4.4 Article

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

Journal

DRUG AND ALCOHOL DEPENDENCE
Volume 108, Issue 1-2, Pages 56-64

Publisher

ELSEVIER IRELAND LTD
DOI: 10.1016/j.drugalcdep.2009.11.018

Keywords

Prevention; Schools; Substance use; Cannabis; Alcohol consumption; Tobacco; Cluster randomized controlled trial; Comprehensive social influence model

Funding

  1. European Commission [SPC 2002376]
  2. Program of Community Action in the field of Public Health [SPC 2005312]
  3. Compagnia di San Paolo [2002-0703]
  4. Lega ltaliana per la Lotta contro i Tumori [2003 43/4]
  5. Novara centre, Swedish Council for Working Life and Social Research [2002-0979]
  6. Stockholm County Council [LS 0401-0117]
  7. Alcohol Research Council of the Swedish Alcohol Retailing Monopoly [07-8:1]

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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, FOR = 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. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

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