Youth in Europe -not a campaign but a

Youth in Europe -not a campaign but a quiet revolution- Dr. Álfgeir Logi Kristjánsson Icelandic Centre for Social Research and Analysis, ICSRA Teachers College, Columbia University, NY, USA The 18 th ECAD Mayors’ conference Varna, 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 from 1992 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 Yi. E • 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

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

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 First data collection of Youth in Europe Vilnius Helsinki St. Petersburg Kaunas Klaipeda Oslo Reykjavik Riga Sofia 9 cities

2008 Second data collection of Youth in Europe Vilnius Reykjavik Arilje Istanbul (Bagcilar) Jurmala Sofia Bucharest Riga Klaipeda Kaunas Oslo 11 cities

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. . . ” • “. . . Yi. E 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 Yi. E • 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 n Primary prevention, preventing the development of substance use before it starts n Secondary prevention, that refers to measures that detect substance use that has began n 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

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 Time Support Monitoring Neighbourhood Leisure time Individual Organized vs. Unorganized Peer group Positive and negative effects School Attitudes to education and school, emotional well-being in school, etc.

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

4. What about evaluation?

An attempt to evaluate the Icelandic success Kristjansson 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 9 th and 10 th graders, from 1997, 2000, 2003, 2006, and 2009 § Number of respondents: 5, 024 (n 1=3, 117, n 2=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

Thank you Álfgeir Logi Kristjánsson kristjansson@tc. columbia. edu alfgeir@rannsoknir. is