Understanding the determinants of health: key decision makers in Saskatchewan Health districts and Saskatchewan Health, 1998.

This research inquiry used qualitative and quantitative methods to examine how key decision makers from Saskatchewan health districts and Saskatchewan Health understand the determinants of health. The inquiry was based on the premise that key decision makers' understanding of the determinants of health, and the consensus regarding these understandings, hinder or facilitate dialogue, choice of effective strategies, and achievement of health promotion goals. Interviews indicated variation in perspective and emphasis regarding how key decision makers understand the determinants of health. A survey of key decision makers found: 1) inconsistencies in respondents' understanding of the determinants of health, particularly between stated beliefs and priorities for actions; and 2) that the degree of consensus among decision makers was higher for stated beliefs and lower for choices of action. Results indicate a need for clarification and consensus-building processes concerning the determinants of health, as well as for clear policies that foster consistency between beliefs and actions and minimize inappropriate or undesirable differences in interpretations.

Substance abuse curricula vs. school drug policies.

Schools are attempting to reduce substance abuse by implementing policies related to use of alcohol and other drugs in school settings. A review of current trends in adolescent substance use, together with research concerning effectiveness of alcohol and drug education and the impact of legal deterrence, indicate that: 1) neither educational nor school policy strategies by themselves are likely to effectively prevent use and abuse; 2) to be effective, education and policies must acknowledge and incorporate clear statements of community norms about alcohol and drug use; 3) to be effective, educational and policy strategies must complement and reinforce each other; and 4) education and policies must acknowledge and reinforce the positive behavior of the large number of students who do not use or abuse alcohol and other drugs.

Drug education: the prevention issues.

This article considers the major issues facing drug education by identifying and discussing eight dichotomies. These dichotomies capture the decisions faced by policy-makers, drug education planners, and practitioners. The dichotomies permit a cohesive, simplified, examination of the complex dilemmas currently faced by the field; they include: identification of the problems to be addressed, etiological under-pinnings, program objectives, target audiences, and effective strategies.

School-based drug education in North America: what is wrong? What can be done?

This article reviews experimental literature concerning the impact of drug (including alcohol and tobacco) education. Major weaknesses are identified with respect to planning, development, implementation, and evaluation of programs. Of special significance are inadequate identification of program objectives and target groups, failure to appreciate the dynamics of effective influence, lack of attention to program dissemination and utilization, and lack of concern with establishing the impact of programs through careful evaluation.

Factors associated with cannabis nonuse and cessation of use: between and within survey replications of findings.

Multivariate analyses (Multiple Classification Analyses) of data obtained from repeated surveys (1981 and 1983) of students (grades 7-13) supported the separate consideration of three aspects of cannabis use and nonuse: not trying cannabis; trying and quitting cannabis use; and trying and continuing cannabis use. Marked consistency was found in results obtained from between and within-survey replications. Many variables which exhibited bivariate relationships with cannabis use were not significant when considered multivariately. Few variables were related to both trying vs. continuing cannabis use. Variables which were expected to be related to cannabis use failed to show a significant relationship, most notably those measuring perceived threat of legal consequences, problems at home, problems outside the home, and threats to health. Methodological and substantive, especially educational/prevention, implications are highlighted.

Consistencies in self-reported drug use among students in Ontario (Canada).

A survey of drug use, carried out in 1981 by means of a self-reported anonymous questionnaire administered to a stratified probability sample of 4,306 school students in grades 5, 7, 9, 11 and 13 in Ontario, Canada, found consistent patterns in the use of drugs, including infrequently used illegal drugs such as heroin. Consistency of drug use was more apparent in the school grades with greater prevalence rates of drug use. Drug use was unevenly distributed and was localized within a relatively small proportion of all schools and geographical areas covered. Among the 17 categories of substances studied, the least frequently used substances were most localized. The study shows a general absence of misrepresentation of drug use by students, which corroborates findings reported by other researchers who have indicated that the problems of reliability and validity of self-reported drug use appear to be more related to difficulties in recalling and self-defining drug use than to its deliberate misrepresentation. The evidence presented in the article suggests that data on self-reported student drug use, as found in this and similar surveys, can be accepted with reasonable confidence.

Peer pressure and drug use--exploding the myth.

"Peer pressure" and "everyone is doing it" have been used as excuses for some drug-taking behavior for too long. We must look harder into reasons for drug use and neither accept these concepts nor teach our young people that this is what is really happening.

Alcohol education programs for university students: a review of their effectiveness.

A review of the experimental evidence concerning the effectiveness of 14 alcohol education programs for university students suggests that such programs, in spite of weaknesses in their experimental evaluation, offer the promise of significant impact on college students' reported alcohol-related behavior, as well as on their attitudes and knowledge. Programs are more likely to be effective if they include field (or laboratory) experience, as well as factual and experiential strategies, and if they occur over an extended period of time.

Non-use and cessation of cannabis use: neglected foci of drug education.

Analysis of responses from a large sample of students (grades 7-13) indicated that a large proportion of students reported never having tried cannabis, and the majority of those who had tried the drug reported no longer using it. Multivariate analyses, employing Multiple Classification Analysis procedures, identified those variables most strongly associated with initially trying cannabis and with discontinuing its use. These results indicated that some variables had a similar relationship to these two aspects of cannabis use, but other variables were related exclusively either to trying cannabis or to continuing its use. Implications for education and other preventive interventions are highlighted.

Three approaches to alcohol education.

An experimental examination of three approaches to alcohol education compared a cognitive program, a decision-making program and a values-clarification program. The cognitive program was most positively received and was superior in raising levels of knowledge; the values-clarification program was least effective, especially as measured by the program's impact on current and expected alcohol use.

Developmental and generational trends in alcohol, cannabis and tobacco use--a ten year cohort analysis.

Six surveys of drug use (including alcohol) among Ontario (Canada) students (grades 7-13) were conducted between 1968-1979. Cohort analyses identified significant increases in the prevalence and incidence of alcohol and cannabis use for all cohorts with, however, some moderation of cannabis use in recent years within the oldest cohort. Recent tobacco use has shown a reduction in the earlier strong trends towards increased use. Developmental influences on drug use were stronger than generational influences. Implications for preventive intervention are discussed.