Development and Guiding Principles of the Icelandic Model for Preventing Adolescent Substance Use

Abstract

Adolescent substance use-the consumption of alcohol, tobacco, and other harmful drugs-remains a persistent global problem and has presented ongoing challenges for public health authorities and society. In response to the high rates of adolescent substance use during the 1990s, Iceland has pioneered in the development of the Icelandic Model for Primary Prevention of Substance Use-a theory-based approach that has demonstrated effectiveness in reducing substance use in Iceland over the past 20 years. In an effort to document our approach and inform potentially replicable practice-based processes for implementation in other country settings, we outline in a two-part series of articles the background and theory, guiding principles of the approach, and the core steps used in the successful implementation of the model. In this article, we describe the background context, theoretical orientation, and development of the approach and briefly review published evaluation findings. In addition, we present the five guiding principles that underlie the Icelandic Prevention Model's approach to adolescent substance use prevention and discuss the accumulated evidence that supports effectiveness of the model. In a subsequent Part 2 article, we will identify and describe key processes and the 10 core steps of effective practice-based implementation of the model.

Keywords: Icelandic model; adolescence; implementation; practice-based evidence; prevention; substance use.

Figure 1

Domains of Community Risk and Protective Factors in the Icelandic Prevention Model

Figure 2

Annual Percentage of Self-Reported Substance Use Among Icelandic Adolescents, 1998-2018 SOURCE: Kristjansson et al. (2016).