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Article Excerpt
Against the background of reports of a rise in psychoactive substance use, particularly among adolescents, the United Nations International Drug Control Program (UNDCP) and the World Health Organization (WHO) initiated the Global Initiative (1999-2003) for the primary prevention of psychoactive substance use among young people (World Health Organization, 2007; United Nations International Drug Control Program 1999). Eight countries in three regions of the world--the Southern African and South East Asian regions, as well as the Central and Eastern European region--were involved.
The Global Initiative project aimed to support local partners in mobilizing communities towards the primary prevention of psychoactive substance-related problems, recognizing evidence that such prevention requires an integrated set of evidence-based activities in which the individual, the small group (e.g. the family) and the wider community participate (World Health Organization, 2007; United Nations Office for Drug Control and Crime Prevention, 2002; United Nations International Drug Control Program, 1999). The Global Initiative generally comprised five sets of interrelated activities: (1) baseline or pre-intervention assessment; (2) training of non-governmental organizations (NGOs) towards pre- and post-intervention situation assessment and public health interventions; (3) public health interventions; (4) monitoring of activities, including the documentation of the experiences of the participating NGOs; and (5) post-intervention assessment. Local research institutions in the project countries carried out the pre- and post-intervention assessments. In order to mobilize the project communities to respond to the identified problems and sustain their involvement beyond the project life, the NGOs were recruited from these communities.
This article only reports the design and core findings of the pre-intervention knowledge, attitudes, and practices (KAP) survey among 10-21 year olds in two sites in the Republic of Belarus and three sites in the Russian Federation. (The design and results of the whole Global Initiative study are described in detail in other documents (World Health Organization, 2007, 2003).) The aim is to contribute to some extent to descriptive epidemiology on the use of psychoactive substances among young people (10-21 year olds) and identify preventive needs, based on the reported data. It focuses on the use of various psychoactive substances among the research group, their perceptions of such use among their close associates ((step)fathers /mothers, older siblings, closest friends), their perceptions as to whether various forms of youth psychoactive substance use entail risk, and the extent to which they approve of various forms of youth psychoactive substance use.
Project sites
Site selection in the Global Initiative was purposive, i.e. based on the presence of demarcated geographical boundaries, psychoactive substance use problems and visible community structures for carrying out primary prevention activities. Local Global Initiative participants' preferences were also taken into consideration in site selection. Provision was made for at least two sites per country. In the Republic of Belarus the pre-intervention youth KAP survey (hereafter referred to as the Global Initiative survey) was done in two urban districts, namely Partizansky District in the city of Minsk and Central District in the city of Gomel. In the Russian Federation three urban communities participated in the Global Initiative survey: Lublino District in the capital city of Moscow; Ivanovo--the capital of Ivanovo Province--in the Moscow Region; and Irkutsk--the capital of Irkutsk Province--situated east of the Ural Mountains in southern Siberia near the central-northern border of Mongolia.
The sites in Belarus had much smaller populations than those in the Russian Federation, but women were in the majority in all the sites (World Health Organization, 2003:6, 46). According to the 1999 census figures for Belarus and the 2000 census figures for the Russian Federation, Central District had a population of 70,800 and Partizanski 94,501; Irkutsk had a population of 589,683, Ivanovo 456,357, and Lublino District 898,800. Women comprised 54.2% of the population in Central District, 53.3% in Partizanski District, 55.3% in Irkutsk, 55.0% in Ivanovo, and 55.1% in Lublino District. The mean age of the populations varied between the late thirties and early forties (43.6 years in Central District, 43.5 years in Partizanski District, 36.9 years in Irkutsk, 39.7 years in Ivanovo, and 40.2 years in Lublino District) (World Health Organization, 2003:6, 46).
Methods
Data collection was underpinned by the assumption that exposure to psychoactive substances (e.g. through family members and friends) as well as permissive attitudes to psychoactive substance use contribute towards the young people's initiation into such use (World Health Organization, 2007:6-7). Local research institutions carried out the Global Initiative survey in the project sites: The Belorussian Medical Academy for Post Graduate Education did the survey in the Belarussian sites and the Research Institution on Addiction in Moscow did the same in the Russian Federation sites. To facilitate standardization, the research agencies followed a WHO survey protocol, except that the research agency in the Russian Federation sampled young people in educational institutions instead of young people in households as recommended by the WHO (World Health Organization, 2000b). The decision to sample young people in educational institutions in the project sites in the Russian Federation was based on the research agency's experience that residents were generally hesitant to invite strangers into their houses because of their fear of crime. It is important to note, though, that by far the majority of the young people sampled in the households in Belarus (94% in Central District and 90% in Partizanski District) were, like their counterparts in the Russian Federation, enrolled at educational institutions at the time of the survey (World Health Organization, 2003:7).
In the Republic of Belarus a multi-stage complex sampling design was used to draw approximately 300 respondents in the age group 10-21 years per site. The...
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