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The Substance Abuse Prevention Specialist Training
Prevention ResearchPrevention ResearchPrevention ResearchPrevention Research
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Prevention ResearchPrevention Research
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
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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)
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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
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What Should a Good Theory Do?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 Identify the internal and external variables that influence these mechanisms, including cultural factorsinfluence these mechanisms, including cultural factors
• Predict points to interrupt the course leading to Predict points to interrupt the course leading to substance abusesubstance abuse
• Specify the interventions to prevent onset of substance Specify the interventions to prevent onset of substance abuseabuse
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Activity
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• Similar to public health model of disease prevention: Similar to public health model of disease prevention: focus on decreasing focus on decreasing riskrisk and increasing protection and increasing protection
• Risk factors predict substance abuse and protective Risk factors predict substance abuse and protective factors can buffer risk factorsfactors can buffer risk factors
• To prevent substance abuse, reduce risk factors and To prevent substance abuse, reduce risk factors and increase protective factors throughout an individual’s increase protective factors throughout an individual’s lifelife
Risk & Protective Factors TheoryRisk & Protective Factors Theory
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Risk and protective factors:Risk and protective factors:
• Can be influenced by individual, family, school, and Can be influenced by individual, family, school, and environmental change strategiesenvironmental change strategies
• Have a cumulative effectHave a cumulative effect
• Occur in communities, families, schools, and individuals Occur in communities, families, schools, and individuals and are subject to changeand are subject to change
Risk & Protective Factors TheoryRisk & Protective Factors Theory
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• Different adolescent health and behavior problems Different adolescent health and behavior problems share common risk factorsshare common risk factors– Substance AbuseSubstance Abuse
– DelinquencyDelinquency
– Teen PregnancyTeen Pregnancy
– School Drop-outSchool Drop-out
– ViolenceViolence
– Depression & AnxietyDepression & Anxiety
Risk & Protective Factors TheoryRisk & Protective Factors Theory
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• Multiple studiesMultiple studies
• LongitudinalLongitudinal
• PredictivePredictive
Criteria for Inclusion Criteria for Inclusion as a Risk Factoras a Risk Factor
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Community Risk FactorsCommunity Risk Factors
• Availability of alcohol/other drugsAvailability of alcohol/other drugs
• Community laws and norms Community laws and norms favorable toward drug usefavorable toward drug use
• Transitions and mobilityTransitions and mobility
• Low neighborhood attachment and community Low neighborhood attachment and community disorganizationdisorganization
• Extreme economic deprivationExtreme economic deprivation
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Risk FactorsAdolescent
Problem BehaviorsDo-
mainSubstance
AbuseDepression & Anxiety
Delin-quency
Teen Preg.
School Dropout
Violence
COMMUNITY
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
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Family Risk FactorsFamily Risk Factors
• Family history of substance abuseFamily history of substance abuse
• Family management problemsFamily management problems
• Family conflictFamily conflict
• Parental attitudes and Parental attitudes and involvement in drug useinvolvement in drug use
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Risk FactorsAdolescent
Problem Behaviors
Do-main
Substance Abuse
Depression & Anxiety
Delin-quency
Teen Preg.
School Dropout
Violence
FAMILY
Family history of the problem behavior
Family management problems
Family conflict
Favorable parental attitudes and involvement in problem behaviors
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School Risk FactorsSchool Risk Factors
• Academic failure beginning in elementary schoolAcademic failure beginning in elementary school
• Lack of commitment to schoolLack of commitment to school
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Risk FactorsAdolescent
Problem Behaviors
Do-main
Substance Abuse
Depression & Anxiety
Delin-quency
Teen Preg.
School Dropout
Violence
SCHOOL
Academic failure beginning n late elementary school
Lack of commitment to school
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Individual/Peer Individual/Peer Risk FactorsRisk 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
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Risk FactorsAdolescent
Problem Behaviors
Do-main
Substance Abuse
Depression & Anxiety
Delin-quency
Teen Preg.
School Dropout
Violence
INDIVIDUAL
Early and persistent antisocial behavior
Rebelliousness
Friends who engage in the problem behavior
Favorable attitudes toward the problem behavior
Gang involvement
Constitutional factors
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Protective FactorsProtective Factors(community, family, school, peer)(community, family, school, peer)
• Individual characteristics
•Resilient temperament
•Positive social orientation
• Bonding
•Opportunities
•Skills
•Recognition
• Healthy beliefs and clear standards
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The Social Development Strategy
Healthy Beliefs&
Clear Standards
Bonding• Attachment
• Commitment
Healthy Behaviors
Opportunities Skills Recognition
IndividualCharacteristics
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Resiliency ApproachResiliency 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
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Developmental AssetsDevelopmental AssetsFrameworkFramework
• 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
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Community
Family School
Individual/Peer
Other Adult RelationshipsOther Adult RelationshipsService to OthersService to Others
Creative ActivitiesCreative ActivitiesYouth ProgramsYouth Programs
Youth as ResourcesYouth as ResourcesTime at HomeTime at Home
Parental InvolvementParental InvolvementReading for PleasureReading for Pleasure
Homework Homework
Personal PowerPersonal PowerCultural CompetenceCultural Competence
Family BoundariesFamily BoundariesInterpersonal CompetenceInterpersonal Competence
Peaceful Conflict ResolutionPeaceful Conflict ResolutionPlanning & Decision MakingPlanning & Decision Making
Resistance SkillsResistance Skills
Community Values YouthCommunity Values YouthYouth Given Useful RolesYouth Given Useful Roles
Caring School ClimateCaring School ClimateHigh ExpectationsHigh Expectations
Neighborhood BoundariesNeighborhood BoundariesEquality & Social JusticeEquality & Social Justice
School BoundariesSchool BoundariesIntegrityIntegrity
Honesty Honesty ResponsibilityResponsibility
Sense of PurposeSense of PurposePositive View of Positive View of Personal FuturePersonal Future
Delays GratificationDelays GratificationOvercomes AdversityOvercomes AdversityExhibits LeadershipExhibits Leadership
Resists DangerResists Danger
Succeeds in SchoolSucceeds in SchoolHelps OthersHelps Others
Values DiversityValues DiversityMaintains Good HealthMaintains Good Health
Caring NeighborhoodCaring NeighborhoodReligious CommunityReligious Community
Adult Role ModelsAdult Role ModelsSafetySafety Family SupportFamily Support
Positive Family Positive Family CommunicationCommunication
Bonding to SchoolBonding to SchoolSchool EngagementSchool Engagement
Achievement MotivationAchievement Motivation
Positive Peer InfluencePositive Peer Influence
Personal Control Self-EsteemPersonal Control Self-EsteemRestraintRestraint
SkillsOpportunities
Healthy Behaviors
Healthy Beliefs &Clear Standards
Individual Characteristics
Recognition
Bonding
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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 PreventionThe Media and Prevention
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• The alcohol industry spends $1.5 billion on TV, radio and print advertising each year(Source: Children, Health and Advertising, 2002) (Source: Children, Health and Advertising, 2002)
• The alcohol industry spends 3 times that much on collateral promotional advertising(Source: Federal Trade Commission)(Source: Federal Trade Commission)
• Annual tobacco industry marketing expenditures nationwide total $8.4 billion ($23 million per day!) (Source: Campaign for Tobacco Free Kids)(Source: Campaign for Tobacco Free Kids)
The Big Business The Big Business of Marketingof Marketing
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• 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 YouthAlcohol Advertising to Youth
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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 MarketingSocial Marketing
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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.
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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)
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Parents Empowered Campaign
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Three Case Studies in PreventionThree 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
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Case StudiesCase 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?
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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
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QUESTIONS and DISCUSSIONQUESTIONS and DISCUSSIONQUESTIONS and DISCUSSIONQUESTIONS and DISCUSSION