The Blueprint for Action (Blueprint) model was developed in 2020, after Canada’s Chief Public Health Officer, Dr. Theresa Tham, sounded the alarm on problematic substance abuse amongst youth in her 2018 State of Public Health in Canada report. In a nutshell, the Blueprint model aims to encourage a different way of thinking about how to approach youth substance abuse, by saying yes to evidence and no to one-size-fits-all interventions, and it supports school stakeholders with engaging their networks: by increasing attention, buy-in, and resources for long-term approaches.
Given the rising prevalence of health and wellness struggles among youth, it is pertinent that we try something different, because past approaches have had limited success. There are three elements to the Blueprint model: the 4 pillars of the Blueprint, a requirement for evidence-based approaches to preventing substance-related harm, and an incorporation of the Comprehensive School Health Approach.
The 4 pillars of the Blueprint for Action
Essential to the Blueprint model are the four key takeaways, or pillars.
The first is that evidence-based substance use education is only one component of a comprehensive approach for preventing substance-related harms among youth. This pillar focuses on outcomes around equitable school policies, positive social and physical environments, and supportive partnerships and services for youth.
The second is that the best prevention measures often have nothing to do with substance use at all. This pillar focuses on outcomes around improving health and wellbeing and reducing social and health inequities.
The third is that efforts to prevent substance-related harms among youth must reflect a school communities’ unique needs, values, preferences, and environments. The third pillar focuses on ensuring active engagement with all school stakeholders including youth and their families but also community leaders and both public and private sectors.
The fourth is that many traditional approaches to addressing youth substance use have limited effectiveness and can produce unintended negative consequences. The fourth pillar emphasizes the important role that schools play and the need to use the best available evidence to prevent substance-related harms, as well as the need to evaluate initiatives on an ongoing basis.
The Blueprint model is meant to support school community members in planning and carrying out a wide range of strategies for preventing substance-related harms among youth that are grounded in evidence, reflect students’ diverse needs and environments, and maximizing the levers school communities can use to support health and wellbeing.
Evidence-based approaches to preventing substance-related harm.
There are four leading approaches to preventing substance-related harms: upstream prevention, harm reduction, stigma reduction, and equity-oriented approaches.
Upstream prevention approaches revolve around providing access to resources, encouragement, and space to students who are looking to participate in extracurricular activities. Upstream prevention approaches are closely related to health promotion since they tend to enhance protective factors like positive social and health outcomes including healthy relationships, a strong sense of self, access to education, a safe environment, and school and community connectedness. However, effective upstream prevention can look different from one school community to the next, depending on the unique needs and the resources available.
Harm reduction approaches revolve around establishing school-board level policies that require schools to have on-site emergency care supports like naloxone kits in the event of a suspected opioid poisoning. Different youth are likely to have different experience with substance use and with their openness to supports or change, so it is essential to have an inclusive and pragmatic approach to preventing substance-related harms among youth. The main goal with this approach is to reduce that potential social and health harms related to substance use, both harms to oneself but harms unto others, and it is a better course of action than a harm reduction approach that entirely focuses on a “just saying no” abstinence campaign.
Stigma reduction initiatives revolve around working with all stakeholders in order to ensure greater access to specialized supports for students. Many health experts and advocates agree that stigma must be a core objective in any plan or strategy to prevent substance-related harms, as stigma prevents us from seeing people as full, complex human beings, which we need to treat as such. Stigma is one of the leading reasons as to why youth do not attempt to access resources or build and sustain health relationships, and, ultimately, why they never reach their full potential.
Equity-oriented approaches revolve around increasing knowledge of the diverse identities and situations that contribute to an individual’s unique lived experience. The importance of equity-oriented approaches has to do with the fact that certain populations tend to be disproportionately impacted by substance-related harms and other negative social and health outcomes, and it requires the creation of unique conditions to help people live their best lives and ensure that no one is systematically disadvantaged from achieving their potential, This is done by recognizing that different people start from different places and they have different needs. Equity-oriented approaches seek to make institutions and systems more accessible, responsive, compassionate, and safer for all people, which can be achieved by developing policies, programs and other interventions that reflect diverse needs.
Comprehensive School Health Approach
The comprehensive school health approach is an approach to building healthy school communities, and it is supposed to guide in the planning, implementation, and evaluation of school initiatives related to various aspects of health. There are four inter-related components to assessing and implementing interventions: social and physical environments, teaching and learning, policy, and partnerships and services.
Social and physical environments revolve around the relationships among and between students and staff, school culture, access to extracurricular spaces and spaces promoting student safety and connectedness.
Teaching and learning revolve around formal and informal curricula and resources and developing understanding and skills toward health and wellbeing.
Policy revolves around policies, guidelines, and practices that promote and support students’ health, wellbeing, and achievement and foster a welcoming environment for all members of the school community.
Partnerships and services revolve around connections between school staff and students’ families, building supportive working relationships between all stakeholders with a focus on community and school-based services that support and promote student and staff health and wellbeing.
Ultimately, school communities have a vested interest in the health and wellbeing of youth, including their risk of experiencing substance-related harms. The Blueprint model provides a tool that school communities can use to inform and strengthen their efforts to prevent substance-related harms among youth. Through thoughtful application and evaluation of this model, school stakeholders can help to support positive shifts in how school communities address substance use, and ultimately, their ability to effectively respond to and prevent substance-related harms.
The Blueprint for Action model remains relatively unknown.
The problem with past approaches to addressing substance use among students has been that those approaches have largely focused on abstinence and minimally on substance use education, but it has also been done without addressing social-emotional learning and how those drivers can push students towards substance misuse. Instead, approaches need to meet students “where they are at”, which is what the Blueprint model incorporates and emphasizes.
Although the Blueprint model has enormous potential to help better the health outcomes of Canada’s future leaders and thinkers, this approach to addressing substance-related harm among youth is still something that many policy makers at the schoolboard level, municipal level, and provincial level all lack familiarity with, as do some people working in health. So, meet them where they are at by bringing the Blueprint to their attention and demanding that we do everything we can to improve the health outcomes of every youth, because it is who we are and it is what they deserve.