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早期无监督饮酒——降低风险。学校健康与酒精危害减少项目。

Early unsupervised drinking--reducing the risks. The School Health and Alcohol Harm Reduction Project.

作者信息

McBride Nyanda, Farringdon Fiona, Midford Richard, Meuleners Lynn, Phillips Mike

机构信息

National Drug Research Institute, University of Western Australia, Perth, WA 6845, Australia.

出版信息

Drug Alcohol Rev. 2003 Sep;22(3):263-76. doi: 10.1080/0959523031000154409.

Abstract

The School Health and Alcohol Harm Reduction Project (SHAHRP) aimed to reduce alcohol-related harm by enhancing students' abilities to identify and deal with high-risk drinking situations and issues. The SHAHRP study involved a quasi-experimental research design, incorporating intervention and control groups and measuring change over a 32-month period. The study occurred in metropolitan, government secondary schools (13 - 17-year-olds) in Perth, Western Australia. The 14 intervention and control schools involved in the SHAHRP study represent approximately 23% of government secondary schools in the Perth metropolitan area. The sample was selected using cluster sampling, with stratification by socio-economic area, and involved over 2,300 intervention and control students from junior secondary schools. The retention rate of the study was 75.9% over 32 months. The intervention incorporated evidence-based approaches to enhance potential for behaviour change in the target population. The intervention was a classroom-based programme, with an explicit harm minimization goal, and was conducted in two phases over a 2-year period. The results were analysed by baseline context of alcohol use to assess the impact of the programme on students with varying experience with alcohol. Knowledge and attitudes were modified simultaneously after the first phase of the intervention in all baseline context of use groups. The programme had little behavioural impact on baseline supervised drinkers; however, baseline non-drinkers and unsupervised drinkers were less likely to consume alcohol in a risky manner, compared to their corresponding control groups. In line with programme goals, early unsupervised drinkers from the intervention group were also significantly less likely to experience harm associated with their own use of alcohol compared to the corresponding control group. Unsupervised drinkers experienced 18.4% less alcohol-related harm after participating in both phases of the programme and this difference was maintained (19.4% difference) 17 months after the completion of the programme. This study indicates that a school drug education programme needs to be offered in several phases, that programme components may need to be included to cater for the differing baseline context of use groups, and that early unsupervised drinkers experience less alcohol-related harm after participating in a harm reduction programme.

摘要

学校健康与酒精危害减少项目(SHAHRP)旨在通过提高学生识别和应对高风险饮酒情况及问题的能力,减少与酒精相关的危害。SHAHRP研究采用了准实验研究设计,包括干预组和对照组,并在32个月的时间内测量变化情况。该研究在西澳大利亚珀斯的大都市公立中学(13 - 17岁)进行。参与SHAHRP研究的14所干预学校和对照学校约占珀斯大都市区公立中学的23%。样本采用整群抽样方法选取,并按社会经济区域分层,涉及2300多名初中干预组和对照组学生。该研究在32个月内的留存率为75.9%。干预措施采用基于证据的方法,以增强目标人群行为改变的可能性。干预是一个基于课堂的项目,有明确的危害最小化目标,在两年内分两个阶段进行。研究结果根据酒精使用的基线情况进行分析,以评估该项目对不同酒精使用经历学生的影响。在干预的第一阶段后,所有使用组的基线情况下,知识和态度同时得到了改变。该项目对基线监督饮酒者的行为影响很小;然而,与相应的对照组相比,基线不饮酒者和无监督饮酒者以危险方式饮酒的可能性较小。与项目目标一致,与相应对照组相比,干预组中早期无监督饮酒者遭受与自身饮酒相关危害的可能性也显著降低。无监督饮酒者在参与项目的两个阶段后,与酒精相关的危害减少了18.4%,并且在项目完成17个月后,这种差异仍保持(相差19.4%)。这项研究表明,学校毒品教育项目需要分几个阶段提供,可能需要纳入不同的项目组成部分以满足不同使用组的基线情况,并且早期无监督饮酒者在参与减少危害项目后,与酒精相关的危害会减少。

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