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一项评价基于学校的毒品预防计划 #Tamojunto2.0 有效性的整群随机对照试验。

A cluster randomized controlled trial evaluating the effectiveness of the school-based drug prevention program #Tamojunto2.0.

机构信息

Department of Preventive Medicine, Section of Epidemiology and Biostatistics, Universidade Federal de São Paulo, Brazil.

Escola de Enfermagem, Universidade Federal do Ceará, Brazil.

出版信息

Addiction. 2021 Jun;116(6):1580-1592. doi: 10.1111/add.15358. Epub 2021 Jan 28.

Abstract

AIMS

The study aimed to evaluate the effectiveness of the government school-based program #Tamojunto2.0, the third Brazilian version of the European drug prevention program, Unplugged, in preventing the use of alcohol and other drugs.

DESIGN

A parallel, two-arm cluster randomized controlled trial was conducted in 205 classes in 73 public schools (37 intervention and 36 control) with a baseline assessment and follow-up after 9 months.

SETTING

Schools in the cities of São Paulo, Fortaleza and Eusebio in Brazil.

PARTICIPANTS

A total of 5208 students in the 8th grade with a mean age of 13.2 years (standard deviation = 0.8 years) and an equal gender ratio.

INTERVENTION

In 2019, the intervention group attended 12 classes of the program #Tamojunto2.0, under the supervision of a team from the Ministry of Health. The control group did not receive any intervention to prevent alcohol and drug use.

MEASUREMENTS

The primary outcome measured was prevalence of binge drinking (five or more doses of alcohol in an occasion) within the past month. Secondary outcomes were prevalence of initiation and use of alcohol, tobacco, inhalants, marijuana and cocaine within the past month.

FINDINGS

A statistically significant difference was not found in the prevalence of binge drinking within the past month between intervention and control groups [odds ratio (OR) = 0.934; 95% confidence interval (CI) = 0.761-1.146]. However, students who were exposed to the program were less likely to initiate alcohol use than those in the control group (OR = 0.782; 95% CI = 0.636-0.961). The Bayes factor for reduction in binge drinking was 0.01, providing evidence in favor of the null hypothesis for this variable.

CONCLUSIONS

The drug prevention program #Tamojunto 2.0 reduced alcohol initiation, but appeared not to reduce past-month binge drinking among 8th grade students in Brazil.

摘要

目的

本研究旨在评估政府学校为本的 #Tamojunto2.0 计划(欧洲毒品预防项目 Unplugged 的第三个巴西版本)的有效性,以预防青少年使用酒精和其他药物。

设计

在巴西圣保罗、福塔雷萨和欧塞比奥的 73 所公立学校的 205 个班级中进行了一项平行、双臂、集群随机对照试验,在基线评估后进行了 9 个月的随访。

地点

巴西的城市圣保罗、福塔雷萨和欧塞比奥。

参与者

共有 5208 名八年级学生参加,平均年龄为 13.2 岁(标准差=0.8 岁),性别比例相等。

干预措施

2019 年,干预组参加了 12 节 #Tamojunto2.0 课程,由卫生部的一个小组监督。对照组没有接受任何预防酒精和药物使用的干预措施。

测量

主要结局指标是过去一个月内 binge drinking(一次性摄入五份或以上酒精饮料)的流行率。次要结局指标是过去一个月内开始使用和使用酒精、烟草、吸入剂、大麻和可卡因的流行率。

发现

干预组和对照组之间过去一个月内 binge drinking 的流行率没有统计学上的显著差异[比值比(OR)=0.934;95%置信区间(CI)=0.761-1.146]。然而,与对照组相比,接触该计划的学生开始使用酒精的可能性较低(OR=0.782;95% CI=0.636-0.961)。对 binge drinking 减少的贝叶斯因子为 0.01,为该变量的零假设提供了证据。

结论

毒品预防计划 #Tamojunto 2.0 减少了酒精的使用,但似乎并没有降低巴西八年级学生过去一个月内 binge drinking 的发生率。

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