. How we as parents approach the peer group Staying outside late Hanging out in malls Inside and outside of school, at home, bullying e.t.c. Organized activities vs. unorganized

21. 1998 Drug-free Iceland Based on these findings a research based action plan was initiated by the government with the aim to try out a totally new methodology in substance use prevention Obviously, what had been done before, was not working

22. Aim of Drug-free Iceland To change the actual behaviour of youth and not only their attitudes Change the life-style environment of our children so that they would be in lesser risk of substance use

23. The methodology

24. Our focus is primary prevention Primary prevention, preventing the development of substance use before it starts Secondary prevention, that refers to measures that detect substance use Tertiary prevention efforts that focus on people already abusing substances

25. Substance use follows cohorts Sigfusdottir et al., 2011, Global Health Promotion

26. Substance use follows cohorts Sigfusdottir et al., 2011, Global Health Promotion

27. What else would we tell the policy makers?

28. Percentage of girls in 9 th and 10 th grade who have become drunk in the last 30 days depending on how much time they spend with parents

29. Percentage of students in 9 th and 10 th grade who have become drunk in the last 30 days depending on if their friends become drunk one pr. month

30. Percentage of students in 9 th and 10 th grade who smoke daily depending on if they practice sports

31. Main actions: Based on research findings

32. Examples of local actions 1.Research as a basis in policy making and actions 2.Strengthen parent organizations and co-operation 3.Support extracurricular activities / sports 4.Support active NGOs’ 5.Support young people at risk inside schools 6.Form co-operative work groups against drugs 7.Anti smoking / drinking campaigns 8.Strengthen social capital

33. Examples of national actions 1.Legal age of adulthood raised from 16 to 18 years 2.Age limits to buy tobacco and alcohol (18 and 20) 3.Strict regulations for sellers of tobacco 4.A total advertising ban of tobacco and alcohol 5.Restricted access to buying alcohol and tobacco 6.Total visibility ban of tobacco and alcohol 7.Rules on outside hours for adolescents

34. Tobacco and chewing gum

35. Peanuts and Gin

36. The scientific isolation needed to be broken

37. The researchers “guru” approach

38. We needed to focus on close community How could an average figure on alcohol use in Sofia help prevention workers in Varna? “Average” doesn´t tell all the story. Local information within 2-3 months of data collection each year.

39. Every school can see where students stand Local figures for smoking in 33 gymnasiums (16-19 years old)

40. Local information fuels dialogue Dialogue between key stakeholders Politicians, municipalities and local authorities Parental groups and family planners School authorities and school workers Health educators, health and social services Leisure time workers, prevention workers Sports and youth institutions

41. The way we work now

42. And what is achieved?

43. Percentage of students in 9 th grade that participate in sports in a sports club four times per week or more Increased participation in organized sports

44. Percentage of students in 9 th and 10 th grade who spend time (often/almost always) with their parents during weekdays Time spent with parents

45. Percentage of students in 9 th and 10 th grade who have been out after 10 pm (3 times or more) in the past week

46. My parents know where I am in the evenings (applies very or rather well to me) 9 th and 10 th grade

47. …and substance use is going down

48. Youth in Europe until 2015

49. Thank you