Page 12 - Focus on Prevention: Strategies and Programs to Prevent Substance Use

According to the diffusion of innovations framework,  Teach the skills needed to perform the behavior.
support for an innovation such as a new substance use  Build a person’s confidence in his or her ability to
behavior spreads as opinion leaders or “trendsetters” talk perform a specific behavior in a particular situation.
about it. In this model, individuals embrace the innovation
according to their readiness to accept and try new ideas.  Provide support for sustaining a new behavior.
Prevention strategies may direct messages to opinion To apply this model, prevention planners must determine
leaders and then engage them to reach people who are where the target audience stands in the change sequence.
more resistant to change. This will provide a starting point for a plan to take the
audience through the remaining steps.
In the stages of change theory, five stages, or steps, are
used to alter personal behavior patterns and lead to The Community organization theory stresses the active
long-term change: involvement and development of communities to
address health and social problems. Key features include
 Precontemplation—being unaware of or refusing understanding the root causes of problems, focusing
to acknowledge risks (e.g., believing that inhalant on specific concerns, engaging in effective problem
use is harmless). solving, encouraging active community participation,
 Contemplation—beginning to consider a change and gaining the power to produce lasting change.
and weighing the costs and benefits (e.g., For example, a community concerned about alcohol-
recognizing the downside of binge drinking). related problems may come together to change local
 Preparation—deciding on and planning for a change laws, regulations, or policies regarding the number and
in behavior (e.g., picking a start date to quit smoking). concentration of alcohol outlets or the hours and days
 Action—implementing a plan to change and when alcohol is sold.
beginning a new behavior (e.g., using refusal skills
or changing social patterns). Starting Points
 Maintenance—reinforcing and making a habit of a
new behavior (e.g., obtaining social support from
family members and peers). The following frameworks can help you fit theories
into your substance use prevention strategy.
People can move from one stage to the next when they
receive and process relevant information. A web of influence model identifies the following
domains, or areas of influence:
According to the health belief model, people are
motivated to change their behavior only as much as they  Individual  Family  Community
value—or worry about—the results of their choices (to  Peers  School  Society
keep smoking or quit) and expect these results (poor This framework can help you understand how risk
health or good health) to happen. People also must be and protective factors interact and where prevention
confident that they can carry out a new action. theories may apply.
Incentives for a behavior should build on an audience’s A continuum of prevention model classifies prevention
motives, needs, values, and self-image as well as concerns programs according to the audiences for which they
about health. A prevention strategy may, thus, focus on are suited best based on risks for substance use:
short-term consequences of substance use such as bad
breath, loss of friends, and getting in trouble.  Universal programs reach the general population
such as all students in a school or all parents in a
Information on reducing the costs of following a course community.
of action and how to overcome obstacles also is key.
New behaviors can be boosted by “cues to action”—for  Selective programs target groups such as
example, when individuals know what to do and how to children of substance users or those who display
do it, a prevention strategy can include simple reminders. problems at school and have an above-average
risk of developing substance use issues.
The Stanford communication/behavior change model
indicates that changes in behavior occur when mass  Indicated programs are for those whose actions—
media messages follow a series of steps: for example, antisocial or other risky behaviors
 Raise awareness of an issue. such as truancy, academic failure, or hanging out
with peers who misuse substances—put them at
 Change what people know, believe, and think about high risk for substance use issues.
the promoted behavior.

8 Focus On Prevention