Drug Education News

News and views from the Drug Education Forum

Changing attitudes, knowledge and behaviour: A review of successful initiatives

The Joseph Rowntree Foundation have published a report looking at what successful public health campaigns dealing with other issues might have to teach those involved in changing attitudes, knowledge and behaviour around alcohol.

They suggest there are a number of common themes in the successful initiatives the authors have examined:

  • Long term commitment
  • (Re)Framing the problem and changing social norms
  • Understanding the target(s)
  • Planning
  • Positive offerings
  • Multiple approaches
  • Competition
  • Research

Read the rest of this entry »

Filed under: alcohol, Health, research, tobacco

Healthy lives, brighter futures

healthy-livesSomehow I missed the launch of the government’s strategy for children and young people’s health, Healthy lives, brighter futures, which was published last week.

As you might expect it has one or two things to say about things this blog is interested in.

For example it acknowledges the role of PSHE in helping young people to reach decisions about their health behaviours.  And mentions the review of drug education which helped convince government of the need to make PSHE a statutory subject on the curriculum.

It helpfully reminds readers of the link between mental health and well-being and decisions around drugs and alcohol.  But it’s in the area of smoking that there appears to be a new commitment to action. Read the rest of this entry »

Filed under: Health

Behaviour Change

Looking around the NICE website I notice they’ve produced guidance on behaviour change which you can get here.

They highlight the neeed to:

Plan carefully interventions and programmes aimed at changing behaviour, taking into account the local and national context and working in partnership with recipients. Interventions and programmes should be based on a sound knowledge of community needs and should build upon the existing skills and resources within a community. 

Equip practitioners with the necessary competencies and skills to support behaviour change, using evidence-based tools. (Education providers should ensure courses for practitioners are based on theoretically informed, evidence based best practice.)

Evaluate all behaviour change interventions and programmes, either locally or as part of a  larger project. Wherever possible, evaluation should include an economic component.

There’s a slide set that goes with the guidance that may be of interest:

Filed under: Health, NICE

Researching Adolescent Health – Conference

Not exactly aimed at us, but possibly of interest none the less is the Association for Young People’s Health Conference in October this year. They say it is:

A one-day multi-disciplinary conference for researchers and practitioners, across the UK, with an interest in adolescent health and well-being. It will provide an opportunity for participants to share their experiences of healthcare research, as well as presenting examples of innovative approaches and encouraging new ideas.

Topics and workshops include:

  • Resilience
  • Sexual health
  • Food and nutrition
  • Primary health care
  • The internet and new ICTs
  • BME young people
  • School nursing
  • Young people’s participation in health care decision-making
  • Methodological issues involved in researching young people’s health

For non-members of the association the cost of the day will be £120.

Filed under: Conferences, Health,

Adolescent services: smells like teen spirit

The Health Service Journal takes a look at health services for teenagers:

This age group is notoriously uncommunicative and parents can be caught between caring for a child and respecting the independence of a burgeoning adult. But the effects of poor health in adolescence can last a lifetime: alcohol, smoking and drug addiction often begin in the teenage years and there are many youngsters with life-long conditions such as diabetes that begin in childhood or at birth and need ongoing support and treatment. It is also estimated that one in 10 young people have a diagnosable mental health disorder, often later resulting in serious mental ill health in adulthood.

The article talks to Russell Viner, consultant in adolescent health at UCL’s institute of child health:

Dr Viner has long campaigned for dedicated services for teenagers, who, he says, have particular issues about confidentiality.

“They don’t use services that are not young people friendly. They are not used to negotiating the health service and do not have the skills to get on and use them if they’re not seen as being friendly,” he says.

Dr Viner believes that although all doctors and nurses need some skills in dealing with adolescents, there is no need for more than “a small cadre of specialists in adolescent health to support and train the generalists and to run specialist services”.

Dr Viner goes on to say that it’s time that the focus of health services was less on particular issues and more holistic and inclusive of wider services such as education, social services and the justice system. The article gives examples of the sorts of configurations that are being piloted:

Bolton primary care trust and council lead on teenage pregnancy and sexual health Jayne Littler says: “We are developing local working in community settings in a range of different ways, of which the Parallel is the hub. Youth services have developed a health curriculum to support adolescent health. They issue condoms and are starting to do chlamydia screening. Youth offending team nurses address the health needs of their client group on site so they don’t
have to go to another appointment and young people’s substance misuse services provide similar support.”

More about this area can be found at the Royal College of Paediatrics and Child Health, Royal College of GPs and Royal College of Nursing Adolescent Health Project, www.rcpch.ac.uk

Filed under: Health,

Is the teenage health message sinking in?

Healthcare Republic News takes a look at the Chief Medical Officer’s report and the latest statistics from the annual survey of 11 to 15 year old pupils in England:

One positive is that data from the NHS Information Centre suggest young people today may not be as bad as their predecessors.

A survey of secondary school pupils in England last autumn found that 10 per cent of 11- to 15-year-olds admitted taking drugs in the previous month, down from 12 per cent in 2001.

Similarly, 6 per cent of teens admitted smoking at least once a week, the lowest rate since the surveys began in 1982.

Despite this, concerns remain. The CMO wants a summit to look at both health promotion and healthcare services for teenagers. He also wants NHS organisations to consult with the Youth Parliament and to set up a panel of teenagers to advise marketing executives on which campaign ideas will and, perhaps more importantly, won’t work.

Filed under: drug information, Health

Alan Johnson speaks to the Fabian Society

Largely his speech is about obesity, but there are one or two wider points that may be of interest:

Despite the abundance of information about how to protect our health, the straight-forward advice about what to eat, how often to exercise, how much we should drink, is easy to ignore and frequently lost in a cacophony of conflicting messages. To use Arthur C Clarke’s analogy, it is like trying to get a glass of water from Niagra Falls.

As the “Know your units” campaign pointed out, the vast majority of people underestimate how much alcohol is in a glass of wine or a pint of beer and thus have little awareness of whether they are drinking too much. While many are probably aware that they should be exercising for half an hour, five times a week, only one in three actually does this in practice.

He goes on to articulate how the government’s approach is different to the one David Cameron outlined recently (and which we covered here).

Not every child is lucky enough to live in an environment that promotes good health. Not every family has a leafy back garden for their kids to play in. Not every family can afford to buy fresh organic produce from the local farmer’s market, or to put food on the table that their children will refuse to eat.

Our strategy made clear that in approaching this problem, we reject both the “nanny state,” which polices shopping trolleys and institutes exercise regimes and the neglectful state, which wipes its hands of the problem, and wags the finger in the direction of the most vulnerable families in the vague hope that they will do as they are told.

The Conservative Party have apparently chosen this approach. Reading David Cameron’s Glasgow speech, I was struck not by how much the Tories have changed, but by how little. Cameron is following a Tory tradition which would have been familiar to the Fabian progressives of the 20s and 30s, and which was distilled to create pure Thatcherism in the 80s. He delivered Tebbit’s “Get on your bike” speech, refined by PR experts. Chingford meets Notting Hill. It attracted predictable support in the pages of the Spectator, where, in an article headed: “Shouting abuse at fat people is not just fun, it’s socially useful,” Rod Liddle congratulates Cameron for “telling these awful people it’s all their own fault that they are hideous, poor and stupid.” He goes on to fantasise about setting a fat mother on fire with his Zippo lighter. For Liddle and others, permission to be cruel and nasty about the obese has been granted by the Leader of the Opposition.

It’s easy for politicians to stand on the sidelines accusing the impoverished, the fat and the excluded of only having themselves to blame. But before we evoke the Victorian notion of the deserving and undeserving poor – the very concept that Fabians have battled against over the years – we should take a moment to consider how complex these issues really are.

Academics and medical experts do not say that children are “at risk” of obesity or poverty because of political correctness – they say this because it’s an accurate assessment of the situation. A child who grows up in poverty, and whose parents have little or no aspiration for them, who doesn’t get to go to the best school, who isn’t blessed with an inspirational teacher, is by any definition “at risk” of becoming a poor adult. It’s not inevitable, but without some help and support, it’s highly likely.

He goes on to talk about how the government are hoping to engage a range of businesses and others interested in improving the nations’ health to create a different climate. Mr Johnson recognises that it is very easy to get the messages wrong, or to frame them in ways that allows those it should be listening to think it’s not aimed at them.

Read the whole speech here.

Filed under: Government, Health

Ambitions for Health

Readers with an interest in the way public health campaigns are planned and executed may remember the concern that Mark Bellis and Harry Sumnall expressed about the use of social marketing. They said:

with access to powerful media such as the internet, professional eye-catching graphics and demographic targeting techniques unimaginable only a decade ago, such views need reassessing. In this report, we highlight the potential for social marketing campaigns to have negative repercussions, using cannabis prevention as an example.

Ambitions for Health

Ambitions for Health

I mention this because I’ve just seen the Department of Health’s Ambitions for Health, the web page for which says:

This strategic framework sets out how we plan to work together with key leaders in the public health community to embed social marketing principles into health improvement programmes. Its also illustrates the practical tools we are developing to build social marketing competencies and capacity in England. It sets out how we will make sure that all of our policy development and public health interventions are informed by our understanding of what motivates people. In turn, this will enable us to build on our successes and ensure that we become a world leader in promoting health.

Writing in the foreword health minister, Dawn Primarolo MP, says:

Huge health challenges are posed by issues like obesity, drug and alcohol misuse, smoking, sexual health and teenage pregnancy, and poor mental health. Our task is to ensure that we use the evidence and our understanding about people to design and deliver interventions that help as many individuals as possible.

One of the case studies makes it clear where things are going.  The project that’s described is trying to reduce the public use of alcohol amongst young people in North Tyneside, they say:

There was little evidence that school-based, or large-scale education or promotional campaigns had any effect on young people when used as the main means of countering alcohol misuse. Drinking was seen by many to be their main or only leisure option, and was also considered to be a safe alternative to drugs.

The PCT who were leading the project identified young women as their particular target and held focus groups and interviews with young people, their parents and key workers.  The focus groups delivered the message that having nowhere to go was a key concern for the young people, something which didn’t surprise the team, but which they found valuable.

The study doesn’t describe the way they are going to take to address the issues, but one of the team is quoted saying:

“But by taking the approach we have, I believe we have more chance of effecting behavioural change than if we had simply adopted the old-style, top-down messaging of the past. Putting the customer at the heart of the process has undoubtedly yielded dividends – even at this early stage.”

Filed under: drug prevention, Health, ,

Drug abuse and risky sex targeted in teen health drive

The Guardian

The health secretary today launched a new initiative to improve care for adolescents, amid concern that substance abuse, risky sexual behaviour and mental health problems are blighting their lives.

Alan Johnson launched the Adolescent Health Project after research showed young people’s health has improved the least of any age group in the past 40 years.

Smoking, drinking, drug use, risky sexual behaviour and poor mental health often start in adolescence – and can have a permanent impact on their health. Chronic illnesses such as diabetes and asthma are also on the rise among teenagers.

You can find out more about the Adolescent Health Project here and see the e-learning site here.

Looking at it quickly it seems to have been developed with health professionals in mind, rather than being something for the whole children’s workforce.

Filed under: Health,

On the State of Public Health: Annual Report of the Chief Medical Officer 2007

The Telegraph report on Sir Liam Donaldson’s annual report which includes a recommendation to reduce the amount of alcohol young drivers are allowed to have in their blood to zero.

That’s not the end of his recommendations as the paper points out:

Other recommendations relating to teenagers included a national summit to take stock of health programmes and services for young people, more involvement of teenagers in the design of healthcare aimed at them and a young person’s panel to advise on national campaigns to address risk taking.Sir Liam said taking risks as a teenager is a rite of passage into adulthood but a problem arises then the habits formed then are continued long-term.

Sexually transmitted diseases and unintended pregnancies, poor diet and obesity, physical inactivity, tobacco, drugs and alcohol, injuries and violence are a major problem for teenagers, the report said.

Annual Report of the Chief Medical Officer 2007

On the State of Public Health: Annual Report of the Chief Medical Officer 2007

You can read the report itself here.  The chapter on teenage health says:

Adolescence is a time of life when peer pressure is a key element of the forces that shape behaviour and attitudes. On top of this, family, the formal education process and the less tangible forces of media, marketing and advertising all influence the young person. Self-expression, individualism, feeling and appearing grown-up as well as impressing peers also strongly influence behaviour.

Sir Liam indentifies 6 risks that are particularly prevalent amongst young people, included in which are tobacco, drugs and alcohol.

On tobacco he points out:

Approximately 290,000 11 to 15-yearolds in England smoke cigarettes regularly (9% of this age group). The percentage has not fallen since 2004 and girls are more likely to smoke than boys. Someone who starts to smoke aged 15 years is three times more likely to die of smoking-related cancer than someone who has smoked from their mid-20s.

In relation to alcohol he says:

Approximately 610,000 11 to 15-yearolds in England are estimated to have been drunk in the previous four weeks, girls more frequently than boys. The proportion of 11 to 15-year-olds who drink has decreased, but those that do drink consume more, more frequently and favour higher strength alcoholic drinks.

And on illegal drugs reminds us:

Roughly 770,000 11 to 15-year-olds have tried drugs, and 170,000 have taken Class A drugs. The percentage who have ever taken any drugs has decreased slightly in the last 10 years, but the percentage taking Class A drugs has stayed constant. Substance misuse in young people has been linked to suicide, depression, conduct disorders, educational problems and long-term mental health effects. There is also evidence that cannabis use is linked to serious mental illness, such as schizophrenia.

I think it’s worth quoting quite a lot of what Sir Liam says in his conclusion:

In relation to many risk factors, the majority of teenagers do not experiment with them or they do so for a brief period only. However, the numbers who do take risks amount to hundreds of thousands of young people every year.

There are immediate consequences of risk taking in the teenage years. For example, the current pattern of teenage drinking creates antisocial behaviour, involvement in crime, injuries from accidents and violence as well as a greater likelihood of having unprotected sex…

Whilst young people want more information to guide them about their health, providing information alone will not make major inroads into the problems described in this chapter. Young people want to be listened to in the individual consultation and to have the opportunity to be involved in the design of services…

There is no simple solution to the risks posed by adverse behaviours and experiences in the teenage years. However, major shifts in behaviour in the fields of fashion, technology use and entertainment show that change can be achieved. Why not the same for health? Efforts need to be oriented to implementing existing strategies and plans but also to seeking new and imaginative ways of getting the health messages across in a way that appeals to youthful minds and outlooks.

Whatever the solution is, it must be identified and developed in partnership with young people themselves. The active participation of young people in making decisions about their health, both at an individual level and at the strategic level of healthcare provision, is key. The free expression of views, given due weight according to the age and maturity of the child, is not only a human right, it is also known to improve health.

He makes a number of recommendations, including:

  • A national summit should be held to take stock of the state of health promotion and healthcare services for teenagers. An action plan should come out of it.
  • A young people’s panel should be established to advise on national campaigns addressing risk-taking in the teenage years.
  • The Association of Public Health Observatories should run a free online database on adolescent health, and produce an annual surveillance report, including positive indicators of health.
  • The legal blood alcohol limit for drivers aged between 17 and 20 years should be reduced to zero.

Filed under: Government, Health,

About this blog

This blog tries to pick up relevant media and research stories about drug education. It mainly focuses on information in England as this is the geographical remit for the Drug Education Forum. We welcome comments that are on topic.

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