Planet Youth Ltd., Reykjavik, Iceland.
Department of Community and Environmental Health, School of Allied Health Sciences, Boise State University, Boise, ID, United States.
Front Public Health. 2023 Mar 16;11:1117857. doi: 10.3389/fpubh.2023.1117857. eCollection 2023.
There is a great need for effective primary prevention intervention strategies to reduce and delay onset of adolescent substance use. The Icelandic Prevention Model (IPM) showed great success in Iceland over the past twenty plus years, however, evidence for the transferability of model is still somewhat limited. Using data collected in Tarragona during regional efforts to begin adoption of the IPM in Catalonia, this study tested the transferability and stability of the core risk and protective factor assumptions of the IPM overtime and examined trends of lifetime smoking, e-cigarette-use, alcohol-use, intoxication, and cannabis-use within the same time period.
This study includes responses from 15- to 16-years-olds from two region-wide samples taken in 2015 and 2019 in Tarragona ( = 2,867). Survey questions assessed frequency of lifetime: smoking, e-cigarette-use, alcohol-use, intoxication, and cannabis-use, and the core model assumptions. Demographic data were also collected. Logistic regression models of main effects with and without time interaction were used to test assumptions and their stability across time. Chi-square tests and Wilcoxon-Mann-Whitney tests were used to compare prevalence of substance use and mean scores of primary prevention variables respectively.
Lifetime: smoking (-7%, < 0.001) and cannabis-use (-4%, < 0.001) decreased, and e-cigarette-use increased (+33%, < 0.001) in Tarragona. Lifetime intoxication (-7%, < 0.001) decreased in a single zone exclusively. Most core model assumptions held in their hypothesised direction across time. The strongest positive association was observed between time spent with parents during weekends and reduced odds of lifetime smoking (OR: 0.62, 95%CI: 0.57-0.67) and the strongest negative association was observed between being outside after midnight and increased odds of lifetime intoxication (OR: 1.41, 95%CI: 1.32-1.51). Mean scores of primary prevention variables also changed disproportionately in Tarragona.
This study confirms that the core IPM assumptions are similar in Tarragona as in Iceland and other contexts previously examined. They also indicate that prevalence of lifetime smoking, intoxication, and cannabis-use decreased disproportionately in Tarragona between 2015 and 2019 during the first phase of regional adoption of the model. Thus, targeting model assumptions represents a viable primary prevention strategy for communities that hope to reduce smoking, alcohol-use, intoxication, and cannabis-use among adolescents.
非常需要有效的初级预防干预策略来减少和延迟青少年物质使用的发生。冰岛预防模式（IPM）在过去二十多年中在冰岛取得了巨大成功，然而，模型可转移性的证据仍然有些有限。本研究利用在塔拉戈纳收集的数据，在加泰罗尼亚地区努力采用 IPM 的过程中，检验了该模型的核心风险和保护因素假设在不同时期的可转移性和稳定性，并在同一时期内研究了终生吸烟、电子烟使用、饮酒、醉酒和大麻使用的趋势。
本研究包括来自 2015 年和 2019 年在塔拉戈纳进行的两次全地区样本中 15 至 16 岁青少年的回答（n=2867）。调查问题评估了终生：吸烟、电子烟使用、饮酒、醉酒和大麻使用的频率，以及核心模型假设。还收集了人口统计学数据。使用带有和不带有时间交互的主要效应逻辑回归模型来测试假设及其在不同时间的稳定性。使用卡方检验和 Wilcoxon-Mann-Whitney U 检验分别比较物质使用的流行率和初级预防变量的平均得分。
在塔拉戈纳，终生：吸烟（-7%，<0.001）和大麻使用（-4%，<0.001）减少，电子烟使用增加（+33%，<0.001）。在一个单独的区域，仅终生醉酒（-7%，<0.001）减少。大多数核心模型假设在其假设的方向上保持一致。观察到周末与父母共度的时间与减少终生吸烟的几率之间存在最强的正相关（OR：0.62，95%CI：0.57-0.67），而观察到午夜后外出与增加终生醉酒几率之间存在最强的负相关（OR：1.41，95%CI：1.32-1.51）。初级预防变量的平均得分也在塔拉戈纳不成比例地发生了变化。
本研究证实，塔拉戈纳的 IPM 核心假设与冰岛和以前检查过的其他背景下的假设相似。它们还表明，在 2015 年至 2019 年期间，在模型的区域采用的第一阶段，塔拉戈纳的终生吸烟、醉酒和大麻使用的流行率不成比例地减少。因此，针对模型假设代表了希望减少青少年吸烟、饮酒、醉酒和大麻使用的社区的可行初级预防策略。
