# Presentation: 146416

## MODULE 2Science-Based Prevention Why Science-Based? 

**Define science-based prevention**
**Describe theoretical approaches to science-based prevention**
**Identify effective prevention principles, programs, and strategies**

## What is Science-Based?

**“****Science-based” refers to a process in which experts:**
**-****	****use commonly agreed upon criteria for rating research interventions**
**-****	****come to a consensus that evaluation research findings are credible and can be substantiated**
**Also referred to as evidence- or  research-based.**

## Definition of Science-Based Prevention

**A prevention activity is judged to be science-based if “good” research—research that has been shown to be rigorous according to a set of carefully defined criteria—demonstrates that the activity is effective.****Research shows:**
**– ****That the activity produces the expected positive results, and**
**– ****That these results can be attributed to the activity or program rather than to other extraneous factors.**

## Why all the concern over                              scientifically-based prevention?

**Federal and state agencies, as well as private funders are asking for it**
**Public accountability**
**The desire to improve programs**
**To use what is effective**
**To use limited resources wisely**

## Slide 6

## Science-Based Programming at the local level is...

**Theory-based**
**Targeted**
**-****	****Audience specific**
**-****	****Goal-oriented**
**-****	****Measurable**
**Carefully implemented**
**Evaluated**

## CAPT Key TermsMODEL PROGRAMS

**Prevention programs that have been rigorously evaluated and have repeatedly demonstrated positive outcomes.**

## CAPT Key TermsBEST PRACTICES

**Strategies, activities, or approaches which have been shown through research and evaluation to be effective in the prevention and/or delay of substance use/abuse.**

## CAPT Key TermsPROMISING APPROACHES

**Programs for which the level of certainty from available evidence is too low to support generalized conclusions, but for which there is some empirical basis for predicting that further research could support such conclusions.**

## Prevention Research

- Why study prevention research?
- Theories assist in identifying how we can prevent a problem behavior from occurring, taking the guesswork out of planning
- Why review the six CSAP strategies?
- To know what the strategies are when encountered in grant applications, etc.
- To use as a tool to create a comprehensive prevention program

## What Should a Good Theory Do?

- Identify the factors that predict substance abuse
- Explain the mechanisms through which they operate
- Identify the internal and external variable that influence these mechanisms, including cultural factors
- Predict points to interrupt the course leading to substance abuse
- Specify the interventions to prevent onset of substance abuse

## Three Major Theoretical Models 

**Risk Factors/Protective Factors**
**Developmental Assets **
**Resiliency**

## Risk factors predict substance abuse and protective factors can buffer risk factors
Risk and protective factors have cumulative effect
Risk and protective factors occur in communities, families, schools, and individuals and are subject to change.

**Risk and protective factors have cumulative effect**
**Risk and protective factors occur in communities, families, schools, and individuals and are subject to change.**

- Risk & Protective Factors Theory

## To prevent substance abuse, reduce risk factors and increase protective factors throughout a child’s life
Risk and protective factors can be influenced by individual, family, school, and environmental change strategies

**Risk and protective factors can be influenced by individual, family, school, and environmental change strategies**

- Risk & Protective Factors Theory

## Similar to public health model of disease
Different adolescent health and behavior problems share common risk factors
	•	Substance Abuse
	•	Violence
	•	Delinquency
	•	School drop out
	•	Teen Pregnancy	

**Different adolescent health and behavior problems share common risk factors**
**	****•****	****Substance Abuse**
**	****•****	****Violence**
**	****•****	****Delinquency**
**	****•****	****School drop out**
**	****•****	****Teen Pregnancy****	**
**	****	**
**	**

- Risk & Protective Factors Theory

## Criteria for Inclusion as a Risk Factor

**Multiple studies**
**Longitudinal**
**Predictive**

## Availability of drugs
Community laws and norms favorable toward drug use
Transitions and mobility
Low neighborhood attachment and community disorganization
Extreme economic deprivation	

**Community laws and norms favorable toward drug use**
**Transitions and mobility**
**Low neighborhood attachment and community disorganization**
**Extreme economic deprivation****	**

- Community Risk Factors

## Family Risk Factors

- •	Family history of substance abuse
- •	Family management problems
- •	Family conflict
- •	Parental attitudes and involvement in drug use

## School Risk Factors

- Academic failure beginning in elementary school
- Lack of commitment to school
- Early and persistent antisocial behavior

## Individual/Peer Risk Factors

- Early and persistent antisocial behavior
- Alienation /rebelliousness
- Friends who engage in problem behaviors
- Favorable attitudes toward drugs
- Early initiation of drug use
- Constitutional factors

## Generalizations About Risk

- Risks exist in multiple domains
- The more risk factors present, the greater the risk
- Common risk factors predict diverse problem behaviors
- Risk factors show consistency across different races and cultures
- Protective factors may buffer exposure to risk

## Protective Factors

- Individual characteristics
- Bonding
- Healthy beliefs and clear standards

## Social Development Strategy

## Developmental Assets Framework

- Emphasize strengths in people
- Focuses on youth as resources, not problems
- Focuses on increasing the number of assets present in youths’ lives
- Is a “promising” framework

## Resiliency Approach

**Focuses on how children “bounce back” in the face of adversity**
**Based largely on the work of Emmy Werner**
**Includes several factors which foster resilience in kids**
**Is a “promising” approach**

## Case Studies on Theories

**Select a facilitator, a timekeeper, and a recorder**
**Read the case study assigned to your group**
**Determine which risk and protective factors are at work in your case**
**Report back to the whole group**

## Case Studies on Theories

**Is there consensus on which risk factors were identified?**
**Is there consensus on which protective factors were identified?**
**How might our values and culture influence which factors we see present?**

## Caution!

**Purpose of this case study activity**
**	****- To begin using the risk factor and protective factor   language**
**	****- To see what risk and protective factors might look like in a community**
**Risk and Protective Factors are identified in communities using a formal assessment**
**	****- Module 3 presents a process for assessing the ****	****levels of risk and protective factors in communities**
**	****- Data collection and analysis drives the process**

## Seven Prevention Strategies[Center for Substance Abuse Prevention (CSAP)]

**Information Dissemination**
**Prevention Education**
**Alternative Activities**
**Community-based Processes**
**Environmental Approaches**
**Problem Identification and Referral**
**Traditional/Cultural (MN Only)**

## Information Dissemination

**Complementary to more intensive/ interactive approaches**
**Appeal to youth motives for using substances or perception of substance use**
**TV and radio spots choice air times**
**Avoid authority figures & exhortations**

## Prevention Education

**Combine information, skills, protective factors**
**Interactive, intense, with booster sessions**
**Include peer-led components**
**Provide social skills training & practice**
**Involve parents individually & with students**

## Alternatives

**High-risk youth who may not have adequate adult supervision can benefit**
**Intense programs with variety**
**Component of a comprehensive prevention plan**
**Community service, mentoring, recreation, cultural activities**
**One-shot community events do not, in themselves, change the behaviors of participants**

## Community-Based Processes

**Characteristics of successful partnerships include:**
**	****-****	****a clear vision**
**	****-****	****committed partnership members**
**	****-****	****diverse participants**
**Paid coalition staff operate as resource providers and facilitators**
**Elaborate committee structures are not productive**

## Environmental

**Examples include:**
**Excise taxes**
**Minimum purchase age laws**
**Use and lose laws. Penalties should not be too harsh**
**Increasing the minimum purchase age for alcohol**
**Outlet density**

## Problem Identification and Referral

**Estimate accurately youth who justify intervention**
**Ensures appropriate referral to meet needs **
**Realize relationship between substance use & other health problems.**
**Risk of exposure to other deviant behaviors **
**Brief interventions appear promising**

## Traditional/Cultural Activities

**Examples:**
**Ceremonies and rituals**
**Learning sacred dances**
**Storytelling**
**Tribal/cultural crafts**
**Cooking traditional foods**

**Youth with strong cultural identification are less vulnerable to risk factors.**

## Enhancing Prevention Programs

**Directions:**
**Think of a familiar prevention program**
**Which CSAP strategy is it?**
**Find that strategy in the work sheet, *****Research Findings and CSAP Strategies***** beginning on p. 2.41**
**Based on the findings presented, make 1 or 2 recommendations to strengthen your program**
**Prepare to share with the group**

## Multiple Efforts

**	****Prevention strategies showing greatest promise of effectiveness focus on change at multiple levels:**
**Individuals**
**Family**
**School**
**Communities**

## 	The expected impact of any single prevention program is likely to be limited and difficult to isolate.
	Classroom-based prevention, in isolation from other prevention approaches, has been consistently demonstrated to have limited impact.

**	****Classroom-based prevention, in isolation from other prevention approaches, has been consistently demonstrated to have limited impact.**

## Social Influences Model

**	****School classroom prevention programs appear to be most effective if based on the social influences model for primary prevention.**

## Elements of the Social Influences Model

**Short-term consequences**
**Reasons for using and not using**
**Accurate information about peer norms**
**Influence of advertising**
**Resistance skills**
**Effects of substance use in community**
**Public commitment to refrain from use**

## Common Attributes of Effective Approaches

**Interactivity**
**Cultural relevance**
**Intensity and duration**
**Credibility of:**** - ****Presenter**
**	****	****-  peers**
**	****	****-  cross-age mentors**
**	****- Message****	****- accuracy**
**	****	****- relevance****  **

## Shifting Focus

**Environmental approaches to prevention are demonstrating a reduction in certain alcohol, tobacco, and other drug related behavior and problems.**
**Emerging evidence supporting the concepts of resiliency and asset development is growing.**

## A Summary of SDFSCA Principles of Effectiveness

**I****	****In General:**
** ****A ****Be based on an assessment of objective data regarding the incidence of local violence and illegal drug use**
** ****B ****Be based on an established set of performance measures**
** ****C ****Be based on scientifically-based research that provides evidence that these programs will reduce violence or illegal drug use**
** ****D ****Be based on an analysis of risk and protective factors**
** ****E ****Include meaningful and ongoing input from parents**

## A Summary of SDFSCA Principles of Effectiveness

**II  Periodic Evaluation**
** ****A ****Periodic evaluations to assess progress**
** ****B ****Results used to refine, improve and strengthen the program and be made public upon request**

## ONDCP Principles

**Address risk and protective factors**
**Use approaches proven to be effective**
**Intervene early**
**Intervene in appropriate settings and domains**
**Manage programs effectively**

## Prevention Research

**Why study prevention research?**
**•****	****Theories assist in identifying how we can prevent a problem behavior from occurring, taking the guesswork out of planning**
**Why review the six CSAP strategies?**
**•****	****To know what strategies are when ****	****	****encountered in grant applications, etc.**
**•****	****To use as a tool to create a ****	****	****	****	****comprehensive program**

## Questions and Discussion

- Questions and Discussion