Faggiano Fabrizio, Vigna-Taglianti Federica D, Versino Elisabetta, Zambon Alessio, Borraccino Alberto, Lemma Patrizia
Department of Experimental and Clinical Medicine, Avogadro University, Novara, Italy.
Prev Med. 2008 May;46(5):385-96. doi: 10.1016/j.ypmed.2007.11.012. Epub 2007 Dec 3.
To evaluate the effectiveness of school-based interventions in preventing or reducing drug use.
The search strategy was conducted according to the Cochrane Collaboration method, and applied to MEDLINE, EMBASE, ERIC, PSYCHINFO, Cochrane Library, ACP Journal Club, Cochrane Drugs and Alcohol Group Register. RCTs and CCTs evaluating school-based interventions designed to prevent substance use were reviewed. Data were extracted independently by two reviewers. Quality was assessed. Interventions were classified as skills, affective, and knowledge focused.
29 RCTs were included; 28 were conducted in the USA; most were focused on 6th-7th grade students. Compared with usual curricula, skills-based interventions significantly reduce marijuana use (RR=0.82; 95% CI: 0.73, 0.92) and hard drug use (RR=0.45; 95% CI: 0.24, 0.85), and improve decision-making skills, self-esteem, peer pressure resistance (RR=2.05; 95% CI: 1.24, 3.42) and drug knowledge. Compared with usual curricula, affective interventions improve decision-making skills and drug knowledge, and knowledge-focused programs improve drug knowledge. Skills-based interventions are better than affective ones in improved self-efficacy. No differences are evident for skills vs. knowledge-focused programs on drug knowledge. Affective interventions improve decision-making skills and drug knowledge to a higher degree than knowledge-focused programs.
Skills-based programs help to deter drug use. Well designed, long-term randomised trials, and evaluation of intervention components are required.
评估以学校为基础的干预措施在预防或减少药物使用方面的有效性。
按照Cochrane协作网方法制定检索策略，并应用于MEDLINE、EMBASE、ERIC、PSYCHINFO、Cochrane图书馆、美国内科医师学会杂志俱乐部、Cochrane药物与酒精研究组注册库。对评估旨在预防药物使用的以学校为基础的干预措施的随机对照试验（RCTs）和半随机对照试验（CCTs）进行综述。由两名评审员独立提取数据。评估质量。干预措施分为技能型、情感型和知识型。
纳入29项随机对照试验；28项在美国进行；大多数针对6至7年级学生。与常规课程相比，基于技能的干预措施显著减少大麻使用（风险比[RR]=0.82；95%置信区间[CI]：0.73，0.92）和硬性毒品使用（RR=0.45；95%CI：0.24，0.85），并提高决策技能、自尊、抗同伴压力能力（RR=2.05；95%CI：1.24，3.42）和药物知识。与常规课程相比，情感型干预措施提高决策技能和药物知识，知识型项目提高药物知识。在提高自我效能方面，基于技能 的干预措施优于情感型干预措施。在药物知识方面，技能型与知识型项目之间没有明显差异。情感型干预措施在提高决策技能和药物知识方面的程度高于知识型项目。
基于技能的项目有助于阻止药物使用。需要设计良好的长期随机试验以及对干预组成部分进行评估。
