Background The EU-Dap study is a multicenter cluster randomized trial for the evaluation of an European school-based curriculum for the prevention of substance use among adolescents. Methods “Unplugged”, a Comprehensive Social Influence program consisting of 12 one-hour sessions delivered by class teachers, was implemented in seven European countries during the 2004-2005 school year. 7079 pupils participated in the pre-test survey, and 6370 in the first post-test survey. Multilevel Analysis, used to investigate the effectiveness of the program, showed that the program was effective in preventing and reducing tobacco, alcohol and cannabis use (POR=0.70, 95CI: 0.52-0.94 for daily smoking, POR=0.72, 95%CI: 0.58-0.90 for sporadic drunkenness, and POR=0.77, 95%CI: 0.60-1.00 for sporadic cannabis use). Possible mediators of effect were studied applying the multilevel model to mediators variables, adjusting for the baseline level of the mediator. Mediators of effect were then identified introducing the mediators in the effectiveness model and estimating the changes in the significance of the model. Results The Unplugged program improved refusal skills toward cigarettes and alcohol, reduced positive expectancies towards cigarettes, alcohol, and cannabis, and reduces positive attitudes towards illegal drugs. For cigarettes, when including refusal skills towards cigarettes and positive attitudes towards illegal drugs, the model looses significance, indicating a mediation effect of these two factors. For drunkenness, the model looses significance when including refusal skills and positive expectations towards drinking and positive attitudes towards illegal drugs. For cannabis, the model looses significance when including normative beliefs on cannabis, positive expectations and positive attitudes towards illegal drugs. Conclusions The EU-Dap project is the first European evaluation of a comprehensive drug prevention program for adolescents. The effectiveness of the program seem mediated by refusal skills for cigarettes and alcohol, by expectations for alcohol and cannabis, by normative beliefs for cannabis and by attitudes towards illegal drugs for all substances.
Mediators of effect of “Unplugged”, an European school-based program for drug use prevention among adolescents
VIGNA-TAGLIANTI, Federica;
2010-01-01
Abstract
Background The EU-Dap study is a multicenter cluster randomized trial for the evaluation of an European school-based curriculum for the prevention of substance use among adolescents. Methods “Unplugged”, a Comprehensive Social Influence program consisting of 12 one-hour sessions delivered by class teachers, was implemented in seven European countries during the 2004-2005 school year. 7079 pupils participated in the pre-test survey, and 6370 in the first post-test survey. Multilevel Analysis, used to investigate the effectiveness of the program, showed that the program was effective in preventing and reducing tobacco, alcohol and cannabis use (POR=0.70, 95CI: 0.52-0.94 for daily smoking, POR=0.72, 95%CI: 0.58-0.90 for sporadic drunkenness, and POR=0.77, 95%CI: 0.60-1.00 for sporadic cannabis use). Possible mediators of effect were studied applying the multilevel model to mediators variables, adjusting for the baseline level of the mediator. Mediators of effect were then identified introducing the mediators in the effectiveness model and estimating the changes in the significance of the model. Results The Unplugged program improved refusal skills toward cigarettes and alcohol, reduced positive expectancies towards cigarettes, alcohol, and cannabis, and reduces positive attitudes towards illegal drugs. For cigarettes, when including refusal skills towards cigarettes and positive attitudes towards illegal drugs, the model looses significance, indicating a mediation effect of these two factors. For drunkenness, the model looses significance when including refusal skills and positive expectations towards drinking and positive attitudes towards illegal drugs. For cannabis, the model looses significance when including normative beliefs on cannabis, positive expectations and positive attitudes towards illegal drugs. Conclusions The EU-Dap project is the first European evaluation of a comprehensive drug prevention program for adolescents. The effectiveness of the program seem mediated by refusal skills for cigarettes and alcohol, by expectations for alcohol and cannabis, by normative beliefs for cannabis and by attitudes towards illegal drugs for all substances.
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