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Assessing school readiness to implement substance misuse prevention: a mixed methods, socio-ecological case study in Wales

Midgley, Luke 2019. Assessing school readiness to implement substance misuse prevention: a mixed methods, socio-ecological case study in Wales. PhD Thesis, Cardiff University.
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Schools are commonly used as a mechanism for delivering substance misuse prevention, with curricula and policies the dominant modes of delivery. Few evaluations have explored the effectiveness of school policy, which suggests enforcement and implementation problems. A complex systems perspective of the school context may aid in understanding implementation failure; and prominent system parts which maintain the status quo. The overall aim was to explore the development and implementation of substance misuse prevention policies in secondary schools in Wales. The first study undertook a policy analysis of education and health policies, applying Bernstein’s (2000) transmission context, followed by semi-structured interviews with 5 regional and local policy makers. The second study explored the school context using semi-structured interviews with 9 teachers and 5 community stakeholders, to explore the relationship between structure and agency in policy implementation. Finally, a multi-level cross sectional analysis was conducted on 18,939 students aged 11-16 across 66 schools, and semi-structured interviews with 38 students (15 and 16 years) across 4 case study schools. The policy analysis found schools have little choice in implementing education policies because of the power and control within the policy discourse. Schools have more control over substance misuse prevention, although implementation is constrained by the system. School teachers reported being under-resourced, under-skilled, and limited by the curriculum and accountability across a narrow range of academic subjects. Cross-sectional analysis found 95.5% (n-63) schools had a substance misuse policy and no beneficial association between the involvement of students in policy development and illicit drug use. This thesis suggests schools are poorly served to deliver substance misuse prevention, despite schools being positioned as part of the solution. More work is needed at the policy level to ensure substance misuse prevention is provided with greater power, resources and funding so that it is better implemented.

Item Type: Thesis (PhD)
Status: Unpublished
Schools: Social Sciences (Includes Criminology and Education)
Subjects: H Social Sciences > H Social Sciences (General)
Funders: ESRC
Date of First Compliant Deposit: 3 August 2020
Last Modified: 17 Mar 2021 02:28

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