Title: Preventing harmful substance use by supporting families.
1Preventing harmful substance use by supporting
families.
Professor John W. Toumbourou, PhD Chair in Health
Psychology, Deakin University VicHealth Senior
Research Fellow, Centre for Adolescent Health,
Murdoch Childrens Research Institute
2The National Drug Research Institute The
Centre for Adolescent Health
3Authors
- Wendy Loxley, John W. Toumbourou, Tim Stockwell,
Ben Haines, Katie Scott, Celia Godfrey, Elizabeth
Waters, George Patton, Richard Fordham, Dennis
Gray, Jann Marshall, David Ryder, Sherry Saggers,
Lena Sanci and Jo Williams - With contributions by
- Susan Carruthers, Tanya Chikritzhs, Simon Lenton,
Richard Midford, Pamela Snow and Catherine Spooner
4Toumbourou, J.W., Stockwell, T., Neighbours, C.,
Marlatt, G.A., Sturge, J., Rehm, J. (2007)
Interventions to reduce harm associated with
adolescent substance use. The Lancet, 369, 1391
-1401.
5Trends in youth alcohol and drug use
6Increased social marketing expenditure
Legislation smoke free spaces, sales to minors
White et al, (2004) National School Survey
7Secondary school illicit drug use - some
reductions
- Cannabis use
- (lifetime use 12-17 29 1999 to 25 2002)
- Other illicit use
- (lifetime use 12-17 13 1999 to 11 2002)
White et al, 2004 Schools survey
8National Drug Strategy Annual Report, 2005
9Why has illicit drug use reduced?
- effective policing / supply reduction
- employment
- generational cycles
- harm minimisation treatment
- prevention
10SOME EVIDENCEto link reductions in illicit drug
use to policy interventions
11alcohol
12GOOD EVIDENCE that harm minimisation policies
have reduced alcohol-related mortality
13National Alcohol Indicators Bulletin. 6
14the trends are not so clear for other
alcohol-related harms
15Some groups such as young people and young women
show particularly increased rates
16Age 15 - Females
17National Alcohol Indicators Bulletin. 7
18We are not monitoring developmental harm
- Female heavy alcohol use contributing to problems
with infants children - Early use increasing levels of dependence
- Mental health impacts (eg., self-harm)
- Brain impacts
Prevention Clearinghouse No. 13, 2004
19There is little political will to limit alcohol
availability
20Growth in liquor licenses Victoria
Turning Point - National Alcohol Strategy, 2006
21complex cause problems require integrated
solutions
22Reduced adolescent tobacco and alcohol use
23Reduced adolescent tobacco and alcohol use
Reduced adult tobacco and alcohol use and harm
24Reduced adolescent tobacco and alcohol use
Universal programs Regulation Taxation Enforcement
Education Family sensitive policies
Reduced adult tobacco and alcohol use and harm
25Targeted early intervention Maternal and parental
support infancy, pre-primary and primary school
Reduced adolescent tobacco and alcohol use
Universal programs Regulation Taxation Enforcement
Education Family sensitive policies
Population-level outcomes Reduced drug use, harm,
dependence, mental health problems and crime
Reduced adult tobacco and alcohol use and harm
Targeted and selective adult Interventions (all
drugs) Brief interventions, harm reduction
treatment and involvement of family
26harm reduction
demand reduction
supply reduction
setting
27Different Pathways
early life childhood
adolescence adulthood
Loxley et al, 2004
28what works?
290 Limited investigation. ý Evidence is
contra-indicative. O Warrants further
research. Evidence for implementation.
Evidence for outcome effectiveness. Evide
nce for effective dissemination.
30??? High priority for implementation and
maintenance
- Tobacco taxation to create price disincentives
- Enforcement of passive smoking regulations
- Alcohol taxation hypothecation, wine excise
- Random Breath Testing visible, high rate
- Brief interventions for tobacco and alcohol
- Treatment Programs
- Needle and Syringe Programs
- Hepatitis B Vaccination
31early yearsprenatal to preschool
320 Limited investigation. ý Evidence is
contra-indicative. O Warrants further
research. Evidence for implementation.
Evidence for outcome effectiveness. Eviden
ce for effective dissemination.
33Integrate early years and drug treatment
investments
- Parents in drug treatment should be
systematically targeted for support. - Support should be evidence-based and focus both
on drug treatment and strategies to encourage
healthy child development.
34primary school
350 Limited investigation. ý Evidence is
contra-indicative. O Warrants further
research. Evidence for implementation.
Evidence for outcome effectiveness. Eviden
ce for effective dissemination.
36 improving primary school social environments
substance use
school
- Schools and Families Educating Children
- Seattle Social Development Project
- Good Behaviour Game
- Linking the Interests of Parents and Teachers
- Child Development Project
- Fast Track
- Kids Matter
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37secondary school
380 Limited investigation. ý Evidence is
contra-indicative. O Warrants further
research. Evidence for implementation.
Evidence for outcome effectiveness. Eviden
ce for effective dissemination.
39improving secondary school social environments
substance use
school
- School Transitional Environment Program
- Olweus Anti-Bullying Program
- The Gatehouse Project
- School Drug Policy
- Health Promoting Schools
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40There is a growing that to enhance development
across the lifespan
41 we need to support families
42trends in families
- high rates of family breakdown family
complexity - work involvement (responsibilities, long hours)
- family community impacts - uneven economic advances (disadvantaged
communities schools) - higher fertility in disadvantaged groups
- increasing child abuse and neglect
43The Resilient Families program Advancing the
health of young Australians by improving early
secondary school environments
44The Resilient Families team John W. Toumbourou,
Alison ShorttConstance JenkinJohn Bamberg
45Resilient Families2004 to 2006
NHMRC Funded Randomised School Trial
46Aims
- Improve adolescent educational outcomes and
reduce alcohol misuse - Enhance school and family protective factors
- Increase family involvement in secondary school
- Reduce marginalised peer groups
47Resilient Families Program
- 10-week Student Curriculum
- Evening Parenting Adolescents Quiz
- 8-week PACE Parenting Groups
- Parent Education Handbooks
- Encouraging a community of parents
48The Evaluation
- 24 disadvantaged Catholic and Government
secondary schools in metropolitan Melbourne were
randomly assigned (62 of approached) - 12 schools did the Resilient Families
intervention and surveys - 12 schools students were surveyed without
intervention - 2,300 Year 7 students (55) surveyed in 2004 and
95 resurveyed annually in 2005 2006
49Baseline Findings - 2004
- In Year 7 the intervention versus control
students were similar - 33 reported prior alcohol use
50Year 2 - 2005
- In Year 8 intervention students showed overall
advantages in family and school adjustment
compared to those in the non-intervention schools - Higher family attachment (OR 1.4)
- Improved school rewards
- Improved school attendance
- Increased anxiety
51Year 2 - 2005
- Students were doing even better in the 10 of
families where the parents had attended the
parent education activities - Improved school grades
- Reduced bullying
- Improved social problem solving
- More adolescent-parent conflict
52Year 3 - 2006
- Database still being analysed
- Preliminary trend - The intervention reduced
Year 9 alcohol use and misuse
53The future
- Reductions in harmful alcohol and drug use
- Community integration of program mix
- Families in primary schools
- Families in secondary schools
- Positive youth development
- Evidence-based
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