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School-based & school-linked prevention of substance use problems

School-based & school-linked prevention of substance use problems. A knowledge summary. Method. Review of high quality research Searched 9 English databases (peer & grey lit) Needed to include substance-related measures Reviews from 1997 Primary studies from 2003

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School-based & school-linked prevention of substance use problems

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  1. School-based & school-linked prevention of substance use problems A knowledge summary School Health 2007, Vancouver, BC

  2. Method Review of high quality research • Searched 9 English databases (peer & grey lit) • Needed to include substance-related measures • Reviews from 1997 • Primary studies from 2003 • Particular attn to Cdn research

  3. Structure • National school health research issue agenda • Nature and extent of the problem • Relevant protective and risk factors • Effective approaches • Substance-related effects • Learning benefits • Cost effectiveness • Implementation issues • Special topics • Prevention among Aboriginal students • D.A.R.E. evaluation update

  4. Nature / extent of the problem • Hazardous patterns • Binge use: 22-36% past month • Use w/ • Driving (past yr): • Alcohol: 13-35% • Cannabis: 20-26% • Sex: 35% of those sexually active had unplanned sex • Tobacco use: 14-27% past yr • Frequent cannabis use : 3-5% report daily use • Multiple drug use: no info

  5. Protective/risk factors • Use vs problem-related factors • Spheres: Individual, Interpersonal, Cultural • Life stage, developmental perspective • Particular attn: school and broad, cultural factors • Adolescent-limited vs life-course deviance

  6. Evidence of effectiveness • Universal classroom education • Universal education to reduce hazardous use • Programs targeting higher risk students • Whole-school, comprehensive approach

  7. Universal classroom drug education • Levels: Elem, Middle & High school • Models: Social Influence & Life Skills • Factors that may affect outcomes • Delivery method • Teacher/leader qualities • Timing • Intensity / duration

  8. Universal education to reduce hazardous use Middle/high school: encouraging evidence • Hazardous use prevention vs harm reduction • SHAHRP program (Aust) • Nova Scotia research on acceptability

  9. Targeted programs for higher risk students • Elementary: good evidence • Montreal Longitudinal Experimental Study • Fast Track • Strengthening Families Program (school-linked) • Middle school: mixed evidence • Opening doors; Reconnecting youth • Aboriginal programming • Brief interventions

  10. Comprehensive, whole school approaches • Elementary: good evidence • Seattle social development project • Child development project • Middle/high school: encouraging evidence • Gatehouse project • School policies • Physical environment

  11. School-linked programs • Community programs: encouraging evidence • Project northlands • Universal family programs: good evidence • Iowa strengthening families program

  12. Learning benefits • Definite link but causal direction is unclear • Academic problems  substance use problems • Substance use problems academic problems • Bi-directional

  13. Cost effectiveness • Which costs to include? Which benefits? • Cost effectiveness has been found for: • Universal classroom drug education • Comprehensive elementary programming • Universal family programming • (Targeted early childhood)

  14. Observations to date • Continuous programming can work • Give research & programming attn to: • Universal: w/ hazardous use prevention • Targeted: elementary and brief intervention • Whole school: at all levels • Public health needs to re-examine its approach to working with schools/educators

  15. Thank you! School Health 2007, Vancouver, BC

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