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Jennifer Hillebrand

Jennifer Hillebrand. Evidence-based practices – Universal school based prevention. Difference between good/best practices and evidence –based practices. Good practice(s) or best practice(s) refer(s) to interventions that are supposed to lead to preferred client outcomes.

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Jennifer Hillebrand

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  1. Jennifer Hillebrand Evidence-based practices – Universal school based prevention

  2. Difference between good/best practices and evidence –based practices Good practice(s) or best practice(s) refer(s) to interventions that are supposed to lead to preferred client outcomes. These may or may not have a scientific evidence-base. Evidence-based practices are interventions that show consistent scientific evidence of being related to preferred client outcomes.

  3. Randomised controlled trials Controlled trialsPrimary level research Meta-analyses Systematic reviewsSecondary level research Review of reviews Tertiary level research Evidence pyramid Retrospective

  4. Evidence base based on tertiary research: univeral based prevention • Buehler, A. & Kroeger C. (2006) Report on the prevention of substance abuse. Federal Centre for Health Education BZgA • McGrath,Y. et al. (2006) Drug use prevention among young people: a review of reviews. National Institute for Health and Clinical Excellence. • Canning, U. et al. (2004) Drug use prevention among young people: a review of reviews. Health Development Agency. • Hawks, D. et al. (2002) A selected review of what works in the area of prevention. World Health Organisation.Faggiano, F. et al. (2005) School based prevention for illicit drugs. The Cochrane Collaboration.

  5. Primary and secondary level research -basis • 59 systematic reviews, meta-analyses and other reviews • Individual studies • 5 primary studies. • 29 Randomised controlled trials, 3 controlled prospective studies

  6. Conclusions: Life skills-based interventions Some evidence of effectiveness Life Skills focused programmes have beneficial effects. They have a positive effect on both mediating variables, e.g. self-esteem, peer pressure resistance and substance use compared to usual curricula (Faggiano et al. 2005). However several concerns (i.e. the number of positive findings are probably similar to the number of negative or null findings) have been raised in regard to life skill programme evaluations (Stothard and Ashton , 2000) and that their degree of effectiveness is overstated (Coggans et al. 2003). Tobler et al. 2000; Coggans et al. 2003; Stothard and Ashton; 2000; Faggiano et al. 2005

  7. Conclusions: Social influence based interventions Some evidence of effectiveness School-based programmes that implement the concepts of social influence are effective. However, data from several longer-term follow-up studies indicate that these effects gradually decay over time. The effectiveness of social influence approaches, particularly the resistance skills training component has been questioned by several reviewers.

  8. Conclusions: Knowledge focused programs/ Knowledge focused components As component: Some evidence of effectiveness As programme: Weak or no evidence of effectiveness The effects of knowledge focused programmes on behaviour change are limited. Compared to usual curricula knowledge focused programs improve mediating variables (especially drug knowledge) but are not more effective then skills based programs. When final outcomes are considered (drug use), their effects are comparable to those of the usual curricula . Some reviewers and recent primary studies have identified that the delivery of knowledge as part of a skills training approach is an important aspect of a programme. The type of knowledge provided, however, needs to be relevant to the students, needs to be applicable to their life experiences and needs to be of immediate practical use to them

  9. Conclusions: Peer-led approaches Inconclusive evidence of effectiveness • The research evidence on effectiveness of school-based programmes through the involvement of peers is inconclusive. Thorough research in the processes and outcomes that can be expected from peer leaders, in comparison to other alternatives, is required before they can be accepted as part of regular substance use education in schools

  10. Conclusions: Interactive versus non-interactive programmes Strong evidence of effectiveness Interactive school-based programmes have preventive effects on consumption behaviour (for tobacco, alcohol, cannabis and other illegal drugs). Interactive educative programmes were ‘statistically superior’ (Black et al., 1998) to non-interactive interventions in preventing drug misuse. Two studies examined by Faggiano et al (2005) show no significant effect of interactive programmes on drug knowledge, decision-making skills, self-esteem and marijuana use. However, interactive techniques were more effective in reducing hard drug use in the study by Sussman, 2002.

  11. Thank you for your attention.Jennifer.hillebrand@emcdda.europa.eu

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