Chapter 2: Foundations of Substance Abuse Prevention Curricula

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• Define substance abuse prevention.

• Describe where substance abuse prevention activities can occur.

• Describe the difference between school-based substance abuse prevention programs and school-based substance abuse prevention curricula.

• Discuss research findings that can be used to guide the selection of substance abuse prevention curricula for use in a classroom setting.

• Explain the importance of interactive activities as part of a successful substance abuse prevention curriculum.

• Defining Prevention
• Foundations for Prevention
• Where Should Communitywide Prevention Occur?
• Elements of an Effective School-Based Prevention Curriculum
• Elements of Successful Program Delivery
• Conclusions

"Every American child will face a conscious choice whether to smoke, drink or use [other] drugs before they graduate from high school. What each chooses will be related to a host of factors, including parental and family engagement, religious and moral values, genetics, learning disabilities and psychological factors. Schools have a unique opportunity to affect two of the critical factors: availability of drugs and students' perception of risk in using them" (CASA, 2001).

Defining Prevention

• Many of those working with youth already possess valuable skills and experiences that can be applied to prevention efforts.

• A thorough understanding of the concept of prevention can maximize the likelihood that prevention efforts will have their desired impact.

• Prevention efforts are activities aimed at various audiences, with the ultimate goal of preventing, postponing, or reducing substance abuse and its negative outcomes.

• Types of prevention:

• Universal programs: designed to reach the general population

• Indicated programs: designed to reach those who have already begun to experiment with drugs or exhibit early danger signs

• Controversy exists over the issue of harm reduction/responsible use:

• Activities or programs might seem to give tacit approval to undesirable behaviors.

• Schools and other institutions may be opposed to harm reduction or responsible-use messages.

• Prevention practitioners should be aware of their institutions' stance on this issue.

• Selective programs: designed to reach youth at high risk for drug use.

Foundations for Prevention

• Prevention efforts should be guided by sound theory and findings from relevant research.

• Theories are useful in planning prevention programs because they:

• Clarify the nature of targeted health behaviors.

• Explain potential processes for changing behavior.

• Explain the effects of external influences on behavior.

• Help identify the most suitable targets for programs, methods for accomplishing change, and outcomes amenable to evaluation.

• The ecological approach:

• Recognizes that individuals are influenced by a multitude of factors.

• Includes interventions aimed at various levels of potential influence.

• Intrapersonal

• Individual characteristics that influence behavior, such as knowledge, attitudes, and beliefs

• Interpersonal

• Social networks (family, peers, roommates, friends) that provide social identity, support, and role definition

• Institutional

• Rules, regulations, policies, and informal structures that may constrain undesirable behaviors or promote recommended behaviors

• Community

• Social networks and norms, which may exist formally or informally among individuals or among groups and organizations

• Public policy

• Laws and regulations at the local, State, and Federal levels

• Most classroom-based prevention programs in use today are based on theoretical models aimed at individual or interpersonal change:
  

Where Should Communitywide Prevention Occur?

• Community-based programs:

• Schools

• Universities

• Daycare centers

• Businesses

• Treatment centers

• School-based programs, as components of broad-based community prevention efforts, are able to:

• Reach a majority of school-aged children and adolescents

• Take advantage of the learning environment

• Use the teaching skills of the staff

• Use resources available in the school/classroom

• Provide opportunities to reach subpopulations at risk for substance abuse

• Many substance abuse prevention activities address the following National Health Education Standards for Students:

• Students will comprehend concepts related to health promotion and disease prevention.

• Students will demonstrate the ability to access valid health information and health-promoting products and services.

• Students will demonstrate the ability to practice health-enhancing behaviors and reduce health risks.

• Students will analyze the influence of culture, media, technology and other factors on health.

• Students will demonstrate the ability to use interpersonal communication skills to enhance health.

• Students will demonstrate the ability to use goal-setting and decision-making skills to enhance health.

• Students will demonstrate the ability to advocate for personal, family, and community health.

• Classroom-Based Prevention: Prevention Curricula vs. Prevention Programs

• The Curriculum Builder is designed to help those working in classrooms and similar community settings select appropriate, research-based activities with which they can build classroom-based prevention curricula that best meet the needs of their particular groups of students.

• Curricular prevention is defined as prevention activities or lesson plans used in a classroom setting.

• Extracurricular prevention is defined as prevention activities used outside the classroom and include school policies, parental components, and school connectedness.

• School-based prevention programs include both curricular and extracurricular activities.

• Who Should Receive School-Based Substance Abuse Prevention Programming, and When Should It Start?

• All youth should be targeted.

• Preschool or kindergarten is not too early.

• Prevention should be an ongoing effort.

• Students should not be oversaturated with information.

Elements of an Effective School-Based Prevention Curriculum

• Most schools do not use effective curricula or delivery methods.

• An effective curriculum includes the following critical elements:

• Enhances "protective factors" and moves toward reversing or reducing known "risk factors"

• Targets all forms of substance abuse

• Elementary school: targets social-emotional learning

• Middle school: focuses on academic and social competence

• Includes skills to:

• Resist drugs when offered
• Strengthen personal commitment against substance use
• Increase social competency



• Employs interactive methods

• Includes a parents' or caregivers' component

• Is administered long-term over the school career, with repeat interventions

• Is adaptable to the specific substance abuse problems in the local community

• Is age-specific, developmentally appropriate, and culturally sensitive

• Is cost-effective

• Critical content areas:

• Normative education: helps students realize that use of alcohol, tobacco, and other drugs is not the norm

• Social skills: help youth develop ease in handling social situations

• Social influences: help youth recognize and resist external pressure (e.g., advertising, role models, peer attitudes) to use alcohol, tobacco, and other drugs

• Perceived harm: helps youth understand the risks and short- and long-term consequences of alcohol, tobacco, and other drug use

• Protective factors: supporting and encouraging the development of positive aspects of life—such as helping, caring, goal setting—challenging youth to live up to their potential and facilitating constructive affiliations with peers

• Refusal skills: teaching youth ways to refuse alcohol, tobacco, and other drugs effectively and still maintain friendships

• What does not work:

• Scare tactics

• Teaching only the adverse consequences of substance use

• Self-esteem building

• Values clarification

• Large assemblies

• Didactic presentation of material

Elements of Successful Program Delivery

• A successful leader:

• Engages students in active learning

• Establishes trust

• Establishes high expectations

• Practices open and supportive communication

• Creates a positive atmosphere of caring and helping

• Prepares for the role

• Is willing to support and work on broader community prevention efforts

• Understands the serious consequences of substance use during the teen years, particularly for younger adolescents

• Examines personal substance use patterns to identify biases that might be conveyed to students

• Interactive activities

• Definitions of interactive activities:

• Exercises that actively involve youth in the learning process

• Instructional techniques that involve youth in activities and allow them to reflect on their performance of those activities

• Endeavors requiring active involvement—youth engaged in higher-order thinking tasks such as analysis, synthesis, and evaluation

• Evidence to support use of interactive activities:

• Interactive activities show more positive results than didactic methodologies in communicating prevention messages to a wide cross-section of children and adolescents.

• Role plays, simulations, Socratic questioning, brainstorming, small-group activities, cooperative learning, class discussions, and service-learning projects have a favorable influence on the attitudes and achievement levels of youth.

• Programs relying solely on the provision of information may result in a greater likelihood of drug experimentation.

• Advantages of interactive activities:

• Interactive activities lend themselves to addressing the critical content areas of substance abuse prevention:

• Refusal skills — practiced in the classroom through role plays in the context of realistic settings where alcohol, tobacco, or other drugs may be used

• Videos and multimedia software — set in real-world environments to provide models of appropriate behavior and stimulate discussion

• Visual-based instruction — to provide a helpful focal point for other interactive techniques

• In-class writing across disciplines — to involve children and adolescents in activities and allow them to reflect on their performance of those activities

• Learning theories/styles:

• Youth present a vast array of intelligences and learning preferences.

• Interactive activities are more likely than didactic methods to engage a variety of learning styles.

• The Curriculum Builder uses the four major modalities of learning to categorize classroom-based activities: visual, auditory, tactile/kinesthetic, and kinesthetic.

• Social skills:

• Interactive activities can improve learning and help develop social skills proven effective in drug use prevention.

• Types of interactive activities:

• Problem solving

• Cooperative learning

• Group discussion

• Fishbowl discussions

• Role plays/simulations

• Games:

  • Competitive
  • Cooperative

• Debates

• Oral reports/presentations

• Demonstrations

• Elements of interactive activities:

• Lesson plan

• Example: Divide youth into five groups and ask them to create antidrug posters to present to the class.

• Educational product (video, magazine, puzzle, etc.)

• Example: An interactive CD on refusal skills that youth can use alone on a computer.

• Lesson plan plus educational product

• Example: A video on teenage smoking accompanied by a leader's guide that illustrates how to conduct a group discussion based on the video.

• Lesson plan plus supplemental, noneducational materials (such as magazines or music CDs)

• Example: An analysis of magazine advertisements for tobacco and alcohol chosen by the youth.

• Lesson plan plus educational product plus supplemental; no educational materials

• Example: After viewing a video analyzing advertisements, students bring in magazine advertisements and perform their own analyses.

Conclusions

• Substance abuse prevention should be targeted to influence people, institutions, and community and societal norms.

• Classroom-based prevention curricula are an important part of school- and community-based prevention programs.

• School- and community-based prevention curricula aimed at children and adolescents should be tailored to the specific characteristics of the target audiences.

• Substance abuse prevention programs must include five basic content areas: normative education, protective factors, social skills, perceived harm, and refusal skills.

• Interactive activities can and should be used across all prevention content areas in order to achieve optimal learning by participants.