Evidence based prevention -The Icelandic ModelJÓN SIGFÚSSON

ICSRA

©ICSRA 2015

42

32

26 26 25

1814

75

23

16 1412 12 10

73 3

17

12 129 9 7

9 6

0

10

20

30

40

50

1998 2000 2002 2004 2006 2008 2010 2012 2015

%

Drunk last 30 days Daily smokingCannabis once or more

Substance use decrease amongst 15-16 year old adolescents

Substance Use Amongst European Youth (ESPAD, 2011)

Youth in Europe until 2015

The role of research

Indicators for 15 – 16 year oldHealth status indicators, anxiety, depressive symptoms, physical health status, lifestyle and leisure time activities, local community networks, negative life events and strain, parents and family, peer group economic and psychological issues, studies and school, substance use, values and attitudes, violence and delinquency, and more…

The twofold use of research 1. Scientific

2. Practical

The scientific role of research1. In depth analysis of the data2. Over 70 peer reviewed publications3. Science forms the platform for practice

The practical role of research1. Data collections on substance use regularly through schools2. Practical descriptive reports immediately to the municipalities3. Local information INTO all levels of prevention work is KEY

Prevention approach background

Upward trend 1992 - 1998

15,1

20,722,8

7,29,6

17,4

0

5

10

15

20

25

30

1992 1993 1994 1995 1996 1997 1998

%

Smoke daily Have tried hashish

1998 At this point of time research had already showed us that certain circumstances and behaviour in the lives of adolescents were strongly connected with use

We tried to establish the risk and protective factors

The main risk and protective factors

Extracurricularactivities, sports

And analysing deeper

Extracurricularactivities, sports

Time spent with parents SupportMonitoringControl

Positive and negative effects.How we as parents approach the peer groupStaying outside lateHanging out in malls

Inside and outside of school, at home, bullying e.t.c.

Organized activitiesvs.

unorganized

1998 Drug-free Iceland Based on these findings a research based action plan was initiated by the government with the aim to try out a totally new methodology in substance use prevention

Obviously, what we had been doing before, was not working.

Police – frighten – ugly advertising campaigns – try to make children be responsible for their own well being

Aim of Drug-free Iceland• To change the actual behaviour of youth and not only their attitudes• Change the life-style environment of our children so that they would be in lesser risk of substance use

The methodology

Our focus is primary prevention• Primary prevention, preventing the development of substance use before it starts.• Secondary prevention, that refers to measures that detect substance use• Tertiary prevention efforts that focus on people already abusing substances

Main actions: Based on research findings

Examples of local actions1. Research as a basis for policy and actions2. Strengthen parent organizations and co-operation with schools3. Support extracurricular activities / sports4. Support active NGOs’5. Support young people at risk inside schools6. Anti smoking / drinking campaigns7. Strengthen social capital

Examples of national actions1. Legal age of adulthood raised from 16 to 18 years2. Age limits to buy tobacco and alcohol (18 and 20)3. Strict regulations for sellers of tobacco and alcohol4. Advertising ban of tobacco and alcohol5. Restricted access to buying alcohol and tobacco6. Rules on outside hours for adolescents7. Visibility ban of tobacco and alcohol

Tobacco and chewing gum

Peanuts and Gin

The scientific isolation needed to be broken

The researchers “guru” approach

Focus on close community• An average figure on alcohol use in Lithuania does not help prevention workers in Kaunas for example.• “Average” doesn´t tell all the story!• Local information is a key element in primary prevention.• Importance of schools in data collections

School importance in local context In order for prevention workers to be able to work locally:• Important that as many schools as possible take part• Without good cooperation with schools – local work is hard• Makes it possible to address local issues• Pupils who attend different schools can be very different

The way we work now

What is gained?Less health problemsLess crime / imprisonmentsLess social benefits costLess unemploymentLess rehabilitation costLess broken families etc., etc.

In general for the past 15 years• Regular monitoring in cooperation with schools• Strengthened the protective factors• Weakened the risk factors

…and substance use is going down

42

32

26 26 25

1814

7

5

23

16 1412 12 10

73 3

17

12 129 9

7

96

0

10

20

30

40

50

1998 2000 2002 2004 2006 2008 2010 2012 2015

%

Drunk last 30 days Daily smoking Cannabis once or more

Thank you 2015