Assessment Plan

Assessment Plan

As a group we have decided to utilize mixed methods to gather information for our community project. We are conducting one focus group and one survey. We are going to utilize social media to recruit members for our focus group as well as to give an invitation to participate in our survey. We are planning on inviting 15 people to participate in our focus group with the hopes of getting 6-8 attendance confirmations. The focus group will be held on February 12, 2015 at 6:00PM at the Hidden Valley Clubhouse where light refreshments will be served. Our group will use social media and email blasts to boost our numbers for the survey. We are hopeful we can get 50+ people to take the survey. The survey will consist of 5 questions based on a 4 point Likert Scale. The questions for our survey are:

1.      I consider recreational marijuana use (non-medicinal) among early adolescents (11-14 years of age) harmful.

2.      It’s important to talk with my early adolescent child about marijuana use.

3.      I am interested in credible information regarding the effects recreational marijuana use has on adolescent development.

4.      It’s important that credible informational materials about early adolescent marijuana use be available to parents through public education.

5.      I believe early adolescent marijuana use is a growing problem.

Dave Coan is responsible for facilitating the focus group while Mylinda Barrick and Robert Brant take notes and assist Dave in answering closing questions. Mylinda is playing the role of the organizer by reserving the clubhouse and creating the event on Facebook. All group members are responsible for creating the survey and focus group questions. Robert and Mylinda will be responsible for transcribing their notes for analysis. All members will take part in assessing what information is most important to address in the final product, the educational pamphlet for parents addressing adolescent marijuana use in southern Utah. 

Semi-structured Assessment Guide

Introductory Verbal Script: Okay, I'd like to get started. I know that we briefly introduced ourselves as you entered. I would like to formally introduce myself and my associates and explain to you why we are here tonight.

My name is Dave. I will be moderating this focus group tonight. With me are Mylinda and Robert who have graciously agreed to take notes and assist me in answering any of your concerns. We are graduate students in a Master of Social Work Program at the University of Utah.

We have asked you to come tonight because we need your help. We are deeply concerned about the growing trend among young adolescents who are getting introduced to recreational marijuana use at an early age. Research strongly indicates that as more states legalize marijuana, the perceived risk of use goes down, and consequently the increased use by adolescents rises. In Washington County, the average age of initial introduction to marijuana use is 14. This means that some youth are older when they start to use, and some adolescents are younger than 14. Thus, we feel this growing problem should be addressed well before this age.

Furthermore, we know from ample research that one of the most effective ways to prevent kids from starting originates in the home. Unfortunately, we know that many parents lack the knowledge necessary for effectively talking to their kids about the dangers of marijuana use.

We hope that in this meeting tonight you can help us to gain further insight so that we may more effectively disseminate this information to parents of young adolescents like yours.

Discussion of Informed Consent: Before we ask you to go around the room and introduce yourselves- first name only, I want to briefly go over the ground rules. Our foremost goal tonight is to create a safe place that will augment discussion. There are no right or wrong answers. The goal is that we throw out ideas. Therefore, we ask that you respect others by listening to their comments without interruption or outwardly expressing judgment. I will be asking questions that we have carefully selected. We ask that you remain focused on each question before we proceed to the next. We also ask that you keep interruptions such as texting or answering your phones to a minimum. By remaining engaged, we expect this meeting to last no more than thirty minutes. Finally, as you might have noticed, we will be recording this meeting to ensure accuracy. Once this audio recording is transcribed, the recording will be erased. We will take all necessary steps to ensure anonymity. You are `not obligated to answer any questions, and should you object to this meeting being recorded you are free to leave at any time.

If there are no questions, I would like to go around the room and have you introduce yourself and answer some questions.  

List of Questions to be Asked:

1.      Do you feel that it would be valuable to talk to your early adolescent child (11-14 years of age) about marijuana use? If so, what might be some of the barriers preventing constructive dialogue?

2.      What type information do you feel is necessary when having a constructive dialogue of marijuana use with your early adolescent child?

3.      Do you feel that you lack credible information regarding the negative effects of early adolescent marijuana use?

Wrap Up: We want to thank you for your time and the valuable insights you have brought to our attention. This information will help us create an effective pamphlet available through Southwest Behavioral Health Center that aids parents in talking about recreational marijuana use with their adolescent children. Are there any closing questions?

Implications of Marijuana Use in Children and Preadolescents: What Parents Need to Know

Mylinda Barrick, Robert Brant, & Dave Coan

The University of Utah

Drugs are commonly used in our country for medical as well as recreational purposes. Along with many other reasons, they are used to self-medicate, to wake up in the morning, to deal with stress during waking hours, to relax after a day of work, and to go to sleep at night. To summarize, according to Newcomb and Bentler, the United States is a drug culture (2014). Of all the illicit drugs in the US, Marijuana is the most commonly used (Gilman et al., 2014). The National Institute on Drug Abuse has reported that one in ten eighth graders, and more than a third of high school seniors use marijuana.  Of the seniors who do use marijuana, 6.5 percent use on a daily basis. Moreover, half of all seniors do not believe marijuana is harmful.

            Prior to the twentieth century, drugs such as cocaine, heroin, opium, and marijuana were freely obtainable. However, during the twentieth century, and particularly since the 1970's, the US government has attempted to eradicate the use of illicit drugs in what President Nixon declared as the "War on Drugs." However, this approach has failed to solve the problem as the drug underworld continues to escalate (Bianculi, 1997). Just like in the Prohibition when the ban on lawful alcohol sales was instituted, resulting in a black market, drug prohibition has created a black market that is flourishing. As a result, there has been recent debate about whether or not certain illicit drugs such as marijuana should remain in that status.

            To make a case for the legalization of marijuana, one only need look to the prison system. According to the Department of Justice Bureau of Statistics, during the years 2002-2012, one person in every 108 in our country have been incarcerated in federal, state, or local prisons for marijuana-related crimes, despite the burgeoning conditions (2012). The efficacy of this policy has been shown to be very ineffective in terms of rehabilitation. According to this same source, the more often individuals are incarcerated for these offenses, the more likely they are to recommit them (Bureau of Justice Statistics, 2012). It can be further argued that if tobacco and alcohol are legal substances, both of which are at times argued to be far more harmful than marijuana, the case for the legalization of marijuana is bolstered.

            Indeed, as a call to address these arguments and others, states such as California began the trend of legalization with so-called "medical marijuana," whereby in certain conditions (a medical condition followed by a doctor's prescription, e.g.) marijuana could be obtained and used lawfully. This has not come without strong federal protestation, but by and large, "medical" marijuana use has continued. However, this "medical" status is rapidly changing into "recreational" status as states like Colorado and Washington have now legalized its use. It is widely speculated that soon, most states will trend this way and marijuana will join alcohol and tobacco as legal substances.

            This paradigm shift may serve well in addressing overcrowded prisons; however, it is not without negative consequences. The argument was once raised by the pro-legalize group that legalization would not necessarily increase the use of marijuana. However, there is now strong indication to the contrary. It is widely understood that along with alcohol and tobacco, marijuana is the most widely used substance among adolescents in the US (Johnston, O'Malley, & Bachman, 2001; Kann et al., 2000). However, as marijuana is gaining more and more legal status throughout the US, the perceived risk of harm decreases among adolescents, and consequently this creates a strong negative correlation. That is, as the perceived risk decreases, the use of marijuana increases (Johnston, O'Malley, & Bachman, 2001; Gilman, et al., 2014). Many other more recent resources, particularly post-Colorado legalization research, support this data. For example, according to Community Anti-Drug Coalitions of America (CADCA), marijuana use by teens in Colorado increased by 11% since 2009 when marijuana was legalized for claimed medicinal use. This is 39% higher than the national average. With the ensuing legalization of marijuana for recreational use, it is not hard to imagine these numbers maintaining or even increasing (CADCA, 2014).

            The increase of cannabis use is projected to continue among adolescents as more states are expected to jump on the pro-legalization bandwagon. Not only does this create potential deleterious physical, emotional, and neurological effects among adolescent users, it also poses greater challenges for parents in dissuading their children from using marijuana due to its lower perceived risk.

            This challenge is increased when parents remain largely uneducated about the negative effects of marijuana use, and are therefore often ineffective in addressing the issue. Two further concerns complicate this problem. First, when parents do not understand or perceive marijuana to be detrimental, it poses the likelihood of complacency or permissiveness. Some parents remain uninvolved, while others allow their children to smoke marijuana at home because if they are at home doing it, they won't be “out there” getting into trouble. Over time, this has shown to be a misconception as adolescents may not contain their use to the home. In fact this twisted sort of parental philosophy will likely encourage use due to the perceived parental "seal of approval" and the lowered perception of risk as a result. Furthermore, there is a problem of parental denial. Parents tend to believe that their children are not the type to do such a thing as smoking marijuana. They do not see negative effects in school performance or social issues, the usual "red flags" of drug use, and therefore conclude that their children are not among those using. Secondly, as most parents are ignorant to the dangers of marijuana, they are unaware of the potential marijuana has to cut across barriers such as socioeconomic status, race, type of neighborhood, and church life, to name a few. In short, marijuana is a social drug (its preferred use is outside of the home at parties and other places), and virtually no child is absolutely protected from marijuana introduction and use, regardless of social standing.

            The negative effects of marijuana, particularly with adolescent and preadolescent youth, are far-reaching. First of all, in this population of users, any amount of use is considered to be abuse (Newcomb, & Bentler, 2014). It is one thing to see an adult occasionally drink or use marijuana only at a party; however, for the younger population occasional use usually escalates into overindulgence, considered to be acute abuse, and tends to lead to chronic abuse. While virtually no one, regardless of age, is immune from addiction, the younger an individual is when he/she starts using drugs such as marijuana, the greater the probability will be for him/her to increase use over time and in greater quantities (Durant, Smith, Kreiter, & Kowchuk, 1999). This is precisely what is elemental in developing an addiction (McCauley, 2012).

            Another hazard of marijuana use unique to young individuals is the cognitive deficits that result. Neuroimaging studies robustly show that children and youthful teens who begin to use have "smaller cortical and subcortical volumes, disruption of white matter integrity, and changes in functional connectivity" (Corcoran, 2014). Simply translated, this means that the brain must exert more effort to produce comparable results. Furthermore, two studies found a substantial decline in intelligence quotient (IQ) among adolescent users. Despite this decline, cessation of use in later pre-adulthood showed a normal gain in IQ. In other words, if this population stopped using at an early enough age, research showed a measureable improvement in IQ. However, in these same studies, those individuals who continued to use marijuana into middle adulthood (~age 38) did not reverse this deficit (Corcoran, 2014).  This factor will continue to gain significance as the potency of marijuana rises. In 1993 for example, the mean concentration of THC in marijuana in the US was 3.3%. By 2008, this concentration increased to 8.8%, and by 2014, 13% (Corcoran, 2014). In summary, earlier introduction to marijuana use increases the likelihood of addiction which suggests continued use well into adulthood resulting in diminished brain function. As potency increases, decreased neurological functioning equating to impaired cognition is the result.

            Finally, there is little mentioned in American culture about emotional maturation and regulation. Research has shown marijuana to have severe effects in these areas (Chassin, et al, 2014). Because individuals who begin marijuana use at a young age do not mature at the same rate overall as non-users, their psychosocial abilities are greatly impaired. According to Erikson and his theories of psychosocial stages, individuals advancing through these stages are required to gain certain competencies or virtues. In this particular stage of life, it is expected that adolescents will gain virtues such as industry, self-identity, and later, intimacy (Erikson, 1969). Research suggests that these virtues are greatly hampered as a result of emotional immaturity caused by chronic marijuana use. Even if an individual ceases use later in life, these factors are harder to attain, as well as to gain normal emotional maturation which has been stunted at an earlier time.

            With all the above factors considered, it can be stated without any hint of shyness that both adolescent and preadolescent populations are at the greatest risk in terms of the harmful effects of prolonged marijuana abuse. In terms of stakeholders, they are vast. Aside from the users themselves, the young adults create hardships for their immediate families both financially and emotionally. Younger siblings who might look up to the user are not only emotionally impacted by their older sibling's use, but may themselves tend to be influenced into using. Parents can potentially spend thousands of dollars in the justice system and for treatment. Because marijuana use by adolescents is a crime (even in Colorado), and because marijuana use creates a propensity to commit crime, use by the adolescent affects their crime victims (theft, e.g.), as well as overburdening the criminal justice system. The higher rate of incarceration of youths for marijuana and other substances necessitates the need for increased correctional facilities; its cost passed on to the taxpayers. Accordingly, it can be argued that society as a whole is the stakeholder in regards to youth marijuana use, as many areas of society are negatively affected due in part to long-term as well as short-term consequences.

            For example, the school drop-out rate for marijuana and drug users is relatively high. Since allowing medicinal use in Colorado, drug related suspensions and expulsions have increased 32% from 2008 to 2009, the vast majority of these attributable to marijuana use (CADCA, 2014). Social and personal skills are important elements in a young person's ability to complete school, as youth with these skills are more equipped to meet social, academic, and vocational challenges (Brion-Meisels & Selman, 1984; Zins et al., 2000). Marijuana and other substance use negatively impacts this crucial ability. As a result, chronic users of marijuana are ill-equipped and more likely to drop out of school and be unemployed which creates a drain on society as well as the education system. This includes educators (teachers and principals) as well as policy at the district, state, and federal level. Moreover, in these same studies it was found that since "medically" allowing marijuana in Colorado, impaired driving has increased as well as driving fatalities which have increased 100 per cent between 2007 and 2012 attributable to drivers testing positive for marijuana (CADCA, 2014). It is easy to imagine that many of the drivers were youthful drivers. Therefore, it is not a stretch to conclude that road fatalities caused by youthful drivers who are impaired not only affect their own families but other families as well. There is little doubt the implications of marijuana use by young people are far reaching.

            As a group we hope to make an impact on this increasing problem. We realize that we will not solve the entire problem; however, we hope to make a dent in it. Our target population is the parents of elementary and middle-school aged children. We understand that the most valuable opportunity to address these issues would be by reaching out before marijuana/drug use ensues. Sadly, it is not uncommon for middle-school aged children to have already started their journey down the dark path of substance use.

            Our goal is to reach out to these parents by way of a very intentional and concise pamphlet. We will not try to be all inclusive, as our feeling is that parents will not be willing to sit down to read a War and Peace-sized publication. However, what we do hope to accomplish is to provide the parents with enough psychoeducational resources, and in doing so, entice them to read further. Along with this pamphlet, we have created an extensive blog (freeinthree.org) that will provide more information condensed from extensive journal articles and further resources. In our pamphlet we will address questions most frequently asked by children and suggestions for how to answer them ("If marijuana is legal in some states, how can it be harmful?" e.g.).

            We are under advisement by Southwest Behavioral Health Center and others such as Dr. Kevin McCauley (Pleasure Unwoven) who have graciously provided us with extensive research. We also are planning focus groups and have the support to speak in schools and on the radio in hopes that we can reach out to as many people as possible.

            By way of connections we have made with various stakeholders who are well-informed, we realize that one of the biggest barriers to slowing down the drug initiation rate is their uninformed parents. Research has strongly suggested that psychoeducational programs (DARE, e.g.) among youths have little lasting effects and may even increase the problem (Griffin & Botvin, 2004) Therefore, we hope to provide an avenue for the parents that will start them in the right direction.

 

References

Bianculli, L. (1997). The war on drugs: Fact, fiction and controversy. Seton Hall Legislative

            Journal, 1-12. Retrieved from http://www.lexisnexis.com.ezproxy.ib.utah.edu

Brion-Meisels, S., Selgman, R., (1984). Early adolescent development of new interpersonal

            strategies: Understanding and intervention. School Psychology Review, 13, 278-

            291.

Bureau of Justice Statistics. (2012). Office of Justice Programs. Data Collections & Surveys.

            Retrieved from http://www.bjs.gov/index

CADCA. (2014). Youth marijuana use rises nearly 11 percent in Colorado since medical

            legalization. Retrieved from http://www.cadca.org 

Chassin, L., Dmitrieva, J., Modecki, K., Steinberg, L., Cauffman, E., Piquero, A., …

            Losoya, S. (2014). Does adolescent alcohol and marijuana use predict suppressed

            growth in psychosocial maturity among male juvenile offenders? Retrieved from

            http://www.ebscohost.com.ezproxy.lib.utah.edu

Corcoran, C. (2014). Marijuana and adolescents: What can be learned from primates? American

            Journal of Psychiatry, 381-383. Retrieved from ajp.psychiatryonline.org

Durant, R., Smith, J., Kreiter, S., & Krowchuk, D. (1999). The relationship between early age

            of onset of initial substance use and engaging multiple health risk behaviors among

            young adolescents. Archives of Pediatric & Adolescent Medicine, 153, 286-291.

Gilman, J., Kuster, J., Lee, S., Lee, M., Kim, B., Makris, N., … Breiter, H. (2014). Cannabis

            use is quantitatively associated with nucleus accumbens and amygdala abnormalities in

            young adult recreational users. The Journal of Neuroscience, 5529-5538.

Griffin, K., Botvin, G. (2004). Prevention and treatment of adolescent drug abuse. In

            Allen-Meares, P., & Fraser, M., Intervention with Children and Adolescents: An

            Interdisciplinary Perspective (pp.336-355). Boston: Pearson.

Johnston, L., O'Malley, P., & Bachman, J. (2001). Monitoring the future national survey

            results on drug use, 1975-2000. Volume 1: Secondary school students. (NIH Publication

            No. 01-4924). Bethesda, MD: National Institute on Drug Abuse

            Interdisciplinary Perspective (pp. 335-355). Boston: Pearson Education Inc.

Kann, L., Kinchen, S., Williams, B., Ross, J., Lowry, R., Grunbaum, J., Kolbe, J. (2000).

            Youth Risk Behavior Surveillance--United States, 1999. Morbidity & Mortality Weekly      Report, 49 (No. SS-5), 1-95.

McCauley, K. (2012). Pleasure Unwoven: a Personal Journey About Addiction. A Study Guide

            To the Film. Salt Lake City: The Institute of Addiction Study.

Newcomb, M., Bentler, P. (2014). Substance use and abuse among children and teenagers. 1-12. Retrieved from http://www.a.ebscohost.com.ezproxy.lib.utah.edu

Zins, J., Elias, M., Greenberg, M., Weissberg, R. (2000). Promoting social and emotional

            competence in children.  In Minke, K., & Bear, G (Eds.), Preventing school problems

            - promoting school success: Strategies and programs that work (pp. 71-99). Bethesda,

            MD. National Association of School Psychologists.

nts

Our group has been in contact with Southwest Prevention to gain information and data that will help us with our final paper. We are in the process of delegating parts of the paper and will meet once more to finalize and edit our final product. We have also discussed how we will plan to gain information from adults (parents, caregivers, teachers) who work with adolescents to get a better idea of what would be helpful information to include in the pamphlet we are going to produce. Our group is energized and excited for the opportunity we have to potentially be on the radio and news spreading the information we are gathering. We have also found research articles that support our perception of the problem involving the rise of adolescent marijuana use in Washington County.

November 20, 2014

Our group has contacted Southwest Prevention to inform them we are still interested in partnering with them to create literature in the form a pamphlet for parents of adolescents regarding the spike in adolescent marijuana use. We have requested data Southwest Prevention has collected to support the section in our paper that addresses what the problem is to ensure our project matches the need of our community. Our group is dissecting the paper and assigning sections for each group member to work on. Our plans are to meet with Southwest Prevention in the beginning of next semester to brainstorm drafts of the pamphlet and to identify and contact more stakeholders.

Progress

Our group was able to meet with some of the staff at Southwest Behavioral Center on 10-24-14. The meeting was very successful as we negotiated some criteria that needed to be met to work alongside this organization with our group project. Our group discussed the possibility of working on a pamphlet with information and statistics on drugs that are prevelant in our community that could be made available to parents who have children enrolled in the local intermediate schools. The organization was open to the idea of allowing us access to their research and statistics to incorporate it into our group project. The focus has thusfar been established toward creating a pamphlet for parents to be able to utilize when engaging their children in discussions about drugs. Our groups next steps are creating a format for the pamphlet, organized with specific topics we hope to address. Once we have the format established we plan on meeting again with the staff members at Southwest Behavioral Center to get their approval so as to attain the desired research and statistics.

Mylinda had originally scheduled a meeting with Southwest Prevention Center today; however, the appointment has been rescheduled to Friday the 24th. This meeting was established to review the data collected by the Southwest Prevention Center to get a perspective of the needs of the community. During the meeting each member of the group hopes to be able to ask prepared questions to ascertain the needs of the community as understood by those that gathered the research. Data is also being sought from the local sheriff's department and possibly a DEA agent. The group hopes to be able to compare and contrast the data from various sources to get a better idea of how to serve the community.

October 2, 2014

Our first ideas for this project were grandiose and focused on creating a substance abuse prevention presentation for middle school students in Washington and Iron County School Districts.  Mylinda attended the Fall Substance Abuse Conference and came back with the idea that we were trying to reinvent the wheel.  We have now decided to brainstorm and refocus our energy to the needs of our community.  Southwest Prevention recently gathered data to report the needs of Washington County. This information will be available after the 9th of October and our group will analyze the data to see where our efforts can best be applied. Dave has been trying to get in contact with Iron County School District with little luck. Robert has a contact who works for the Drug Enforcement Agency whom he will talk to in order to learn of the resources we can tap into for our project.