Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV 26505, USA.
Icelandic Center for Social Research and Analysis, Reykjavik University, Reykjavik 101, Iceland.
Health Educ Res. 2021 Jul 12;36(3):309-318. doi: 10.1093/her/cyaa052.
Iceland has witnessed a dramatic decline in adolescent substance use that may be partly the result of efforts related to the Icelandic prevention model (IPM). We sought to test risk and protective factor assumptions of the IPM using a prospective cohort study with 12 months separating baseline from follow-up. Participants were students in grades 8 and 9 in the national Icelandic school system enrolled in the spring of 2018 and 2019 (N=2165). Participants self-reported their experiences of cigarette smoking, alcohol consumption, and cannabis use and seven risk and protective factors. Analyses were conducted with generalized linear modeling with extension to general estimating equations with correlated outcomes data. Both individual main-effects models and collective models including all main-effects were tested. Out of 28 individual main-effects models, 23 produced findings consistent with study premises (P<0.05). Multiple main-effects models largely sustained the findings of the individual main-effects models. Findings support the assumption that the risk and protective factors commonly emphasized in the IPM are associated with the four different substance use outcomes in the hypothesized direction. Communities that plan to implement the IPM among adolescents might consider these factors in their work.
冰岛见证了青少年物质使用的急剧下降，这可能部分是由于与冰岛预防模式（IPM）相关的努力。我们试图使用前瞻性队列研究来检验 IPM 的风险和保护因素假设，该研究在基线和随访之间有 12 个月的间隔。参与者是参加 2018 年和 2019 年春季全国冰岛学校系统 8 年级和 9 年级的学生（N=2165）。参与者自我报告了他们的吸烟、饮酒和大麻使用经历以及七个风险和保护因素。分析采用广义线性建模，并扩展到具有相关结果数据的一般估计方程。测试了 28 个个体主效应模型和包括所有主效应的集体模型。在 28 个个体主效应模型中，有 23 个模型得出的结果与研究前提一致（P<0.05）。多个主效应模型在很大程度上支持了个体主效应模型的发现。研究结果支持了这样一种假设，即 IPM 中通常强调的风险和保护因素与假设方向的四种不同物质使用结果相关。计划在青少年中实施 IPM 的社区可能会在工作中考虑这些因素。
