Is the provision of information enough to reduce risky behaviours in young people?

Drugs Kill, photo by Flikr user Randy Edwards

The government’s drug strategy talks about ensuring schools provide accurate information on drugs and alcohol through drug education as a core element in its attempts to reduce drug use, but is does the evidence suggest that information provision will work?

The Department for Education have commissioned the Centre for Understanding Behaviour Change to produce a review looking at research focused on raising awareness of the consequences of risk taking behaviours and studies using a social norms approach.

The report finds that focusing on providing information is more successful at changing knowledge and perceptions than changing actual behaviour, and this is particularly true on programmes that focus on the consequences approach.

This is something we’ve been clear about for some time, we consistently point out that emphasising knowledge and health harms (particularly extreme harms) without building up protective factors, skills and values  and reducing risk factors have a history of being ineffective.

The report suggests that the consequence approach – despite the lack of evidence for it – continues to be widely used, and while there are strong advocates for social norms it remains an under-researched approach.  They go on to argue:

The limitations that have been highlighted do not mean that these approaches cannot be useful or successful, especially as part of a broader prevention programme.

Despite the wider lessons being reasonably clear the following set of questions posed by the review makes clear there are a number of very important knowledge gaps:

  • Where consequence-based or social norms-based approaches have been found to be unsuccessful, is this due the approach itself, to the behaviour that it tries to deter, or to the method of delivery? 
  • Would the same programme have different effects if it were delivered in two different ways?
  • What rate do programme effects deteriorate at, and are there any factors that might alleviate that deterioration?
  • Do the same interventions have different effects on different age groups or cohorts? How much does programme success hinge on implementation at the correct time? 
  • Do interventions conducted in other countries (mainly the United States) translate directly into a UK context?
  • What is the effectiveness of interventions in reducing the future consequences and harm associated with risky behaviour, rather than (or in addition to) the prevalence of it?

Conclusions

The authors main policy and practice conclusions are, I think, a very useful reminder to us all in the prevention field about some of the broad principles we can use to develop more effective interventions.

They argues that the timing of the intervention is critical, it needs to be earlier than the risky behaviour being targeted, but point out that too early and the intervention could be wasted.

Schools offer both protection from and exposure to risky behaviours and as such should be a useful setting to identify target populations.

To be more likely to work programmes should be interactive rather than passive and didactic.

Information on consequences isn’t sufficient.

The social norms approach may be a more promising way forward, but there is still more research to be done before that conclusion can be definitive.

We, in the UK, could do with more RCTs testing the effectiveness of interventions over a suitable time period.

Their final conclusion is I think the most important:

In reality, policy-makers are not faced with a choice between the two approaches examined in this report, nor are they faced with a choice between the provision of information and other types of intervention. It appears likely that an effective programme would combine a number of different approaches, including (but not limited to) the two types of approach that have been considered in this report.

This hits the nail on the head; we should not see prevention as a single intervention, particularly one that focuses on the provision of information.  Rather we need a broad prevention strategy, which is based around an understanding of what is the most likely interventions to reduce risky behaviours, enhance protective factors and draw together the variety of settings that help young people with their development.

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