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Health promotion and drug prevention within the public health system

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. A ctively working in health promotion since 1905 Departments :

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Health promotion and drug prevention within the public health system

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  1. Public Health Institute of Primorsko-goranska county Krešimirova 52A, 51 000 Rijeka Health promotion and drug prevention within thepublic health system …evidence based approach Darko Roviš, prof.

  2. Public Health Institute • Actively working in health promotion since 1905 Departments: • Social medicine • Health ecology • Epidemiology • Microbiology • School and university medicine • Drug prevention and outpatient treatment

  3. Department for Drug prevention and outpatient treatment Office for Drug prevention Office for Outpatient treatment • Health promotion and drug prevention programs: • Universal • Selective • Indicative • 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

  4. Office for Drug preventionFiorellolaguardie 23, Rijeka • 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

  5. Drug abuseandaddiction - 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

  6. Drug abuseandadictionin Rijeka county TREATED DRUG ADDICT 1995. year– 17 addict 1996. year– 115addict 2001. year– 649addict 2004. year– 460addict 2006. year– 634addict 2007. year– 666addict 1 148 Criminal Acts 707 Other Offences

  7. Why do we talk of addicts when we are discussing children ?

  8. Substance use … • 44% highschool childrenregularly or occasionally consume alcohol • 51-64 % 2nd grade students engage in ” Binge drinking” – ESPAD 2007 • 2002. - 50 interventions of ER service Drinking 10 times or often (last 30 day) 1st and 2nd grade students • 1/3 tried marihuana more than once • 25-40 % • smokes often • Majority thinks it is “normal” to drink and smoke

  9. 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

  10. Based on

  11. Based on

  12. Possible solutions 1 Based on

  13. How to direct our efforts to produce wanted effect ? Less mental & behavioural problems and drug abuse in communities and the population !

  14. evidence-based • research-based • science-based • blueprint programs • model programs • promising programs • effective programs Evidence based

  15. Based on evidence, • Tested in practice • Methodologically clear design • Significant reduction of negative outcomes and related risks • Based on theory • Detail evaluated Science based programs

  16. High quality implementation of best evidence based model programs. • Careful pilot program design following the principles of effectiveness • Quasi experimental evaluation design Evidence based aproach in Rijeka

  17. Comprehensiveness • Variety of teaching methods • Sufficient lasting • Theory based • Building positive, strong and stabile relationships • Time • Following developmental psychopathology • Social-cultural appropriateness • Evaluation • Education Principles of effectiveness

  18. Developing a prevention model on a community level Package of multiple interventions that target • 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

  19. Prevention programs at PHI Youth Counseling Family self help group Educating Educators Ready Steady Health Support group in Penal system Life Skills Training Health youth Junior in the house Bulletin RIzik Narodni Zdravstveni List

  20. LIFE SKILLS TRAINING • 2005/06 • - 31 school • - 1657 students • 2006/07 • - 38 school • - 150 assistants • 3168 students • 2007/08 • - 39š school • 165 assistants • 3427 students • 2008/09 • 44 school • 180 assistants • over 3500 students Series of workshops for 6th and 7th grade Pilot program for 3rd and 4th garde

  21. Life Skills Training (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 • Protective factors • 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 • Risk factors • Early first contact with cigarettes, alcohol, drugs • Lack of self-control • Poor assertiveness

  22. Workshops Self image and self esteem Decision making Smoking Alcohol Marihuana Media Anxious emotions Facing anger Communication skills Social skills Asertivness Conflict resolution

  23. Activitiesin 2007/08 MATERIALS Prepared and printed materials for 6th and 7th grade • Student manualfor 6th grade • Teacher manual for 6th grade • Student manualfor 7th grade • Teacher manual for 7th grade • Student questioners • Evaluation forms for teachers

  24. Activities in 2007/08 EVALUATION AND SUPEVISION • Pre-test • Re-test • Post-test • Evaluation forms filled after each workshop • Supervision workshop in February 2008 EDUCATION • 2 X two day education for teachers and school coordinators • October 2008 • February 2009

  25. Evaluation...

  26. Evaluation...

  27. Evaluation... • Reduction higher than 50 % • Evidence that program WORKS • Corresponds to results form USA,EU • Troubles for the firs generation

  28. 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 • Coping with stress • Communication skills • Social skills • Assertivens • Sef-esteem • Decision making • Smoking • Media advertisement

  29. Ready 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

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