Abstract
The prevention of the use of alcohol and other drugs in Brazil is markedly discontinuous with a predominant model not based on evidence. In 2013, the General Coordination Office of Mental Health, alcohol and other drugs (Ministry of Health) implemented the European school program Unplugged#Tamojunto in the municipalities of São Paulo (SP), São Bernardo do Campo (SP) and Florianópolis (SC), involving 2,161 public school students. The research aimed to elaborate recommendations to adapt the program to the Brazilian context. The qualitative study is based on the Constructivist Grounded Theory and analyzed the institutional documents: "Cartographic Diaries", "Logical Spreadsheet of Cultural Adaptation" and a research report titled "Results of the Implementation of the Unplugged Pilot Program in São Paulo and Santa Catarina" (UFSC and UNIFESP). The theoretical formulations were organized from the Theory of Dissemination of Innovations and revealed that the following is required: a paradigmatic change in the professional approach to drugs, greater adherence to interactive methodologies, adaptation of class time, commitment to school management, promotion of intersectoriality between health and education, consolidation of the monitoring process and ethical alignment with the principles of health promotion.
Highlights
Health promotion is established as a policy in Brazil[1] and assumes the need to take health problems and their determinants as an object, calling for an expanded, intersectoral action not focused on the health-disease binomial and under a purely clinical perspective
Health promotion has both approached and distanced itself from the preventive approaches over the last few years, precisely because they focus, in some aspects, a view exclusively geared to individual aspects[2]
Far from being a social policy, organized by principles and guidelines agreed among the spheres of government, something more diffuse and less articulated is found in Brazil between projects and programs that are defined as preventive but whose effect has not been verified[3]
Summary
Health promotion is established as a policy in Brazil[1] and assumes the need to take health problems and their determinants as an object, calling for an expanded, intersectoral action not focused on the health-disease binomial and under a purely clinical perspective. We understand that the construction of inductive and deductive hypotheses based on evidence of implementation of the Unplugged program favor the construction of public policies in the field of prevention and health promotion, in the identification of factors that can operate in a determining the sustainability of the initiative[38,39]. This qualitative study was based on the Constructivist Grounded Theory[40,41], which consists of developing theories from data-based research rather than interpreting analyzable hypotheses from existing theories, with the construction of explanations of the processes. The preparation of the theoretical classifications followed the methodological recommendation of the construction of diagrams (Figure 1)
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