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The Guidebook of Effective Prevention of Youth Problems written by Szymon Grzelak, PhD (Institute for Integrated Prevention).
Link to the Polish version of Guidebook in PDF format. Within few months we should finalize the translation of Guidebook into English.
The Guidebook of Effective Prevention of Youth Problems1 has been developed by a team of the Institute for Integrated Prevention and published in September 2015 by the Centre for Education Development (CED) (as a part of the project ESF- the European Social Fund).
The publication summarizes an experience of many years of positive work of its authors. In our opinion, it has strategic importance in the process of creating the foundation of a coherent programme of action in the area of education and prevention, which are based on scientific research, values and practical experiences. The recommendations included in The Guidebook of Effective Prevention (…) should be known to social, educational and health policy makers.
The Guidebook of Effective Prevention (…) has been sent out by the CED to education departments of all local authorities in Poland. Its recommendations have been included recently by the Ministry of Health in the work on the National Programme of Public Health 2016-2020. The authors are making great efforts for the publication to reach also other institutions. The Guidebook of Effective Prevention (…) is written in an intelligible language and it represents a form of a hybrid between a scientific report and a practical guide.
From the Foreword:
The Guidebook of Effective Prevention of Youth Problems is a publication consisting of a rational, consistent and courageous vision which represents something more than simply a promotion of a healthy lifestyle.
The idea is for us, adults, to effectively support young people in building a mature world of values and fulfilling their deepest dreams and life goals. The symbol of this vision is a picture chosen for the cover, which features the dynamism and the potential of youth.
Many years of research and practical experience of the team of the authors and the broader environment associated with the Institute for Integrated Prevention constitute the foundation of The Guidebook of Effective Prevention (…)
We are professionals who work, with passion and commitment, with youth, parents, teachers and local authorities on every day basis, while constantly looking for ways to increase effectiveness of our actions. We conduct extensive research on youth, creating prevention programmes, and implement it in direct cooperation with schools and local authorities in all Polish regions. These experiences gave us an opportunity to discover many adults with a positive attitude, who care about the good of youth, and who, despite serious barriers, spare no effort in working towards education and prevention. We believe that, if you reach for this publication, you're one of those people. The original title The Vade Mecum od Effective Prevention (…) comes from Latin and stands for "follow me." We, therefore, invite you our Reader, to join us on this path. How to support young people in preparation for the lifetime journey? How to strengthen their resistance to negative influences? How to effectively prevent youth risk behaviors and problems? - These are the questions that we are raising at the beginning of this track. Our answer is Seven levers of effective prevention. Thinking according to the principle of levers consists in the search a foothold which would allow achieving possibly great effects, despite the use of limited forces and resources. Seven levers of effective prevention are seven supporting points, seven aspects of reality that are a key to effectiveness.
Opinion of reviewers:
Wiesław Poleszak, PhD, psychologist
The issue of risk behaviors prevention analysed in the monograph represents an important element of the contemporary discourse on the quality and effectiveness of prevention activities. There has not been such a profiled study on prevention in Poland so far. One of its undoubted advantages is the proposals for preventive measures based on the diagnosis and systemic thinking. The publication is a part of a prevention trend, emphasising the role of early intervention and protective factors as the key variables in the effectiveness of preventive programmes.
Leszek Putyński MD, PhD, clinical psychologist
The book presents a unique approach to prevention of the youth risk behaviours issue. It is based on a profound analysis of own research, recent scientific literature and previous practical experiences. The book refers to the use of the strong potential of an individual (biological, psychological, social and spiritual) young man and widely understood social facilities, including the one that was considered "neglected" such as an extended family or a religious group. The publication draws attention to the very important social and legal issue which is to respect the hierarchy of attitudes and values in prevention actions.
Prof. Zbigniew B. Gaś, PhD, psychologist
I appreciate the concept developed by the team led by Szymon Grzelak, PhD and I agree with the authors in its many aspects. I hope that the group of specialists, restoring values in education and building prevention efforts based on a healthy image of a human will continue to grow.
The Institute for Integrated Prevention
ul. Ogrodowa 8, 05 - 230 Kobyłka near Warsaw
1 Grzelak, Sz. et al., 2015. The Guidebook of Effective Prevention of Youth Problems, guidelines for local authorities and practiocioners based on the results of scientific research . Warszawa. Ośrodek Rozwoju Edukacji (258 pp.)
Current State of Research in the World and in Poland
Grzelak, S. Prevention of Youth Sexual Risk Behaviour: The current state of research worldwide and in Poland. Kraków: The Rubikon Publishing House, 2009. (479 pp.)
The first edition of the Prevention of Youth Sexual Risk Behaviour: The current state of research worldwide and in Poland was published in 2006 (Grzelak, 2006) and was a first attempt to summarize and present contemporary knowledge on the topic described in the book's title to the Polish reader.
The current 2009 edition is a second such attempt, and it has been expanded with a new, third section which describes the author's selection of the latest achievements in theory and research.
The first section of the book consists of four chapters, and takes an international perspective. In the first chapter the main health and social problems relating to early sexual activity are presented with emphasis on STIs and out-of-wedlock teen pregnancies. Indicators of sexual risk behaviour are discussed as well as antecedents of early sexual debut.
The second chapter presents different theoretical approaches to prevention of youth sexual risk behaviour over the past four decades. Etiological and behavioural change theories underlying contemporary prevention programmes are described. Other sources of inspiration for widely used prevention programmes (sometimes unrevealed in scientific articles) have also been presented, such as Christian philosophy and anthropology or the theoretical background of so-called 'indigenous' programmes implemented in some developing countries on the basis of a mixture of general knowledge about prevention, common sense, and local culture.
The last part of the second chapter introduces different typologies of programmes preventing the sexual risk behaviour of youth. One of these typologies divides programmes into two main groups: risk avoidance (aimed at sexual abstinence and mutually faithful permanent relationships in future), and risk reduction (aimed at reducing consequences of early sex by use of condoms and other contraceptives), and also some combinations of the two.
The third chapter presents detailed information about the current state of evaluation research on prevention of sexual risk behaviour. Methodological and ethical aspects are discussed in depth, and the criteria for high quality, controlled evaluation research are presented. A broad review of results of evaluation research on different programmes of different types concludes with the conditions for success of programmes preventing youth sexual risk behaviour. A list of characteristics or elements of programmes proven to be effective is presented and discussed.
The fourth chapter focuses on a different approach to evaluation, in which country-wide prevention policies are assessed through the lens of epidemiological research showing the number of new sexually transmitted infections and teen pregnancies in the context of sexual behaviours and over the course of the period of implementation of a given preventive strategy. The choice of countries that serve as case studies reflects the author's desire to depict the effects of two main types of preventive strategies: risk avoidance-focused strategies (abstinence, fidelity), and risk reduction-focused strategies (condoms, other contraceptives). Data from a number of developed and developing countries (UK, USA, Poland, Uganda, Senegal, Jamaica, Thailand) is presented and discussed. The prevailing opinion that prevention focusing on risk reduction strategies is the most effective and the only realistic approach is challenged with data showing rapid increase in new STIs in some countries which based their health and educational policies on risk reduction, and new STI decrease in some of the countries which promoted risk avoidance. Theoretical explanations for the observed phenomena include a combination of three main factors: (1) empirical data on the limitations of condom effectiveness in prevention of different STIs even when used properly and consistently, (2) the crucial importance of proper adaptation of the prevention goals and methods to the cultural conditions and religious beliefs of societies to which the prevention campaigns are addressed, and (3) the psychological effect of risk compensation. The model of risk homeostasis (Richens, Imrie, and Weiss, 2003; Wilde, 1994) provides an explanation as to why the relatively high protection given by a condom in an individual sexual contact cannot be easily transferred to effectiveness of condom promotion strategies implemented on a scale of entire societies. The chapter ends with the conclusion that - in the light of the body of research presented - far too little interest is paid to risk avoidance strategies, and far too much trust is placed in risk reduction strategies in prevention of youth sexual risk behaviour.
The second part of the book consists of four chapters concerning empirical research on effectiveness of prevention of youth sexual behaviour in Poland. Of all five Polish evaluation projects which were completed before 2005, two are mentioned only briefly, as they did not meet most of the basic criteria for methodologically sound evaluation. Three quasi-experimental studies are presented in detail, and discussed in Chapters 5 to 8. Two of them regard a Polish adaptation of the TeenSTAR® Programme (known as PiON in Poland). The first of the two studies (1996-98), described in Chapter 5, was also the first Polish attempt to evaluate a programme preventing youth sexual risk behaviour. The small sample size (N = 215, age 13-15) and simple pretest-posttest research scheme with programme and control group (given the relatively late sexual debut among Polish youth at the time of the study) resulted in insufficient statistical power to verify the programme's impact on sexual behaviour. Nevertheless, the study indicated a significant change in line with programme goals with regard to nine variables (attitudes, normative beliefs, convictions, and knowledge regarding sexuality, love, and relationships) with no side-effects.
Chapter 6 presents a newer high-quality evaluation study of the TeenSTAR programme (2002-03), which was the Polish part of an international evaluation of the programme that was also conducted in USA and Chile by the author. The study [2x3 quasi-experimental design; N = 428, age 14-16] indicated a small delay in sexual debut among boys (statistical trend), significant decrease of psychoactive substances use among boys (alcohol, illegal drugs, cigarettes), and a wide scope of significant effects regarding attitudes towards love and sexuality as well as changes in convictions, knowledge, and normative beliefs. Changes were in line with the goals of the programme, but differed in their duration. Some changes were observed only in a posttest conducted immediately after the programme end; some were also significant in the second posttest four months after the end of the programme. A large section of Chapter 6 is devoted to the results of statistical analyses of risk and protective factors regarding early sexual debut. Greater value is attached to aspects of the programme's nonbehavioural effectiveness, which relate to variables identified that play a role in antecedents of early sexual activity in youth. The behavioural effects of a 3-year follow-up of this research are presented (in English) in the Appendix.
In Chapter 7 an evaluation of the Polish Archipelago of Treasures® Programme is presented. The study [2x2 quasi-experimental design; N = 410, age 14-16] compared answers given by students from experimental and control groups a week prior to the programme and one month after its end. While it lacked statistical power to verify effects on sexual behaviour, it indicated a significant decrease in alcohol use and a significant decrease in violent behaviour among younger participants of the programme. Several significant effects on attitudes, behavioural intentions, convictions, and knowledge regarding sexuality, love, and relationships were found.
The results of all Polish controlled evaluations are summarized in Chapter 8. It is emphasized that none of the three evaluations showed side-effects, and all confirmed the effectiveness of the scrutinized programmes in provoking several nonbehavioural changes as well as generalized behavioural changes such as reduction of violence or alcohol use.
Chapter 9 presents a list of conclusions for educational and health authorities as well as proposals for further research on the issues presented in the first two parts of the book.
A third section of the book was added to the 2nd edition in order to present some of the latest developments (2005-09), with much stronger emphasis on what has been done in Poland.
Chapter 10 contains a few updates on international literature on the subject. It largely focuses on summarizing the Report of the APA Task Force on the Sexualization of Girls (Zurbriggen et al., 2007). The report is considered by the author of the book to be of great value from the point of view of prevention of youth sexual risk behaviour. The second part of the chapter provides the reader with updates regarding current research results on condom effectiveness in prevention of STIs.
In Chapter 11, the author describes his own Integrated Prevention Model (IPM) - an eclectic yet consistent model of prevention of youth problems developed over the past decade. The chapter gives the first, quite broad and profound presentation of the philosophical assumptions of IPM, its background in psychology, its methods of working with youth, and its approach to evaluation research. The model is a theoretical tool designed to help authors to create cost-effective prevention programmes which impact youth behaviour and attitudes in several realms of problem behaviour at once. Personalistic philosophy and anthropology lend the model a holistic view on the human person. Erikson's theory of psychosocial development (Erikson, 1950)1 forms most of its psychological foundations. Other elements of the model come from broad empirical knowledge about risk and protective factors relating to different kinds of youth problem behaviour, as well as from knowledge about key elements of effective programmes in youth prevention. One of the assumptions of IPM is the need to focus on universal risk and protective factors in prevention, i.e. on those which correlate with different kinds of problem behaviour of youth. The model encourages the use of as many effective strategies, or key elements, as possible. The content of programmes based on the model does not necessarily have to be closely related to the goals of the programme. It is believed that as long as a programme speaks about developmentally important topics, fosters healthy development, and uses methods of working with youth proven to be effective in other programmes, it can produce generalized effects. In order to verify this assumption of the model, a special approach to evaluation is needed. IPM-based programmes have to be evaluated using a broad scope of indicators covering the whole range of youth problems, risk behaviours, and related variables. It is considered an ethical obligation to verify possible side-effects. On the other hand, due to IPM's holistic approach to the human person, it is believed that effects may generalize beyond the original goals of the programme. However it may seem, presenting the Integrated Prevention Model in a book devoted to prevention of youth sexual risk behaviour is not contradictory. Love and sexuality are at the centre of adolescents' attention. IPM-based programmes widely explore love and sexuality-related topics in order to pass on a broader message concerning a healthy lifestyle.
Chapter 12 presents an evaluation of the Archipelago of Treasures® programme, an integrated prevention programme fully based on the IPM model in its most recent form. This study was actually the first that was designed to verify the Integrated Prevention Model. It adopted a 2 x 3 experimental design with random assignment [N = 1267; two age cohorts 14-15, and 16-17]2. Posttests were held one month and six months after the end of the programme. The study shows several behavioural effects for the younger cohort: reduction of current sexual activity (p<0.04), reduction of alcohol use (p<0.04) and illegal drug use (p<0.03), reduction of contact with pornography among boys (p<0.03), and reduction of suicidal thoughts among girls (p<0.04). Several effects regarding behavioural intentions, attitudes, convictions, and knowledge about love, sexuality, and relationships are also found - all in line with the goals of the programme. The conclusion is that the Archipelago of Treasures® programme is an effective prevention tool for younger adolescents, capable of supporting healthy development and reducing a wide scope of risk and problem behaviours.
The study indicates a different pattern for the older age cohort. Most of the effects observed in the first posttest (all related to the goals of the programme) totally expired half a year later, and a single, however important, side-effect was observed (increase in alcohol use in the second posttest being the most severe). It has been concluded that the Archipelago of Treasures® programme cannot be proposed to older youth belonging to risk groups (such as the youth from vocational schools included in the study as the older cohort) without serious consequences. It has been suggested that the programme needs to be better adapted to youth with high level of problem behaviour and should include some form of follow-up a few months after completion of its main part.
Chapter 12 ends with the conclusion that the Integrated Prevention Model was empirically confirmed for the first time with regard to primary prevention (when the programme is offered to younger youth with less experience in risk and problem behaviour), but that it probably demands further development in order to be safely used for older youth from risk groups.
Chapter 13, written by guest author Grażyna Węglarczyk, presents evaluation research on the 'Without Risk' programme. The programme is based on a similar theoretical approach as the Integrated Prevention Model, but was created independently. The programme is well known in Poland as it has been the main tool of two annual nationwide HIV/AIDS prevention campaigns. It aims at reducing the level of early sexual activity and levels of alcohol and drug use. A 2x3 experimental design was adopted with a pretest and two posttests (one month and one year after the programme). The study was conducted in 2007 and 2008 in average public secondary schools [N = 555; age 16-17]. The results section presents frequencies for indicators of several risk behaviours which suggest the possibility of the behavioural impact of the programme on youth, but does not show statistical significance of the effects, as analyses were not yet completed.
The Appendix - written in English - presents the behavioural effects noted in the three year follow-up of the evaluation of TeenSTAR® Programme (PiON). The results of the first three waves of the study [2002-03] are presented in Chapter 6. The last posttest was conducted in December 2005, three years after the end of the programme. The sample size was reduced [N = 204; age 18 at the last posttest] due to difficulties in locating youth at their new schools. The study showed two long-term behavioural effects. There was less heavy petting in the last 12 months among programme girls (p<0.05), and a trend was observed regarding a lower level of sexual contact ever experienced (p<0.10). The indicator for level of sexual contact distinguished between three levels: no contact, heavy petting, and sexual intercourse. The nonbehavioural long-term effects of this evaluation are presented in English elsewhere (Grzelak, 2008)3.
Chapter 14 provides the reader with brief conclusions for prevention and research from the third section of the book.
All sound Polish evaluations conducted over the last two decades consider programmes that motivate youth to risk avoidance (primary behavioural change), where risk avoidance is defined with regard to sexuality as sexual abstinence that is replaced in time by fidelity in a permanent relationship. No Polish controlled evaluation studies of harm reduction programmes motivating youth to use condoms and other contraceptives are known to the author of this book. Contrary to what the reader can find in the international literature on the subject, in Poland, abstinence-directed prevention is the only scientifically verified approach. After 15 years of Polish experience in the evaluation of programmes preventing youth sexual risk behaviour, both effective prevention programmes and well-developed research tools can be offered to specialists from other countries.
(1) Erikson, E.H. (1950). Childhood and Society. New York: Norton.
(2) The younger cohort consisted of students from average public schools. The older cohort were students of vocational schools with high levels of problem behaviour.
(3) Grzelak, S. (2008). 'The impact of the TeenSTAR Programme on attitudes, intentions, convictions and knowledge in the Polish controlled evaluation 2002-2005'. In: Wieczorek, W. et al. (eds.), Naturalne planowanie rodziny w ujęciu wybranych dyscyplin naukowych, Lublin: Instytut Nauk o Rodzinie, KUL.
This article was published in the Polish prevention journal Świat Problemów (1/2016), which is edited with the assistance of the State Agency for Prevention of Alcohol-Related Problems.
Doctor of Psychology, President of the Institute for Integrated Prevention, author of prevention programmes.
The Guidebook to Effective Prevention of Youth Problems as an action programme
The Guidebook to Effective Prevention of Youth Problems proposes a strategy which is based on a bold but very rational vision. This perspective may lead to cross-sectoral cohesion in actions taken by the government, local authorities, schools, and all entities engaged in the area of prevention and supporting youth development actions.
The context: The sectoral and reactive character of contemporary Polish prevention programmes
The 'golden age' for prevention programme development certainly came in the 1990s. After the collapse of communism, we in Poland were once again able to draw from the rich, more than century-old native tradition of sobriety cultivated in the environments associated with the Catholic Church and other Christian denominations.
It was a time when numerous original prevention programmes were devised. Polish specialists began to adapt foreign programmes to their native environment and created their own with time, on the basis of experience gained. More and more professional evaluation programmes assessing the effectiveness of prevention programmes appeared. The foundations of the post-communist Polish legal system were also developed in the 1990s; this divided tasks and financing between the state and local governments, and regarding the state itself - it divided tasks and financing among various ministries.
A system was designed which Poland could be proud of: a system which, at the time, was largely effective. It suited the state of knowledge, abilities and needs of that period perfectly.
This system, with certain adjustments introduced over the years, is still being used to the present day. However, there is no longer as much dynamism in it as there once was. There is no vision behind it capable of inspiring people. There is no holistic, coherent strategy that could be simultaneously realized by both the government and local authorities. At the national level, tasks in the area of health promotion and prevention of risk behaviours and problems of children and adolescents have been implemented in recent years by at least four ministries: the Ministry of Health, Ministry of National Education, Ministry of Labour and Social Policy and the Ministry of Internal Affairs and Administration. Unfortunately, cooperation between the ministries has left much to be desired. It was often the case that senior officials in charge of the area of prevention had no idea as to the basics of the field of prevention nor the tools available for the existing legal and institutional system. A sectoral approach prevailed, in which each department performed their own tasks in the area of prevention for better or worse, with was no real coordination between ministries.
A similar sectoral approach is visible in the way local governments (but not all of them!) operate. Below are some authentic examples:
- A local health department organizes a significant conference on prevention involving eminent experts, during which neither representatives of the department of education, department of social affairs, nor town authorities appear (the vice-president was present for 10 minutes at the opening and then left). From the point of view of creating a coherent strategy for prevention in the community, it is a wasted opportunity.
- One local department of education ordered a diagnosis of youth problems, not aware of the fact that the health department had ordered similar research earlier. In this way, sectoral divisions resulted in a waste of financial resources.
- The local police carry out their prevention tasks in cooperation with schools, but they are not integrated into a meaningful whole with the activities of local government offices, OPS (Social Welfare Centres) or psychological and pedagogical clinics. There is no person in the local community authorized to verify whether, by chance, the actions and prevention ideas of some entities do not stand in opposition to the actions of others. Thus, apart from effective and useful measures, there might also be adverse effects of such activity.
As a result, many various institutions are in charge of prevention, yet their efforts are fragmented and do not add up to a meaningful whole. A great number of people are involved in action, but their energy dissipates into a series of tasks, the implementation of which is not assessed for its efficacy, but for its correspondence with the narrow criteria of official reporting.
The lack of a coherent vision of Polish prevention creates ideal conditions for chaos, where the course of action does not arise from long-term goals and strategy, but is rather a response to current events. Special publicity of such events is given by the media, which is always keenly interested in having a sensational topic to comment on.
When the topic of the media becomes legal highs, policy makers give the green light (and thus power and resources) to the legal highs prevention programs, without any regard to why they should treat this one of many threats as such a priority.
Neither the comprehensive effectiveness of prevention is taken into account here nor even whether such activities actually reduce the number of young people reaching for legal highs. What counts is that the state, municipalities, and schools respond to the ad hoc expectations imposed by media pressure.
As a result, the reactive approach prevails. Today, it is legal highs we are dealing with, yesterday it was violence (because somewhere a football fan was killed), while the day before yesterday the hot topic was depression and suicide (because one suicide was publicized by the media, prompting a whole series of them)...
Seven levers of effective prevention
Seven levers of effective prevention described in The Guidebook to Effective Prevention of Youth Problems is a synthesis of experiences and knowledge based on scientific research conducted by a team of authors from the Institute for Integrated Prevention (Polish acronym IPZIN). The research data was collected by the staff of the Institute for many years. However, it was when the project was commissioned in the spring of 2014 by the Centre for Education Development (financed by the European Social Fund ESF with the support of IPZIN sponsors) that IPZIN developed the holistic synthesis, Seven levers of effective prevention.
The most important sources of data that were used for the creation of The Guidebook to Effective Prevention of Youth Problems:
The last subchapter of the Guidebook is entitled: The End with the Perspective for the Future. In this part the image of youth development and prevention in the local community is described. It is an idea in which the preparation of young people for life is fully based on the seven levers of effective prevention:
- In the daily work of youth development led by schools and the activities of the community the positive potential of young people is noticed and reinforced. There are more positives than negatives expressed with reference to young people; praise greatly outweighs criticism. There is an atmosphere of trust and confidence in the capabilities of youth.
- At the local level, youth prevention is approached in a comprehensive, holistic and integrated way. Awareness of the fact that problems and risk behaviours of youth are linked and have a great number of common protective and risk factors leads to the local strategy being aimed at causal, not symptomatic effects.
- Local resources are treated as the basis for a system of prevention and support for the upbringing process, and actions to promote youth development are based on broad cooperation. In the actions conducted by local officials, there is visible respect for the role of parents, relatives, educators, teachers, religious organizations, youth organizations, and all other guides who have young people's well-being at heart.
- The actions supporting youth development and the prevention programme appeal to the deepest dreams, desires, and values of young people. As a result, young people themselves view the efforts of adults as a way of offering them help in discovering a way of life, not as imposing incomprehensible restrictions on them.
- Local government, schools, and the entire local community treat development of young people and prevention as a priority, realising that the future growth and prosperity of the entire community depends largely on youth. Adequate resources are allocated for prevention and support of the development of young people. They are also the subjects of meetings, conferences, and trainings. Prioritising prevention translates into establishing clear boundaries for all practices of an anti-prevention character in the daily life of the local community and public events.
- The resources dedicated to tasks in the area of education and prevention are spent to bring the maximum effect. A comprehensive diagnosis of needs, high efficiency, and broad implementation are the criteria that are taken into consideration in both individual programmes as well as the entire prevention system.
- A team of people who share a common passion and engagement in work with young people are involved in cooperation on behalf of prevention and the youth development system. The experience, abilities, and social roles of team members complement each other. The bold vision realized by the team turns into reality and becomes one of the flagships of the municipality.
Each of the seven points above refers to one of the seven levers of effective prevention described comprehensively in the Guidebook. Together they provide a comprehensive programme. In local communities where matters of education and prevention have been treated in such a way, the severity of risk behaviours and problems of young people substantially decrease, and conditions for positive youth development improve. Through the growth of social trust and social capital such an approach turns into a lever for development of the local community. The joint implementation of wise policies in the field of promoting youth development could make the local community a place where young people want to return, where they would want to live and work for the common good, passing on what they themselves have received to the next generation.
Writing this text I would like to point out one select reason (among several major reasons) why the recommended approach is truly the answer to the problem of the lack of a coherent vision of social, health, and education policy in the field of prevention.
The Guidebook to Effective Prevention of Youth Problems creates a fundamental change in thinking about risk behaviours and problems of youth. Solid research arguments leave no doubt that one needs to consider prevention in an integrated way, not in parts; to address it in a holistic rather than sectoral manner. The positive potential of young people is discussed with a presentation of the results of our own research, conducted by the Institute for Integrated Prevention (IPZIN) (N = 8613, 14-15 years old 2nd year intermediate school pupils from eight different voivodeships in Poland). The research shows that a large percentage of high school students do not engage in a variety of risk/problem behaviours (drinking, binge drinking, smoking, drug use, early sexual contact, engaging in violence, suicidal thoughts, etc.).
When youth problems and risk behaviours are referred to in the book, a range of different problems in different areas is always addressed - whether it concerns the classification of the problems themselves, observation of trends over the years, or finally the consequences of various threats to individuals, families, and the entire population.
Gathering such cross-sectional data conclusively shows that the range of specific problems is too wide to be effectively coped with using an approach that emphasizes a narrow specialization.
If we compare the resources of the school headmaster or a local government official who has a particular budget at their disposal with the multiplicity of risk behaviours which should be prevented and problems that need to be addressed, there seems to be no way out of the situation. For instance, if we choose to fight against legal highs and violence, we will be left with insufficient funds for alcohol prevention, sexual risk behaviours, depression, anorexia, and gambling…
An integrated approach is the only rational option. Because if it is true that youth problems are interrelated and that they have some common causes, risk factors, and protective factors, we do not have to fall into the trap of a narrow specialization, which is economically limiting. If the above-mentioned correlations are scientifically proven, we have every right to direct people's energy and funds toward integrated actions, those which affect the key risk factors for the range of youth behaviours and strengthen protective factors. Then, while specialized activities will still be needed, they will be a supplement to, and not a principle of, prevention.
The IPZIN study results show that different indicators within a given category of problems are strongly or very strongly connected. For example, there are high correlations for use of different psychoactive substances by young people (alcohol, cigarettes, drugs, legal highs). Just this simple fact calls into question the significance of the separate prevention of the use of legal highs, which has been so strongly emphasized over the last six months. We can expect that if we focus on legal highs as a threat and manage to effectively discourage young people from using them (and don't encourage this behaviour... we cannot be certain until we study the effects!), it's very likely that young people will switch to beer, drugs or even gambling or pornography. Such are the effects of an exclusive focus on the symptoms. This particular approach does not bring deeper change.
The test results included in the Guidebook show us something more. They draw a parallel not only between different indicators of problems in a given area, but also between a group of problems in various areas.
Tables 1 and 2 (statistical considerations required a separate calculation for each sex) demonstrate a high correlation between the use of psychoactive substances and sexual and violence variables as well as a slightly lower but still considerable correlation with the variables from the category of 'depression'.
Table 1. Correlations between groups of problems for girls (age 14-15)
Table 2. Correlations between groups of problems for boys (age 14-15)
Various problems and risks coexist, collide and mix with one other in the young person and their peer environment. In fact, it's more difficult to find a rationale for isolating these problems and creating separate paths and programmes to counteract them than arguments for an integrated approach.
Research by IPZIN also shows that there are a number of risk factors and protective factors that are common to different kinds of threats. Factors such as being in the company of alcohol drinkers or the degree of sexualization are also risk factors for binge drinking, drug use, engaging in violence, early sexual contact and suicidal thoughts. At the same time, the scope of impact of protective factors related to family (mom and dad as the most important guides in life), religion or school (class climate, classmates' acceptance) is equally broad.
This means that an integrated approach is a rational direction for prevention as it focuses on strengthening protective factors against simultaneous multiple threats. It is, therefore, the most economical approach in the sense that it draws on the resources that exist in every community. Because in each municipality, prevention can be developed which supports the authority of parents, uses the potential of schools in youth development, and promotes religious communities and organizations passing values on to young people, treating them as assets in the battle against youth problems.
Support for prevention
The Guidebook to Effective Prevention of Youth Problems offers guidelines for state authorities and local government, demonstrating that the area of education and prevention is worth being treated as one of the top priorities in social, health, and education policy - and should be treated as such. Only an area that is treated as a priority can be wisely managed at the interministerial level. Only the policy priorities of the state and local government can count on adequate funding.
The Guidebook was published just before the parliamentary elections. We managed to convince the previous government to organize an interministerial meeting in the Office of the Prime Minister, which was held on 8th October, 2015. Immediately after the elections we began working to convince the new government of this approach. At the time of printing this article, the effects of our action are not yet known. We hope that with the help of a few parliamentarians - ambassadors of prevention, who know and appreciate the Guidebook, we will succeed in influencing the creation of a new prevention strategy, one which breaks the barrier of rigid sectoral divisions, and is rational and economical. And at the same time, it should wisely expand on the strengths of the current system of prevention (institutional backing of governmental agencies such as PARPA (National Agency for the Solution of Alcohol-related Problems), KBPN (National Bureau for Drug Prevention) or CED (Centre for Education Development), a number of effective prevention programmes, meaningful legal provisions included in the System of Recommendations for Prevention Programmes and Promotion of Mental Health).
We treat the Guidebook as a proposal for a meeting ground for cooperation across political divisions, because such significant and long-term issues as youth development and prevention must not be neglected due to the short-sighted media or political battles. While state and local government officials change every few years, passionate practitioners have been working in the field of prevention for decades. What they need is a wise and sustainable framework. They need politicians to improve and streamline the system, giving the priority for action to professionals.
Due to the demand reported by local governments, our Institute has developed a programme of training workshops that teaches government officials, counsellors, school administrators and other key individuals how to apply the approach based on the seven levers of effective prevention in practice. The whole idea of these workshops is to ensure that there are representatives of the different sectors in one group (health department, department of education, department of social affairs, social welfare centre, police, etc).
Someone may perceive it as audacious for the Institute for Integrated Prevention to suggest to the state and local government a new ground for building a coherent system of prevention and the promotion of youth development. The problem is that no one else has offered such an overall vision yet.
Therefore, we encourage you to Vade me cum (join us)!
(1) Grzelak, S. et al. (2015). 'Vademecum skutecznej profilaktyki problemów młodzieży. Przewodnik dla samorządowców i praktyków oparty na wynikach badań naukowych.' (The Guidebook to Effective Prevention of Youth Problems. Guidelines for Local Authorities and Practitioners Based on the Results of Scientific Research). Warsaw: Centre for Education Development. (258 pp.)