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School and community social influence programming for preventing tobacco and drug use: Evidence and implications for Public Health
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School and community social influence programming for preventing tobacco and drug use: Evidence and implications for Public Health

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Health Evidence hosted a 90 minute webinar on substance use prevention and treatment interventions in children and adolescents, funded by the Canadian Centre on Substance Abuse. This webinar presented …

Health Evidence hosted a 90 minute webinar on substance use prevention and treatment interventions in children and adolescents, funded by the Canadian Centre on Substance Abuse. This webinar presented key messages and implications for practice.

This webinar focussed on interpreting the evidence in the following review, which synthesizes evidence related to social influence programming:

Skara, S. & Sussman, S. (2003). A review of 25 long-term adolescent tobacco and other drug use prevention program evaluations. Preventive Medicine (37) 451-474.

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  • 1. This webinar has been made possible with support from the Canadian Centre on Substance Abuse Welcome!School and community social influence programming forpreventing tobacco and drug use: Evidence andimplications for public health You will be placed on hold until the webinar begins. The webinar will begin shortly, please remain on the line.
  • 2. Participant Side Panel in WebEx HousekeepingUse Q&A to post comments/questions during the webinar •‘Send’ questions to All (not privately to ‘Host’)Connection issues •Recommend using a wired Internet connection (vs. wireless), to help Q&A prevent connection challenges WebEx 24/7 help line: 1-866-229-3239
  • 3. The Health Evidence Team Kara DeCorby Heather Husson Robyn Traynor Managing Director Project Manager Research CoordinatorMaureen DobbinsScientific DirectorTel: 905 525-9140 ext 22481E-mail: dobbinsm@mcmaster.ca Lori Greco Yaso Gowrinathan Knowledge Broker Research Assistant/Coordinator
  • 4. What is www.healthevidence.org? Evidence inform Decision Making
  • 5. Why use www.healthevidence.org?1. Saves you time2. Relevant & current evidence3. Transparent process4. Supports for EIDM available5. Easy to use
  • 6. Canadian Centre onSubstance AbuseProject
  • 7. About CCSA • National non-profit organization; ~ 50 staff • Vision: All Canadians should live in a healthy society, free of alcohol and drugs-related harm • Mission: Provide national leadership and advance solutions to address alcohol and other drug-related harm • Initiate change through partnerships and knowledgewww.ccsa.ca • www.cclt.ca 7
  • 8. What is CCSA’s SystemAction?• National knowledge exchange network of diverse networks across Canada• Facilitates exchange of research evidence to inform addictions related prevention and treatment practices• Public/private online space to share information and contacts• For more information, contact  Rod Olfert (rolfert@ccsa.ca), or  Rebecca Jesseman (rjesseman@ccsa.ca) 8
  • 9. A Model for Evidence-Informed Decision Making Client, community, Community political preferences Context Clinician expertise Research Resources evidenceAdapted with permission from National Collaborating Centre for Methods and Tools. (revised 2012). A Model for Evidence-Informed Decision-Making in Public Health. [fact sheet]. Retrieved fromhttp://www.nccmt.ca/pubs/FactSheet_EIDM_EN_WEB.pdf
  • 10. Evidence-Informed Decision Making1. Cultivate a culture of inquiry, critical thinking and evidence-based practice “culture”2. Ask a clear, focused, searchable question3. Search for the best available evidence4. Critically appraise the relevant evidence
  • 11. Evidence-Informed Decision Making5. Integrate the evidence with expertise and clientpreference6. Evaluate the outcome(s) of the change in practice orpolicy7. Engage in knowledge exchange
  • 12. Importance of this Review• Canadian youth are the highest users of marijuana world wide• Using strong quality evidence to understand what works in prevention for tobacco and drug use• Examining the long-term effectiveness of social influence programs for adolescent substance use
  • 13. ReviewSkara, S. & Sussman, S. (2003). A review of 25 long-term adolescent tobacco and other drug useprevention program evaluations. Preventive Medicine(37) 451-474.
  • 14. Who has heard of a PICO(T) question before? 1. Yes 2. No
  • 15. Searchable Questions – Does it work Think “PICOS” 1. Population (situation) 2. Intervention (exposure) 3. Comparison (other group) 4. Outcomes 5. Setting
  • 16. Summary Statement: Skara (2003)P adolescents 12-15, and 16-19, in the transition period between junior high and high schoolI school or community social influence programming for the prevention of tobacco and drug useC other intervention or usual careO primary outcomes: long-term tobacco use, smoking initiation; secondary outcomes: alcohol and marijuana useQuality Rating: 8 (strong)
  • 17. Social Influences Programming• Not defined explicitly in the review itself.• Working definition: Social influences programming increases the awareness of the social influences on substance-use behaviours-- family, peer, and media-- and provides normative information and skill instruction to resist such pressures.
  • 18. Overall ConsiderationsRelatively consistent findings for social influence programming, mainly delivered in schools, to reduce both tobacco use rates and other drug use (marijuana, alcohol) in adolescents 12-19, in transition period between junior high and high school in the long term (from 2 to 15 years).Interventions which either offered booster sessions or programming over longer time frames appeared to enhance maintenance of program effects at least to end of studyThe school setting offers good potential to address tobacco, marijuana, and alcohol use reduction
  • 19. General ImplicationsPublic health should promote/support/implement:Social influence programming for adolescents 12-19, to reduce BOTH tobacco and other drug use (marijuana, alcohol) in the long term (at least 24 months and beyond).Either booster sessions or curriculum delivered over a longer time frame, for long-term maintenance of program effects
  • 20. What’s the evidence - Outcomes reported in the reviewTobacco use (total 25 studies, 17 of which assessed outcomes via difference in % smoking between intervention and control groups from baseline to follow up)Other drug use – alcohol & marijuana (9 studies providing long-term data)
  • 21. What’s the evidence - Tobacco UseTobacco use (total 25 studies, 17 of which assessed outcomes via difference in % smoking between intervention and control groups from baseline to follow up) • 15 of 25 studies reported at least one long-term (at least 2 years) positive effect (reductions in ever, daily, weekly, or monthly smoking) • 11 of 17 studies that reported tobacco use from baseline to follow up found 11.4% lower smoking rates (range 9-14%) from intervention group and control group • Of studies specifying booster sessions or programming delivered over two- year time frames (total 14 studies), 57% maintained long-term reductions in use by the end of study
  • 22. What’s the evidence - Alcohol & Marijuana UseAlcohol & Marijuana Use (9 studies with long-term data) • 8 of 9 studies reported initial or interim positive impact for follow up periods ranging 3 months to 5 years. For 6 of these 8 projects, maintenance effects persisted the entire duration of the project. • Studies calculating % reduction in use rates from baseline to follow up found a long-term reduction ranging from 6.9-11.7% for weekly alcohol use (2 studies) and 5.7% reduction for 30-day marijuana use (1 study) • Of 7 studies specifying booster sessions, 5 of 7 studies maintained long-term reductions in use by the end of study
  • 23. General ImplicationsPublic health should promote/support/implement:Social influence programming for adolescents 12-19, to reduce BOTH tobacco and other drug use (marijuana, alcohol) in the long term (at least 24 months and beyond).Either booster sessions or curriculum delivered over a longer time frame, for long-term maintenance of program effects
  • 24. Questions?
  • 25. Contact Usinfo@healthevidence.org

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