“What Works?”
A Compendium of Evidence-Based Strategies
In reference to the
Prevention of Youth Substance Abuse and Violence
February 14, 2012
DEFINING EVIDENCE-BASED
Evidence-based prevention refers to a set of prevention activities that evaluation research has
shown to be effective. Some of these prevention activities help individuals develop the intentions
and skills to act in a healthy manner. Others focus on creating an environment that supports
healthy behavior. (http://captus.samhsa.gov/prevention-practice/defining-evidence-based)
PREVENTION OF YOUTH SUBSTANCE ABUSE
 Prevention Approaches
Some substance abuse prevention interventions are designed to help individuals develop the
intentions and skills to act in a healthy manner. Others focus on creating an environment that
supports healthy behavior.
Research tells us that the most effective prevention interventions are those that incorporate both
these approaches. In other words, it's not enough to just convince a teenager that underage
drinking is harmful or provide her with the skills to resist peer pressure; you also need to make it
difficult for him to obtain the alcohol in the first place—by training liquor store clerks to check
identification and enforcing laws that penalize merchants who sell to underage patrons.
(http://captus.samhsa.gov/prevention-practice/prevention-approaches )
 Changing Individuals
Many prevention approaches focus on helping people develop the knowledge, attitudes, and
skills they need to change their behavior. Most of these strategies are classroom-based. A
comprehensive review of classroom-based programs yielded these conclusions about effective
programs:
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Programs that focus on life and social skills are most effective.
Programs that involve interactions among participants and encourage them to learn drug
refusal skills are more effective than non-interactive programs.
Interventions that focus on direct and indirect (e.g., media) influences on substance use
appear to be more effective than interventions that do not focus on social influences.
Programs that emphasize norms for and a social commitment to not using drugs are
superior to those without this emphasis.
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Adding community components to school-based programs appears to add to their
effectiveness.
Programs delivered primarily by peer leaders have increased effectiveness.
Adding training in life skills to trainings that focus on social resistance skills may
increase program effectiveness.
Source: O’Connell, M. E., Boat, T., & Warner, K. E. (Eds.). (2009). Preventing mental,
emotional, and behavioral disorders among young people: Progress and possibilities. National
Research Council and Institute of Medicine of the National Academies. Washington, D.C.: The
National Academies Press. (http://captus.samhsa.gov/prevention-practice/preventionapproaches/changing-individuals)
 Changing the Environment
Environmental strategies are prevention efforts that aim to change or influence community
standards, institutions, structures or attitudes that shape individuals’ behaviors. While individual
approaches focus on helping people develop the knowledge, attitudes, and skills they need to
change their behavior, environmental approaches focus on creating an environment that makes it
easier for people to act in healthy ways.
The most effective environmental prevention strategies are those with the potential to create both
environmental and individual change. These include:
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Policy
Enforcement
Communications
Education
These strategies can be used to change public perceptions or attitudes, improve or reinforce laws
and regulations, and decrease the availability or access to harmful substances.
(http://captus.samhsa.gov/prevention-practice/prevention-approaches/changing-environment)
PREVENTION OF YOUTH VIOLENCE
 School Violence
In the United States, an estimated 50 million students are enrolled in pre-kindergarten through
12th grade. Another 15 million students attend colleges and universities across the country.
While U.S. schools remain relatively safe, any amount of violence is unacceptable. Parents,
teachers, and administrators expect schools to be safe havens of learning. Acts of violence can
disrupt the learning process and have a negative effect on students, the school itself, and the
broader community.
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What is School Violence?
School violence is a subset of youth violence, a broader public health problem. Violence is the
intentional use of physical force or power, against another person, group, or community, with the
behavior likely to cause physical or psychological harm. Youth Violence typically includes
persons between the ages of 10 and 24, although pathways to youth violence can begin in early
childhood.
Examples of violent behavior include:
 Bullying
 Fighting (e.g., punching, slapping, kicking)
 Weapon use
 Electronic aggression
School violence occurs:
 On school property
 On the way to or from school
 During a school-sponsored event
 On the way to or from a school-sponsored event
http://www.cdc.gov/ViolencePrevention/youthviolence/schoolviolence/index.html
Recommendations
The guidelines consist of eight recommendations, for schools from pre-kindergarten through the
12th grade, that help prevent injuries that occur on school property and elsewhere. Every
recommendation is not appropriate or feasible for every school to implement. Schools should
prioritize the recommendations on the basis of their needs and available resources.
1. Social Environment
Establish a social environment that promotes safety and prevents unintentional injury,
violence, and suicide.
o Ensure high academic standards.
o Encourage students’ connectedness to school.
o Designate a school safety coordinator.
o Establish a supportive climate that does not tolerate harassment or bullying.
o Develop, implement, and enforce written policies, including disciplinary policies.
o Infuse prevention strategies into multiple school activities and classes.
o Assess programs and policies at regular intervals.
2. Physical Environment
Provide a physical environment, inside and outside school buildings, that promotes safety
and prevents unintentional injuries and violence.
o Conduct regular safety and hazard assessments.
o Maintain structures, equipment, and grounds.
o Actively supervise all student activities.
o Ensure that the school environment is weapon-free.
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3. Health Education
Implement health and safety education curricula and instruction that help students
develop the knowledge, attitudes, behavioral skills, and confidence needed to adopt and
maintain safe lifestyles and to advocate for health and safety.
o Choose programs and curricula that are grounded in theory or have evidence of
effectiveness.
o Implement prevention curricula consistent with national and state standards for
health education.
o Encourage student involvement in the learning process.
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Provide adequate staffing and resources.
4. Physical Education and Physical Activity Programs
Provide safe physical education and extracurricular physical activity programs.
o Develop, teach, implement, and enforce safety rules.
o Promote unintentional injury prevention and nonviolence through physical
education and sports participation.
o Ensure that spaces and facilities meet or exceed recommended safety standards.
o Hire physical education and activity staff trained in injury prevention, first aid,
and CPR, and provide ongoing staff development.
5. Health Services
Provide health, counseling, psychological, and social services to meet students’ physical,
mental, emotional, and social health needs.
o Coordinate school-based services.
o Establish strong links with community resources.
o Identify and provide assistance to students in need.
o Assess the extent to which injuries occur on school property.
o Develop and implement emergency plans.
6. Crisis Response
Establish mechanisms for short- and long-term responses to crises, disasters, and injuries
that affect the school community.
o Establish a written response plan.
o Have short- and long-term responses and services in place after a crisis.
7. Family and Community Involvement
Integrate school, family, and community efforts to prevent unintentional injuries,
violence, and suicide.
o Involve family members in all aspects of school life.
o Educate and involve family members in prevention strategies.
o Coordinate school and community services.
8. Staff Development
For all school personnel, provide regular staff development opportunities that impart the
knowledge, skills, and confidence to effectively promote safety and prevent unintentional
injuries, violence, and suicide and support students in their efforts to do the same.
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Ensure that staff are knowledgeable and skillful about unintentional injury,
violence, and suicide prevention.
Train all personnel to be positive role models for a healthful and safe lifestyle and
support them in their efforts.
(http://www.cdc.gov/HealthyYouth/injury/guidelines/summary.htm)
 How can we prevent youth violence?
The ultimate goal is to stop youth violence before it starts. Several prevention strategies have
been identified.
• Parent- and family-based programs improve family relations. Parents receive training on
child development. They also learn skills for talking with their kids and solving problems
in nonviolent ways.
• Social-development strategies teach children how to handle tough social situations. They
learn how to resolve problems without using violence.
• Mentoring programs pair an adult with a young person. The adult serves as a positive role
model and helps guide the young person’s behavior.
• Changes can be made to the physical and social environment. These changes address the
social and economic causes of violence. (http://www.cdc.gov/ViolencePrevention/pdf/YVFactSheet-a.pdf)
 Youth Violence Prevention at CDC
The Centers for Disease Control and Prevention (CDC) is actively engaged in efforts to stop
youth violence before it starts. CDC’s strategic areas for youth violence prevention include
 monitoring and researching the problem,
 developing and evaluating prevention strategies,
 supporting and enhancing prevention programs,
 providing prevention resources, and
 encouraging research and development.
CDC’s youth violence prevention activities are geared toward practical actions that make a
difference right now. We study the factors that increase the risk of violence and the factors that
protect youth from harm, and we use the results of these studies to guide prevention programs
and policies. We conduct studies that evaluate how well these programs work and identify those
with the greatest impact. Knowing what works is crucial in implementing effective prevention
programs in schools and communities. (http://www.safeyouth.gov/Pages/YV_PreventionatCDC.aspx)
 Ten key strategies for violence prevention – World Health
Organization
There are a number of interventions in different sectors whose effectiveness in preventing
violence and reducing its burden on health are relatively well established. The World Health
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Organization (WHO) and its Violence Prevention Alliance (VPA) partners recommend that
ODA agencies support:
• interventions for which there is evidence from one or more countries showing that
they have led to benefits in reduced levels of violence, and
• which have the potential to simultaneously decrease different forms of violence
because they address underlying risk factors common to multiple types of violence.
Based upon these considerations (and consistent with the strategies prioritized in a
2007 workshop on violence prevention in low- and middle-income countries, held
by the United States Institute of Medicine, National Academies of Science, the
following are 10 key strategies for violence prevention. The strategies are scientifically
credible, can potentially impact multiple forms of violence, and represent areas where
developing countries and funding agencies can make reasonable investments.
1. Increase safe, stable, and nurturing relationships between children and their
parents and caretakers
2. Reduce availability and misuse of alcohol
3. Reduce access to lethal means
4. Improve life skills and enhance opportunities for children and youth
5. Promote gender equality and empower women
6. Change cultural norms that support violence
7. Improve criminal justice systems
8. Improve social welfare systems
9. Reduce social distance between conflicting groups
10. Reduce economic inequality and concentrated poverty.
(http://whqlibdoc.who.int/publications/2008/9789241596589_eng.pdf)
Compiled by:
Lora M. Church, MPA, MS
Bridge Grant Coordinator
School and Family Support Bureau
New Mexico Public Education Department
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