Programmes, target groups and intermediaries

There is no general standard drug education model or drug prevention programme suitable for the whole population or community. Distinctions must be made between different communities and target groups, each population group in a country or local community needing its own prevention programme, often with different goals, content and communication techniques.

There is also a difference in the ways preventive education can reach target groups, not all of whom need to be contacted directly by drug education workers. Some intermediary groups, community key persons or community communication channels (local radio and TV), have regular contacts with specific target groups and can play a crucial role in preventive education 8). Informing, educating and training these intermediaries to carry out educational activities, sometimes referred to as the two-step model of communication 9), can be a very efficient and cost-effective strategy. For example, it is possible to directly provide different risk groups school-leavers, school drop-outs, unemployed youth - with drug information by means of mass media communication. However, this approach is rather time consuming, cost intensive and it would be more appropriate to train key persons who have close relationships and personal contacts, or who are able to communicate in other ways, to inform and persuade groups at risk of the harmful effects of drug abuse. Another approach would be to train and educate primary health care professionals like family doctors, social workers, district nurses who, through daily contacts with families and groups in the local community, can play an important role in drug education and prevention.

8) Buisman, W.R. Drug Prevention in The Netherlands. In: Ghodse, H. A. et.al. Drug Misuse and Dependence, Parthenon. Lancs. 1990

9) Rogers, E.M. Diffusion of Innovations. New York. Free Press. 1983

Figure 2 shows several possibilities of intermediary groups and professions and educational contacts with target groups.

Besides strategical questions of addressing drug education programmes via intermediaries or directly to population target groups, a choice has to be made about the level of prevention at which the intervention will take place: primary (no use of drugs or slight experimentation), secondary (experimentation with drugs, for example, by risk groups) and tertiary prevention (relapse prevention or risky use of new dangerous drugs).

FIGURE 2. INTERMEDIARIES AND TARGET GROUPS

Figure 3 gives an overview of the three levels of primary, secondary and tertiary prevention 10). Different types of intervention and educational activities that could be applied to a great number of different target groups are indicated. As previously mentioned in this report, prevention programmes can have a unique, one-time character, or can be carried out several times for different target groups in a community. They might also be carried out over a long period, for example, a mass media programme on radio or television running for several months.

10) See Note. 8

On the other hand, especially in the context of formal education a prevention programme might be conducted over a two-year period. An example of a long-lasting drug prevention programme at secondary school level, is the "Skills for Adolescents" programme (11). This educational programme has a broad focus and is very much person and peer group oriented. Beside providing basic facts and information on drugs, it emphasizes values and attitudes, awareness of social influences and the development of personal and social skills like critical thinking, decision-making, etc. The rationale behind the programme is that positive and healthy choices about drug behaviour are much more likely to be made within the context of self-confidence, critical thinking and decision making and an individual's awareness of (negative) social influences he or she is exposed to. However, schools and teachers who decide to carry out this well-tried prevention programme need an average of 8 hours a week at their disposal.

11) Skills for Adolescents. Columbus, Ohio. The Quest National Centre. 1985

FIGURE 3. PREVENTION LEVELS AND TARGET GROUPS

Examples of intensive, comprehensive education and training courses for health professionals can be found in several medical education training programmes in the USA and the Netherlands (12). At the start of medical training, attention is paid to factual knowledge on drugs and drug use and to the development of adequate attitudes. In later years, students are trained in skills of early recognition of drug problems and care and treatment (13).

12) Buisman, W. R. & P. J. Geerlings. The Amsterdam Substance Abuse Programme for Medical Students. Bilthoven, Amsterdam. 1985

13) See Note.

The next Chapter describes methods and techniques of drug education in more detail.