Transcript Health promotion and drug prevention within the public - kcpe-kcse

Public Health Institute of Primorsko-goranska county
Krešimirova 52A, 51 000 Rijeka
Health promotion
and drug prevention
within the public health system
…evidence based approach
Darko Roviš, prof.
Public Health Institute
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Actively working in health promotion since 1905
Departments:
 Social medicine
 Health ecology
 Epidemiology
 Microbiology
 School and university medicine
 Drug prevention and outpatient treatment
Department for Drug prevention and outpatient treatment
Office for Drug
prevention
Health promotion and drug
prevention programs:
• Universal
• Selective
• Indicative
Office for Outpatient
treatment
Outpatient treatment:
• Drug free approach
• Maintainence
• Detox program
Specific drug treatment:
• Psychotherapy in penal system
• Family support groups
Community involvement
• Drug prevention committees
• Healthy cities
• University programs
Office for Drug prevention
Fiorello la guardie 23, Rijeka
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Team of Two psychologists, defectologist, and teacher
Formed in 2005.
Health promotion and drug prevention:
Life Skills Taining
 Ready- Steady-Healthy
 Youth Counselling
 Bulletin – Rizik
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Drug abuse and
addiction
- Major and still rising problem for Croatia
- Drug rate of 250 /100 000 population
- EU countries 200-800 / 100 000 population
Total number of addict
Opiate addict
New addict
New opiate addict
Drug abuse and adiction in
Rijeka county
TREATED DRUG ADDICT
1995. year– 17 addict
1996. year– 115 addict
2001. year– 649 addict
2004. year– 460 addict
2006. year– 634 addict
2007. year– 666 addict
1 148 Criminal Acts
707 Other Offences
Why do we talk of addicts
when we are discussing
children ?
Substance use …
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44% highschool children regularly or occasionally consume alcohol
51-64 % 2nd grade students engage in ” Binge drinking” – ESPAD 2007
 2002. - 50 interventions of ER service
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Drinking 10 times or often (last 30 day)
1st and 2nd grade students
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1/3 tried
marihuana more
than once
25-40 %
smokes often
Majority thinks it
is “normal” to
drink and smoke
Starting from early age…
First time hard liker?
Research on 8th grade PGZ
• bullying, gambling
• Up to 20 % of children low
self-esteem
• ½ exposed to social violence
• 12-25% peer rejection
• ½ go out where other are
smoking, drinking drug
using
• Fammily and school
communication poor
Prevention
in lower
elementary school grades
Based on
Based on
Possible solutions
1
Based on
How to direct our efforts
to produce wanted effect ?
Less mental & behavioural
problems and drug abuse
in communities and the
population !
Evidence based
evidence-based
 research-based
 science-based
 blueprint programs
 model programs
 promising programs
 effective programs
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Science based programs
Based on evidence,
 Tested in practice
 Methodologically clear design
 Significant reduction of negative outcomes and related risks
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Based on theory
Detail evaluated
Evidence based aproach in Rijeka
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High quality
implementation of best
evidence based model
programs.
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Careful pilot program
design following the
principles of effectiveness
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Quasi experimental
evaluation design
Principles of effectiveness
Comprehensiveness
 Variety of teaching methods
 Sufficient lasting
 Theory based
 Building positive, strong and stabile relationships
 Time
 Following developmental psychopathology
 Social-cultural appropriateness
 Evaluation
 Education
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Developing a prevention model
on a community level
Package of multiple interventions that target
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Children in different age groups
Children, families, social network, community
Risk and protective factors
Common and disorder-specific factors
Use of variety of intervention methods
Building evidence-based interventions
Prevention programs at PHI
Family self help group
Educating Educators
Ready
Steady
Health
Support
group in
Penal system
Health youth
Bulletin
RIzik
Narodni Zdravstveni List
LIFE SKILLS TRAINING
2005/06
- 31 school
- 1657 students
2006/07
Series of workshops
- 38 school
th
th
- 150 assistants for 6 and 7 grade
- 3168 students
2007/08
- 39š school
-165 assistants
-3427 students
Pilot program for
3rd and 4th garde
2008/09
- 44 school
-180 assistants
- over 3500 students
Life Skills Training
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(Dr.Gilbert J. Botvin)
Universal prevention level (smoking, alcohol, drugs, violence)
Evidence based
Experience in implementation and evaluation (SAD, EU, Australia)
Based on theory (Risk reduction model)
Aim: reduce the increase in substance use in adolescents
Risk factors
Protective factors
• Early first contact with cigarettes,
alcohol, drugs
• Lack of self-control
• Poor assertiveness
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High Sef-esteem
Good social and communication skills
Good decision making skills
Good problem solving skills
assertivness
Coping with stress and anxiety,
Goal setting
• Resistance to peer pressure
Workshops
Self image and self esteem
Decision making
Smoking
Alcohol
Marihuana
Media
Anxious emotions
Facing anger
Communication skills
Social skills
Asertivness
Conflict resolution
Activities
in 2007/08
MATERIALS
Prepared and printed materials for 6th and 7th grade
– Student manual for 6th grade
– Teacher manual for 6th grade
– Student manual for 7th grade
– Teacher manual for 7th grade
– Student questioners
– Evaluation forms for teachers
Activities in 2007/08
EVALUATION AND SUPEVISION
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Pre-test
Re-test
Post-test
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Evaluation forms filled after each workshop
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Supervision workshop in February 2008
EDUCATION
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2 X two day education for teachers and school
coordinators
– October 2008
– February 2009
Evaluation...
Evaluation...
Evaluation...
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Reduction higher than 50 %
Evidence that program WORKS
Corresponds to results form USA,EU
Troubles for the firs generation
Life Skills Training
… for 3rd and 4th grade (8-9 years)
• 4 Rijeka school + 1 County school
• Total: 300 učenika
• Piloting for two years
• 8 workshops held 1 x month
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Sef-esteem
Decision making
Smoking
Media advertisement
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Coping with stress
Communication skills
Social skills
Assertivens
Ready
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Steady
Healthy
Pilot program u 2007/08 based on risk reduction model
5 workshops with 8th graders (14 years)
Evaluation questionery
Scholl staff + parents engagement
Deliver the program to school services
Themes
Adolescence
Coping skills
Drugs –one way street
Peer pressure
Health lifestyles