Article

“Unplugged”: A school-based randomized control trial to prevent and reduce adolescent substance use in the Czech Republic

January 2012
Drug and Alcohol Dependence 124(1-2):79-87

DOI:10.1016/j.drugalcdep.2011.12.010

Source
PubMed

Authors:

Roman Gabrhelík

Charles University, 1st Faculty of Medicine

Michal Miovsky

Charles University in Prague

C Debra Furr-Holden

Johns Hopkins Bloomberg School of Public Health

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The Czech Unplugged Study, inspired by the European Drug Addiction Prevention Trial, is a prospective, school-based, randomized controlled prevention trial designed to reduce the risk of alcohol, tobacco, inhalant, and illegal drug use in 6th graders in the Czech Republic. The intervention uses the comprehensive social influence model to affect alcohol and drug using norms among primary school students. Descriptive statistics and chi-square analyses were used to assess differences between the experimental and control groups on demographic characteristics and study outcomes. Multilevel techniques were used to take the hierarchical structure of the data into account. Prevalence odds ratios using the Bonferroni correction were calculated to assess the differences between the experimental (N = 914) and control (N = 839) groups on each outcome 1, 3, 12, 15, and 24 months after the end of the intervention. Multilevel analysis using the Bonferroni correction showed statistically significant intervention effects at the final follow-up for any smoking (OR = 0.75, 99.2% CI 0.65-0.87), daily smoking (OR = 0.62, 99.2% CI 0.48-0.79), heavy smoking (OR = 0.48, 99.2% CI 0.28-0.81), any cannabis use (OR = 0.57 99.2% CI 0.42-0.77), frequent cannabis use (OR = 0.57, 99.2% CI 0.36-0.89), and any drug use (OR = 0.78, 99.2% CI 0.65-0.94). This study adds new evidence on the effectiveness of the Unplugged school-based prevention program for primary school students in the Czech Republic.

Acceptability, feasibility and fidelity of the culturally adapted version of Unplugged (“Yo Se Lo Que Quiero”), a substance use preventive program among adolescents in Chile: a pilot randomized controlled study

Article

Full-text available

Jul 2024
BMC PUBLIC HEALTH

Introduction The consumption of alcohol, tobacco, and cannabis is a public health problem that impacts the cognitive, social, and emotional development of adolescents. Prevention strategies such as the “Unplugged” program are effective in delaying the progression of daily smoking and episodes of drunkenness among adolescents. “Yo Se Lo Que Quiero” (YSLQQ) corresponds to the adaptation of this program to the Chilean context. This study assesses the acceptability and feasibility of implementing this program to the local reality. Material and methods This was a cluster-randomized controlled pilot study conducted on six public schools. All consented students attending 6th, 7th, and 8th grades (n = 1,180) participated in the study. The schools were randomly assigned to one of two conditions in a 1:1 ratio: (1) the “YSLQQ” intervention group (n = 526), and (2) the Control group (n = 654). The program consisted of a 12-hour class-based curriculum based on a comprehensive social-influence approach delivered by a trained facilitator. The acceptability and feasibility were assessed in the intervention group at the end of the intervention using questionnaires answered by students and facilitators. The quality and fidelity of the program were evaluated during the implementation using self-ported surveys answered by the facilitators and the assessment of video-recorded sessions rated by external observers. Finally, a pre-test and a post-test survey assessing past and current substance use and risk and protective factors were conducted before and immediately after the program’s implementation. Results A high proportion of students (49.6%) liked the sessions. 79.2% reported that the YSLQQ helped them learn about the dangers of substances, while 65.8% reported having more skills to avoid substance use in the future. Regarding students’ satisfaction with YSLQQ, 62.9% reported being happy or very happy with the program. Facilitators reported implementing the intervention according to the manual in 73.9% of sessions. Regarding substance use, students who participated in the intervention groups reported a significant reduction in drunkenness in the last year and last 30-day prevalence and also a significant reduction in a lifetime and 30-day prevalence of cannabis use when compared with those students in the control group. Conclusions Our results suggest that YSLQQ has adequate acceptability and feasibility to be implemented in the Chilean context, and there were promising results in reducing drunkenness and cannabis use. Future research should confirm these results in a larger RCT study. Trial registration The trial was registered in ClinicalTrials.gov, NCT04566627; registration date: 01/03/2019

Evaluation of Effectiveness of the Unplugged Program on Gambling Behaviours among Adolescents: Study Protocol of the Experimental Controlled Study “GAPUnplugged”

Article

Full-text available

Feb 2024
J Primary Prevent

Gambling risk behaviour is an emerging problem among adolescents. “Unplugged” is an effective Social Influence curriculum for preventing substance use among students. This study aims to develop and test a new component focused on gambling added to the Unplugged program. Schools of Piedmont region and Rome city were invited to participate in the study. A self-completed anonymous questionnaire including questions on socio-demographic characteristics, addictive behaviours, beliefs, attitudes and risk perceptions about gambling, normative perceptions, parental practices, school climate, refusal skills, impulsiveness, self-esteem, antisocial behaviours and sensation seeking was prepared for baseline and follow-up surveys. The protocol of the study was submitted and approved by the Novara Ethical Committee and registered in ClinicalTrials.gov (NCT05630157, Protocol ID: 080.742, 11/17/2022). Twenty-nine schools accepted to participate in the study. Sixty-three classes (1325 students) satisfied the eligibility criteria for intervention and were allocated to the intervention arm, and the other 61 (1269 students) were allocated to the control arm. Because of drop-out, absentees, refusals, and invalid questionnaires, data on 1874 students (998 in the intervention and 876 in the control arm), were available for the analysis at baseline. Data management of follow-up questionnaires is in progress. Results of the present study will be useful to clarify the effectiveness of prevention interventions in reducing gambling behaviours among adolescents. Moreover, this will be the first experience of evaluating a new component focused on a different risk behaviour, added to a curriculum previously shown as effective on other risk behaviours.

Influencing adolescents’ attitudes towards nicotine products: A systematic review

Article

Full-text available

Jun 2022

Background and aim: Use of nicotine can harm adolescents’ brains and increase risk for future addiction to other drugs. Several international studies show that an acceptable attitude towards nicotine products increases the initiation or use of the products. Adolescents have limited or distorted knowledge about nicotine products. Many of them have a positive image of the properties and effects of nicotine products, which increases the chances of smoking or using snus. Yet, we know little about the relationship between youth nicotine use, youth attitudes towards nicotine products and the interventions to influence these attitudes. This systematic review synthesised adolescents’ attitudes towards nicotine products and the ways to influence them. Methods: Systematic searches were carried out from PubMed, MEDLINE, CINAHL, and MEDIC databases and were targeted to randomised controlled trial (RCT) studies published in 2010–2021. Results: A total of seven RCT studies were reviewed with a total population (age range 9–17 years, adolescents 11–17 years) of 15,974. Findings were classified into four categories: school-based interventions, tobacco prevention campaigns, advertisements’ influence on adolescents’ opinions towards nicotine products, and their responses to cigarette pack warnings. Conclusion: Based on this systematic literature review, particularly school-based interventions have an effect on adolescents’ attitudes towards smoking and preventing them from starting to smoke, when they are targeted before the age of puberty. School-based interventions should be further implemented and strengthened, as the school has been shown to have significant potential to support youth’s health. There is a need for further information about the most effective interventions in the different age groups and the qualitative studies on the topic.

Effects of the "Unplugged" school-based substance use prevention program in Nigeria: A cluster randomized controlled trial

Article

Aug 2021
DRUG ALCOHOL DEPEN

Background School-based programs are the most convenient interventions to tackle substance use among youth. “Unplugged” is a Social Influence universal school curriculum developed and tested in the “EU-Dap” project. In 2015, Nigeria implemented a large-scale project to promote healthy lifestyles in schools, families and communities. Within the project, the effectiveness of “Unplugged” was evaluated through a cluster randomized controlled trial. Methods The program was adapted to the Nigerian context, assembling suggestions from monitoring forms and interviews, and performing fidelity checks on content and method. Thirty-two secondary schools were extracted from a list provided by the Federal Ministry of Education, and randomly allocated to intervention and control arms. A self-completed anonymous questionnaire was used for baseline and follow-up surveys. The analysis sample finally included 2685 pupils (mean age 14,2 years). Multilevel models were run to estimate program effects on prevalence of self-reported cigarettes, alcohol, and marijuana use. Mediation analysis was performed to identify possible mediators of program effects on alcohol use. Results Unplugged significantly reduced the prevalence of recent alcohol use in intervention vs control pupils. The effect on prevalence of cigarette and marijuana use was not statistically significant. The program prevented progress and encouraged regress across stages of intensity of alcohol use. Negative beliefs, risk perceptions, and class climate mediated the effect of Unplugged on alcohol use. Conclusions Unplugged was effective in preventing alcohol use improving beliefs, class climate and risk perceptions among Nigerian students. The implementation of the program at a larger scale in the country should be supported.

Results of process evaluation of the Unplugged school-based prevention program in Nigeria

Article

Sep 2020

Background The UNODC with the collaboration of the Government implemented in Nigeria a large-scale project to promote healthy lifestyles in schools, families and communities. Within the project, the prevention program Unplugged was tested through a randomized controlled trial. This study aims to evaluate the implementation of the program in the intervention schools and the satisfaction of teachers and students. Methods 32 schools were randomly extracted from a list of 60 schools provided by the Federal Ministry of Education. 16 schools were randomly allocated to intervention and implemented Unplugged. To monitor program implementation, the teachers filled a form reporting data on fidelity of implementation. To monitor satisfaction, teachers and students filled an anonymous form at the end of the program. Results 69% of intervention schools participated in the process evaluation. The duration of the units was on average 55 min. The implementation rate was very high. All classes implemented six units whilst less than 10% did not implement the other six units. The highest rate of not implementing classes was observed for unit 11 and 12. The highest student interest as declared by the teachers was observed for Unit 1 and 8, the highest interactivity for Unit 9 and 8. Most teachers found the units easy to lead and referred an improvement of teaching skills, knowledge about substances, relationship with the students and class climate, and found very useful the Teacher Handbook. Ninety percent of students considered Unplugged useful for their choices, for 82% it improved the vision of themselves, for 95% their knowledge, for 80% the relationship with mates and for 77% the relationship with teachers. 97.5% of students would like to have a similar program next year. Conclusions Unplugged reached in Nigeria very good results in terms of implementation and satisfaction of teachers and students. Process evaluation is useful to improve the quality of prevention interventions. Key messages School based prevention interventions like Unplugged can be successfully implemented in low income countries, especially when supported by printed Handbook for teachers. Teachers and students participating in Unplugged perceived an improvement of class climate and relationship between teachers and students due to the program.

Piloting of the Just Say Know prevention program: a psychoeducational approach to translating the neuroscience of addiction to youth

Article

Jul 2020

Background: Substance use during adolescence can have a number of negative consequences and interfere with normal brain development. Given limited time and resources, brief group- and school-based prevention programs are an efficient strategy for educating youth about the effects of substance use on health outcomes. Objectives: To determine if a science-based, interactive substance prevention program could improve student knowledge and influence students’ attitudes toward future substance use behaviors. Methods: The Just Say Know program was given to 1,594 middle and high school students. The facilitator engaged students in an interactive, hour-long session covering brain basics and effects of substance use. Students completed an eight-item pre- and post-knowledge-based test to measure learning outcomes along with feedback questions about youths’ attitudes toward substance use and the program. Results: After the program, 94% of students reported that it provided helpful information; 92% reported it may influence their approach to substance use, with 76% specifying that they would delay or cut back on substance use. Knowledge-based test performance increased by 78%, with high schoolers displaying significantly higher scores than middle schoolers, but both showing similar improvements in scores. Students who reported higher levels of friends’ substance use had smaller improvements from pre- to post-test. Conclusion: Results suggest Just Say Know, a scientifically-based prevention program, is effective in increasing adolescents’ program based-knowledge, has the potential to affect youths’ attitudes toward substance use, and is well-received. These findings provide preliminary evidence that a cost-effective, neuroscience-informed group prevention program might reduce or delay adolescents’ future substance use.

Bestandsaufnahme schulbasierter Modelle zur Reduktion oder Verhinderung von riskantem Alkoholkonsum bei Kindern, Jugendlichen und jungen Erwachsenen

Research

Full-text available

Aug 2018

Five typologies of alcohol and drug prevention programmes. A qualitative review of the content of alcohol and drug prevention programmes targeting adolescents

Article

Jul 2017

Adolescents exhibit a high rate of use of alcohol and illicit drugs. Effect studies rarely describe the actual content of the interventions in detail. Less is known about what was actually done in the prevention than about their effects. Aim: This study is a review study grouping the qualitatively different content components of the various approaches into five categories. Methods: A systematic literature review from Western countries on the topic of school-based interventions and prevention initiatives targeting young people aged 12–20. A modified version of the narrative synthesis approach is used for analysis. The sample consisted of 33 peer-reviewed articles published between January 2010 and December 2014. Findings: Five categories of intervention and prevention programmes were identified: ‘Information-based or testing-based primary prevention approaches’, ‘Primary prevention approaches incorporating skill-training components’, ‘Universal or primary prevention approaches that include family components’, ‘Targeted approaches incorporating skill-training components’, and ‘Approaches incorporating digital features’. Conclusion: Only four studies that employed any form of targeting or profiling of the subjects prior to the delivery of the prevention intervention or initiative were identified. The skewness towards primary prevention skill-training approaches should be addressed, given the diverse consumption patterns among adolescents.

Efficacy evaluation of the school program Unplugged for drug use prevention among Brazilian adolescents

Article

Full-text available

Nov 2016
BMC PUBLIC HEALTH

Background Most Brazilian schools do not have a continuous program for drug use prevention and do not conduct culturally adapted activities for that purpose. This study evaluated the impact of the Unplugged program on drug use prevention among children and adolescents in public middle schools of Brazil. MethodsA non-randomized controlled trial was conducted in 2013 with 2185 students in 16 public schools from 3 Brazilian cities. The intervention group attended 12 weekly classes of the Unplugged program for drug use prevention, and the control group did not attend to any school prevention programs in the same year. Multilevel analyses were used to evaluate temporal and between group changes in the consumption of each drug. ResultsThe study suggested that there was no evidence that Unplugged effected 11- to 12-year-old students. However, the program seemed to stimulate a decrease in recent marijuana use (transition from use to non-use in 85.7% of intervention cases and 28.6% of control cases, OR = 17.5, p = 0.039) among 13- to 15-year-old students. In addition, students in this age range who received the Unplugged program had similar drug consumption levels to those observed before the program began. However, students in the control group presented a significant tendency to increase marijuana use and binge drinking. Conclusions This study adds to the evidence of program efficacy among Brazilian middle school students by presenting marginal effects on binge drinking and marijuana use. An 18-month randomized controlled trial is recommended for a future study.

Effectiveness of Health Promotion Interventions in Primary Schools—A Mixed Methods Literature Review

Article

Full-text available

Jun 2023

School-based health promotion interventions (HPIs) are commonly used in schools, but scientific evidence about the structures of effective interventions is lacking. Therefore, we conducted a mixed methods systematic literature review to recognize the HPI structures related to their effectiveness. Based on the inclusion criteria, 49 articles were selected for the literature review. The articles, published in 2011–2022, described 46 different school-based interventions conducted in 20 different countries. The average duration of the interventions was 12 months, and they were implemented mostly with an RCT study design (61.2%) and by targeting children (69.4%). Three main groups of interventions were identified and explained: (1) extensive and long-term interventions; (2) school policy-changing interventions; and (3) highly effective interventions. Effective school-based HPIs included multiple target groups, multiple providers with external experts, and an efficient duration and timing of follow-ups. The implications for educational research and school practice are presented. Evidence on the effectiveness of health-related interventions is still lacking and needs to be addressed in further studies.

REVISIÓN SISTEMÁTICA DE INTERVENCIONES PREVENTIVAS EN AMBIENTE ESCOLAR PARA EL CONSUMO DE ALCOHOL Y TABACO EN ADOLESCENTES

Article

Full-text available

Feb 2022
Salud Drogas

Benito Israel Jiménez-Padilla

Conocer cuáles son las intervenciones preventivas más efectivas aplicadas en ambientes escolares para disminuir o retrasar el consumo de alcohol y tabaco en adolescentes y sus caracteristicas. Metodo: en base a la Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), se realizó una revisión sistemática de la literatura mediante las siguientes bases de datos: PubMed, Web of science en el Social Science Citation Index, Science Citation Index Expanded y Emergin Sources Citation Index, así como en Scopus y otras fuentes. Resultados: se incluyeron en el análisis 10 articulos en los que encontró que las intervenciones que tenian como caracteristica el sustentarse en teoria demostraron mayor efectivad; seguidas de las intervenciones multicomponentes. Conclusiones: La utilización de una teoria como sustento de la intervención fue la caracteristica que mas peso agregó a la efectividad de las intervenciones, al igual que aquellas que utilizaron algun componente tecnológico.

The Speed of Progression to Tobacco and Alcohol Dependence: A Twin Study

Article

Full-text available

Mar 2018
BEHAV GENET

We investigated the etiological role of genetic and environmental influences for two milestones of tobacco and alcohol use: age of initiation, and speed of progression to dependence (latency). Study participants included 1352 monozygotic and 1422 dizygotic twins (mean age at assessment = 24.31). Earlier ages of initiation significantly increased the likelihood of developing dependence, but were associated with longer dependence latencies for tobacco and alcohol. Latencies to dependence were heritable traits for tobacco (a2 = 0.63) and alcohol (a2 = 0.64). Genetic influences contributing to early age of initiation were associated with faster latencies to dependence but sometimes were counteracted by environmental factors, the extent to which depended on substance and, sometimes, sex. Our findings may have important implications for public policy and add to the literature by characterizing the genetic and environmental contributions to the speed of progression to tobacco and alcohol dependence.

Estratégias de prevenção ou redução do consumo de drogas para adolescentes: revisão sistemática da literatura

Article

Full-text available

Jun 2016

Foi realizada uma revisão sistemática com o objetivo de identificar as evidências científicas acerca das estratégias de prevenção ou redução do consumo de drogas entre adolescentes. A busca foi realizada nas bases de dados LILACS, CINAHL, MEDLINE, Scopus e Cochrane Library, com os descritores Ensino, Educação em Saúde, Transtornos relacionados ao uso de substâncias, Adolescentes e Enfermagem Psiquiátrica. Foram selecionados 27 artigos. Os resultados demonstraram uma variedade de programas, projetos e intervenções utilizados como estratégias de prevenção ou redução do consumo de drogas entre adolescentes. Dentre os estudos, 74,1 % (n=20) observaram resultado satisfatório e 25,9% (n=7) parcialmente satisfatório. Apenas o Projeto Narconon e a Intervenção Breve demonstraram efetividade, de maneira ampla, na redução do consumo de diferentes tipos de drogas entre adolescentes, uma vez que as demais foram direcionadas à algum tipo específico de drogas ou ainda se limitaram à prevenção do consumo destas sustâncias à adolescentes não usuários.

Neuroscience-informed psychoeducation for addiction: a conceptual and feasibility study

Article

Full-text available

Feb 2025

Over the past few decades, our understanding of substance use disorders (SUD) has been reshaped by evidence from neuroscience, which suggests that SUD are characterized by specific neuromarkers that transcend traditional diagnostic boundaries and act as pre-diagnostic markers that could be targeted through preventive attempts. Connectivity-based neuromarkers or brain networks have emerged as a promising framework, providing new insights into the neurocognitive mechanisms of SUD. Utilizing this data-driven framework assists prevention and intervention developers in offering a non-judgmental insight for adolescents regarding the potential vulnerability of neurocognitive systems to continued substance use. Given the importance of such awareness, this paper proposes a neural network-informed approach based on research domain criteria (RDoC) to characterize the content of neuroscience-informed psychoeducation designed for SUD. Furthermore, we argue that various features related to content and structure need to be considered when developing such interventions delivered through digital platforms (e.g., apps and websites). Finally, we introduce a theory-driven app called “NIPA”, developed with the aim of increasing adolescents’ awareness and resilience to the effects of drugs and other emotional triggers on brain and cognitive functions.

The Effectiveness of a TPB Educational Program for Preventing Alcohol Use Among Adolescents

Article

Full-text available

Jul 2024

Psychosocial competences in the continuing training of French National Education professionals in 2024: A major issue in promoting health in school environment

Article

Full-text available

Jun 2024

The effect of gamification-based training on the knowledge, attitudes, and academic achievement of male adolescents in preventing substance and internet addiction

Article

Full-text available

Nov 2023
BMC Med Educ

Background Preventing addiction through training takes precedence over treatment and plays a crucial role in enhancing the well-being of adolescents. Utilizing inclusive and participatory methods can significantly enhance the effectiveness of education. Numerous studies have demonstrated that gamification, as an interactive and comprehensive approach, has the potential to boost teenagers’ motivation to engage in learning and contributes to better comprehension. Aim This study aimed to assess the impact of gamification-based training to prevent substance and internet addiction on the knowledge and attitudes of male adolescents. Additionally, the study examined this educational program’s effects on male adolescents’ academic achievement. Methods This study employed a quasi-experimental design with a control group. One hundred fourteen male adolescents were randomly assigned to the intervention or control groups. They completed a pre-intervention questionnaire assessing addiction-related knowledge, attitudes, and academic achievement. Subsequently, the intervention group received the gamification-based drug and internet addiction prevention training. Post-tests were conducted immediately after the training and again one month later for both groups. Results Before the intervention, there were no significant differences in knowledge of substance and internet addiction, attitudes toward substances and the Internet, and academic achievement between the intervention and control groups (P > 0.05). However, after the intervention, the intervention group demonstrated significantly higher scores in knowledge of substance and internet addiction, attitudes toward substances and the Internet, and academic achievement compared to the control group (P < 0.001). Conclusion The current study highlights the positive impact of gamification-based training on enhancing male adolescents’ knowledge, attitudes, and academic achievement.

Habilitation à Diriger des Recherches : Approches sociocognitives et affectives de la motivation : Promouvoir la motivation à l’École, en contexte sportif et pour l’activité physique

Thesis

Full-text available

Jun 2022

Damien Tessier

Cette note de synthèse réalisée en vue de l’obtention de l’Habilitation à Diriger des Recherches vise à retracer les éléments saillants de mes travaux de recherche portant sur la promotion de la motivation à l’École et en contexte sportif, et sur la promotion de la motivation pour l’activité physique (AP) à des fins de santé. Elle est structurée en trois parties : La première porte sur la promotion de la motivation pour l’AP à des fins de santé. Les travaux qui s’inscrivent sur cet axe de recherche se sont intéressés à trois mécanismes de promotion de l’AP : des mécanismes cognitifs visant le développement des intentions d’AP, des mécanismes comportementaux visant le développement des capacités d’autorégulation facilitant l’implémentation des intentions, et des mécanismes affectifs visant le développement d’expériences d’AP positives. La deuxième partie concerne la promotion de la motivation en EPS et en sport. Les travaux menés dans cette perspective, ont consisté à élaborer, tester, et répliquer plusieurs programmes de formation des enseignants et des entraineurs à dessein d’améliorer leur style motivationnel, ainsi que l’engagement et la motivation autonome de leurs élèves/sportifs. Enfin, la troisième partie s’intéresse à la promotion de la motivation et du bien-être à l’école. Les travaux relatifs à cet axe se sont notamment intéressés au développement des compétences psychosociales des élèves en tant que vecteur de promotion de la motivation et du bien-être. Le projet ProMoBE consistant à combiner des leviers de la promotion de la motivation (i.e., formation au soutien des besoins psychologiques visant l’amélioration du style motivationnel) et des leviers de la promotion du bien-être (i.e., IPP-multi-composantes visant le développement des CPS) représente le coeur de cet axe de recherche.

Changes in alcohol beliefs mediate the effects of a school-based prevention program on alcohol use among Brazilian adolescents

Article

Oct 2022

Objective: To investigate the mechanisms of the #Tamojunto2.0 program that mediated the prevention of lifetime alcohol and drug use, including drug knowledge, behavioral beliefs, attitudes, decision-making skills, and refusal skills. Methods: A cluster-randomized controlled trial was conducted in 73 public middle schools in three Brazilian cities. The sample included 5208 students (49.4 % girls; Mage = 13.2 years). The intervention group attended twelve #Tamojunto2.0 lessons conducted by their previously trained teachers. The control group did not receive any intervention. Data were collected pre-intervention and at the 9-months follow-up. We performed multiple mediation models (for the whole sample, users, and non-users) with a post-estimation adjustment to standard errors to account for nesting. We analyzed all available mediators simultaneously according to each drug: alcohol, binge drinking, tobacco, marijuana, and inhalant lifetime use. To handle missing data, we used the "full-information maximum-likelihood" paradigm. Results: Outcomes in the whole sample and among non-users showed that #Tamojunto2.0 indirectly prevented lifetime alcohol use and binge drinking by increasing negative and non-positive alcohol beliefs. Only the direct effect on decreasing lifetime alcohol consumption was statistically significant. However, an indirect increase in binge drinking was observed through knowledge about alcohol, but the direct effect was not statistically significant. No effects were reported for marijuana, tobacco, or inhalants. Among users, no statistically significant effects were found for alcohol or drug use. Conclusions: The results suggest that the #Tamojunto2.0 program was only effective in delaying alcohol consumption via increasing negative and non-positive alcohol beliefs. It seems that mediating mechanisms vary depending on contextual characteristics, differences in socializing among adolescents, features of the educational systems, psychosocial conditions, or, fidelity issues of program implementation.

Developing and implementing a national quality assurance policy and control policy in school- based prevention of risk behaviors: a case study

Article

Jun 2022

Background The implementation of quality standards and measures in the school-based prevention of risk behaviors is not well evidenced in the literature. Aims The description of the emergence and implementation of an original nationwide quality management for the prevention of risk behaviors. Methods Narrative review from database searches, including gray literature, followed by a subsequent content analysis. Results The implementation was divided into six stages characterized by specific activities, measures and concepts given by parameters of the thematic scope and approaches. The driving element turned out to be the changing responses of service providers. It was the response, engagement and the increasing level of providers self-organization that had the greatest effect on development. This interactive process had a major influence on the eventual wide thematic range and scope. It led to establishing of a unique system represented by four components: a certification system and standards for the quality of methods and their delivery to the target group, the monitoring and evaluation of the programs at the school level, qualification standards for professionals, and ethical standards. Conclusions Reflection on the implementation of quality management in school-based prevention in the past 20 years may empower similar processes in other countries.

THE EFFECT OF A SCHOOL PREVENTION PROGRAM ON ALCOHOL CONSUMPTION A SOLOMON FOUR GROUP DESIGN

Conference Paper

Apr 2022

"The aim of this study was to investigate the direct and indirect effect of the Unplugged program on alcohol consumption (AC) as reported by schoolchildren a year after program implementation within a Solomon four group design. A randomized control trial using the Unplugged program was carried out among schoolchildren at 24 primary schools. Twelve schools were assigned to the experimental group (EG, n = 798, n = 401EG no pre-test, n = 397EG pre-test) while 12 schools were assigned to the control group (CG, n = 622, n = 298CG no pre-test, n = 333CG pre-test). The mean age of the schoolchildren was 13.5 years, SD = 0.59; 47.5% girls. The sample consisted of 1420 schoolchildren in total. The data collection was carried out immediately before implementing the program (T1, experimental and control group with a pre-test), immediately after implementing the program (T2) and a year after program implementation (T3). The consumption of alcohol during the last 30 days (Hibbel, Guttormsson, Ahlström, & Kraus, 2012) was dichotomized for the purposes of the statistical analysis. A serial mediation analysis was performed through the Hayes´ PROCESS tool in SPSS 25 (Model 6). The controlled variables in the serial mediation analysis were ACT2, pretest, and gender. The mediation effect was tested on 5000 samples by means of Bootstrapping. The direct effect of Unplugged on ACT3 was confirmed. The effect of Unplugged on ACT3 was serially mediated by meaningful participation in the community T3 and satisfaction with oneself T3. The results of this study have contributed to the effectiveness of the European school-based drug use prevention program Unplugged among Slovak schoolchildren."

Measuring Parental Behavior towards Children's Use of Media and Screen-Devices: The Development and Psychometrical Properties of a Media Parenting Scale for Parents of School-Aged Children

Article

Full-text available

Aug 2021
Int J Environ Res Publ Health

Children's excessive screen use is associated with health risks such as obesity, sleep problems , attention problems, and others. The effect of parental regulative efforts focused on screen/me-dia use (media parenting) is currently unclear and difficult to examine given the heterogeneity of measuring tools used for its assessment. We aimed to develop an inventory that would enable reliable and valid measurement of media parenting practices (especially active and restrictive mediation) in parents of primary school children. The inventory builds on existing tools, it is comprehensive , yet easy to use in research setting. The original MEPA-36 (36 items) and revised MEPA-20 (20 items) inventories were examined using data from 341 Czech and Slovak parents of children aged between 6 and 10 years. Psychometrical properties were estimated using confirmatory factor and reliability analyses. Model fit was better for MEPA-20 and similar to other currently available tools. Both active and restrictive mediation subscales demonstrated high internal consistency. The internal consistency of newly constructed risky mediation subscales (risky active, risky restrictive, and over-protective mediation) was low. MEPA-20, especially active and restrictive mediation sub-scales, can be recommended for research on media parenting in context of screen/media use of school-aged children.

Does #Tamojunto alter the dynamic between drug use and school violence among youth? Secondary analysis from a large cluster-randomized trial

Article

Full-text available

Aug 2021
EUR CHILD ADOLES PSY

The present study investigated how intervention might alter the relationship between perpetrating violence and later drug use. A cluster-randomized controlled trial design involving 72 schools (38 intervention, 34 control) and 6390 students attending grades 7 and 8 was employed in Brazil. Drug use and violence were assessed at three points. A random-intercept cross-lagged panel model examined the reciprocal association between drug use and school violence domains across the three data collection waves. For both groups, we found that the cross-lagged effect of perpetration on further drug use in adolescents was stronger than the reverse, but the interrelationship was not statistically significant between #Tamojunto and control schools. The carry-over effects of drug use and violence were also not significantly different between groups. There is a lack of evidence showing that #Tamojunto can modify the dynamics between drug use and school violence across the 21-month period. The direction of the causal effect (i.e., the more perpetration behavior, the more subsequent drug use behavior) is present, but weak in both groups. The trial registration protocol at the national Brazilian Register of Clinical Trials (REBEC) is #RBR-4mnv5g.

School-Based Prevention of Screen-Related Risk Behaviors during the Long-Term Distant Schooling Caused by COVID-19 Outbreak

Article

Full-text available

Aug 2021
Int J Environ Res Publ Health

The COVID-19 outbreak and related restrictions meant a higher incidence of screen-related risk behaviors in both children and adolescents. Our goal was to assess the perceived importance and extent of school-based preventions related to these risks during the long-term, nation-wide distant schooling period in the Czech Republic. The online survey was responded to by the school-based prevention specialists (N = 1698). For the analysis, within-subject analysis of variance (ANOVA) and binominal logistic regression were used. At-risk internet use and cyber-bullying were perceived as pressing, but other risks, for example, excessive internet use or the use of cyberpornography, received substantially less priority. The differences in all grades were significant and moderate to large (η2G between 0.156 and 0.288). The proportion of schools which conducted prevention interventions of screen-related risks was low (between 0.7% and 27.8%, depending on the grade and the type of the risk). The probability of delivering prevention intervention was in all grades significantly predicted by the presence of screen-related problems in pupils (OR 3.76–4.88) and the perceived importance of the screen-related risks (OR 1.55–1.97). The limited capacity of schools to deliver prevention interventions during distant schooling as well as the low awareness and impaired ability to recognize the importance of some screen-related risks should be addressed.

Predictors of School Violence Perpetration and Victimization: Effects of Drug Use and Sociodemographic Characteristics

Article

Full-text available

Aug 2022
Int J Ment Health Addiction

A randomized controlled trial was conducted with 6391 7th- and 8th-grade students in 72 public schools in six Brazilian cities. A confirmatory factor analysis was performed to create a unidimensional model for validity. Linear regression was used to evaluate how baseline past-month drug use, violence, and sociodemographic characteristics affected violence at follow-up. The results showed that previous involvement in violent episodes at school (β = 0.397, p < 0.001) as well as the use of inhalants at baseline (β = 0.358, p = 0.026) predicted higher levels of violence 9 months after baseline. Additionally, girls showed lower levels of involvement in violence than boys (β = −0.144, p < 0.001). School prevention programs and policies should simultaneously address drug use and violence. Inhalant use seems to act as a proxy of future involvement in school violence, independent of previous involvement in violent episodes. Trial registration: RebEC, RBR-4mnv5g. Registered 3 July 2014, http://www.ensaiosclinicos.gov.br/rg/RBR-4mnv5g/.

Attitudes are associated with the drug use profiles of middle school adolescents: A latent class analysis

Article

Nov 2020
PSYCHIAT RES

The association between positive and negative attitudes and drug use profiles is examined. Participants were public middle school students (N = 5213; 49.9% girls; M age= 13.2 years) in three Brazilian cities. Analysis was performed using baseline surveys of a randomized controlled trial of the #Tamojunto2.0 drug use prevention program. We validated the attitudes construct via a confirmatory factor analysis and performed a simultaneous multinomial regression with a latent class analysis. Three latent classes were identified: abstainers/low users (ABS) (63.4%), alcohol users/binge drinkers (ALC) (29.5%), and polydrug users (POL) (7.1%). An association gradient was found between attitudes and latent classes. Using ABS as reference, a direct association was identified between positive attitudes and ALC and POL. An inverse association was found between negative attitudes and POL only. Girls and older students were more likely to be ALC and POL. These findings, from a large probabilistic sample, provide guidance that drug use prevention programs should focus on deconstructing positive attitudes -mainly- and broadening negative attitudes, and should adapt their thematic content by considering the differential drug use possibilities among girls and older students.

A cluster randomized controlled trial evaluating the effectiveness of the school‐based drug prevention programme, #Tamojunto2.0

Article

Nov 2020

Aims The study aimed to evaluate the effectiveness of the government school‐based programme #Tamojunto2.0, the third Brazilian version of the European drug prevention programme, Unplugged, in preventing the use of alcohol and other drugs. Design A parallel, two‐arm cluster randomized controlled trial was conducted in 205 classes in 73 public schools (37 intervention and 36 control) with a baseline assessment and follow‐up after 9 months. Setting Schools in the city of São Paulo, Fortaleza, and Eusebio in Brazil. Participants 5,208 students in the 8th grade with a mean age of 13.2 years (SD 0.8 years) and an equal gender ratio. Intervention: In 2019, the intervention group attended 12 classes of the programme, #Tamojunto2.0, under the supervision of a team from the Ministry of Health. The control group did not receive any intervention to prevent alcohol and drug use. Measurements The primary outcome measured was prevalence of binge drinking (5 or more doses of alcohol in an occasion) within the past month. Secondary outcomes were prevalence of initiation and use of alcohol, tobacco, inhalants, marijuana and cocaine within the past month. Findings A statistically significant difference was not found in prevalence of binge drinking within the past month between intervention and control groups (odds ratio (OR)=0.934; 95% CI 0.761‐1.146). However, students who were exposed to the programme were less likely to initiate alcohol use than those in the control group (OR = 0.782; 95% CI 0.636‐0.961). The Bayes factor for reduction in binge drinking was 0.01, providing evidence in favor of the null hypothesis. Conclusions The drug prevention programme #Tamojunto2.0 appeared not to reduce past month binge drinking among 8th grade students in Brazil. However, the programme reduced alcohol initiation.

Effectiveness evaluation of the school-based drug prevention program #Tamojunto2.0: protocol of a cluster randomized controlled trial

Article

Full-text available

Jun 2019
BMC PUBLIC HEALTH

Background The European school-based drug addiction prevention program Unplugged was adapted to the Brazilian context by the Ministry of Health and renamed #Tamojunto. Its first implementations, in the form of a public policy in Brazil, showed contradictory and different effects from those observed in Europe. Adaptations were made to #Tamojunto in 2018 to reintroduce the essential content of the original program. Methods A parallel, two-arm, randomized controlled trial (RCT) will be conducted to evaluate the effectiveness of the new version of the school-based government program #Tamojunto2.0 for the prevention of drug use among 8th grade middle school students from 70 public schools in three Brazilian cities, totaling approximately 6.300 participating students distributed in 210 classes. For intervention, the experimental group will receive the 12 lessons of the #Tamojunto2.0 program under the supervision of a Brazilian Ministry of Health team. The control group will not receive any intervention. Information will be collected from the students at three time points: preintervention and 9 and 18 months postintervention. Multilevel analyses will be performed using the Gllamm Stata program to assess simultaneous differences in prevalence, in time and among groups for the outcomes of interest. Structural equation modeling will be used to evaluate the effectiveness of the intervention in changing the behavioral patterns of the adolescents through latent transition analysis. The effect of the mediators involved in the program effectiveness outcomes will also be analyzed. The program doses applied in all classes of the intervention group will be collected using a form completed by the teacher at the end of each lesson, indicating the activities taught and not taught in each lesson. Discussion This study will show whether the #Tamojunto2.0 program can be expanded as a public policy for all schools with the aim of preventing drug use among Brazilian students. Trial registration Brazilian Clinical Trials Registry (RBR-8cnkwq) under the name “Avaliação do Efeito do Programa de Prevenção Escolar ao Uso de Drogas #Tamojunto2.0, Versão 2018”, on August 30th, 2018 (http://www.ensaiosclinicos.gov.br/rg/RBR-8cnkwq/).

A DADA drogprevenciós program hatékonyságvizsgálata hetedik évfolyamos általános iskolai tanulók körében

Article

Jun 2019

Introduction: Drug-taking habit is not infrequent in the young population. There is a need of proven effective drug prevention programs. Aim: The aim of our study was to analyze the efficiency of the Hungarian Police’s DADA school-drug prevention program. Method: The research program was carried out by a standard questionnaire at Apáczai Csere János Primary School in Pécs and Kodolányi János Primary School in Pécsvárad. Results: After analyzing the participating students’ answers, the results showed that the rate of those, who “know everything” about drugs, increased from 27% to 37.3%, and of those, who did “not know anything”, decreased from 5.6% to 1.6% (p<0.001). Regarding self-efficiency, the DADA program did not show any significant change (p = 0.364). However, less than 60% of the students agreed the statements: “I have learned a lot from the trainings” and “I received answers to several questions that I had been interested in earlier.” Conclusion: We can conclude that the DADA program was successful. Regarding the chosen reactions and opinions about the program, we have to consider the sociocultural background of the participants. Orv Hetil. 2019; 160(23): 914–920.

Tobacco control in Europe: A review of campaign strategies for teenagers and adults

Article

Apr 2019
CRIT REV ONCOL HEMAT

Background: In Europe the prevalence of tobacco use in adults and adolescents is among the highest within the WHO regions. Many resources have been allocated toward the prevention and support for smoking cessation. However, the implemented strategies in Europe have not been systematically evaluated. Methods: A systematic literature review was carried out to identify studies that analyzed the efficacy of the main smoking-prevention campaigns conducted in Europe. PRISMA guidelines were used to systematically review and extract data. Results: A total of 24 studies meeting inclusion criteria were identified. Each article was thoroughly reviewed and evaluated for quality, design, and methodology, with reference to the main areas of intervention: school (8); mass media (4) and technological tools (4); smoke-free environments (3); packaging (2) and taxes (3). The school programmes focusing on building skills to recognize and resist negative influences, the intensive use of media and technological equipments, health warnings and excise taxes have showed to be effective tools in reducing the tobacco use. Conclusions: Intervention programmes to implement tobacco control policies and smoking cessation are active in many European countries. However, these programmes need to be constantly sustained to achieve a long term efficacy.

A Latent Transition Analysis of a Cluster Randomized Controlled Trial for Drug Use Prevention

Article

Full-text available

Aug 2018

Objective: The objective of the study was to evaluate the impact of #Tamojunto, a Brazilian adaptation of the Unplugged prevention program, on patterns of drug use among adolescents and to characterize their trajectories of drug use over time. Method: An in-cluster randomized controlled trial was conducted in 2014-2015 with 2 parallel arms (intervention and control). The intervention group attended 12 weekly classes of the #Tamojunto intervention. The control schools did not offer a prevention program. The target population was students attending seventh and eighth grades. The primary dichotomous outcome measures were use of drugs (any alcohol use, binge drinking, tobacco, marijuana, inhalants, and cocaine) in the past year assessed using a questionnaire before intervention and in 2 waves of follow-up (9 and 21 months). Results: A latent transition analysis in 6,391 students from 72 public schools in 6 Brazilian cities revealed 3 distinct patterns of drug use behavior: abstainers/low users (81.54% at baseline, 70.61% after 21 months), alcohol users/binge drinkers (16.65% at baseline, 21.45% after 21 months), and polydrug users (1.80% at baseline, 7.92% after 21 months). No differences in the probabilities of transitions between these drug use patterns were found between the intervention and control groups. The most likely trajectory was no transition between patterns, regardless of the intervention and baseline pattern. Conclusions: The intervention was not successful in changing adolescent drug use patterns over time, showing that the components of the Brazilian adaptation of the Unplugged prevention program should be reevaluated. (PsycINFO Database Record

Book

Full-text available

Jan 2015

Evaluating the potential negative effects of school-based prevention programs aiming to reduce alcohol and drug misuse in adolescents: A systematic review of research articles prior to 2013.

Working Paper

Full-text available

Dec 2017

Karin Hannes

The #Tamojunto Drug Prevention Program in Brazilian Schools: a Randomized Controlled Trial

Article

Full-text available

Mar 2017
PREV SCI

A randomized controlled trial was conducted in 2014 with 7th and 8th grade students from 72 public schools in 6 Brazilian cities. This trial aimed to evaluate the effects of an adapted European school-based drug prevention program Unplugged, called #Tamojunto in Brazil, which was implemented by the Ministry of Health as part of public policy. The experimental group (n?=?3340) attended 12 classes in the #Tamojunto program, and the control group (n?=?3318) did not receive a school prevention program. Baseline data were collected prior to program implementation, and follow-up data were collected 9?months later, allowing a matching of 4213 adolescents in both waves. The substances examined were alcohol, tobacco, marijuana, inhalants, cocaine, and crack. Multilevel analyses were used to evaluate the changes in consumption of each drug between time points and between groups. The intervention and control groups had similar baseline characteristics. The mean age of the adolescents was 12.5???0.7?years, and 51.3% were female. The program seemed to increase alcohol use initiation (first alcohol use); students in the experimental group had a 30% increased risk of initiating alcohol use during the 9-month follow-up (aRR?=?1.30, 95% confidence interval (95%CI) 1.13-1.49, p?<?0.001) compared to the control group. The opposite was found for the first inhalant use: the risk of using inhalants for the first time after baseline was lower in the experimental group (aRR?=?0.78, 95%CI 0.63-0.96, p?=?0.021) than the control group. The results of the #Tamojunto program suggest that the content and lessons regarding alcohol may enhance curiosity about its use among adolescents. We suggest a re-evaluation of the expansion of the #Tamojunto program in schools while analyzing why the program's effects were inconsistent with those of previous European studies.

Medeiros et al 2016 Process Evaluation

Data

Full-text available

Oct 2016

Evaluating School-based Interventions for Preventing and Reducing Tobacco use among Adolescents in Low- and Middle-income Countries: A Systematic Review and Meta-Analysis

Article

May 2025
AM J PREV MED

Determinants of use and perceived harm of combustible tobacco and electronic cigarettes among high school students in Prague

Article

Full-text available

Mar 2025

Understanding the mechanisms of change in social norms around tobacco use: A systematic review and meta-analysis of interventions

Article

Oct 2024
ADDICTION

Background and Aims Tobacco use spreads through social networks influencing social norms around tobacco use. However, the social norms scholarship is extremely diverse and occasionally conflicting, complicating efforts to understand how best to leverage social norms to reduce tobacco use. This study systematically reviewed and meta‐analyzed this vast terrain by focusing on social norms measurement and mechanism, and intervention effectiveness and modality aimed at changing social norms around tobacco use and actual tobacco use. Methods We searched Scopus, PubMed, PsycInfo, Clinicaltrials.gov , ProQuest Dissertations, the Cochrane Trial Registry, as well as the websites of the Society for Research on Nicotine and Tobacco, the Open Science Framework, medrXiv and the Truth Initiative for experimental and quasi‐experimental evaluation studies of interventions designed to shift tobacco use. We included studies written in English from inception to 30 May 2024. We only included studies which noted social norms or social influence as part of the intervention design or set of measured variables. We excluded studies with only one time point, without an intervention being evaluated and those not published in English. Study screening followed the PRISMA 2020 guidelines, and was conducted by at least two independent reviewers who resolved discrepancies through discussion and consensus. All included studies were analyzed in a narrative synthesis, and those providing sufficient statistics for tobacco and social norms outcomes were included in meta‐analyses, which were performed separately for tobacco outcomes and social norms outcomes. Study outcomes were transformed into a standardized mean difference (Hedges' g ) and several meta‐regressions were fit to explore sources of heterogeneity using a robust variance estimation specification to handle effect size dependency. Results A total of 95 studies met inclusion criteria for the narrative synthesis, 200 effect sizes from 86 studies were included in the tobacco outcomes meta‐analysis, and 66 effect sizes from 29 studies were included in the social norms outcomes meta‐analysis. Nearly 90% of included studies were conducted in high‐income settings, with the remainder conducted in middle‐income settings. No studies were conducted in Latin America or on the African continent. Social norms change interventions had a statistically significant effect on reducing tobacco use and pro‐tobacco social normative perceptions [ g = 0.233, 95% confidence interval (CI) = 0.166, 0.301, P < 0.001 and g = 0.292, 95% CI = 0.090, 0.494, P = 0.007, respectively]. Interventions were commonly conducted among schoolchildren in classrooms through multicomponent education sessions, often coupled with regular ‘booster' sessions over time. Among adult populations, motivational interviewing and other counselling approaches were used in some cases, and few interventions leveraged digital technologies to change social norms. Conclusions Social norms change interventions appear to be effective for reducing tobacco use and pro‐tobacco social normative perceptions. In particular, leveraging role models appears to be the most effective social norms change mechanisms for tobacco control.

Formation de professionnels pluri-catégoriels en matière de compétences psychosociales : perspectives andragogiques, professionnalisation et développement professionnelTraining multi-category professionals in psychosocial skillspsychosocial skills: andragogical perspectives, professionalization and professional development

Article

Full-text available

Jun 2023

This article analyzes the tensions between professionalization and professional development of multi-category professionals working with young people aged 7 to 12 engaged in an adult training system in psychosocial skills (CPS). The CPS are one of the emblematic objects in order to develop the promotion of the health and well-being of children. This article aims to question the relevance of the deployment of adult training in order to professionalize CPS and if this is the case, what would be its characteristics and for what effects? The theoretical framework is based on the analysis of the activity with reference to ergonomic psychology and calls upon three other notions: andragogy, professionalization and professional development. A qualitative methodology based on the conduct of semi-structured interviews (30) with multi-category professionals involved in this system was implemented. Professional development indices have been identified according to the andragogical and professionalization characteristics of the training deployed.

Effects on secondary outcomes of the Brazilian version of the European unplugged drug use prevention program: drug knowledge, intention predictors, and life skill competencies

Article

Dec 2022

The drug use prevention program #Tamojunto2.0, a Brazilian version of the European Unplugged, showed effectiveness in preventing the alcohol use onset at short term. However, we aimed to evaluate the program effects on its secondary outcomes, such as drug knowledge, behavioral beliefs, attitudes, decision-making skills, and refusal skills. A cluster-randomized controlled trial (registration: RBR-8cnkwq) was conducted in 73 public middle schools in three Brazilian cities (N = 5,208 students; 49.4% girls; Mage= 13.2 years). The intervention group attended twelve #Tamojunto2.0 lessons conducted by their own teachers previously trained. The control group received no intervention. Data were collected pre-intervention (February/March 2019) and at nine-month follow-up (November/December 2019). We used multiple imputation to handle missing data and performed multilevel mixed-effect regression models, adjusted for sex, age, socioeconomic status, and city. The #Tamojunto2.0 program seems to have increased drug knowledge (Coef.= 0.26, 95%CI = 0.17–0.36), and negative and non-positive alcohol beliefs (Coef.= 0.24, 95%CI= 0.05–0.42), according to its logical framework. Nevertheless, it was found no evidence regarding the program’s effect on marijuana beliefs, attitudes, decision-making skills, and refusal skills. These findings could explain the effectiveness of the program in preventing the onset of alcohol consumption in adolescent participants. More research is needed to observe the long-term effects of the program on primary and secondary outcomes.

Infračervené termovizní snímání a analýza mimiky při detekci úmyslného zkreslování informací – případová studie

Conference Paper

Full-text available

Jul 2022

The expanding technological possibilities have opened up space for the detection of psychophysiological changes and behavioral manifestations by non-contact methods that do not interfere with normal interaction. This paper aims to present the experimental design and data of the first pilot case study applying functional infrared thermal imaging and emotional expression analysis for deception detection. In the pilot psychophysiological experiment, we focused on monitoring changes in facial temperature, heart rate variability, and overall facial emotional expression during prepared and spontaneous lie scenarios spoken towards different interviewers.

Chapter # 12 THE EFFECTIVENESS OF DRUG USE PREVENTION PROGRAMS ON SUBSTANCE USE AMONG SLOVAK SCHOOLCHILDREN

Article

Full-text available

Dec 2021

The objective of the study is to examine the long-term effectiveness of the school-based drug prevention programs Unplugged and Unplugged2 supplemented with n-Prevention booster sessions on reported alcohol use(AU), smoking and the cumulative index(CI) of AU and smoking. In Unplugged, a sample of 744(M=12.5;58.72%girls) was collected before program implementation(T1) and 12months later(T3). In Unplugged2, a sample of 408(M=14.48;51.96%girls) was collected before program implementation(T1), immediately after implementation(T2) and 12months later(T3). In Unplugged, the sample was divided into control and experimental groups while Unplugged2 was split into control, experimental and experimental groups with n-Prevention, a pre-test or without a pre-test. Binary logistic regressions were used to analyze the data at every measurement point. There was no significant effect of Unplugged and Unplugged2 with a pre-test. However, gender was significantly associated with smoking and girls were more likely to report smoking than boys. Unplugged2 without a pre-test was significantly associated with AU and CI at T3. The experimental and experimental groups with n-Prevention were less likely to report AU. The experimental group with n-Prevention was less likely to report AU and/or smoke. There was no significant moderation effect. The results show the effectiveness of Unplugged2 without a pre-test design, especially with booster sessions.

What Works in School-Based Interventions? A Systematic Review of Evaluation Research

Chapter

Sep 2021

What approaches and methods can be employed that will effectively reduce the risk of antisocial behaviour and of other criminal offending in schools? We report an evidence review involving a search of eight electronic databases from 2010 to 2020. This produced 6331 unique items and a final set of 49 review articles and 116 research studies. Only a small amount of evidence supported direct placement of police personnel in schools risked opening a “school-to-prison pipeline”. It is possible to reduce levels of several types of problems amongst school students, of kinds that are associated with participation in delinquency and adult crime including reduction of bullying, other forms of conflict and aggression, dating and relational violence and risk of involvement in alcohol and drug abuse. School-wide interventions that emphasize social norms emerged more positively than selectively targeted interventions. Disciplinary responses to violations worked best in a positive and supportive school climate rather than responses that emphasized security or punishment. Police services can advise and engage in multi-agency initiatives through liaison roles, highlighting potential links between problems exhibited in schools and the appearance of more serious delinquent activity.

Meta-analysis of the effects of smoking prevention programs for young adolescents

Article

Full-text available

Apr 2021

Purpose: This meta-analysis aimed to analyze the effects of smoking prevention programs for young adolescents at early smoking stages to identify the appropriate characteristics of prevention programs for this population. Methods: Searches of health-related databases and Google Scholar were conducted, and 23 randomized studies were included in the analysis. The main outcome variable was smoking behavior. The analysis was conducted using Comprehensive Meta-Analysis software (version 3.0). Results: Smoking prevention programs significantly reduced smoking behaviors (OR=0.85, 95% CI=0.77-0.93). School-based programs (OR=0.79, 95% CI=0.75-0.83), programs by trained teachers or educators (OR=0.77, 95% CI=0.71-0.83), high-intensity programs (OR=0.82, 95% CI=0.75-0.91), and programs in an in-school setting (OR=0.82, 95% CI=0.74-0.90) had the most significant effect on reducing smoking behavior. Conclusion: For young adolescents, smoking prevention programs are most effective when they are school-based or highintensity programs, and when conducted by teachers or educators with proper training. Further studies are required since there was insufficient research to explore the effect of web-based programs or family-centered programs on adolescent smokers.

A escola como dispositivo de prevenção ao uso de drogas na adolescência

Chapter

Full-text available

Dec 2019

Adolescent Mental Health Program Components and Behavior Risk Reduction: A Meta-analysis

Article

Full-text available

Jul 2019

Abstract CONTEXT: Although adolescent mental health interventions are widely implemented, little consensus exists about elements comprising successful models. OBJECTIVE: We aimed to identify effective program components of interventions to promote mental health and prevent mental disorders and risk behaviors during adolescence and to match these components across these key health outcomes to inform future multicomponent intervention development. DATA SOURCES: A total of 14 600 records were identified, and 158 studies were included. STUDY SELECTION: Studies included universally delivered psychosocial interventions administered to adolescents ages 10 to 19. We included studies published between 2000 and 2018, using PubMed, Medline, PsycINFO, Scopus, Embase, and Applied Social Sciences Index Abstracts databases. We included randomized controlled, cluster randomized controlled, factorial, and crossover trials. Outcomes included positive mental health, depressive and anxious symptomatology, violence perpetration and bullying, and alcohol and other substance use. DATA EXTRACTION: Data were extracted by 3 researchers who identified core components and relevant outcomes. Interventions were separated by modality; data were analyzed by using a robust variance estimation meta-analysis model, and we estimated a series of single-predictor meta-regression models using random effects. RESULTS: Universally delivered interventions can improve adolescent mental health and reduce risk behavior. Of 7 components with consistent signals of effectiveness, 3 had significant effects over multiple outcomes (interpersonal skills, emotional regulation, and alcohol and drug education). LIMITATIONS: Most included studies were from high-income settings, limiting the applicability of these findings to low- and middle-income countries. Our sample included only trials. CONCLUSIONS: Three program components emerged as consistently effective across different outcomes, providing a basis for developing future multioutcome intervention programs.

The role of normative beliefs in the mediation of a school-based drug prevention program: A secondary analysis of the #Tamojunto cluster-randomized trial

Article

Full-text available

Jan 2019
PLOS ONE

Aims To investigate the mediating effects of normative beliefs of drug use on the effects of the #Tamojunto school-based prevention program (Unplugged). Design Secondary analysis of a cluster randomized controlled trial. Setting Brazil. Participants: A total of 6,391 adolescents (12.68 y.o) from 72 public schools in 6 Brazilian cities. Intervention: Schools were assigned to an experimental condition (#Tamojunto curriculum) or a control condition (no prevention program). Measurements: Baseline data were collected prior to program implementation, and follow-up data were collected 9 and 21 months later. The substances examined were alcohol (including binge drinking), tobacco, marijuana and inhalants. Five in-parallel mediation models evaluated whether the positive and negative beliefs were mediators of the likely effects of the intervention on drug use. Findings Lack of evidences regarding differences in normative beliefs or drug use were found between the intervention and control groups. However, there was a clear association between negative drug beliefs and lower consumption (i.e. OR = 0.78; 95% CI 0.70; 0.87, for cannabis use) as well as between positive drug beliefs and higher consumption (i.e. OR = 1.77; 95% CI 1.56; 2.02, for cannabis use) independent of the assigned group. Conclusions These results suggest that there is a lack of evidence that the program impact the normative beliefs, as proposed by the theoretical model of the program, suggesting that modifications are needed to produce the intended effect of the program. Negative normative beliefs seem to be a potential protective factor for drug use, but the program’s effect itself on drug use via normative beliefs was not found to be statistically significant. Program activities intended to affect normative beliefs should be improved.

Percepções da comunidade escolar sobre a implantação do programa Unplugged em escolas

Article

Full-text available

Jun 2018

Resumo O objetivo do presente estudo foi investigar as percepções da comunidade escolar sobre o programa Unplugged, implantado pelo Ministério da Saúde em escolas públicas brasileiras de ensino fundamental II. A metodologia utilizada foi a qualitativa e envolveu coleta de dados através de 11 grupos focais de professores (n=13), alunos (n=54) e administradores escolares (n=11) em 8 escolas de 3 cidades brasileiras. Análise de conteúdo permitiu a identificação de 3 eixos temáticos. As facilidades identificadas estiveram relacionadas com o suporte técnico para implantação da metodologia, como a formação e supervisão recebida, além do suporte dos administradores das escolas. As dificuldades apontadas estiveram relacionadas ao tempo das aulas, a obtenção de materiais de suporte para as aulas e ao cumprimento adequado do currículo regular. Como potencialidade, identificou-se a melhoria das relações de convivência. Os resultados aqui alcançados permitem o aprimoramento da implantação do programa Unplugged nas escolas brasileiras.

Evaluace procesu české adaptace programu cílené krátké intervence PreVenture a jeho pilotní implementace pro žáky základních škol

Article

Full-text available

Apr 2015

Citation: Maierová, E., Charvát, M., Miovský, M., Šťastná, L. (2015). Preventure: Adaptation and Pilot Implementation of a Targeted Brief Intervention in the Czech Setting-Process Evaluation Study [Evaluace procesu èeské adaptace programu cílené krátké intervence PreVenture a jeho pilotní implementace pro žáky základních škol]. Adiktologie, 15(1), 12-32. BACKGROUND: Despite the high prevalence of drug use and other forms of risk behaviour among children and adolescents, only a few indicated prevention programmes are delivered in Czech schools. Therefore, we decided to implement Preventure in the Czech setting. It is an evidence- based indicated prevention programme which was developed in Canada in 2001. The programme was tested for its effectiveness and shows very promising results. It is intended for children aged 12-15. AIMS: The manuscript describes the process of adapting and implementing this indicated prevention tool in the Czech setting, as well as presenting the results of the evaluation of the process. RESULTS: The method was implemented following the steps proposed by the EMCDDA. Specifically, it involved the translation and standardisation of the Substance Use Risk Profile Scale (SURPS). The methodological guidelines VÝCHODISKA: Z dùvodù vysoké prevalence užívání drog a rizikového chování u dìtí a dospívajících a nedostatku programù indikované prevence, které se realizují ve školách v Èeské republice, implementujeme do Èeského prostøedí efektivní program indikované prevence. Program Preventure vznikl v Kanadì v roce 2001, prošel testováním efektivity a vykazuje velmi slibné parametry a byl implementován v dalších zemích (napø. Velká Británie, Nizozemí, Austrálie atd.). Tento program se skládá ze dvou èástí, diagnostického screeningového dotazníku a intervenèních setkání face-to-face. Urèen je pro cílovou skupinu dìtí ve vìku 12–15 let. CÍLE: Èlánek popisuje proces pøevodu a implementace indikované prevence do èeského prostøedí. Zároveò popisuje výsledky hodnocení tohoto procesu. VÝSLEDKY: Metoda byla implementována dle krokù EMCDDA, konkrétnì se jednalo o pøeklad a standardizaci

PREVENTION SCIENCE AS A BASE FOR SUBSTANCE ABUSE PREVENTION PLANNING – LESSONS LEARNED FOR IMPROVING THE PREVENTION

Article

Full-text available

Jan 2013

Addiction prevention programs in Croatia are still not sufficiently scientifically based as recommended by both foreign and Croatian scholars in the field of science and research. In order to achieve this objective, it is necessary to invest in the development of programs , notably by (1) linking program activities with theoretical and research insights, (2) defining program activities on the basis of comprehensive needs assessment, and (3) planning and conducting program evaluations. Therefore, this paper will present principles and elements of effective risk behaviors prevention in general, as well as specific traits of programs and strategies aimed at substance abuse prevention. Those program characteristics which have been proved effective and which contain components of knowledge and information, but are also based on psycho-educational approaches, such as development of skills and healthy lifestyles, will be described according to all prevention levels, from the environmentally-based prevention strategy to universal, selective and indicated prevention.

Is universal prevention against youths' substance misuse really universal? Gender-specific effects in the EU-DAP school-based prevention trial

Article

Full-text available

May 2009
J EPIDEMIOL COMMUN H

Background: Studies of effectiveness of school-based prevention of substance misuse have generally overlooked gender differences. The purpose of this work was to analyse gender differences in the effectiveness of a new European school-based curriculum for prevention of substance misuse among adolescents. Methods: The European Drug Abuse Prevention (EU-Dap) trial took place in seven European countries during the school year 2004–05. Schools were randomly assigned to either a control group or a 12-session standardised curriculum (‘‘Unplugged’’) based on a comprehensive social influence model. The analytical sample consisted of 6359 students (3324 boys and 3035 girls). The use of cigarettes, alcohol and illicit drugs, adolescents’ knowledge and opinions about substances, as well as social and personal skills were investigated through a selfcompleted anonymous questionnaire administered at enrolment and 3 months after the end of the programme. Adjusted Prevalence Odds Ratios were calculated as the measure of association between the intervention and behavioural outcomes using multilevel regression modelling. Results: At enrolment, boys were more likely than girls to have used cannabis and illicit drugs, whereas girls had a higher prevalence of cigarette smoking. At the follow-up survey, a significant association between the programme and a lower prevalence of all behavioural outcomes was found among boys, but not among girls. Age and selfesteem emerged as possible modifiers of these gender differences, but effects were not statistically significant. Conclusions: Comprehensive social influence school curricula against substance misuse in adolescence may perform differently among girls and boys, owing to developmental and personality factors.

“Unplugged”: A new European School programme against substance abuse

Article

Full-text available

Jul 2009

This paper presents the rationale, development and application of ‘Unplugged’, a new school programme for the prevention of substance abuse, which is based on the comprehensive social influence approach (CSI). The programme was developed, implemented and evaluated by a cross-disciplinary group of experts in the frame of a multi-centre study in seven European countries. The basic curriculum consists of 12 units, which are delivered by class teachers to a target population of 12–14 year-old students. Additional programme components were workshops for the students’ parents and debriefing sessions led by class peers. The programme’s application was monitored by means of structured report forms. This process monitoring allowed for the analysis of problems in implementation, as well as of participatory aspects. ‘Unplugged’ is the first comprehensive social influence school curriculum in Europe of which the efficacy has been evaluated in a field trial, and it also constitutes an example of a theory- and evidence-based programme against youths’ substance use. This report can provide public health and school decision makers with tools to make an informed choice on these kinds of programmes and to survey their application.

Pozitivní a negativní očekávání mládeže od konzumace alkoholu (Positive and Negative Alcohol Expectancies Among Young People)

Article

Full-text available

Jun 2006

Pozadí: Řada studií ukazuje, že existuje velice úzký vzájemný vztah mezi pozitivními a negativními očekáváními ve vztahu ke konzumaci alkoholu, jeho spotřebou a nadměrným užíváním; očekávání se mění s vlastní zkušeností s konzumací alkoholu, která se zpětně promítá do dalších očekávání. Soubor: Cílem článku je zhodnotit pozitivní a negativní očekávání ve vztahu k alkoholu mezi českými dospívajícími. Soubor 16letých studentů dotázaných v rámci studie ESPAD (3 172 respondentů) byl rozdělen na neproblémové konzumenty alkoholu, konzumenty se zvýšeným rizikem a problémové konzumenty. Výsledky: Mezi studenty převažují pozitivní očekávání nad negativními. Problémoví konzumenti alkoholu se od svých vrstevníků významně liší: mají výrazně vyšší pozitivní očekávání, častěji připouštějí také pravděpodobnost výskytu negativních situací v souvislosti s konzumací alkoholu. Background: Several studies show a close mutual relationship between positive and negative alcohol expectancies and alcohol consumption and abuse; alcohol expectancies change with one’s own experience with alcohol consumption, and this is reflected in future expectations. Sample: The aim of the article is to assess positive and negative alcohol expectancies among Czech adolescents. The sample of 16-year-old students participating in the ESPAD study (3172 respondents) was divided into non-problem consumers, consumers with increased risks in relation to alcohol use, and problem alcohol drinkers. Results: Positive alcohol expectancies among students predominate over negative expectancies. Problem drinkers behave significantly differently compared to their peers; they have stronger positive expectancies and they also admit to a higher probability of negative effects from alcohol.

Uživani alkoholu u diti 5. a 7. toid zakladnich škol: Vysledky kvaziexperimentalni evaluaeni studie [Substance use in fifth- and seventh-grade basic school pupils: Results of quasi-experimental evaluation study]

Article

Full-text available

Jan 2006

Substance use in fifth-and seventh-grade basic school pupils: Review of results of quasi-experimental evaluation study

Article

Full-text available

Jan 2007

Primární prevence na školách zapojených do projektu EUDAP 2

Article

Full-text available

Jan 2009

Selected aspects of organisational and expert support for teachers and other education professionals in delivering the unplugged programme in schools: Findings of the evaluation of the implementation of the EUDAP project [Vybrané aspekty organizační a odborné podpory pedagogů při realizaci metodiky unplugged ve školách: Výsledky evaluace implementace projektu EUDAP]

Article

Full-text available

Sep 2010

BACKGROUND: The Unplugged primary prevention programme was piloted and tested in Czech schools in the 2007-2008 academic year and was adapted according to the findings of its evaluation. The providers of the programme (teachers and other education professionals in the schools involved in the project) received expert support (from regional coordinators) during the pilot implementation stage. AIMS: The aim of our study is to propose a system of expert organisational support for teachers and other education professionals during their continuous implementation and dissemination of the Unplugged programme in the Czech Republic. METHODOLOGY: Two semistructured interviews with regional coordinators of the Unplugged programme, 16 semistructured interviews with education professionals delivering the programme in schools, analysis of project documentation. SAMPLE/DATA: Two regional coordinators of the Unplugged project, 16 education professionals, project documentation (meeting reports, feedback questionnaires completed by programme deliverers after each lesson). RESULTS: The results summarise the course of the meetings between education professionals and regional project coordinators, perceived positives and negatives, and their feelings and opinions about these meetings. The findings also suggest the ways in which the expert support could be carried out in the future. CONCLUSIONS: The results of our study show that the expert and organisational support during the provision of the Unplugged programme should remain an integral part of its implementation in order to maintain the high standard of the programme. Regional primary prevention centres could contribute to such support considerably.

Alcohol and Other Drug Use Among Students in 35 European Countries

Article

Full-text available

Jan 2003

Inequalities in Young People's Health: HBSC International Report from the 2005/06 Survey

Book

Full-text available

Feb 2009

Three Decades of Drug Prevention Research

Article

Full-text available

Jul 2009

Pim Cuijpers

Dozens of drug prevention programmes have been developed and examined in the past few decades. These interventions are aimed at tobacco, alcohol or all substances. Prevention programmes have different goals, including the following: increasing knowledge about drugs; reducing the use; delaying the onset of first use; reducing abuse; minimizing the harm caused by the use. Most research has been conducted on school-based drug prevention programmes. School-based drug prevention programmes that used interactive methods were found in research to reduce the use of drugs. All school-based drug prevention programmes (interactive and non-interactive) that have examined increase the knowledge about drugs. Although effective school-based prevention programmes are available, the dissemination at schools has not been successful for most programmes. Family-based drug prevention programmes are a promising new area of drug prevention. Most research examining the effects of mass media campaigns about drugs is flawed by major methodological problems. Results suggest that these campaigns cannot reduce the use of substances, but they may increase the effects of community-based interventions. Community interventions (a combined set of activities organized in a specific region or town, with the participation of the residents) are possibly more effective than each of the interventions alone.

Evropská školní studie o alkoholu a jiných drogách (ESPAD) : výsledky průzkumu v České republice v roce 2007 /

Article

Full-text available

1. vyd. Pod názvem: Národní monitorovací středisko pro drogy a drogové závislosti

The Adolescent Substance Abuse Prevention Study: A randomized field trial of a universal substance abuse prevention program

Article

Full-text available

Apr 2009

The purpose of the study was to determine whether a universal school-based substance abuse prevention program, Take Charge of Your Life (TCYL), prevents or reduces the use of tobacco, alcohol, or marijuana. Eighty-three school clusters (representing school districts) from six metropolitan areas were randomized to treatment (41) or control (42) conditions. Using active consenting procedures, 19,529 seventh graders were enrolled in the 5-year study. Self-administered surveys were completed by the students annually. Trained Drug Abuse Resistance Education (D.A.R.E.) police officers presented TCYL in seventh and ninth grades in treatment schools. Analyses were conducted with data from 17,320 students who completed a baseline survey. Intervention outcomes were measured using self-reported past-month and past-year use of tobacco, alcohol, and marijuana when students were in the 11th grade. Main effect analyses show a negative program effect for use of alcohol and cigarettes and no effect for marijuana use. Subgroup analyses indicated that the negative effect occurred among nonusers at baseline, and mostly among white students of both genders. A positive program effect was found for students who used marijuana at baseline. Two complementary papers explore the relationship of the targeted program mediators to the use of alcohol, tobacco, and marijuana and specifically for students who were substance-free or who used substances at baseline. The negative impact of the program on baseline nonusers of alcohol and tobacco indicate that TCYL should not be delivered as a universal prevention intervention. The finding of a beneficial effect for baseline marijuana users further supports this conclusion. The programmatic and methodological challenges faced by the Adolescent Substance Abuse Prevention Study (ASAPS) and lessons learned offer insights for prevention researchers who will be designing similar randomized field trials in the future.

The Number Needed to Treat: A Clinically Useful Measure of Treatment Effect

Article

Full-text available

Mar 1995

The relative benefit of an active treatment over a control is usually expressed as the relative risk, the relative risk reduction, or the odds ratio. These measures are used extensively in both clinical and epidemiological investigations. For clinical decision making, however, it is more meaningful to use the measure "number needed to treat." This measure is calculated on the inverse of the absolute risk reduction. It has the advantage that it conveys both statistical and clinical significance to the doctor. Furthermore, it can be used to extrapolate published findings to a patient at an arbitrary specified baseline risk when the relative risk reduction associated with treatment is constant for all levels of risk.

The Motivation, Skills, and Decision-Making Model of “Drug Abuse”1 Prevention

Article

Full-text available

Feb 2004

This article summarizes the theoretical basis for targeted prevention programs as they apply to different high-risk groups. We explain the advantages and disadvantages of different definitions of risk and discuss strategies for preventing drug use related problems in high-risk youth. Productive prevention programs for many at-risk groups share similar components, including those that address motivation, skills, and decision making. We present key aspects of these three components and link them to theories in clinical psychology, social psychology, sociology, and chemical dependence treatment. Among a total of 29 promising targeted prevention programs, we describe examples of empirically evaluated, intensive interventions that have made a positive impact on the attitudes and behavior of multiple problem youth. Incorporating the perspectives of multiple disciplines appears essential for progress in drug abuse and other problem behavior prevention.

A cluster randomized controlled trial of school-based prevention of tobacco, alcohol and drug use: The EU-Dap design and study population

Article

Full-text available

Mar 2007

The empirical evidence of effectiveness of many school-based programs against substance abuse is rather weak. The EU-Dap study is a multicenter cluster randomized community trial (CRCT) designed to evaluate such a program. This paper presents study design and baseline characteristics of the study population. 170 schools from 9 centers from seven countries (Austria, Belgium, Germany, Greece, Italy, Spain, Sweden), stratified according to average social status in the catchment area, were randomized to either three variants of the active intervention (basic curriculum, basic with peer involvement, and basic with parent involvement) or to a control group. The program under evaluation is based on a comprehensive social influence approach, and was delivered during the scholar year 2004-2005 to a population of 12- to 14-year-old students attending junior high school. An anonymous questionnaire administered before and after the intervention was used to track behavioral and attitudinal changes. All in all, we included in the study 143 schools and 7079 students, of which 3547 in the intervention groups and 3532 in the control group. At baseline, 34.9% of students had smoked cigarettes, 24.7% had been drunk, and 8.9% had used cannabis at least once in life. EU-Dap is the first European multicenter randomized study to evaluate the effectiveness of a school program targeting tobacco, alcohol and drug use. The baseline assessment showed high prevalence and wide geographical variations of substance use.

School-based prevention for illicit drugs use: A systematic review

Article

Full-text available

Jun 2008

To evaluate the effectiveness of school-based interventions in preventing or reducing drug use. The search strategy was conducted according to the Cochrane Collaboration method, and applied to MEDLINE, EMBASE, ERIC, PSYCHINFO, Cochrane Library, ACP Journal Club, Cochrane Drugs and Alcohol Group Register. RCTs and CCTs evaluating school-based interventions designed to prevent substance use were reviewed. Data were extracted independently by two reviewers. Quality was assessed. Interventions were classified as skills, affective, and knowledge focused. 29 RCTs were included; 28 were conducted in the USA; most were focused on 6th-7th grade students. Compared with usual curricula, skills-based interventions significantly reduce marijuana use (RR=0.82; 95% CI: 0.73, 0.92) and hard drug use (RR=0.45; 95% CI: 0.24, 0.85), and improve decision-making skills, self-esteem, peer pressure resistance (RR=2.05; 95% CI: 1.24, 3.42) and drug knowledge. Compared with usual curricula, affective interventions improve decision-making skills and drug knowledge, and knowledge-focused programs improve drug knowledge. Skills-based interventions are better than affective ones in improved self-efficacy. No differences are evident for skills vs. knowledge-focused programs on drug knowledge. Affective interventions improve decision-making skills and drug knowledge to a higher degree than knowledge-focused programs. Skills-based programs help to deter drug use. Well designed, long-term randomised trials, and evaluation of intervention components are required.

The effectiveness of a school-based substance abuse prevention program: EU-Dap cluster randomised controlled trial ☆

Article

Nov 2008
PREV MED

To evaluate the effectiveness of the school-based drug abuse prevention program developed in the EU-Dap study (EUropean Drug Abuse Prevention trial) in preventing the use of tobacco, alcohol and drugs at the post-test. Cluster Randomised Controlled Trial. Seven European countries participated in the study; 170 schools (7079 pupils 12-14 years of age) were randomly assigned to one of three experimental conditions or to a control condition during the school year 2004/2005. A pre-test survey assessing past and current substance use was conducted before the implementation of the program. The program consisted in 12-hour class-based curriculum based on a comprehensive social-influence approach. A post-test survey was carried out in all participating schools, 3 months after the end of the program. The association between program condition and change in substance use at post-test was expressed as adjusted Prevalence Odds Ratio (POR), estimated by multilevel regression model. Program effects were found for daily cigarette smoking (POR=0.70; 0.52-0.94) and episodes of drunkenness in the past 30 days (POR=0.72; 0.58-0.90 for at least one episode, POR=0.69; 0.48-0.99 for three or more episodes), while effects on Cannabis use in the past 30 days were of marginal statistical significance (POR=0.77; 0.60-1.00). The curriculum was successful in preventing baseline non-smokers or sporadic smokers from moving onto daily smoking, but it was not effective in helping baseline daily smokers to reduce or stop smoking. School curricula based on a comprehensive social-influence model may delay progression to daily smoking and episodes of drunkenness.

The effectiveness of a school-based substance abuse prevention program: 18-Month follow-up of the EU-Dap cluster randomized controlled trial

Article

Apr 2010

Aim: To evaluate the effectiveness of a school-based substance abuse prevention program developed in the EU-Dap study (EUropean Drug Addiction Prevention trial). Materials and methods: Cluster Randomized Controlled Trial. Seven European countries participated in the study; 170 schools (7079 pupils 12–14 years of age) were randomly assigned to one of three experimental conditions or to a control condition during the school year 2004/2005. The program consisted of a 12-h curriculum based on a comprehensive social influence approach. A pre-test survey assessing past and current substance use was conducted before the implementation of the program, while a post-test survey was carried out about 18 months after the pre-test. The association between program condition and change in substance use at post-test was expressed as adjusted prevalence odds ratio (POR), estimated by multilevel regression models. Results: Persisting beneficial program effects were found for episodes of drunkenness (any, POR = 0.80; 0.67–0.97; frequent, POR = 0.62; 0.47–0.81) and for frequent cannabis use in the past 30 days (POR = 0.74; 0.53–1.00), whereas daily cigarette smoking was not affected by the program as it was at the short-term follow-up. Baseline non-smokers that participated in the program progressed in tobacco consumption to a lower extent than those in the control condition, but no difference was detected in the proportion of quitters or reducers among baseline daily smokers. Conclusion: The experimental evaluation of an innovative school curriculum based on a comprehensive social influence approach, indicated persistent positive effects over 18 months for alcohol abuse and for cannabis use, but not for cigarette smoking.

Statistical Analysis with Missing Data.

Article

Jan 1989

School-based programmes for preventing smoking

Article

Jan 2013
Evid Base Child Health

Meta-Analysis of 143 Adolescent Drug Prevention Programs: Quantitative Outcome Results of Program Participants Compared to a Control or Comparison Group

Article

Oct 1986

Nancy S. Tobler

Presented is a meta-analysis of the outcome results for 143 adolescent drug prevention programs to identify the most effective program modalities for reducing teenage drug use. Glass' et al. (1981) meta-analysis techniques provided a systematic approach for the accumulation, quantification and integration of the numerous research findings. Five major modalities were identified and their effect sizes computed for five distinctly different outcomes: Knowledge, Attitudes, Use, Skills and Behavior measures. The magnitude of the effect size was found dependent on the outcome measure employed and the rigor of the experimental design. These factors were controlled for through use of a standard regression analysis. Peer Programs were found to show a definite superiority for the magnitude of the effect size obtained on all outcome measures. On the ultimate criteria of drug use, Peer Programs were significantly different than the combined results of all the remaining programs (p < .0005). Peer Programs maintained high effect size for alcohol, soft drugs and hard drugs, as well as for cigarette use. Recommendations are made concerning the effectiveness of the underlying theoretical assumption for the different program modalities. Future programming implications are discussed as Peer Programs were identified as effective for the average school-based adolescent population, but the Alternatives programs were shown to be highly successful for the “at risk” adolescents such as drug abusers, juvenile delinquents or students having school problems.

Evaluation of the Drug Prevention Interventions in the Czech Republic

Article

Jan 2011

The development and implementation of prevention interventions in the Czech Republic have experienced a number of challenges in the Czech Republic. It is common for such interventions to be inappropriately documented, precluding thorough preparation and process evaluation. In addition, the publication standards and the availability of the documents are rather poor. The insufficient documentation, the deliverers' lack of interest in the evaluation being conducted, and the low level of economic and political support also make it almost impossible to carry out an evaluation of the impact/effectiveness of such programmes. Therefore, the authors searched the Czech literature in order to ascertain what studies have been published in the Czech Republic within the past 20 years and which of them meet at least the general criteria for the implementation of evaluation studies of preventive interventions in terms of the evaluation of impact/effectiveness. A total of five studies were identified. They pertain to the following programmes: "Smoking and Me", "Community-based Programme in the Prague 6 District", "Skills for Adolescence", "Drugs-Reason-Impact", and "Unplugged". The article provides an outline of the current situation concerning the implementation of the evaluation of the effectiveness of prevention interventions in the Czech Republic as reflected by the specific studies that have been carried out. Each study is consistently described, including the methodology used to undertake the respective evaluation study and the results it generated. The set of studies that is presented constitutes a presumable "good practice" base for this sphere of research which may, first and foremost, help in the better systematisation of future activities in this field and serve as both a theoretical and practical foundation, as well as inspiring other similar studies.

Formativní evaluace procesu implementace preventivního programu Unplugged školními metodiky prevence

Article

Jan 2009

Vybrané aspekty organizační a odborné podpory pedagogů při realizaci metodiky Unplugged ve školách: Výsledky evaluace implementace projekdu EUDAP

Article

Jan 2010

Systém odborné a organizační podpory pedagogů po realizaci preventivního programu Unplugged při jeho další inseminaci v ČR.

A Comparison of Confidential versus Anonymous Survey Procedures: Effects on Reporting of Drug Use and Related Attitudes and Beliefs in a National Study of Students

Article

Dec 2000

This study presents a comparison of reporting of drug use and related attitudes and beliefs by national samples of eighth and tenth grade students under two different modes of administration conditions: confidential and anonymous. The results show that there were clearly no differences between the conditions in tenth graders' reports of drug use and related attitudes and beliefs. With eighth graders, the results show, at most, only a very modest mode of administration effect and quite possibly no effect at all. The results are reassuring to researchers who conduct surveys of drug use and related attitudes and beliefs among secondary school students.

The Effectiveness of Supportive and Refutational Defenses in Immunizing and Restoring Beliefs Against Persuasion

Article

Jun 1961
Sociometry

William J. McGuire

The abstract for this document is available on CSA Illumina.To view the Abstract, click the Abstract button above the document title.

Statistical Analysis With Missing Data

Article

Aug 1989

School-Based Adolescent Drug Prevention Programs: 1998 Meta-Analysis

Article

Jun 2000

This paper reports on a meta-analysis of 207 universal school-based drug prevention programs that compared the self-reported drug use of treatment to control or comparison youth. Programs are classified into Interactive and Non-Interactive groups based on a combination of content and delivery method. Weighted categorical and weighted regression methods have been used to determine the attributes that most effectively reduce, delay, or prevent drug use, including program size, type of control group and leader, attrition, target drug, intensity, grade, special population and level of drug use. Program type and size are found to be significant predictors of effectiveness. Non-interactive lecture-oriented prevention programs that stress drug knowledge or affective development show small effects. Interactive programs that foster development of interpersonal skills show significantly greater effects that decrease with large-scale implementations.

School-based programs for preventing smoking

Article

Sep 2013

Background: Helping young people to avoid starting smoking is a widely endorsed public health goal, and schools provide a route to communicate with nearly all young people. School-based interventions have been delivered for close to 40 years. Objectives: The primary aim of this review was to determine whether school smoking interventions prevent youth from starting smoking. Our secondary objective was to determine which interventions were most effective. This included evaluating the effects of theoretical approaches; additional booster sessions; programme deliverers; gender effects; and multifocal interventions versus those focused solely on smoking. Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Tobacco Addiction Group's Specialised Register, MEDLINE, EMBASE, PsycINFO, ERIC, CINAHL, Health Star, and Dissertation Abstracts for terms relating to school-based smoking cessation programmes. In addition, we screened the bibliographies of articles and ran individual MEDLINE searches for 133 authors who had undertaken randomised controlled trials in this area. The most recent searches were conducted in October 2012. Selection criteria: We selected randomised controlled trials (RCTs) where students, classes, schools, or school districts were randomised to intervention arm(s) versus a control group, and followed for at least six months. Participants had to be youth (aged 5 to 18). Interventions could be any curricula used in a school setting to deter tobacco use, and outcome measures could be never smoking, frequency of smoking, number of cigarettes smoked, or smoking indices. Data collection and analysis: Two reviewers independently assessed studies for inclusion, extracted data and assessed risk of bias. Based on the type of outcome, we placed studies into three groups for analysis: Pure Prevention cohorts (Group 1), Change in Smoking Behaviour over time (Group 2) and Point Prevalence of Smoking (Group 3). Main results: One hundred and thirty-four studies involving 428,293 participants met the inclusion criteria. Some studies provided data for more than one group.Pure Prevention cohorts (Group 1) included 49 studies (N = 142,447). Pooled results at follow-up at one year or less found no overall effect of intervention curricula versus control (odds ratio (OR) 0.94, 95% confidence interval (CI) 0.85 to 1.05). In a subgroup analysis, the combined social competence and social influences curricula (six RCTs) showed a statistically significant effect in preventing the onset of smoking (OR 0.49, 95% CI 0.28 to 0.87; seven arms); whereas significant effects were not detected in programmes involving information only (OR 0.12, 95% CI 0.00 to 14.87; one study), social influences only (OR 1.00, 95% CI 0.88 to 1.13; 25 studies), or multimodal interventions (OR 0.89, 95% CI 0.73 to 1.08; five studies). In contrast, pooled results at longest follow-up showed an overall significant effect favouring the intervention (OR 0.88, 95% CI 0.82 to 0.96). Subgroup analyses detected significant effects in programmes with social competence curricula (OR 0.52, 95% CI 0.30 to 0.88), and the combined social competence and social influences curricula (OR 0.50, 95% CI 0.28 to 0.87), but not in those programmes with information only, social influence only, and multimodal programmes.Change in Smoking Behaviour over time (Group 2) included 15 studies (N = 45,555). At one year or less there was a small but statistically significant effect favouring controls (standardised mean difference (SMD) 0.04, 95% CI 0.02 to 0.06). For follow-up longer than one year there was a statistically nonsignificant effect (SMD 0.02, 95% CI -0.00 to 0.02).Twenty-five studies reported data on the Point Prevalence of Smoking (Group 3), though heterogeneity in this group was too high for data to be pooled.We were unable to analyse data for 49 studies (N = 152,544).Subgroup analyses (Pure Prevention cohorts only) demonstrated that at longest follow-up for all curricula combined, there was a significant effect favouring adult presenters (OR 0.88, 95% CI 0.81 to 0.96). There were no differences between tobacco-only and multifocal interventions. For curricula with booster sessions there was a significant effect only for combined social competence and social influences interventions with follow-up of one year or less (OR 0.50, 95% CI 0.26 to 0.96) and at longest follow-up (OR 0.51, 95% CI 0.27 to 0.96). Limited data on gender differences suggested no overall effect, although one study found an effect of multimodal intervention at one year for male students. Sensitivity analyses for Pure Prevention cohorts and Change in Smoking Behaviour over time outcomes suggested that neither selection nor attrition bias affected the results. Authors' conclusions: Pure Prevention cohorts showed a significant effect at longest follow-up, with an average 12% reduction in starting smoking compared to the control groups. However, no overall effect was detected at one year or less. The combined social competence and social influences interventions showed a significant effect at one year and at longest follow-up. Studies that deployed a social influences programme showed no overall effect at any time point; multimodal interventions and those with an information-only approach were similarly ineffective.Studies reporting Change in Smoking Behaviour over time did not show an overall effect, but at an intervention level there were positive findings for social competence and combined social competence and social influences interventions.

Monitoring the Future National Results on Drug Use: 2012 Overview, Key Findings on Adolescent Drug Use

Article

Jan 2012

Monitoring the Future (MTF) is a long-term study of American adolescents, college students, and adults through age 50. It has been conducted annually by the University of Michigan's Institute for Social Research since its inception in 1975 and is supported under a series of investigator-initiated, competing research grants from the National Institute on Drug Abuse. The 2011 the MTF survey encompassed about 46,700 8th-, 10th-, and 12th-grade students in 400 secondary schools nationwide. The first published results are presented in this report. Recent trends in the use of licit and illicit drugs are emphasized, as well as trends in the levels of perceived risk and personal disapproval associated with each drug. This study has shown these beliefs and attitudes to be particularly important in explaining trends in use. In addition, trends in the perceived availability of each drug are presented. A synopsis of the design and methods used in the study and an overview of the key results from the 2011 survey is presented in the introductory section. These are followed by a separate section for each individual drug class, providing figures that show trends in the overall proportions of students at each grade level (a) using the drug, (b) seeing a "great risk" associated with its use (perceived risk), (c) disapproving of its use (disapproval), and (d) saying they could get it "fairly easily" or "very easily" if they wanted to (perceived availability). For 12th graders, annual data are available since 1975, and for 8th and 10th graders, since 1991, the first year they were included in the study. The tables at the end of this report provide the statistics underlying the figures; in addition, they present data on lifetime, annual, 30-day, and (for selected drugs) daily prevalence. (Contains 17 tables and 9 footnotes.) [For "Monitoring the Future National Results on Adolescent Drug Use: Overview of Key Findings, 2010," see ED528077.]

Analysis of Incomplete Data

Book

Aug 1997

Joseph L. Schafer

Introduction Assumptions EM and Inference by Data Augmentation Methods for Normal Data More on the Normal Model Methods for Categorical Data Loglinear Models Methods for Mixed Data Further Topics Appendices References Index

Effects of the “Preparing for the Drug Free Years” Curriculum on Growth in Alcohol Use and Risk for Alcohol Use in Early Adolescence

Article

Sep 2000

Preparing for the Drug-Free Years (PDFY) is a curriculum designed to help parents learn skills to consistently communicate clear norms against adolescent substance use, effectively and proactively manage their families, reduce family conflict, and help their children learn skills to resist antisocial peer influences. This study examined the effects of PDFY on the trajectories of these factors, as well as on the trajectory of alcohol use from early to mid adolescence. The sample consisted of 424 rural families of sixth graders from schools randomly assigned to an intervention or a control condition. Data were collected from both parents and students at pretest, posttest, and 1-, 2- and 3 \frac12\frac{1}{2} -year follow-ups. Latent growth models were examined. PDFY significantly reduced the growth of alcohol use and improved parent norms regarding adolescent alcohol use over time. Implications for prevention and evaluation are discussed.

A Meta-Analytic Review of School-Based Prevention for Cannabis Use

Article

Oct 2010
HEALTH EDUC BEHAV

This investigation used meta-analytic techniques to evaluate the effectiveness of school-based prevention programming in reducing cannabis use among youth aged 12 to 19. It summarized the results from 15 studies published in peer-reviewed journals since 1999 and identified features that influenced program effectiveness. The results from the set of 15 studies indicated that these school-based programs had a positive impact on reducing students' cannabis use (d = 0.58, CI: 0.55, 0.62) compared to control conditions. Findings revealed that programs incorporating elements of several prevention models were significantly more effective than were those based on only a social influence model. Programs that were longer in duration (≥15 sessions) and facilitated by individuals other than teachers in an interactive manner also yielded stronger effects. The results also suggested that programs targeting high school students were more effective than were those aimed at middle-school students. Implications for school-based prevention programming are discussed.

Age at First Drink and the First Incidence of Adult-Onset DSM-IV Alcohol Use Disorders

Article

Oct 2008

Existing studies of the association between age at first drink (AFD) and the risk of alcohol use disorders (AUD) suffer from inconsistent levels of control and designs that may inflate associations by failure to control for duration of exposure to risk. This study examined associations between AFD (ages <15 and 15-17 vs. 18+ years) and first incidence of DSM-IV alcohol dependence, abuse, and specific AUD criteria over a 3-year follow-up in a longitudinal study of U.S. drinkers 18 years of age and older at baseline (n = 22,316), controlling for duration of exposure, family history, and a wide range of baseline and childhood risk factors. After adjusting for all risk factors, the incidence of dependence was increased for AFD <15 years (OR = 1.38) and for women only with AFD at ages 15 to 17 (OR = 1.54). The incidence of abuse was increased at AFD <15 and 15 to 17 years (OR = 1.52 and 1.30, respectively). Most dependence criteria showed significant associations with AFD, but hazardous drinking and continued drinking despite interpersonal problems were the only abuse criteria to do so. All associations were nonsignificant after controlling for volume of consumption, except that AFD at all ages <18 combined was associated with a reduced likelihood of impaired control, and AFD at ages 15 to 17 was associated with lower odds of drinking more/longer than intended among heavy-volume drinkers. In a population of low-risk drinkers that excluded those with positive family histories, personality disorders, and childhood risk factors, there were strong associations between early AFD (<18) and the incidence of dependence (OR = 3.79) and continued drinking despite physical/psychological problems (OR = 2.71), but no association with incidence of abuse. There is a robust association between AFD and the risk of AUD that appears to reflect willful rather than uncontrolled heavy drinking, consistent with misuse governed by poor decision-making and/or reward-processing skills associated with impaired executive cognitive function (ECF). Additional research is needed to determine causality in the role of impaired ECF, including longitudinal studies with samples of low-risk adolescents.

Developmental Trajectories of Cigarette Smoking from Adolescence to the Early Thirties: Personality and Behavioral Risk Factors

Article

Sep 2008

The purpose of this study was to identify distinct trajectories of cigarette smoking from ages 14 to 32, and to examine adolescent personality factors that distinguish trajectories of smoking behavior. Participants (N = 975) were randomly selected and followed prospectively since 1975. Follow-up data on cigarette use and personality and behavioral attributes were collected at five points in time, using structured interviews given in private by trained interviewers. Of these subjects, 746 comprised the cohort used in this study. Growth mixture modeling identified five smoking trajectory groups: nonsmokers, occasional smokers, late starters, quitters, and heavy/continuous smokers. Adolescent personality and behavioral risk factors such as lower ego integration, more externalizing behavior, and lower educational aspirations distinguished the trajectory groups. No gender differences were noted. The findings supported the hypotheses indicating multiple distinct trajectory groups of smoking behavior. Smoking behavior appeared in early adolescence and most often continued into adulthood. Emotional difficulties (i.e., lower ego integration), externalizing behavior, and lower educational aspirations in early adolescence were associated both with smoking at an early age and with continuing to smoke into the thirties. To be more effective, smoking prevention programs should target personality and behavioral variations before smoking becomes habitual, particularly focused on characteristics reflecting behavioral problems as manifested in emotional difficulties, externalizing behavior, and low educational aspirations in early adolescence. The implications for research, prevention, and treatment are discussed.

Prevention of adolescent substance abuse through the development of personal and social competence

Article

Feb 1983

Gilbert J Botvin

Experimentation with a wide variety of substances for many adolescents appears to have become an integral part of the coming of age in America. Unfortunately, early experimentation often leads to regular use and, for all too many individuals, this may result in compulsive patterns of use characterized in many cases by both psychological and physiological dependence. Treatment programs designed to either help individuals achieve total abstinence, or modify their pattern of use, appear to be only moderately effective, with virtually all programs being plagued by high rates of recidivism. As a consequence, the prospect of developing effective substance abuse prevention strategies holds a great deal of appeal. However, until recently the development of effective substance abuse prevention programs has remained only an illusive goal. In this chapter an argument is made for a more comprehensive approach to substance abuse prevention than has been utilized previously. The type of approach being suggested focuses on both the enhancement of personal competence through the development of basic 'life skills' and the acquisition of problem-specific skills and knowledge designed to increase adolescents' ability to resist the various forms of social pressure to smoke, drink, or use drugs.

Age at smoking onset and its association with alcohol consumption and DSM-IV alcohol abuse and dependence: Results from the National Longitudinal Alcohol Epidemiologic Survey

Article

Feb 1998
J Subst Abuse

Bridget Grant

The major purpose of this study was to examine the relationship of early onset smoking with lifetime drinking and the subsequent development of DSM-IV alcohol abuse and dependence using a large representative sample of the U.S. general population. Prevalences of lifetime drinking, alcohol abuse and dependence, and their associated severity were compared among smoking groups defined by age at onset of smoking and among nonsmokers. Linear logistic regression analyses were conducted to assess the relationship between age at smoking onset and lifetime drinking, alcohol abuse and dependence, controlling for important covariates. Early onset smoking was a significant predictor of lifetime drinking and the subsequent development of lifetime alcohol abuse and dependence, a relationship that generally remained consistent for males, females, whites and blacks. Early onset smoking was significantly associated with more excessive alcohol consumption and more severe alcohol use disorders relative to late onset smokers and nonsmokers. Early onset smoking was also significantly associated with heavier and longer smoking careers compared to late onset smokers. Implications of these findings are discussed in terms of prevention of adolescent smoking and the need for further research on understanding the mechanisms underlying the associations between early onset smoking and lifetime drinking, alcohol abuse and dependence.

Age of Onset of Drug Use and its Association with DSM-IV Drug Abuse and Dependence: Results from the National Longitudinal Alcohol Epidemiologic Survey

Article

Feb 1998
J Subst Abuse

The purpose of this study was to examine the relationship between early onset drug use and the development of lifetime DSM-IV drug abuse and dependence using a representative sample of the U.S. population. Prevalences of lifetime drug abuse and dependence were estimated for each year of age of onset of drug use from ages 13 and younger to 21 and older for the overall sample of drug users by race and gender. Linear logistic analyses were conducted to assess the relationship between age of drug use onset and lifetime drug use disorders controlling for important covariates. The major finding of this study was that early onset drug use is a significant predictor of the subsequent development of drug abuse over the life course. Early onset drug use was also a significant predictor of the subsequent development of lifetime alcohol dependence among males, females, and nonblacks, but not among blacks. After adjusting for important model covariates, the likelihood of lifetime drug abuse and dependence among the total sample of lifetime drug users was reduced by 4% and 5% with each year drug use onset was delayed. Implications of these findings are discussed in terms of the importance of collecting national data on drug use, abuse and dependence and the need for further research and its integration with prevention efforts.

Effective ingredients of school-based drug prevention programs: A systematic review

Article

Nov 2002
ADDICT BEHAV

Pim Cuijpers

Drug prevention in schools is a top priority in most Western countries and several well-designed studies have shown that prevention programs have the potential of reducing drug use in adolescents. However, most prevention programs are not effective and there are no general criteria available for deciding which program is effective and which is not. In this systematic review of the literature, the current scientific knowledge about which characteristics determine the effectiveness of drug prevention programs is examined. Three types of studies are reviewed: meta-analyses (3 studies were included), studies examining mediating variables of interventions (6 studies), and studies directly comparing prevention programs with or without specific characteristics (4 studies on boosters, 12 on peer-versus adult-led programs, and 5 on adding community interventions to school programs). Seven evidence-based quality criteria were formulated: the effects of a program should have been proven; interactive delivery methods are superior; the "social influence model" is the best we have; focus on norms, commitment not to use, and intentions not to use; adding community interventions increases effects; the use of peer leaders is better; and adding life skills to programs may strengthen effects.

Age of Onset of Drinking and the Use of Alcohol in Adulthood: A Follow-up Study From Age 8–42 for Females and Males

Article

Jun 2005

To investigate longitudinally for both genders the relation between the age of onset of drinking and several indicators of alcohol use. In the Finnish Jyväskylä Longitudinal Study of Personality and Social Development, data have been collected by interviews, inventories, and questionnaires. Data on alcohol consumption was gathered at ages 14, 20, 27, 36 and 42 years; behavioural data at age 8. A total of 155 women and 176 men; 90.4% of the original sample consisting of 12 complete school classes in 1968. The age of onset of drinking was determined based on participants' responses that were closest to the actual age of onset of drinking. Four indicators of the adult use of alcohol were used: frequency of drinking, binge drinking, Cut-down, Annoyed, Guilt, Eye-opener (CAGE) and Malmö modified Michigan Alcoholism Screening Test (Mm-MAST). Socio-emotional behaviour at age 8 was assessed using teacher ratings and peer nominations. Early onset of drinking was related to the four indicators of the use of alcohol in adulthood both in men and women. The level of adult alcohol use and alcohol problems was significantly higher in men. The risk for heavy drinking was highest in men and women if drinking was started at less than age 16 years. Socio-emotional behaviour and school success at age 8 did not predict the age of onset of drinking. Delaying the initiation of drinking from early adolescence to late adolescence is an important goal for prevention efforts. No clear risk group for early initiators of drinking could be identified on the basis of preceding behaviour among 8-year-olds.

Smoking Trajectories of Adolescent Novice Smokers in a Longitudinal Study of Tobacco Use

Article

Aug 2005
ANN EPIDEMIOL

To describe longitudinal trajectories of smoking intensity in adolescent novice smokers and to identify predictors of trajectory class membership. Cigarette consumption among 369 novice smokers (mean age 13 years) was measured over a mean 24 months of follow-up after smoking onset. Classes of smoking intensity trajectories were identified using latent class growth modeling. Predictors of trajectory class membership were identified in polytomous logistic regression. There was considerable between-subject heterogeneity in individual trajectories over time. Four classes of smoking intensity trajectories were identified: low-intensity, non-progressing smokers (72.4% of subjects), and slow, moderate, and rapid escalators (11.1%, 10.8%, and 5.7% of subjects, respectively). Gender, poor academic performance, and having more than half of friends who smoke at smoking onset independently predicted development of trajectory pattern. Escalating trajectory patterns were associated with earlier development of nicotine dependence and tolerance. Cigarette consumption will not escalate rapidly among three-quarters of adolescent novice smokers. Novice smokers who do escalate rapidly should be targeted for early tobacco control intervention to prevent development of nicotine dependence and sustained smoking.

School-based programmes for preventing smoking Meta-anaiysis of 143 adolescent drug prevention programs: quantitative outcome results of program participants compared to a control or comparison group

Jan 1986
537-567

R E Thomas
R Perera

Thomas, R.E., Perera, R., 2006. School-based programmes for preventing smoking. Cochrane Database Syst. Rev., 3. Tobler, N.S., 1986. Meta-anaiysis of 143 adolescent drug prevention programs: quantitative outcome results of program participants compared to a control or comparison group. J. Drug Issues 16, 537–567.

The 2007 ESPAD Report -Substance Use Among Students in 35 European Countries. The Swedish Council for Information on Alcohol and Other Drugs (CAN)

Jan 2009

B Hibell
U Guttormsson
S Ahlström
O Balakireva
T Bjarnason
A Kokkevi
L Kraus

Hibell, B., Guttormsson, U., Ahlström, S., Balakireva, O., Bjarnason, T., Kokkevi, A., Kraus, L., 2009. The 2007 ESPAD Report -Substance Use Among Students in 35 European Countries. The Swedish Council for Information on Alcohol and Other Drugs (CAN). Stockholm, Sweden.

Užívání drog v národnostních menšinách v ˇ CR–Souhrn dostupn´ychtupn´ tupn´ych informací

Jan 2005

L Miovska

Miovska, L., 2005. Užívání drog v národnostních menšinách v ˇ CR–Souhrn dostupn´ychtupn´ tupn´ych informací. Drugs in Focus 2. Úřad vládyČeskévládyˇvládyČeské republiky, Praha.

Centrum adiktologie PK 1. LF UK v Praze/o.s. Prev-centrum

Závěrečná Zpráva

Závěrečná zpráva. Centrum adiktologie PK 1. LF UK v Praze/o.s. Prev-centrum.

Jan 2012
79-87

R Author
Gabrhelik

Author's personal copy R. Gabrhelik et al. / Drug and Alcohol Dependence 124 (2012) 79– 87 87

Názory občanobčan˚občanů na drogy. Centrum pro v ´ yzkum veřejného mínění

Jan 2010

J Cervenka

Cervenka, J., 2010. Názory občanobčan˚občanů na drogy. Centrum pro v ´ yzkum veřejného mínění, Praha.

Evropska skolni studie o alkoholu a jinych drogach (ESPAD): Výsledky prlzkumu vČeské republice v roce

Jan 2003

L Csemy
P Lejckova
P Sadilek
H Sovinova

Csemy, L., Lejckova, P., Sadilek, P., Sovinova, H., 2006. Evropska skolni studie o alkoholu a jinych drogach (ESPAD): Výsledky prlzkumu vČeské republice v roce 2003. Úřad vládyČeské republiky, Praha.

Názory občanů na drogy. Centrum pro výzkum veřejného mínění

J Cervenka

Cervenka, J., 2010. Názory občanů na drogy. Centrum pro výzkum veřejného mínění, Praha.

Alcohol and Other Drug Use Among Students in 35 European Countries. The Swedish Council for Information on Alcohol and Other Drugs (CAN) and the Pompidou Group at the Council of Europe

Jan 2003

B Hibell
B Andersson
T Bjarnason
S Ahlström
O Balakireva
A Kokkevi
M Morgan

Hibell, B., Andersson, B., Bjarnason, T., Ahlström, S., Balakireva, O., Kokkevi, A., Morgan, M., 2004. The ESPAD Report 2003. Alcohol and Other Drug Use Among Students in 35 European Countries. The Swedish Council for Information on Alcohol and Other Drugs (CAN) and the Pompidou Group at the Council of Europe. Stockholm, Sweden.

“Unplugged”: A school-based randomized control trial to prevent and reduce adolescent substance use in the Czech Republic

Abstract

No full-text available

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