Our work group felt it was important that prevention be science based, and I wanted to underscore the importance of using the appropriate prevention methods and appropriate teaching methods for implementing prevention programs in the schools.
Group members also wanted to emphasize the importance of using a consistent prevention message, multiple prevention channels, multiple modalities, and multicomponent approaches. They felt that, although there had been a great deal of emphasis on school-based interventions, even school-based interventions must consider the parents and must foster more parental involvement. There were some concerns raised in our group about how to handle kids from dysfunctional families, especially from families where either one or both parents may be drug users themselves, or from families where the parents may be 16-, 17-, or 18-year-olds.
Work group members discussed the need to foster the involvement of other stakeholders in the community and to reach out to community leaders, parents, and other organizations that can help support the effort of the overall community.
They also want to emphasize the inadequacy of a "sloganish" approach to prevention and the simplicity that is conveyed in slogans like, "Just Say No," or the most recent slogan, "Just Don't Do It." That is not enough; we have to take into account the whole child.
The work group also discussed the need to think seriously about the role of peer socialization, taking into account psychological factors and issues related to normal child and adolescent development, so that we foster the healthiest and most successful children that we can produce.
There is the need to move away from negative language, such as military metaphors like the "war on drugs," and to move toward a more positive, growth-enhancing approach and a more positive, growth-enhancing message with respect to prevention.
Although we talked about wonderful prevention programs, including the Life Skills Training that I talked about yesterday, work group members expressed a good deal of concern that there are significant barriers not being addressed. Issues of training and implementation fidelity can be addressed fairly readily, but there are other barriers that are more formidable, such as the adequacy of funding for prevention programming on a local level. Work group members expressed concern about curriculum time requirements and how to do interventions that must take up a substantial amount of time if they are to be effective. Concerns were raised about how to reconcile that with pressure to achieve academic goals and improve academic standards.
There was a consensus about the importance of, and a tremendous thirst for, information about proven approaches that can help give people a sense that they are on the right track, and that they are doing the right thing. This can help to reenergize community prevention efforts that are being done more and more with fewer people and with fewer resources.
Finally, there was a concern that, although there have been advances in working with minority populations, we need a better understanding of the needs of minority kids, the kinds of prevention approaches that can be effectively used with these populations, and ways to tailor those approaches so they satisfy community needs.
After summarizing those general concerns and issues, as was our charge, we came up with some recommendations, which are not presented in priority order:
- There was a feeling that prevention has to have a different posture and has to ascend more to the national agenda, not just in terms of all of the negative statistics. Drug abuse prevention must be a national priority on the same level as national immunization. It has to be something that occurs for all kids all over the country and is taken seriously. Drug abuse prevention has to be funded. There must be a consistent and sustained effort to do the most effective prevention programs in communities around the country. This interest in prevention on the part of the general public and on the part of the media must not rise and fall from day to day, becoming a "hot issue" only during this political season. It must outlast the political season, and we must move with sustained effort.
- A national effort has to involve cooperation of relevant Federal agencies, and there was a great deal of concern over the lack of interagency cooperation. We have several agencies represented here, but there was concern expressed that the Department of Education is not here and that a lot of Government agencies have a stake in drug abuse prevention but are not working with the necessary collaboration. Some effort is needed to pull together Federal agencies and perhaps to form a coalition among agencies such as NIDA, the Department of Education, CDC, CSAP, and even the Department of Defense to work together in a coordinated way with the same mission, singing the same song, and marching to the same beat. This may be an impossible task, but it is something that we should strive for nonetheless.
- Going beyond this conference, there has to be an intensive effort to disseminate information about what works, including such ideas as regional seminars around the country. Our group felt that it was necessary to "take the show on the road" with workshops to provide training and some mechanism for providing technical assistance. Members recommended collaboration with national coalitions and national organizations in the area of prevention and education.
- There was great concern about the need for a funding mechanism to make training and prevention materials available and the need to give schools financial incentives to use the right programs. Unfortunately, many people felt that, left to their own devices, some schools might have a somewhat venal tendency to use available money to plug holes in their own budgets rather than to implement the most effective and proven drug use prevention approaches. It was suggested that this could be averted - and there may be hisses in the group - by reallocating some of the money from the Safe and Drug-Free Schools budget to help support proven prevention approaches.
- Our work group recommended a formal collaboration between the Department of Health and Human Services and the Department of Education, modeled after a program called the School-to-Work Opportunities Act, which provides a mechanism for financing and delivering high-quality programs to schools in that arena. It was suggested that a similar kind of program could be developed on a Federal level to deliver high-quality drug use prevention programs to schools around the country.
- There must be a development of national prevention standards, again to increase accountability on a local level and to ensure that people are using the most effective prevention approaches. There is also a corresponding need for some standard evaluation tools that communities can use, rather than all relying on major NIDA-funded studies. Some folks felt that they could do a lot on their own local level, and they want to have the ability to evaluate the many worthwhile things that they are doing. However, it was also acknowledged that there is already much duplication among the State and local surveys that are being done by a variety of groups around the country. There has to be some way of coordinating all of these to get the kind of data that individuals need that can serve as a barometer for how their community is doing rather than conducting yet another survey that could easily be included in an ongoing survey.
- Finally, there was a suggestion for considerably more money for research.
Overall, the work group wanted to commend NIDA for putting together an excellent conference to help communities and schools use the best science-based prevention approaches. The group members voiced hope that this conference would not be a single event but, rather, would become part of a major, sustained effort to disseminate effective, user-friendly, research-based, prevention approaches that can be easily utilized by communities throughout the country. They also expressed hope that we would see changes in the way in which prevention is done and the way in which prevention is currently funded.
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