(introduction...)

A number of communication methods and techniques can be applied to attain the goals and objectives of drug education. In general, a distinction is made between education using group methods and education using mass media techniques.

Education using group methods refers to a wide range of techniques and methods, for example:

- Classroom teaching, e.g effects of drugs on the brain in biology-classes;

- Lectures, e.g «drug use by adolescents» for an audience of parents;

- Small group discussion, e.g "how to cope with a drug user in a family";

- Training, e.g general practitioners how to detect drug problems early;

- Role playing, e.g counsellors teach communication with a pupil;

- Panel or forum discussions, e.g. community-leaders and citizens on prevention plans and policies;

- Demonstrations, e.g how to work with a drug information kit;

- Exhibitions, e.g of educational materials: posters, leaflets, videos;

- Symposia and study conferences on a wide range of drug prevention matters.

Education using mass media signifies several types of mass communication methods and approaches. For example:

- Mass media campaigns at national, regional, local levels, broadcasting anti-drug spots on television and/or radio;

- Television and radio programmes: drug information series, drug education, drug treatment, interviews with drug users, ex-addicts, drug experts; - Newspaper advertisements (or in weekly, monthly magazines);

- Magazines for young people with background information, interviews, prevention and education materials;

- Educational materials containing drug information distributed house-to-house;

- Posters, booklets, stickers, leaflets, distributed to the general public in the streets, stations, markets, etc;

- Audio or audio-visual material (audio tapes, videos); - Information services using public telephone numbers.

A decision about which educational method or technique is the most appropriate very much depends on the goals of the prevention programme or educational action, the target group to whom the programme is addressed and the funds available. Generally speaking, the first choice to be made is between an approach using group methods or one in favour of mass media techniques and, in this respect, a very important question is the desired influence on the target group. What does one want to change, strengthen or confirm? Education using group methods essentially has more impact on attitudes, social norms and behaviour like "stay drug free", learn peer refusal skills, etc. Moreover, the relationship between an educator or change agent and the selected target group is close, especially if the educator is considered both credible and expert.

An educator applying group methods can also pay more attention to specific cultural and social psychological factors presumed to have great impact on attitudes and social norms in respect of drugs and drug abuse.

To illustrate this point, in the Netherlands as in many other countries, there live several ethnic minority groups who are considered to be at higher risk of involvement in drug abuse. The introduction and spread of heroin among the young Mollucan community (originally living in Indonesia), for example, indicates a specific pattern, rather different from that in other community groups. It might be argued that heroin use is seen as a symbolic expression of the confirmation of solidarity of the group members in the Mollucan community and aimed at strengthening cohesion of specific clusters of young people within this community (14). A mass media campaign to communicate a message with strong emphasis on the dangers of heroin use would run the risk of denying the socio-psychological function of drug use in this community and would, therefore, probably be ineffective. A more effective strategy would be to educate and train the minority community leaders in discussion techniques to heighten the awareness of youth in their community to the dramatic impact and counter effects of heroin use on cohesion and solidarity.

(14) Buisman, W. R. Educational Messages in Alcohol and Drug Education. In: Proceedings of the 34th ICAA International Congress on Alcoholism and Drug Dependence, Calgary, Canada.

Education utilising mass media channels has a potentially wider range of public exposure, but the relationship between the source (educator or educational organisation) and the target audience is often rather weak. It is hardly possible to discuss social norms and behaviour with the target audience in these circumstances, and we cannot therefore expect dramatic changes in attitudes or behaviour through mass media education. On the other hand, mass media could serve to raise awareness of the existence of drug problems by offering correct information and news about the latest methods of treatment and research findings. Another important function of mass media can be to support drug education activities initiated in a community by using the "news and agenda setting" function to announce information on those activities, to interview key persons involved in the programme and broadcast statements of opinion by community leaders about their attitudes towards drug education programmes.

The next paragraph describes the possibilities, advantages and disadvantages of mass media in drug education, as well as concepts and methods of group drug education (mainly in formal education).

Drug Education and Mass Media

Television, radio and magazines play a major role in forming the perceptions, attitudes and opinions of people, many of whom are strongly influenced by television programmes or articles on illness - and health related issues, like HIV/AIDS and psychoactive substances, such as medicines or drugs. Often they are exposed to advertising messages that try to persuade them to buy a specific medicine to prevent or to cure a certain disease.

People are also influenced by television programmes such as movies, soap operas or detective series that dramatise or glamorize drug use and drug users and which have a great impact on opinions and behaviour of which most people are unaware.

Over the past twenty years, drug education has been making increasing use of the possibilities of mass media to pass on educational messages to a large audience. Superficially, the only similarity between all these types of campaigns seems to be that they all make use of mass media based on the assumption that mass media campaigns greatly influence people's behaviour. On many other points, such differences exist as to make much more difficult any qualitative comparison between campaigns. Furthermore, especially in the older campaigns, clearly formulated, operational objectives in terms of hoped-for changes in attitude, social norms or behaviour are sadly lacking. Mostly there is nothing more than "awareness of the damaging effects of drug abuse" or "change of mentality", "influencing social norms" goals that can hardly be measured scientifically. A positive development has, however, recently been observed, which is probably linked with newly acquired insights in mass communication studies. Previous campaigns were particularly characterised by untargeted bombardments of information, based on the then popular "hypodermic needle theory" of the effects of mass media (15), whereas over the past 15 years many more campaigns have been aimed at specific target audiences.

(15) Klapper. J. T. The Effects of Mass Communication. New York. Free Press. 1960

The National Institute on Alcoholism and Alcohol Abuse (NIAAA) in the USA, has run separate mass media campaigns for specific social groups, such as drivers ("If you drink, don't drive, if you drive don't drink"), pregnant woman ("Pregnant? Before you drink think!") and young people. Relevant opinion leaders are selected and local support provided for the campaigns. Use is made of recently acquired scientific insights, for example, fear arousal techniques (slow motion replay of a drunk driver knocking down a child), and the latest research findings on the use of media, and the mechanisms of selectivity and exposure are taken into account (16).

(16) See Note. 7

Principles of Mass Media

To most people mass media means television, radio and newspapers. This is partly correct, but education makes use of a much wider arsenal of media, such as posters, leaflets, brochures, videos, etc. A general characteristic of mass media is that, in principle, nobody is excluded, mass media are public, accessible to everybody. But there are also many differences. The best-known, that is, television and radio, reach virtually everybody, contrary to a poster in a station, whose message is seen only by train passengers. Television exerts a great influence, not only because this powerful medium reaches many people, but also because it has an aura of authority. Television is also a penetrating medium because it has an audio as well as a visual dimension which can be used to great advantage given the present level of television technology.

The printed media, and radio in particular, rather trail behind this development. In the world of the media and in drug and health education circles, a distinction is often made between high-key and low key use of mass media. These concepts apply to the medium of choice, as well as to the way in which media are used. Television is the most frequently used high-key medium because it is so large-scale, is generally considered to be authoritative and reliable and offers many possibilities. Printed media, like newspapers, weeklies and brochures are much more low-key. Not everybody is literate, reads the same newspaper, or the same weekly. Besides, exposure to an educational message or an advertisement is much more indirect; it is part of a number of other messages and so there is selectivity on the part of the reader.

The following example of a recent high-key American mass media campaign can serve to illustrate this somewhat theoretical point (17). The United States of America has contended with probably the largest drug problem in the Western world, and for some years a "War on drugs" has been declared. Recently, instead of strong emphasis on tracing and prosecuting drug traffickers, there is now more stress on discouraging Americans to use drugs, with slogans like "Using is losing".

(17) Strategy and Research Task Force Campaign Recommendation. The Media Advertising Partnership for a Drug Free America (MAPDA). New York. 1986

At the end of 1986, more than 200 American advertising agencies set up the "Media Advertising Partnership for a Drug free America" (MAPDA) (18). The largest anti-drug campaign ever initiated was begun in 1987 involving a total budget of about 3 billion dollars. The organizers of this tremendous campaign first carried out wide-range market research on the basis of which about 50 different campaigns were developed. The campaign was split into three main target groups - youngsters, adults between 18 and 35 and older people. Youngsters were chosen because they are curious and have strong experimental instincts. Adults aged between 18 and 35 are often indifferent to drug abuse, are not aware of the risks and often assume the attitude: "Some use drugs, some drink too much". The third large target group of older people is furthest away from drug abuse, having very little knowledge of drugs and many misconceptions. The anti-drug campaigns set up are very varied. Besides those already mentioned, there are separate campaigns for numerous target groups such as sportsmen and women, show business personalities, opinion leaders, educators. Special campaigns were run for marijuana, cocaine, crack and heroin. There is no general emphasis on the damaging long-term effects of drug abuse but, particularly in the campaigns for youngsters, much stress is laid on the short term adverse effects. The campaigns are very high-key, using a dramatic tone, a double vocabulary, a language couched in teenage slang. TV commercials are as shocking as they are oversimplified to pound home messages to the public, such as "Drugs are a dead end". Full page advertisements are printed in well-known papers and magazines like Playboy and include emotional slogans such as "Cocaine, it can cost you your brain".

(18) See Note. 17

(introduction...)

There are many different kinds and types of group methods: methods and techniques that stress transfer of knowledge (lectures, classroom teaching), attitude change (discussion, role playing), development of social skills (training, modelling) or exploration and exchange of opinion (panel, forum). The best way to elaborate and illustrate group methods and techniques in drug education, is to refer to school drug education. The main arguments for choosing this formal educational context are:

- It is within formal education that most children and young people can be reached for preventive education;

- School settings have a clear organisational structure, with opportunities to develop links with parents, community groups, etc;

- School settings are, in spite of many cultural and societal differences, present in all countries and regions in the world;

- Most drug educational experiences have been acquired within a formal education context during the past 30 years;

- Many different school drug education methods can also be applied to other group and community settings; in most cases only a few adaptations have to be made;

- Most experimentation with drug use starts during school when children are between 14-18 years old.

Knowledge and drug information model

For a long time, health and drug information education was a popular first choice strategy in prevention and it is still a commonly used method. The underlying assumption is that the presentation of factual information about drugs and the biological, social and psychological effects, the risks and dangers of drug use and its consequences, would have a sufficient preventive impact. Knowing the facts would lead directly to staying off drugs. In this model, besides techniques of fear arousal, often applied to increase the salience and impact of the message: "Drugs are a dead end" and "Using is losing" rather moderate techniques are often also used. The British "High Profile Curriculum" (19) is an example of such a low profile cognitive oriented drug education programme.

19) High Profile Youth Work Curriculum and Consultation Materials about Drugs. ISDD London. 1988

Affective education model

This model was developed in the seventies and presents a rather different model of drug education where drug information plays only a minor role. The affective education model is based on the assumption that drug abuse has its main cause in the shortcomings of young personalities low self-esteem, inability to make rational decisions and express feelings and inadequate problem-solving skills. Therefore, the main goal of prevention should be enhancing self-esteem, improvement of decision-making and problem solving skills. This model IS largely rooted in the principles of humanistic psychology, the expectation being that once a young person has solved his or her basic interpersonal problems, the risk of involvement in drug abuse will be much lower. The Californian School and Community Prevention Programme '20) is a very recent example of a drug prevention programme developed according to these principles.

20) Towards a State of Esteem. Final Report of the Californian Task Force to Promote Self Esteem. Cal. State Department of Education, Sacramento, USA. 1990

Social influence model

This approach is based on Bandura's Social Learning Theory which focuses on the notion that behaviour is the result of positive or negative influences. Individuals in the social environment, like parents and peers, and exposure to the media often serve as impact models, providing examples of adequate or inadequate behaviour. Prevention programmes designed within the framework of the social influence approach comprise elements such as influence resisting training (peer, media influences) innoculation against the impact of mass media (analyzing anti-health advertising), role playing, etc.

More recent is the model of reasoned action developed by Fishbein and Ajzen (21). The Dutch drug prevention programme "Talking about alcohol and drugs at school" '22) and the British programme "Facts and Feelings about Drugs, but Decisions about Situation" '23) are examples of educational programmes based on this approach.

21) Fishbein, M. & A. Ajzen. Belief, Attitude, Intention and Behaviour: an introduction to theory and research. Reading, Mass. Addison/Wesley. 1975

22) Buisman. W. R. & J. J. van Belois. Praten over Alcohol en Drugs op School ("Talking about Alcohol and Drugs at School"). Netherlands Institute of Alcohol and Drugs, Utrecht. 1990

23) Facts and Feelings about Drugs, but Decisions about Situation. Teachers manual. ISDD London. 1982

Life skills model of drug education

A most promising new approach is the life skills development model of prevention. Whilst, there is a conceptual similarity between the life skills model and the affective model, the former emphasizes balanced development of personal and social coping skills, which can be divided into five dimensions critically important for adolescent learning, thinking, feeling, decision making, communication and action. The model encompasses the improvement of positive peer influence, peer role models and peer teaching and includes teaching specific values, such as respect, compassion, responsibility, honesty and self-discipline. This programme attempts to link community groups and school groups (teachers, tutors, counselors, parents, board members), because of the belief that prevention and health education is the collective responsibility of the whole school and local community. The life skills approach is a challenging model, appropriate for both drug prevention and health promotion. The well-known "Skills for Adolescents" programme, originally developed in the USA '24), has now been culturally adapted and introduced in many countries, including inter alia, the United Kingdom, Switzerland, France, The Netherlands, Belgium and Sweden.

24) See Note. 11