Arizona State University Foundation

Culturally-appropriate and effective substance abuse prevention for all youth Highly Ranked

Lead Organization

Arizona State University Foundation

Tempe, Arizona, United States

http://www.asufoundation.org

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Project Summary

Drug abuse and addiction are major global public health challenges. Deaths caused by drug use increased 60% in the past 15 years. While youth in the rich North have access to efficacious substance abuse interventions, most children in the rest of the world do not, and when they do, prevention programs are seldom culturally appropriate or sustainable. Our solution will reach 1.1 million youth, 18,750 teachers, 3,750 schools across 15 countries and will: (1) Engage in an equitable, community-based campaign to adapt, implement, and evaluate keepin’ it REAL (kiR), an efficacious substance abuse prevention program; (2) Enhance community capacity to ensure lasting results of kiR; and (3) Partner with ETR for global product development, dissemination, and adoption of kiR. This initiative will facilitate collaboration between communities with similar needs and challenges and will impact the long-term health of communities in ways that are culturally appropriate, feasible, efficacious, replicable, and sustainable.

Problem Statement

Drug abuse and addiction are a global crisis. According to the WHO, “Many of today's and tomorrow's leading causes of death, disease and disability … can be significantly reduced by preventing six interrelated categories of behavior that are initiated during youth.” These behaviors are directly linked to substance abuse and the risky decisions that arise from addiction – tobacco use, alcohol/substance use, behavior resulting in violence or injury, and risky sexual behaviors. Preventing the initiation of substance use before age 14 is critical, as early use predicts a substantially higher risk of substance use disorders. Every $1 spent on substance abuse prevention is estimated to save $10 in social costs, $10 in treatment, and $16 in control efforts. While substance abuse prevention programs have been widely accepted and evaluated in the US and Europe, less is known about prevention approaches in other parts of the world. The most widely implemented prevention programs have limited relevance in many non-Western and developing countries because they lack resonance with the socio-environmental context, cultural traditions, and life experiences of children. They often pay insufficient attention to the local context and are unable to address specific risk factors and build resilience to prevent substance abuse. School-based prevention programs are one of the most cost-effective methods to deliver interventions. However, schools often face considerable capacity challenges to implement and sustain prevention programs long-term. Multi-sector capacity-building for key stakeholders and program facilitators are critical components for creating sustainable and lasting reductions in substance abuse and addiction.

Solution Overview

Our solution will prevent substance abuse and strengthen communities in vulnerable social and cultural contexts. We will adapt, implement, and evaluate kiR, our scientifically proven, effective substance abuse prevention program with youth ages 12-14. kiR teaches a repertoire of drug resistance strategies—Refuse, Explain, Avoid, Leave [REAL]. Youth also learn how to assess risk, make good decisions, and communicate effectively. kiR is delivered in regular classrooms by regular teachers. This school-based intervention strategy will allow us to maximize our outreach to 1.1 million students currently without access to effective prevention programs. We expect youth to: (a) Reduce alcohol, tobacco, marijuana, and inhalant use; (b) Abstain from opioid, cocaine, heroin, amphetamine, and prescription drug initiation; and (c) Increase use of drug resistance strategies. Long-term, we will reduce rates of adolescent and young adult substance abuse and addictions.As our current efforts indicate, close collaboration with stakeholders is imperative, as they know the cultural values and resilience strategies that are leverage points for promoting health. However, communities need support and training to sustain prevention efforts. Capacity building is critical for ensuring the long-term success of kiR and for maximizing the community’s successful engagement in future health promotion efforts. Through our solution, stakeholders will: (a) Acquire new knowledge and skills in program adaptation and implementation; (b) Use a variety of strategies to evaluate kiR; (c) Assume leadership and ownership in substance abuse prevention; and (d) Develop dissemination strategies that will lead to broad adoption of kiR and changes in policies and practices.

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Project Funders

  • National Institutes of Health/ National Institute of Drug Abuse 2015 - 2020
  • National Institutes of Health/ Minority Health and Health Disparities 2012 - 2017
  • National Institutes of Health/ Minority Health and Health Disparities 2007 - 2012

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