Editor's note: This is the second in a two-part series about preventing youth substance use following the Just Say Yes community summit in September. Read the first installment ("Guest columnists: Franklin County ready to tackle youth substance abuse," Oct. 16).
The recent Just Say Yes summit brought together a wide range of local people and organizations to learn together about proven strategies for substance abuse prevention from a world-renowned expert on the topic, Dr. Harvey Milkman. Summit attendees overwhelmingly affirmed an eagerness to begin implementing these strategies in Franklin County.
At its core, prevention is about reducing risk factors and increasing protective factors. While some sources list dozens of these factors, Dr. Milkman simplifies the discussion to four spheres: family, peer group, extracurriculars and general well-being (including school experience). Strength in any one sphere is protective, while weakness increases risk. Protective factors in one sphere can offset risk in another, so “interventions” — actions taken to prevent substance use, whether at the individual or community level — focus on maximizing protective factors and minimizing risk.
Importantly, there is considerable overlap in the risk/protective factors associated with substance use and those for suicidality, criminality and violence, meaning that effective prevention of one tends to produce positive results in the others as well.
The unprecedented success of the Icelandic model of prevention (see adjacent graphic) demonstrates the results that can be achieved when a community focuses coordinated, data-driven effort and resources on prevention. The model rests on three pillars of success: evidence-based practice; community-based approach (using local data to inform local interventions); and continuous dialogue between research, policy and practice.
It is notable that the Icelandic model places heavy emphasis on “primary prevention” — strategies that apply to all youth, before any sign of trouble or particular risk. For example, when Iceland identified parenting practices that were correlated with lower rates of substance use in youth, they set out to share this information with all parents, not just those whose kids were having trouble.
What would this process look like if adapted to Franklin County? First, schools would collect data from youth using anonymous surveys adapted to our local context. Next, researchers would analyze the data and report back within a few months on key risk and protective factors at each school. It would then be up to our community to determine how to act on the results.
In Iceland, the findings led to heavy investment in after-school activities, parent education and policy changes to limit youth access to alcohol and tobacco. Franklin County’s interventions would need to be responsive to our local conditions, addressed with local resources and implemented by local people.
The surveys would be repeated regularly to track progress and make adjustments as needed.
The “why” is obvious. The “how” is, at its heart, common sense and straightforward.
Franklin County’s kids are worth it. Let’s get to work.
Amelia Berry is executive director of Yes Arts and a Robert Wood Johnson Foundation Culture of Health Leader. Charles Kendell is board coordinator of Franklin County ASAP. Judy Mattingly is executive director of the Franklin County Health Department.