The Guidebook to Effective Prevention of Youth Problems
The Guidebook to Effective Prevention of Youth Problems written by Szymon Grzelak, PhD (Institute for Integrated Prevention).
Link to the Polish version of Guidebook in PDF format.
Click here to order this publication.
The Guidebook to Effective Prevention of Youth Problems1 was developed by a team from the European Institute for Integrated Prevention and published in October 2017.
The publication summarizes the experience of many years of positive work of its authors. In our opinion, it is strategically important in establishing the foundations for a coherent action programme in the area of education and prevention that is based on scientific research, values, and practical experience. The recommendations included in The Guidebook should be known by social, educational, and health policy makers.
The first, Polish edition of the The Guidebook to Effective Prevention of Youth Problems was co-financed by the EU's European Social Fund and published in 2015. Link to the entire Guidebook in Polish in PDF format.
The Polish edition of The Guidebook to Effective Prevention of Youth Problems was distributed by the CED to the education departments of all local government authorities in Poland. Its recommendations have been recently incorporated by the Ministry of Health in their work on the National Public Health Programme 2016-20. The authors are making great efforts for the publication to reach other institutions as well. The Guidebook is written in an intelligible language and it takes the form of a hybrid between a scientific report and a practical guide.
Opinions of reviewers
Our youth in many nations around the world are trying to cope with many risk factors in their lives and not succeeding. Fortunately, this new book, The Guidebook to Effective Prevention of Youth Problems, presents both effective solutions, and even more importantly, it lays out in clear language many empirically and practically tested strategies for prevention! I endorse it wholeheartedly for everyone who wants to make a positive difference in saving the hearts and souls of our next generation while also enriching their minds.
Philip G. Zimbardo, PhD
Professor Emeritus
Stanford University, USA
The Guidebook contradicts many harmful negative myths concerning adolescents. The results of the authors' research challenge the popular view that teenagers generally reject adult authority. In my practical experience, I see how essential the role of mothers and grandmothers is in the lives of young people, and it is them to whom adolescents turn first if they are in need. This observation is in harmony with the authors' research results, showing that the majority of adolescents point to their mother, father and grandmother as the most important life guides. This valuable publication can help professionals as well as local and state authorities to appreciate and respect the fundamental role of the family in their daily work with youth.
Ms Axelle Trillard
Coach supporting mothers
MA in psychology and philosophy, France
Grzelak's The Guidebook to Effective Prevention of Youth Problems is today's most positive book about youth challenges. Based on sound reasoning and strong evidence, impressively researched and accessibly written, this book provides hope and help to the new generation. It is also a welcome relief to see how important parents and the family are, and the values passed on by them, in supporting the healthy development of adolescents. I hope this publication will be widely used.
Petar Valkov, PhD
Chief Assistant Professor of Psychology
Trakia University, Bulgaria
The Guidebook is based on a very thorough scientific, methodological, and statistical analysis. It reaches the deep foundations of prevention and not its surface. It suggests tackling the broadest possible real social base (rather than a virtual one - which is a common practice today), in the context of the positive aspects of people's functioning, and not its defects. I highly recommend reading this valuable and unique work.
Leszek Putyński, PhD
Doctor of Medicine, Clinical Psychologist
University of Łódź, Poland
Foreword to the English Edition
Dear International Reader,
Youth are the future of the world. Youth are the future of every country, every local community and every family. There is no better investment in the future than investing in youth. This book is a brave and professional inspiration that you can use to better support the healthy development of the young generation.
The modern world is full of divisions and brings many global dangers. Yet, at the same time, it offers new, previously unheard of and unique opportunities for cooperation. The strategic publication of the European Institute for Integrated Prevention that you hold in your hands is an invitation to international cooperation to support youth development and reduce the barriers and risks that might hamper their development.
During the last year - between July 2016 and June 2017 - we presented our approach to research on youth and to supporting youth development at a number of international conferences and workshops. Our Institute organized such conferences in Poland, Germany, and France. We were invited to Hungary, Russia, and Italy. Some of those conferences hosted participants from European countries, others - representatives of different continents. We were surprised and happy to see their lively interest in our research methods, results, and the recommendations based on them. We saw how necessary it is to provide a brave, holistic but also rational vision of youth development support and problem prevention. The interest in the integrated approach to prevention was equally lively on the part of professionals from Eastern European countries as those from Western Europe; from both highly developed countries (like the USA and Canada) and the developing countries in Africa and Asia. As evidence of this interest, we received many letters asking for our book, the Polish Vademecum, to be translated into English, and for international research and practical cooperation to be initiated. The present publication answers this need.
Good international cooperation requires mutual respect. It calls for recognizing and appreciating the positive potential of each country that wants to join it. Representatives of each nation can contribute their own values due to their unique history and culture. Affirmation of the positive potential contributed by the cultural heritage of different countries and appreciation of their values provides a better foundation for cooperation than attempts at unification or standardization, based on underestimation or denial of cultural differences. The inspiration for cooperation that you hold in your hands comes from Poland. A few words should be said, then, about the history and potential of the country of its authors.
Poland, as a country, is located in the geographical centre of Europe. For over one thousand years, it has culturally belonged to the West. It has continually drawn on the rich achievements of the West for centuries, while at the same time actively contributing to them. Poland is the historical borderland between Western and Eastern Europe, and was for centuries the meeting point of Western Christianity with the Orthodox Church, Judaism and Islam. In the 16th and 17th centuries, when Europe was caught up in religious wars and persecutions, Poland stood out with its openness and religious tolerance. It is here that numerous refugees from Western countries, of different denominations, found asylum. Throughout the 19th and 20th centuries, Poland experienced many devastating wars. Periods of foreign occupation were much longer than the brief moments of independence. Poland is a country that still has many traces of the destructive power of totalitarian ideologies brought on by the bayonets of foreign superpowers - first fascism, then communism. Poles have greatly contributed to abolishing both ideologies in Europe. Despite so many adversities, Poland has retained its identity, values, culture, and dynamism. Due to all this experience, Poles highly value their own freedom, and feel a rational distrust towards ideologies imposed on them in a top-down manner. For the same reason, they naturally sympathize with all nations in the world that fight for freedom in the face of political, military, economic or ideological pressure. Politically, Poland is a member of the European Union. At the same time, it has long ceased to be a military or economic superpower whose domination could be feared by anyone. Poles are a nation in which the family is treated as a central value. Respect for the woman and the mother is a part of our cultural tradition. And, last but not least, Poland's achievements in the field of youth problem prevention are among the greatest in Europe. This is confirmed by experiences from many international meetings and conferences.
All of these factors combine to make Poland a good place for the seat of the European Institute for Integrated Prevention, and a centre of international cooperation.
The original Polish edition of this book was prepared by the Institute for Integrated Prevention (IPZIN) as part of a project financed with funds from the European Union, and precisely, from the European Social Fund. It was published and directly commissioned by the Centre for Education Development (Ośrodek Rozwoju Edukacji), subordinate to the Ministry of National Education. The publication was directed toward representatives of
Polish local and national authorities and Polish professionals - both practitioners and researchers.
The English-language edition has been entirely prepared by the European Institute for Integrated Prevention (EIIP) - a new, international institution, recently formed by the Institute for Integrated Prevention. Ninety percent of the content of the English edition corresponds to that of the Polish edition. The remaining 10% covers changes resulting from the need to adapt the text for international readers, as well as updates due to the two-year gap between the publishing of the Polish and the English editions.
Polish studies on youth are discussed in the Guidebook most extensively. However, this should not diminish the fact that recommendations resulting from these studies are more universal in nature, and that they are also supported by international research. We have recognized that setting the book in the Polish reality and retaining references to the Polish legal system is also valuable for readers from other countries. Every country has a different legal and cultural context. The Guidebook to Effective Prevention may be an inspiration as to how to use this context. But reflecting on how to use the Guidebook's recommendations in the context of your country's individual situation is your own creative task, Dear Reader.
We hope to publish a new English-language edition of the Guidebook in a few years' time. We would like to present more study results from different countries in it. We hope that some of the readers of the present edition will feel encouraged to conduct similar studies in their countries in cooperation with EIIP. Initial talks are already being held with researchers from some countries.
This publication is the first step in a fascinating cooperative adventure to which you are cordially invited, Dear Reader. It is the future that is at stake in this adventure, because youth are the future. The better we support youth in preparing for their journey of life, the brighter our common future will be.
Szymon Grzelak, PhD
Chairman of the Board
The European Institute for Integrated Prevention
Prevention of Youth Sexual Risk Behavior
The current state of research in the worldwide and in Poland
Abstract
Grzelak, S. Prevention of Youth Sexual Risk Behaviour: The current state of research worldwide and in Poland. Kraków: The Rubikon Publishing House, 2009. (479 pp.)
The first edition of the Prevention of Youth Sexual Risk Behaviour: The current state of research worldwide and in Poland was published in 2006 (Grzelak, 2006) and was a first attempt to summarize and present contemporary knowledge on the topic described in the book's title to the Polish reader.
The current 2009 edition is a second such attempt, and it has been expanded with a new, third section which describes the author's selection of the latest achievements in theory and research.
The first section of the book consists of four chapters, and takes an international perspective. In the first chapter the main health and social problems relating to early sexual activity are presented with emphasis on STIs and out-of-wedlock teen pregnancies. Indicators of sexual risk behaviour are discussed as well as antecedents of early sexual debut.
The second chapter presents different theoretical approaches to prevention of youth sexual risk behaviour over the past four decades. Etiological and behavioural change theories underlying contemporary prevention programmes are described. Other sources of inspiration for widely used prevention programmes (sometimes unrevealed in scientific articles) have also been presented, such as Christian philosophy and anthropology or the theoretical background of so-called 'indigenous' programmes implemented in some developing countries on the basis of a mixture of general knowledge about prevention, common sense, and local culture.
The last part of the second chapter introduces different typologies of programmes preventing the sexual risk behaviour of youth. One of these typologies divides programmes into two main groups: risk avoidance (aimed at sexual abstinence and mutually faithful permanent relationships in future), and risk reduction (aimed at reducing consequences of early sex by use of condoms and other contraceptives), and also some combinations of the two.
The third chapter presents detailed information about the current state of evaluation research on prevention of sexual risk behaviour. Methodological and ethical aspects are discussed in depth, and the criteria for high quality, controlled evaluation research are presented. A broad review of results of evaluation research on different programmes of different types concludes with the conditions for success of programmes preventing youth sexual risk behaviour. A list of characteristics or elements of programmes proven to be effective is presented and discussed.
The fourth chapter focuses on a different approach to evaluation, in which country-wide prevention policies are assessed through the lens of epidemiological research showing the number of new sexually transmitted infections and teen pregnancies in the context of sexual behaviours and over the course of the period of implementation of a given preventive strategy. The choice of countries that serve as case studies reflects the author's desire to depict the effects of two main types of preventive strategies: risk avoidance-focused strategies (abstinence, fidelity), and risk reduction-focused strategies (condoms, other contraceptives). Data from a number of developed and developing countries (UK, USA, Poland, Uganda, Senegal, Jamaica, Thailand) is presented and discussed. The prevailing opinion that prevention focusing on risk reduction strategies is the most effective and the only realistic approach is challenged with data showing rapid increase in new STIs in some countries which based their health and educational policies on risk reduction, and new STI decrease in some of the countries which promoted risk avoidance. Theoretical explanations for the observed phenomena include a combination of three main factors: (1) empirical data on the limitations of condom effectiveness in prevention of different STIs even when used properly and consistently, (2) the crucial importance of proper adaptation of the prevention goals and methods to the cultural conditions and religious beliefs of societies to which the prevention campaigns are addressed, and (3) the psychological effect of risk compensation. The model of risk homeostasis (Richens, Imrie, and Weiss, 2003; Wilde, 1994) provides an explanation as to why the relatively high protection given by a condom in an individual sexual contact cannot be easily transferred to effectiveness of condom promotion strategies implemented on a scale of entire societies. The chapter ends with the conclusion that - in the light of the body of research presented - far too little interest is paid to risk avoidance strategies, and far too much trust is placed in risk reduction strategies in prevention of youth sexual risk behaviour.
The second part of the book consists of four chapters concerning empirical research on effectiveness of prevention of youth sexual behaviour in Poland. Of all five Polish evaluation projects which were completed before 2005, two are mentioned only briefly, as they did not meet most of the basic criteria for methodologically sound evaluation. Three quasi-experimental studies are presented in detail, and discussed in Chapters 5 to 8. Two of them regard a Polish adaptation of the TeenSTAR® Programme (known as PiON in Poland). The first of the two studies (1996-98), described in Chapter 5, was also the first Polish attempt to evaluate a programme preventing youth sexual risk behaviour. The small sample size (N = 215, age 13-15) and simple pretest-posttest research scheme with programme and control group (given the relatively late sexual debut among Polish youth at the time of the study) resulted in insufficient statistical power to verify the programme's impact on sexual behaviour. Nevertheless, the study indicated a significant change in line with programme goals with regard to nine variables (attitudes, normative beliefs, convictions, and knowledge regarding sexuality, love, and relationships) with no side-effects.
Chapter 6 presents a newer high-quality evaluation study of the TeenSTAR programme (2002-03), which was the Polish part of an international evaluation of the programme that was also conducted in USA and Chile by the author. The study [2x3 quasi-experimental design; N = 428, age 14-16] indicated a small delay in sexual debut among boys (statistical trend), significant decrease of psychoactive substances use among boys (alcohol, illegal drugs, cigarettes), and a wide scope of significant effects regarding attitudes towards love and sexuality as well as changes in convictions, knowledge, and normative beliefs. Changes were in line with the goals of the programme, but differed in their duration. Some changes were observed only in a posttest conducted immediately after the programme end; some were also significant in the second posttest four months after the end of the programme. A large section of Chapter 6 is devoted to the results of statistical analyses of risk and protective factors regarding early sexual debut. Greater value is attached to aspects of the programme's nonbehavioural effectiveness, which relate to variables identified that play a role in antecedents of early sexual activity in youth. The behavioural effects of a 3-year follow-up of this research are presented (in English) in the Appendix.
In Chapter 7 an evaluation of the Polish Archipelago of Treasures® Programme is presented. The study [2x2 quasi-experimental design; N = 410, age 14-16] compared answers given by students from experimental and control groups a week prior to the programme and one month after its end. While it lacked statistical power to verify effects on sexual behaviour, it indicated a significant decrease in alcohol use and a significant decrease in violent behaviour among younger participants of the programme. Several significant effects on attitudes, behavioural intentions, convictions, and knowledge regarding sexuality, love, and relationships were found.
The results of all Polish controlled evaluations are summarized in Chapter 8. It is emphasized that none of the three evaluations showed side-effects, and all confirmed the effectiveness of the scrutinized programmes in provoking several nonbehavioural changes as well as generalized behavioural changes such as reduction of violence or alcohol use.
Chapter 9 presents a list of conclusions for educational and health authorities as well as proposals for further research on the issues presented in the first two parts of the book.
A third section of the book was added to the 2nd edition in order to present some of the latest developments (2005-09), with much stronger emphasis on what has been done in Poland.
Chapter 10 contains a few updates on international literature on the subject. It largely focuses on summarizing the Report of the APA Task Force on the Sexualization of Girls (Zurbriggen et al., 2007). The report is considered by the author of the book to be of great value from the point of view of prevention of youth sexual risk behaviour. The second part of the chapter provides the reader with updates regarding current research results on condom effectiveness in prevention of STIs.
In Chapter 11, the author describes his own Integrated Prevention Model (IPM) - an eclectic yet consistent model of prevention of youth problems developed over the past decade. The chapter gives the first, quite broad and profound presentation of the philosophical assumptions of IPM, its background in psychology, its methods of working with youth, and its approach to evaluation research. The model is a theoretical tool designed to help authors to create cost-effective prevention programmes which impact youth behaviour and attitudes in several realms of problem behaviour at once. Personalistic philosophy and anthropology lend the model a holistic view on the human person. Erikson's theory of psychosocial development (Erikson, 1950)1 forms most of its psychological foundations. Other elements of the model come from broad empirical knowledge about risk and protective factors relating to different kinds of youth problem behaviour, as well as from knowledge about key elements of effective programmes in youth prevention. One of the assumptions of IPM is the need to focus on universal risk and protective factors in prevention, i.e. on those which correlate with different kinds of problem behaviour of youth. The model encourages the use of as many effective strategies, or key elements, as possible. The content of programmes based on the model does not necessarily have to be closely related to the goals of the programme. It is believed that as long as a programme speaks about developmentally important topics, fosters healthy development, and uses methods of working with youth proven to be effective in other programmes, it can produce generalized effects. In order to verify this assumption of the model, a special approach to evaluation is needed. IPM-based programmes have to be evaluated using a broad scope of indicators covering the whole range of youth problems, risk behaviours, and related variables. It is considered an ethical obligation to verify possible side-effects. On the other hand, due to IPM's holistic approach to the human person, it is believed that effects may generalize beyond the original goals of the programme. However it may seem, presenting the Integrated Prevention Model in a book devoted to prevention of youth sexual risk behaviour is not contradictory. Love and sexuality are at the centre of adolescents' attention. IPM-based programmes widely explore love and sexuality-related topics in order to pass on a broader message concerning a healthy lifestyle.
Chapter 12 presents an evaluation of the Archipelago of Treasures® programme, an integrated prevention programme fully based on the IPM model in its most recent form. This study was actually the first that was designed to verify the Integrated Prevention Model. It adopted a 2 x 3 experimental design with random assignment [N = 1267; two age cohorts 14-15, and 16-17]2. Posttests were held one month and six months after the end of the programme. The study shows several behavioural effects for the younger cohort: reduction of current sexual activity (p<0.04), reduction of alcohol use (p<0.04) and illegal drug use (p<0.03), reduction of contact with pornography among boys (p<0.03), and reduction of suicidal thoughts among girls (p<0.04). Several effects regarding behavioural intentions, attitudes, convictions, and knowledge about love, sexuality, and relationships are also found - all in line with the goals of the programme. The conclusion is that the Archipelago of Treasures® programme is an effective prevention tool for younger adolescents, capable of supporting healthy development and reducing a wide scope of risk and problem behaviours.
The study indicates a different pattern for the older age cohort. Most of the effects observed in the first posttest (all related to the goals of the programme) totally expired half a year later, and a single, however important, side-effect was observed (increase in alcohol use in the second posttest being the most severe). It has been concluded that the Archipelago of Treasures® programme cannot be proposed to older youth belonging to risk groups (such as the youth from vocational schools included in the study as the older cohort) without serious consequences. It has been suggested that the programme needs to be better adapted to youth with high level of problem behaviour and should include some form of follow-up a few months after completion of its main part.
Chapter 12 ends with the conclusion that the Integrated Prevention Model was empirically confirmed for the first time with regard to primary prevention (when the programme is offered to younger youth with less experience in risk and problem behaviour), but that it probably demands further development in order to be safely used for older youth from risk groups.
Chapter 13, written by guest author Grażyna Węglarczyk, presents evaluation research on the 'Without Risk' programme. The programme is based on a similar theoretical approach as the Integrated Prevention Model, but was created independently. The programme is well known in Poland as it has been the main tool of two annual nationwide HIV/AIDS prevention campaigns. It aims at reducing the level of early sexual activity and levels of alcohol and drug use. A 2x3 experimental design was adopted with a pretest and two posttests (one month and one year after the programme). The study was conducted in 2007 and 2008 in average public secondary schools [N = 555; age 16-17]. The results section presents frequencies for indicators of several risk behaviours which suggest the possibility of the behavioural impact of the programme on youth, but does not show statistical significance of the effects, as analyses were not yet completed.
The Appendix - written in English - presents the behavioural effects noted in the three year follow-up of the evaluation of TeenSTAR® Programme (PiON). The results of the first three waves of the study [2002-03] are presented in Chapter 6. The last posttest was conducted in December 2005, three years after the end of the programme. The sample size was reduced [N = 204; age 18 at the last posttest] due to difficulties in locating youth at their new schools. The study showed two long-term behavioural effects. There was less heavy petting in the last 12 months among programme girls (p<0.05), and a trend was observed regarding a lower level of sexual contact ever experienced (p<0.10). The indicator for level of sexual contact distinguished between three levels: no contact, heavy petting, and sexual intercourse. The nonbehavioural long-term effects of this evaluation are presented in English elsewhere (Grzelak, 2008)3.
Chapter 14 provides the reader with brief conclusions for prevention and research from the third section of the book.
All sound Polish evaluations conducted over the last two decades consider programmes that motivate youth to risk avoidance (primary behavioural change), where risk avoidance is defined with regard to sexuality as sexual abstinence that is replaced in time by fidelity in a permanent relationship. No Polish controlled evaluation studies of harm reduction programmes motivating youth to use condoms and other contraceptives are known to the author of this book. Contrary to what the reader can find in the international literature on the subject, in Poland, abstinence-directed prevention is the only scientifically verified approach. After 15 years of Polish experience in the evaluation of programmes preventing youth sexual risk behaviour, both effective prevention programmes and well-developed research tools can be offered to specialists from other countries.
(1) Erikson, E.H. (1950). Childhood and Society. New York: Norton.
(2) The younger cohort consisted of students from average public schools. The older cohort were students of vocational schools with high levels of problem behaviour.
(3) Grzelak, S. (2008). 'The impact of the TeenSTAR Programme on attitudes, intentions, convictions and knowledge in the Polish controlled evaluation 2002-2005'. In: Wieczorek, W. et al. (eds.), Naturalne planowanie rodziny w ujęciu wybranych dyscyplin naukowych, Lublin: Instytut Nauk o Rodzinie, KUL.
Seven levers of effective prevention
(C) 2015 Institute for Integrated Prevention, Poland
Thinking according to the principle of a lever consists of searching for a foothold that would allow great effects to be achieved despite limited forces and resources. Seven levers of effective prevention are seven footholds, seven aspects of reality, which are key to effectiveness in the area of prevention and the upbringing process.
FIRST LEVER
Pay attention to what is good
(then you will find better solutions to the problems)
This is the lever of awareness of the impact that information has on motivation and the creative search for solutions. Positive information about youth and the educational potential of local communities are the best starting points in the creative search for solutions to problems. The fact that (according to our research) the majority of young high school students do not engage in risk behaviours is an example of such positive information. Focusing on these types of facts triggers a new way of thinking, which is, ?What can I do to let more young people develop their potential, live healthily and be an inspiration to others?.
SECOND LEVER
Think in an integrated way about problem behaviours and prevention
(then solutions will be holistic and efforts economical)
The second lever of effective prevention is based on the fact that similar factors are involved with the occurrence of various risk behaviours from many different areas (drug and alcohol use, violence, sexual risk behaviours, pornography use, violence, depression and suicidal tendencies, etc.). Strengthening the protection factors and weakening the risk factors of one problem should be seen in the context of its impact on other issues.
A holistic and integrated approach can be a source of savings and significant increase in the efficiency of public expenditures for the goals of prevention. It is, therefore, advisable to incorporate into municipal/local strategy those activities which enhance the protective factors and weaken risk factors associated with not one, but many threats. Such an approach will certainly intensify the effects of every penny invested in prevention actions.
THIRD LEVER
Base on the resources of local communities
(by respecting them, you gain powerful allies)
The most rational and effective approach relies on local resources. Just analyse and link some facts. Relationships with parents, religiousness, positive school climate and good atmosphere in the class are proven protective factors which prevent many youth problems and risk behaviours. They represent important resources for each local community. Additionally, the daily care and upbringing of children by parents is an effort and 'expense' of the family, not the municipality or the state. The activity of religious organizations in terms of their primary mission also takes place without the funding of local authorities. An approach based on respect for these natural social resources promotes the development of social capital, prevents conflicts and builds a broad positive front (around prevention and educational activities).
FOURTH LEVER
Build on the values and dreams of youth
(then they accept a healthy lifestyle as a means to achieving their own goals)
Thanks to understanding the meaning of the life aspirations, values, and dreams of youth we are able to base prevention of youth problems on a very strong and deep motivation. Lack of support in their environment or bitter experiences in life may have covered young people's dreams with a layer of fears and concerns. As the results of many studies show, the aspirations of young people are focused on great matters and aims - those that are associated with the most important interpersonal bonds, at the same time they are connected with matters that may bring purpose and meaning to their adult lives.
Supporting youth in achieving their dreams of creating a happy family in the future or developing passions and interests that prepare them for professional life is an important lever which can be used to unite the efforts of different entities in local communities. Prevention programmes referring to such motivations are well received by youth, even if their message associated with a healthy lifestyle poses very difficult challenges for young people.
FIFTH LEVER
Fight for education and prevention to be a developmental priority
(there are more people seriously concerned about youth than you think there are)
For the fifth lever of effective prevention we use the term 'developmental priority'. Treating education and prevention of youth problems as a priority is a condition for the development of young people. Supporting youth and preventing youth problems should be included as a priority in the strategy of development of every municipality and the state itself. Therefore, anyone who is engaged in prevention has a very important social role. Treating some areas as priority creates conditions for and gives the green light to actions, facilitates finding financial resources and enables the achievement of crucial objectives in this area, regardless of difficulties and barriers. For this reason, it is vital to discuss the importance of prevention and the upbringing process and to demonstrate the costs of social and financial consequences of youth risk behaviours.
SIXTH LEVER
While creating a strategy, search for maximum effect at optimal cost
(then the effort makes the most sense)
Optimal costs are not the lowest possible cost, but the cheapest way to achieve maximum results. The effect we want to attain in the prevention field is a radical reduction in the scale of multiple different risk behaviours and youth problems throughout the whole local community. In order to obtain such an outcome, the most cost-effective ways of preventing and solving problems and the economics of prevention should be taken into account. This approach allows us to achieve maximum effect at optimal cost by combining two factors: comprehensive effectiveness of actions and their wide range of implementation. When using this lever, two questions should be posed: how to create a strategy that will assure comprehensive effectiveness and how to implement it on a large scale in the most economical manner? In finding the answers to these questions, The Guidebook to Effective Prevention of Youth Problems can be helpful. The tables included in the text may facilitate the development of a cost-effective local prevention strategy.
SEVENTH LEVER
Invite the cooperation of people with a passion and love for youth
(a team of people with passion achieves great goals and doesn’t burn out)
The whole strategy would not be complete without the seventh lever, which emphasizes the significance of the people who create a vision for the prevention system as well as those who implement the strategy. People with a passion for working with youth are able to pursue their goals even when confronted with numerous obstacles and barriers.
The key combination of two values: a positive, kind attitude towards youth, and sincere commitment to action for the benefit of youth is of fundamental importance. Professionalism, strong capabilities, and appropriate formal qualifications are assets that can be fully manifested when they are accompanied by enthusiasm and commitment rooted in a passion for working with youth.
Seven levers of effective prevention is a mindset that can become the basis for the formation of local teams cooperating to support young people and prevent youth problems. The whole philosophy of The Guidebook to Effective Prevention of Youth Problems is pragmatic and applicable, as it is rooted in common sense and based on noticing and enhancing the resources naturally present in local communities.
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This article was published in the Polish prevention journal Świat Problemów (1/2016), which is edited with the assistance of the State Agency for Prevention of Alcohol-Related Problems. |
Szymon Grzelak
Doctor of Psychology, President of the Institute for Integrated Prevention, author of prevention programmes.
The Guidebook to Effective Prevention of Youth Problems as an action programme
The Guidebook to Effective Prevention of Youth Problems proposes a strategy which is based on a bold but very rational vision. This perspective may lead to cross-sectoral cohesion in actions taken by the government, local authorities, schools, and all entities engaged in the area of prevention and supporting youth development actions.
The context: The sectoral and reactive character of contemporary Polish prevention programmes
The 'golden age' for prevention programme development certainly came in the 1990s. After the collapse of communism, we in Poland were once again able to draw from the rich, more than century-old native tradition of sobriety cultivated in the environments associated with the Catholic Church and other Christian denominations.
It was a time when numerous original prevention programmes were devised. Polish specialists began to adapt foreign programmes to their native environment and created their own with time, on the basis of experience gained. More and more professional evaluation programmes assessing the effectiveness of prevention programmes appeared. The foundations of the post-communist Polish legal system were also developed in the 1990s; this divided tasks and financing between the state and local governments, and regarding the state itself - it divided tasks and financing among various ministries.
A system was designed which Poland could be proud of: a system which, at the time, was largely effective. It suited the state of knowledge, abilities and needs of that period perfectly.
This system, with certain adjustments introduced over the years, is still being used to the present day. However, there is no longer as much dynamism in it as there once was. There is no vision behind it capable of inspiring people. There is no holistic, coherent strategy that could be simultaneously realized by both the government and local authorities. At the national level, tasks in the area of health promotion and prevention of risk behaviours and problems of children and adolescents have been implemented in recent years by at least four ministries: the Ministry of Health, Ministry of National Education, Ministry of Labour and Social Policy and the Ministry of Internal Affairs and Administration. Unfortunately, cooperation between the ministries has left much to be desired. It was often the case that senior officials in charge of the area of prevention had no idea as to the basics of the field of prevention nor the tools available for the existing legal and institutional system. A sectoral approach prevailed, in which each department performed their own tasks in the area of prevention for better or worse, with was no real coordination between ministries.
A similar sectoral approach is visible in the way local governments (but not all of them!) operate. Below are some authentic examples:
- A local health department organizes a significant conference on prevention involving eminent experts, during which neither representatives of the department of education, department of social affairs, nor town authorities appear (the vice-president was present for 10 minutes at the opening and then left). From the point of view of creating a coherent strategy for prevention in the community, it is a wasted opportunity.
- One local department of education ordered a diagnosis of youth problems, not aware of the fact that the health department had ordered similar research earlier. In this way, sectoral divisions resulted in a waste of financial resources.
- The local police carry out their prevention tasks in cooperation with schools, but they are not integrated into a meaningful whole with the activities of local government offices, OPS (Social Welfare Centres) or psychological and pedagogical clinics. There is no person in the local community authorized to verify whether, by chance, the actions and prevention ideas of some entities do not stand in opposition to the actions of others. Thus, apart from effective and useful measures, there might also be adverse effects of such activity.
As a result, many various institutions are in charge of prevention, yet their efforts are fragmented and do not add up to a meaningful whole. A great number of people are involved in action, but their energy dissipates into a series of tasks, the implementation of which is not assessed for its efficacy, but for its correspondence with the narrow criteria of official reporting.
The lack of a coherent vision of Polish prevention creates ideal conditions for chaos, where the course of action does not arise from long-term goals and strategy, but is rather a response to current events. Special publicity of such events is given by the media, which is always keenly interested in having a sensational topic to comment on.
When the topic of the media becomes legal highs, policy makers give the green light (and thus power and resources) to the legal highs prevention programs, without any regard to why they should treat this one of many threats as such a priority.
Neither the comprehensive effectiveness of prevention is taken into account here nor even whether such activities actually reduce the number of young people reaching for legal highs. What counts is that the state, municipalities, and schools respond to the ad hoc expectations imposed by media pressure.
As a result, the reactive approach prevails. Today, it is legal highs we are dealing with, yesterday it was violence (because somewhere a football fan was killed), while the day before yesterday the hot topic was depression and suicide (because one suicide was publicized by the media, prompting a whole series of them)...
Seven levers of effective prevention
Seven levers of effective prevention described in The Guidebook to Effective Prevention of Youth Problems is a synthesis of experiences and knowledge based on scientific research conducted by a team of authors from the Institute for Integrated Prevention (Polish acronym IPZIN). The research data was collected by the staff of the Institute for many years. However, it was when the project was commissioned in the spring of 2014 by the Centre for Education Development (financed by the European Social Fund ESF with the support of IPZIN sponsors) that IPZIN developed the holistic synthesis, Seven levers of effective prevention.
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The most important sources of data that were used for the creation of The Guidebook to Effective Prevention of Youth Problems:
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The last subchapter of the Guidebook is entitled: The End with the Perspective for the Future. In this part the image of youth development and prevention in the local community is described. It is an idea in which the preparation of young people for life is fully based on the seven levers of effective prevention:
- In the daily work of youth development led by schools and the activities of the community the positive potential of young people is noticed and reinforced. There are more positives than negatives expressed with reference to young people; praise greatly outweighs criticism. There is an atmosphere of trust and confidence in the capabilities of youth.
- At the local level, youth prevention is approached in a comprehensive, holistic and integrated way. Awareness of the fact that problems and risk behaviours of youth are linked and have a great number of common protective and risk factors leads to the local strategy being aimed at causal, not symptomatic effects.
- Local resources are treated as the basis for a system of prevention and support for the upbringing process, and actions to promote youth development are based on broad cooperation. In the actions conducted by local officials, there is visible respect for the role of parents, relatives, educators, teachers, religious organizations, youth organizations, and all other guides who have young people's well-being at heart.
- The actions supporting youth development and the prevention programme appeal to the deepest dreams, desires, and values of young people. As a result, young people themselves view the efforts of adults as a way of offering them help in discovering a way of life, not as imposing incomprehensible restrictions on them.
- Local government, schools, and the entire local community treat development of young people and prevention as a priority, realising that the future growth and prosperity of the entire community depends largely on youth. Adequate resources are allocated for prevention and support of the development of young people. They are also the subjects of meetings, conferences, and trainings. Prioritising prevention translates into establishing clear boundaries for all practices of an anti-prevention character in the daily life of the local community and public events.
- The resources dedicated to tasks in the area of education and prevention are spent to bring the maximum effect. A comprehensive diagnosis of needs, high efficiency, and broad implementation are the criteria that are taken into consideration in both individual programmes as well as the entire prevention system.
- A team of people who share a common passion and engagement in work with young people are involved in cooperation on behalf of prevention and the youth development system. The experience, abilities, and social roles of team members complement each other. The bold vision realized by the team turns into reality and becomes one of the flagships of the municipality.
Each of the seven points above refers to one of the seven levers of effective prevention described comprehensively in the Guidebook. Together they provide a comprehensive programme. In local communities where matters of education and prevention have been treated in such a way, the severity of risk behaviours and problems of young people substantially decrease, and conditions for positive youth development improve. Through the growth of social trust and social capital such an approach turns into a lever for development of the local community. The joint implementation of wise policies in the field of promoting youth development could make the local community a place where young people want to return, where they would want to live and work for the common good, passing on what they themselves have received to the next generation.
Writing this text I would like to point out one select reason (among several major reasons) why the recommended approach is truly the answer to the problem of the lack of a coherent vision of social, health, and education policy in the field of prevention.
The Guidebook to Effective Prevention of Youth Problems creates a fundamental change in thinking about risk behaviours and problems of youth. Solid research arguments leave no doubt that one needs to consider prevention in an integrated way, not in parts; to address it in a holistic rather than sectoral manner. The positive potential of young people is discussed with a presentation of the results of our own research, conducted by the Institute for Integrated Prevention (IPZIN) (N = 8613, 14-15 years old 2nd year intermediate school pupils from eight different voivodeships in Poland). The research shows that a large percentage of high school students do not engage in a variety of risk/problem behaviours (drinking, binge drinking, smoking, drug use, early sexual contact, engaging in violence, suicidal thoughts, etc.).
When youth problems and risk behaviours are referred to in the book, a range of different problems in different areas is always addressed - whether it concerns the classification of the problems themselves, observation of trends over the years, or finally the consequences of various threats to individuals, families, and the entire population.
Gathering such cross-sectional data conclusively shows that the range of specific problems is too wide to be effectively coped with using an approach that emphasizes a narrow specialization.
If we compare the resources of the school headmaster or a local government official who has a particular budget at their disposal with the multiplicity of risk behaviours which should be prevented and problems that need to be addressed, there seems to be no way out of the situation. For instance, if we choose to fight against legal highs and violence, we will be left with insufficient funds for alcohol prevention, sexual risk behaviours, depression, anorexia, and gambling…
An integrated approach is the only rational option. Because if it is true that youth problems are interrelated and that they have some common causes, risk factors, and protective factors, we do not have to fall into the trap of a narrow specialization, which is economically limiting. If the above-mentioned correlations are scientifically proven, we have every right to direct people's energy and funds toward integrated actions, those which affect the key risk factors for the range of youth behaviours and strengthen protective factors. Then, while specialized activities will still be needed, they will be a supplement to, and not a principle of, prevention.
The IPZIN study results show that different indicators within a given category of problems are strongly or very strongly connected. For example, there are high correlations for use of different psychoactive substances by young people (alcohol, cigarettes, drugs, legal highs). Just this simple fact calls into question the significance of the separate prevention of the use of legal highs, which has been so strongly emphasized over the last six months. We can expect that if we focus on legal highs as a threat and manage to effectively discourage young people from using them (and don't encourage this behaviour... we cannot be certain until we study the effects!), it's very likely that young people will switch to beer, drugs or even gambling or pornography. Such are the effects of an exclusive focus on the symptoms. This particular approach does not bring deeper change.
The test results included in the Guidebook show us something more. They draw a parallel not only between different indicators of problems in a given area, but also between a group of problems in various areas.
Tables 1 and 2 (statistical considerations required a separate calculation for each sex) demonstrate a high correlation between the use of psychoactive substances and sexual and violence variables as well as a slightly lower but still considerable correlation with the variables from the category of 'depression'.
Table 1. Correlations between groups of problems for girls (age 14-15)
Table 2. Correlations between groups of problems for boys (age 14-15)
Various problems and risks coexist, collide and mix with one other in the young person and their peer environment. In fact, it's more difficult to find a rationale for isolating these problems and creating separate paths and programmes to counteract them than arguments for an integrated approach.
Research by IPZIN also shows that there are a number of risk factors and protective factors that are common to different kinds of threats. Factors such as being in the company of alcohol drinkers or the degree of sexualization are also risk factors for binge drinking, drug use, engaging in violence, early sexual contact and suicidal thoughts. At the same time, the scope of impact of protective factors related to family (mom and dad as the most important guides in life), religion or school (class climate, classmates' acceptance) is equally broad.
This means that an integrated approach is a rational direction for prevention as it focuses on strengthening protective factors against simultaneous multiple threats. It is, therefore, the most economical approach in the sense that it draws on the resources that exist in every community. Because in each municipality, prevention can be developed which supports the authority of parents, uses the potential of schools in youth development, and promotes religious communities and organizations passing values on to young people, treating them as assets in the battle against youth problems.
Support for prevention
The Guidebook to Effective Prevention of Youth Problems offers guidelines for state authorities and local government, demonstrating that the area of education and prevention is worth being treated as one of the top priorities in social, health, and education policy - and should be treated as such. Only an area that is treated as a priority can be wisely managed at the interministerial level. Only the policy priorities of the state and local government can count on adequate funding.
The Guidebook was published just before the parliamentary elections. We managed to convince the previous government to organize an interministerial meeting in the Office of the Prime Minister, which was held on 8th October, 2015. Immediately after the elections we began working to convince the new government of this approach. At the time of printing this article, the effects of our action are not yet known. We hope that with the help of a few parliamentarians - ambassadors of prevention, who know and appreciate the Guidebook, we will succeed in influencing the creation of a new prevention strategy, one which breaks the barrier of rigid sectoral divisions, and is rational and economical. And at the same time, it should wisely expand on the strengths of the current system of prevention (institutional backing of governmental agencies such as PARPA (National Agency for the Solution of Alcohol-related Problems), KBPN (National Bureau for Drug Prevention) or CED (Centre for Education Development), a number of effective prevention programmes, meaningful legal provisions included in the System of Recommendations for Prevention Programmes and Promotion of Mental Health).
We treat the Guidebook as a proposal for a meeting ground for cooperation across political divisions, because such significant and long-term issues as youth development and prevention must not be neglected due to the short-sighted media or political battles. While state and local government officials change every few years, passionate practitioners have been working in the field of prevention for decades. What they need is a wise and sustainable framework. They need politicians to improve and streamline the system, giving the priority for action to professionals.
Due to the demand reported by local governments, our Institute has developed a programme of training workshops that teaches government officials, counsellors, school administrators and other key individuals how to apply the approach based on the seven levers of effective prevention in practice. The whole idea of these workshops is to ensure that there are representatives of the different sectors in one group (health department, department of education, department of social affairs, social welfare centre, police, etc).
Someone may perceive it as audacious for the Institute for Integrated Prevention to suggest to the state and local government a new ground for building a coherent system of prevention and the promotion of youth development. The problem is that no one else has offered such an overall vision yet.
Therefore, we encourage you to Vade me cum (join us)!
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(1) Grzelak, S. et al. (2015). 'Vademecum skutecznej profilaktyki problemów młodzieży. Przewodnik dla samorządowców i praktyków oparty na wynikach badań naukowych.' (The Guidebook to Effective Prevention of Youth Problems. Guidelines for Local Authorities and Practitioners Based on the Results of Scientific Research). Warsaw: Centre for Education Development. (258 pp.)