Department of Clinical and Biological Sciences, University of Torino, Regione Gonzole 10, 10043, Orbassano, Torino, Italy; Piedmont Centre for Drug Addiction Epidemiology, ASL TO3, Via Sabaudia 164, 10095, Grugliasco, Torino, Italy.
Department of Clinical and Biological Sciences, University of Torino, Regione Gonzole 10, 10043, Orbassano, Torino, Italy; Piedmont Centre for Drug Addiction Epidemiology, ASL TO3, Via Sabaudia 164, 10095, Grugliasco, Torino, Italy.
Drug Alcohol Depend. 2021 Nov 1;228:108966. doi: 10.1016/j.drugalcdep.2021.108966. Epub 2021 Aug 28.
School-based programs are the most convenient interventions to tackle substance use among youth. "Unplugged" is a Social Influence universal school curriculum developed and tested in the "EU-Dap" project. In 2015, Nigeria implemented a large-scale project to promote healthy lifestyles in schools, families and communities. Within the project, the effectiveness of "Unplugged" was evaluated through a cluster randomized controlled trial.
The program was adapted to the Nigerian context, assembling suggestions from monitoring forms and interviews, and performing fidelity checks on content and method. Thirty-two secondary schools were extracted from a list provided by the Federal Ministry of Education, and randomly allocated to intervention and control arms. A self-completed anonymous questionnaire was used for baseline and follow-up surveys. The analysis sample finally included 2685 pupils (mean age 14.2 years). Multilevel models were run to estimate program effects on prevalence of self-reported cigarettes, alcohol, and marijuana use. Mediation analysis was performed to identify possible mediators of program effect on alcohol use.
Unplugged significantly reduced the prevalence of recent alcohol use in intervention vs control pupils. The effect on prevalence of cigarette and marijuana use was not statistically significant. The program prevented progress and encouraged regress across stages of intensity of alcohol use. Negative beliefs, risk perceptions, and class climate mediated the effect of Unplugged on alcohol use.
Unplugged was effective in preventing alcohol use improving beliefs, class climate and risk perceptions among Nigerian students. The implementation of the program at a larger scale in the country should be supported.
以学校为基础的项目是解决青少年药物使用问题最便捷的干预措施。“ unplugged ”是一个在“欧盟- dap ”项目中开发和测试的社会影响通用学校课程。2015 年，尼日利亚在学校、家庭和社区实施了一个促进健康生活方式的大型项目。在该项目中，通过集群随机对照试验评估了“ unplugged ”的有效性。
该方案适应当地情况，从监测表和访谈中收集建议，并对内容和方法进行保真度检查。从联邦教育部提供的名单中抽取 32 所中学，并随机分配到干预组和对照组。使用自我完成的匿名问卷进行基线和随访调查。分析样本最终包括 2685 名学生（平均年龄 14.2 岁）。使用多层次模型估计方案对自我报告的香烟、酒精和大麻使用流行率的影响。进行中介分析，以确定方案对酒精使用效果的可能中介因素。
与对照组相比，“ unplugged ”显著降低了干预组中学生近期饮酒的流行率。对香烟和大麻使用的影响在统计学上并不显著。该方案防止了饮酒强度各阶段的进展和倒退。消极信念、风险认知和课堂氛围中介了“ unplugged ”对酒精使用的影响。
“ unplugged ”有效预防了青少年饮酒，改善了尼日利亚学生的信念、课堂氛围和风险认知。应该支持该方案在该国更大规模的实施。
