Federica Vigna-Taglianti1, Emina Mehanović2, Marta Alesina2, Ljiljana Damjanović2, Akanidomo Ibanga3, Juliet Pwajok4, Glen Prichard3, Peer van der Kreeft5, Harsheth Kaur Virk3. 1. Department of Clinical and Biological Sciences, University of Torino, Regione Gonzole 10, 10043, Orbassano, Torino, Italy; Piedmont Centre for Drug Addiction Epidemiology, ASL TO3, Via Sabaudia 164, 10095, Grugliasco, Torino, Italy. Electronic address: federica.vignataglianti@unito.it. 2. Department of Clinical and Biological Sciences, University of Torino, Regione Gonzole 10, 10043, Orbassano, Torino, Italy; Piedmont Centre for Drug Addiction Epidemiology, ASL TO3, Via Sabaudia 164, 10095, Grugliasco, Torino, Italy. 3. United Nations Office on Drugs and Crime, Project Office, NDLEA Headquarters, 4 Onilegbale Road, Ikoyi, Lagos, Nigeria. 4. University of Jos, P.M.B. 2084, 93001, Jos, Nigeria. 5. Faculty of Education, Health and Social Work, University College Ghent, Valentin Vaerwyckweg 1, 9000, Ghent, Belgium.
Abstract
BACKGROUND: School-based programs are the most convenient interventions to tackle substance use among youth. "Unplugged" is a Social Influence universal school curriculum developed and tested in the "EU-Dap" project. In 2015, Nigeria implemented a large-scale project to promote healthy lifestyles in schools, families and communities. Within the project, the effectiveness of "Unplugged" was evaluated through a cluster randomized controlled trial. METHODS: The program was adapted to the Nigerian context, assembling suggestions from monitoring forms and interviews, and performing fidelity checks on content and method. Thirty-two secondary schools were extracted from a list provided by the Federal Ministry of Education, and randomly allocated to intervention and control arms. A self-completed anonymous questionnaire was used for baseline and follow-up surveys. The analysis sample finally included 2685 pupils (mean age 14.2 years). Multilevel models were run to estimate program effects on prevalence of self-reported cigarettes, alcohol, and marijuana use. Mediation analysis was performed to identify possible mediators of program effect on alcohol use. RESULTS: Unplugged significantly reduced the prevalence of recent alcohol use in intervention vs control pupils. The effect on prevalence of cigarette and marijuana use was not statistically significant. The program prevented progress and encouraged regress across stages of intensity of alcohol use. Negative beliefs, risk perceptions, and class climate mediated the effect of Unplugged on alcohol use. CONCLUSIONS: Unplugged was effective in preventing alcohol use improving beliefs, class climate and risk perceptions among Nigerian students. The implementation of the program at a larger scale in the country should be supported.
BACKGROUND: School-based programs are the most convenient interventions to tackle substance use among youth. "Unplugged" is a Social Influence universal school curriculum developed and tested in the "EU-Dap" project. In 2015, Nigeria implemented a large-scale project to promote healthy lifestyles in schools, families and communities. Within the project, the effectiveness of "Unplugged" was evaluated through a cluster randomized controlled trial. METHODS: The program was adapted to the Nigerian context, assembling suggestions from monitoring forms and interviews, and performing fidelity checks on content and method. Thirty-two secondary schools were extracted from a list provided by the Federal Ministry of Education, and randomly allocated to intervention and control arms. A self-completed anonymous questionnaire was used for baseline and follow-up surveys. The analysis sample finally included 2685 pupils (mean age 14.2 years). Multilevel models were run to estimate program effects on prevalence of self-reported cigarettes, alcohol, and marijuana use. Mediation analysis was performed to identify possible mediators of program effect on alcohol use. RESULTS: Unplugged significantly reduced the prevalence of recent alcohol use in intervention vs control pupils. The effect on prevalence of cigarette and marijuana use was not statistically significant. The program prevented progress and encouraged regress across stages of intensity of alcohol use. Negative beliefs, risk perceptions, and class climate mediated the effect of Unplugged on alcohol use. CONCLUSIONS: Unplugged was effective in preventing alcohol use improving beliefs, class climate and risk perceptions among Nigerian students. The implementation of the program at a larger scale in the country should be supported.
Authors: Kimberly Johnson; Irina Pinchuk; Marie Isabel E Melgar; Martin Osayande Agwogie; Fernando Salazar Silva Journal: Ann Med Date: 2022-12 Impact factor: 5.348