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PREVENTION
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PREVENTION TRAINING SESSIONS


COMPREHENSIVE SCHOOL-BASED PROGRAMS INVOLVING THE FAMILY

Introduction to Programs on Schools and Families

Carmen Mille
National Council on Addictions
(CONADIC)
Ministry of Health
Mexico

“Construye tu Vida sin Adicciones” (Build your Life Without Addictions) Program in Schools
Carmen Mille,
Maria Teresa Sanchez Fragoso,
Fernando Bilbao,
Norma Merena
Council on Addictions (CONADIC)
Ministry of Health
Mexico

Bi-national Implementation of “Construye tu Vida sin Addiciones”
Dr. Ignacio Benedicto Reyes
Baja, California
Mexico

In a prevention track session on school and family-based programs, CONADIC staff provided an overview of Mexico’s wide-ranging prevention effort, “Construye Tu Vida Sin Addiciones,” (build your life without addictions) followed by a presentation by Dr. Ignacio Benedicto Reyes about a cross-border implementation of Construye in Baja California in both Mexico and the U.S.. Construye programs have many elements including role-plays for young people on decision making, community work in which facilitators form groups of community prevention workers, and projects specifically planned by and for young people. Materials include posters, bulletins, flyers, four books and three videos. The biggest problem in getting prevention programs in schools is that school officials think they have no time for such activities. Presenters noted, however, that the students find time and even work on Saturdays on tournaments, parties, fairs, basketball games—all drug-free and promoting healthy lifestyles. At this time, process evaluations are being done on Construye programs, and Carmen Mille of CONADIC stated that a follow-up study will be conducted that will enable measurement of program impact. Other CONADIC staff noted the need for improved dissemination systems.

Noting that Baja is a “third culture,” Dr. Reyes, of Baja California, described bi-national implementation of Construye programs there. Baja, Mexico’s activities were coordinated with those of Imperial, California’s, and these communities jointly chose Construye as their prevention model. A youth committee and an adult prevention committee were formed, and bi-national training was conducted. Construye went through its entire process, from the identification of small groups of students to lead the effort in particular schools, to their identification of activities. In this case, under the theme “Baja Fighting Drugs Together,” the community held prevention fairs and art shows, and a youth-operated hotline has been started. At this point, Construye is at the community level but some training has begun in the schools. In some schools, Construye lessons have become part of the curriculum; in others, it is an after school activity. Sometimes teachers invite parent participation and provide training for both students and parents. Reyes concluded that all models have to be adapted to the specific culture, be easily understood, and have direct relevance to the target population.

EFFECTIVE COMMUNITY MOBILIZATION APPROACHES

Drug-Free Communities Support Program: Community Mobilization in the Border States to Reduce Substance Abuse
Mary Ann Solberg, Moderator
Advisory Commission on Drug-Free Communities
United States

Panel:

Harry Montoya
Hands Across Cultures, Inc.
Espanola, New Mexico
United States

Luz Arriola
West Texas Council on Alcoholism and Drug Abuse
El Paso, Texas
United States

Lorenzo Merritt
Project HEAVY West
Los Angeles, California
United States

Luis Navarro
Chimalli System for the Integral
Development of the Family (DIF)
Mexico

Grantees from the Drug-Free Communities Support Program (DFCSP) facilitated this training session. This program is a collaborative program of ONDCP, OJJDP and SAMHSA/CSAP created by the Drug-Free Act of 1997 (Public Law 105-20). This act funds community coalitions (collaboratives) to reduce substance abuse among youth, and over time among adults; and increase collaboration among Federal, State, local, and private non-profit community based organizations.

The DFCSP projects all serve a diverse bi-national target community on the U.S. side of the border.

Harry Montoya, presented cultural relevance, vision and principals of community mobilization. Luz Arriola, WTCADA, provided a step-by-step guide to plan and form a community coalition to mobilize the community to reduce substance abuse. Dr. Lorenzo Merritt, PHW, presented the developmental stages of community mobilization, the challenges and opportunities, and the outcomes of community mobilization. Luis Navarro, Chimalli-DIF, Mexico, presented the results of a Mexican research project on homeless children living in the streets in 100 cities in Mexico. Mr. Navarro’s presentation provided the many risk factors that these children are exposed to, including a higher incidence of substance abuse and substance abuse related violence.

The main points of this training were:

  • Assess the community that you are trying to mobilize in order to establish baseline data.

  • Balance inter-cultural issues in community mobilization process.

  • Determine steps and developmental stages relating to community mobilization for the target community.

  • Impact negative social norms by using the proven Community Mobilization training model.

  • Utilize community challenges and opportunities for community mobilization to design, provide ongoing review of effectiveness, and revise, if necessary, evaluation of mobilization efforts.

BUILDING EFFECTIVE PARTNERSHIPS FOR DRUG PREVENTION IN THE WORKPLACE

Robert Stephenson, Acting Director,
Division of Workplace Programs
Center for Substance Abuse Prevention,
Substance Abuse and Mental Health Services Administration
United States

Building Partnerships for Drug Prevention in the Workplace

Elizabeth Edwards, Gabriela Garcia,
Arizonans for a Drug-Free Workplace
United States

Model Program on Alcohol and Drug Use Prevention Between Workers and Their Families

Agustin Vélez, Director,
Trusteeship for the Institute for Street Kids and Addictions
Mexico

Click to see the slide presentations.

PREVENTION ACROSS THE LIFE CYCLE

Ruth Sanchez-Way
Introductory Remarks
Substance Abuse and Mental Health Services Administration
Department of Health and Human Services
United States

Prevention in Early Childhood
Rosa Bonifaz, Carmen Mille
National Council on Addictions
Ministry of Health
Mexico

U.S. Efforts – Prevention in Early Childhood
Eileen O’Brien
Casey Family Program
Substance Abuse and Mental Health Services Administration
Department of Health and Human Services
United States

Dr. Ruth Sanchez-Way, Acting Director of SAMHSA's Center for Substance Abuse Prevention (CSAP), opened the session by underscoring the need to view prevention as a life-long process, not just one or two interventions.

Ms. Mille described Mexico's "Construye Tu Vida sin Addiciones" a comprehensive prevention effort covering physical, mental, spiritual, social, and cultural aspects of prevention. She noted that the health promotion aspects of Construye are based on elements of "care" and a healthy environment. Ms. Mille then described the public awareness features of the effort, including the use of television, radio (with specific targets), written guides, and hotlines.

Ms. Rosa Bonifas, also of CONADIC, described Construye's media campaign, which targets youth ages 9-14, older adolescents, and adults 20+ years of age. Materials for the youth include activity guides, self-surveys, and discussion guides. For older adolescents, self-help manuals have been developed, along with self-evaluations. For adults, self-help manuals and facilitator guides have been developed, along with specific guides for parents and teachers.

Ms. Eileen O'Brien, of SAMHSA's CSAP, then described an early childhood prevention program developed by CSAP called Starting Early/Starting Smart (SESS). Describing brain research that shows early experiences (i.e., positive or negative interactions) shape neural pathways, she then recounted the various elements of SESS as listed below. In general, she noted that SESS provides integrated substance abuse and mental health services in early childhood setting, and SESS services may include: case management, pediatric primary care, language development, reading readiness, and family services including parenting education and support groups. Ms. O'Brien stressed that SESS is based on acknowledging and building family strengths with a direct focus on both substance abuse and mental health, and is implemented through collaborations and partnerships.

Pre-natal:

  • improving attachment and parenting skills for expectant parents

  • nutrition support for the future mothers

  • general support and encouragement for future fathers.

Infants and toddlers:

  • health care, child care

  • links with Healthy Start, and well-baby care.

Children ages 3-5:

  • Access to primary care clinics, child care, pre-school and early reading programs.

PREVENTION IN YOUNG ADULTHOOD

Higher Education Programs

John Clapp
Research Director
College of Health & Human Services,
School of Social Work
San Diego State University
United States

Dr. John Clapp described a college prevention program called CAPP, the Collegiate Community Alcohol Prevention Partnership. From 1989- 1999, individual colleges in the U.S. conducted prevention programs based on raising awareness and peer education, with modest success. Now, according to Clapp, colleges are funding "environmental prevention" programs that involve all sectors of a community, from recognizing the role of the social environment in preventing alcohol and other drug abuse by college students, to developing prevention programs that target real needs.

The strategy used to develop these realistic prevention efforts starts with data collection, then goes to strategy identification (e.g., media advocacy, server training, party penalty programs), and finally to strategy selection. Clapp stressed the importance of starting with community assessment of problems and needs, in order for communities to identify desired outcomes (reduce binge drinking or reduce alcohol-related injuries, etc.).

Parent Prevention Education in the Workplace

Bernie McCann
Office of National Drug Control Policy
United States

The National Youth Anti-Drug Media Campaign Workplace Program Objective is to use the workplace to communicate Media Campaign messages and strategies to parents, grandparents and others involved with youth. The Media Campaign’s workplace component is designed in conjunction with National Drug Control Strategy’s Goal Number 1: to educate and enable America’s youth to reject illicit drugs as well as alcohol and tobacco.

Business Case
America’s workplaces offer an efficient, effective and, at this time, an underutilized channel to reach parents and guardians with drug prevention information, solutions, and resources to help raise drug-free children. And research demonstrates there is a need for these resources in the workplace:

  • A recent poll conducted in conjunction with the Society for Human Resource Management (SHRM) showed that most human resource professionals believe an employee’s concerns over their child’s possible drug use could lead to decreased morale and productivity, and a concomitant increase in turnover, and healthcare costs. The Media Campaign workplace program is designed to reduce youth drug use while assisting with a company’s efforts to find solutions for critical performance issues.

How the program will work
The Media Campaign will recruit employers to work in partnership to incorporate Media Campaign messages and in the internal communications vehicles employees know and trust – employee newsletters, company intranets and e-mail systems, posters, benefit and employee assistance program kits, workplace seminars, etc.

Media Campaign will accomplish recruiting efforts by:

  • A nationwide publicity and promotion effort emphasizing the importance and organizational benefits of providing youth-focused drug prevention information to employees who are parents, grandparents and guardians of teens and tweens. Materials and resources will be easily adaptable to a company’s existing employee communications program.

  • Reaching out to business leaders and professional, business, labor and government organizations willing to serve as Media Campaign messengers and as influential conduits into employer organizations.

  • Contacting and offering Media Campaign information directly to employer organizations.

What materials will be distributed?
Print and electronic media will be made available to employers for their employees. Print materials will consist of a collection of items from nationally recognized drug prevention programs. Each company participating in the workplace program will have the option of ordering materials directly from the publisher. Materials will be available in either print or electronic formats (downloadable files via the World Wide Web). Items include:

  • Pamphlets, posters, etc., appropriate to the parent target audience

  • Media Campaign-created newsletter articles for use in employee magazines, newsletters, human resource benefit kits and employee mailers

  • Electronic communications including Media Campaign-generated e-mails, down-loadable PSAs, screen savers, banner ads for use on corporate Web pages, and electronic links for drug prevention resources available for parents/guardians on the World Wide Web.

Screening and Brief Alcohol Interventions with Older Adults

Kristen Barry
Senior Associate Research Scientist
University of Michigan
United States

The purpose of Dr. Barry’s presentation was to provide state-of-the-art information and techniques regarding alcohol screening and brief alcohol interventions targeted to adults age 60 and over. Dr. Barry pointed out the fact that a growing number of people reach later life, and that the promotion of healthy lifestyles and primary disease prevention among these older adults is becoming a critical issue. She presented information regarding how many aging adults are seeking costly health care for acute and chronic conditions and how because of the increased incidence of health care problems, elderly adults are more likely to seek health care on a regular or semi-regular basis than are younger adults. In addition, Dr. Barry identified older adults as being more vulnerable to the effects of alcohol and, this combined with the increases in co-morbid diseases and their use of prescription and over-the-counter medications, may cause them to seek health care for a variety of conditions that are not immediately associated with increased alcohol consumption.

She stressed the importance of systematic alcohol screening and intervention methods and tools, and said that they can help insure relevant and high quality health care to older adults. Older adults with alcohol problems are a special and vulnerable population who require elder-specific screening and intervention procedures focused on the unique issues associated with drinking in later life. She stressed the following important points to consider when working with these older adults, including:

  • The prevalence of at-risk drinking in community samples of older adults has been estimated to be between 1-15%, depending on the group studied.

  • Randomized controlled clinical trials indicate that older adults whose alcohol use exceeds the National Institute on Alcoholism and Alcohol Abuse (NIAAA) guidelines will significantly decrease alcohol use in response to brief structured workbook-driven interventions.

  • Implementing alcohol screening and brief intervention strategies for older adults in clinical settings will require the development of systematized protocols that provide easy service delivery.

DRUG AND VIOLENCE PREVENTION PRESENTATIONS ON SAFE-SCHOOLS

Healthy Students Initiative

William Modzeleski, Moderator
Director, Safe and Drug-Free Schools Program
U.S. Department of Education
United States

Presenters:
Ann Clark
Supervisor, Safe and Drug-Free Schools
Houston Independent School District
Houston, Texas
United States

Philmer Bluehouse
Pinon Unified School District #4
Pinon, Arizona
United States

Forrest Van Camp
Leon County Schools
Tallahassee, Florida
United States

Martha Fletcher
Leon County School District
Tallahassee, Florida
United States

Dra. Marisa Oceguera
Latin American Institute for Family Studies
Mexico

Overview

The drug and violence prevention session began with an introduction by the moderator, followed by presentations on three Safe Schools/Healthy Students projects in the United States, and a presentation on the Latin American Institute for Family Studies program in Mexico.

Introduction

Bill Modzeleski opened the session with an overview of issues and data regarding school safety in the United States. For the most part, U.S. schools are safe. Recent data indicate that 43 percent of schools experience no crime, and 90 percent experience no serious violent crime. The most common crimes that occur in schools are theft and fighting. Serious violent crimes against students at school or going to and from school have been decreasing since 1992, and remain much lower than the same types of crimes committed in communities. With regard to weapon carrying, based on data from 1993- 1999, the general trend in weapon carrying on school grounds has been decreasing.

With regard to the frequently asked question of how many homicides there are in schools, according to a study by the Centers for Disease Control (CDC) over a two-year period between 1992-1994, there were 105 school associated violent deaths, of which 85 were homicides. From 1997-1998, there were 58 violent deaths, representing a slight increase from the previous period studied. Today, there is a lower incidence of homicides in schools, but more victims, due to an increase in multiple homicides. Much attention is being directed to homicides; however, not enough attention is given to more basic, prevention-related issues such as discipline, truancy, and bullying. Prevention of violence needs to start with a strong foundation of clear standards of behavior.

How are we addressing the problem of violence in schools? Through the following broad approaches: 1) improving physical conditions at schools; 2) targeting high-risk youth; 3) implementing drug and violence prevention programs and 4) increasing security and establishing strong discipline policies. It is important to use comprehensive strategies that involve many partners, including schools, law enforcement, health services, community organizations, families, and many others.

The following recent publications of the U.S. Department of Education and the U.S. Department of Justice can be ordered free of charge by contacting ED Pubs at 1-800-877-433-7827.

  • Safeguarding Our Children: An Action Guide

  • 1999 Annual Report on School Safety

  • Early Warning/Timely Response: A Guide to Safe Schools

Safe Schools/Healthy Students Initiative

Houston Independent School District, Houston, Texas

Ann Clark, Safe and Drug-Free Schools Coordinator, Houston Independent School District (I.S.D.) presented information on Houston’s Safe Schools/Healthy Students Initiative. The purpose of the program is to provide students, schools, and communities in the feeder schools to Houston’s secondary schools with enhanced comprehensive educational, mental health, social, law enforcement, and juvenile justice services that promote healthy childhood development and prevent violence, drug and alcohol abuse. The Houston I.S.D. serves a diverse population which speaks 87 different languages. The program has six goals:

  • Establish a safe school environment by reducing the levels of violence, aggression, and substance abuse among children and youth in the community.

  • Improve mental health and increase pro-social behavior through an integrated, coordinated continuum of programs and services.

  • Ensure that children at risk of emotional and behavioral problems receive appropriate school and community mental health preventive and treatment intervention services.

  • Assist high risk families to build resilience to adversity so that children enter school with the necessary pro-social and academic skills to succeed.

  • Support educational reform efforts that increase academic achievement through development of school climate.

  • Improve integration and coordination of services among Houston I.S.D. and various community agencies.

Activities for accomplishing these goals include strategies for increasing parent involvement; improving the availability of after-school programs; providing ongoing training to students, parents, and teachers on accessing resources and services; providing mental health treatment services for children at risk for emotional and behavioral problems; providing intensive early prevention and therapeutic services to high-risk families of children ages 0-5; and many other strategies.

Pinon Unified School District, Pinon, Arizona

Philmer Bluehouse, Director of the Safe Schools/Healthy Students Initiative for Pinon Unified School District, began his presentation with the Navajo greeting “Ya’a’te”, which means “I come to you with the universe” and “It is perfect.” As he introduced himself as a full-blooded Navajo of the Many Goats Clan, he explained that it is critical to teach children who they are, and that it is Navajo custom to introduce oneself through one’s clan. One must start from one’s clan to understand where one fits in. The Many Goats Clan has a “humble” side and a “warrior” side. We are all designed in the same way, in that we have a linear side and a cultural side, or a peace side and a warrior side. This creates balance.

Pinon School District is very rural, with a population of 8,000. Children are bused to school, leaving their homes at 6:00 a.m. and not returning until late afternoon. Services are stretched thin, meaning that the community must play an important role. The Safe Schools/Healthy Students initiative is looking at a strategy of re-empowering the community to decide what services to provide, and how the services should be provided, including education, health, and law enforcement. There are Federal, State, and Tribal laws that apply. The community must be involved, and all parts of the community must work together.

The goal is to achieve a state of harmony or “hosanosnin.” How can harmony be achieved? How can the process make things better? How do we allow the process to heal rather than destroy? The overall objective is to allow people to be involved in making decisions at the community level rather than being acted on by outside forces, and to encourage traditional ways to flourish. The problems and the solutions are local.

Leon County School District, Tallahassee, Florida

Forrest Van Camp, Executive Director, Leon County School District, provided an overview of the Safe Schools/Healthy Students Initiative in Leon County School District.

The initiative places an emphasis on early childhood, providing early intervention for at-risk children. Five elementary schools are being targeted. Objectives are to build student resiliency and increase access to mental health and prevention services. Strategies include increasing alternative after school programs and recreational activities for students. School security strategies include increasing surveillance cameras and radios in schools.

Martha Fletcher, Program Specialist, Early Childhood Programs, provided further information about the Leon County initiative. Leon County is unique in that all funding for early childhood services is under one umbrella. This blending of funds for early childhood services enables more children to be served. Services include programs for teen parents, and mental health programs for young children. Many children are coming to school from chaotic home environments. Mental health intervention services need to be provided early, rather than waiting until children are older. Children need to be taught how not to become victims. Teachers are being trained through a problem solving approach. Leon County has produced a training curriculum for parents and a video entitled “Discipline with Love.” The Safe Schools/ Healthy Students initiative will provide an “active parenting” parent education curriculum.

Latin American Institute for Family Studies

Marisa Oceguera presented information on the Latin American Institute for Family Studies and its family therapy services. The focus is on prevention among families. One must consider the family in various contexts, such as social and economic environments, as part of an ecosystem. Legislation related to family violence in Mexico has been recent. According to a 1999 study, family violence occurs in one out of three homes in Mexico. In fact, family violence is sometimes seen as normal behavior. Another study found that 38.4% of women had suffered some type of violence. Family violence is often associated with alcohol abuse by men. Violence against women is a significant social problem. Its impact often extends to children, resulting in behavioral problems and problems at school. One of the main reasons that girls leave home is due to sexual abuse. One must have an ecological outlook when considering family violence, such as personal history, distribution of power within the family, lack of equality, gender roles, stereotypes, and a certain way of looking at men in relation to women. Many studies on alcoholic men show a close relationship between alcohol use and violence. Women with drug and alcohol problems often come from families where there is a lack of care and support. To be a female addict is worse than to be a male addict. Women are prey to violence. According to one study, two-thirds of people on controlled substances had been subjected to violence. There is a “social silence” on the subject of family violence. It is hushed up, reinforcing the negative effects, and creating difficulties in seeking help. The ecosystem approach is recent. It is an approach that must involve all parts of many complex systems in addressing the problem.