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Primární prevence na školách zapojených do projektu EUDAP 2

Authors:
  • Charles University, 1st Faculty of Medicine
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... The target group were sixth-graders (typically 11–13 years old). The intervention was delivered by teachers with 12 hours of training in Unplugged (Adámková, Jurystová, Gabrhelík, Miovská, & Miovský, 2009). The teachers from the intervention and control groups completed a 2.5-hour-long workshop that was needed for successful participation in the study. ...
Article
Aim To study the effect of a universal prevention intervention targeting cannabis use in individual children with different risk profiles. Methods A school-based randomized controlled prevention trial was conducted over a period of 33 months (n=1,874 sixth-graders, baseline mean age 11.82). We used a two-level random intercept logistic model for panel data to predict the probabilities of cannabis use for each child. Specifically, we used eight risk/protective factors to characterize each child and then predicted two probabilities of cannabis use for each child if the child had the intervention or not. Using the two probabilities, we calculated the absolute and relative effect of the intervention for each child. According to the two probabilities, we also divided the sample into a low-risk group (the quarter of the children with the lowest probabilities), a moderate-risk group, and a high-risk group (the quarter of the children with the highest probabilities) and showed the average effect of the intervention on these groups. Results The differences between the intervention group and the control group were statistically significant in each risk group. The average predicted probabilities of cannabis use for a child from the low-risk group were 4.3% if the child had the intervention and 6.53% if no intervention was provided. The corresponding probabilities for a child from the moderate-risk group were 10.91% and 15.34% and for a child from the high-risk group 25.51% and 32.61%. School grades, thoughts of hurting oneself, and breaking the rules were the three most important factors distinguishing high-risk and low-risk children. Conclusions We predicted the effect of the intervention on individual children, characterized by their risk/protective factors. The predicted absolute effect and relative effect of any intervention for any selected risk/protective profile of a given child may be utilized in both prevention practice and research.
Article
Full-text available
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.
Article
Understanding the developmental pathways and sex differences in cigarette smoking behaviors in adolescents has the potential to positively impact substance abuse prevention and to reduce smoking-related health problems. Using data from the Unplugged school-based prevention trial, we investigated different patterns of smoking behavior development among secondary school students in the Czech Republic. Growth mixture modeling was used to examine different trajectories in cigarette smoking behaviors among male and female students (N=1874 6th graders; 50.4% male, mean age 11.8 years at baseline) participating in the Unplugged school-based randomized control trial for substance use prevention. A two-class model characterized cigarette use as a function of sex and Unplugged intervention status. More rapid cigarette use increases were observed in females (OR=1.17, p=0.01 in both rapid/moderate and slow smoking escalator classes) as compared to males. Further, in both classes, more rapid increases in smoking were observed for the control group as compared to the intervention group (OR=1.22, p<0.01 slow escalators; OR=1.54, p=0.08 rapid/moderate escalators). There was no difference in sex distribution when comparing the two classes (OR=1.02, p=0.98). This study adds to a growing literature on developmental and sex differences in cigarette use among adolescents. This research supports additional multi-year prevention strategies aimed at adolescent females and early treatment programs for adolescent smokers to prevent increasing cigarette use with age.
Article
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.
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