1. Planning an improved prevention response up to early childhood Ms. Giovanna Campello UNODC Prevention, Treatment and Rehabilitation Section

2. Two aims Present the structure of this session and the following three sessions. Present additional material with regard to evidence- based interventions and policies targeting the prenatal, infancy and early childhood ages.

3. Structure of this and the three following sessions (1/2) Presentation – Summary of etiological issues with regard to the relevant age group – Present the characteristics that have been found to be associated with positive outcomes in the interventions and policies which have been found to have a positive indication of efficacy for the relevant age group Group work in your national groups (1) – Achieve an understanding of the situation: Drug use and substance abuse Vulnerability and resilience factor Existence, coverage and quality of interventions and policies

4. Structure of this and the three following sessions (2/2) Group work in your national groups (2) – Plan improvements in the national drug prevention response with regard to the relevant age group. Presentation of group work to plenary and discussion/ feedback – Two national delegations

5. Infancy and early childhood

6. Key developmental goals Development of safe attachment to caregivers Age-appropriate language skills, as well as other executive cognitive functions Self regulation Pro-social attitudes and skills

7. Key resilience factors Responsiveness to the environment and caregivers’ interactions Caregivers who are responsive Surroundings that provide stimulation Learning how to be effective in having needs met Easy to soothe Not temperamental

8. Vulnerability factors on the achievement of developmental goals

9. Evidence-based strategies

10. Characteristics of evidence-based strategies linked to positive outcomes (Mostly!)

11. Interventions targeting pregnant women with substance abuse disorders Characteristics associated with positive outcomes Provide integrated, evidence- based treatment services to pregnant women who suffer from substance disorders. Include treatment of concurrent mental health disorders. Include attachment-based parenting interventions.

12. Prenatal and infancy visitation Characteristics associated with positive outcomes Delivered by trained health workers Regular visits up to two years of age of the baby, at first every two weeks, then every months and less towards the end Provide basic parenting skills Support mothers to address a range of socio-economic issues (health, housing, employment, legal, etc.)

13. Early childhood education Characteristics associated with positive outcomes Improves the cognitive, social and language skills of children. Delivered by trained teachers. Provide support to families on other socio-economic issues.

14. Community-based multi-component initiatives Characteristics associated with positive outcomes Promote the implementation of evidence-based strategies. Promote work in a range of community settings (e.g. families, schools, workplace, etc.) Provide training and resources to the communities. Promote the involvement of universities to support the implementation of evidence-based programmes and their monitoring and evaluation. Support communities in the medium term (e.g. longer than a year).

15. Media campaigns Characteristics associated with positive outcomes Precisely identify the target group of the campaign. Based on a scientific theoretical basis. Based on formative research. Achieve adequate exposure of the target group for an adequate period of time. Connect to other existing drug prevention programmes. Target parents. Aim at changing cultural norms about substance abuse Aim at educating about the consequences of substance abuse Aim at suggesting strategies to avoid substance abuse

16. Media campaigns Characteristics associated with NO or negative outcomes Media campaigns that are badly designed or poorly resourced should be avoided as they can worsen the situation by making the target group resistant to or dismissive of other interventions and policies.

17. TASK 1 – The situation – 30’ (1/2) 1.1Identify factors of vulnerability and resilience in the age group under discussion in your country. 1.2List existing interventions and policies (from now referred to as ‘strategies’) targeting the age group under discussion, including their coverage.

18. TASK 1 – The situation – 30’ (1/2) 1.3 Review the quality of each existing strategy. Is the strategy: – a. Data driven? – b. Adhering to the characteristics described in the presentation and the Standards? – c. Based on a scientific theory of change? – d. Based on a protocol of activities that has been scientifically evaluated? – e. Including a monitoring component looking at reach (coverage) and fidelity of implementation? – f. Including an evaluation component scientifically assessing the impact in terms of prevented substance abuse?

19. Task 2 – The plan – 30’ Discuss what could be priorities for improvement of the drug prevention response with regard to this age group. – Examples of possible issues to be addressed: coverage, evaluation, characteristics, new evidence-based strategy, vulnerability or resilience factor that needs to be addressed. 2.2Formulate the most important priorities as objectives/ outcomes, including (to the extent possible) indications of: – Dimension of target group – Timeframe (short, medium, long term) – (If you have time), activities