Preventing Drug Abuse What Do We Know? (1993) / Chapter Skim
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Appendix: Community Settings and Channels for Prevention
Appendix: Community Settings and Channels for Prevention
Pages 119-154
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From page 119... ...
The first principle, for example, would qualify as a corollary of the theory of participation. That is, cumulative research in educational psychology and various applied fields demonstrates with some consistency that cognitive, affective, and behavioral changes in learners or clients are greater in response to interventions when the subjects engage actively rather than passively, agree on the purpose of the change (especially when convinced that the purpose 119
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From page 120... ...
Our purpose is to draw implications whenever possible between other bodies of prevention research and the prospects for drug abuse prevention through various community-based channels and settings. Promising community-wide interventions are examined first, followed by specific settings within communities including schools, families, work sites, and medical care settings.
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From page 121... ...
So too disaggregation of community must also be part of the planning process for programs in order for them to adapt to cultural differences. Important to the development of drug abuse prevention is the dispersed "community of interest." National advocacy organizations such as the Smoking Control Advocacy Resource Center, Americans for Nonsmokers' Rights, Mothers Against Drunk Driving, the National Association of Prevention Professionals and Advocates all rely on a constituency of concerned citizens scattered around the country.
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From page 122... ...
Communities and Mass Media Community-based interventions can be distinguished from interventions carried out at the state or national levels, yet regional- and national-level campaigns can also have a complementary and supportive role in local efforts. (For descriptions of national campaigns sponsored by Public Health Service agencies, including the Office of Substance Abuse Prevention, see Office of Disease Prevention and Health Promotion, 1990.)
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From page 123... ...
Nevertheless, there is reason to redirect some program and research efforts toward more community-wide interventions and studies. Encouraging results from several sources have fostered growing sophistication and larger numbers of community-wide health promotion and disease prevention programs: the large-scale family planning and immunization programs reported in the 1960s and early 1970s (Cuca and Pierce, 1977; Green and McAlister, 1984~; antismoking campaigns (Flay, 1987a,b; Warner and Murt, 1983~; and cardiovascular and cancer community prevention trials initiated in the late 1970s and early 1980s (Farquhar et al., 1990; Farquhar et al., 1983; Lasater et al., 1984; Nutbeam and Catford, 1987; Puska et al., 1985~.
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From page 124... ...
Two questions arise, however, in translating the epidemiologic case from disease prevention and health promotion specifically to drug use prevention research. One is whether the prevention of conditions or behaviors that pertain to whole populations, such as the risk of heart disease and related eating behavior, apply in the same ways to prevention of illicit drug abuse prevention.
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From page 125... ...
This is a fundamental thesis of social learning theory (Bandura, 1986; Clark, 1987; Parcel and Baranowski, 1981~. Employing a combination of targeted and community approaches recognizes the reciprocity between individuals and environments and between individualized approaches and system approaches.
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From page 126... ...
Economic and other motives that might underlie public responses to drug problems, such as those revealed in studies of voting behavior and support for school initiatives, need greater attention from the drug abuse prevention research field if
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From page 127... ...
For these reasons, community coalitions have become the mainstay of most health promotion/disease prevention programs. Despite their popularity, there has been little formal research even to describe the array of coalition types (Couto, 1990)
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From page 128... ...
As more organizations adopt or extend components of the program, a multiplier effect gets under way, with the funded demonstration projects being emulated by others without external funding (Kreuter et al., 1982~. Research on examples of the diffusion or multiplier effect of drug abuse prevention projects should be possible, considering, for example, the number of community demonstration projects being funded by the Center for Substance Abuse Prevention grants.
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From page 129... ...
A growing body of literature on the evaluation of implementation, or process evaluation, has developed in recent years (King et al., 1987; Ottoson and Green, 1987, Reid and Hanrahan, 1988~. Considering the wide variety of personnel implementing drug abuse prevention programs as well as the rapid development of new strategies, further research on implementation problems and evaluations of implementation must be supported.
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From page 130... ...
Upgrading the skills of personnel working in drug abuse prevention is necessitated by the fast-breaking results of research and evaluation on new innovations in prevention programming. Training, like program implementation, has been relatively neglected as an object of research and evaluation in all fields of prevention until recent years, but a growing literature is taking shape (Easterby-Smith, 1986; Fitz-enz, 1984; Phillips, 1983; Staropoli and Waltz, 1978~.
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From page 131... ...
Drawing on the experience of the recently completed community trials in cardiovascular risk reduction funded by the National Heart, Lung, and Blood Institute, the papers presented at that conference brought out many of the same methodological differences and similarities that face research on community-wide strategies for drug abuse prevention. SCHOOL AS A SETTING FOR INTERVENTION Most of the drug abuse prevention research, as seen in the chapters of this report, has been conducted in school settings.
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From page 132... ...
Yet there is growing evidence of the benefits of these elements and services for school-age children in reducing absenteeism, increasing average daily attendance, improving attentiveness, reducing vandalism, and other aspects of the school's mission (Kolbe et al., 1986~. Components of School Health The basic structure of school health programs as reflected in the literature has remained relatively unchanged for over 50 years.
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From page 133... ...
within the context of school health services and environment; and the role of the school within the context of a network of other community resources and channels of communication to determine how the school programs in drug abuse prevention complement other community efforts. Evaluation of School Health Education After decades of basing support for comprehensive school health on learning principles and research evidence borrowed from other fields, contemporary school health literature is suddenly endowed with rigorous evaluations of well-designed school health and school health education programs.
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From page 134... ...
As a result, this collection of studies placed rather strong emphasis on the home to address reinforcing factors in the social environment as a complement to school interventions. A panel convened by the Kaiser Family Foundation concluded that drug abuse prevention programs are likely be most effective when implemented in the context of comprehensive school health programs linked with community health promotion programs (Flay, 1986; Pentz, 1986; Perry, 19861.
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From page 135... ...
International investigators have also conducted studies that employ close collaboration among key institutions within the community and with the family. The North Karelia, Finland, Youth Project included modifications in the school diet, health screening, mass media, comprehensive school health education, and parental support to reduce the major risk factors for noncommunicable diseases.
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From page 136... ...
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From page 137... ...
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From page 138... ...
concluded: If drug abuse prevention is to be found in industry, one might expect to find it within the growing number of health promotion programs in the workplace, programs that emphasize the development of healthful practices through preventive means. Yet an examination of even the most comprehensive health promotion programs (e.g.
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From page 139... ...
Workplace health promotion appears to be today about where school health education was in 1980 with respect to rigor of research evaluation. Considering their potential for effective drug abuse prevention, workplace programs deserve much more research attention than they have been given.
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From page 140... ...
Of greater significance from a prevention perspective, dentists often treat entire families rather than isolated and independent individuals. Dental offices are good settings for drug abuse prevention because cigarettes, smokeless tobacco products, and other drugs that are smoked (e.g., marijuana, cocaine)
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From page 141... ...
The development of drug abuse prevention research need not repeat all of these studies to ensure that their results are applicable to the specific problems of preventing drug abuse. Many of the research furrows plowed by investigators in family planning, communicable disease control, chronic disease control, and alcohol abuse prevention have proved to be unfruitful and so need not be repeated with drug abuse prevention.
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From page 142... ...
For example, the "community partnership" grants of OSAP require the applicants to have community coalitions. This requirement is based on strictly anecdotal experience from drug abuse prevention projects, and a little research on coalitions in other fields.
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From page 143... ...
Best, J.A. 1989 Intervention perspectives on school health promotion research.
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From page 144... ...
Luepker 1984 Organization for a community cardiovascular health program: experiences from the Minnesota Heart Health Program. Health Education Quarterly 11 :243-252.
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From page 145... ...
Turner, and E.F. Mason 1985 Summary findings of the school health education evaluation: health promotion effectiveness, implementation and costs.
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From page 146... ...
Breslow 1983 Health promotion programs sponsored by California employers. American Journal of Public Health 73 :538-542.
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From page 147... ...
Katz 1985 Design of the school health education evaluation. Journal of School Health 55:301304.
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From page 148... ...
Kolbe, L.J. 1982 What can we expect from school health education?
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From page 149... ...
Hersey 1984 Getting messages on the air: findings from the 1982 alcohol abuse prevention campaign. Health Education Quarterly 1 1 :273 -292.
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From page 150... ...
Turner, D Orenstein 1985 Development and application of the student test used in the school health education evaluation.
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From page 151... ...
Mason, and D.B. Connell 1985 Selecting and recruiting health programs for the school health education evaluation.
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From page 152... ...
Office of Substance Abuse Prevention Mono graph 4, DHHS Publ.
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From page 153... ...
Luepker 1989 Synthesis of cardiovascular behavioral research for youth health promotion. Health Education Quarterly 16(2)
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From page 154... ...
Williams, L.S. 1986 AIDS risk reduction: a community health education intervention for minority high risk group members.
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