Abstract
AimsTo investigate the mediating effects of normative beliefs of drug use on the effects of the #Tamojunto school-based prevention program (Unplugged).DesignSecondary analysis of a cluster randomized controlled trial.SettingBrazil. Participants: A total of 6,391 adolescents (12.68 y.o) from 72 public schools in 6 Brazilian cities. Intervention: Schools were assigned to an experimental condition (#Tamojunto curriculum) or a control condition (no prevention program). Measurements: Baseline data were collected prior to program implementation, and follow-up data were collected 9 and 21 months later. The substances examined were alcohol (including binge drinking), tobacco, marijuana and inhalants. Five in-parallel mediation models evaluated whether the positive and negative beliefs were mediators of the likely effects of the intervention on drug use.FindingsLack of evidences regarding differences in normative beliefs or drug use were found between the intervention and control groups. However, there was a clear association between negative drug beliefs and lower consumption (i.e. OR = 0.78; 95% CI 0.70; 0.87, for cannabis use) as well as between positive drug beliefs and higher consumption (i.e. OR = 1.77; 95% CI 1.56; 2.02, for cannabis use) independent of the assigned group.ConclusionsThese results suggest that there is a lack of evidence that the program impact the normative beliefs, as proposed by the theoretical model of the program, suggesting that modifications are needed to produce the intended effect of the program. Negative normative beliefs seem to be a potential protective factor for drug use, but the program’s effect itself on drug use via normative beliefs was not found to be statistically significant. Program activities intended to affect normative beliefs should be improved.
Highlights
Since the 1980s, prevention programs have been created to address the major public health [1,2] issue of the premature use of substances during adolescence [3]
Normative beliefs in drug prevention program. These results suggest that there is a lack of evidence that the program impact the normative beliefs, as proposed by the theoretical model of the program, suggesting that modifications are needed to produce the intended effect of the program
This study showed that the program seemed to increase first alcohol use and decrease first inhalant use in the intervention group compared to the control group at the 9-month follow up [13]
Summary
This study showed that the program seemed to increase first alcohol use (aRR = 1.30, 95% CI 1.13–1.49) and decrease first inhalant use (aRR = 0.78, 95% CI 0.63–0.96) in the intervention group compared to the control group at the 9-month follow up [13]. Considering these contradictory results, an understanding of the mechanisms underlying the success and failure of this program is needed to identify whether the intervention is effective for changing normative beliefs and to determine where program curricula may be improved to achieve the expected outcome. Does the prevention program affect the mediating variables that are targeted by the intervention as proposed in its logic model [14,15], which in turns, change the drug use as main outcome?
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call