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Youth in Europe -not a campaign but a quiet revolution-
Dr. Álfgeir Logi KristjánssonIcelandic Centre for Social Research and Analysis, ICSRA
Teachers College, Columbia University, NY, USA
The 18th ECAD Mayors’ conferenceVarna, Bulgaria, May 11-14 2011
Presentation overview
• 1. ICSRA introduction
• 2. The background of the Youth in Europe project
• 3. Main characteristics of Youth in Europe
• 4. What about evaluation?
• 5. Further evidence and possible future directions
1. ICSRA introduction
ICSRA
• A governmental Youth research centre from1992 focusing on education and the upbringing of youth
• ICSRA established 1998 with a broad focus on several aspects of youth research
• Lead Youth research centre since 1998
• Coordinated studies in 16 countries across Europe
ICSRA scientific collaborators
• Karolinska Instututet, Sweden
• Kings College, London
• National University of Ireland, Galway
• University of California, Irvine
• Columbia University, Teachers College, NY
• University of Iceland
• Penn State University, PA
• Reykjavik University
ICSRA specialization
• 10 to 13 year old in Primary schools
• 14 to 16 year old in Secondary schools
• 16 to 20 year old in High schools/Junior colleges
• 16 to 20 year old and outside schools
-Dropout students
•Longitudinally designed study of the 2000 birth cohort in
planning stages
2. The background of the Youth in Europe project
What is Youth in Europe?
• An evidence based drug prevention approach
• A way to decrease the use and demand for drugs among young people
•Similar methodology in place in most Scandinavian countries – still with notable differences
A few milestones of YiE
• 1992 – First ICSRA data collection
• 1998 – Severe substance use and abuse problems
• 2004 – A gradual downward trend
• 2005 – Youth in Europe began
• 2006 – First Youth in Europe data collection
• 2008 – Second Youth in Europe data collection
• 2012 – Third Youth in Europe data collection planned
Iceland in 1992
• Governmental decision to start collecting data
from 15-16 year old students
• Aim: To see if and how information collected
could benefit policymaking and decisions for
actions in youth matters
• Several data collections until 1998
Upward trend 1992 - 1998
17,015,1
20,7 21,0 21,422,8
4,0
7,2
9,6
11,513,0
17,4
0
5
10
15
20
25
30
1989 1990 1991 1992 1993 1994 1995 1996 1997 1998
%
Smoke daily Have tried hashish
Iceland in 1998
• A research based action plan initiated by the
government with the aim to try out a different
methodology in substance use & abuse prevention
• A nationwide task to decrease substance use
•Collaboration between researchers, policy makers and
practitioners begins
2004
42
35
3233
2628
26
23
1916
15 14 141217
1512 11 12 13
9
0
5
10
15
20
25
30
35
40
45
50
1998 1999 2000 2001 2002 2003 2004
%
Drunk last 30 days Daily smoking Hashish once or more
2005
Youth in Europe – A drug prevention program launched by:
• European Cities Against Drugs, ECAD
• City of Reykjavik: Chair
• President of Iceland, HE Grimsson: Patron
• ICSRA: Project leader and data collection
coordinator
• ACTAVIS: Main sponsor
2006
Vilnius ReykjavikHelsinki RigaSt. Petersburg Sofia KaunasKlaipedaOslo 9 cities
First data collection of Youth in Europe
2008
Second data collection of Youth in Europe
Some comments from cities...
•“...data from research is now used as a basis for desicion making...”
•“...information from data is already having impact on policymaking...”
•“...YiE method is a successful step in drug prevention...”
•“...empirical data is of vital support in our work...”
3. Main characteristics of Youth in Europe
The “research guru” approach
Main characteristics of YiE
• First and foremost a primary prevention approach
• A program without a timeframe
• Based on by-annual cross sectional research
•Aims to identify risk and protective factors and to assess their trends as well as trends in substance use
• A tool for policymakers and practitioners/fieldworkers
•Aims to create a dialogue between researchers, policy makers and practitioners
Approach to prevention
Primary prevention, preventing the
development of substance use before it
starts
Secondary prevention, that refers to
measures that detect substance use that has
began
Tertiary prevention efforts that focus on
people already abusing substances
A primary prevention model because substance use follows cohorts
Sigfusdottir et al. 2011, Global Health Promotion
20,3
40,5
56,9
10
24,9
41
8,2
22,3
31,5
3,9
11,5
20,9
6,1
13,915,7
0,9 5,6
10,7
0
10
20
30
40
50
60
13 14 15 13 14 15
Cohort 1984 Cohort 1991
%
Lifetime drunkenness Drunkenness in last 30 days Smoke cigarettes daily
A program “without a timeframe”
• Not based on classical interventions with a defined beginning and end points
• Aims to alter society as a whole for the benefit of young people, making their environment and living conditions encouraging in such a way that they do not choose to begin to use drugs
• Change behaviour and not merely attitudes towards drug use
Based on by-annual cross sectional research
• Relies on repeated cross-sectional surveys of the same age group rather than a within group cohort design or randomized trials
• Not a longditunal study design
• Why?
- Concernes the study focus between a within group
behavioral change design vs. a between groups
environmental change design
Find risk and protective factors
Three simple steps:
1. Measure drug use, risk and protective factors
in a cohort
2. Form policy and actions accordingly
3. Repeat regularly in same age-group
A way of conveying risk and protective factors in OUR society
Sigfusdottir et al. 2009, Health Promotion International
Family
Peer group
School
Leisure time Individual
Neighbourhood
Organized vs.
Unorganized
TimeSupportMonitoring
Attitudes to education and school, emotional well-being in school, etc.
Positive and negative effects
A different way…Sameroff 2010, Child Development
28
The collaborative approach
Example of our local actions
• Research is a basis for local level actions (prerequisite)
• Strengthen parent organizations and cooperation
• Support organized extra – curricular activities
• Support active NGOs´
• Support Young people at risk inside schools
• Form co-operative work groups against drugs
• Anti drug-use campaigns
Example of our national actions
• Legal age of adulthood raised from 16 to 18 years
• Outside hours for adolecents ,,Youth curfew”
• Age limits to buy tobacco and alcohol (18 and 20)
• Strict regulations around the selling of tobacco
• A total advertising ban of tobacco and alcohol
• Restricted access to buying alcohol and tobacco
• Total visibility ban of tobacco and alcohol in shops
Dialogue
• The Youth in Europe approach relies on active collaboration and constant dialogue between researchers, policymakers and practicioners in the field of young people
Dialogue between key practitioners
• Politicians (elected officials), municipal- and local authorities
• Parental groups and family planners
• School authorities and school workers
• Health educators, health- and social services
• Leisure time workers, prevention people
• Sports and youth institutions
• Suggest open meetings for anyone interested
• Encourage open discussion about improvements
Our results 1998-2010...Sigfusdottir et al. 2008, Substance Abuse Treatment, Prevention and Policy
42
35
3233
2628
26
22
25
18 19
14
23
1916
15 14 1412
11 12 1010
7
1715
12 11 12 13
9 9 97
66
0
5
10
15
20
25
30
35
40
45
50
1998 1999 2000 2001 2002 2003 2004 2005 2006 2008 2009 2010
%
Drunk last 30 days Daily smoking Hashish once or more
4. What about evaluation?
An attempt to evaluate the Icelandic successKristjansson et al. 2010, Preventive Medicine
The study used a quasi-experimental, non-randomized control group design, to assess the relative change in substance use and associated factors in 4 intervention- and 7 control communities, depending on their participation and committement to the prevention activities
Uses pooled data from 5 cross-sectional data collections among 9th and 10th graders, from 1997, 2000, 2003, 2006, and 2009
Number of respondents: 5,024 (n1=3,117, n2=1,907)
Response rates:
Intervention communities: 85.7%
Control communities: 90.1%
Interaction effect: time*intervention, OR 0.90 (95% CI: 0.77-1.00, p= .099)
Interaction effect: time*intervention, OR 0.86 (95% CI: 0.78-0.96, p= .004)
Interaction effect: time*intervention, OR 1.11 (95% CI: 1.00-1.22, p= .044)
Interaction effect: time*intervention, OR 1.11 (95% CI: 1.02-1.21, p= .015)
Interaction effect: time*intervention, OR 0.85 (95% CI: 0.73-0.99, p= .034)
5. Further evidence and potential future directions
Some future directions: Caffeine use?James et al. 2011, Journal of Adolescence
Some future directions: Group effects?Kristjansson et al. in preparation
• A new analysis of peer-group influences shows that the odds of daily smoking and lifetime drunkenness increases 300% and 258% respectively, for each point in increase on a five-point Likert scale, for the number of friends that do so
• In addition; attending schools were the prevalence of peer group relationships with substance using friends, measured on the same scale, increases by one unit, the odds of daily smoking and lifetime drunkenness increases by 89% and 61% respectively, for each point, over and above the individual-level odds
• => school context matters in addition to individual level effects
