QJER 15, 1999: Fritz and Carroll - principles for drug education in schools: Beyond the visions

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Principles for drug education in schools: Beyond the visions

Eva Fritz & Annemaree Carroll
Schonell Special Education Research Centre
Graduate School of Education
The University of Queensland

The purpose of the present research was to examine the extent to which the practices of drug education in a rural Queensland high school were based on the Principles for Drug Education proposed by the School Development in Health Education Project. The Principles for Drug Education are the only nationally accepted principles that fulfil Education Queensland's criteria to provide drug programs that are consistent with accepted principles for drug education in schools. Eighty-two students from Years 9, 10 and 11, and three teachers completed questionnaires which were specifically designed for the study. The results have implications for the implementation of drug education programs in schools. Developers of drug education programs need to promote their programs in schools; schools need support in terms of teacher education and professional resources.

Each year it is estimated that over 26,000 Australians die from drug-related causes, comprising about one-fifth of all deaths (Report of the Task Force on Drug Abuse, 1995). Drug abuse is estimated to cost the Australian community more than $18 billion a year, including the cost of health care, loss of productivity, and law enforcement associated with alcohol-related road crashes and illicit drugs (Queensland Health, 1997). The damage brought about by drugs upon our adolescent population is equally alarming. By Year 12, 75 percent of students are regular users of alcohol (Stanton, Walker, Ballard, & Lowe, 1997) and subsequently many adolescent deaths are alcohol-related. With one in four Year 12 students smoking approximately 50 cigarettes per week, many young people are establishing potential victim status for the greatest drug-related cause of death in the country.

Early adolescence is generally acknowledged as the first risk period for onset of drug use. Common adolescent characteristics of risk taking, acquiring adult roles and responsibilities, and establishing an understanding of their own abilities, ideas and values, contribute to psychological and social vulnerability amongst youth. When these challenges are exacerbated by negative social experiences such as dysfunctional family environments or threats to employment opportunities, then alcohol and other drug misuse represent an attractive, easily accessible coping tool. In contrast to popular belief, adolescents should commonly be identified as victims of drugs rather than drug users by choice.

Understandably, young people were a priority in the Queensland Drug Strategy 1995-97, and continue to be (Ballard, Fitton, Harrigan, & Roche, 1999), with strategies aimed at alcohol use, drink driving, smoking and illicit drug use by the youth population (Queensland Ministerial Task Force on Drug Strategy, 1995). Given the nature of the target group, schools are considered as an ideal setting to promote positive health behaviour regarding drug use (Carter & Carter, 1995). The majority of primary prevention programs for adolescent drug abuse have been implemented as school programs. The interaction between schools and young people and the overall experience of attending school, provides unique opportunities for health promotion which can be sustained and reinforced over time. From a social justice perspective, the school setting enables a broad reach to many youth, regardless of socioeconomic status, ethnicity or location. The fact that drug use impairs learning and self-discipline and reduces motivation to achieve in school provides schools with further call for action. Nonetheless, while school programs have experienced much change during the last decade (Harris & Ludwig, 1996), adolescent substance use still remains an enormous challenge for professionals in the field of education.

Developing effective drug programs presupposes an understanding of the factors promoting drug use. While no isolated cause can account for all types of drug use or types of drug abusers (Newcomb, Maddahian & Bentler, 1986), reviews indicate that the most promising abuse prevention approaches are those that focus primarily on the psychosocial factors promoting substance use initiation (Botvin, 1986; Flay, 1985). Psychosocial factors include the social, cognitive, attitudinal, personality and developmental influences believed to promote substance use. Prevention programs with this approach focus on the social influences believed to promote substance use as well as enhancing personal and social competence by teaching broad life coping skills (Botvin, 1986; Semlitz & Gold, 1986).

In 1991, with the support of the National Campaign Against Drug Abuse (NCADA), the School Development in Health Education (SDHE) Project proposed a set of fifteen principles for Australian school drug education called the Principles for Drug Education in Schools (see table 1). The SDHE Project is a national health education development project which aims to develop strategies for schools to identify and address drug and health issues for students. As part of Education Queensland's responsibility to provide students with comprehensive drug education throughout their school years, schools must implement drug programs that are consistent with accepted principles for drug education in schools (Queensland Department of Education, 1994). Using sound principles can prevent the use of programs and resources that in the past have had immediate appeal, but fail to achieve long-term drug education aims. The Principles for Drug Education in Schools are the only nationally accepted principles that fulfil the Education Queensland's criteria for the provision of drug education in schools.

The principles are based on sound research and extensive consultation with educational personnel and are aimed to equip young people with the information, skills, and support to enable them to make responsible decisions about drugs (Ballard, Gillespie & Irwin, 1994). These principles present a framework which school personnel can use in the selection, design and implementation of drug programs in the school. Factors addressed in the principles include the delivery and duration of drug education, the selection of program content and goals and evaluation of drug education.

While it seems vital to encourage dissemination of promising approaches to school drug education, little is known about the fidelity of implementation of current Australian school drug programs. This would suggest that the implementation of present approaches to drug education in the school, such as the Principles for Drug Education in Schools, is worth further investigation. The purpose of the present research was to examine the current practice of drug education in a rural Queensland high school. The primary focus of this research was to examine the implementation of drug education in the framework of the Principles for Drug Education proposed by the SDHE Project.

Table 1: Principles for drug education in schools

1 Drug education is best taught in the context of the school health curriculum.

2 Drug education in schools should be conducted by the teacher of the health curriculum.

3 Drug education programs should have sequence, progression, and continuity over time throughout schooling.

4 Drug education messages across the school environment should be consistent and coherent.

5 Drug education programs and resources should be selected to complement the role of the classroom teacher, with selected external resources enhancing not replacing that role.

6 Approaches to drug education should address the values, attitudes, and behaviours of the community and the individual.

7 Drug education needs to be based on research, effective curriculum practice and identified student needs.

8 Objectives for drug education in schools should be linked to the overall goal of harm minimisation.

9 Drug education strategies should be related directly to the achievement of the program objectives.

10 The emphasis of drug education programs should be on drug use likely to occur in the target group and drug use which causes the most harm to the individual and society.

11 Effective drug education should reflect an understanding of characteristics of the individual, the social context, the drug, and the interrelationship of these factors.

12 Drug education programs should respond to developmental, gender, cultural, language, socio-economic, and lifestyle differences relevant to the level of student drug use.

13 Mechanisms should be developed to involve students, parents, and the wider community in the school drug education program at both planning and implementation stages.

14 The achievement of drug education objectives, processes and outcomes should be evaluated.

15 The selection of drug education programs, activities, and resources should be made on the basis of an ability to contribute to long-term positive outcomes in the health curriculum and the health environment of the school.

Source: Ballard, R., Gillespie, A., & Irwin, R. (1994).

METHOD

Participants

The participants of the present research were 82 high school students from Years 9, 10 and 11, and three teachers of drug education in a rural high school. The student ages ranged from 15 to 17 years, with a total of 43 male and 39 female participants. The three teachers who participated in the research were the sole providers of any drug education in the school.

Instrumentation

Feedback was obtained from two questionnaires devised for the study. Students received a written questionnaire based on the Principles for Drug Education. Twenty-four questions were devised which comprised a student evaluation of the current drug education in their class (e.g., Do you feel the drug education program is generally helpful for most students? Who do you think is the best person to give drug education at your school? Have you received any information about the effects of using any of the following drugs? Does your teacher use any of the following resources during drug education?). The overall readability of the student questionnaire was intended for Year 8 level.

Teachers completed a questionnaire of 30 questions also based on the Principles for Drug Education (Ballard et al., 1994). This questionnaire addressed aspects of drug education in the classroom, such as teacher training (e.g., Have you received post preservice training in the area of drug education?, Would you like to receive more training in drug education?) and presentation and evaluation of drug education (e.g., To which Year level(s) do you teach drug education? Is there a system of evaluation for the attainment of the program goals?).

Procedure

The school principal was approached by the researchers and permission was obtained prior to conducting the research. Students from the three year levels (Years 8, 9 and 10) were given information and permission sheets to take home to their parent(s) or guardian(s). If the parent(s) or guardian(s) and the student both consented to participate then the students completed the questionnaire. Teacher questionnaires were given to the coordinator of Human Relationship Studies who then distributed the questionnaires to those who teach drug education at the school. No information about the Principles for Drug Education was disclosed to the teachers prior to the completion of the questionnaires.

The questionnaires took approximately 20 minutes to complete and were administered to class groups by one of the researchers during Human Relationships Education class time. At the start of each session one of the researchers gave a brief introduction to the students explaining the purpose of the questionnaire. Students were informed that the questionnaires were completely confidential and that no names were required. The researcher was present throughout the session to answer any questions.

Student and teacher responses

Responses from the student and teacher questionnaires were organised into: multiple choice questions (e.g., What Year levels do you think should have drug education: (a) Year 6, (b) Year 7, etc); closed question format (e.g., How often do you think you should receive drug education at this Year level?); and open question format (e.g., What things do you think your school could do to improve its drug education program?). Separate analyses were performed for the student and teacher questionnaires. The student responses were organised into a percentage frequency for each question. Frequency counts were calculated on the responses to each question of the teacher questionnaire. The results of these analyses were used to determine the extent to which the prnciples were fulfilled.

RESULTS

Of the fifteen principles, eight were fulfilled, four were partially fulfilled, and three were not adequately addressed in the drug program. The eight principles fulfilled in the program were: Principles 5, 6, 8, 9, 10, 11, 12 and 14 (see Table 1). These principles were fulfilled as indicated by the following factors:

There is involvement of outside professionals who have complemented the role of the teacher on all but one occasion.
The program addresses the values, attitudes, and behaviours of the community as well as the individual.
The content of the drug program emphasises the drugs most likely to be used in the student group, within a 'harm minimisation' objective for drug education.
The program addresses individual, developmental, and cultural factors.
There is a system of evaluation for the outcomes of the program.

The principles which were partially fulfilled in the program included Principles 4, 7, 13 and 15. These principles were partially fulfilled as indicated by the following:

Slightly more than half the students and teachers felt that the school had a firm policy that supports the drug education messages in the classroom.
Teachers base the design of their drug education primarily through perceived levels of student drug taking, rather than research and effective curriculum practice.
Presently there is no involvement of parents or the wider community in the school drug program, and very few students felt there are community resources for help with drug issues.
Teachers have a clear understanding and commitment to the ultimate goals for drug education, although the short duration of the school's drug program and the teacher's lack of awareness of the Principles for Drug Education in Schools limit an awareness of the issues involved in a comprehensive approach to drug education.

Only three of the principles were not adequately addressed in the school's drug program. These principles (Principles 1, 2, and 3), pertain to the delivery of drug education at the school. Drug education is not being taught in the school health curriculum, by health teachers, and is not being delivered throughout all year levels in the school.

DISCUSSION

The results of the study indicate that the drug program at this school is generally working within the framework of the Principles for Drug Education in Schools. Unfortunately, the principles which are unaddressed are those most likely to undermine the potential success of the program. Specifically, drug education is not delivered in the school health currciulum, by health teachers, throughout all year levels in the school. The fact that no teacher was aware of the principles is a serious matter for the school, and one which raises the critical issue of the school's responsibility towards its students drug education.

Where do the barriers to the adoption of the principles lie?

From the outset of the present research, the lack of teacher awareness of the principles would indicate that the developers of the Principles for Drug Education in Schools have not included in their role the promotion or follow up of the program. While it is the school's responsibility to implement drug education programs that are consistent with accepted principles for drug education (Queensland Department of Education, 1994), it seems only appropriate within the context of the existing pressures of the school system, that program developers ensure the implementation and follow-up of these programs. The question is whose role it is to promote and follow-up education packages?

A further reason for under-utilisation of promising principles for drug education may be that the key ingredients of prevention curricula require techniques less familiar to teachers, including: comprehensive identification of student background and needs; interactive teaching techniques; and awareness of research and evaluation methods applicable to drug education. Adequate teacher training therefore is crucial if the proposed principles for drug education are to be successfully accepted and implemented.

The potential to develop school initiatives in the health curriculum and in the school's broader environment is substantially limited by the paucity of pre-service training about health for those teachers not specialising in health education, and also comprehensive, ongoing professional development programs, particularly for rural teachers (Report of the Task Force on Drug Abuse, 1995). These are needed to equip teachers with the knowledge and skills required to develop and deliver the quality school health programs associated within an integrated health-promoting school framework.

Many of the requirements placed on school systems and teachers are unrealistic if they are not provided also with the resources necessary for implementing them. However, this should not be an excuse for failing to provide comprehensive health programs for our schools; rather this should be the pivotal issue for the education sector.

Making good ideas workable

While drug abuse is an issue of such importance as to warrant specific attention, drug abuse represents only one of many health problems associated with the adolescent age group. For example, sexually transmitted diseases and suicide are also serious problems. There are limits to a school's capacity to address health issues. The education sector has experienced significant changes in recent years, leading to increased school responsibilities. Alongside this change has been a reduction in support services, particularly in curriculum consultancy and professional development for teachers. This places great pressure on school time and resources, and as a result health education is in great competition for curriculum time, teacher attention and resources. For these reasons, to implement comprehensive drug education fully, there must be supportive health promotion through multidisciplinary team networks associated with the school, in order for schools to withstand the pressures brought upon by resource threats and departmental restructuring.

An additional complication is that one of the key causes of the relative failure of drug education has been the focus on the individual to the exclusion of the environment (O'Connors & Saunders, 1992; Wallack & Holder, 1987). The belief that if the individual is sufficiently informed, sustainable behavioural change will occur, negates the individual's exposure to and influence by those actions that occur at different levels, such as the family, community, and cultural environment.

The superiority of smoking intervention programs over those which address other drugs (Botvin, 1986; O'Connor & Saunders, 1992) supports the contention that school-based drug education will only be effective if it belongs to a broad ranging, community endorsed, and system-wide approach to the prevention of drug problems (O'Connor & Saunders, 1992; Wallack & Holder, 1987). The lesson learned from the success of anti-smoking education is that it has occurred in conjunction with a social milieu supportive of its messages. Evidence of this has been federal and state restrictions on tobacco promotion, regulation of smoking in the workplace and public areas, higher taxation policies, increased salience of nonsmokers' rights and intolerance of smoking. Most recently, increased age policy of tobacco purchasing has contributed to and been enhanced by educational intervention.

A multidisciplinary approach to school health programs has been proposed in the Health Promoting School philosophy (National Health and Medical Research Council, 1996). The Health Promoting Schools concept was developed as an initiative of the World Health Organisation in the mid-1980s. The strategy aims to improve the effectiveness of health education/promotion in schools, creating environments that are supportive of the health and welfare of the whole school community. Improved collaboration between the health and education sectors, and the development of methods for monitoring progress and evaluating health outcomes are also major issues in the concept of Health Promoting Schools. The results of this research point directly to the need to endorse a more coordinated and collaborative working relationship between key agencies, and the need to keep the monitoring and evaluation of any program as a priority.

Program evaluation and future research

An important issue for any drug abuse prevention curriculum is whether it can be demonstrated to have an impact on drug use behaviour. All too frequently, health-endorsing programs are established with no effective mechanism for management, quality control or monitoring. Such programs are often doomed to failure, and even where potentially or tangibly successful have been incapable of yielding supportive evidence to ensure their continuation. Research on the effectiveness of any school-based drug program is subject to certain methodological problems. This research study suggests some important implications for future research on the effectiveness of the Principles for Drug Education in Schools.

Although the principles are not intended to address other issues such as professional development (Ballard et al., 1994), program awareness and teacher training would seem to be the focal points which are necessary to address the weaknesses of the drug education in the school in this study. Future research which looks at awareness and implementation of the principles is a necessary first step for ensuring schools are addressing their responsibility to the drug education of their students. In addition, if the messages communicated in the classrooms are to be consistent with school policy regarding drug issues, then that policy must define the school's responsibility and accountability in relation to the design and delivery of drug education principles.

CONCLUSIONS

Educational interventions of substance abuse have increased over recent years, as effective programs derived from social influence models have been developed and evaluated. Given the target group, much of the responsibility for drug interventions has fallen on the school setting. The present research explored the implementation in a rural Queensland school of the school drug education principles designed for Australian schools, Certain barriers to the implementation and evaluation of this program were identified; these barriers may be of particular relevance to a rural setting. The present research has sought to encourage possible strategies which can overcome these barriers, at the developmental and implementation stage of the Principles for Drug Education in Schools. Several necessary actions have been identified to move school health programs towards achieving their optimal educational outcomes. these include: a wider promotion and adoption of established guidelines for comprehensive school health programs; allocating resources to educating and training teachers; and maximising the contribution of health services to achieve better co-ordination in contacts with schools.

While health interventions of proven value reach wider population segments, such as the school, new challenges usually arise concerning their implementation and evaluation. Indeed, more recent innovations suggest that drug education must move in the direction of a broader community base. Monitoring is clearly the key to ensure proper program implementation. The present research has highlighted the lack of and need for such monitoring in drug education. The particular reality of the rural community may present additional issues which need to be considered in the implementation of new programs. The first issue to be considered is whether the isolation of rural communities makes school workers vulnerable to lack of information access, as might be inferred by the teachers' unawareness of the principles. Further research throughout both rural and urban areas would address this question. Another issue, as expressed by the student respondents, is that rural communities can have the disadvantage of having limited local professional collaboration where the privacy of individuals is of particular issue, as in relation to topics such as drug use. This factor only heralds the need to make these concerns and needs known so that systems can be put in place to remediate such gaps in the health system of local communities. As with any community, rural or otherwise, it should be the responsibility of all school and school health workers to familiarise themselves with and commit themselves to working alongside other key agencies, including health and education departments, who can bring collaborative power to the school seeking a coordinated and sustainable health program.

REFERENCES

Ballard, R., Fitton, I., Harrigan, K. & Roche, A. (1999). No deal: Minimising the presence of illicit drugs in schools. Brisbane: Education Queensland.

Ballard, R., Gillespie, A. & Irwin, R. (1994). Principles for drug education in schools. Canberra: University of Canberra.

Botvin, G.J. (1986). Substance abuse prevention research: Recent developments and future directions. Journal of School Health, 56, 386-374.

Carter, D.S.G. & Carter, S.M. (1995). Adolescent receptivity to the health curriculum in Western Australian high schools. Australian Journal of Education, 39, 189-199.

Flay, B.R. (1985). Psychosocial approaches to smoking prevention: A review of findings. Health Psychology, 4, 449-488.

Harris, J.L. & Ludwig, M. (1996). The trading cards program: An evaluation of use of high school role models for dug abuse prevention. Journal of Health Education, 27, 183-186.

National Health and Medical Research Council. (1996). Effective school health promotion: Towards health promoting schools. Canberra: AGPS.

Newcomb, M.D., Maddahian, E. & Bentler, P.M. (1986). Risk factors for drug use among adolescents. American Journal of Public Health, 76, 525-531.

O'Connor, J. & Saunders, B. (1992). Drug education: An appraisal of a popular preventive. The International Journal of the Addictions, 27, 165-184.

Queensland Department of Education. (1994). Drug education in schools: Policy, procedures, and guidelines. Brisbane: Queensland Department of Education (now Education Queensland).

Queensland Health. (1997). Alcohol and other drug patterns of use and harm in Queensland. Brisbane: Alcohol, Tobacco, and Other Drug Services.

Queensland Ministerial Task Force on Drug Strategy. (1995). Queensland drug strategy 1995-1997. Brisbane: Queensland Health.

Report of the Task Force on Drug Abuse. (1995). Reviews and Recommendations Vol. 1. Perth: Government of Western Australia.

Semlitz, L. & Gold, M.S. (1986). Adolescent drug use. Psychiatric Clinic of North America, 9, 455-473.

Stanton, W., Walker, D., Ballard, R. & Lowe, J. (1997). Alcohol, cigarette and illicit drugs use among year 7 to 12 students in Queensland, 1996. ASSAD Survey Report No. 4. Brisbane: Health Issues Section, Education Queensland.

Wallack, L. & Holder, H. (1987). The prevention of alcoholo-related problems: A systems approach. In H. Holder (Ed.), Control issues in alcohol abuse preventions: Strategies for states and communities. Advances in Substance Abuse: Behavioural and Biological Research, Supplement 1.

Author contact: Dr Annemaree Carroll
Schonell Special Education Research Centre
Graduate School of Education
The University of Queensland
Brisbane Qld 4072
Phone: 07 3365 6476 Fax: 07 3365 8553 Email: a.carroll@mailbox.uq.edu.au

Please cite as: Fritz, E. and Carroll, A. (1999). Principles for drug education in schools: Beyond the visions. Queensland Journal of Educational Research, 15(2), 245-257. http://education.curtin.edu.au/iier/qjer/qjer15/fritz.html

[ Contents Vol 15, 1999 ] [ QJER Home ]
Created 3 Mar 2005. Last revision: 3 Mar 2005.
URL: http://education.curtin.edu.au/iier/qjer/qjer15/fritz.html

1	Drug education is best taught in the context of the school health curriculum.
2	Drug education in schools should be conducted by the teacher of the health curriculum.
3	Drug education programs should have sequence, progression, and continuity over time throughout schooling.
4	Drug education messages across the school environment should be consistent and coherent.
5	Drug education programs and resources should be selected to complement the role of the classroom teacher, with selected external resources enhancing not replacing that role.
6	Approaches to drug education should address the values, attitudes, and behaviours of the community and the individual.
7	Drug education needs to be based on research, effective curriculum practice and identified student needs.
8	Objectives for drug education in schools should be linked to the overall goal of harm minimisation.
9	Drug education strategies should be related directly to the achievement of the program objectives.
10	The emphasis of drug education programs should be on drug use likely to occur in the target group and drug use which causes the most harm to the individual and society.
11	Effective drug education should reflect an understanding of characteristics of the individual, the social context, the drug, and the interrelationship of these factors.
12	Drug education programs should respond to developmental, gender, cultural, language, socio-economic, and lifestyle differences relevant to the level of student drug use.
13	Mechanisms should be developed to involve students, parents, and the wider community in the school drug education program at both planning and implementation stages.
14	The achievement of drug education objectives, processes and outcomes should be evaluated.
15	The selection of drug education programs, activities, and resources should be made on the basis of an ability to contribute to long-term positive outcomes in the health curriculum and the health environment of the school.
Source: Ballard, R., Gillespie, A., & Irwin, R. (1994).