Improving the reach of outreaching addiction prevention among vulnerable youngsters by region-tailored prevention strategies

The consequences of substance abuse among youngsters are substantial. Adolescent substance abuse has been associated with health problems, school drop-out, homelessness, nuisance and feelings of insecurity in the public population, and domestic violence. Consequently, societal costs of adolescent substance abuse are high. Therefore, it is important that addiction care reaches out to these individuals and provides them with early preventive interventions. Over the past few years the activities of Dutch addiction care and prevention organizations have increasingly focused on reaching out to vulnerable individuals specifically, i.e., individuals at high risk for or with early signs of problematic substance use. However, the reach of this selective or indicative prevention is not optimal and the methods used have not been standardized and scientifically evaluated. The main goal of the present project is to implement, scientifically evaluate and optimize a region-tailored approach (Rapid Assessment and Response) in addiction prevention activities, which has already been proven effective in other domains of health care, and has in recent years experimentally been used by addiction care workers for improving the reach of prevention among vulnerable youngsters. Rapid Assessment and Response (RAR) aims to improve reach amongst hidden populations by carefully assessing characteristics and needs of the target groups in a certain region, becoming connected with the target group, and seeking cooperation with a wide range of local partners (e.g., youth work, social care, local police officer, schools). In addition, it stimulates an integral approach within selective and indicated prevention work, which implies that problems experienced in other domains of life are addressed in addition to substance use problems. The aggregation of knowledge and effort of different local parties by using RAR is predicted to result in enhanced signaling of vulnerable youngsters, improved reach among target groups and an increased number of referrals to appropriate help. Using RAR in a region-tailored addiction prevention approach will be piloted in three different municipalities. IVO Addiction Research Institute and three addiction care organisations (Mondriaan, Bouman GGZ and Tactus) will cooperate in this developmental project. The proposed project consists of four stages. In the first stage the project and study is prepared. Local partners will be contacted, participating field workers, researchers, and interviewers will be trained. A monitor of preventive activities will be set up and a literature study is conducted. In stage two, the RAR method will be assessed in three different regions. Results will be discussed in a focus group meeting with all parties involved, as well as how a translation of research outcomes (assessment) into practice can be obtained (response). In stage three the prevention activities will be carried out. Results of the prevention activities will be monitored and evaluated for one year. Outcome measures include the number of reached youngsters and the achieved help- and care supply as a result of the preventive intervention on the individual level. Eventually, results will be discussed with the outreaching addiction prevention workers and the local partners in focus group meetings per region. Finally, in stage four, details of the project as well as knowledge gained from the three foregoing stages will be reported and shared. The end product of the project is a clearly written report of the developed method for region-tailored outreaching addiction prevention focusing on vulnerable groups of adolescents. This report will integrate the scientific evidence for effective methods to enhance the reach of prevention among vulnerable groups with knowledge from prevention practice in order to underpin region-tailored intervention. All gained knowledge will be transferred to policy officials, prevention workers, care facilities, professionals, patients, and other interested parties, which will be accomplished by means of short reports, fact sheets, scientific publications, notifications in newsletters and a concluding seminar.