Preventing Substance Use Problems Among Young People - A Compendium of Best Practices

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Section 6 - Appendix

This section contains several additional resources:

• Prevention principles checklist: a summary of questions drawn from Section 3. The checklist is intended to be used as a tool for briefly assessing a program;
• Study quality and outcomes rating form: the form that was used by raters of the published articles found in Section 4;
• Authoritative reviews of youth substance use problem prevention effectiveness: reviews referred to in the development of the compendium;
• Articles associated with published programs: articles by which published programs were rated;
• Index of programs: a listing of programs described in the compendium and where to find them.

Prevention Principles Checklist

1. Address protective and risk factors and promote resiliency

What risk factors does our program address (individual, family, school and/or community)?

Do we give more emphasis to promoting protective factors (or resiliency) than reducing risk factors?

Have we worked with other agencies to address shared protective or risk factors?

Have we considered the impact of the broad determinants of health (e.g., income and educational levels, social supports, early childhood experiences) in our community?

2. Seek Comprehensiveness

Do we involve other sectors (e.g., parents/families, schools, agencies) in our program?

Are we working with all relevant agencies and stakeholders, including reaching out to new groups (for example, those who interact with high-risk youth?)

Does our organization support its staff in working with other agencies? Are we advocating for a comprehensive approach and comprehensive policies from local school boards, health boards, addiction agencies and others?

Do government regulations and their enforcement provide adequate support for our aims?

Is preventative attention being given to all ages of children and youth in the community?

Is there a good mix of programming for youth at various levels of risk in our community?

3. Ensure Program Duration and Intensity

Have we clearly identified our target group?

Is the length and intensity of the program appropriate for our target group and sufficient for our intended outcomes?

When selecting at-risk youth for programming, do we have a reasonable basis for selection (e.g., poor academic performance, alcohol dependent parent)?

When selecting at-risk youth, how do we avoid labelling and stigmatization?

When targeting an Indicated population, do we have effective ways to identify and recruit participants (e.g., conduct problem at school as identified by guidance counsellor)?

When working with high-risk youth, in what way do we seek to address their multiple needs?

4. Base Program on Accurate Information

Have we assessed local needs, issues and concerns with respect to substance use?

Are there specific substances or substance use patterns that we need to address through our program?

How much do we know about the extent of occasional, regular and heavy use (and age, gender differences) among our participants or group we wish to engage?

Do we have more than one source of information on usage patterns?

5. Set Clear and Realistic Goals

Do we have an overall plan or strategy for achieving our program goals?

Are our program goals appropriate in light of age and use patterns of youth we wish to engage?

Are our goals and objectives linked logically and are they measurable and time-limited?

Do our program activities link logically to our objectives?

6. Monitor and Evaluate the Program

Do we devote a set percentage of our budget for evaluation?

In what way(s) do we evaluate our program?

What can we say about our program's impact? Does it achieve what is expected?

Have we monitored the process (activities, number of participants, timelines, community support, etc.) throughout?

Have we sought participant and stakeholder feedback and revised our program based on that feedback?

What can we say about our program's costs (direct and indirect) to our agency, our participants and partners?

7. Address Sustainability from the Beginning

If sponsored, how fully have we integrated our program into our sponsoring organization in terms of its policies, staffing, core budget, training, and other forms of support?

To what extent do we rely on short-term funding?

Do we have strategies planned for longer-term funding such as fund-raising, foundation grants, and registration fees from participants?

Do we have the appropriate stakeholders and partners involved and do they have a long-term commitment to the program?

How much do we contribute to sensitizing the public to substance use issues in our community?

8. Account for the Implications of Adolescent Psychosocial Development

Does our programming approach match the stage of development of participants?

Does our program reflect an understanding of the vulnerability associated with the early adolescents phase of development (e.g., impulsive, reckless behaviour)?

Does our program take general adolescent psychosocial needs into account, such as: the need to be independent, consider values distinct from parents and authorities, take risks, join a peer group, form lasting relationships with others?

If working with higher risk youth, do we support their development of a healthy self-identity with achievable tasks and realistic goals?

9. Recognize Youth Perceptions of Substance Use

Does our program acknowledge both the perceived benefits of using substances and the perceived benefits of not using in a balanced, unbiased manner?

Do we provide tools for youth to weigh the costs and benefits themselves and make appropriate decisions?

Do we address perceptions that some youth hold about drugs?

Do we understand why our participants or youth of interest might use substances?

Does our program give more attention to immediate social consequences (vs. long term) health risks and consequences?

10. Involve Youth in Program Design and Implementation

Do we give adequate effort to maintaining the trust and respect of our participants?

To what extent are young people involved in designing, implementing and evaluating the program? Is it more than "tokenism"?

Do we provide our youth with appropriate support, such as payment or some other form of compensation for their involvement, transportation, accessible hours, and back-up support?

Do we ensure that youth members are representative of the population we want to serve?

Do we plan for turnover of our youth and have successors in place?

11. Develop Credible Messages

Have we involved youth in the development of messages?

Do our messages match our overall goals for the program (e.g., harm reduction messages such as avoiding drinking and driving, chugging, unplanned sex)?

Do we avoid scare tactics and misleading information?

Do we avoid simplistic messages such as "just say no" or "play sports"?

What are the unspoken implied messages (e.g., participants are worthy of respect)?

What are the unspoken implied messages (e.g., participants are worthy of respect)?

To what extent have we connected messages to issues or attributes that are important

12. Combine Knowledge, and Skills Development

Does our program present practical information about alcohol and other drugs in a factual and balanced way?

Does our program teach general life skills (e.g., coping skills, conflict resolution, problem-solving, decision-making, communications skills)?

Does our program allow youth to role-play or rehearse strategies to avoid or manage higher risk situations?

Does our program address influences of drug use, including societal and media influences?

Does our program address participant self-confidence, where to find help, overcoming barriers to getting help, and providing help to others?

Does our program address other concerns of youth (e.g., failing grades, poor peer relationships), recognizing the link between those concerns and drug use?

13. Use Interactive Group Process

Does our program use activity-based learning strategies rather than didactic methods?

Does our program help participants to reflect on what they are learning (journal writing, small group discussions, encouraging conversation with close friends) and to set goals for changes in their lives?

Do we use peers in program delivery in a meaningful way?

14. Give Attention to Teacher or Leader Qualities and Training

Do the participants consider our leaders credible?

Are our program leaders/teachers comfortable with a facilitative role within an interactive approach?

Do our program leaders convey empathy and encourage youth involvement?

Do we provide training and support for leaders/teachers?

Are participants given a chance to evaluate program leaders?

Study Quality and Outcomes Rating Form

Program:

Title of Article:

Author:

Publication Date:

Study Quality and Outcomes Rating Form

Item	Criteria	Score
Study Quality
1. Sampling technique	If randomized=2pts; quasi-exp=0	/2
2. Comparison group	Equivalence at baseline (differences controlled)=1pt	/1
3. Attrition rate	Non-differential attrition (differences controlled)=1pt	/1
4. Accounting for non-participants	If accounted for and similar to participants=1pt	/1
5. Data collection instruments	Reliable and valid=1pt	/1
Outcomes
6. Findings	Positive effect on behaviour (inc. delayed onset)=2pt;Positive effect on beliefs=1pt; Positive effect on intermediary factors (e.g. school bonding, anti social behaviour, school achievement); = 1pt. Intermediary factors measured	/4
7. Duration of effect measured	Following completion of the intervention. 1 year or >=1pt; 2 year or >=2pt	/2
8. Extent of compliance or fidelity to designed intervention	If compliant=1pt	/1
9. Extent of replication and out comes	Using a program having shown + effect=1; in doing so, if showing behavioural results=1pt	/2
		Total   /15

Comment:

Note:

• Unless obvious discrepancy, will take authors word on measures taken
• If author does not address a criteria, score will be 0
• Full points only - all or nothing
• In findings section, score for each measure showing effect and add together; eg change in behaviour (2) + beliefs (1)=3
  

Reviews of Youth Substance Use Problem Prevention Effectiveness

• Aguirre-Molina, M., Gorman, D.M., Community-based Approaches for the Prevention of Alcohol, Tobacco and Other Drug Use. Annual Review of Public Health, Vol.17: 337-358, 1996.
• Brounstein, P.J., Zweig, J.M., Understanding Substance Abuse Prevention: Toward the 21st Century: A Primer on Effective Programs. Rockville, MD: U.S. Department of Health and Human Services, 1999.
• Bukoski, W.J., Evans, R.I., Cost-benefit/Cost-effectiveness Research of Drug Abuse Prevention: Implications for Programming and Policy. Rockville, MD: U.S. Department of Health and Human Services, 1998.
• Bukoski, W.J. (ed.), Meta-analysis of Drug Abuse Prevention Programs. Rockville, MD: U.S. Department of Health and Human Services, 1997.
• Drug Strategies, Making the Grade: A Guide to School Drug Prevention Programs. Washington, DC: Drug Strategies, 1996.
• Durlak, J.A., Primary Prevention Programs in Schools. Advances in Clinical Child Psychology, Vol.19: 283-318, 1997.
• Dusenbury, L., Falco, M., Lake, A., A Review of the Evaluation of 47 Drug Abuse Prevention Curricula Available Nationally. Journal of School Health, Vol.67, #4: 127-132, 1998.
• Eggert, L.L., Kumpfer, K.L., Drug Abuse Prevention for At-risk Individuals. Rockville, MD : U.S. Department of Health and Human Services, 1997.
• Eliany, M., Rush, B., How Effective are Alcohol and Other Drug Prevention and Treatment Programs? A Review of Evaluation Studies. Ottawa, ON: Minister of Supply and Services, 1992.
• Kreft, I.G., Brown, J.H. (eds.), Evaluation Review, A Journal of Applied Social Research: Zero Effects Of Drug Prevention Programs: Issues And Solutions. Thousand Oaks, CA : Sage Periodicals Press, Vol.22, #1, 1998.
• National Institute of Justice,  Preventing Crime: What Works, What Doesn't, Whats Promising http://www.ncjrs.org/pdffiles/171676.pdf
• Paglia, A., Room, R., Preventing Substance-use Problems Among Youth: A Literature Review and Recommendations. ARF research document series #142, Addiction Research Foundation, 1997.
• Quinlan, J.W., (production officer), A Review of Alternative Activities and Alternative Programs in Youth-oriented Prevention. Rockville, MD: U.S. Department of Health and Human Services, 1996.
• Ross, J., Quinn, T., Gardner, S.E., Bass, R.D., Signs of Effectiveness in Preventing Alcohol and Other Drug Problems. Rockville, MD : U. S. Department of Health and Human Services, 1993.
• Tobler, N.S., Stratton, H,H., Effectiveness of School-based Drug Prevention Programs: A Meta-analysis of the Literature. Journal of Primary Prevention, Vol.18, #1: 71-128, 1997.
• Tobler, N., et al., School-based Adolescent Drug Prevention Programs: A 1998 Meta-analysis. Journal of Primary Prevention, Vol.20, #4, 2000.
• University of Colorado, Blueprints for Violence Prevention.
  http://www.colorado.edu/cspv/blueprints
• U.S. Department of Health and Human Services. National Institutes of Health. National Institute on Drug Abuse, Preventing Drug Use Among Children and Adolescents: A Research-based Guide. Rockville, MD: U. S. Department of Health and Human Services, 1997.
• White, D., Pitts, M., Educating Young People About Drugs: A Systematic Review. Addiction, Vol.93, #10: 1475-1487, 1998.

Articles Associated with Published Programs

Universal

School

• Bell, R.M., Ellickson P.L, Harrison E.R., Do Drug Prevention Effects Persist into High School? How Project ALERT Did With Ninth Graders. Preventive Medicine, Vol.22: 463-483, 1993.
• Botvin, G.J., Baker, E., Filazzola, A.D. and Botvin, E.M., A Cognitive-Behavioral Approach to Substance Abuse Prevention: A One Year Follow-up, Addictive Behaviors, Vol.15, 47-63. 1990.
• Botvin, G.J., Baker, E., Dusenbury, L., Botvin, E.M. and Diaz, T., Long-Term Follow-up Results of a Randomized Drug Abuse Prevention Trial in a White Middle Class Population, Journal of the American Medical Association, Vol.273, 1106-1112, 1995a.
• Botvin, G.J., Baker, E., Dusenbury, L., Tortu, S., Botvin, E.M., Preventing Adolescent Drug Abuse Through a Multimodal Cognitive-Behavioral Approach: Results of a Three-Year Study. Journal of Consulting and Clinical Psychology, Vol.58: 437-446, 1992.
• Ellickson, P.L. and Bell, R.M., Drug Prevention in the Junior High: A Multi-Site Longitudinal Test, Science, Vol.247, 1299-1305. 1990.
• Hansen, W.B. and Graham, J.W., Preventing Alcohol, Marijuana, and Cigarette Use Among Adolescents: Peer Pressure Resistance Training Versus Establishing Conservative Norms, Preventive Medicine, Vol.20, 414-430, 1991.
• Shope, J.T., Copeland, L.A., Kamp, M.E. and Lang, S.W., Twelfth Grade Follow-up of the Effectiveness of a Middle School-Based Substance Abuse Prevention Program, Journal of Drug Education, Vol.28, #3: 185-97, 1998.
• Shope, J.T., Kloska, D.D., Dielman, T.E., Maharg, R., Longitudinal Evaluation of An Enhanced Alcohol Misuse Prevention Study (AMPS) Curriculum for Grades Six-Eight. Journal of School Health, Vol.64: 160-166, 1994.
• Werch, C.E., Carlson, J.M., Pappas, D.M., DiClemente, C., Brief Nurse Consultations for Preventing Alcohol Use Among Urban Youth. Journal of School Health, Vol.66, #9, 335-338, 1996.
• Wragg, J. The Longitudinal Evaluation of Primary School Drug Education Program : Did it Work? Drug Education Journal of Australia, Vol.4, 33-44, 1990.

Family

• Ashery, R.S., Robertson, E.B., Kumpfer, K.L., "Drug Abuse Prevention Through Family Interventions" NIDA Research Monograph Series 177 Rockville, MD : U.S. Department of Health and Human Services, 1998.

Community

• Biglan, A., Ary, D., Smolkowski, K., Duncan, T., Black, C., A Randomized Controlled Trial of a Community Intervention to Prevent Adolescent Tobacco Use. Tobacco Control Vol.9: 24-32, 2000.
• Hawkins, J.D., Catalano, R.F., Kosterman, R., Abbott, R., Hill, K.G., Preventing Adolescent Health-Risk Behaviours By Strengthening Protection During Childhood, Archives of Pediatrics and Adolescent Medicine, Vol.153, 226-234. 1999.
• Hawkins, J.D., Catalano, R.F., Gillmore, M.R. and Wells, E.A. Skills training for Drug Abusers: Generalization, Maintenance, and Effects On Drug Use, Journal of Consulting and Clinical Psychology, Vol.57, 559-563, 1989.
• Hingson, R., McGovern, T., Howland, J., Heeren, T., Winter, M., and Zakocs, R., Reducing Alcohol-Impaired Driving in Massachusetts: The Saving Lives Program. American Journal of Public Health, Vol.86, 791-797, 1996.

Selective/Indicated

School

• Botvin, G.J., Schinke, S.P., Epstein J.A., Diaz, T., Effectiveness of Culturally Focused and Generic Skills Training Approaches to Alcohol and Drug Abuse Prevention Among Minority Youths. Psychology of Addictive Behaviors, Vol.8: 116-127, 1994.
• Caplan, M., Weissberg, R.P., Grober, J.S., Sivo, P.J., Grady, K., Jacoby, C., Social Competence Promotion With Inner-City and Suburban Young Adolescents: Effects on Social Adjustment and Alcohol Use. Journal of Consulting and Clinical Psychology, Vol.60: 56-63, 1992.
• Dewit, D.J., Braun, K., Steep, B., Ellis, K., Rye, B.J., Silverman, G., Smythe, C., and Stevens Lavigne, A., Evaluation of an In-School Drug Prevention Program for At-Risk Youth. Manuscript submitted for publication. 1997.
• Eggert, L.L., Thomson, E.A., Herting, J.A., Nicholas, L.J., and Dicker, B.G., Preventing Adolescent Drug Abuse and High School Dropout Through An Intensive School-Based Social Network Development Program. American Journal of Health Promotion Vol.8, #3: 202-215, 1994.
• Kivlahan, D., Marlatt, A., Fromme, K., Coppel, D., and Williams, E., Secondary Prevention With College Drinkers: Evaluation of An Alcohol Skills Training Program. Journal of Clinical and Consulting Psychology, Vol.58, 805-810, 1990.
• Marlatt, G.A., and Baer, J.S., Harm Reduction and Alcohol Abuse: A Brief Intervention for College-Student Binge Drinking. In P.G. Erikson, D.M. Riley, Y.M. Cheung, and P.A. O'Hare (Eds.), Harm Reduction: A New Direction for Drug Policies and Programs (pp.245-262). Toronto: University of Toronto Press, 1997.
• Sussman, S., Dent, C.W., Stacy, A.W., Craig, S., One-Year Outcomes of Project Towards No Drug Abuse, Preventive Medicine, Vol.27, #4, 632-642, 1998.
• Thompson, E.A., Horn, M., Herting, J.R., Eggert, L.L., Enhancing Outcomes in an Indicated Drug Prevention Program for High-Risk Youth, Journal of Drug Education, Vol.27, #1, 19-41, 1997.

Family

• Catalano, E., Haggerty, K.P., Gainey, R.R. and Hoppe, M.J., Reducing Parental Risk Factors for Children's Substance Misuse: Preliminary Outcomes With Opiate-Addicted Parents. Substance Use and Misuse, Vol.32, 699-721, 1997.
• Johnson, K., Bryant, D., Collins, D., Noe, T., Strader, T. and Berbaum, M., Preventing and Reducing Alcohol and Other Drug Use By Increasing Family Resiliency. Social Work Vol.43, #4: 297-308, 1998.
• McDonald, L. Impact of a Family School Based Prevention Program on Protective Factors for High Risk Youth: Issues in Evaluation, Drugs and Society, 1997.

Community

• Gilchrist, L.D., Schinke, S.P., Trimble, J.E., Cvetkovich, G.T., Substance Abuse Prevention for American Indian Adolescents, International Journal of Addictions, Vol.22, #9, 869-879., 1987.
• Gleghorn, Alice A.; et al. The Impact of Intensive Outreach on HIV Prevention Activities of Homeless, Runaway, and Street Youth in San Francisco: the AIDS Evaluation of Street Outreach Project (AESOP). AIDS and Behavior, Vol.1, #4: 261-271, 1997.
• Godley, M.D., Velasquez, R., Effectiveness of the Logan Square Prevention Project : Interim results, Drugs and Society, Vol.12, #1/2, 61-85, 1998.
• Hunt, N., Stillwell, G., Taylor, C., and Griffiths, P., Evaluation of a Brief Intervention to Reduce Initiation Into Injecting, Drugs: Education, Prevention and Policy Vol.5, #2: 185-193, 1998.
• Hunt, N., Griffiths, P., Southwell, M., Stillwell, G., and Strang, J., Preventing and Curtailing Injecting Drug Use: Opportunities for Developing and Delivering 'Route Transition Interventions'. Drug and Alcohol Review. Vol.18, #4: 441-451. 1999.
• Magura, S., Kang, S.Y., Shapiro, J., "Outcomes of Intensive AIDS Education for Male Adolescent Drug Users in Jail", Journal of Adolescent Health Vol.15: 457-463, 1994.
• Monti, P.M., Colby, S.M., Barnett, N.P., Spirito, A., Rohsenow, D.J., Myers, M.,Woolard, R., Lewander, W., Brief Intervention for Harm Reduction with Alcohol-Positive Older Adolescents in a Hospital Emergency Department, Journal of Consulting Clinical Psycholology, Vol.67, #6, 989-994, 1999.
• Ochoa, K., Moss, A., et al., "Toward Participatory Action Research: The Challenges and Rewards of Collaborative Study" The Case of the UFO Study: A Project of the Haight Ashbury Youth Outreach Team, the Santa Cruz Needle Exchange and the University of California, San Francisco, CA: The Authors, 2000.
• O'Neil, K., et al., Evaluation of A Cognitive-Behavioural Intervention for Pregnant Injecting Drug Users At Risk of HIV Infection. Addiction, Vol.91, #8, 1115-1125, 1996
• Stillwell, G., Hunt, N., Taylor, C. and Griffiths P., The Modelling of Injecting Behaviour and Initiation Into Injecting. Addiction Research Vol.7, #5: 447-459. 1999.
• Weiker, R.L., Edgington, R., Kipke, Michele, D., A Collaborative Evaluation of Needle Exchange Program for Youth. Health Education and Behavior, Vol.26, #2: 213-224, 1999

Comprehensive

• Chou, C.P., Montgomery, S., Pentz, M.A., Rohrbach, L.A., Johnson, C.A., Flay, B.R., Phil, D., MacKinnon, D.P., Effects of A Community-Based Prevention Program On Decreasing Drug Use In High-Risk Adolescents, American Journal of Public Health, Vol.88, #6, 944-948, 1998.
• Johnson, C.A., Pentz, M.A., Weber, M.D., Dwyer, J.H., Baer, N., MacKinnon, D.P., Hansen, W.B., Flay, B.R., Relative Effectiveness of Comprehensive Community Programming for Drug Abuse Prevention With High Risk and Low-Risk Adolescents. Journal of Consulting and Clinical Psychology, Vol.58: 447-456, 1990.
• Perry, C.L., Williams, C.L., Veblen-Mortenson, S., Tooney, T.L., Komoro, K.A., Anstine, P.S., McGovern, P.G., Finnegan, J.R., Forster, J.L., Wagenaar, A.C., Wolfson, M., Outcomes of a Community-Wide Alcohol Use Prevention Program During Early Adolescence: Project Northland. American Journal of Public Health, Vol.86, # 7, 1996.

Index of Published Programs

School

All Stars - Adolescent Alcohol Prevention Trial - 54
Alcohol Misuse Prevention Study - 8
Illawara Program - 61
Life Skills Training Program - 65
Project ALERT - 70
STARS - 75

Family

Strengthening Families Program - 79

Community

Project SixTeen - 82
Saving Lives Program - 85

Comprehensive

Midwestern Prevention Project (MPP) - 88
Project Northland - 92

Selective

School

Lifestyles '94 - 96
Opening Doors - 98
Personal Growth Class - 101
Project Toward No Drug Abuse - 104
Seattle Social Development Project Intervention - 108
Skills Training for College Students - 112
Social Competence Promotion Program for Young Adolescents - 115

Family

Adolescent Transitions Program - 119
Creating Lasting Family Connections - 122
Families and Schools Together - 130

Community

Motivational Interviewing - 135
Community Partnership Program - 138
The Heroic Journey - 140

Indicated

Family

Focus on Families - 143

Community

AIDS Education for Male Adolescents in Jail - 150
AIDS Evaluation of Street Outreach Project - 152
Clean Needles Now - 155
Intervention for Pregnant Injection Drug Users - 157
Logan Square Prevention Project - 159
Prevent Initiation of Drug Users into Injecting - 163
UFO (U-Find-Out) Study - 165
Substituting Naltrexone for Heroin - 169

Index of Canadian Programs

School

Making Decisions: Grade 6 and Grade 7 - 175
Peer Support Program - 177
Student Alcohol and Drug Use Policy and School Curriculum Resources - 180
Teens Against Drinking and Driving (TADD) - 184
Tuning In To Health - 186
Your Life: Your Choice! - 188

Family

Developing Capable People (DCP) - 191

Community

C3 (Community Cooperation for Change): A Workable Solution - 193
Communities in Action for Children and Youth - 195
Drug Education and Awareness for Life (DEAL) - 198
Media Arts Program - 201
Opti-Jeunesse : Une force contre la toxicomanie - 204
Town Youth Participation Strategies (TYPS) - 206
Youth Web site Project - 208

Comprehensive

Alcohol, Cannabis and Tobacco Health Promotion for Youth (ACTION) - 210
Dallas Society Prevention Services - 213

Selective

School

Aboriginal Shield - 218
Opening Doors - 220
Student Assistance for Everyone (S.A.F.E.) - 222

Family

Families and Schools Together (F&ST) - 224
Nobody's Perfect - 226
Ready or Not - 228

Community

Alternatives for Youth - 230
Harm Reduction for Rural Youth - 232
Healthy Choices for our Children - 234
Let 'Em Go: The Street Involved Youth Harm Reduction Experience - 237
Project Y.O.U - 239
Saskatoon Downtown Youth Centre/EGADZ - 243
Teen Touch Inc. Helpline - 246

Indicated

Family

Youth Substance Abuse and Parent Programs - 248

Community

Downtown Eastside Youth Activities Society - 252
Exit Community Outreach - 255
First Contact, A Brief Treatment for Young Drug Users - 257
HIV Education Program - 260
Intervention par les pairs auprès des jeunes de la rue du centre-ville de Montréal - 263
McDougall House - 265
Keep Six Needle Exchange Program - 267
Point de repère - 270
Streetworks - 272