Risk Factor to Best Practices Matrix
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Suggested Strategies and Guiding Principles

This matrix identifies best practices that have been associated with risk factors, lists suggested or sample strategies and identifies guiding principles. The best practices are hyperlinked to the resource sheets. The (Example:) programs underlined in blue are linked to sites or documents regarding those programs.  This matrix was co-developed with support from Central CAPT and The Wisconsin Clearinghouse for Prevention Resources.

Community Risk Factors

Risk Factor

Best Practices

Strategies
(Examples - Partial List)

Guiding Principles (CSAP)

Availability

The more available drugs are in the community, the higher the risk that young people in the community will abuse drugs. Perceived availability is also associated with risk.

Environmental Approaches

Social Norms 

• Reduce Access
• Monitor Activities
• Change Hours and Days of Sale
• Change Conditions of Availability
• Responsible Beverage Service
• Retailer Directed Interventions
• Promote retailer compliance checks
• Keg Registration (Example: UW- Madison, PACE, http://pace.uhs.wisc.edu/index.php
• Limit location and density of retail outlets
• Restrictions on advertising in public places

• Develop integrated, comprehensive prevention strategies rather than one-time community-based events.
• Control the environment around schools and other areas where youth gather. (Example: Safe Places, www.safesound.org)
• Promote youth development through collaborative relationships (Example: Community Advocates inc. http://my.execpc.com/~comadvo / or The Brighter Futures Initiative)
• Ensure planning and clear understanding for coalition effectiveness
• Organize at the neighborhood level (Example: Northwood's Coalition  or Community Trials)  PDF
• Communicate peer norms against the use of alcohol and illicit drugs

Community Laws / Norms

Community norms-the attitudes and policies a community holds about drug use and crime-are communicated in a variety of ways: through laws, written policies, through informal practices, and through the expectations parents and other members of the community have of young people.

Social Marketing

Social Norms

Environmental Approaches

Community Service

• Economic Interventions ( Example: Wisconsin's' Proposed Beer Tax) PDF
• Tobacco-free Environment Policies
• Zero Tolerance Laws
• Blood Alcohol Concentration Laws
• Enactment of  Deterrence Laws
• Develop community awareness and media efforts
  (Example: University of Wisconsin-Whitewater, Choices and Voices) or (Underage Drinking Education Watch Program - Luxemburg-Casco Community http://www.udew.org/index.html )

• Communicate clear school policy
• Communicate peer norms against use
• Use mass media appropriately
• Broadcast messages frequently over an extended period of time.
• Avoid the use of authority figures
• Use community groups to provide positive and negative feedback to merchants.
• Target Underage Drivers (Example: Youth Alcohol Enforcement and Education Road R.A.V.E.)
• Correct misperceptions about the prevalence of use in conjunction with other educational approaches

Transitions and Mobility

Even normal school transitions predict increases in problem behaviors. When children move from one elementary school to middle or from middle to high school, significant increases in the rate of drug use, school misbehavior, and delinquency result. Communities with high rates of mobility appear to be linked to an increased risk for drugs and crime.

Mentoring

Personal and Social Skills Training

School Climate Change Approaches

• Cross-age prevention programs
• Build social and personal skills
• Communicate peer norms against the use of alcohol and illicit drugs
• Transfer Student Programs
• Transfer/New Family Programs
• Promote awareness of school /community resources

• Provide structured time with adults through mentoring
• Design culturally sensitive interventions (example: PARITY: Promoting Academic Retention for Indian Tribal Youth or Zibi Quest Program, Bad River, WI)
• Provide positive alternatives to help youth in high-risk environments develop skills
• Provide opportunities to practice new skills
• Involve parents in school-based approaches (Safe and Sound-Milwaukee www.safesound.org )
• Provide transportation to prevention programs
• Increase positive attitudes through community service

Low Neighborhood Attachment / Community Disorganization

Higher rates of drug problems, juvenile delinquency, and violence occur in communities or neighborhoods where people have little attachment to the community, where rates of vandalism are high, and where there is low surveillance of public places. These conditions are not limited to low income neighborhoods; they can also be found in wealthier neighborhoods

Environmental Approaches

Community Service

Leadership and Youth Development

Alternative Activities

• Support programs that address youth violence (Safe & Sound - Milwaukee www.safesound.org )
• Plan "get to know your neighbor" events
• Promote Family Resource Centers Example: Wisconsin Family Resource Centers)
• Encourage law enforcement to be present and supervise public places
• Conduct community readiness surveys (Example: Tri-ethnic Center PDF,  http://www.triethniccenter.colostate.edu/)
• Promote Youth Leadership (Example: Wisc. Regional Teen Institute http://www.uwec.edu/ce/wrti.htm ) PDF

• Support neighborhood development
• Support community coalitions and community efforts (Example: Communities That Care PDF or Ohio Bridgebuilders)
• Mobilize and engage diverse members of the community in positive youth development (Example: FACTS Family and Community Town Suppers or GLITC Intercultural Leadership Initiative - Great Lakes Inter-Tribal Council )
• Encourage the cultural development of the community (Example: Strengthening Multi-Ethnic Families or Okiyapi: Devils Lake Sioux Community Partnership Project)
• Promote involvement in positive youth oriented school and community organizations and activities
• Provide positive alternatives for high risk youth

Extreme Economic Deprivation

Children who live in deteriorating and crime ridden neighborhoods characterized by extreme poverty are more likely to develop problems with delinquency, teen pregnancy, school dropout, and violence. Children who live in these areas-and have behavior and adjustments problems early in life-are also more likely to have problems with drugs later on.

Family Strengthening

School Climate Change

High Risk Youth Programs

• Develop parenting skills and make neighborhoods safer (Example: CASASTART or Head Start   PDF )
• Train parents to listen and interact
• Train parents to use positive and consistent discipline
• Provide "wraparound' services for students with intensive needs (Example: Project Achieve or Milwaukee Wrap-Around)

• Target the entire family
• Help develop bonds among parents in programs: provide meals, transportation, and small gifts; sponsor family outings; and ensure cultural sensitivity. (Example: Quantum Opportunities Program)
• Provide positive alternatives to help youth in high risk environments develop personal and social skills
• Recognize that relationships exist between substance abuse and a variety of other adolescent health problems (Example: Nurse-Family Partnership)

Family Risk Factors

Family History of Problem Behavior

If children are raised in a family with a history of addiction to alcohol or other drugs, the risk of having alcohol and other drugs themselves increases. If children are born or raised in a family with a history of criminal activity the risk of juvenile delinquency increases, Similarly, children raised by a teenage mother are more likely to be teen parents, and children of dropouts are more likely to drop out.

High Risk Youth Programs

Family Strengthening

Early Identification and Referral

Mentoring

Identification and Referral

• Provide educational programs for youth who have experienced familial substance abuse (Example: I am Special Program-Kenosha County or Native American Program, Lac Du Flambeau)
• Develop parenting skills
• Train parents to listen and interact
• Train parents to use positive and consistent discipline
• Provide "wraparound' services for students with intensive needs (Milwaukee Wrap-Around or Joining Forces, Dane County)

• Provide comprehensive sustained interventions targeting multiple risk factors (Example: Early Risers, Skills For Success)
• Provide positive alternatives to help youth in high risk environments develop personal and social skills ( Zibi Quest or Project Venture Menomonee )
• Strengthen the bonds between adults and youth and provide opportunities for positive community involvement (Example: Across Ages)
• Improve family functioning through family therapy where indicated
• Promote clear rules and emphasize family, personal, public and legal consequences of involvement in crime and the use of alcohol, tobacco and other drugs
• Communicate peer norms against use

Family Management Problems

The risk factor has been shown to increase the risk of drug abuse, delinquency, teen pregnancy, school dropout, and violence. Poor family management practices include lack of clear expectations of behavior, failure of parents to monitor their children (knowing where they are and who they are with), and excessively severe or inconsistent punishment.

Family Strengthening

Personal and Social Skills Training

High Risk Youth Programs

Violence Prevention

• Develop parenting skills            (Strengthening Families, Age 0-12 PDF, 10-14 PDF)
• Emphasize family bonding
• Train parents to listen and interact
• Train parents to use positive and consistent discipline
• Provide programs that strengthen social competence and problem solving (Example: Incredible Years)
• Provide "wraparound"services for students with intensive needs (Milwaukee Joining Forces)
• Provide opportunities for youth to develop conflict resolution skills

• Target the entire family
• Emphasize family bonding
• Employ strategies to overcome parental resistance to family-based programs
• Provide positive alternatives to help youth in high risk environments develop personal and social skills
• Promote new skills in family communication through interactive techniques
• Improve family functioning through family therapy where indicated

Family Conflict

Persistent, serious conflict between primary caregivers or between caregivers and children appear to enhance risk for children raised in these families. Conflict between family members appears to be more important than structure.

Family Strengthening

Personal and Social Skills Training

High Risk Youth Programs

• Develop parenting skills  (Strengthening Families, Age 0-12 PDF, 10-14 PDF)
• Provide opportunities for youth to develop conflict resolution skills with peers and family (Example: High/Scope Perry Preschool Program)
• Train parents to listen and interact
• Train parents to use positive and consistent discipline
• Provide skill based programs for youth who may be dealing with grief, loss, or divorce (Example: Children in the Middle)

• Target the entire family
• Emphasize family bonding
• Employ strategies to overcome parental resistance to family-based programs
• Provide positive alternatives to help youth in high risk environments develop personal and social skills
• Promote new skills in family communication through interactive techniques
• Improve family functioning through family therapy where indicated

Parent Attitudes and Involvement in Drug Use, Crime and Violence

Parental attitudes and behavior toward drugs, crime, and violence influence the behavior of their children. Parental approval of young people's moderate drinking, even under parental supervisions, increases the risk of the young person using marijuana. Similarly, children of parents who excuse their children for breaking the law are more likely to develop problems with juvenile delinquency.

Family Strengthening

Mentoring

High Risk Youth Programs

Personal and Social Skills Training

Early Identification and Referral

• Develop parenting skills (Native American Program, Lac Du Flambeau)
• Provide opportunities for parents to increase their understanding and beliefs about substance abuse (Strengthening Families, Age 0-12 PDF , 10-14 PDF )
• Provide a program where youth can learn the consequences of using drugs and develop their own reasons not to use. (Example: Project Alert)
• Utilize goal setting to increase motivation to avoid drug use

• Build personal and social skills
• Design culturally sensitive interventions
• Communicate peer norms against the use of alcohol and illicit drugs
• Incorporate problem identification and referral into prevention programs
• Strengthen the bonds between adults and youth and provide opportunities for positive community involvement (Example: Project Alert)
• Improve family functioning through family therapy where indicated
• Promote high expectations of youth by parents, teachers and other adults (Example: Start Taking Alcohol Risks Seriously - STARS- for Families)

School Risk Factors

Early and Persistent Antisocial Behavior

Boys who are aggressive in grades K-3 are at higher risk of substance abuse and juvenile delinquency. When aggressive behavior is combined with isolation or withdrawal, there is even a greater risk of problems in adolescence. The risk applies to aggressive behavior combined with hyperactivity or attention deficit disorder. Persistent antisocial behavior like misbehaving in school, skipping school and getting into fights with other children appears to increase risk for drug abuse, violence, dropout, and teen pregnancy.

School Climate Change Approaches

Violence Prevention

Family Strengthening

• Promote school-wide climate with qualities such as respect, safety, caring, and helpfulness (Example: Child Development Project)
• Address discipline practices through classroom management techniques and instructional innovation Promote emotional and social competencies to reduce acting out behaviors (Example: PATHS: Promoting Alternative Thinking Strategies)
• Provide opportunities for youth to develop skills for decision making, positive goal setting and self-regulation (Example: Second Step or Sticks n' Stones)  PDF

• Avoid relying solely on knowledge-oriented interventions designed to supply information about negative consequences
• Counter the effects of deviant norms and behaviors by creating an environment for youth with behavior problems to interact with other non problematic youth
• Build personal and social skills
• Target the entire family
• Emphasize family bonding
• Involve parents in school based approaches
• Provide comprehensive sustained interventions that target multiple risk factors (Example: Strengthening Families Program - SFP)

Academic Failure Beginning in Early Elementary School

Beginning in late elementary grades, academic failure increases the risk of drug abuse, delinquency, violence, pregnancy and school dropout. Children fail for many reasons. It appears that the experience of failure-not necessarily ability- increases the risk of problem behavior.

School Climate Change Approaches

Mentoring

Family Strengthening

• Provide staff development opportunities to promote school-wide climate with qualities such as caring, and helpfulness (Quantum Opportunity Program, Racine County)
• Provide early childhood education and family support programs (Example: Parents As Teachers  or Appleton Even Start Family Literacy - P.A.T. or Red Cliff P.A.T.)

• Involve parents in school-based approaches
• Avoid relying solely on knowledge-oriented interventions designed to supply information about negative consequences
• Design culturally sensitive interventions (African American, Native American, and Hispanic students have disproportional higher rates of academic failure)
• Explore alternative community sponsors and sites for schools (Example: Faith-based Prevention Model)

Lack of Commitment to School

Low commitment to school means the young person has ceased to see the role of student as a viable one. Young people who have lost this commitment to school are at higher risk for substance abuse, delinquency, teen pregnancy, and school dropout.

School Climate Change Approaches

High Risk Youth Programs

Alternative Activities

Community Service

• Increase community involvement in promoting the healthy development of youth and the valuing of adolescents
• Improve youth identification with positive roles
• Promote involvement in school and community activities and organizations
• Promote job skills and career development (Example: Job Training Adolescent Self-Sufficiency Program - Menominee)

• Strengthen the bonds between adults and youth and provide opportunities for positive community involvement
• Provide positive alternative to help youth in high-risk environments develop personal and social skills
• Design culturally sensitive interventions targeting youth involved in tribal or alternative (Example: Project Venture)
• Avoid relying solely on knowledge-oriented interventions designed to supply information about negative consequences
• Increase positive attitudes through community service

Individual / Peer Risk Factors

Alienation / Rebelliousness

Young people who feel they are not part of society, bound by rules, don't believe in trying to be successful or responsible, or who take an active rebellious stance toward society, are at higher risk of drug abuse, delinquency, and school dropout.

School Climate Change Approaches

Family Strengthening

Mentoring

Alternative Activities

Violence Prevention

• Utilize restorative justice approaches (Example: Sticks n' Stones or Olweus Bullyng Program)
• Restructure the existing school environment to reduce opportunities and rewards for bullying (Example: Olweus Bullying Program)
• Promote involvement in school and community activities and organizations
• Provide structured time with adults through mentoring

• Provide positive alternative to help youth in high-risk environments develop personal and social skills
• Target the entire family
• Emphasize family bonding
• Promote clear rules and emphasize family, personal, public and legal consequences of involvement in crime and the use of alcohol, tobacco and other drugs
• Design culturally sensitive interventions
• Strengthen the bonds between adults and youth and provide opportunities for positive community involvement
• Cite immediate consequences
• Avoid relying solely on knowledge-oriented intervention designed to supply information about negative consequences

Friends Who Engage in The Problem Behavior

Young people who associate with peers who engage in problem behavior, delinquency, substance abuse, violent activity, sexual activity or school dropout-are much more likely to engage in the same behavior.

School Climate Change

Mentoring

Alternative Activities

High Risk Youth Programs

Community Service

• Increase community involvement in promoting the healthy development of youth and the valuing of adolescents
• Improve youth identification with positive roles (Mentor/Tutors School District of Janesville)
• Provide structured time with adults through mentoring (Example: Big Brothers Big Sisters Dane County)
• Promote involvement in school and community activities and organizations

• Counter the effects of deviant norms and behaviors by creating an environment for youth with behavior problems to interact with other non problematic youth
• Communicate peer norms against the use of alcohol and illicit drugs
• Strengthen the bonds between adults and youth and provide opportunities for positive community involvement
• Structure alternative activities and supervise alternative events
• Design intensive alternative activities that include a variety of approaches and time commitment
• Avoid relying solely on knowledge-oriented interventions

Favorable Attitudes Toward The Problem Behavior

During the elementary years, children usually express anti-drug, anti-crime and pro-social attitudes. They have difficulty imagining why people use drugs, commit crimes, and drop out of school. However, in middle school, as others they know participate in such activities, their attitudes often shift toward greater acceptance of these behaviors. This acceptance places them at higher risk

High Risk Youth Programs

Personal and Social Skills Training

Early Identification and Referral

Leadership and Youth Development

Social Norms

Social Marketing

Violence Prevention

• Utilize both cognitive sophistication and cognitive dissonance approaches (Example: Sticks n' Stones)
• Provide opportunities for youth to increase their understanding and beliefs about substance abuse
• Provide a program where youth can learn the consequences of using drugs and develop their own reasons not to use. (Example: Keep A Clear Mind)
• Utilize goal setting to increase motivation to avoid drug use (Example: All-Stars)
• Utilize peer mediation and peer helper programs

• Target the entire family
• Provide positive alternative to help youth in high-risk environments develop personal and social skills
• Design culturally sensitive interventions targeting youth involved in tribal or alternative
• Incorporate problem identification and referral into prevention programs
• Communicate peer norms against use
• Cite Immediate consequences
• Avoid relying solely on knowledge-oriented interventions
• Combine information dissemination and media campaigns with other interventions

Early Initiation of The Problem Behavior

The earlier young people begin using drugs, committing crimes, engaging in violent activity, dropping out of school, and becoming sexually active, the greater the likelihood that they will have problems with these behaviors later on. For example, research shows that young people who initiate drug use before the age of 15 are at twice the risk of having drug problems as those who wait until after the age of 19.

School Climate Change Approaches

Mentoring

Family Strengthening

Identification and Referral

Violence Prevention

• Provide first time offender programs  (Brighter Futures Program Walworth County )
• Provide a program where youth can learn the consequences of using drugs and develop their own reasons not to use. (Example: Keep A Clear Mind)
• Provide structured time with adults through mentoring
• Utilize goal setting to increase motivation to avoid drug use
• Provide skill building opportunities    (Life-skills Training)

• Target the entire family
• Involve parents in school-based approaches
• Counter the effects of deviant norms and behaviors by creating an environment for youth with behavior problems to interact with other non problematic youth
• Improve family functioning through family therapy where indicated
• Strengthen the bonds between adults and youth and provide opportunities for positive community involvement
• Cite immediate consequences
• Avoid relying solely on knowledge-oriented interventions

Constitutional Factors

Constitutional factors are factors that may have a biological or physiological; basis. These factors are often seen in young people with behaviors such as sensation-seeking, low harm-avoidance, and lack of impulse control. These factors appear to increase the risk of young people abusing drugs, engaging in delinquent behavior, and or committing violent acts.

Personal and Social Skills Approaches

Family Strengthening

Violence Prevention

• Provide skill building opportunities
• Provide opportunities for youth to increase their understanding and beliefs about substance abuse
• Provide a program where youth can learn the consequences of using drugs and develop their own reasons not to use. (Example: Keep A Clear Mind)
• Provide developmental screening (Example: Safe Kids, Safe Neighborhoods Program - Milwaukee BFI )

• Counter the effects of deviant norms by creating an environment for youth with behavior problems to interact with non-problematic youth
• Involve parents in school-based approaches
• Help minority families respond to cultural to cultural and racial issues
• Help develop bonds among parents in programs: provide meals, transportation, and small gifts; sponsor family outings and ensure cultural sensitivity
• Improve family functioning through family therapy where indicated
• Avoid relying solely on knowledge-oriented interventions
• Offer sessions where parents and youth learn and practice skills