How to unleash the power of prevention

Essential reading for people interested in preventing mental health problems, youth substance use, risky driving behaviors, aggressive and delinquent behaviors, adolescent violence, and self-inflicted injury:

Unleashing the Power of Prevention and A Challenge to Unleash the Power of Prevention, both released last month by the Institute of Medicine. 

The first article starts with: Every day across America, behavioral health problems in childhood and adolescence, from anxiety to violence, take a heavy toll on millions of lives. For decades the approach to these problems has been to treat them only after they’ve been identified—at a high and ongoing cost to young people, families, entire communities, and our nation. Now we have a 30-year body of research and more than 50 programs showing that behavioral health problems can be prevented. This critical mass of prevention science is converging with growing interest in prevention across health care, education, child psychiatry, child welfare, and juvenile justice. Together, we stand at the threshold of a new age of prevention. The challenge now is to mobilize across disciplines and communities to unleash the power of prevention on a nationwide scale.

Parents connecting with parents important for preventing teen drug use

Most people know that teaching parents how to guide their children so that they make healthy decisions is part of a multi-pronged strategy for preventing adolescent drug use.  But what does that mean?  What can parents actually do?

One thing that parents can do is connect with other parents.  Making connections with the parents of your child's friends opens up opportunities to discuss views on teen drug use.  Many parents are surprised to find out that the vast majority of parents think that teen drug use is unacceptable, even in high school.  In fact, when Prevention WINS conducts surveys among NE Seattle parents, more than 90% agree that teenagers should not use drugs, including alcohol.

Connecting with other parents also makes it easier to monitor your child.  It makes it easier to call another parent to make sure your child is at a friend's house and that there are no drugs, including alcohol, available.

In the video below, Dr. Leslie R. Walker from Seattle Children's Hospital talks about why connecting with other parents is important.

  

The beginning of a school year provides many opportunities for parents to connect with one another.  Curriculum nights, PTSA-sponsored socials, and sporting events are just a few opportunities during which parents can easily connect with others.  

Parent norms affect teen drug use

Norms and availability are two of the strongest predictors of youth marijuana use (see previous posts for details).  While the availability risk factor is relatively well known, the risk factor of "norms" is less well known.

"Norms" refers to what people think is normal and acceptable behavior.  If a certain behavior is considered normal or acceptable, it can shape human behavior.  Norms are present in different domains -- community, family, school, and peer groups.  The strongest predictors of youth marijuana use are peer norms followed by community and parent norms.  Following is more information about parent norms and how they affect teenage drug use.

Parental attitudes and behavior toward drugs . . . influence the attitudes and behavior of their children.  Parental approval of young people's moderate drinking, even under parental supervision, increases the risk of the young person using marijuana. . . . Further, in families where parents involve children in their own drug or alcohol behavior -- for example, asking the child to light the parent's cigarette or get the parent a beer from the refrigerator -- there is an increased likelihood that their children will become substance abusers in adolescence.  (From: Substance Abuse Prevention: The Intersection of Science and Practice, page 20)

In NE Seattle, Eckstein Middle School 8th graders report that parents think it is wrong from them to use marijuana or alcohol.  (WA Healthy Youth Survey)  Parents have been good at getting their attitude about kids not using drugs across to their young teenage children.

While the Prevention WINS coalition will continue to monitor NE Seattle student's perceptions about their parent's attitudes, we are also interested in how other adults in the community affect youth drug use.  While young teens still overwhelmingly perceive that adults think that their use of drugs is wrong, between 2010-12 there was a dip of 5 percentage points when 8th graders were asked about marijuana.  

Designing healthy communities for children

Earlier this summer, Dr. Richard Jackson spoke at Seattle Children's Hospital about "Designing Healthy Communities for Children".  Many examples of the connection between health and the physical design of communities were discussed.

Though Dr. Jackson mostly spoke about health problems related to obesity, his presentation can be used when thinking about preventing youth substance abuse.  What can we do in our community to support healthy choices when it comes to teen drug use?  Are there a lot of stores selling alcohol, tobacco, and soon marijuana?  How about advertising?  Are youth exposed to ads for these substances?  Are there easy to access pro-social activities for youth?

He noted that we are all living in environments imagined by the people from previous generations.  He stressed that is is important for us to imagine healthy environments for future generations and work together to turn that imagination into reality.

Early conversations about drugs and alcohol are important for building trust

The March 2013 edition of Seattle's Child includes an article from "The Dad Next Door" about what parents can do to prevent youth substance abuse.

When providing advice about building trust he writes, "Start early, and keep it up.  Because one day, if you run out of trust, your options will be few, and none of them will be good."  If parents start talking with their kids about drugs and alcohol, set up family rules, and monitor their whereabouts before 8th grade, it will just become how things are done at home.  Establishing rules and starting to monitor children after they enter high school is much more difficult.

If you are a NE Seattle parent of a fifth grade student and don't know how to start a conversation with your child, two Prevention WINS coalition members can help.  They can provide free 30-minute presentations to NE Seattle parent groups about how to start talking now.

Make your voice heard in Olympia on Prevention Policy Day!

What parents can say to their children about marijuana

From Seattle Children's Hospital:

Marijuana becomes legal in Washington state on Thursday, and a commercial marijuana market is on the horizon. Dr. Leslie Walker, chief of adolescent medicine at Seattle Children’s Hospital and president elect for the Society for Adolescent Health and Medicine, says that now’s the time for parents to talk with their children – especially teens – about the consequences of marijuana use.


“High school students who smoke marijuana report that they started between the ages of 13 -14,” says Dr. Walker, “So conversations need to start early.”

Read more at the Teenology blog.

The role of public policy in preventing underage substance use

Community coalitions like Prevention WINS advocate for policies that are proven to prevent underage drinking and substance abuse.  Below are a few examples.

Taxes
While consumers may complain about the cost of alcohol since the approval of Initiative 1183 last year, high prices are actually good when it comes to preventing underage drinking.


Raising alcohol excise taxes can help deter young people from drinking, according to a leading expert on preventing drinking in youth.

“These taxes prevent and reduce drinking and death among young people, as well as among heavy drinkers,” says David H. Jernigan, PhD, Associate Professor and Director, Center on Alcohol Marketing and Youth (CAMY), Johns Hopkins Bloomberg School of Public Health, who has conducted research on the effect of the taxes.


“When alcohol is cheaper at the corner store than milk, orange juice or sometimes even water, it sends young people the wrong message,” Jernigan says. “It makes alcohol look like an ordinary commodity when it is not.” He notes that prices on alcohol used to be much higher than those on other beverages. The most important factor in the price drop has been the inability of alcohol taxes to keep up with inflation.

State Alcohol Policy Changes

The Alcohol Policy Information System (APIS) has updated its list of state alcohol policies to reflect substantive changes that occurred last year. The list is available online.

Many of the state policy changes are consistent with the goal of reducing underage drinking and its consequences, as well as the goal of reducing alcohol-related death and injury in the general population, according to APIS.

Changes to state alcohol policies include an increase in Connecticut’s excise taxes for beer, wine and distilled spirits and Mississippi’s prohibition against hosting underage drinking parties.

Law Enforcement
Policies are only effective if they are enforced.  This story, Laws to Crack Down on Serving Intoxicated People in Bars Largely Ignored, provides a good example.

A recent study published in the Journal of Adolescent Health supports previous studies that show that, when enforced, laws meant to prevent and reduce underage drinking can be effective.  

Changing behavior by changing community environments

Though this 5 minute video from the National Institutes of Health (NIH) focuses on food policy, those of us who work to prevent youth substance abuse can learn from it.

In the video, Dr. Wansink discusses:

• How we can change behavior by changing the environment in which people live, work and play.  People are highly influenced by the things around them.
• That even small barriers to accessing unhealthy foods give people pause to reconsider if they should eat it or not.  (The same is true for drugs and alcohol.)
• The importance of "small p" policy such as putting healthy foods first in a school cafeteria.  While large scale ("big P") public policy is important, small scale policy implemented in community organizations, schools and neighborhoods play an important role, as well.   

"Family Checkup" helps parents prevent teen drug abuse

Family Checkup, an online resource that equips parents with research-based skills to help keep their children drug-free, recently was launched by the National Institute on Drug Abuse (NIDA) .

NIDA-funded research has shown the critical role parents play in preventing their children from using drugs. Family Checkup poses questions for parents to consider as they interact with their children; highlighting parenting skills that are important in preventing the initiation and progression of drug use among youth. The resource incorporates video examples that show parents how-to and how-not-to emulate each skill with their own children.

Here is one of the videos included in the Family Checkup:

Preventing youth substance abuse: everyone has a role

Here is a great video that shows how everyone in the community has a role to play when it comes to preventing youth substance abuse.

New guide available about mobilizing communities

People Power: Mobilizing Communities for Policy Change is a new, free publication from the Community Anti-Drug Coalitions of America (CADCA).  This publication provides an overview of the steps associated with engaging in community mobilizing to implement environmental strategies with a particular emphasis on adopting alcohol, tobacco, and drug (ATD) policies at the community level.

Why a guide about community mobilization and policy change?  The guide starts by explaining: What can communities do when faced with issues such as underage drinking, drinking and driving, misuse of prescription drugs, proliferation of medical marijuana dispensaries and other similar concerns?  As a result of the growing body of research demonstrating the effectiveness of population level interventions, also called environmental strategies, funders in the ATD field are increasingly looking to community coalitions to adopt these strategies as a central part of their work.  

Short YouTube videos for parents a great resource for promoting healthy youth development

Over on the Prevention WINS Facebook page, I've been posting videos from the YouTube DrugFree Channel.  The videos are for parents who want to learn how to prevent substance abuse among their teenage children.  Each video is less than two minutes long.

Here is one about setting standards and creating a supportive family environment:

These videos are a great resource for organizations that support healthy youth development.  The videos are short and easy to share on Facebook pages, blogs, and websites.

Free webinar: skills for parenting drug-free kids

Free webinar: Seven Simple Skills to Promote Happy Families, Healthy Brains, and Alcohol- and Drug-Free Kids

Thursday, June 21, 2012
12:00-1:15 p.m.
Click here to register


For children to do well in school, succeed in life, and remain addiction free, parents need to be well-trained in bonding, setting boundaries, and monitoring kids’ activities.  Kids need to learn skills to help them make healthy decisions in the face of peer pressure, media influences, and easy access to drugs. But where can parents and kids learn these skills?

During this webinar, parents will be given seven specific skills that include communicating politely, establishing rules and routines for youth success, and using positive discipline.  Parents will learn how they can prevent underage drinking and other substance abuse in their family.

Nathan Hale High School Town Hall Meeting on preventing youth drug & alcohol use

For parents: A discussion on why, when and how to talk to your kids about drugs and alcohol!
Wednesday, May 30, 2012
7-8:45 p.m.
Nathan Hale High School

Sponsored and hosted by Raiders Against Destructive Decisions, a student-run organization promoting healthy choices in high school.

Overview of youth substance abuse problem and possible solutions

A commentary published in the May 2012 edition of the Journal of Adolescent Health provides a good overview of the adolescent substance abuse problem.  Some things I learned from the article are:

• Among adolescents who use addictive substances, 65% use more than one drug.  

• Among adolescents who have ever used tobacco, alcohol, or other drugs, 19% meet the clinical criteria for having a substance use disorder as do 33% of current users.

• Only 6% of high school students who have a substance use disorder receive formal treatment.  Fewer teens who need treatment receive it compared with other age groups.

"Moreover, addictive substances have a greater negative impact on the adolescent brain than the adult brain, increasing the risk of further use, adversely influencing the development of the regions of the brain associated with judgment, attention, memory and reward seeking, and increasing the risk of addiction."  

The article goes on to outline influences that drive adolescent substance abuse such as parents, the media, availability and individual challenges.  It closes by stating, "Despite a significant body of scientific evidence demonstrating these facts, this knowledge [about adolescent substance abuse] has not been translated broadly into public health and medical practice."  

This is where coalitions can begin to create change.  Since coalitions are composed of individuals representing different sectors of a community, information about adolescent substance abuse and how we can prevent it can be widely shared.  Coalition members can play a significant role in educating others in the community.  

Postcard encourages parents to support safe and healthy activities for their teenagers

During Mid-Winter Break, Eckstein Middle School families received the third of three postcards with tips about how they can encourage healthy decision making among their teenage children. 

This final postcard provides information about how parents can connect with other parents and ensure that their children are participating in healthy and safe social activities.

Town hall meeting on youth substance abuse in NE Seattle

Save the date!

Town Hall Meeting
Topic: youth substance abuse & what parents can do to prevent it

January 31, 2012
6:00 - 8:00 p.m.
Eckstein Middle School

Free pizza!
Free childcare! 

More information will soon be posted on the Prevention WINS website.

Underage drinking rates decline thanks to community-wide prevention activities

More than 50 people attended Monday's Celebrate Healthy Youth at Nathan Hale High School and learned about how the community in northeast Seattle came together to reduce underage drinking rates.  Following are links to media coverage of the event. 

How alcohol use was cut at two Seattle schools (Seattle Times)

Finding: North Seattle teens are drinking less (KOMO)

How parents influence adolescent substance abuse

While I was doing some research for the Social Marketing Workgroup's (SMW) action plan, I found a report entitled, "Family Ties: How Parents Influence Adolescent Substance Abuse".  It clearly explains why certain parenting practices are effective in preventing youth substance abuse.

One of the parenting practices that the SMW will be promoting is monitoring teenage children.  According to the report:  Support and control have been identified by researchers as two complementary components of parenting (Barnes and Farrell, 1992). The construct of support includes areas such as nurturance, attachment, acceptance, and love, whereas the construct of control includes discipline, supervision, and monitoring. Monitoring has further been defined as parental knowledge of their child’s companions, whereabouts, and activities . . . High levels of parental monitoring are associated with low frequencies of drinking and illicit drug use.
 
According to community parent surveys conducted by Prevention WINS in 2008 and 2010, while NE Seattle parents talk to their children about not using alcohol and/or marijuana, many do not monitor their teenage children.