(From Drug & Alcohol Findings) The featured review brought together the findings of three reviews conducted for the Cochrane collaboration, each concerned with the effectiveness of ‘universal’ programmes aiming to prevent the development of drinking or drink-related problems in young people aged 18 or younger. As opposed to programmes for high-risk groups, universal programmes target large groups such as an entire age range, whether or not they are known to be specially prone to substance use or problems.The reviewed evidence supports the effectiveness of some but not all universal programmes for alcohol misuse prevention among young people. Given the variability in the results, particular attention should be paid to the content of programmes and the context in which they are delivered, including the setting, key personnel and target age. A programme may for example be effective where adolescent alcohol drinking is rare, but ineffective where it is the norm and reflects powerful social and cultural pressures to drink. Specifically in the school setting, some studies found no effects of preventive programmes, others statistically significant effects. Most commonly observed positive effects were for drunkenness and binge drinking, and it seems that certain generic psychosocial and developmental prevention programmes can be effective and could be considered as policy and practice options.

Main findings School-based programmes Of the 53 trials, 41 were conducted in North America. Relative to a standard curriculum, six of the 11 trials of alcohol-specific interventions found some statistically significant reductions in drinking. Another 39 studies tested more generic programmes. Of these, 14 found some statistically significant reductions in drink-related outcomes relative to a standard curriculum. Some apparently positive results may have been due to inadequate adjustment for ‘clustering’ effects (eg, of children in a class and of classes in schools), and in some studies results were confined to certain subgroups and/or some measures of drinking but not others. Most commonly, significant effects related to drunkenness and binge drinking. Impacts tended to last longer after generic than after alcohol-specific or other programmes. Overall, the evidence is more convincing for certain generic rather than alcohol-specific programmes. Among generic programmes, those based on psychosocial or developmental approaches (life skills in Life Skills Training; social skills and norms in Unplugged; behaviour norms and peer affiliation in the Good Behaviour Game) were most likely to report statistically significant effects over several years when compared to standard school curricula or other types of interventions.

Family-based programmes All but one of the 12 trials were conducted in North America. Nine recorded statistically significant reductions in drinking, in some cases over longer as well as shorter term follow-ups. One study recorded apparently negative effects which may have arisen by chance or due to methodological issues. In another, though ineffective on its own, the family-based intervention was effective when combined with a school-based intervention. There is some evidence for the short to medium-term success of gender-specific interventions for daughters, typically involving their mothers. Some trials found impacts only among children already using substances at the start of the trial.

Multi-component programmes All but three of the 20 trials were conducted in the USA. Relative to comparison conditions, 12 trials reported statistically significant reductions in drinking lasting up to three years among children allocated to multi-component programmes. Six of the 20 trials found no statistically significant differences, and in another significant reductions were confined to children already drinking at the start of the trial. It was unclear whether in general adding further prevention components to an existing programme improved outcomes; reports on four trials indicated some possible benefits, but another three trials found no such indications.  Read More>>

(An item from the ISHN Member information service) In a thorough and provocative article in the Winter 2014 issue of the AASA Journal of Scholarship and Practice, the author begins with these words: " In this article I argue, with evidence, that the scores and rankings from PISA are not important and that they cannot give policy makers or educators meaningful insights into student preparedness for the global economy." He then goes on later in the article to say that "The Organisation for Economic Co-operation and Development (OECD, 2013, p. 265), the private entity that develops and vends the PISA, explains that policy makers should not use results either to indict or commend education systems. Furthermore, they should not use the results to make important policy decisions. In fact, the OECD authors explain that PISA results are due to a combination of variables, including but not limited to schooling, life experiences/home environment, poverty, access to early childhood programs, and health."   After further analysis and quoting of the PISA authors about their own report, the analysis concludes that " So, if the vendors of PISA repeatedly warn that (a) PISA is not aligned to school curricula, (b) the scores and ranks are influenced strongly by poverty and selection bias, (c) the skills are left over from the 19th and early 20th centuries, and (d) one test of a 15- year-old child cannot possibly represent the future success of that child or of a country, then what does PISA really tell us about the quality of a school system? Not much." Yet, for those who advocate for health and social development through schools, the recent report is already putting pressure on the school systems to do more about math in schools. Read more>>

(An item from the ISHN Member information service) The research supporting multi-intervention approaches and programs in school health promotion is abundant and long standing. Recent research is underlining the need for long-term, systemic planning and investments in capacity-building in areas such as coordination, work force development, inter-agency agreements, coordinated policy development and joint issue management. However, experience in the real world suggests that local health authorities (LHA) do not follow that research and instead, constantly try to implement short-term, project-style interventions based on a "training, then hoping" strategy. Four articles in Issue #6, 2013 of American Journal of Preventive Medicine examine evidence-based decision-making in LHA's and provide clues for this cognitive dissonance.  One article examines the factors that affect evidence-based decision-making (EBDM) and found that "Although most people understood the concept, a relatively small number had substantial expertise and experience with its practice. Many indicated that they applied EBDM unevenly. Factors associated with use of EBDM included strong leadership; workforce capacity (number and skills); resources; funding and program mandates; political support; and access to data and program models suitable to community conditions." A second article found that "Local decision-making authority was perceived as greatly restricted by what public health activities were legally mandated and the categoric nature of funding sources, even as some leaders exercised deliberate strategic approaches. One’s workforce and board of health were also influential in making decisions regarding resource allocations. Programmatic mandates, funding restrictions, local stakeholders, and workforce capacity appear to trump factors such as research evidence and perceived community need in public health resource allocation." A third article suggested that LHA participation in a "Practice-based Research Network" will help in the implementation of research. A fourth article introduced the idea that LHA's could make use of local taxation revenue.  Read More>> 

(An item from the ISHN Member information service) "Going beyond training and hoping" is a colourful way to describe the paradigm shift now underway in research, practice and policy-making in school health promotion and social development. The words in the titles of the articles the October 2013 Issue of implementation Science are indicative of the new concepts that must be among the new, fundamentally different way that we approach our work and careers in the future. Although these concepts are applied to non-school settings and practices, their resonance should be self-evident. They include: transfer and implementation, scale-up, spread, and sustainability, making change last, leadership in complex networks, multifaceted, multilevel continuous quality improvement programs, dynamic sustainability frameworks and Social network diagnostics. Read more>>