Federal Funding to Support Research of Adventure

Programming and Experiential Education:

The Why’s and How To’s

Aleta L. Meyer, Ph.D.Health Scientist Administrator

(e.g, Program Official, Cheerleader)Prevention Research Branch

National Institute on Drug AbuseDepartment of Health and Human Services

# 1 What is NIDA and what does it have to do with adventure

programming and experiential education?

National Institutes of Health(a sampling)

• National Cancer Institute (NCI)• National Institute on Child and Human

Development (NICHD)• National Institute of Mental Health (NIMH)• National Institute on Diabetes and

Digestive and Kidney Disease (NIDDK)• National Institute on Heart , Lung, and

Blood Infections (NHLBI)• National Institute of Drug Abuse (NIDA)

The Science of Addiction Brochure

• Office of Science Policy and Communication– Knowledge Transfer Goals – Draws from research done by all Divisions

• Research done through:– Program Announcements (PA)– Request for Proposals Announcements (RFA)– Intramural Research– Small Business Grants (SBIRs/STTRs)

• Walk Through Content Application to Current World ViewQuestion: How and what is relevant to the work of

adventure programming and experiential education?

Exercise that pre-frontal cortex!!

DESPR Organization and Mission

EPIDEMIOLOGY RESEARCH BRANCH

PREVENTION RESEARCH BRANCH SERVICES RESEARCH BRANCH

DESPR promotes epidemiology, services and

prevention research to understand and address the range

of problems related to drug abuse, in order to improve public health.

DESPR’s Vision is to Promote --

Extraordinary Extraordinary Public Health Public Health

Research to Eradicate Research to Eradicate Drug AbuseDrug Abuse

Extraordinary Extraordinary Public Health Public Health

Research to Eradicate Research to Eradicate Drug AbuseDrug Abuse

DESPR: Major Research Questions

1. THEORIES• What new theories inform our

research?

2. INTERACTIONS• What intrapersonal and environmental

factors interact across development?

3. BLENDING• How can we blend science and services

to measurably impact public health outcomes?

New Opportunities:

• New Theories Economics &

organization/management Neurobehavioral disinhibition Measuring severity of drug

addiction Geo-mapping drug abuse and

risk factors Exercise and drug abuse

prevention

New Opportunities:

Interactions Implementation

science Gene-environment-

development studies Built environment and

individual factors

New Opportunities:

• Science to Services Medical settings– Screening (especially SBIRTs)– Prescription drug abuse

(especially opioids) HIV interventions among drug

abusers Drug abuse services in criminal

justice settings

Division of Epidemiology, Services and Prevention

Research

Promoting Extraordinary Public Health Research to

Eradicate Drug Abuse

Promoting Extraordinary Public Health Research to

Eradicate Drug Abuse

#2Given what you know about adventure

programming and experiential education….

….how could Extraordinary Extraordinary research that makes a difference happen without them??

• Core Experiential Learning Theory Assertions:– The actual behavior is elicited in context with real-

life contingencies• Behavioral reinforcement is built-in to the activity

– Effective use of metaphors promotes transfer across contexts

– Learning styles of youth favor experiential strategies

#3The Time is Ripe!

• NIDA is investing in the development of a research portfolio that looks at potential role of physical activity, healthy leisure, outdoor adventure, and restorative recreation in the prevention of drug use

• SA Treatment and Physical Activity Science Meeting in December 2007– PA and relapse prevention – PA and healing of reward-pleasure circuitry

• Prevention Science Meeting June 5 & 6, 2008

Can Physical Activity and Exercise Prevent Drug Abuse?

Promoting a Full Range of Science to Inform Prevention

Draft Agenda• Welcome from NIDA

– 3 Divisions and Why Physical Activity of Interest

• Panel 1: Informing Drug Abuse Prevention Through Research on the Epidemiology and Etiology of Physical Activity and Substance Use– Physical Activity from Cells to Neighborhoods: Setting

the Stage– The Physiology/Neurobiology of Physical Activity in

Humans– Trends in Physical Activity, Substance Abuse, and the

Interaction Between Them: Data from Monitoring the Future

Draft Agenda Contd.

• Panel 2: Show and Tell of Technological Tools to Help Assess Physical Activity: Product Demonstrations– The Pros and Cons of Physical Activity

Assessments: An Overview– Integrated Measurement System (IMS) to

Assess Physical Activity– Population-Scale Physical Activity

Measurement Using Mobile Phones– Geospatial Analysis of Physical Activity– Measuring the Restorative Character of

Nature-Based Activity

Draft Agenda Contd.

• Panel 3: The Potential Role of Physical Activity, Attention, and Other Cognitive Processes in Preventing Drug Abuse– Exercise and Attention Disorders– Physical Activity and Cognition Across the

Lifespan– Motor and Physical Instructional

Strategies for Young Children– Effectiveness of Social-Emotional

Learning on Impulse Control

Draft Agenda Contd.• Panel 4: Physical Activity and Mood:

Implications for Prevention– The Physiology/Neurobiology of Stress and Physical Activity in

Animal Research– Exercise, Depression and Nicotine Treatment– Physical Activity and Prevention of Internalizing Disorders

• Panel 5: Physical Activity and Reward Mechanisms: A Model for Prevention Intervention Development– Exercise as an Alternative to Drug Seeking in Young

Animals– The Effect of Enhanced Environment on Drug

Seeking and Sensation Seeking Behavior– Experiential Approaches and Motivation

Draft Agenda Contd.

• Panel 6: Physical Activity in Prevention Interventions: Understanding the Context– Health Wise and Time Wise: Teaching Adolescents to

Structure and Use Their Leisure Time– Creating Supports for Physical Activity in School

Settings– School Environment and Obesity: The HEALTHY Study

to Lower Diabetes Risk in Youth– School-Community Partnerships to Prevent

Cardiovascular Disease and Obesity in Girls Through Physical Activity

– Use of Public Spaces: Experiences of Diverse Ethnic Groups

• What Have We Learned and Next Steps?

#4Lessons Learned in Moving Prevention Beyond Good

Intentions• Prevention Makes Sense BUT….

– How do we know it works?• For whom, under what conditions, and when?

– Not as provocative as treatment• Benefits not as concrete• Not crisis driven

– How do we get people to spend scarce resources of time, energy, and money?

Creation of Prevention Research Branch and Development of Research

Portfolio (~1990)• Investigator Initiated Research

– Program Announcements for Preventive Interventions for Substance Abuse Prevention• R-01• R-21• R-03

– Specific RFA’s with set-asides– Mentorship/Training (K-series; Diversity

supplements)– FAST TRACK for new investigators– Small Business Grants (SBIRs/STTRs)

Mission and Purpose of the Prevention Research Branch

• “…to support a developmentally grounded program of research on the prevention of the initiation of drug use, progression to abuse and dependence, and transmission of drug-related HIV infection.…” (p. 4)

Noteworthy Tidbits• “To advance the field, novel interventions must

build on basic science findings from diverse fields…” (p. 5)

• Universal, selected, and indicated • Underdeveloped areas:

– Developmental transitions– Differential effectiveness – Fidelity of implementation– Emerging technologies

• Question: What does adventure programming and experiential education do that is relevant to NIDA prevention research priorities?

#5Going Beyond Best

Practices and Evidence-Based Programs

PRINCIPLES OF PREVENTION

Clearly Established Principles

• Arrived at from an extensive literature review of articles from NIDA funded research

• Reviewed by an expert scientific panel

• Reviewed by a professional practitioner panel

• Resulted in 18 principles

Risk and Protective Factors

• Prevention programs should– enhance protective factors and reverse

or reduce risk factors– address all forms of drug abuse, alone or

in combination– Address the drug abuse problems of the

local community by targeting modifiable risk factors and strengthening protective factors

– Be tailored to address the risks specific to the target population

Principles Related to:

Prevention Planning

• Family programs should– Enhance family bonding, parenting skills, and

communication

• School Programs should be specific to the developmental status of the children– Before/during the elementary school years: self

control, emotional awareness, problem solving, communication & academic readiness/competence

– Middle, junior high, and high school: peer relations, study habits and academic support, communication, self-efficacy and assertiveness, drug resistance skills

Principles Related to:

Prevention Planning

• Community Programs – Aimed at the general population during key

transition points (e.g, moving to junior high) can be beneficial for those at all levels of risk

– That combine 2 or more effective programs (e.g., school and family component) can be more effective than one program

– When using multiple context to implement programs, policies and practices consistent messages should be presented across settings

Principles Related to:

Prevention Program Delivery

• When communities select programs to meet their needs, the implementation should retain the core elements of the original program

• Prevention is an on-going effort with repeated programming over time to reinforce earlier goals and develop new skills

• Teacher training in classroom management is a critical school-based prevention strategy

• Evidence based prevention interventions are cost effective

Principles Related to:

Emerging Principles• Preventive interventions can have long term

effects• Preventive interventions can have cross over

effects• Early intervention may alter the life course

trajectory in a positive direction• High risk populations may benefit the most

from prevention interventions• Prevention interventions can influence

physiological functioning• Drug abuse prevention can be HIV

prevention• Environment can be a natural intervention

Preventive Interventions Can Have Long Term

Effects

Preventive Interventions Can Have Cross Over

Effects

Early Intervention May Alter The Life Course Trajectory In

A Positive Direction

High Risk Populations May Benefit The Most From

Prevention Interventions

Prevention Interventions Can Influence

Physiological Functioning

Drug Abuse Prevention Can Be HIV Prevention

Environment Can Be A Natural Intervention

#6Expanding Our Understanding of

Prevention, Health Promotion, and Positive Youth Development

• Moving Beyond– A focus on individuals– A focus on programs – Conceptual models based on early aggression

• Moving Toward– Health Promotion Across Domains– Positive Youth Development– Conceptual Models Based on New Science from the

Micro to the Macro– Systems-Level Change

Evidence-Based Kernels and Behavior Vaccines (Embry,

2004)• Evidence-based kernels are irreducible units of behavior-change

technology, and they can be put together into behavioral vaccines (daily practices) with powerful longitudinal results.

• Breadth of reach (self-directed, dyadic, group, community)

• Multi-level Approach– Level One – Cultural Modeling– Level Two – Brief Tools– Level Three – Narrow Focus Tools– Level Four – Broad Focus Tools– Level Five – Intensive Tools

Related Paradigm Shifts

• Public Health Model vs. Medical Model– Curve Shifters

• Supply-Push vs. Demand-Pull

• Public Health Approach vs. Service Development Model

“If we spend so lavishly on medical care and we care so much about

health, why are we so unhealthy?” (Cohen & Farley, 2005)

• A public health approach used to address preventable chronic diseases Shifting the Curve

• A focus on environmental contexts that serve as cues or triggers for behaviors that are risks for health or are health promoting– Environments can be physical or social

• Example of heart disease– What aspects of our environment make it easy to

do the things that put us at risk for heart disease?

Bell Curves• Basic shape of bell curve

– High and low ‘tails’ of extreme behavior– Mean or average in the middle (at the height of

the curve)• Example of eating salt

– A medical approach would focus on changing ALL the unhealthy behaviors of people at the high end (in addition to medications)

• A focus on getting rid of the tail at the right of the curve– A public health approach would focus on

changing small behaviors of ALL people• A focus on shifting the mean of the curve to the left

– This reduces level of risk for all– This moves the ‘extreme’ tail farther to the left, so even

though the same number of people, they are at less risk

• Greater reduction of public health burden of heart disease when mean is shifted (than when efforts are focused on those at highest risk)

Curve Shifters• Curve shifters are changes in the physical

and social environment that move the curve to the left– More sidewalks, mass transit – Time in schedule for taking a walk with

family/friends

• Not surprisingly, changing the environment to support healthy behavior is easier said than done

• Even so, it is a powerful tool for thinking about how we can prevent youth violence and/or bullying

Developing Effective Prevention Services for the Real World

(Sandler et al., 2005)

• Prevention Research Cycle– Description of the problem– Development of intervention– Experimental test– Experimental test in service setting– Adoption and implementation

• Problems with this model (e.g., on-going services research)– Has not made a dent in prevalance at

population level– Not being adopted / Sustainability issues

Prevention Service Development Model

• Service Marketing Perspective considers customer input at all stages (both ultimate client who is recipient and the agency that adopts)

• Front-end planning – Organizational mission and goals?– Idea generation– Concept development – Feasibility Analysis

• New Phases: Prototype Development and Testing; Introduction to the Market; Post Introduction Evaluation

Small Business Approaches• Small Business Innovation Research

(SBIR) / Small Business Technology Transfer Research (STTR)

• Goal: Promote small businesses through innovation and technology, to “spread the news” about what works

• Small businesses create the applied possibilities, after Ivory Tower researchers create the concept

• Example: Evidence-based programs– Test on new populations and settings– Create marketing and implementation opportunities

for greater use/dissemination

# 7What are priority areas of

hypothesis-testing for adventure programming and experiential

education?

• Specific Areas of Research Interest (pp. 6-9)

• Question: What would the little ‘line items’ be for adventure programming and experiential education look like? – WRITE THESE DOWN AND GET A COPY TO ME

Food for Thought• Testing Experiential Learning Approaches

– Comparison of EBPs with and without EE

• Additive Effects Use of metaphors/language from school-based prevention curriculum to field trips

• Diffuse Binge Drinking with Rites of Passage• Teach parents how to facilitate ‘natural high’

experiences to promote competence and transfer across settings (and over time)– E Sharp’s research on leisure guidance from

parents

• Event-Affect Links– Social-Emotional-Information Processing

• Relational Frame Theory / Contextual Psychology– Move from belief we need to change beliefs or

thoughts before behavior will change– Focus on function over form– Have you feet follow values, not thoughts

• Positive Risk-Taking • Learning Orientation Toward Goals• Possible Selves / Willingness to Fail• Mindfulness

REPEAT MESSAGE:

Get Ready The Time is Ripe!!

Final Question: How many people have said something like this

“Opportunity favors the prepared…”Who were they and what did they

say?

Contact information

• meyera2@nida.nih.gov• 301-402-1725

• Active Living Research Meeting April 9-11, 2008, Washington DC

• Society for Prevention Research Meeting May 28-30, San Francisco CA