Grummitt Lucinda, Rowlinson Kirsty, Cassar Joanne, Conroy Chloe, Birrell Louise, Stapinski Lexine, Barrett Emma Louise, Macauley Julia, Teesson Maree, Newton Nicola C, Kelly Erin V
The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Level 6, Jane Foss Russell Building, Sydney, NSW, 2006, Australia.
BMC Public Health. 2025 Jan 28;25(1):349. doi: 10.1186/s12889-025-21493-1.
Preventure is a selective school-based personality-targeted program that has shown long-term benefits in preventing student alcohol use, internalising and externalising problems when delivered by psychologists. In this first Australian randomised controlled trial of school staff implementation of Preventure, we aimed to examine i) acceptability, feasibility, and fidelity and ii) effectiveness of Preventure on student alcohol use, internalising, and externalising symptoms.
A cluster-randomised controlled implementation trial was conducted in Sydney, Australia and was guided by the RE-AIM framework (Glasgow et al. 1999); which measures reach, effectiveness, adoption, implementation, and maintenance. Schools were randomly assigned to either the Preventure intervention or active control (health education as usual). Nominated school staff from intervention schools received training and delivered the program to students with elevated scores on one of four personality types targeted in the program. School staff completed surveys on RE-AIM measures, which were analysed using descriptive statistics and thematic analysis. Students completed surveys at baseline and six months post-intervention; mixed-effects regression examined intervention by time interactions on alcohol use, internalising and externalising problems, at six-month follow-up. The study was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12620000790943, registration date 6 August 2020).
553 students across 8 schools participated in the baseline survey. Of these, 40% had elevated scores on one of the four personality profiles, resulting in 220 students in the current study (102 students in intervention schools, 118 students in control schools; mean age 13.6, 45.7% female). Most RE-AIM domains showed high ratings, with school staff showing good adherence and confidence in delivery. However, teachers reported difficulties with feasibility, particularly a lack of time. Student outcomes: There were significant improvements in depression and conduct problems across both intervention and control across time. There were no significant main or interaction effects of the intervention on student alcohol use, internalising, or externalising problems.
Teachers and students rated the program highly. However, concerns around feasibility may limit teacher-led application of the program in the Australian context. Alternative approaches, such as delivery by dedicated personnel within schools without a teaching load, may be critical in implementing such evidence-based interventions at scale.
The study was prospectively registered with the Australian New Zealand Clinical Trials Registry, registration number: ACTRN12620000790943, registration date: 6 August 2020.
“预防计划”（Preventure）是一项以学校为基础的针对特定人格类型的选择性项目，由心理学家实施时，已显示出在预防学生饮酒、内化和外化问题方面具有长期益处。在澳大利亚首次针对学校工作人员实施“预防计划”的随机对照试验中，我们旨在研究：i）可接受性、可行性和保真度；ii）“预防计划”对学生饮酒、内化和外化症状的有效性。
在澳大利亚悉尼进行了一项整群随机对照实施试验，并以RE-AIM框架（格拉斯哥等人，1999年）为指导；该框架衡量覆盖面、有效性、采用率、实施情况和维持情况。学校被随机分配到“预防计划”干预组或积极对照组（照常进行健康教育）。干预学校中被提名的学校工作人员接受培训，并将该项目提供给在该项目所针对的四种人格类型之一上得分较高的学生。学校工作人员完成了关于RE-AIM指标的调查，并使用描述性统计和主题分析进行了分析。学生在基线和干预后六个月完成调查；混合效应回归在六个月随访时检查干预与时间交互作用对饮酒、内化和外化问题的影响。该研究已在澳大利亚新西兰临床试验注册中心进行前瞻性注册（ACTRN12620000790943，注册日期2020年8月6日）。
8所学校的553名学生参加了基线调查。其中，40%的学生在四种人格特征之一上得分较高，因此本研究中有220名学生（干预学校102名学生，对照学校118名学生；平均年龄13.6岁，45.7%为女性）。大多数RE-AIM领域的评分较高，学校工作人员在实施过程中表现出良好的依从性和信心。然而，教师报告了可行性方面的困难，尤其是时间不足。学生结果：随着时间的推移，干预组和对照组的抑郁和行为问题都有显著改善。干预对学生饮酒、内化或外化问题没有显著的主效应或交互效应。
教师和学生对该项目评价很高。然而，对可行性的担忧可能会限制该项目在澳大利亚背景下由教师主导的应用。替代方法，例如由学校内无教学负担的专职人员实施，对于大规模实施此类循证干预措施可能至关重要。
该研究已在澳大利亚新西兰临床试验注册中心进行前瞻性注册，注册号：ACTRN12620000790943，注册日期：2020年8月6日。
