Transcript Effectiveness of substance abuse prevention Dr. Anneke Bühler IFT Institut für Therapieforschung, München, Germany Pompidou Group Conference „Families, lifestyles and drugs – reaching families in prevention“,

Effectiveness of substance abuse
prevention
Dr. Anneke Bühler
IFT Institut für Therapieforschung, München,
Germany
Pompidou Group Conference „Families, lifestyles and
drugs – reaching families in prevention“, Porto,
Anneke Bühler, IFT München: Expertise Suchtprävention
Report on prevention of substance abuse
(Bühler & Kröger, 2006)*
• Aim: up-to-date record of research results on substance
abuse prevention
• Method: Systematic search and analysis of 49 highquality reviews and meta-analyses
• Results: Evidence-based conclusions about effectiveness
of preventive measures (avoidance, delay, or reduction
of substance use behaviour)
– status quo, mean , mainly US research
*in cooperation and with financial support of the BZgA
Anneke Bühler, IFT München: Expertise Suchtprävention
Strength of evidence rating
Conclusion is based on...
°°°°°
meta-analyses including high-quality studies (M)
°°°°
systematic review including high-quality studies (S)
°°°
meta-analyses or systematic review including all
types of studies
°°
unsystematic review (U), expert interview (E) or best
practice survey(BP)
°
generalized empirical result which does not directly
inform about or test the assumption
-
contradictory body of evidence
Anneke Bühler, IFT München: Expertise Suchtprävention
Family
M
S
3
U
1
E
1
• Comprehensive family-oriented approaches (training
with parents, children and whole families) have
preventive effects on consumption behaviour (in
relation to alcohol). °°°
• Measures to involve hard-to-reach families are
successful. °°
• Preventive measures for pre-school children (aged
3-5 years) should be family orientated. °
Anneke Bühler, IFT München: Expertise Suchtprävention
School
M
6
S
5
U
4
E
1
• Interactive school-based programmes have
preventive effects on consumption behaviour (for
tobacco, alcohol, cannabis and other illegal drugs).
°°°°°
– Social influence model and life skills approach
• Non-interactive programmes are not effective:
Information giving alone, affective education alone,
value clarification and decision-making alone. °°°°°
Anneke Bühler, IFT München: Expertise Suchtprävention
Peers/Leisure time
M
• No aggregated information available in report
• For selective approach
S
U
E
2
– Springer et al., 2004 : National Cross-Site Evaluation of
High-Risk Youth Programs with 48 programs with over
10.500 youths at high risk
– Behavioral life skills and recreation focused programs are
effective.(°°°°°)
Anneke Bühler, IFT München: Expertise Suchtprävention
Media campaigns
M
S
3
U
2
E
• Mass-media campaigns in combination with other
components (school-based, community-based and
national programmes) have preventive effects on
consumption behaviour (in relation to tobacco). °°°
• Isolated mass-media campaigns have no preventive
effects on consumption (of tobacco). °°°°
Anneke Bühler, IFT München: Expertise Suchtprävention
Community
M
S
1
Collaboration
–
–
–
U
E
•
Capacity building
Integrating services
Influencing policy
Collaborative initiatives aimed at getting policies or
regulations introduced are effective because of the
effectiveness of policy measures.°°
Anneke Bühler, IFT München: Expertise Suchtprävention
Community
M
1
S
2
U
1
E
1
Multi-level approach
– Measures in different settings (school, media, family,
community)
• Inconclusive:
Multi-level projects have preventive effects on
consumption behaviour.
(pro: °°°°°; inconclusive: °°°°)
Anneke Bühler, IFT München: Expertise Suchtprävention
Policy and regulations
M
S
6
U
2
E
1
• Higher tobacco prices reduce the prevalence and
quantity of tobacco consumption. °°°
• Isolated measures to prevent the sale of tobacco to
young people under the legal age do not reduce
consumption. °°°
Anneke Bühler, IFT München: Expertise Suchtprävention
Policy and regulations
• Raising the minimum legal drinking age reduces alcohol
consumption. °°°°
• Higher ´full‘ alcohol prices (including indirect costs)
have effects on alcohol consumption.°°
Anneke Bühler, IFT München: Expertise Suchtprävention
Selective prevention
• Selective prevention measures have preventive effects
on consumption behaviour if they are implemented in
the form of
– school-based social-skills programmes or
– mentoring programmes.°°°°°
– Behavioral life skills and recreation focused programs
are effective.(°°°°°)
– Characteristics of effectiveness:
•
•
•
•
•
Life skills development content
Intense contact (>3h per week)
Connection-Building methods
Instrospection methods
Coherence of program theory
Anneke Bühler, IFT München: Expertise Suchtprävention
What can be learnt so far...
• Personal and environmental measures can be
effective.
• Certain measures are ineffective.
• Effective measures
–
–
–
–
are based on a coherent program theory
include general and specific content
use interactive measures
have a certain intensity
Anneke Bühler, IFT München: Expertise Suchtprävention
Thank you!
Anneke Bühler, IFT München: Expertise Suchtprävention