promoting the bilateral relations and analyzing the icelandic model for prevention contract № bg...
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Substance use decrease amongst year old adolescentsTRANSCRIPT
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Promoting the bilateral relations and analyzing the Icelandic model for prevention
Contract № BG 01-002/12.06.2015
Supported by the Fund for Bilateral Relations at National Level for Bulgaria under the EEA FM and NFM 2009-2014
www.eeagrants.org
ConferenceAnalyzing the Icelandic model for prevention addictions
among children and adolescents and promoting the bilateral relations
02.02.2016
Grand Hotel Bulgaria
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Promoting the bilateral relations and analyzing the Icelandic model for prevention
Contract № BG 01-002/12.06.2015
Supported by the Fund for Bilateral Relations at National Level for Bulgaria under the EEA FM and NFM 2009-2014
www.eeagrants.org
“Evidence Based Primary Prevention –The Icelandic Model”
Jón Sigfússon
02.02.2016Grand Hotel Bulgaria
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42
32
26 26 25
1814
75
23
16 1412 12 10
73 3
17
12 129 9 7
9 6
0
10
20
30
40
50
1998 2000 2002 2004 2006 2008 2010 2012 2015
%
Drunk last 30 days Daily smokingCannabis once or more
Substance use decrease amongst 15-16 year old adolescents
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Substance Use Amongst European Youth (ESPAD, 2011)
Iceland Malta Lichtenstein0
10
20
30
40
50
60
70
80
Cigarette use past 30 days Alcohol use past 30 days Lifetime use of cannabis
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Structure of presentation1. The role of research in prevention work2. Background of the prevention model3. Methodology, characteristics and emphasis4. Actions in regard to primary prevention
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The role of research
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Prevention work must be evidence based!
If we do not than we are steering blind!
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ICSRA specialization• Research in three age groups:
• 10 to 13 year old in primary school• 14 to 16 year old in primary school• 16 to 20 year old in high school / junior college
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ICSRA database 1992 - 2015 Twenty two data collections amongst 15-16 year old pupils since 1992
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IndicatorsHealth status indicators, anxiety, depressive symptoms, physical health status, lifestyle and leisure time activities, local community networks, negative life events and strain, parents and family, peer group economic and psychological issues, studies and school, substance use, values and attitudes, violence and delinquency, and more…
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The twofold use of research 1. Scientific
2. Practical
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The scientific role of research1. In depth analysis of the data2. 50 peer reviewed papers past 5 years3. Publications in journals in Europe and USA4. Science forms the platform for practice
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The practical role of research1. Data collections on substance use every year2. Practical descriptive reports within 2-3 months of each data
collection to the municipalities3. School reports to the schools4. Local information INTO all levels of prevention work is a KEY issue
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Importance of frequent measuringEvery school, every parent, every prevention worker can see the current situation in their close community and can act accordingly.
Not 2-3 years later but almost immediately
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Children's rights1. Children have the right to have a say about what they want, what
they do and how they feel2. We have the obligation to make good use of what they tell us,
react and constantly try to make their lives better.
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Prevention approach background
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Upward trend 1992 - 1998
15,1
20,722,8
7,29,6
17,4
0
5
10
15
20
25
30
1992 1993 1994 1995 1996 1997 1998
%
Smoke daily Have tried hashish
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1998 At this point of time research had already showed us that certain circumstances and behaviour in the lives of adolescents were strongly connected with use
We tried to establish the risk and protective factors
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The main risk and protective factors
Familyfactors
Peer group effect
General well being
Extracurricularactivities, sports
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And analysing deeper
Familyfactors
Peer group effect
General well being
Extracurricularactivities, sports
Time spent with parents SupportMonitoringControl
Positive and negative effects.How we as parents approach the peer groupStaying outside lateHanging out in malls
Inside and outside of school, at home, bullying e.t.c.
Organized activitiesvs.
unorganized
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1998 Drug-free Iceland Based on these findings a research based action plan was initiated by the government with the aim to try out a totally new methodology in substance use prevention
Obviously, what had been done before, was not working
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Aim of Drug-free Iceland• To change the actual behaviour of youth and not only their attitudes• Change the life-style environment of our children so that they would be in lesser risk of substance use
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The methodology
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Our focus is primary prevention• Primary prevention, preventing the development of substance use before it starts• Secondary prevention, that refers to measures that detect substance use• Tertiary prevention efforts that focus on people already abusing substances
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Substance use follows cohortsSigfusdottir et al., 2011, Global Health Promotion
20
41
57
10
25
41
8
22
32
4
12
21
614 16
1 611
0
10
20
30
40
50
60
13 14 15 13 14 15
Cohort 1984 Cohort 1991
%
Lifetime drunkenness
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Substance use follows cohortsSigfusdottir et al., 2011, Global Health Promotion
20
40
57
10
25
41
0
10
20
30
40
50
60
13 14 15 13 14 15
Cohort 1984 Cohort 1991
%
Lifetime drunkenness
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What else would we tell the policy makers?
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Percentage of girls in 9th and 10th grade who have become drunk in the last 30 days depending on how much time they spend with parents
42,0
27,8
17,612,0 10,4
0
10
20
30
40
50
60
70
80
90
100
Girls who have become drunk last 30 days
%
Almost never Seldom Sometimes Often Almost always
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Percentage of students in 9th and 10th grade who have become drunk in the last 30 days depending on if their friends become drunk one pr. month
4,6
23,3
49,3
68,2
0
10
20
30
40
50
60
70
80
90
100
Boys who have become drunk past 30 days
%
None or few A few Many Almost all
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Percentage of students in 9th and 10th grade who smoke daily depending on if they practice sports
12,5
24,9
10,4 9,9
4,0 3,5
0
10
20
30
40
50
Boys who smoke daily Girls who smoke daily
%
Almost never Up to 3 times pr. week 4 times or more often
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Main actions: Based on research findings
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Examples of local actions1. Research as a basis in policy making and actions
2. Strengthen parent organizations and co-operation
3. Support extracurricular activities / sports
4. Support active NGOs’
5. Support young people at risk inside schools
6. Form co-operative work groups against drugs
7. Anti smoking / drinking campaigns
8. Strengthen social capital
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Examples of national actions1. Legal age of adulthood raised from 16 to 18 years2. Age limits to buy tobacco and alcohol (18 and 20)3. Strict regulations for sellers of tobacco4. A total advertising ban of tobacco and alcohol5. Restricted access to buying alcohol and tobacco6. Total visibility ban of tobacco and alcohol7. Rules on outside hours for adolescents
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Tobacco and chewing gum
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Peanuts and Gin
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The scientific isolation needed to be broken
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The researchers “guru” approach
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We needed to focus on close community• How could an average figure on alcohol use in Sofia help prevention workers in Varna?• “Average” doesn´t tell all the story.• Local information within 2-3 months of data collection each year.
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Every school can see where students standLocal figures for smoking in 33 gymnasiums (16-19 years old)
2,3 5,
25,
8 6,6 7,
9 8,5 8,8
8,9
9,1
9,2 10
,6 11,9
12,0
12,5
12,5
12,6
12,8
12,8
13,2 14,3
14,9
15,5
15,6 16
,917
,1 18,6 19
,8 20,9
21,0 23
,1 25,5 27
,031
,4
0
10
20
30
40
50
Scho
ol
Ave
rage
Scho
ol
%
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Local information fuels dialogue• Dialogue between key stakeholders • Politicians, municipalities and local authorities• Parental groups and family planners• School authorities and school workers•Health educators, health and social services• Leisure time workers, prevention workers• Sports and youth institutions
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The way we work now
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And what is achieved?
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Percentage of students in 9th grade that participate in sports in a sports club four times per week or more
23,0
34,0
42,0
0
5
10
15
20
25
30
35
40
45
50
2000 2006 2012
%
Increased participation in organized sports
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Percentage of students in 9th and 10th grade who spend time (often/almost always) with their parents during weekdays
23,0
33,0
46,0
05101520253035404550
1997 2006 2012
%
Time spent with parents
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Percentage of students in 9th and 10th grade who have been out after 10 pm (3 times or more) in the past week
53,0
40,0
29,0
-5
5
15
25
35
45
55
65
75
2000 2006 2012
%
Less late outside hours
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My parents know where I am in the evenings (applies very or rather well to me) 9th and 10th grade
52,0
67,071,0
0
10
20
30
40
50
60
70
80
2000 2006 2012
%
I ncreased parental monitoring
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…and substance use is going down
42
32
26 26 25
1814
7
5
23
16 1412 12 10
73 3
17
12 129 9
7
96
0
10
20
30
40
50
1998 2000 2002 2004 2006 2008 2010 2012 2015
%
Drunk last 30 days Daily smoking Cannabis once or more
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Youth in Europe until 2015
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Thank you
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