The effectiveness of a school-based substance abuse prevention program: 18-Month follow-up of the EU-Dap cluster randomized controlled trial
Received 28 May 2009; received in revised form 16 September 2009; accepted 16 November 2009.
Abstract
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.
eUniversity of Turin, Via Santena 5 bis, 10126 Torino, Italy
fUniversity of L’Aquila – Ospedale San Salvatore, Edificio n.6, Località Coppito, 67010 L’Aquila, Italy
gEDEX, Particolar de Indautxu 9, 48011 Bilbao, Spain
hFaculty for Social Work and Social Welfare Studies of the University College, Kortrijksesteenweg 14, 9000 Gent, Belgium
iPyxida – Drug Abuse Prevention and Health Promotion Centre, Eptapyrgiou 151, 56626 Thessaloniki, Greece
jUniversity Mental Health Research Institute 2, Soranou Tou Efessiou, 11527 Athens, Greece
kIFT Nord, Düsternbrooker Weg 2, 24105 Kiel, Germany
lDept. of Public Health Sciences, Karolinska Institutet – Norrbacka, SE-171 76 Stockholm, Sweden
Corresponding author at: Department of Clinical and Experimental Medicine, Avogadro University, Via Solaroli 17, 28100 Novara, Italy. Tel.: +39 0321 660661/011 40188309; fax: +39 0321 660682.
1 EU-Dap Study Group: Roberta Siliquini, Barbara Zunino, Luca Cuomo, Federica Vigna-Taglianti, Serena Vadrucci, Laura Vitale (Piedmont Centre for Drug Addiction Epidemiology – Turin, Italy); Peer van der Kreeft (De Sleutel – Gent, Belgium); Juan Carlos Melero, Laura Varona (EDEX – Bilbao, Spain); Gudrum Wiborg (IFT-Nord – Kiel, Germany); Clive Richardson (University Mental Health Research Institute – Athens, Greece); Maro Vassara (Pyxida – Thessaloniki, Greece); M. Rosaria Galanti, Sara Sanchez and Lotta Jansson (Dept. of Public Health Sciences, Karolinska Institutet – Stockholm, Sweden, formerly of the Stockholm Centre of Public Health); Gregor Burkhart (EMCDDA – Lisbon, Portugal); Fabrizio Faggiano, Massimiliano Panella (Dept of Clinical and Experimental Medicine, Avogadro University – Novara, Italy); Leila Fabiani, Maria Scatigna (Dept of Internal Medicine and Public Health – University of L’Aquila – L’Aquila, Italy).
ABSTRACT