The effectiveness of a school-based substance abuse prevention program: EU-Dap cluster randomised controlled trial

• Published in: Preventive medicine 2008-11, Vol.47 (5), p.537-543
• Main Authors: Faggiano, Fabrizio, Galanti, Maria Rosaria, Bohrn, Karl, Burkhart, Gregor, Vigna-Taglianti, Federica, Cuomo, Luca, Fabiani, Leila, Panella, Massimiliano, Perez, Tatiana, Siliquini, Roberta, van der Kreeft, Peer, Vassara, Maro, Wiborg, Gudrun
• Format: Article
• Language: English
• Subjects: Adolescent; Alcohol drinking; Cannabis; Child; Cluster randomised controlled trial; Comprehensive social-influence model; Curriculum; Drug education; Europe - epidemiology; Female; Health Promotion - methods; Health Surveys; Humans; Internal Medicine; Male; Medicin och hälsovetenskap; Preventive programmes; School based; School-based prevention; Schools; Smoking; Substance use; Substance-Related Disorders - epidemiology; Substance-Related Disorders - prevention & control; Tobacco
• ISSN: 0091-7435; 1096-0260; 1096-0260
• DOI: 10.1016/j.ypmed.2008.06.018

Abstract Objective To evaluate the effectiveness of the school-based drug abuse prevention program developed in the EU-Dap study (EUropean Drug Abuse Prevention trial) in preventing the use of tobacco, alcohol and drugs at the post-test. Methods Cluster Randomised 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. A pre-test survey assessing past and current substance use was conducted before the implementation of the program. The program consisted in 12-hour class-based curriculum based on a comprehensive social-influence approach. A post-test survey was carried out in all participating schools, 3 months after the end of the program. 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 model. Results Program effects were found for daily cigarette smoking (POR = 0.70; 0.52–0.94) and episodes of drunkenness in the past 30 days (POR = 0.72; 0.58–0.90 for at least one episode, POR = 0.69; 0.48–0.99 for three or more episodes), while effects on Cannabis use in the past 30 days were of marginal statistical significance (POR = 0.77; 0.60–1.00). The curriculum was successful in preventing baseline non-smokers or sporadic smokers from moving onto daily smoking, but it was not effective in helping baseline daily smokers to reduce or stop smoking. Conclusion School curricula based on a comprehensive social-influence model may delay progression to daily smoking and episodes of drunkenness.