Presentation Youth Marijuana webinar Prev Week FINAL · Preventing Youth Marijuana Use ... marijuana5 Individual RiskFactors 21 Family ... Project Success38 Keep a Clear Mind29 District-wide

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CAPT WEBINAR

Preventing Youth Marijuana UseChanging Perception of RiskGisela Rots, MSc, CPS

Coordinator, CAPT Northeast Resource Team

Lourdes Vázquez, MSW CPP

Coordinator, CAPT Southeast Resource Team

May 19, 2016

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Technical Information

This webinar is being recorded and archived, and will be available to all webinar participants. Please

contact the webinar facilitator if you have any concerns or questions.

This training was developed under the Substance Abuse and Mental Health Services Administration’s

Center for the Application of Prevention Technologies task order. Reference

#HHSS283201200024I/HHSS28342002T.

For training use only.

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Objectives

• Describe how attitudes, beliefs, and norms about marijuana influence its use

• Identify factors and strategies for preventing youth marijuana use

• Locate CAPT decision-support tools on preventing youth marijuana use

• Describe key considerations when addressing youth marijuana use if evidence-based strategies are not available

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Presenters

Gisela RotsCoordinator

Northeast Resource TeamSAMHSA’s CAPT

Lourdes VázquezCoordinator

Southeast Resource TeamSAMHSA’s CAPT

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Please Note:

This presentation highlights research findings related to the prevention of youth marijuana use. It does not endorse the selection of any specific risk/protective factor(s) or strategy(ies) to address this problem.

Questions related to funding allocation and the approval of interventions or strategies should be directed to the funding agency.

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Caveats and Considerations

• This presentation focuses on preventing marijuana use among youth aged 12 to 17

• This presentation will not address:

o Marijuana use among young adults aged 18 to 20

o Adult marijuana use

o Community, state, or national policy

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The Changing Landscape

State Marijuana Laws Map

State Marijuana Laws

DC

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Risk and Protective

Factors

Risk and Protective

Factors

Youth Marijuana Use and Related Behaviors


InterventionsInterventions

Preventing Youth Marijuana Use: Our Road Map

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Short Answer Poll:

Why is it important to

address youth marijuana use?

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Past-Month Marijuana Use Among 8th, 10th, and 12th Graders: 2006-2015

6.5 5.7 5.8 6.58 7.2 6.5 7 6.5 6.5

14.2 14.2 13.815.9 16.7 17.6 17

1816.6

14.8

18.3 18.8 19.420.6 21.4

22.6 22.9 22.721.2 21.3

0

5

10

15

20

25

30

35

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015Pe

rcen

tage

of P

ast

Mon

th U

se

Years

8th graders 10th graders 12th graders

Johnston, L. D., O’Malley, P. M., Miech, R. A., Bachman, J. G., & Schulenberg, J. E. (2016). Monitoring the Future national survey results on drug use, 1975‐2015: Overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, The University of Michigan.

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Past-Month Marijuana Use Among High School Youth, by Gender: Percentages, 2003-2013

22.4

20.2 19.720.8

23.1 23.4

19.318.2

1717.9

20.121.9

25.1

22.1 22.423.4

25.925

0

5

10

15

20

25

30

35

2003 2005 2007 2009 2011 2013

Pe

rce

nta

ge

of P

ast

Mo

nth

Use

Years

Total

Female

Male

Centers for Disease Control and Prevention (CDC). 1991-2013 High School Youth Risk Behavior Survey Data. Available at http://nccd.cdc.gov/youthonline . Accessed on January 11, 2016.

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Perception of Risk, Nationally

34.5 34.3 34.6 34.232.3

29.928.6

2725.3

23.5

0

5

10

15

20

25

30

35

40

2004-05 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14

Per

cent

age

of P

erce

ptio

n of

Gre

at R

isk

Years

Percentage of Persons Aged 12 to 17 Perceiving Great Risk from Smoking Marijuana Once a

Month: 2004-05 to 2012-13

Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, National Survey on Drug Use and Health, 2004–2013.

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Perception of Harmfulness, Nationally

73.2 74.3 72 69.8 68 68.3 66.961 58.9 58

69.464.5 64.8

59.5 57.2 55.250.9

46.5 45.4 43.2

57.954.8

51.7 52.446.8 45.7 44.1

39.536.1

31.9

0

50

100

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Per

cent

age

of P

ast

Mon

th U

se

Years

8th, 10th, and 12th Graders Perception of Harmfulness from Smoking Marijuana Regularly: 2009-2015



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Perception of Availability, Nationally

39.6 37.4 39.3 39.8 41.437.9 36.9 39.1 36.9 37

70.7 69 67.4 69.3 69.4 68.4 68.8 69.7 66.9 65.6

84.9 83.9 83.9 81.1 82.1 82.2 81.6 81.4 81.3 79.5

0

50

100

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Per

cent

age

of P

ast

Mon

th U

se

Years

8th, 10th, and 12th Graders Perceived Availability of Marijuana: 2009-2015



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Risk and Protective

Factors

Risk and Protective

Factors





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Poll:Which factors are influencing

youth marijuana use in your

community?

• Positive attitudes toward marijuana use

• Perception of greater availability of marijuana

• Low parental monitoring

• Having friends who use marijuana

• Community norms favorable to substance use

• Others?

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Highlights of Risk and

Protective Factors

Related to Perceptions

of Harm

Handout: Overview of CAPT Tools on Youth Marijuana Use

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Social-Ecological Framework

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• Positive attitudes toward marijuana use1

• Intention to use marijuana2

• Belief that marijuana use will relieve tension and help relax3

• Positive attitudes towards drugs4

• Perception of greater availability of marijuana5

Individual Risk Factors

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FamilyRelationship

• Family history or current family use of marijuana (parents have ever used)6

• Low parental monitoring7,8

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• Having friends who use marijuana9,10,11,12,13

• Perceived use of marijuana among friends14Peer

Relationship

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• Community norms favorable to substance use15

• Community law enforcement permissive of substance use15

• Availability of marijuana16,17

Community Risk

Factors

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Protective Factors

• Intention not to use marijuana1

• Parental monitoring and youth perception of monitoring18,19,20,21,22

• Having fewer friends who use marijuana21

• Having parents and peers who disapprove of marijuana use23

• Perception that friends “do what is right”24

• Neighborhood cohesion25

• Traditional religious beliefs and practices26

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CAPT Decision-Support Tool

Risk and Protective Factors

Associated with Youth Marijuana

Use

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Revisiting the Poll:

Which factors are influencing

youth marijuana use in your

community?

• Positive attitudes toward marijuana use

• Perception of greater availability of marijuana

• Low parental monitoring

• Having friends who use marijuana

• Community norms favorable to substance use

• Others?

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Risk and Protective

Factors

Risk and Protective

Factors





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Poll: Which programs or strategies are

you implementingto target

perceptions of harm and/or social norms related to youth marijuana

use?

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Implementing a Combination of Strategies

Selected Risk or Protective Factor

Intervention #1

Intervention #2

Intervention #3

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Evidence-Based Programs

Multi-part/component drug-education and curriculum programs with positive outcomes related to increasing perception of harm:

• Key Element(s):

o Focus on increasing knowledge of consequences related to marijuana use27, 30

o Emphasize refusal skills27,28,29,30

Individual

Handout: Strategies to Address Youth Marijuana Use

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Evidence-Based Programs (cont.)

Multi-part/component drug-education and curriculum programs with positive outcomes related to increasingperception of harm:

• Outcomes for Youth:o A greater increase in perceived risk associated with regular

marijuana use at immediate post intervention27

o A higher percentage of participants disapproving of marijuana use at immediate post intervention and 6 month follow-up27

o Less perceived widespread peer use of marijuana28

o Fewer perceived social benefits from smoking marijuana30

Individual


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Multi-part/component drug-education and curriculum programs with positive outcomes related to increasingperception of harm:

• Outcomes for Parents: o Greater discussions with their children about how to resist peer

pressure to try marijuana28

o More changed perceptions of their child’s ability to resist peer pressure to use marijuana29

o More changed expectations that their child will try marijuana29

Individual


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Multi-component programs with positive outcomes related to reducing favorable attitudes/beliefs about marijuana use:

• Key Element(s): Emphasis on the importance of relationship building31,32 and/or school bonding33

• Outcomes:

o A lower increase in reported marijuana use in the past month at one-year and two-year follow-up32

o Fewer students intending to use marijuana, and less likely to believe in the positive consequences of their use one year after program implementation31

o Compared to students in the comparison group, participants reported less increase in intention to use marijuana33

Individual


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Elements of media programs influencing school and community norms favorable to marijuana use:• Key Element(s): Anti-marijuana advertising and in-school marketing

and communications campaigns

• Outcomes:

o Above the Influence34,35,36

Reduced 30-day use, 8th grade girls only

Reduced upward use trends among sensation seekers.

o Be Under Your Own Influence37

Fewer marijuana users in intervention schools

School/ Community

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Implementing a Combination of Strategies

Project Success38

Keep a Clear

Mind29

District-wide

Social Marketing Campaign

Perception of Harm

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Scare Tactics/Fear-Based Approaches

• Diverse perspectives and disagreement on influence of fear appeals on attitudes, intentions and behavior

• Important aspects of fear-based communications:

o Type of message

o Audience characteristics

o Recommended behavior

o Ethical considerations

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CAPT Decision-Support Tool

Strategies and Interventions to Prevent Youth Marijuana Use

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What ifevidence-

based strategiesdo not yet

exist?

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Consider the following:

• Effective strategies for other substance use issues (e.g., underage drinking)

• Theories that can inform your prevention planning

• Lessons learned from the implementation of new prevention practices for other substances

When There is Lack of Evidence...

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• Social marketing campaign targeting low perception of harm from alcohol use

• Lessons learned from tobacco and alcohol use prevention to create initiatives addressing youth marijuana use

Effective Strategies for Other Substances, and New Practices

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Moving Forward

How can we use the information discussed today to build on the approaches we are

already using to prevent youth

marijuana use?

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Questions?

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Available Resources: CAPT Tools

• Risk and Protective Factors Associated with Youth Marijuana Use http://www.samhsa.gov/capt/sites/default/files/resources/risk-protective-factors-marijuana-use.pdf

• Strategies and Interventions to Prevent Youth Marijuana Use: An At-a-Glance Resource http://www.samhsa.gov/capt/sites/default/files/resources/prevent-youth-marijuana-use-tool.pdf

• Prevention Programs That Address Marijuana Use http://www.samhsa.gov/capt/sites/default/files/resources/prevention-youth-marijuana-use.pdf

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Available Resources (cont.)

• Preventing Youth Marijuana Use: An Annotated Bibliography http://www.samhsa.gov/capt/sites/default/files/resources/bibliography-youth-marijuana-use.pdf

• Youth Marijuana Use: Consumption Consequence, and Risk and Protective Factor Data Sources http://www.samhsa.gov/capt/sites/default/files/resources/marijuana-consumption-consequence.pdf

• Applying SAMHSA’s Strategic Prevention Framework (Steps 1-3) to the Prevention of Youth Marijuana Use (handout)

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Accessing these Tools

• These tools are available to the general public on the CAPT area of the SAMHSA website (samhsa.gov/capt)

• Look under Grantee Stories, Tools, and Other Resources text).

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If you have questions or comments, please don’t hesitate to contact:

Molly Lowe

National and Cohort-Based Services Manager

SAMHSA’s CAPT

[email protected]

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Evaluation

Your feedback is very important to us!

Please click on the link below to provide feedback on this event:

https://www.surveymonkey.com/r/feedback-SP-36377

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Citations

1. Stephens, P.C., Solboda, Z., Stephens, R., Teasdale, B., Grey, S.F., Hawthorne, R.D., & Williams, J. (2009). Universal school-based substance abuse prevention programs: Modeling targeted mediators and outcomes for adolescent cigarette, alcohol and marijuana use. Drug and Alcohol Dependence, 102(1-3), 19-29.

2. Perez, A., Ariza, C., Sanchez-Martinez, F., & Nebot, M. (2010). Cannabis consumption initiation among adolescents: A longitudinal study. Addiction, 35(2), 129-134.

3. Hayaki J, Hagerty C.E., Herman, D.S., de Dios, M.A., Anderson, B.J., & Stein, M.D. (2010). Expectancies and marijuana use frequency and severity among young females. Addictive Behaviors, 35(11), 995-1000.

4. Tonin, S.L., Burrow-Sanchez, J.J., Harrison, R.S., & Kircher, J.C.(2008). The influence of attitudes, acculturation and gender on substance use for Mexican American middle school students. Addictive Behaviors, 33(7), 494-954.

5. Collins, D., Abadi, M.H., Johnson, K., Shamblen, S., & Thompson, K. (2011). Non-medical use of prescription drugs among youth in an Appalachian population: Prevalence, predictors, and implications for prevention. Journal of Drug Education, 41(3), 309-326.

6. Miller, S.M., Siegel, J. T., Hohman, Z., & Crano, W.D. (2013). Factors mediating the association of the recency of parent’s marijuana use and their adolescent children’s subsequent initiation. Psychology of Addictive Behaviors, 27(3), 848-853.

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Citations (cont.)

7. Tobler, A. L., & Komro, K. A. (2010). Trajectories of parental monitoring and communication and effects on drug use among urban young adolescents. Journal of Adolescent Health, 46(6), 560-568.

8. Pinchevsky, G. M., Arria, A. M., Caldeira, K. M., Garnier Dykstra, L. M., Vincent, K. B., & O’Grady, K. E. (2012). Marijuana exposure opportunity and initiation during college: Parent and peer influences. Prevention Science, 13, 43-54.

9. Ali, M.M., Amialchuk, A., & Dwyer, D. S. (2011). The social contagion effect of marijuana use among adolescents. PLoS One, 6(1), e16183.

10. Collins, D., Abadi, M.H., Johnson, K., Shamblen, S., & Thompson, K. (2011). Non-medical use of prescription drugs among youth in an Appalachian population: Prevalence, predictors, and implications for prevention. Journal of Drug Education, 41(3), 309-326.

11. Korhonen, T., Huizink, A. C., Dick, D.M., Pulkkinen, L., Rose, R.J., & Kapiro, J. (2008). Role of individual, peer and family factors in the use of cannabis and other illicit drugs: A longitudinal analysis among Finnish adolescent twins. Drug and Alcohol Dependence, 97(1-2), 33-43.

12. Pinchevsky, G. M., Arria, A. M., Caldeira, K. M., Garnier-Dykstra, L. M., Vincent, K. B., & O’Grady, K. E. (2012). Marijuana exposure opportunity and initiation during college: Parent and peer influences. Prevention Science, 13, 43-54.

.

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Citations (cont.)

13. Walker, D. D., Neighbors, C., Rodriguez, L. M., Stephens, R. S., Roffman, R. A. (2011). Social norms and self-efficacy among heavy using adolescent marijuana smokers. Psychology of Addictive Behaviors, 25(4), 727-732.

14. Pejnovic, F.I., Kuzman, M., Pavic, S.I., & Kern, J. (2011). Impact of environmental factors on marijuana use in 11 European countries. Croatian Medical Journal, 52(4), 446-457.

15. Van Horn, M.L., Hawkins, J.D., Arthur, M.W., & Catalano, R.F. (2007). Assessing community effects on adolescent substance use and delinquency. Journal of Community Psychology, 35(8), 924-946.

16. Fagan, A.A., Van Horn, M.L., Hawkins, J.D., & Arthur, M. (2007). Using community and family risk and protective factors for community-based prevention planning. Journal of Community Psychology, 35(4), 535-555.

17. Martino S.C., Ellickson P.L., & McCaffrey, D.F. (2008). Developmental trajectories of substance use from early to late adolescence: A comparison of rural and urban youth. Journal of Studies on Alcohol and Drugs, 69(3), 430-440.

18. Dever, B. V., Schulenberg, J. E., Dworkin, J. B., O’Malley, P.M., Kloska, D. D., & Bachman, J. G. (2012). Predicting risk-taking with and without substance use: The effects of parental monitoring, school bonding, and sports participation. Prevention Science, 13(6), 605-615.

19. Farhat, T., Simons-Morton, B., & Luk, J. W. (2011). Psychosocial correlates of adolescent marijuana use: Variations by status of marijuana use. Addictive Behaviors, 36(4), 404-407.

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Citations (cont.)

20. Tang, Z. & Orwin, R. G. (2009). Marijuana initiation among American youth and its risks as dynamic processes: Prospective findings from a national longitudinal study. Substance Use & Misuse, 44(2), 195-211.

21. White, H.R., McMorris, B.J., Catalano, R.F., Fleming, C.B., Haggerty, K.P., & Abbot, R.D. (2006). Increases in alcohol and marijuana use during the transition out of high school into emerging adulthood: The effects of leaving home, going to college and high school protective factors. Journal of Studies on Alcohol, 67(6), 810-822.

22. Yabiku, S. T., Marsiglia, F. F., Kulis, S., Parsai, M. B., Becerra,D., & del Colle, M. (2010). Parental monitoring and changes in substance use among Latino/a and Non-Latino/a pre-adolescents in the southwest. Substance Use & Misuse, 45(14), 2524-2550.

23. King, K., & Hoffman, A. R. (2012). Sex and grade level differences in marijuana use among youth. Journal of Drug Education,42(3), 361-377.

24. Dunn, M. S., Kitts, C., Lewis, S., Goodrow, B., & Scherzer, G. D. (2011). Effects of youth assets on adolescent alcohol, tobacco, marijuana use, and sexual behavior. Journal of Alcohol and Drug Education, 55(3), 23-40.

25. Clark, T. T., Nguyen, A. B., & Belgrave, F. Z. (2011). Risk and protective factors for alcohol and marijuana use among African-American rural and urban adolescents. Journal of Child & Adolescent Substance Abuse, 20, 205-220.

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Citations (cont.)

26. Nasim, A., Corona, R., Belgrave, F., Utsey, S.O., & Fallah, N. (2007). Cultural orientation as a protective factor against tobacco and marijuana smoking for African American young women. Journal of Youth & Adolescence, 36(4), 503-516.

27. Turner-Musa, J. O., Rhodes, W. A., Harper, P. T. H., & Quinton, S. L. (2008). Hip Hop to Prevent Substance Abuse and HIV among African American youth: A preliminary investigation. Journal of Drug Education, 38(4), 351-365.

28. Werch, C. E., Young, M., Clark, M., Garrett, C., Hooks, S., & Kersten, C. (1991). Effects of a take-home drug prevention program on drug-related communication and beliefs of parents and children. Journal of School Health, 61(8), 346-350.

29. Young, M., Kersten, C., & Werch, C. (1996). Evaluation of a parent child drug education program. Journal of Drug Education, 26(1), 57-68.

30. St Pierre, T.L., Kaltreider, D.L., Mark, M.M., & Aikin, K.J. (1992). Drug prevention in a community setting: A longitudinal study of the relative effectiveness of a three-year primary prevention program in boys & girls clubs across the nation. American Journal of Community Psychology, 20(6):673-706.

31. MacKinnon, D. P., Johnson, C. A., Pentz, M. A., Dwyer, J. H., Hansen, W. B., Flay, B. R.,& Wang, E. Y. I. (1991). Mediating mechanisms in a school-based drug prevention program: first-year effects of the Midwestern Prevention Project. Health Psychology, 10(3), 164.

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Citations (cont.)

32. Pentz, M. A., Dwyer, J. H., MacKinnon, D. P., Flay, B. R., Hansen, W. B., Wang, E. Y. I., & Johnson, C. A. (1989). A multicommunity trial for primary prevention of adolescent drug abuse: Effects on drug use prevalence. JAMA, 261(22), 3259-3266.

33. Petoskey, E. L., Van Stelle, K. R., & De Jong, J. A. (1998). Prevention through empowerment in a Native American community. In J. Valentine, J. A. De Jong, & N. J. Kennedy (Eds.), Substance abuse prevention in multicultural communities(pp.147-162). New York: Haworth Press.

34. Carpenter, C. S., & Pechmann, C. (2011). Exposure to the Above the Influence antidrug advertisements and adolescent marijuana use in the United States, 2006-2008. American Journal of Public Health, 101(5), 948-954.

35. Palmgreen, P., Donohew, L., Lorch, E.P., Hoyle, R.H., & Stephenson, M.T. (2001). Television campaigns and adolescent marijuana use: Tests of sensation-seeking targeting. American Journal of Public Health, 91(2), 292-296.

36. Palmgreen, P., Lorch, E.P., Stephenson, M. T., Hoyle, R. H., & Donohew, L. (2007). Effects of the Office of National Drug Control Policy's Marijuana Initiative Campaign on High-Sensation-Seeking Adolescents. American Journal of Public Health, 97(9), 1644-1649.

37. Slater, M. D., Kelly, K. J., Lawrence, F. R., Stanley, L. R., & Comello, M. L. (2011). Assessing media campaigns linking marijuana non-use with autonomy and aspirations: “Be Under Your Own Influence” and ONDCP’s “Above the Influence”. Prevention Science, 12(1), 12-22.

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Citations (cont.)

38. Morehouse, E.& Tobler, N. S. (2000). Preventing and reducing substance use among institutionalized adolescents. Adolescence, 35(137), 1-2.

39. Latkin, C., Davey-Rothwell, M., & Tobin, K. E. (2014). Behavior change at the interpersonal level. In S. Kahan, A. C. Gielen, P. J. Fagan, & L. W. Green (Eds.), Health behavior change in populations (pp. 101-119),. Baltimore, MD: Johns Hopkins University Press.

Documents

Presentation Youth Marijuana webinar Prev Week FINAL · Preventing Youth Marijuana Use ... marijuana5 Individual RiskFactors 21 Family ... Project Success38 Keep a Clear Mind29 District-wide