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Hart13 ppt ch17

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(c) McGraw-Hill 2011

(c) McGraw-Hill 2011

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  • Image source: Centers for Disease Control and Prevention (Image Ch17_15CDCSmokingPoster2) Image source: Corbis Images (Image Ch17_12SmokingRefusal) Image source: The McGraw-Hill Companies, Inc./John Flournoy, photographer (Image Ch17_20CommunityMural1) Image source: © image100 Ltd (Image Ch17_05Classroom3)
  • Image source: Nick Koudis/Getty Images (Image Ch17_02RainbowDroplet)
  • Image source: Stockbyte/PunchStock (Image Ch17_03Classroom1)
  • Image source: BananaStock / JupiterImages (Image Ch17_07CollegeAlcohol)
  • Image source: The McGraw-Hill Companies, Inc./Lars A. Niki, photographer (Image Ch17_08TargetedMethPrevention)
  • Image source: © image100 Ltd (Image Ch17_04Classroom2)
  • Image source: Brand X Pictures/PunchStock (Image Ch17_09Police Badge)
  • Image source: © image100 Ltd (Image Ch17_05Classroom3)
  • Image source: Creatas/PunchStock (Image Ch17_10KidSport)
  • Image source: Imagesource/PictureQuest (Image Ch17_11TeenSmoker)
  • Image source: Royalty-Free/Corbis (Image Ch17_06Classroom4)
  • Image source: Corbis Images (Image Ch17_12SmokingRefusal)
  • Image source: Brand X Pictures/PunchStock (Image Ch17_13SchoolLocker)
  • Image source: Centers for Disease Control and Prevention (Image Ch17_16CDCSmokingPoster3)
  • Image source: Centers for Disease Control and Prevention (Image Ch17_14CDCSmokingPoster1)
  • Image source: Comstock/PictureQuest (Image Ch17_17AdolescentPeers)
  • Image source: Kerry-Edwards 2004, Inc./Sharon Farmer, photographer (Ch17_19CommunityService)
  • Image source: BananaStock/PunchStock (Image Ch17_18ParentTeen); Simon Marcus/Corbis (Image Ch17_01MotherDaughter)
  • Image source: The McGraw-Hill Companies, Inc./John Flournoy, photographer (Image Ch17_21CommunityMural2)
  • Image source: The McGraw-Hill Companies, Inc./John Flournoy, photographer (Image Ch17_20CommunityMural1)
  • Image source: Spike Mafford/Getty Images (See Chapter 3; Image Ch03_16DrugTesting)
  • Image source: Centers for Disease Control and Prevention (Image Ch17_15CDCSmokingPoster2) Image source: Corbis Images (Image Ch17_12SmokingRefusal) Image source: The McGraw-Hill Companies, Inc./John Flournoy, photographer (Image Ch17_20CommunityMural1) Image source: © image100 Ltd (Image Ch17_05Classroom3)
  • Transcript

    • 1. Chapter 17 Preventing Substance Abuse© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 2. Society’s Attempts to Limit Drug Availability  Key facts  As long as there is a market for drugs, there will be people to supply them  To attack the source of the problem, the demand for drugs must be eliminated  Drugs will never disappear, so people need to learn to live in a world that includes them  Our society has accepted the continued existence of tobacco and alcohol despite the harm they cause  Is it possible to teach people to coexist with legal and illegal substances that can impair their health?© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 3. Defining Goals and Evaluating Outcomes  Goal of presenting negative information about drugs in schools = prevention of use  Programs should be evaluated according to how many students in the program later tried drugs  Until the early 1970s, most drug prevention programs were not evaluated© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 4. Types of Prevention  Public health model: primary, secondary, and tertiary prevention  Primary prevention  Aimed at young people who have not yet tried the substances in question  May encourage abstinence and help teach people how to view the potential influence of drugs on their lives, emotions, and social relationships  Must avoid giving information in ways that arouses children’s curiosity and encourages them to try the substances in question© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 5. Types of Prevention  Secondary prevention  Aimed at people who have experimented with drugs but who typically aren’t suffering serious consequences from drug use  Many college students fall into this category  Goals  Prevention of use of other, more dangerous substances  Prevention of more dangerous forms of use  Example = college programs encouraging responsible use of alcohol© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 6. Types of Prevention  Tertiary prevention  Aimed at people have been through substance abuse treatment or who stopped using a drug on their own  Goal is relapse prevention© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 7. Types of Prevention  Institute of Medicine’s “continuum of care”  Prevention  Treatment  Maintenance  Classification scheme for prevention efforts  Universal prevention  Selective prevention  Indicated prevention© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 8. Types of Prevention  Universal prevention = for an entire population  Example: community, school  Selective prevention = for high-risk groups within a population  Example: students doing poorly in school  Indicated prevention = for individuals who show signs of developing problems  Example: adult arrested for a first offense of driving under the influence of alcohol© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 9. Drugs in the Media  Don’t be a Patsy Advertisement Campaign  The ads showed an over-protective mother “patting down” her daughter before she left the house.  The ad ended with “Don’t be a Patsy. Learn a better way at drugfree.org.”  The advertisements are a shift from the 1980s “This is your brain on drugs ads, which overstated the harmful effects of drugs on young people.  These types of embellishments decrease the credibility of drug educators and lead young people to reject all drug-related information from so-call informed sources.© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 10. Prevention Programs in Schools  Knowledge-attitudes- behavior model  Affective education  Anti-drug norms  Social influence model  DARE and other programs in use© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 11. Knowledge-Attitudes-Behavior Model  Programs typically involve presentations by police and former users  Often include traditional scare tactics and/or pharmacological information  Approach assumes that increasing student knowledge about drugs will change their attitudes and that these changed attitudes will be reflected in decreased drug-using behavior© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 12. Knowledge-Attitudes-Behavior Model  Model questioned by research findings  Students with more knowledge about drugs tend to have more positive attitudes about drug use  All early prevention approaches  Effective in increasing knowledge about drugs  Ineffective in altering attitudes or behavior  Concerns raised that drug education programs were actually teaching students about drugs that they otherwise wouldn’t have been exposed to© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 13. Knowledge-Attitudes-Behavior Model  Evaluation of effectiveness depends on program goals  Possible goals  No experimentation with drugs by students  Rational decisions about drugs by students  Research on early drug prevention education efforts  Students more likely to experiment with drugs  Students less likely to develop abuse problems  Does society view this as an appropriate goal?  Teaching students to make rational decision about their own drug use with the goal of reducing the overall harm produced by misuse and abuse© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 14. Affective Education  Affective domain focuses on emotions and attitudes, which may underlie some drug use  Students may use drugs for excitement or relaxation, for feelings of power or control, or in response to peer pressure  Drug use may be reduced by helping children  To know and express their feelings  To achieve altered emotional states without drugs  To feel valued and accepted© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 15. Affective Education  Values clarification: Teach students to recognize and express their own feelings and beliefs  Assumes students have factual information about drugs  What they lack is the ability to make appropriate decisions based on that information  Programs that teach generic decision-making skills may be appropriate in this approach  Students are taught to analyze and clarify their own values  Parents may not understand this approach as it may run contrary to the particular set of values that parents want their children to learn© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 16. Affective Education  Alternatives to drugs  Assumes that one reason young people take drugs is for the experience of altered states of consciousness  Teaches students other ways of obtaining a “high” such as relaxation exercises, meditation, vigorous exercise, or sports  Alternatives need to be realistic and tailored to particular audiences© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 17. Selected Suggested Alternatives to Drug Use Level of experience Motives Possible Alternatives Physical Relaxation Relaxation exercises Increased energy Athletics, dancing Sensory Stimulation Skydiving Magnify senses Sensory awareness training Interpersonal Gain acceptance Learn about social norms, find a group that “fits” Spiritual/mystical Develop spiritual insight Meditation© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 18. Affective Education  Personal and social skills  Assumes that personal and social problems are causes of drug use  Based on the known association of drug use with poor academic performance and lack of involvement in school activities  Teaches students communication skills and provides opportunities for successful interpersonal interaction  Examples  A group of students operates a school store  Older students tutor younger students© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 19. Anti-Drug Norms  1984 review of drug prevention programs  Most programs don’t contain an appropriate evaluation component  Few studies have demonstrated any success in terms of actual substance abuse prevention  Increased knowledge about drugs has virtually no impact on substance abuse  Affective education approaches appear too experiential and place too little emphasis on skills necessary to resist pressure to use drugs  Anti-drug norms programs were developed in part in response to these findings© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 20. Anti-Drug Norms  Refusal skills and pressure resistance strategies  Focus on teaching students to recognize and respond to peer pressure to use drugs  Presented within the broader context of self-assertion and social skills training© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 21. Anti-Drug Norms  Typical program  Film that demonstrates effective ways of responding  Follow-up student discussion  Practice with techniques presented in the film  Approach shown to be effective in reducing cigarette smoking among adolescents  Adapted for other drugs and behaviors© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 22. Anti-Drug Norms  Drug-free schools  1986: Government began providing direct aid to local school districts for drug-prevention activities  DOE recommended school policies designed to demonstrate that the school and community do not condone drug use or underage alcohol use  Examples of school policies  Locker searches  Ban on tobacco use on school grounds  Part of trend of teaching generally accepted values rather than the more “value-free” approach taken in the 1970s© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 23. Social Influence Model  Advantages of education research on smoking prevention programs directed at adolescents  Large enough proportion of adolescents smoke so that measurable behavior change is more easily detectable  Health consequences of smoking are so clear that there is a good community consensus that preventing smoking is an appropriate goal  Easy to verify self-reported use of tobacco through saliva tests© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 24. Social Influence Model  Many approaches to drug-abuse prevention have been tried with smoking behavior  Key lessons can be learned from research findings about these approaches  It is possible to design effective smoking prevention programs  Presenting information about the delayed consequences of smoking (e.g., lung cancer) is relatively ineffective  Presenting information on immediate effects (e.g., shortness of breath) is more effective© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 25. Social Influence Model  Five key elements of the social influence model 1. Training in refusal skills through films, discussion, and practice  Students taught ways to refuse without being negative as well as ways to be assertive and insist on the right to refuse 1. Public commitment such as making a public pledge© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 26. Social Influence Model 3. Countering advertising by inoculating children against it  Students taught to analyze and discover the hidden messages in ads and how these messages differ from the actual effects of smoking  Example: advertisements associating cigarette use with healthy young athletes© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 27. Social Influence Model 4. Normative education to teach students that they may overestimate the number of their peers who smoke  Countering the “everybody is doing it” attitude 4. Use of teen leaders to talk to younger students about cigarettes  Older students can explain that neither they nor their friends smoke and how they have dealt with others’ attempts to get them to smoke© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 28. Social Influence Model  Possible improvements by applying the cognitive development approach to smoking behavior  Don’t automatically assume that all students need training in social skills or refusal skills  Students make active, conscious decisions in preparation for trying smoking and becoming an occasional or regular user  Prevention programs might be different at each stage of cognitive development  Risk and protective factors reviewed in Chapter 1 have more influence on drug behavior than any information or education program devised© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 29. Drug Abuse Resistance Education (DARE)  Developed in 1983 in Los Angeles; spread to all states by the early 1990s  Widely accepted initially despite lack of studies supporting its effectiveness  Contains many components of earlier prevention models  Delivered by trained, uniformed police officers  Includes elements of social influence model  Refusal skills, teen leaders, and public commitment  Includes elements of affective education  Self-esteem building, alternatives to drug use, decision making© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 30. Drug Abuse Resistance Education (DARE)  Studies on effectiveness of DARE  1994: Program shown to affect self-esteem but no evidence for long-term reduction in drug use  1994: Program shown to increase knowledge about drugs and knowledge about social skills, but the effects on drug use were marginal  2004: Review of earlier studies showed program effect is small and not statistically significant  Despite failure to demonstrate a significant impact of the DARE program on drug use, it continues to be widely used© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 31. Programs That Work  Some programs have been demonstrated to have beneficial effects on actual drug use  ALERT: Based on social influence model  Cigarette experimenters were more likely to quit or to maintain low rates of smoking  Initiation of marijuana smoking among nonusers was reduced  Level of marijuana smoking among users was reduced  Life Skills Training: Based on social influence model  Teaches resistance skills, normative education, media influences, and general self-management and social skills© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 32. Peer Programs  Peer influence approaches  Based on open discussion among a group of children or adolescents  Underlying assumption is that the opinions of an adolescent’s peers are significant influences on behavior© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 33. Peer Programs  Peer participation programs  Emphasize becoming participating members of society  Often focus on youth in high-risk areas  May involve activities such as paid community service Community service (YouthBuild)  Data on effectiveness are not yet available or are inconclusive© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 34. Parent and Family Programs  Informational programs for parents  Provide basic information about alcohol and drugs and their use and effects  Also may aim to make parents aware of their own alcohol and drug use  Rationale for these programs is that well- informed parents  Can teach appropriate attitudes  Can recognize potential problems© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 35. Parent and Family Programs  Parenting skills programs  Focus on communication, decision-making, setting goals and limits, and when and how to say no to a child  Parent support groups  Key adjuncts to skills training or in planning community efforts© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 36. Parent and Family Programs  Family interaction approaches  Families work as a unit to examine, discuss, and confront issues relating to drug use  Programs can improve family communication and strengthen knowledge and skills  Example: Strengthening Families program  Targets children of substance abusers  Goals are improving parenting skills and family relationships and increasing children’s skills  Evaluations indicate it reduces tobacco and alcohol use in children and reduces substance abuse and other problems in parents© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 37. Community Programs  Reasons for organizing prevention programs on the community level  Coordinated approach at different levels can have a greater impact  Drug education and prevention can be controversial, and programs that involve many groups can receive more widespread community support© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 38. Community Programs  Community-based programs can involve other resources, including local businesses and the public media  Communities Mobilizing for Change on Alcohol is one of SAMHSA’s model prevention programs  Works for community policy changes and encourages participation of many community organizations and businesses© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 39. Workplace Programs  Most consistent feature of workplace programs is random urine screening  All companies and organizations that obtain grants or contracts from the federal government have to adopt a “drug-free workplace” plan  Ultimate goal is to prevent drug use by making it clear through policies and actions that it is not condoned© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 40. What Should We Be Doing?  What needs to be done in a particular situation depends on the motivations for doing it  Example 1: State requirement for drug education as part of health curriculum, in the absence of a particular drug problem  Most appropriate approach might be a balanced combination of factual information and social skills training  Important to avoid inadvertent demonstration of things you don’t want students to do© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 41. What Should We Be Doing?  Example 2: Widespread concern and fervor about a local “epidemic” of drug and alcohol use  Goal would be to use energy to organize a community planning effort  Best approach would combine efforts on many levels  Need to avoid scary, preachy, negative approaches than have been shown to be ineffective  Information and training available from the SAMHSA Center for Substance Abuse Prevention© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 42. SAMHSA Center for Substance Abuse Prevention: Model Programs  Across Ages  Project ALERT  Athletes Training and Learning  Project Northland to Avoid Steroids (ATLAS)  Project Towards No Tobacco  Child Development Project Use  Communities Mobilizing for  Reconnecting Youth Change on Alcohol  Residential Student Assistance  Creating Lasting Family Program Connections  Dare to Be You  Safe Dates  Families and Schools Together  SMART Team  Keep a Clear Mind  Strengthening Families  Life Skills Training Program  Too Good for Drugs© 2011 McGraw-Hill Higher Education. All rights reserved.
    • 43. Chapter 17 Preventing Substance Abuse© 2011 McGraw-Hill Higher Education. All rights reserved.

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