Ramirez Saray, Ríos Natalia, Rojas-Barahona Cristian A, Cárcamo Marcela, Sepulveda-Pañaloza Alejandro, Araya Ricardo, Gaete Jorge
Research Center for Student Mental Health (ISME), School of Education, Faculty of Social Sciences, Universidad de los Andes, Santiago, Chile.
ANID, Millennium Science Initiative Program, Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, Santiago, Chile.
BMC Public Health. 2025 May 20;25(1):1860. doi: 10.1186/s12889-025-23033-3.
Substance use among adolescents is a public health problem. We culturally adapted The Social Competence Promotion Program for Young Adolescents (SCPP-YA) program to the school context in Chile (henceforth "Mi Mejor Plan or MMP") and assessed the acceptability, feasibility, fidelity, and quality of the implementation among 6 graders. We also explored the efficacy of the program in improving individual protective factors and reducing risk factors and substance use.
Cluster randomized controlled trial conducted in Chile. The schools were randomly assigned to one of two conditions in a 1:1 ratio: 1) the "MMP" intervention group, and 2) the Control group. The program consisted of a 16-h class-based curriculum promoting social problem-solving skills delivered by a trained facilitator. Primary outcomes were acceptability, feasibility, fidelity, and quality of the implementation using detailed reports of facilitators and from observers of the performance of the facilitators in vivo. Additionally, we explored the efficacy of the intervention on secondary outcomes: 30-day prevalence of tobacco, alcohol, and cannabis use and individual risk and protective factors promoted by MMP. We performed an intention-to-treat analysis using mixed models, taking into account the hierarchical nature of the data.
Seven hundred sixty-five 6th graders from 11 schools were enrolled (one school dropped out after the randomization); 608 were analyzed at baseline, and 538 were analyzed post-intervention. 52.5% were male, and the average age was 11.3 in both groups. All 16 sessions were implemented, and students' attendance at each session ranged from 83.8% to 92.4%. The program was generally well-received, with up to 91.3% of students rating acceptability positively. Facilitators and observers reported high adherence to the contents of the program in most sessions. Protective factors, such as negative beliefs about tobacco and alcohol, increased significantly in the IG. Still, there were no significant changes in substance use, risk factors, emotion regulation, or school membership.
The MMP program was well accepted, and we achieved high levels of implementation and fidelity. The program improved some individual protective factors, such as negative beliefs about tobacco and alcohol, with no changes in substance use among adolescents.
ClinicalTrials.gov, number NCT04236947; registration date: 17/01/2020.
青少年物质使用是一个公共卫生问题。我们将青少年社会能力促进项目（SCPP - YA）在文化上进行了调整，以适应智利的学校环境（以下简称“Mi Mejor Plan或MMP”），并评估了六年级学生对该项目的可接受性、可行性、保真度和实施质量。我们还探讨了该项目在改善个体保护因素、降低风险因素和物质使用方面的效果。
在智利进行整群随机对照试验。学校以1:1的比例随机分配到两种情况之一：1）“MMP”干预组，2）对照组。该项目包括一个由经过培训的主持人授课的、时长16小时的基于课堂的课程，旨在提高社会问题解决能力。主要结果是通过主持人的详细报告以及现场观察主持人表现的观察员来评估实施的可接受性、可行性、保真度和质量。此外，我们探讨了干预对次要结果的效果：烟草、酒精和大麻使用的30天患病率以及MMP所促进的个体风险和保护因素。我们使用混合模型进行意向性分析，同时考虑到数据的分层性质。
来自11所学校的765名六年级学生参与了研究（一所学校在随机分组后退出）；608名学生在基线时进行了分析，538名学生在干预后进行了分析。两组中男性占52.5%，平均年龄均为11.3岁。所有16节课程都得以实施，学生在每节课的出勤率在83.8%至92.4%之间。该项目总体上受到好评，高达91.3%的学生对其可接受性给予积极评价。主持人和观察员报告说，在大多数课程中对项目内容的遵守程度很高。干预组中，诸如对烟草和酒精的负面信念等保护因素显著增加。然而，在物质使用、风险因素、情绪调节或学校归属感方面没有显著变化。
MMP项目被广泛接受，我们实现了高水平的实施和保真度。该项目改善了一些个体保护因素，如对烟草和酒精的负面信念，青少年的物质使用情况没有变化。
ClinicalTrials.gov，编号NCT04236947；注册日期：2020年1月17日。
