The ComprehensiveComprehensive Approach to School Health Education

Primary Drug Prevention Primary Drug Prevention for K-12 Students for K-12 Students

and the and the Michigan Model for HealthMichigan Model for Health®®

“Just Say No” to drugs has had about as

much impact on drug use as “Have a nice day” has on clinical depression.

Goals:

Learn what works in primary drug prevention for children and youth.

Explore drug prevention lessons in the Michigan Model for Health.

Understand how to access local resources and technical assistance.

What Do We Know About What Do We Know About Drug Abuse and Children?Drug Abuse and Children?

Some drugs are medicines and must be used Some drugs are medicines and must be used correctly.correctly.

Any use of non-medicinal drugs is illegal.Any use of non-medicinal drugs is illegal. Underage use of tobacco and alcohol is illegal.Underage use of tobacco and alcohol is illegal. Any illegal drug use by minors is drug abuse. Any illegal drug use by minors is drug abuse. Preventing underage use of legal drugs is likely to Preventing underage use of legal drugs is likely to

prevent future use of illegal drugs.prevent future use of illegal drugs. The earlier drug abuse begins, the more likely The earlier drug abuse begins, the more likely

negative consequences will result.negative consequences will result. Drug abuse is linked to additional risk-taking Drug abuse is linked to additional risk-taking

behavior.behavior.

Initiation of Drug Use Before Age Initiation of Drug Use Before Age 1313

21%

24%

14% 14%

9%8%

0%

5%

10%

15%

20%

25%

Alcohol Cigarettes Marijuana

Michigan United States

2007 MI & US YRBS

Early Initiation of Drug Use*Early Initiation of Drug Use*

18%

14%

38%

26%

20%

16%

33%

24%

14% 14%

36%

31%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Alcohol Cigarettes Marijuana10 Years or Younger 11 to 12 Years13 to 14 Years 15 to 16 Years

*Among those who ever used 2007 MI YRBS

Illicit Drug Use*

*Lifetime use among students 2007 MI YRBS

223244

7687910

3833

0 10 20 30 40

Heroin

Steroids

Methamphetines

Cocaine

Club Drugs

Barbituates

Marijuana

Females

Males

Tobacco Use

0% 50% 100%

Ever Smoked

Smoked Recently*

Smoked Heavily*

Smoked at School*1997

1999

2001

2003

2007

* During previous month

1997, 1999, 2001, 2003, 2007 MI YRBS

Adversely affects development

and transition to adulthood

Alcohol &Other Drug Use:

Impact on Learning

Leads to lowered:

• Investment in homework

• Grades

• Sense of well-being

• Attention span

• Commitment & attachment to family & school

Increases:

• Absenteeism & truancy

• Likelihood for depression and/or rebellion

• Ties to peers & drug-using subcultures

• Risk-taking behaviors related to delinquency, intentional and unintentional injuries, sex

• Classroom management problems

Interferes with:

•Brain’s ability to receive, sort, and synthesize information

• Cognitive functioning

• Memory

• Sensation & perception

May directly predict dropping

out of school

Pervasive drug use threatens

positive school climate

Stiflescreativity

Suppressesambition

Thwarts imagination

Erodes self-discipline & motivation

What Does NOT WorkInformation-only

programs about negative effects of drugs

Listing & describing a menu of drugs

Affective-only programsScare tacticsTestimonies of ex-

addicts

Nonpromotion of students to the next grade

Pre-packaged curricula used in isolation

One-shot programsInconsistent

messages

What DOES WorkEnhance protective

factors; reduce risk factorsTarget gateway drugsPromote refusal skills,

anti-drug commitments, social competency

Use interactive methodsInclude parent/caregiver

component for family focus

Provide continuity and repeated reinforcement

Enhance school & family interventions with community campaigns and policy changes

Address community drug problems

Tailor age-specific, developmentally-appropriate, & culturally-sensitive programs

National Institutes of Drug Abuse, 1997

Coordinated School Health Coordinated School Health ProgramsPrograms

Family &CommunityInvolvement

PhysicalEducation

School Health

Services

Nutrition Services

Counseling, Psychological & Social Services

ComprehensiveSchoolHealth

Education

School-site Health

Promotion forStaff

HealthySchool

Environment

The ComprehensiveComprehensive Approach to School Health Education

Michigan Model Michigan Model for Healthfor Health®®

1. Model health curricula for grades K-12:

◦ Elementary manuals are organized by GRADE.

◦ Secondary modules are organized by TOPIC.

◦ All major CDC risk behaviors are addressed.

2. Infrastructure of health coordination sites statewide

A skills-based comprehensive curriculum

Designated as a “Promising Program” by the U. S. Department of Education

Aligned to Health Education Standards

Based on current research

Addresses Safe & Drug-Free Schools goals

The product of a statewide joint effort of partners from various disciplines

A living document – continuously updated

Comprehensive CurriculumA planned, sequential, age-appropriate curriculum, developed by qualified professionals to promote the development of knowledge, health-related skills, and positive attitudes toward health and well-being for students in kindergarten through grade 12.

Skill-based Instruction - explains the skill,- models the skill,- guides practice, and, - personalizes the use of the skills.

Research indicates that:Behavior change is more likely if the followingfactors are included in a health education program:

● Knowledge ● Self-efficacy

● Skills ● Environmental

SupportThe Michigan Model for Health® is based on building knowledge and skills so that students feel confident and have the self efficacy to act in a safe and healthy way.

The Ultimate Goal of the Michigan Model for Health® is that young people adopt healthy lifestyles.

Three means of meeting this goal include:

1) Meet Health

Education Standards

2) Increase and Maintain Positive Health Behaviors

3) Extend Learning & Reinforcement of Health Behaviors Beyond the

Classroom

Michigan Department of Education

Michigan Department of Community Health- Adolescent and School Health Unit- Office of Drug Control Policy- Mental Health Services- Public Health Administration

Michigan Department of Human Services

Michigan State Police Department- Office of Highway Safety Planning

Additional non-voting representatives

Implemented state-wide to 1.5 million students (even though it is a recommended, not required, curriculum)

Delivered and supported by a network of 25 Health Coordinators at ISDs, RESAs, RESDs and major school districts, all of whom are members of a state Comprehensive School Health Coordinators’ Association (CSHCA)

Oversight at state level by State Steering Committee

Published and supported by the Educational Materials Center (EMC) at Central Michigan University

Michigan Model® substance abuse lessons had a statistically significant positive impact in curtailing rates of alcohol, tobacco and marijuana use in middle school students. (Shope 1996, 1998)

The Michigan Model® was the comprehensive health program to receive an “A” designation in “Making the Grade.” (Drug Strategies 1996, rev. 1999)

Michigan Model® rated as one of the best violence prevention programs in the United States (Drug Strategies 1998)

MORE

Longitudinal data reported improvements realized in terms of student’s knowledge, peer susceptibility, alcohol and marijuana use with the implementation of the Michigan Model® (Addiction Research Institute, Wayne State University/Skillman 1999)

Michigan Model® designated a “Promising Program” by the U.S. Department of Education (2001)

Pilot study documents positive changes in nutrition knowledge and behaviors among middle school children who received Michigan Model nutrition module (Fahlman, Journal of School Health, April 2008)

Major, three-year, evaluation study begun in 2006 involving sixty school buildings in Michigan and Indiana.

Measures effectiveness of Michigan Model for Health® curriculum: Social & Emotional Health, Nutrition, Physical Activity, Safety, and Alcohol, Tobacco & Other Drugs.

Largest data set of its kind measuring risk behaviors at grades 4 & 5

Initial results indicate positive changes in drug abuse knowledge and behaviors.

Published results will be available in 2008-09

Two primary purposes of 2006-2009 revision: 1.Check for medical accuracy, modify to add new health

issues and examine to refine instructional methodology.

2.Reduce number of lessons at each grade level to ensure more consistent implementation of health education, and increase likelihood that critical content and skills are taught.

K: 53 to 21 lessons1st: 51 to 24 lessons 2nd: 53 to 20 lessons

3rd: 56 to 25 lessons4th: 53 to 26 lessons5th: 58 to 31 lessons

Revised lessons correlated to: National Health Education Standards Michigan Curricular Framework

Revised Units include: Embedded Assessments Family Resource Sheets CD-ROM including masters

for all reproducible pages, PowerPoint slides, materials photos, and active web links.

Social & Emotional Managing Strong

Feelings Showing Respect and

Caring Accepting Responsibility

Nutrition & Physical Activity Healthy Eating & Healthy Physical Activity Variety Food Groups Variety Physical Activity Balanced Physical Activity, Rest & Sleep Serving Numbers & Sizes Information Labeling Influences Food Safety Safe Physical Activity Plan for Snacks, Balanced Meals, &

Physical Activity Weight Management Advocacy MORE

Safety Pedestrian Vehicle Safety Belt

Use/Vehicle Occupant Wheeled Recreational

Safety Fire Safety Water and Sun Home and Public Safety Internet Safety Weapons/Dangerous

Objects Child Abuse Prevention

Alcohol, Tobacco & Other Drugs Medicines Poisons/Inhalants Caffeine Tobacco Alcohol Marijuana

Personal Health & Wellness Hygiene Dental Health Exercise and Rest Sun, Water and Ice Safety Safe Food Handling Medicines

Introductory sections- Why Teach Health Education- Overview of the Michigan Model for Health®

- How to Use the Manual

Social and Emotional Health

Nutrition and Physical Activity

Safety

Alcohol, Tobacco, and Other Drugs

HIV and Reproductive Health (supplements)

Lesson Number

Lesson Title

Learning Objectives

Health Standard

Lesson Synopsis

Time Requirement

Materials Needed

Column Headings: Consistentthroughout all Lesson Procedure sections

Bridging StatementOutline format:

Easy reference for experienced

teachers

Suggestion:Tips to help

teachers

Scripted: Help for new teachers or new to the

subject matter

IntroductionSection

Slide Masters:Offered in

black and white (for overhead

transparency) as well as PowerPoints

Assessments:Student self

assessments & assessment tools

for teachers

Michigan Model for Health®:Strategies to Prevent Alcohol,

Tobacco, and Other Drug Abuse

States a clear “no use” message for children Informs children about the physical, social, emotional, and legal

consequences Builds skills for refusing situations involving ATOD use Avoids media portraying underage use of drugs and utilizes

media portraying youth demonstrating a “no use” stand Addresses current information and trends in developmentally

appropriate manner Draws on best practice in drug abuse prevention

Safe use of medicines (K, 1) Poisoning prevention (K, 1, 3) Inhalant prevention (3, 5) Caffeine cautions (2, 6) Tobacco prevention (1-6) Avoidance of secondhand smoke (1, 2, 4) Alcohol prevention (2-6) Media literacy (4, 6) Refusal skills (3, 4, 6) Families and alcohol (3, 4, 6) Avoidance of impaired drivers (5, 6) Marijuana prevention (6)

Michigan Model for Health®:Alcohol, Tobacco, and Other Drug Abuse

Prevention Topics

There are a total 19 titles available at the secondary level of the Michigan Model®:nine modules at grades 7-8ten modules at grades 9-12

Modules vary in size from 4 to 22 lessons, depending on the subject matter and options for instruction.

The goals of this 7-lesson module are that students will: Understand the health benefits of abstaining from tobacco use. Understand the health, legal, social and financial issues related to tobacco use. Analyze the influences to use tobacco and demonstrate ways to counter these negative influences. Apply their knowledge of tobacco and their skills to promote the norm of abstinence from tobacco use. Utilize the skills needed to abstain from tobacco use and support others who choose to abstain. Utilize the skills needed to support others who want to quit.

“It's No Mystery: Tobacco Is a Killer”Tobacco Prevention

Module for Grades 7 and 8

The goals of this 13-lesson module are that students will: Understand the rules and laws related to alcohol, tobacco, and other drugs and apply them in their homes, schools, and communities. Understand the influences that promote alcohol, tobacco, and other drug use in young people. Understand the potential health, social, and legal consequences of alcohol, tobacco, and other drug use. Review and teach four important skills needed to live a drug-free lifestyle. Apply knowledge and skills in promoting drug-free messages to their peers. Identify and locate reliable sources of information and assistance for drug-related issues. Make personal commitments to living drug free.

“Protect A Friend–Share Your Skills”Alcohol, Tobacco, and Other Drug Prevention

Module for Grades 7 and 8

The goals of this 6-lesson module are that students will: Understand the health benefits of abstaining from tobacco use. Apply their knowledge of tobacco in preparing a campaign to reduce or eliminate tobacco use among their peers, at youth activities and in the community. Utilize the skills needed to abstain from tobacco use and encourage others to abstain. Utilize the skills needed to quit using tobacco and encourage others to quit.

“Teens Campaign Against Tobacco”Tobacco Prevention

Module for Grades 9-12

The goals of this 15-lesson module are that students will: Comprehend the physical, emotional, social, and economic consequences of alcohol, tobacco, and other drug use. Analyze the impact of the school and community environment on the problem of alcohol, tobacco, and other drug use. Understand the legal issues related to alcohol, tobacco, and other drug use among adolescents. Research topics related to alcohol, tobacco, and other drug use by using print materials, interviews, and technology and will synthesize their findings. Apply assertive communication, refusal, and problem-solving skills to situations related to alcohol, tobacco, and other drug use.

continued

“Teens Voice Solutions to the Problem of Alcohol, Tobacco, and Other Drugs”

Substance Abuse Prevention Grades 9-12

Goals continued: Apply problem-solving skills to the social problem of alcohol, tobacco, and other drug use among adolescents. Propose possible solutions for reducing alcohol, tobacco, and other drug use among adolescents. Evaluate possible solutions to the problem of alcohol, tobacco, and other drug use among adolescents to identify the solution most likely to succeed. Apply their knowledge and skills by presenting a proposed solution to the problem of alcohol, tobacco, and other drug use to school and/or community representatives.

“Teens Voice Solutions to the Problem of Alcohol, Tobacco, and Other Drugs”

Substance Abuse Prevention Grades 9-12

Skills-based

Effective

Sequential K-12

Aligned to Health Education Standards and Grade Level Content Expectations and Guidelines

Based on research

Comprehensive

Current and Accurate

The ComprehensiveComprehensive Approach to School Health Education

Let’s try out an

activity!

Refusal Skills Grade 5

Stand Up for Yourself

Say “No” to Tobacco and Other Drugs:

Say a direct “No.” Repeat the same phrase over

and over. Suggest another activity. Give a reason.

◦ Give a fact.◦ State your feelings

or opinion. Walk away.

How to say “no” How to say “no” firmly:firmly:

• Use a firm voice and speak loudly, but don’t shout.

• Look the person straight in the eye.

• Stand tall.

Skills-Based InstructionSkills-Based Instruction

1.1. IntroduceIntroduceMotivateMotivateExplainExplain

2.2. ModelModelDemonstrateDemonstrateCheck for UnderstandingCheck for Understanding

3.3. PracticePracticeGuided Practice With Guided Practice With

FeedbackFeedback4.4. ApplyApply

Use in real lifeUse in real life

Refusal Skills Practice

Refusers Listen as I try to get

you to do something. Respond to me by using

any of the five refusal strategies.

Afterwards, you will receive feedback.

Observers Watch and listen as the

refuser responds. Say nothing. Afterwards, be prepared

to give feedback about what was effective and what could be improved.

Practice Situation 1You are walking across the playground

during recess looking for something to do. Two students approach you: Taylor and Maria. They are people you really like. Taylor says, “We have some cigarettes. Do you want to go smoke with us behind the school? How will you say no?

5-ATOD-4

Practice Situation 2You are helping your older brother wash his

car. Some of his friends stop by to talk. They are drinking beer. One of them asks you if you are cool enough to have a beer with them. How will you say no?

4-ATOD-5

Regional Regional ComprehensiveComprehensive

School Health School Health Coordination Coordination

SitesSites

Next Steps: What are your next steps for improving the health

of students in your role?

Who might you partner with in this effort?

What assistance would you like in accomplishing your goals?

Contact:

Wendy L. Sellers, RN, MA, CPC

Comprehensive School Health Coordinator, Eaton ISD

517-541-8768 or wsellers@eaton.k12.mi.us

www.michiganmodel.org