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D. PREVENTION: Activities designed to reduce, postpone, or eliminate the incidence of alcohol and other drug problems in individuals, families, institutions, neighborhoods, communities, and the environment
1. Challenge: Prevention can only be effective when every aspect of society is included, and yet the term Prevention is most often associated with children and the education system. When the education system is considered, individuals think immediately of grades K through 12 in the public school system. While a coordinated system is in place in the public schools, notwithstanding its multi-district structure, other elements of the education system are often not considered, such as parochial and other private schools, community colleges, libraries, the County's Public Health Education program, and other agencies, organizations, and groups that carry messages to various segments of the public. While children and other individuals are appropriate recipients of prevention activities, the public health approach suggests that families, institutions, neighborhoods, communities, and the. larger environment need to be included as well. Many of the public policy and planning goals described above are also appropriate goals for community centered prevention efforts and they are not repeated below. Experience with their implementation in some communities suggests that prevention is more effective when communities participate in it than when individuals are the recipients of it.
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Goals/Recommendations: |
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a. |
Assure that there is a well coordinated prevention effort that addresses alcohol and other drug, problems at every level - including families, institutions, neighborhoods, communities, and the environment - - and not just at the individual level. (H, SS, E; Short-Term and Ongoing,)
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b. |
Assure that strategies are aimed at each aspect of the problem, as described in the public health, community model approach to alcohol and drug programming, which includes the agent (alcohol and other drums), the host (individuals who use alcohol and other drugs), and the environment (the societal or cultural context in which alcohol and other drug use occur). (H, SS, E; Short-Term)
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c. |
Expand the educational community to include community leaders beyond those most often associated with prevention efforts, involving parks and recreation authorities, businesses, churches, service clubs, and other influential elements. (H, SS, E; Short-Term and Ongoing) (Priority)
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2. Challenge: Few programs, including prevention efforts, validate the pride, traditions, and values of people from non-Euro-American cultures. Many individuals, and particularly undocumented immigrants, are not literate - - not only in English but also in their own languages. In trying to "get ahead" in California, many of these individuals are forced to repress their cultures. Ironically, studies have shown that the more acculturated immigrants become, the more likely they are to inappropriately use alcohol and other drugs and to suffer negative health indicators in many other areas. Traditional prevention efforts often are so focused on alcohol, drug, and other health interventions that they overlook the social justice underpinnings of many of the problems experienced by transplanted individuals, families, and groups. This may have the effect of depriving groups of their cultural pride and dignity and treating them, instead, as victims.
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Goals/Recommendations: |
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a. |
Develop and make available a variety of multi-lingual literacy programs for Latinos, Southeast Asians, and other groups. (E; Long-Term)
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b. |
Support efforts of groups such as the Hunger and Homeless Action Coalition to develop low income housing resources. (H, SS, E, CJ; Long-Term)
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c. |
Encourage and work with the business community to develop training programs and job opportunities. (H, SS, E; Long-Term) (Priority)
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d. |
Encourage all institutions to support the efforts of multicultural groups to integrate into American culture while simultaneously preserving and passing on to their children their unique cultural values, traditions, and languages. (H, SS, E, CJ; Long-Term)
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e. |
Develop appropriate informational and educational materials in Spanish for use in the schools and in the community, including information specific to DUI. (H, E, CJ; Short-Term)
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f. |
Ensure that the staffing patterns in all programs, services, and activities throughout the four major systems (Health, Social Service, Education, and Criminal Justice) reflect the demographic makeup of the recipients of those programs, services, and activities. (H, SS, E, CJ; Long-Term)
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g. |
Validate the use of, and fund, community organizers as a first-line prevention effort in multicultural communities, with minimum allocations to each of the following four, substantially numerous communities: African American, Chinese, Filipino, and Latino. (H, SS, E; Short-Term)
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3. Challenge: Because society is youth oriented, and because the language of the prevention field most often evokes images of youth, the elderly are often overlooked in identifying prevention needs. However, the older adult population is a group at high risk of developing alcohol and other drug problems for a number of very special reasons: use of one or more prescription medications, declining health, declining financial resources, loss of spouses and friends, and associated isolation and loneliness. Often the older adult is being seen by a number of physicians and health care practitioners, each of them unaware of the treatments and medications being prescribed to the same patient by others. Even minimal alcohol use under such circumstances may pose severe problems. Often societal denial of the extent of problems in this population is manifest in inappropriate humor about the drinking practices of older adults, which trivializes the magnitude and the seriousness of the issue. Even more disturbing are occasional reports of the use of alcohol and prescription drugs by staff in residential programs serving the older adult to control patients. Senior medication (SRx) programs which addressed many of these issues, though highly thought of, are no longer funded.
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Goals/Recommendations: |
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a. |
Provide ongoing training to alcohol and drug program workers about the problems and needs of the older adult, and to agencies, organizations, and individuals - - including medical practitioners - - who serve the older adult about the need to know what older adults are ingesting. (H, SS; Short-Term and Ongoing)
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b. |
Provide prevention education to older adults through the use of printed material and the electronic media. (H, SS; Short-Term and Ongoing)
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c. |
Support legislative efforts to renew funding of and institutionalize the Senior Medication (SRx) Programs formerly existing in Bay Area counties and elsewhere. (H, SS, State; Short-Term) (Priority)
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4. Challenge: Providing prevention programs, services, and activities directed only at children ignores the larger environment of family and community within which children live. Mixed messages occur when children are told to not use alcohol and drugs, only to see them in use in the home, or when they hear the horror stories about drugs in very black-and-white terms and yet see the financial reward available to the young drug runners. People live in one community and work in another, causing fragmentation and breakdown in the neighborhood. Often the means to reach the adult community, including young adults, are simply not there. In those areas where families are breaking down and disintegrating at an alarming rate, the problem is very intense.
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Goals/Recommendations: |
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a. |
Provide childcare and financial support for community prevention groups and parent groups to help them organize and sustain their efforts in creating community change. (H, SS; Long-Term)
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b. |
Provide prevention programs directed at families, with emphasis on hard-to-reach, single-parent families, multicultural families, families with grandparents raising children, and groups of unrelated individuals living under one roof. (H, SS, E; Long-Term)
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c. |
Include in family prevention strategies information on alcohol and drug problems, health and human services resources, basic living skills, work-seeking skills, money management, parenting, nutrition, and programs designed to help parents become positive role models. (H, SS, E; Long-Term) (Priority)
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d. |
Work with families very early, reaching infants, young, children, and children still at home, in recognition that disruption in children's behavior begins very early. (H, SS, E; Long-Term)
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e. |
Direct efforts at encouraging young women to become healthy, including the need for prenatal care for pregnant women in order to ensure healthy babies. (H, SS, E; Long-term)
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5. Challenge: Alcohol and other drug problems underlie the incident leading to the arrest and conviction of most individuals who occupy jail and prison cells. During the period of incarceration, little productive programming is available for addressing these problems. The enormity of the cost to society of criminal justice efforts would suggest that the opportunity for preventive strategies designed to reduce law enforcement involvement with this population should be taken advantage of.
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Goals/Recommendations: |
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a. |
Provide prevention specific alcohol and drug information, with a focus on DUI prevention and alternatives to driving after drinking,, to all incarcerated individuals. (H, SS, CJ; Short-Term and Ongoing)
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b. |
Provide information to the families of people in jail in order to prepare them to live and interact more effectively with offenders upon release. (H, SS, CJ; Short-Term and Ongoing)
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6. Challenge: Preventive opportunities exist within a school setting that have not been clearly defined or articulated because they exist outside of the traditional curriculum base that is most often the focus of attention when school-based prevention is discussed. Members of the San Mateo County community frequently mention a need to expand the concept of the school beyond buildings and the activities that occur there during the school day. The school does play a role in preparing children for the job market, and it does have a custodial role. But, it is also a community center, with a richness of staffing that includes a number of distinct players. Teachers are trained to teach, and presumably they are allowed to do that. Student service workers - - the counselors, school nurses, social workers, etc. - - are the ones who know the community agencies, who are the brokers for other programs, services, and activities that children need to access. Administrators are tasked with policy implementation, with getting things going: they are the catalysts in the school system. And, there are other workers - - such as secretaries, support staff, custodians - - who are of the community, and who may function as positive advocates on behalf of children. The talents of all of these forces are necessary to a fully operating school-based prevention program, and clearly this extends far beyond that which can be presented in a classroom. There is increasingly more pressure on the schools to make up for the things that are lacking in society; the schools need help from society in order to do all of the things that are being asked.
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Goals/Recommendations: |
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a. |
Continue to support the quarterly Prevention Network Breakfast and other activities that join families, schools, and communities in the prevention effort. (H, SS, E; Short-Term and Ongoing)
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b. |
Provide a place for all levels of school personnel in the comprehensive county-wide prevention effort. (E; Short-Term and Ongoing)
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7. Challenge: While the existing school-based prevention programs are widely supported and are closely reviewed by the multidisciplinary Local Coordinating Committee (LCC), there are a number of areas where there is support for increased emphasis.
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Goals/Recommendations: |
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a. |
Place major emphasis on the primary role of the schools - - the "Three R's" - - as the most important single prevention strategy for youth that is available. (E; Long-Term)
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b. |
Expand the use of peers in conflict resolution, problem solving decision making,, far beyond alcohol- and drug-use issues. (E; Short-Term)
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c. |
Focus on resiliency, critical thinking skills, decision making, esteem building, alternative ways of coping and dealing with stress. (E; Short-Term and Ongoing,)
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d. |
Develop prevention exercises designed to refine critical thinking skills in children, such as activities designed to dissect and analyze the manner in which the alcohol industry is duping those who are the targets of industry advertising efforts. (E; Short-Term and Ongoing)
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e. |
Work with the libraries and other groups successful at doing community outreach to develop methods of carrying prevention messages more effectively to multicultural communities. (H, SS, E; Short-Term and Ongoing)
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8. Challenge: Areas of the County have high concentrations of culturally diverse groups, such as the Filipino communities of Daly City and the Black/African American communities of East Palo Alto, wherein gang activity, crime, and violence create an environment that offers scant support for alcohol- and drug-free activities.
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Goals/Recommendations: |
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a. |
Support and encourage the creation of alcohol- and drug-free youth recreational centers that promote productive utilization of children's free time. (H, SS, E, CJ; Long-Term)
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b. |
Develop and disseminate information in Tagalog and other selected Asian languages on alcohol and other drug problems and the resources available for addressing those problems. (H; Short-Term)
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c. |
Increase prevention programs and activities in the schools and in the communities that are under siege. (H, SS, E, CJ; Long-Term)
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9. Challenge: Information on alcohol and other drug problems, and resources to address those problems, although widespread and institutionalized in some segments of the County, continue to be perceived by many as not available or as inadequate.
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Goals/Recommendations: |
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a. |
Provide more community education that alcoholism and addiction are diseases and not moral problems, and that everybody - - at some level - - has problems that relate to alcohol and drug use in the family, among friends, in the workplace, and in the community. (H,SS, E; Long-Term)
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b. |
Include information to the community that alcohol and drug problems are not just problems of individual behavior, but that there are many ways that the actions - - or nonactions - - of institutions, neighborhoods, and communities support drinking and drug-using behavior and discourage abstinence or moderate use of alcohol. (H, SS, E; Long-Term)
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c. |
Charge the County Drug and Alcohol Advisory Board with the task of educating the community about the dollar cost of alcohol and other drug, problems, and their relationship to criminal justice problems. (H, SS; Long-Term)
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d. |
Provide more information on how to contact alcohol and drug problem "Hot Lines". (H, SS; Short-Term)
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e. |
Offer alcohol and drug problem information and outreach at all community recreation centers. (H, SS; Short-Term and Ongoing)
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f. |
Provide information simultaneously about the interrelated problems of alcohol and other drug use, Human Immunodeficiency 'Virus (HIV), and birth control. (H, SS, E, CJ; Short-Term and Ongoing)
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