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Promoting health with campus substance use policy
- 1. Promoting Health with Campus Substance Use Policy Dan Reist, CARBC Tim Dyck, CARBC A Framework for Thought and Action
- 2. First, in a series of 4 discussion papers A framework for thought and action
- 3. The Okanagan Charter understands health promotion as endeavors that enable people to increase control over their health and the factors that influence it move beyond a focus on individual behavior towards a wide range of social and environmental interventions A framework for thought and action
- 4. A framework for thought and action HP Orientation Determinants Focus Interventions Behaviour/lifestyle change Individual health behaviour Individual attitudes, beliefs and behaviour Active (require action on part of target population) Environmental enhancement Physical and social environment Environmental hygiene/safety and social supports Passive Socio-ecological approach Fit between individual needs and environmental resources available Integration of behavioural and environmental strategies Combination of active and passive Adapted from Stokols. (1996). Translating social ecological theory into guidelines for community health promotion. Am J of Health Promotion 10, 287.
- 5. Socio-ecological: fit between individual needs and environmental resources available Bruce Alexander: “profound interdependence between individual and society” A framework for thought and action If your campus is an ecosystem and members of the campus community each need to find a balance between vital but competing needs, what does health promotion look like? Feel like?
- 6. A framework for thought and action When you start to think of benefit and risk as intersecting factors, what new insights or questions emerge?
- 7. A framework for thought and action In the policy sphere… … how can we respond when community views compete with expert advice? … how can power be used to support empowerment and health?
- 8. A framework for thought and action Forthcoming CCSU discussion papers will address three interdependent, complementary policy domains.
- 9. Thank you! Tim Dyck: tdyck@uvic.ca Dan Reist: dreist@uvic.ca Changing the Culture of Substance Use healthycampuses.ca A framework for thought and action
Hinweis der Redaktion
- In this session we want to acquaint you with a tool that seeks to apply the Okanagan Charter’s approach in addressing substance use. It’s a policy discussion document emerging from the Changing the Culture of Substance Use project, CCSU as we tend to call it. CCSU: an HM|HC initiative to build sustained capacity in campus communities of practice for cultivating climates conducive to healthier relationships with substances. [[11+ campus groups are involved so far in different endeavors, learning alongside each other: you can get a sense of what they have been doing at the Pop-Up market later this afternoon; I invite you all to pay them a visit in the downstairs concourse during that session.]] CCSU has been funded by the BC MoH out of its concern to reduce use-related harm in campus settings. The Ministry regards policy as a useful mechanism for shaping environments less liable to riskier patterns of use and has encouraged us to promote sound policy to that end. This paper is the first in a series of 4 discussion papers to respond to that challenge and attempts to lay out a framework for appropriate employment of healthy campus policy pertinent to substance use (incl. – but not only – policies that explicitly refer to substance use). The paper articulates a fair bit of its conceptual underpinnings, but rather than walk you through the paper, we’re going to elaborate a bit more on its theoretical perspective. First we have a video for you to illustrate the CCSU project and the cultural context for campus policy efforts relevant to substance use: Under our influence: shifting a culture, https://healthycampuses.ca/resource/under-our-influence-changing-our-culture/.
- Okanagan Charter (p.4, and this discussion paper, p.3) concurs with WHO on health & health promotion: viewing health in a more inclusive, holistic, and positive salutogenic (wellness) frame rather than staying within a more narrow, negatively-focused pathogenic (illness, absence of disease) paradigm, where the preoccupation is with harm viewing people as active agents rather than passive patients, as interdependent social actors in community and not as insular individuals unaffected by their surroundings So (slide) health promotion is about helping people as individuals and communities to better manage their personal and shared health and better affect/have an impact on the factors that influence well-being. Health promotion initiatives are also of a cultural, contextual nature, to improve conditions, settings, make their contribution to health more beneficial, less detrimental
- A simple reading of Stokols’ table would suggest the socio-ecological approach simply combines the behaviour change and environmental approaches. But on reflection this combination unleashes a world of complexity. In Changing the Culture of Substance Use we have embraced that complexity and seek to explore its implications, including for how we approach policy.
- In defining the cause of addiction, Bruce Alexander references the breakdown in psychosocial integration which sought to reconcile “people’s vital needs for social belonging with their equally vital needs for individual autonomy and achievement.” As in the socio-ecological approach we see this combining of competing interests that result in a complex equilibrium that can be thrown out of balance. Pair-share question – quick debrief
- Historically the health discourse about substance use has been a risk discourse – how substance use can harm your health. [[Often that has esp. been about how bad that harm can be than about how likely it is to occur, with a tendency to overstate on both counts.]] More recently the need to recognize potential benefits was added with benefits and risks arranged on a continuum from beneficial use to clearly harmful use. But risk and benefit are not end points on a single continuum – they are separate intersecting continua. [[So, e.g., some use of lower risk may also be minimally beneficial, while some involving higher risk may appeal because of greater gains to be experienced.]] This complexity in the phenomena of substance use suggests the propriety of considering various issues, and posing distinct questions around, and entertaining different responses to, different situations. Pair-share question – quick debrief
- Quote from: Nilsson, L. (2005). The Roles of Participation and Dialogue in Health Promoting Schools: Cases from Sweden. In S. Clift & B. B. Jensen (Eds.), The Health Promoting School: International Advances in Theory, Evaluation and Practice (pp. 253–269). Copenhagen: Danish University of Education Press. The theme of empowerment has been an essential part of health promotion discourse since the Ottawa Charter (1986). And policy studies suggest policy is most effective when it is a reflection of the community rather than something imposed on the community. But it is not without its tensions. Pair-share question – quick debrief
- Paper identifies three interdependent, complementary policy domains for progressing in health relative to substance use (these domains to be addressed in forthcoming CCSU discussion papers) People might expect focus right from the start on the regulatory aspect, but it is in our judgment critically important to appreciate the impact of initiatives in the other domains and realize that when a campus establishes a healthy environment on those counts/fronts, not nearly so much may be needed in explicit direct formal regulation. We invite you to read the paper carefully at your convenience and begin to discuss with your campus colleagues its possible helpfulness in contributing to your campus’s approach to addressing substance use-related concerns.
- Feedback on this framework is most welcome.