Delivering prevention: a systems approach
The prevention of drug use and drug-related problems among young people encompasses a wide range of approaches. Environmental and universal approaches target entire populations, selective prevention targets vulnerable groups who may be at greater risk of developing drug use problems, and indicated prevention focuses on at-risk individuals.
Many differences exist between European countries in the way prevention is addressed, with some tending to adopt broader community-based and environmental approaches (e.g. regulating alcohol and nightlife) and others primarily using manual-based programmes. The use of manualbased prevention programmes, characterised by strictly defined content and delivery, can be an effective way to reach large populations with evidence-based interventions. Such programmes are reported as a central component in national prevention approaches in 6 Member States.
Quality standards currently exist in most European countries
Other countries have prioritised a broader systems approach to their prevention interventions, focusing not just on individual programmes, but also on factors such as delivery mechanisms, interaction between interventions and the social and policy context. An example of this is the Communities That Care approach, which is being implemented in 5 EU countries. This approach, developed in the United States, is based on the premise that a reduction in the prevalence of health and behavioural problems among youth can be achieved by identifying risk and protective factors, and selecting effective early intervention programmes that address these. A recent systematic review found some positive evidence of effectiveness of the Communities That Care approach as a drug prevention initiative in US studies, although it has yet to be evaluated in the European context.