Social Factors and Prevention Interventions: Research Annual Report 2002

Research in the Social Factors and Prevention Interventions Section is directed toward identifying environmental (e.g., social, physical, cultural) and individual (e.g., personality, predisposition, risks and protection) factors that are associated with mental health and substance use problems. We then use this knowledge to develop and evaluate research-driven interventions to reduce the occurrence and severity of such problems.

At present, work in the section focuses on: social factors associated with aggression and violence, including alcohol-related aggression; alcohol, gender and aggression; theoretical constructs linking different forms of aggression; school-based and workplace-based prevention programs; research on the relationship between healthy psychosocial development and childhood social factors including poverty, parenting and school culture and environment; the evaluation of early intervention programs for at-risk youth; and research and evaluation on the factors associated with preventing and treating problem gambling.

The following are highlights of current initiatives.

Reducing Aggression and Injury in Bars

Drinking in licensed premises is often associated with aggressive behaviour and injury. Our investigators are leading an international project funded by the U.S. National Institute on Alcohol Abuse and Alcoholism (niaaa) to evaluate the impact of the Safer Bars program on reducing aggression and injury related to drinking in licensed premises. During Phase 1 of the project, conducted during 2000/2001, we completed 800 nights of observations in large-capacity bars in Toronto. This allowed us to develop a baseline measure of the frequency and severity of aggressive incidents.

Phase 2, completed in 2001/2002, involved implementing the Safer Bars program in up to 26 randomly selected bars and clubs in Toronto and five bars selected for early participation. A total of 522 bar staff and managers in 23 bars and clubs in Toronto participated in the training program.

The overall response to the program was extremely positive: 98 per cent of respondents who completed the feedback questionnaire indicated that they would recommend the training to others. Significant positive changes were evident on 31 of 32 pre-post training knowledge/attitude questions. Participants also gave high ratings on different aspects of the training and of the trainers. The majority of participants said they would change how they work as a result of the program.

Strengthening Families

Children whose parents have substance use problems are at high risk for a number of problems. In partnership with the University of Buffalo and funded by the niaaa, our investigators continue to evaluate the Strengthening Families program. The primary objective of the program is to prevent the onset and progression of alcohol and other drug use problems among children whose parents have alcohol problems. This five-year project, now entering its third year, will involve approximately 720 families in which at least one parent was previously in treatment for an alcohol problem.

Currently, five alcohol/drug treatment facilities in Ontario are collaborating on the project: Addiction Services for York Region, Simcoe Outreach Services, the Jean Tweed Centre, St. Mary's Counselling Services, and Alcohol and Drug Services of Thames Valley. Over 150 Ontario families have participated in the program, and retention rates have been very high (in excess of 95 per cent), an indication that families are enjoying the activities.

Preliminary findings from the study were presented in at a meeting of the Society for Prevention Research in June 2002.

Fairness and the Human Spirit at Work

CAMH has been a leading partner with Health Canada over the last 16 years in a research, development and evaluation program devoted to promoting mental health and preventing substance use problems in the workplace. Our ongoing projects focus on the role of interpersonal fairness in the employment relationship and how this affects mental health.

Fairness has been isolated as a powerful influence on mental health and a key mediator of how stress affects health in general. CAMH is the virtual hub of a network that involves hundreds of workplace partners, including the National Quality Institute, the Canadian Business and Labour Centre, the Conference Board of Canada and a consortium of largely university-based Centres for Health Promotion.

To address the issue of stress and fairness in the workplace, researchers from CAMH and the consortium have successfully advanced an instrument called the ssos (the Stress Satisfaction Offset Score) as a means of assessing the extent to which workplace environments are health- or harm-promoting. In addition, we are developing several promising interventions that attempt to redress the balance between satisfaction and stress in troubled workplaces. The ability to balance stress and satisfaction is being used as a criterion for managerial performance in at least one major public utility with which we have been working.

Understanding and Preventing Problem Gambling

As gambling opportunities increase, so does the incidence of problem gambling. To better understand how gambling problems develop, our investigators have completed a study of people who win at gambling and how winning affects the development of problem gambling. Our findings indicate that early wins, along with impulsivity and stressful life experiences, play a role in the development of problem gambling. In addition, people who became problem gamblers tended to have a poorer understanding of random eventsthan those who were not problem gamblers and were more likely than non-problem gamblers to rely on escape or avoidance as a method of coping with problems.

Ongoing work in the gambling area also includes evaluating a curriculum (eight lesson plans and a cd-rom) developed for Ontario schools for preventing gambling problems. The program addresses two main sources of vulnerability: a lack of knowledge about the nature of random events (e.g., the erroneous belief that you can beat the odds); and the inability to cope with stress.

The evaluation involves classes randomly selected to receive the curriculum.