Session 5

1. Session 5 Lifeskills education: evidence and good practices

2. Why life skills education? • Cochrane collaboration 2005 • A meta-analysis of 32 studies of different school based programmes; • Methodology had to be rigorous and include a control group (e.g. Randomised Control Trial).

3. Continued … • Results: • Programmes based on lifeskills are the most effective in reducing drug use; • If implemented properly they will prevent 20% of initiations; • No other kind of prevention activities has been studied and/or has been demonstrated to be effective to the same extent.

4. What makes good substance abuse education? • Tobler, N.S. (2000), School-Based Adolescent Drug Prevention Programs • 1998 Meta-Analysis of 207 programmes.

5. What makes good drug abuse education? • UNODC (2004), SCHOOLS School-Based Education for Drug Abuse Prevention • Review of international literature. • Meeting of youth, practitioners, experts from all over the world.

6. Content appropriate to age and culture • Appropriate to the age of the youth. • Starting from simple concepts and building and expanding on them. • In younger ages, you will include basic health promotion concepts, on which you will build in later ages. • Culturally sensitive.

7. 3 to 7 7 to 10 11 to 13 14 to 16 What medicines are and what they are for. Second hand smoke can be harmful. Effects of substances on the body and health. Effects of substances on health & the performance of tasks. Short- & long-term effects. Dependence. The law. All household products can be harmful, including medicines. Basic facts, incl. legal status, on substances. School rules and the basic legal facts about substances. How to keep safe, incl. basic road safety. Bacteria and viruses affect health. How to reduce their spread through simple routines. How to keep healthy and what influences health (incl. media). Short- and long-term effects of food choices, lack of exercise, early sexual activity & pregnancy. What is a healthy lifestyle (incl. nutrition & exercise). The impact of media messages on health behaviour of individuals and society. Example of progression – Knowledge about health & substances

8. Not necessarily only substance abuse • Focusing on one or two specific risk/ problematic behaviours, e.g.: • Tobacco, alcohol and other drugs; • Healthy nutrition; • Sexual & reproductive health/ HIV/AIDS prevention; • Violence prevention.

9. Knowledge, attitudes … • Effects of substances, especially short terms effects that are important to the target group; • Correction of perception of prevalence among peers.

10. … & skills! • Resistance skills • Addressing both internal (e.g. stress, anxiety) and external (peers, advertising) pressures; • Personal and social skills: • Communication & interpersonal skills; • Goal setting, decision-making & critical thinking skills; • Coping and self-management skills; • Media and advertisement literacy.

11. Knowledge Attitudes Communication & interpersonal skills Decision-making & critical thinking skills Coping & self-management skills Learn the short and long term effects of commonly used substances. Respect for one's body and respect for others is more important that looking cool. Observe and practise listening and showing understanding of the reasons a friend might choose to use drugs. Observe and practise suggesting alternatives in an appealing and convincing manner. Observe and practise analysing advertisements directed towards young people to use tobacco or alcohol. Observe and practise analysing what contributes to stress and exercising reducing stress through constructive activities (time management, meditation) Learn how many (young) people are actually using (correct the perception that 'everybody's doing it' Observe and practise resisting a friend's repeated request to smoke tobacco, without losing face or friends. Observe and practise critically gathering information about the consequences of tobacco and alcohol use and weighing the consequences against common reasons young people give for using tobacco and alcohol. Examples of content made specific to substance abuse prevention

12. Interactive methodology • An interactive methodology is the most effective. • Tobler (2000): • Non-interactive programmes showed only a 4% reduction in prevalence rate, while interactive programmes showed a 21% reduction in prevalence rate.

13. Duration and intensity • A typical programme will be rather intensive: e.g. one session a week for four months. • Because interactive techniques are key, groups cannot be too large (20-25 max). • Booster sessions are a good idea. • A complete programme should start early and accompany children and youth through adolescence. Targeting key transitions (e.g. right before and after the change from middle to high school) is a way to focus.

14. Who should deliver? • Teachers and youth will be your first obvious choice, depending on the age/ circumstances. • Youth workers, religious leaders, sport coaches have also been involved. • Extensive training, support and monitoring of educators is key.

15. Who should be involved? • Involving a range of stakeholders is key: • Effective lifeskills education in school needs: • A healthy school (including safe water, basic sanitation, nutrition) • A health promoting school policy developed with the involvement of the entire school community. • The same principle could be applied to any public setting (e.g. youth clubs, etc.) • Programmes that provide lifeskills education for children and parenting skills education for their parents are more effective than one kind of education on its own.

16. School-based policy • A clear policy about the use of substances in the school and during school functions: • Developed in advance; • Developed with the collaboration of everyone (teachers, staff, stundents, parents, law enforcement, health and social services); • Addressing the use of both legal and illegal substances by stundents and possibly teachers and staff; • Clear action in case of an incidence of substance use, ALWAYS aimed at supporting, not punishing.

17. Monitoring • How many sessions? How often? Covering what? • A frequent problem with drug education programmes is fidelity. • How many participants? Age? Gender? • Did anyone drop out? Why? • What was the feedback of participants? • What was the feedback of trainers? • Regular quality control and support by organising agency.

18. Evaluation indicators • Assess education about what it can do, i.e. educate, not about changing behaviours. • Assess the change in knowledge, attitudes and skills. • Change in attitudes is one of the most reliable indicators of future change in behaviour.

19. Evaluation instruments & methodologies • Instruments exist, but they might need to be tested for your particular target group and for this you might need expert advice. • An alternative is a mixture of qualitative methods (e.g. observation, key informant interviews and focus groups discussions with teachers, parents and youth, visual/drama exercises with youth) to ascertain if and how the attitudes and the skills of youth have changed.