Prevention

Question 1

Risk Factors for Substance Misuse (Adolescent and Young Adult)

Answer 1

early initiation of substance use
early and persistent problem behaviour such as emotional distress and aggressiveness
rebelliousness against parental and other authority
favourable attitudes towards substance use
peer substance use
genetic predisposition
family conflict
favourable parental attitudes towards substance use
family history of substance use
academic struggles beginning in elementary school
lack of commitment to education and school attendance
low cost of alcohol in the community
high availability of substances in the community
positive media portrayal of alcohol, tobacco and other drugs
low neighbourhood attachment
low socioeconomic status
high degree of transition and mobility

Question 2

Prevention Initiative Levels

Answer 2

1. Primary
2. Secondary
3. Tertiary

Question 3

Primary prevention level

Answer 3

occuring before a person begins to use substances. The goal is to prevent or delay the onset of first use.

Question 4

secondary prevention level

Answer 4

occuring once a person has begun to experiment with drug use. The goal is to prevent more frequent, regular use.

Question 5

tertiary prevention level

Answer 5

occuring after substance use has become problematic. The goal is to reduce the harm associated with use or, if possible, achieve complete abstinence.

Question 6

Prevention Programs focus on:

Answer 6

• those who chose to abstain from drug use
• those who chose to postpone drug use
• those already using drugs
• those experiencing difficulties with their current drug use
• those experiencing difficulties with the use of drugs by relatives or friends
• the larger family system

Question 7

prevention programming:
Three prevention focuses that can be adopted within the risk continuum

Answer 7

(1) universal
(2) selective
(3) indicated or targeted

Question 8

the risk continuum

Answer 8

no risk: health enhancement
low risk: risk avoidance
at risk: risk reduction - early intervention
intervention required: tx/rehabilitation

Question 9

INDICATED PREVENTION

Answer 9

• designed to prevent the onset of substance misuse in individuals who are showing early danger
• for those who are already using or involved with psychoactive drugs
• programming is individualized and can include a formal counselling component
• targets injection drug users (IDUs) and teaches them harm-reduction techniques with or without a goal of abstinence

Question 10

SELECTIVE PREVENTION

Answer 10

• targets subsets of the total population that are deemed to be at risk for substance misuse
• A more intensive approach targets specific subgroups deemed to be at greater risk
• Those with:
  academic struggles;
  family issues and dysfunction;
  issues of poverty;
  problematic social environments; and
  a family history of substance misuse

Question 11

UNIVERSAL PREVENTION

Answer 11

• addressing the whole population
• such as all Grade 9 students or all parents of high school students, with the aim of promoting the health of the population or preventing or delaying the onset of substance use

Question 12

Selective Prevention Programs

Answer 12

Programs have:
- smaller numbers of participants per group
- recipients who are known and who are specifically recruited to participate in the intervention
- longer and more intensive structure
- more intrusive intervention, with a goal of changing existing behaviours in a positive direction
- a higher degree of skill among program leaders and staff
- a greater cost per participant
- a greater likelihood of demonstrating change

Question 13

prevention program components

Answer 13

1. knowledge
2. attitudes and value
3. skills

Question 14

prevention program components: KNOWLEDGE

Answer 14

• the concept of abstinence and alternative behaviours to drug use
• definitions of drugs and psychoactive drugs, drug misuse, and drug dependency
• how different contexts and situations influence personal values, attitudes, beliefs, and behaviour in relation to drug use
• how different drugs can affect a person’s ability to perform tasks
• the impact of media messages on the health behaviour of society
• the importance of self-esteem, self identity, self concept
• the rights and responsibilities of interpersonal relationships

Question 15

prevention program components: Attitude and Values

Answer 15

• a value stance regarding drug use and the confidence to act on those values
• the significance of the social and cultural influences on beliefs
• empathy and acceptance of a diverse range of people
• individual responsibility for health and universal health protection
• personal beliefs about drugs and their effects on decisions

Question 16

prevention program components: SKILLS

Answer 16

• the ability to communicate constructively with parents, teachers, and peers
• giving and receiving care in a variety of health-related situations
• setting short- and long-term health goals
• demonstrating conflict, aggression, stress, and time-management skills
• identifying and assessing personal risk and practising universal protection
• developing assertiveness and dealing with influences from others; working effectively with others; and coping with change, loss, and grief

Question 17

A Prevention Programming Framework

Answer 17

• address protective factors, risk factors, and resiliency
• ensure sufficient program duration and intensity
• use accurate information
• set clear and realistic goals
• monitor and evaluate the project
• addresses sustainability from the beginning
• account for the participant’s stage of psychosocial development
• recognizes youth perceptions of drugs and community’s use of drugs
• involve youth in program design and implementation
• develop credible messages delivered by credible messengers
• combine knowledge and skill development
• use an interactive group process
• provide sufficient attention to teacher/leader qualities and training

Question 18

Prevention strategies

Answer 18

1. information strategies
2. normative education
3. perceived harm reduction
4. social influence education
5. advertising pressures education
6. protective factors
7. resistance (refusal) skills
8. competence enhancement skills training
9. persuasion strategies
10. counselling strategies
11. tutoring/teaching strategies
12. peer group strategies
13. family strategies
14. recreational activities
15. harm minimization/harm reduction
16. affective education
17. resilience development

Question 19

information (prevention) strategies

Answer 19

Teaching facts about the legal, physiological, and psychological consequences of psychoactive drug use and misuse

Question 20

normative education (prevention) strategies

Answer 20

Makes students aware that most people do not use drugs and do not think drug use is “cool”

Question 21

Perceived Harm Education: prevention strategies

Answer 21

Teaching about the risks and short- and long-term consequences of alcohol and other drug use

Question 22

social influence Education: prevention strategies

Answer 22

Teaches to recognize external influences, such as social and peer pressure

Question 22

social influence Education: prevention strategies

Answer 22

Teaches to recognize external influences, such as social and peer pressure

Question 23

Advertising Pressures Education

Answer 23

Teaches individuals to recognize the purposes and effects of social media, advertising, and other media, and the cognitive skills to resist these influences

Question 24

Protective Factors:

Answer 24

Teaches, supports, and encourages the development of positive aspects of life, such as helping, caring, goal setting, and challenging students to live up to their potential

Question 25

Resistance (Refusal) Skills:

Answer 25

Teaches how to recognize and resist pressure from others to use drugs

Question 26

Competence Enhancement Skills Training:

Answer 26

This approach teaches generic social and personal skills

Question 27

Persuasion Strategies:

Answer 27

Influencing attitudes or behaviours regarding drugs through persuasive messages

Question 28

Counselling Strategies:

Answer 28

Peer, self-help, or professional counselling programs for those experiencing both drug- and non-drug-related personal and family problems

Question 29

Tutoring/Teaching Strategies:

Answer 29

Peer or cross-age tutoring or teaching to assist in enhancing academic achievement

Question 30

Peer Group Strategies:

Answer 30

Attempts to strengthen or exploit natural peer group dynamics to inhibit drug use

Question 31

Family Strategies:

Answer 31

Efforts aimed at strengthening parenting skills and family relationships to address student drug issues

Question 32

Recreational Activities:

Answer 32

Programs to occupy leisure time and provide alternative activity other than drug use

Question 33

Harm Minimization/Harm Reduction:

Answer 33

Imparts information to reduce the harm stemming from substance use and to promote safer drug-using skills

Question 34

Affective Education:

Answer 34

developing positive self-esteem, good interpersonal skills, and decision-making ability

Question 35

Resilience Development:

Answer 35

development of social competence; increasing bonding; communicating high expectations for academic, social, and work performance; maximizing opportunities for students’ meaningful participation in the school environment or employees in a work environment; and creating partnerships with families and community resources

Question 36

Effective Programming Components

Answer 36

- bonding - social competence - cognitive competence - moral competence - spirituality - clear and positive identity - recognition for positive behaviour - opportunity for pro-social involvement - resilience - emotional competence - behavioural competence - self-determination - self-efficacy - belief in the future - pro-social norms

Question 37

School-based Programs should:

Answer 37

- be evidence-informed - involve parents and the wider community - involve the entire school - be taught in a sequentially developmentally and appropriate school health curriculum - be based on students’ expressed needs and responsive to their developmental, gender, cultural, language, socioeconomic, and lifestyle differences - be initiated before drug use begins - be harm-minimization focused - use interactive teaching techniques - use trained peer facilitators to lead discussions - utilize the classroom teacher as central in the education process - be practical, immediate, relevant information on the harms associated with drug use, influences that promote drug use, and normative student drug use - focus on general social skills training, including the values, attitudes, and behaviours of the broader community - consider the interrelationship among the individual and the student’s social context - focus on drug use that is most likely to occur initially, to minimize experimentation that becomes integrated and ultimately excessive use

Question 38

education programs

Answer 38

- BRAVO (Building Respect Attitudes and Values with Others) - DARE (Drug Abuse Resistance Education) - Kids in the know - MADD - Racing against drugs - VIP (Values, Influences, and Peers) - Weeding out drugs

Question 39

Ineffective (prevention) Programming Features examples

Answer 39

- single-shot assemblies and testimonials by former drug dependent persons - inadequate facilitator training, preparation and instruction - presentations where abstinence is the only criteria of success - fear arousal and scare tactics - no parental involvement

Question 40

what works for prevention

Answer 40

1. Knowledge: information about short term and long term health consequences 2. Attitudes about drug use : feedback from school surveys of peer drug use; analysis of media and social influences that promote pro drug attitudes; perception adjustment regarding actual peer use 3. Drug refusal-based interpersonal skills: drug refusal skills; assertiveness skills; communication skills; safety skills 4. Intrapersonal skills: coping skills; stress reduction techniques; goal setting; decision-making/problem solving 5. Active involvement: student-generated role plays; participation between peers; supportive comments from peers; peer modeling of appropriate behaviour; rehearsal of drug refusal skills; sufficient practice time; developmentally appropriate activities

Question 41

What is Family Programming

Answer 41

The goal of family skills programs is not only to decrease substance misuse, but to positively affect parent-child family relations by increasing family cohesion, decreasing family conflict, and decreasing family health and social problems overall - the greatest risk to family programming are the PARENTS OWN DRUG USE

Question 42

Family Programming Options

Answer 42

1. Information sharing (harm reduction) 2. parental skills training 3. parents support (counselling for parents) 4. family interaction (family counselling)

Question 43

The best family harm reduction practice:

Answer 43

- parents having dinner with their children - As frequency of family dinners increases, reported drinking, smoking, and other drug use decreases. - this is a correlational finding and not causation - Being together is what decreases risk; speaking and listening to one another and giving children undivided parental attention