Menezes Alessandra A S, de Oliveira Sandro Barbosa, Sanchez Zila M, Demarzo Marcelo, Rezende Leandro F M, Miskolci Richard
Section of Epidemiology and Biostatistics, Department of Preventive Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, Rua Botucatu, 740, 4Th Floor, Vila Clementino, São Paulo, SP, CEP: 04023-062, Brazil.
Serviço Nacional de Aprendizagem Comercial, State of São Paulo, City of São Paulo, Brazil.
J Racial Ethn Health Disparities. 2025 Sep 2. doi: 10.1007/s40615-025-02619-y.
Adolescent alcohol and tobacco use are associated with various health risks, including cognitive and developmental impairments. Minority youth may face additional vulnerabilities, such as racism and discrimination, which contribute to stress and an increased risk of substance use. This study examined the effects of a school-based prevention program implemented by the Brazilian state-level police forces in schools, focusing on differences across racial groups. We analyzed data from two cluster-randomized controlled trials conducted in 2019 in public schools on the outskirts of São Paulo. The sample included fifth- and seventh-grade students and assessed the effectiveness of the PROERD program in preventing alcohol and tobacco use across racial groups. Racial classification was based on self-identification and categorized according to the official Brazilian census: White (branca), Black (including preta and parda), and Others (Indigenous people, Asians, and their descendants). After nine months, Black seventh-grade students had a higher risk of initiating alcohol and tobacco use compared to their White counterparts. We found no significant preventive effect on alcohol or tobacco use in any racial group within any given grade level. The findings underscore the need for more comprehensive, culturally sensitive prevention strategies that address the specific risk factors affecting racial minority adolescents and promote greater health equity.
青少年饮酒和吸烟与各种健康风险相关，包括认知和发育障碍。少数族裔青少年可能面临更多的不利因素，如种族主义和歧视，这会导致压力增加和物质使用风险上升。本研究考察了巴西州级警察部队在学校实施的一项基于学校的预防计划的效果，重点关注不同种族群体之间的差异。我们分析了2019年在圣保罗郊区公立学校进行的两项整群随机对照试验的数据。样本包括五年级和七年级学生，并评估了PROERD计划在预防不同种族群体饮酒和吸烟方面的有效性。种族分类基于自我认同，并根据巴西官方人口普查进行划分：白人（branca）、黑人（包括preta和parda）以及其他（原住民、亚洲人及其后裔）。九个月后，与白人七年级学生相比，黑人七年级学生开始饮酒和吸烟的风险更高。我们发现在任何给定年级水平的任何种族群体中，该计划对饮酒或吸烟均无显著预防效果。研究结果强调需要制定更全面、对文化敏感的预防策略，以解决影响少数族裔青少年的特定风险因素，并促进更大程度的健康公平。
