Post on 24-Dec-2015
ALCOHOL AND DRUG PARTNERSHIP
Key Role
• Implementing national drug and alcohol strategies
• Planning and delivering effective local strategies
• Contribution to the Single Outcome Agreement • National ADP Performance Framework
Focus National ADP Outcome
1. Health People are healthier and experience fewer risks as a result of alcohol and drug use
2. Prevalence Fewer adults and children are drinking or using drugs at levels or patterns that are damaging to themselves or others.
3. Recovery Individuals are improving their health, wellbeing and life chances by recovering from problematic drug and alcohol use.
4. CAPSM Children and family members of people misusing alcohol and drugs are safe, well supported and have improved life chances.
5. Community Safety
Communities and individuals are safe from alcohol and drug related offending and anti-social behaviour.
6. Local Environment
People live in positive, health promoting local environments where alcohol and drugs are less readily available.
7. Services Alcohol and drug services are high quality, continually improving efficient evidence based and responsive, ensuring people move through treatment and to sustained recovery.
UTILISNG SALSUS DATAALCOHOL AND DRUG PARTNERSHIP
• Vital Primary Source of Data on Substance Using Behaviours
• Informs development of ADP strategy and delivery plan
• Monitors progress against a number of ADP outcomes
• Core suite of national performance indicators
Focus National ADP Outcome
2. PREVALENCE Fewer adults and children are drinking or using drugs at levels or patterns that are damaging to themselves or others.
• % 15 year olds taking illicit drugs at least once in the last month
• % of 15 years reporting using illicit drugs in the last year
• % of 15 year olds reporting drinking on a weekly basis
6. ENVIRONMENT People live in positive, health promoting local environments where alcohol and drugs are less readily available.
% of 15 year pupils being offered drugs.
UTILISNG SALSUS DATAALCOHOL AND DRUG PARTNERSHIP
• Series of SALSUS Interactive Briefing Sessions planned across a range of partnerships and key stakeholders
• New three year ADP delivery plans in place by June 2015
• Timely opportunity to reflect and review the ADP delivery plan and prevention and education framework.
UTILISNG SALSUS DATAALCOHOL AND DRUG PARTNERSHIP
• New SALSUS reporting is welcomed
• Access to extended data sets
• Long term trend analysis
• Benchmarking
• Increased opportunity to engage with wider stakeholders
Making the most of SALSUS in Fife
Clare CampbellHealth Intelligence TeamPublic Health DepartmentNHS Fife
• The Health Intelligence Team is responsible for:• ensuring access to current and reliable information• providing information to meet need• making information widely available• presenting information in a variety of ways • supporting the understanding and use of
information
• SALSUS provides us with information about young people that we cannot get from other sources
In Fife:
• We have used SALSUS or helped others to use SALSUS to:• describe health behaviours, needs associated with these
and changes to these over time; • to help create and monitor progress towards health
improvement targets and outcomes; • to help inform local strategies/plans;• to provide information for planning, delivering and
evaluating initiatives
• We have made information from SALSUS available from a variety of sources and in a variety of formats
• Examples of how we have used SALSUS include:
In Fife:
As indicators to support the monitoring of the progress of:
Fife’s Joint Health Improvement Plan 2007-10
SALSUS 2006Indicator: Regular
smokingIndicator: Weekly
drinkingIndicator: Monthly drug
use
Chapter 5: Teenage Transitions
Outcome: increasing the proportion of young people adopting a healthier
lifestyle
...focusing upon ‘supporting healthier lifestyles’:
People have the personal skills, strengths, knowledge and opportunity to improve their health and wellbeing
Indicator Time periods Source
2002 2006 2010 Percentage of young people (aged 13 and 15) who are regular smokers
14 11 8SALSUS
FHWB Plan Indicator Template:
SALSUS 2002, 2006, 2010
Smoking
Drug Use
Alcohol Consumption
by age group
Fife and Scotland
As indicators within the KnowFife Dataset:
....provide population WEMWBS scores for teenagers in Fife to compare with scores collected from participants of ‘7 Habits of Highly Effective Teenagers’ programme running in Fife
To:
SALSUS 2010 WEMWBS 13 & 15 year olds
Fife Mean WEMWBS
Score
13 year olds
49.2
15 year olds
49.4
To create a Fife version of:
Children and Young People's Mental Health Indicators
Indicator MeasureSchool year/
AgeFife Scotland
Source/ Year
Engagement with Learning
School Attendance % of half day attendances in school yearPrimary 94.6 95 KnowFife
2010/11Secondary 90.1 91
Liking of School % who like school a lot or a bit at the momentS2 73 74 SALSUS
2010S4 65 63Peer and Friend Relationships
Close Friends % who have at least 3 or more close friendsS2 86 85 SALSUS
2010S4 86 84
Relationship with Best Friend% who find it easy to talk to their best friends about things that really bother them
P7 - 86HBSC2010
S2 - 88S4 - 92
Peer Relationship Problems% with borderline or abnormal score on the peer relationship problems scale of the SDQ
S2 16 15 SALSUS 2010S4 15 15
SALSUS 2010WEMWBS, Strengths and Difficulties Questionnaire, Friendship, Liking of school, Drug use, Smoking, Alcohol Consumption
• Smoking, Alcohol consumption and Drug use:• Extracted figures from Fife report and Scotland report
• WEMWBS, SDQ, Friendship, School:• A bit more of a challenge!• Downloaded SALSUS 2010 dataset from UK data archive to
SPSS • Used variable SPSS list and syntax to analyse data
(eventually!)• Produced figures for variables of interest – it was worth it!
How did we do it?
• Updating the indicators and the work described above
• Widening the range of SALSUS data available in KnowFife
• Looking in more detail at changes over time
• Exploring different ways of presenting SALSUS data
What will we be using SALSUS 2013 for ?
THANK YOU
clare.campbell@nhs.netKnowFife - https://knowfife.fife.gov.uk/
Scottish Schools Adolescent Lifestyle and Substance Use Survey
Education Resource
John HigginsDevelopment Officer
What did we hope to achieve with the Education Resource?
• Support, promote and complement SALSUS Survey
• Greater understanding of the importance of surveys
• How to use and Interpret Data• Challenge perceptions about Drinking, Smoking
and Drug use.• Promoting discussion about the issues young
people face in relation to drinking, smoking, drug use?
• Reinforce health messages• Recognise ways in which young peoples’ views
can contribute to decision making at school, local and national levels.
What is a learning journey?
• Framework for suggested learning activities• Template for planning• Links to Curriculum for Excellence Experience
and Outcomes / 3rd Level
What is a learning journey?
• Framework for suggested learning activities• Template for planning• Links to CFE Experience and Outcomes / 3rd
Level• Key Learning within each learning journey
What is a learning journey?
• Framework for suggested learning activities• Template for planning• Links to CFE Experience and Outcomes / 3rd
Level• Key Learning within each learning journey• Taking it further section
What is a learning journey?
• Framework for suggested learning activities• Template for planning• Links to CFE Experience and Outcomes / 3rd
Level• Key Learning within each learning journey• Taking it further section• List of useful resources
What is a learning journey?
• Framework for suggested learning activities• Template for planning• Links to CFE Experience and Outcomes / 3rd
Level• Key Learning within each learning journey• Taking it further section• List of useful resources• Delivered within PSE but opportunities for
Interdisciplinary learning.
Learning Journeys
1. What are surveys and why is SALSUS Important?
2. Working with Data – What does SALSUS tell us?3. How can we respond positively to the survey?4. What are the potential costs of drinking,
smoking, or drug use and how can we use the data to influence others?
John HigginsEducation Scotland
John.Higgins@educationscotland.gsi.gov.uk
Cheryl DennyISD
Cheryl.Denny@nhs.net
Interventions to address multiple risk behaviours in
adolescents
Marion Henderson & Helen Sweeting
MRC/CSO Social & Public Health Sciences Unit, University of Glasgow
SALSUS Launch event – Edinburgh, 11.12.14
Why multiple risk behaviours?
• Increasing evidence (mainly US studies) that many risk behaviours cluster in youth.
• Especially in young people from the most deprived backgrounds.
• Evidence that early initiation of one behaviour (e.g. smoking, drinking), is associated with later uptake of other risk-taking behaviours (e.g. sexual risk taking, binge drinking, teenage pregnancy).
SPHSU (2011) data – clustering of smoking and drinking in Scottish S2, S3 & S4 pupils
• Ever smoking• Ever alcohol without parental knowledge
S2
Neither62%
Smoke1%
8%
Drink29%
SPHSU (2011) data – clustering of smoking and drinking in Scottish S2, S3 & S4 pupils
• Ever smoking• Ever alcohol without parental knowledge
S2
Neither62%
Smoke1%
8%
Drink29%
S3
Neither43% Smoke
2%
14%
Drink42%
SPHSU (2011) data – clustering of smoking and drinking in Scottish S2, S3 & S4 pupils
• Ever smoking• Ever alcohol without parental knowledge
S2
Neither62%
Smoke1%
8%
Drink29%
S3
Neither43% Smoke
2%
14%
Drink42%
S4
Neither28% Smoke
2%
19%
Drink50%
SPHSU (2011) data – clustering of smoking and drinking in Scottish S2, S3 & S4 pupils
• Ever smoking• Ever alcohol without parental knowledge
S2
Neither62%
Smoke1%
8%
Drink29%
S3
Neither43% Smoke
2%
14%
Drink42%
S4
Neither28% Smoke
2%
19%
Drink50%
Which means that almost all smokers are also secret drinkers = CLUSTERING.
SPHSU (2011) data – clustering of smoking and drinking by deprivation
• Ever smoking• Ever alcohol without parental knowledge
Least deprived
Neither50%
Smoke3%
17%
Drink29%
Mid
Neither44% Smoke
4%
28%
Drink25%
Most deprived
Neither34% Smoke
4%
38%
Drink24%
SPHSU (2011) data – clustering of smoking and drinking by deprivation
• Ever smoking• Ever alcohol without parental knowledge
Least deprived
Neither50%
Smoke3%
17%
Drink29%
Mid
Neither44% Smoke
4%
28%
Drink25%
Most deprived
Neither34% Smoke
4%
38%
Drink24%
Which means clustering is more likely in the most deprived pupils.
SALSUS 2013 - clustering
So … 19%regularly used one or more substance
And … 8%regularly used twoor more substances
SALSUS 2013 - clustering
So … 19%regularly used one or more substance
And … 8%regularly used twoor more substances
Which means that of those who DID regularly use substances,
around 40% used two or more.
SPHSU (2003) data – odds of 3+ sexual partners in late adolescence according
to current substance use
Males Females
Smokers 2.6 4.3
Heavy drinkers 3.4 3.6
Ever drugs 2.7 6.7
SPHSU (2003) data – odds of 3+ sexual partners in late adolescence according
to current substance use
Males Females
Smokers 2.6 4.3
Heavy drinkers 3.4 3.6
Ever drugs 2.7 6.7
SPHSU (2003) data – odds of 3+ sexual partners in late adolescence according
to current substance use
Males Females
Smokers 2.6 4.3
Heavy drinkers 3.4 3.6
Ever drugs 2.7 6.7
SPHSU (2003) data – odds of 3+ sexual partners in late adolescence according
to current substance use
Males Females
Smokers 2.6 4.3
Heavy drinkers 3.4 3.6
Ever drugs 2.7 6.7
Which means a clear link between adolescent substance use and sexual risk behaviours
Risky sexual behaviour
Average daily school attendance
Perceived parent disapproval of adolescent sex
More parental-adolescent activities
Low parental aspirations
Low school attendance/truancy
Overlap in risk and protective factors for risky sexual behaviour and substance use
Overlap in risk and protective factors for risky sexual behaviour and substance use
Smoking, drinking and cannabis use
Risky sexual behaviour
Parental presence
Household access to substances
Self-esteem
Average daily school attendance
Perceived parent disapproval of adolescent sex
More parental-adolescent activities
Community norms pro drug use
Perceived high availability of drugs
Family history of substance use
Favourable attitudes towards antisocial behaviour
Sensation seeking
Low parental aspirations
Low school attendance/truancy
Overlap in risk and protective factors for risky sexual behaviour and substance use
Smoking, drinking and cannabis use
School connectedness
Family-parent connectedness
Academic achievement
Risky sexual behaviour
Parental presence
Household access to substances
Self-esteem
Appears older than most
Average daily school attendance
Perceived parent disapproval of adolescent sex
More parental-adolescent activities
Community norms pro drug use
Perceived high availability of drugs
Family history of substance use
Favourable attitudes towards antisocial behaviour
Family history of problem behaviour
Availability of drugs
Sensation seeking
Low income & poor housing
Experience of authority care
Low parental aspirations
Low school attendance/truancyAntisocial behaviour
Review of adolescent and young adult health in Scotland
Jackson C, Frank J, Haw S; 2010. Available at: www.scphrp.ac.uk
• Focused on tobacco, illicit drug and alcohol use and risky sexual behaviour
• Aimed to provide a synthesis of what works to prevent multiple risk behaviour, for policy-makers, practitioners and academics
Peer reviewed article: Jackson CA, Henderson M, Frank J, Haw S. An overview of prevention of multiple risk behaviour in adolescence and young adulthood. Journal of Public Health 2012;34:i31-i40
1st review method
Literature search to identify (post 2000) reviews of intervention studies on multiple risk behaviour outcomes, including substance use and sexual risk behaviour.
Identified no such reviews
2nd review method
Searched published and grey literature for reviews (or reviews of reviews) focused on single risk behaviours.
Aim = to identify effective intervention approaches across risk behaviours.
Risk behaviour
Intervention type Alcohol Smoking Illicit drug use
Sexual behaviour
Pricing - -
Overview of current evidence for effectiveness of interventions across risk behaviours
Good evidence for effectiveness Mixed evidence for effectiveness
Limited data (largely due to lack of studies)*includes community interventions (which generally included school elements etc)
Risk behaviour
Intervention type Alcohol Smoking Illicit drug use
Sexual behaviour
Pricing - -
Controlling availability - -
Overview of current evidence for effectiveness of interventions across risk behaviours
Good evidence for effectiveness Mixed evidence for effectiveness
Limited data (largely due to lack of studies)*includes community interventions (which generally included school elements etc)
Risk behaviour
Intervention type Alcohol Smoking Illicit drug use
Sexual behaviour
Pricing - -
Controlling availability - -
Mass media/advertising
Overview of current evidence for effectiveness of interventions across risk behaviours
Good evidence for effectiveness Mixed evidence for effectiveness
Limited data (largely due to lack of studies)*includes community interventions (which generally included school elements etc)
Risk behaviour
Intervention type Alcohol Smoking Illicit drug use
Sexual behaviour
Pricing - -
Controlling availability - -
Mass media/advertising
School-based intervention
Overview of current evidence for effectiveness of interventions across risk behaviours
Good evidence for effectiveness Mixed evidence for effectiveness
Limited data (largely due to lack of studies)*includes community interventions (which generally included school elements etc)
Risk behaviour
Intervention type Alcohol Smoking Illicit drug use
Sexual behaviour
Pricing - -
Controlling availability - -
Mass media/advertising
School-based intervention
Parenting/family-based programmes
Multi-domain intervention *
Overview of current evidence for effectiveness of interventions across risk behaviours
Good evidence for effectiveness Mixed evidence for effectiveness
Limited data (largely due to lack of studies)*includes community interventions (which generally included school elements etc)
3rd review method
Performed a primary systematic review of experimental evaluations of interventions where both substance use and sexual risk behaviour outcomes were reported.
Found:Types of intervention very mixed (programme, setting,
populations).Results generally mixed (some behaviours not others;
one gender or the other; short-term results).
Significant effects found in ...
4 of 9 studies reporting on smoking2 of 11 studies reporting on alcohol3 of 10 studies reporting on illicit drug use5 of 13 studies reporting on sexual risk behaviour
3 studies had a significant +ve effect on at least one substance use outcome and one sexual risk behaviour outcome
Example of a promising intervention approach
Seattle Social Development Project
• Primary schools.• Aimed to promote family and school connectedness/bonding.• Included school (teacher training), individual (social and emotional skills) and parenting components.
At age 18:• reduced heavy drinking, • reduced lifetime sexual activity and history of multiple partners
At age 21:• increased condom use at last intercourse (among single people);• reduced pregnancy and childbirth among women;• reduced the prevalence of having multiple partners.
Conclusions of review
Most effective or promising interventions for multiple risk behaviour:• target underlying risk and protective factors of risk
behaviours;• target more than one domain of risk and protective factors
(individual, school, family, community);• promote family- and/or school-connectedness;• intervene early (pre-adolescence) and continue through
adolescence.
Any cross-domain approach will require effective cross-sector engagement and collaboration, particularly between the education and health sectors.
Social context very important – e.g. availability and pricing of substances; cultural attitudes and social norms; marketing & media; access to attractive leisure and social facilities.