Three Critical Hours -- Three Critical Years:IF THIS IS A "WAR ON DRUGS"....During World War II, Allied air forces estimated that only 5% to 10% of the bombs that they dropped actually hit their intended targets. Most fell on nearby buildings and facilities, causing terror, waste, and collateral damage. World War II bombing raids were effective at causing terror in the populations, but were not very efficient in hitting their targets. By war's end, they had to resort to mass dectruction via "carpet bombing" and use of incendiary and nuclear bombs to win the war.
During the Gulf War, Allied air forces were using newly developed precision "smart bombs" that were guided directly into their intended targets. Using sophisticated guidance systems, these technological marvels were both effective and efficient in hitting their intended targets. Precision targeting minimized Allied casualties and won the war.
If we are in a "war on drugs," we need to use the metaphorical equivalent of "smart bombs" -- we need a system of directing our prevention efforts precisely, so that they have maximum impact on their targets. Precision Targeting in Prevention will increase efficiency and reduce waste and collateral damage. It will allow the taxpayers and other funders to get the optimal benefit for their hard-earned dollars.
Precision targeting in prevention means:
- reaching the RIGHT audience
- at the OPTIMAL TIMING
- with the RIGHT SET of messages
The word "prevention" comes from the Latin word "prevenire", which means "to come before." The object of prevention is to reduce or eliminate problems before they develop. The target population for a drug prevention effort, therefore, is people who have not developed drug problems -- non abusers. For youth, this is usally operationally defined as being a target audience consisting of "non-users, rare users, and occasional users who have not yet developed a pattern of regular use or symptoms of abuse." For adult populations, there is often a distinction that also considers the differences between legal and illegal drug use.
In the best of all worlds, there would be no need for drug abuse prevention programs. The next best situation would be that adequate resources, staffing, and funding would be available for all prevention populations and settings. In the real world, however, funding agencies have to make tough decisions on where to direct the limited amount of available prevention funds. Federal, state, and local government funders, as well as private- and nonprofit-sector funders are becoming much more aware of the need to target their funding to get the most "bang for the buck" when funding prevention programs.
Over the past decade, new evidence had emerged that helps prevention planners identify that portion of the entire population that is most likely to begin using drugs in the next few years. Precision Targeting in Prevention identifies those prevention populations that are most likely to begin using alcohol, tobacco, and other drugs in the near future. This allows funders and program staff to concentrate their resources on the population most likely to benefit from prevention programs -- those most likely to change from non-users, rare users, and occasional users who have not yet developed a pattern of regular use or symptoms of abuse.
Drug abuse prevention programs aim to prevent transitions: for examples:
- the transition from non-use to experimental use,
- the transition from experimental use to casual use,
- the transition from casual use to regular use, and
- [for adults] the transition from regular use to abuse.
It isn't "prevention," if it doesn't prevent anything. The key to precision
targeting in prevention is to identify the populations most likely to undergo these
transitions, identify the time the transistions are most likely to occur, and plan
prevention programs precisely to prevent those transitions from occurring.
Recently, new evidence has emerged that has identified a "36 month window of increased
vulnerability," between 7th and 9th grade -- about ages 12 through 14 -- when more
than half of these transitions occur. Other evidence pinpoints three specific hours
of each weekday when these middle school youth are most likely to undergo these
transitions -- between the hours of 3:00 and 6:00 p.m. -- the time between school
dismissal and when the youth's family comes home from work.
This new information allows prevention funders to direct discretionary funding to programs that focus on these three critical hours and three critical years. In Indiana, for example, the Indiana Family and Social Services Administration, Division of Mental Health, has reallocated most of its community-based prevention funding to support new afterschool prevention programs for middle school-aged youth.
We now have compelling evidence that more than half of all new drug use begins during the three critical years -- 7th, 8th, and 9th grade. Furthermore, with this age population, most new drug use begins in the afterschool hours -- three critical hours -- between 3:00 and 6:00 p.m. on school days, when youth are unsupervised before their families return home from work. The national data are comparable to Indiana data in confirming the importance of these three crtiical hours and three critical years.
This information allows us to precisely target this segment of the population that is most likely to begin using drugs in the next year or two. An appropriate anti-drug message can be delivered to this target audience at the precise time in their lives, and the precise time of day, at which they are most vulnerable to beginning drug use.
"When the school bell rings, leaving millions of young people without responsible adult supervision or constructive activities, juvenile crime suddenly triples and prime time for juvenile crime begins."-- Fight Crime - Invest in Kids"Over the three-year period from age 12 to 15, the proportion of teens who have smoked cigarettes in the last month soars from 2% to 15%; the share of teens who report having been drunk in the last month climbs from 2% to 21%, and the share saying they smoked marijuana jumps from 1% to 34%."
-- National Center on Addiction and Substance Abuse
Columbia University
"This period of time between the school bell and the factory whistle is a most vulnerable time for children. These are the hours when children are more likely to engage in at-risk behavior and are more vulnerable to the dangers that still exist in too many neighborhoods and communities."--Vice President Gore"Why is the period of early adolescence so critically important? With the exception of infancy, no time of life compresses more physical, intellectual, social, emotional, and moral development into so brief a span."
-- A Matter of Time: Risk and Opportunity in the Nonschool Hours
Carnegie Council on Adolescent Development"Unsupervised after-school hours represent a period of significant risk: It is a time when adolescents may engage in dangerous and even illegal activities, and is the most common time for adolescent sexual intercourse (usually at the boy's home while his parents are at work). Unsupervised young adolescents stand a greater chance of engaging in substance abuse....[and] are also more likely to be subject to negative peer pressure."
-- A Matter of Time: Risk and Opportunity in the Nonschool Hours
Carnegie Council on Adolescent Development
In
the 1970's, when the "alternatives approach" was developed, it was hoped that simply
providing drug-free alternatives would be effective in reducing adolescent drug use. This
hope was based upon two underpinnings: occupying idle time, and fulfilling certain
psychological needs (ie. sensation seeking) via drug-free means. However, evidence of
the effectiveness of "alternatives programs" in reducing the use of alcohol, tobacco, and
other drugs is mixed. A few programs have demonstrated effectiveness, a few have failed
to show any significant differences, and most have not been rigorously evaluated.
Despite the development of some complex theoretical models to improve the application of the alternatives approach (eg. Cook R., "The Alternatives Approach Revisited: A Biopsychological Model and Guidelines for Application," International Journal of the Addictions 20:1399-1419, 1985), the results have still been mixed. The evidence suggests that it is inadequate to simply provide "alternatives." In order to produce a reduction in ATOD use, the alternatives aspect needs to be supplemented with adult supervision, psotive youth development activities, and preferably some focused attention to alcohol, tobacco, or other drug issues. In order to expect prevention outcomes, something more than unstructured recreation or entertainment is required. A "safe haven" without positive youth development seems not to prevent ATOD use.
"Conclusions about the effectiveness of this approach have been difficult to draw because so few programs have been evaluated and the results have been mixed and difficult to interpret. Some programs appear to have prevented or reduced use of alcohol and other drugs, whereas others have had little or no effect, and some have even increased use. Most reviewers of prevention research ignore the strategy, or conclude that there is little or no evidence of its effect on behavior, or admit only that it "may be" effective."-- U.S. Department of Education
Beyond Prevention Curricula: A Guide to Developing Alternative Activities Programs
Readings on Afterschool and Alternatives Programs
Last Updated: September 5, 1998 - wjb