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The School as a Prevention Setting—The Experience of Drug Abuse Prevention Zili Sloboda, Sc.D. Senior Research Associate Institute of Health and Social.

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Presentation on theme: "The School as a Prevention Setting—The Experience of Drug Abuse Prevention Zili Sloboda, Sc.D. Senior Research Associate Institute of Health and Social."— Presentation transcript:

1 The School as a Prevention Setting—The Experience of Drug Abuse Prevention Zili Sloboda, Sc.D. Senior Research Associate Institute of Health and Social Policy The University of Akron Tucson, Arizona October 20, 2008

2 The source for this presentation comes from Sloboda, Z., School Prevention, In: Leukefeld, C.G., Gullota, T.P.and Stanton- Tindall, M. (Eds.), Adolescent Substance Abuse Evidence-Based Approaches to Prevention and Treatment. Springer:New York, December 2008

3 Presentation Demonstrate the availability of effective drug abuse interventions for schools Demonstrate how these interventions take advantage of the protective environment of the school Summarize recommendations for school administrators arising from the drug abuse prevention research history to date

4 The Beginning of a New Era For Drug Abuse Prevention Up through the 1980s—federal moratorium on funding for drug abuse prevention research Experience of cardiovascular disease prevention—tobacco and community- based interventions

5 The New Era The late 1980s till today –Publication of outcomes of prevention programs with demonstrated effectiveness in key journals –The First National Institute on Drug Abuse Prevention Conference Dialogue between researchers and practitioners The “Red Book” (Preventing Drug Abuse among Children and Adolescents) –The establishment of the Society for Prevention Research and journal, Prevention Science –Recognition that prevention programming can be effective

6 The Science Base of Prevention Epidemiology Child development Health behaviors—sociology, psychology, economics Biology and neuroscience Intervention development Evaluation methodologies

7 Two Types of Epidemiologic Studies Contribute to Prevention Descriptive Analytic

8 Descriptive Studies Types of drugs used Relationship of ‘legal’ substances to ‘illegal’ substances Ages of initiation Trends in rates of use Characteristics of drug users


10 Analytic Studies Based on longitudinal studies following children and adolescents over time: –Identify origins and pathways to initiation of drug use –Factors associated with the continuation of use to abuse/dependence or non- continuation –Specify protective factors for vulnerable populations

11 Stancavage: Theory

12 Risk Factors: Early Childhood Early Childhood Factors have the longest potential impact as they may interfere with normal and successful development –Chaotic home environments –Ineffective parenting –Lack of mutual attachments and nurturing

13 Risk Factors Outside the Family Schools, Peers and Community Inappropriate shy and aggressive behavior in the classroom Failure in school performance and school bonding Poor social coping skills Affiliation with deviant peers Perceptions of approval of drug-using behaviors

14 Protective Factors For Vulnerable Populations Strong family bonds Parental monitoring—clear rules of conduct and involvement of parents in lives of children Success in school performance Strong bonds with prosocial institutions Adoption of conventional norms about substance use

15 Other Factors Influencing Drug Use Availability of alcohol, tobacco and drugs Trafficking patterns Beliefs that drug use is generally tolerated

16 What Have We Learned from the Epidemiologic Studies? Most children initiate tobacco, alcohol and illicit drug use between the ages of 13 and 16 There is about a 150% to 200% increase in the use of tobacco, alcohol and other drugs between grades 8 and 10 Risk to move on to marijuana has been estimated to be at least 3 times greater for persons who smoke or drink

17 What Have We Learned from the Epidemiologic Studies? Risk to move on to cocaine is estimated to be at least 75 times greater for persons who used marijuana The more risk factors someone has the greater likelihood to use substances. The process of becoming a drug user or abuser takes place over time

18 Applying Epidemiologic Findings To Prevention Introduce prevention programming PRIOR to ages of initiation Target alcohol, tobacco and marijuana and other substances Reinforce prevention messages at the ‘At Risk’ years As the process of becoming a drug user takes place over time, prevention interventions must take place across time also!

19 Applying Knowledge to Prevention Programming to School Settings

20 The School As A Prevention Setting Where children in the United States spend a great proportion of their time. The school remains a major socialization institution to reinforce societal values, norms, and acceptable behaviors. The school is a protective environment for children where they should feel safe.

21 The School Environment And Prevention Strategies School culture—norms, beliefs and expectancies School bonding—classroom behavior and academic performance Classroom curriculum School policy—social control

22 School Culture Common elements or principles: –Creating anti-/non-drug using (tobacco and alcohol also) normative setting –Dispelling misconceptions regarding expectancies associated with use of tobacco, alcohol and drugs –Comprehensive programs involving students, school administration and, when appropriate, parents/caregivers.

23 School Culture: Examples Child Development Project--Schaps Challenging College Alcohol Abuse-- Johannessen

24 Findings from the Child Development Project Prevalence of alcohol use declined 11% over 4 years compared to 2% in matched comparison schools Prevalence of marijuana use declined by 2% compared to a 2% increase in matched comparison schools Prevalence of cigarette use declined by 8% compared with a 3% decline in matched comparison schools

25 School Bonding Common elements or principals: –Focus is on early years, pre-school to middle school –Enhance competency in reading and math –Provide interpersonal skills to relate positively with peers and adults –Involvement of parents in communication/parenting skills and in school activities

26 School Bonding: Examples Seattle Social Development Program- -Hawkins Incredible Years—Webster-Stratton Early Risers Skills for Success-- August

27 Seattle Social Development Program: Observed Mean Level of School Bonding by Age


29 Seattle Social Development Program Heavy Alcohol Use at Age 18

30 Early Risers Skills for Success

31 Classroom Curriculum— Universal/Selected Programs Common elements: –Dispel misconceptions regarding normative nature of substance use and expectancies –Impact perceptions of risks associated with substance use as children and adolescents –Provide resistance skills to refuse use of tobacco, alcohol and illicit drugs –Provided over multiple years—middle school and high school

32 Universal School Curricula: Examples Life Skills Training--Botvin Project Alert--Ellickson Project STAR--Pentz

33 Findings from 4 Follow-up Studies of Life Skills Training




37 Classroom Curriculum— Indicated Programs Common Elements or Principles: –Identify students at high risk for substance abuse or other associated behavior –Provide self-control, communications and decision-making skills –Self-esteem/competency enhancement –Create positive peer support

38 Indicated School Curricula: Examples Reconnecting Youth—Eggert Project Towards No Drug Abuse— Sussman Project SUCCESS--Morehouse

39 Reconnecting Youth

40 Other Findings (7 months post intervention) Compared to students not participating in RY: –18% improvement in grades in all classes –7.5% increase in credits earned per semester –54% decrease in “hard” drug use –48% decrease in anger and aggression problems –32% decline in perceived stress –23% increase in self-efficacy –33% reported ending alcohol use

41 Project Toward No Drug Use

42 School Policy Common elements or principles, to be effective: –Infractions among students handled positively with counseling NOT suspension/expulsion –Should be tied to other prevention activities

43 School Policies: Examples No substance use on school properties Set aside areas for smoking Drug Free Zones discouraging use and sales Reducing or eliminating access to and availability of tobacco, alcohol or other drugs. Addressing infractions of policies with positive sanctions by providing counseling or treatment and special services to the students rather than punishing them through suspension or expulsion.

44 Drug Testing 1995--the United States Supreme Court upheld a school’s right to conduct random drug tests of student athletes without any suspicion of use of drugs 2002--the Supreme Court carried this decision further by upholding school districts’ rights to extend testing to students participating in other extracurricular activities

45 Effectiveness of DrugTesting Only one randomize, longitudinal study has been conducted –No differences between control and experimental students on past month drug use –Authors conclude drug testing is not an effective deterrent to drug use and actually may increase the risk for future substance use Goldberg, L., Elliot, D.L., MacKinnon, D.P., Moe, E.L., Kuehl, K.S., Yoon, M., Taylor, A., & Williams, J. (2007). Outcomes of a prospective trial of student- athlete drug testing: the Student Athlete Testing Using Random Notification (SATURN) study. Journal of Adolescent Health, 41(5): 421-429.Goldberg, LElliot, D.LMacKinnon, D.PMoe, E.LKuehl, K.SYoon, MTaylor, AWilliams, J

46 Alternatives to Drug Testing Screening for at-risk students –Examples: Drug Use Screening Inventory Problem Oriented Screening Inventory for Teenagers Personal Experience Screening Questionnaire

47 IF YOU SCREEN… WARNING!!! –Have a plan in place for handling students found positive That includes the family That includes counseling That includes follow-up

48 Focus on Other Types of Prevention Programs Family Relationships: Teach parents skills for better family communications, discipline, firm and consistent rule making, get to know friends, understand problems and concerns

49 Other Types of Prevention Programs Peer Relationships: Develop social competency skills for improved communications, enhancement of positive peer relationships and social behaviors and resistance skills to refuse substances

50 Other Types of Prevention Programs The Community Environment: Enhance anti-substance use norms and prosocial behavior through policy or regulations, mass media efforts, community-wide awareness programs; new laws and enforcement, advertising restrictions; drug free school zones.

51 Recommendations Substance use is not the sole problem of the school Prevention is a process that takes place across the lifespan Interactive programs are more effective for middle school rather than high school students Prevention programs should address multiple substances Implementation fidelity is one of the great challenges The field of drug abuse prevention is relatively new

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