Inadequate Models of Adolescent Substance Use Prevention: Looking for Options to Promote Pro-Social Change and Engagement

Abstract

In the adolescent substance use prevention two competing models can be found: negative and positive. The negative model is entirely focused on risks and problems that young people should avoid. The positive model goes beyond that problem-oriented perspective and calls for positive youth growth and development. Both models of prevention seems to be inadequate to address effectively the challenging problem of adolescent substance use associated consequences. Both models are in fact flawed, but in different ways. Old, negative model neglects the power of individual strengths and ecological developmental assets, while new, positive model is often instrumentally used by politicians and other stakeholders for completely different goals than an informed, science-based prevention. As a result many substance use prevention programs implemented at schools and in communities are neither theoretically nor empirically informed. In order to address these flaws, the model of balanced prevention was outlined. It posits that triple well informed efforts are needed to achieve both specific substance use prevention goals and youth personal/social development. These efforts include protection building, risks reducing and individual assets development support. The proposed model is an ongoing work in progress. It can be considered as an encouragement for international dialogue to build a balanced conceptual foundation for adolescent substance use prevention.

Keywords:

• adolescents
• substance use prevention
• risk factors
• promotive factors
• models of prevention

GLOSSARY

• Risk factors: variables associated with a high probability of onset, greater severity, and longer duration of major health/ social problems.

• Promotive factors: assets or resources that may help youth reduce or avoid the negative effects of risks and therefore enhance healthy development.

• Meaningful behavior: refers to involvement in activities that provide youth with opportunities to develop skills, a sense of competence and worth, and a sense of environmental mastery.

• Prevention: mid-15c., ‘action of stopping an event or practice,’ from Middle French prévention and directly from Late Latin praeventionem (nominative praeventio) ‘action of anticipating,’ noun of action from past participle stem of praevenire http://www.etymonline.com/ downloaded 11/17/14.

Notes

¹ This relatively new term, introduced into the intervention literature by Friedman et al (Samuel R. Friedman, Diana Rossi, Peter L. Flom. (2006). ‘Big events’ and networks: Thoughts on what could be going on. Connections 27(1): 9–14.) refers to major events such as mega-disasters, natural, as well as man-made, famine, conflict, genocide, disparities in health, epidemics, mass migrations, economic recessions, etc. which effect adaptation, functioning and quality-of-life of individuals as well as systems. Existential threat, instability and chaos are major dimensions and loss of control over one's life is experienced. The necessary conditions (internal and external, levels and qualities, amongst other relevant dimensions) for any ‘big event’ to operate, or not, have yet to be sufficiently demonstrated empirically. Editor's note.

² The reader is reminded that the concepts of ‘risk factors,’ as well as ‘protective factors’, are often noted in the literature, without adequately noting their dimensions (linear, nonlinear; rates of development and decay; anchoring or integration, cessation, etc.), their ‘demands’, the critical necessary conditions (endogenously as well as exogenously; from a micro to a meso to a macro level) which are necessary for either of them to operate (begin, continue, become anchored, and integrate, change as de facto realities change, cease, etc.) or not to, and whether their underpinnings are theory-driven, empirically-based, individual, and/or systemic stake holder-bound, based upon ‘principles of faith, doctrinaire positions,’ ‘personal truths,’ historical observation, precedents, and traditions that accumulate over time, conventional wisdom, perceptual, and judgmental constraints, ‘transient public opinion’ or what. This is necessary to consider and to clarify if these terms are not to remain as yet additional shibboleths in a field of many stereotypes, tradition-driven activities, and stakeholder objectives. Editor's note.

Additional information

Notes on contributors

Krzysztof Ostaszewski

Dr. Krzysztof Ostaszewski is Head of the Youth Unit in the Department of Public Health, at the Institute of Psychiatry and Neurology in Warsaw, Poland. He is interested in identifying protective and risk factors in adolescent problem behaviors which can be modified by educational strategies. During his professional career, he was involved in several projects aimed at development and dissemination of evidence-based alcohol and drug use prevention programs for children and adolescents in Poland. One of them, conducted in cooperation with the University of Minnesota, resulted in the Polish version of the Slick Trace Home Team Program (a part of Project Northland), an American alcohol use prevention program targeting 10–11 year olds and their parents. He was a Research Fellow within the Fogarty International Substance Abuse Research Program (academic year 2003–04) conducted by the University of Michigan Section of Substance Abuse and Addiction Research Center. He is active in teaching in the field of substance abuse prevention, prevention programming and evaluation. Member of the European Society for Prevention Research and the Association of Psychological Science.