Needs Assessment

William Laubach
Professor Schedin
HSC3713
Needs Assessment

The issues regarding substance use in the United States is a public health concern that has

managed to infiltrate into our very community in Jacksonville, Florida. Within Duval County,

adolescents, especially those in high school, have been reported utilizing substances such as

alcohol and other drugs. Substance use can be described as a pattern of harmful use of substances

including drugs, alcohol, and even medications. Adolescents are young people in the stage of life

from developing from a child to an adult, typically between the ages of 12-17. According to the

Centers for Disease Control and Prevention, or CDC, substance use in adolescents could

contribute to “health problems in the later stages of life such as heart disease and sleep disorders”

(CDC, 2020). Substance use in adolescents can also effect “brain development among teenagers”

(CDC, 2020). Another health consequence to consider is that of oral health. Oral diseases

“remains to be one of the most common chronic disease among adolescents” (National Institute

of Health, 2017). Risk factors that could contribute to oral disease include alcohol, tobacco and

drug use.

The YBRS, or Youth Risk Behavior Surveillance System, breaks down data from

national state and local levels. The YRBS reports that within 30 days of taking the survey, 29.8%

of high school students in the United States had consumed alcohol (YBRS, 2017) and 19.8% of

high school students within the United States currently smoke marijuana (YBRS, 2017). It is also

reported through the YBRS that about 15.5% of high school students had their first alcoholic

drink before the age of 13 (YBRS, 2017) and 6.8% of high school students tried marijuana

before the age of 13 (YBRS, 2017). At the state level the YRBS reports that 34.5% of high

school students in the state of Florida currently smoke marijuana (YRBS, 2017) which is a

significant increase from the national data of high school students.

 More specifically, in Duval County approximately 29% of students were offered, sold or

given drugs on school property (Florida Department of Health, 2015) . 30.2% of students in

Duval county currently use alcohol while 25% of students currently smoke marijuana (Florida

Department of Health, 2015). The data here is evident of a large scale within the nation entirely.

The ages of 12-17 is critical as students begin to become more independent and make their own

choices. With many health consequences occurring later on in life in the form of various chronic

diseases, it becomes an important task to dissuade students from engaging in this behavior or

stop all together.

With regards to disparities among different racial/ethnic groups, a study was conducted to

see if there were any differences between the groups when it come to illegal alcohol, tobacco,

and drug usage. The article concluded in the results with the data showing that Asian Americans

had the lowest substance use compared to other ethnic groups and Hispanic Americans reporting

the highest use compared to the other groups (Regina et all, 2010). Another disparity I found

among adolescents was that as the students get older the more likely they are exposed or use

substances such as alcohol and marijuana. (Regina et all, 2010).

There are many reasons why young adolescents begin using illegal substances and begin

underage drinking. The CDC reports that there are risk factors that an adolescent may experience

that could lead to them using substances. These factors include “poverty, family history of

substance use and abuse, favorable parental attitudes towards substances and use by minors, peer

pressure, lack of parent engagement in the student’s life, and a general rebellious attitude” (CDC,

2018). These factors and family circumstances can lead to students eventually engaging in these

unhealthy behaviors. The CDC has some suggestions for preventing these behaviors all together.

Some primary prevention strategies for substance use among adolescents include school based
programs, parenting skills training, peer-led drug and alcohol resistance programs. These

programs can help to prevent students from engaging in these behaviors all together. This is

especially important for those students who may be already at risk due to the risk factors

mentioned above.

A common theme found among my research and articles suggest that substance use

disorders, or SUDs, among parents can have a direct affect on their children’s own substance

use. The article states “adolescence as a critical period for the deleterious effects of exposure to

parental SUDs” (Bierderman et all, 2000). These findings suggest a need for early intervention

for these children especially during adolescence period where they will be the most vulnerable

and most easily influenced by their parents behavior. Although there has always been substance

use problems among high school students, the total amount of substance use activity has declined

over the past 40 years (Levy et all, 2014). Marijuana use has increased over time among

adolescents as the tobacco rate has dropped. Public health strategies should focus on “increased

counterbalance measures on the marijuana industry as opposed to the tobacco industry” (Levy et

all, 2014). Furthermore, pediatricians can help deliver simple and clear messages towards

adolescents about alcohol and drugs use that is “backed by neuroscience as well as acute and

long-term morbidity and mortality” (Levy et all, 2014).

Solutions to the adolescent use of substances include “Community-Based Family-

Centered Interventions” (Loke, 2013). Families should be supported in a positive and

encouraging way. Many adolescents who choose to engage in these sort behaviors end up to

doing so due to peer pressure and parental or sibling substance use. It was even found that

siblings use of substances had a more significant effect on whether or not an adolescent smoked

“ Our results show that having siblings who smoke is a more influential factor in adolescent
smoking than having parents who smoke” (Loke, 2013). This stresses the importance of

developing a healthier home environment where poverty and crime may already predispose the

behaviors and actions in which adolescents will find themselves engaging in. “Healthy families

also facilitate communication between parents and children and have a good influence on an

adolescent’s selection of friends, both of which will greatly influence an adolescent’s choice of

health behaviors” (Loke, 2013). Community based interventions with the family can help

increase communication and could eventually allow adolescents to make better choices in the

future.

Another article I read found that some sports that high schoolers participated in could

lead to increased or decreased substance use based on whether the sport was a school sponsored

activity or out of school event (Moore et all, 2005). Public Health approaches should center

around these sport team interventions either through the coaching staff of teams or through a

health educator interaction with a team informing them of dangers and risk of substance use.

Benefit from all of the community, sport, and school base interventions could lead to an increase

in school attendance among adolescents. It was studied that a increase in substance use lead to a

decrease in school attendance where a decrease in substance abuse lead to a increase in school

attendance (Engberg, 2006). The findings only prove the cost effectiveness of intervention

programs that reduce the amount of students engaging substance use. Reducing substance use

and increasing school attendance has been linked to positive long term social and economic

outcomes for individuals (Engberg, 2006). Based on these findings the goal of my program is to

decrease substance use in Duval County by targeting unhealthy family environments, adolescent

awareness of health consequences later in life, and a larger focus on marijuana use in adolescents

compared to tobacco among high school students in Duval County health zone 1.