New culturally inclusive program for school-based drug prevention

Over the past three years, researchers at the Matilda Centre have partnered with Indigenous creative agency Gilimbaa and Aboriginal and/or Torres Strait Islander and non-Indigenous youth, school staff and communities to develop Strong & Deadly Futures, the first wellbeing and drug education program that is culturally inclusive for Aboriginal and Torres Strait Islander students.

Alcohol and other drug use is a leading cause of harm for Aboriginal and Torres Strait Islander adolescents aged 15-24 . Despite resilience and a continuous strong connection to culture, the ongoing impacts of colonisation, disempowerment, and inequity have an intergenerational impact on the wellbeing of Aboriginal and Torres Strait Islander adolescents. This intergenerational impact contributes average initiation of substance use two to six years earlier among Aboriginal and Torres Strait Islander compared to non-Indigenous adolescents. Prevention of youth alcohol and drug use has therefore been identified as a key strategy to improve health of Aboriginal people by the Commonwealth Government.

Research has found that curriculum programs implemented in secondary school can effectively prevent uptake of these substances by young people, and have flow-on benefits for social and emotional wellbeing, physical health, school attendance, and educational attainment. However, there were no wellbeing and drug prevention programs that are culturally inclusive and effective for Aboriginal and/or Torres Strait Islander students.

The Australian Government Department of Health funded the development of Strong & Deadly Futures to addresses the need for an online drug and alcohol prevention program for Aboriginal and Torres Strait Islander youth that is:

• inclusive
• builds on cultural strengths
  
• is informed by the latest evidence about effective wellbeing promotion and alcohol and drug prevention.

Engaging with an Aboriginal and Torres Stait Islander stakeholders and communities throughout the development has been an important part of this project.

Strong & Deadly Futures was co-developed through workshops involving the Matilda Centre, Gilimbaa, and Aboriginal and/or Torres Strait Islander and non-Indigenous youth, school staff and community.

An advisory group comprised of Aboriginal and non-Indigenous experts in Aboriginal health and drug prevention provided oversight and direction throughout the development of this inclusive program.

Strong & Deadly Futures is based on Climate Schools, a computerised program that uses an illustrated story to convey prevention messages, combined with classroom activities facilitated by the teacher. Climate Schools has been shown to be effective in reducing alcohol use, binge-drinking, alcohol-related harms and truancy; and adds in elements of cultural strengths, wellbeing and coping with stress.

During development of the Strong & Deadly Futures program, students shared their stories, role models, things they love about their community and positive reasons for not using alcohol and other drugs. These experiences formed the basis for the story arc and characters of the program.

Following development, Strong & Deadly Futures was piloted in four schools in New South Wales and Queensland, with preliminary results demonstrating:

• increased knowledge of harms related to alcohol, tobacco and cannabis
• safer attitudes towards alcohol
• an improvement in overall wellbeing.
  

The project’s Principal Investigator, Dr Lexine Stapinski, and the trial’s Project Manager, Dr Kylie Routledge recently shared information about the program’s development and trial in an online webinar:

Supported by funding from the National Health and Medical Research Council, Matilda Centre researchers are now rolling out the program to 24 secondary schools across Australia as part of a cluster randomised controlled trial to test the program’s effectiveness.

Half the schools will be allocated to implement Strong & Deadly Futures in 2021, while the other half will delay implementation until 2023.

Strong Aboriginal and Torres Strait Islander representation continues to be key to the project.

“We have allowed a period of 6 to 9 months to consult with Aboriginal and/or Torres Strait Islander members in each community, so we can adapt the program for the local area before trialling it in schools from mid-2021,” explains Dr Routledge.

Identified positions are another important aspect of the trial. "We will be recruiting Aboriginal and/or Torres Strait Islander research assistants in each community to lead the consultations and support implementation of the program in schools," adds Dr Routledge..

Anticipated benefits after 24 months include reductions in alcohol and drug uptake and psychological distress.

The Strong & Deadly Futures team is currently recruiting schools from across NSW, QLD, WA and NT to participate in the upcoming trial. For further information, please contact Dr Kylie Routledge at kylie.routledge@sydney.edu.au or visit strongdeadly.org.au.

Declaration: Strong & Deadly Futures receives funding from the Australian Government Department of Health and the National Health and Medical Research Council.