Journal
JOURNAL OF ADOLESCENT HEALTH
Volume 48, Issue 2, Pages 182-188Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jadohealth.2010.06.003
Keywords
School-based prevention; Alcohol abuse; Randomized controlled trial; Comprehensive social influence model; Program evaluation
Funding
- European Commission [SPC 2002376]
- Compagnia di San Paolo [2002-0703]
- Lega Italiana per la Lotta contro i Tumori [2003 43/4]
- Swedish Council for Working Life and Social Research [2002-0979]
- Stockholm County Council [LS 0401-0117]
- Alcohol Research Council of the Swedish Alcohol Retailing Monopoly [07-8:1]
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Purpose: School-based substance abuse prevention programs are widespread but are rarely evaluated in Europe. We aimed to evaluate the effect of a new school-based prevention program against substance use on the frequency of alcohol consumption and alcohol-related problem behaviors among European students. Methods: During the school year 2004-2005, a total of 7,079 students aged 12-14 years from 143 schools in seven European countries participated in this cluster randomized controlled trial. Schools were randomly assigned to either control (65 schools, 3,532 students) or to a 12-session standardized program based on the comprehensive social influence model (78 schools, 3,547 students). Alcohol use and frequency of alcohol-related problem behaviors were investigated through a self-completed anonymous questionnaire at baseline and 18 months thereafter. The association between intervention and changes in alcohol-related outcomes was expressed as odds ratio (OR), estimated by multilevel regression model. Results: The preventive program was associated with a decreased risk of reporting alcohol-related problems (OR = .78, 95% confidence intervals [CI] = .63-.98), although this reduction was not statistically significant in the subgroup of 743 current drinkers at baseline. The risk for alcohol consumption was not modified by exposure to the program (OR = .93, 95% CI = .79-1.09). In the intervention group, nondrinkers and occasional drinkers at baseline progressed toward frequent drinking less often than in the control group. Conclusions: School curricula based on the comprehensive social-influence model can delay progression to frequent drinking and reduce occurrence of alcohol-related behavioral problems in European students. These results, albeit moderate, have potentially useful implications at the population level. (C) 2011 Society for Adolescent Health and Medicine. All rights reserved.
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