Building engagement to support adoption of community-based substance use prevention initiatives

Abstract

Background System-level approaches that target social determinants of health are promising strategies to support substance use prevention, holistic youth development and wellbeing. Yet, the youth services system is largely based on individual-focused programs that do not adequately account for social determinants of health and place the responsibility for wellness on the individual. There is a need to understand how to enhance adoption of complex system-level approaches that support comprehensive youth development. The Icelandic Prevention Model (IPM) represents a collaborative initiative that takes an ecological, system-level approach to prevent substance use and promote wellness in youth. This research was designed to examine key stakeholder perceptions to better understand social motivations and contextual complexities that influence stakeholder support to garner community-level adoption of the IPM in a rural Canadian community. Methods This research applies a case study approach using qualitative interviews to explore strategies to support uptake in the early stages of IPM adoption associated with developing community buy-in and acceptance. A thematic analysis was applied using QSR NVivo. Results Nine interviews were conducted with community partners leading the implementation of the IPM. Three over-arching themes emerged from the data: 1) Motivating influences 2) Strategies to develop buy-in, and 3) Resistance to the adoption of the IPM. Findings reflect issues that affect behaviour change in system transformation in general as well as upstream prevention and the IPM, in particular. Conclusions The findings from this research describe critical insight derived from implementing community-driven initiatives that are designed to support health promotion. It contributes new scientific knowledge related to implementation of complex system-level innovations and practical information that is useful for communities interested in implementing the IPM or following similar approaches to prevent substance use.

Implications of time and space factors related with youth substance use prevention: a conceptual review and case study of the Icelandic Prevention Model being implemented in the context of the COVID-19 pandemic

“…Finally, participants noted that significant shifts in social norms that resulted from the pandemic may impact community willingness to change. This is an important factor in adopting new interventions (Halsall, et al, forthcoming ) and is particularly important in the case of the IPM as communities often experience initial difficulties building stakeholder buy-in (Bajwa, 2017 ).…”

“…Future research should pursue broader youth engagement both in intervention and research design to integrate their lived experience of key equity issues in decision-making to help focus efforts on risk and protective factors that influence developmental contexts. Integrating young people in this work will help to enhance community engagement in health promotion and upstream efforts (Halsall et al, forthcoming ).…”

“…This study is a component of a larger mixed methods case study that was guided by a pragmatic research paradigm and designed to examine the implementation and impact of the IPM within Lanark County (see Halsall et al, 2020 ; Halsall, et al, forthcoming ). Data were collected through semi-structured qualitative interviews with PYLC Steering Committee members.…”

“…PYLC is currently being led by the PYLC Steering Committee and at the time of publication, they had completed the first six steps of IPM implementation. PYLC was formed in response to community concerns regarding the opioid crisis (see Halsall, Mahmoud, Pouliot, & Iyer, forthcoming ). Activities within the first six steps include the creation of a local coalition, development of community engagement, funding and support, preparation for the collection of a population-level youth survey, data collection, community engagement and dissemination of the findings (see, Kristjánsson et al, 2020b ).…”

We cannot keep doing what we have always done and expect that things will be different: A scoping review of the lifestyle drift concept

“…The critical in uence of the biomedical model is translated into a near singular focus on the healthcare system and dismissal of the potential of health promotion opportunities within other contexts (21,50,51). This practice also fails to recognize Indigenous conceptions of wellbeing or to address the holistic needs of Indigenous communities (50).…”