OBID interviews researcher Sanela Talic
What is prevention?
I think the definition of "prevention science" by the Academic Science for Prevention Network (SPAN) fully encompasses the role of this field. It is a very rich field in terms of combining and using knowledge from many disciplines to consider etiology, epidemiology, intervention design, efficacy and implementation for the prevention of a variety of health and social problems. We don't just talk about substance use prevention, but also violence, suicide, obesity, mental illness, sexual health, chronic disease, etc. We focus on behavior as a determinant of poor health and health inequality. Behavioral risk factors are important causes of non-communicable diseases (NCDs). (SPAN, 2019)
What is prevention in the field of chemical dependency?
Prevention in the field of substance use (by substance, we mean alcohol, tobacco products, inhalants, cannabis, cocaine, heroin...) are all science-based activities aimed at preventing people from starting to use substances and can help those who have already started using to prevent problems from developing.
How can prevention contribute to avoiding drug addiction?
Evidence-based prevention involves different services and processes that have been shown to consistently improve measurable outcomes. In a short time, negative health outcomes (also resulting from substance use) can be avoided by reducing risk factors (e.g., laws and norms favorable to behavior, availability (of alcohol, tobacco), some personal characteristics such as inadequate impulse control, In addition to the goals mentioned above, substance use prevention has a broader intent – to help people realize their potential and talents and keep them safe and Healthy. To put it simply, we can never know which risk factor or combination of risk factors will "push the individual across the border" and this means that we need to focus on systematic prevention (from the earliest age of the child and in different settings) and only then can we expect a positive impact from prevention efforts.
What types of prevention can be applied to different audiences?
As mentioned earlier, we all go through the process of socializing. When we're born, we don't know the language, we don't have norms and customs – we learn all of that in the process and it helps us function well in society. First, we bring into this world our »own package« – genetic susceptibility, personal traits, and we interact with different people in different environments – in our families, educational institutions, community... So in prevention science, we aim for the synergy of prevention efforts in all of these settings – schools, families, communities, workplaces, and we also have environmental and media-based prevention.
What are the characteristics of efficient prevention systems?
Very interesting and good question. Speaking from our experiences (and I think many of our colleagues share the same thoughts), we have focused too much on prevention programs, their adaptations, education in the field of prevention science, etc. and too little on "prevention systems" (sustainable infrastructure, financing, professionalization, etc.).
I often say that most of the time we are sowing asphalt – you can have the best seeds, but nothing will grow if there is no rich soil. Or vice versa – there were some efforts to establish local action groups that involve different stakeholders who decide which programs or interventions best meet their needs – but the problem was that there were no evidence-based prevention programs available. There are many factors to ensure the prevention system with quality and we are aware of this, but no information is valuable if it is not implemented in practice. Sure?
Is the cost of prevention worth it?
Definitely, yes. There are many studies on the cost-effectiveness of prevention efforts. Many of these studies emphasize the importance of supporting effective prevention programs as part of a comprehensive substance use prevention strategy. The WHO reports that non-communicable diseases kill more than 36 million people each year and 80% of these diseases share four preventable behavioural risk factors – tobacco use, harmful alcohol use, physical inactivity and unhealthy diets. The most recent article in The Lancet shows that the annual costs of $143 billion in Europe are due to the harmful use of alcohol. There are some estimates that show that the cost-effectiveness of prevention ranges from $4 to $56 per $1 spent on evidence-based prevention.
How long can a prevention program show positive results?
For example, the Unplugged school prevention program is a three-month program that has shown some positive results in terms of alcohol use and smoking. But the post-tests revealed what we already know – the results are not retained for a long time, which again brings us to the basics of prevention science – it is important to work systematically from the earliest years and take into account the different stages of children's development. I always say that we should consider prevention as a process and not as a destination. In this process, we learn about the needs of a specific community, its capabilities, opportunities... And all of this takes time. The important aspect of this process is the monitoring and evaluation of our efforts.
I see this area as the window of opportunity that could improve our work – to make better choices that would bring better results. Unfortunately, however, this part of the science of prevention is not fully utilized in practice and much of the prevention activities are still based on "what people think works".
What motivates you to work in the field of prevention?
A lot of things. First, it offers tools, addresses knowledge that can be used in practice and can impact the most vulnerable groups in our society. Garaudy said that "the person is not only what he already is, but also everything he is not yet." And the whole of society has a responsibility to offer our children the best possibilities to develop what does not yet exist. And the science of prevention can contribute to this development. Second, prevention science brings together knowledge from various disciplines – psychology, epidemiology, policy development, media literacy, social marketing, unhealthy industry tactics and strategies, advocacy, learning psychology, adult education, neuroscience, and epigenetics. You see, you never stop learning, which is why I love this area. And I had the chance to listen to one of its famous writers, Augusto Cury. In his books, he offers some great ideas that can also be helpful in our prevention work.
How can the OBID contribute to your work?
I think the best way would be to follow our work that we're probably going to do in some of your cities. We had the chance to spend two full days with very enthusiastic and motivated participants in Sao Paulo during the Freemind congress. They gave us some insight into the prevention situation in their communities and showed an interest in the science of prevention. I think your platform can serve as a good place to share our activities, work, and results and promote our work in other cities as well.
Sanela Talić is the director of prevention programs at the Institute for Research and Development "Utrip" (UTRIP). She has been involved in several EC-funded projects in the areas of addiction prevention, health promotion and healthy lifestyles, social-emotional learning, violence and injury prevention for over 10 years. She is also a researcher and PhD candidate in Prevention Science at the University of Zagreb, Croatia. She is a master instructor of the prevention programs in the Unplugged (12-14 years) and EFFEKT (parents) schools (www.effekt.org) and national coordinator and master instructor of the Strengthening Families Program of Prof Dr Karol Kumpfer (SFP), Boys and Girls Plus Program, Good Behavior Game (GBG) etc. Sanela is a member and former elected secretary of the European Society for Prevention Research (EUSPR) (two terms). Her notable achievements are especially the following: leadership in the dissemination of evidence-based prevention practices nationally and internationally, exceptional training skills, which inspire trainees to work even better in practice, an exceptional advocate for evidence-based policies and practices, nationally and internationally. Sanela was awarded the ISSUP Early Career Award at the fourth ISSUP conference in Nairobi (Kenya) in 2018.
Source: http://mds.gov.br/obid/entrevistas/sanela-talic
