What is Appreciative Inquiry (AI)?

Appreciative Inquiry Research Dealing with Student Prescription Drug Abuse Dr. Jeanelle Boyer, Dr. Marj Droppa, Dr. John Finneran and Dr. Margaret A Smith Keene State College, NH NAADAC 2014

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Today’s Objectives 

Discuss the following:  Prescription drug abuse on college

campuses  Current prevention strategies used to address prescription drug abuse  The use of Appreciative Inquiry (AI) research as an evidence-based prevention strategy

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Objective One Prescription drug abuse on college campuses Dr. John Finneran

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Prescription Drug Use on College Campuses Approximately one in every five college students reported nonmedical use of at least one prescription medication in their lifetime.  Past year prevalence of medical use, diversion and nonmedical use of prescription stimulants increased significantly between 2003 and 2013.  Past year use was greater among males, Whites, members of social fraternities and sororities, those with a lifetime history of medical use of prescription medications, or past year history of being approached to divert their prescription medications.  Past year prevalence of medical use, diversion and nonmedical use of prescription opioids decreased significantly over the same period. 



McCabe et al. (2014) Trends in medical use, diversion, and nonmedical use of prescription medication among college students from 2003 to 2013: Connecting the dots. Addictive Behaviors, 39, 1176-1183

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Trends in past-year nonmedical use of prescription medications in college students: 2003–2013 McCabe et al., 2014

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Percent of Other drug use - *Excludes alcohol, cigarettes, tobacco from a water pipe, and marijuana within the past 12 months – ACHA/NCHA 2013 All other drugs combined (percent)

Male Female Total Male Actual use Actual use Actual use Perceived use

Female Perceived use

Total Perceived use

Never used

58.3

75.5

69.7

14.2

10.9

12.1

Used but not in the last 30 days

23.2

16.2

18.5

17.4

14.4

15.4

Used 1 – 9 13.3 days

6.4

8.7

41.8

42.3

41.9

Used 1029 days

2.5

1.2

1.7

17.4

20.3

19.2

Used 30 days

2.7Fe

0.7

1.4

9.2

12..2

11.4

8.3

11.9

68.4

74.8

72.5

Any use in 18.5 last 30 days

Percent of college students who reported using drugs that were not prescribed to them within the last 12 months ACHA/NCHA 2013 Drug

Percent

Male

Female

Total

Antidepressants

2.2

3.1

2.8

Erectile dysfunction drugs

1.2

0.8

0.9

Pain killers

6.2

5.5

5.8

Sedatives

3.1

3.1

3.2

Stimulants

7.1

5.4

6.0

Used one or more of the above

12.3

11.4

11.8

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Problems Associated with Prescription Drug Abuse among College Students Health risks (seizures, stroke, death)  Most college students abusing Adderall were also binge drinkers and half heavy alcohol users(SAMSHA, 2009)  Students who take prescription drugs non-medically are 5x more likely to develop a drug abuse problem (McCabe, 2008) 

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Objective 2 Current techniques used to address prescription drug abuse Dr. Margaret Smith

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What prevention strategies are you using in your community or campus?

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Current Methods of Reducing Drug Abuse on College Campuses Environmental approaches (ex: Social Norms, campus wide policies)  Orientation Programs (ex: Under the Influence Program, New Student Orientation)  Late night and Weekend Activities/Events/Programs 

Current Methods of Reducing Drug Abuse on College Campuses Education Groups (ex: Policy Violators Group, Residential Education Programs)  Individual Counseling  Peer Education  Special programs for Athletes, Fraternities, Sororities 

What isn’t working Individual (for the most part)  One-time only  Non-environmental approaches 

Objective 3

The use of Appreciative Inquiry (AI) research as an evidence-based prevention strategy What is AI? Dr. Marj Droppa

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What is Appreciative Inquiry (AI)? A framework for creating an imagined future that builds on the most positive and vital elements of a community or organization

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APPRECIATIVE INQUIRY Values the best of what is DISCOVER

Envisions what might be DREAM

Engages in dialogue about what should be DESIGN

Develops strategies to bring about what will be DELIVER 17

“Appreciative Inquiry focuses us on the positive aspects of our lives and leverages them to correct the negative. It’s the opposite of ‘problem-solving.” 

White, T.H. Working in Interesting Times: Employee morale and business success in the information age. Vital Speeches of the Day, May 15, 1996, Vol XLII, No. 15.

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PROBLEM SOLVING

APPRECIATIVE INQUIRY

Analytical Process 

Define the Problem



Fix what is broken





Creative Process 

Search for strengths that already exist



Amplify what is working



Focus on life-giving forces



“What is working well around here?”

Focus on what is wrong “What are the root causes of problems or gaps in services?”

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Creative Process 

Each 4D is guided by Positive Questions  High point experiences  Values  Core, life-giving factors  Images of future success



Encourage visual design

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Appreciative Assumptions 

In every society, organization, or group, something is working



What we focus on becomes our reality



The act of asking questions of a group influences the group in some way



Looking for what works well and doing more of it is motivating and effective 21

Outcomes of AI 

Recognition and affirmation of the group’s strengths, values and resources



Deep understanding of the factors that contribute to success



Strategies to build on success



Synergy within the group



Momentum moving forward 22

The Phases

Discov er

Delive r

Dream Design

Discover

Inquiry into the group’s experience of what works; look for themes.

Dream

Develop common images for the future; envision “what could be”. Develop provocative propositions.

Design

Align strengths, values, structure, and mission with vision. Develop achievable plans and steps to make vision a reality.

Deliver

Co-create a sustainable, envisioned future. 23

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The BEST part of AI? It is community-based  It is a participatory event  It empowers 

“It focuses on what a community does well rather than on eliminating what a community does badly”

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Objective 3 cont…. The use of Appreciative Inquiry (AI) research as an evidence-based prevention strategy AI at Keene State College Dr. Jeanelle Boyer

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AI at Keene State College 40 participants: faculty, staff, students, community members  4 weekday evenings  2 hour sessions 

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AI at Keene State: Discovery 

Partner Interviews and small group discussion uncovered the BEST about Health and Wellness at KSC



Results- “Positive Core” • • • • • • •

Wellness facilities and student clubs Non-judgmental attitudes by peers Supportive environment Safety and challenge Volunteer opportunities Close community Student involvement outside the college 28

Discovery: Let’s try it! 

Think of a time when a prevention strategy worked really well. Talk about that experience with your partner. Take notes. (~3 min per person)

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AI at KSC: Discovery

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AI at KSC: Dream KSC opens the communities eyes to a new drug-free horizon! Supporters watched today as over half of KSC’s students took a pledge to be H.I.P. (Healthy, Involved, Positive). Stigma No More: Keene Community Unites to Provide Support and Alternatives leading to national prescription drug reform.

Going the extra mile, the KSC community leads the way to prescription drug reform through new ways of resource support and prevention for communities across the nation

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AI at KSC: Design  

    

Increase the number of peer educators as well as the number of educated RA’s and RD’s Educate all new teachers/staff/faculty at KSC Increase awareness about stress relievers (ex yoga, meditation, music, dance) Mobilizing the whole community Community endorsement/more resources for the cause/grants Maintaining what we already have in place Inspirational speakers for the public

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Strengths of AI Community driven prevention strategies  Spring board for a grant and a larger AI summit  Empowering  Engaged participants  Great attendance 

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Reflections from the Research Team 

Best Part of AI as a Prevention Strategy?

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Where we are today Applied for and received a federally funded grant to use AI inquiry to evaluate community needs and to eventually implement prevention strategies  Partnership with Franklin Pierce College and Cheshire County  AI summit in October at Keene State College with participants from both the college and the greater Keene community 

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Questions & Overview How does prescription and other substance misuse affect the members of a large, closed community, a college campus?  What is the biopsychosocial impact of a person with moderate to severe substance use disorder upon suite mates, dorm mates, class mates, and others within the college community?  Are responses similar to a nuclear or extended family with substance misuse at its center? 

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Questions?

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Thank You

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