anneke bühler, ift münchen: expertise suchtprävention effectiveness of substance abuse prevention...

Anneke Bühler, IFT München: Expertise Suchtprävention

Effectiveness of substance abuse prevention

Dr. Anneke BühlerIFT Institut für Therapieforschung, München,

Germany

Pompidou Group Conference „Families, lifestyles and drugs – reaching families in prevention“, Porto,

Portugal 19-20 November 2007


Report on prevention of substance abuse (Bühler & Kröger, 2006)*

• Aim: up-to-date record of research results on substance abuse prevention

• Method: Systematic search and analysis of 49 high-quality reviews and meta-analyses

• Results: Evidence-based conclusions about effectiveness of preventive measures (avoidance, delay, or reduction of substance use behaviour)– status quo, mean , mainly US research

*in cooperation and with financial support of the BZgA


Strength of evidence rating

Conclusion is based on...

°°°°° meta-analyses including high-quality studies (M)

°°°° systematic review including high-quality studies (S)

°°° meta-analyses or systematic review including all types of studies

°° unsystematic review (U), expert interview (E) or best practice survey(BP)

° generalized empirical result which does not directly inform about or test the assumption

- contradictory body of evidence


Family

• Comprehensive family-oriented approaches (training with parents, children and whole families) have preventive effects on consumption behaviour (in relation to alcohol). °°°

• Measures to involve hard-to-reach families are successful. °°

• Preventive measures for pre-school children (aged 3-5 years) should be family orientated. °

M

S 3

U 1

E 1


School

• Interactive school-based programmes have preventive effects on consumption behaviour (for tobacco, alcohol, cannabis and other illegal drugs). °°°°° – Social influence model and life skills approach

• Non-interactive programmes are not effective: Information giving alone, affective education alone, value clarification and decision-making alone. °°°°°

M 6

S 5

U 4

E 1


Peers/Leisure time

• No aggregated information available in report• For selective approach

– Springer et al., 2004 : National Cross-Site Evaluation of High-Risk Youth Programs with 48 programs with over 10.500 youths at high risk

– Behavioral life skills and recreation focused programs are effective.(°°°°°)

M

S

U 2

E


Media campaigns

• Mass-media campaigns in combination with other components (school-based, community-based and national programmes) have preventive effects on consumption behaviour (in relation to tobacco). °°°

• Isolated mass-media campaigns have no preventive effects on consumption (of tobacco). °°°°

M

S 3

U 2

E


Community

Collaboration– Capacity building– Integrating services– Influencing policy

• Collaborative initiatives aimed at getting policies or regulations introduced are effective because of the effectiveness of policy measures.°°

M

S 1

U

E


Community

Multi-level approach– Measures in different settings (school, media, family,

community)

• Inconclusive:Multi-level projects have preventive effects on consumption behaviour. (pro: °°°°°; inconclusive: °°°°)

M 1

S 2

U 1

E 1


Policy and regulations

• Higher tobacco prices reduce the prevalence and quantity of tobacco consumption. °°°

• Isolated measures to prevent the sale of tobacco to young people under the legal age do not reduce consumption. °°°

M

S 6

U 2

E 1


Policy and regulations

• Raising the minimum legal drinking age reduces alcohol consumption. °°°°

• Higher ´full‘ alcohol prices (including indirect costs) have effects on alcohol consumption.°°


Selective prevention

• Selective prevention measures have preventive effects on consumption behaviour if they are implemented in the form of – school-based social-skills programmes or – mentoring programmes.°°°°°

– Behavioral life skills and recreation focused programs are effective.(°°°°°)

– Characteristics of effectiveness: • Life skills development content• Intense contact (>3h per week)• Connection-Building methods• Instrospection methods• Coherence of program theory


What can be learnt so far...

• Personal and environmental measures can be effective.

• Certain measures are ineffective.• Effective measures

– are based on a coherent program theory– include general and specific content– use interactive measures– have a certain intensity


Thank you!

anneke bühler, ift münchen: expertise suchtprävention effectiveness of substance abuse prevention...

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