Original article
Effects of a School-Based Prevention Program on European Adolescents' Patterns of Alcohol Use

https://doi.org/10.1016/j.jadohealth.2010.06.003Get rights and content

Abstract

Purpose

School-based substance abuse prevention programs are widespread but are rarely evaluated in Europe. We aimed to evaluate the effect of a new school-based prevention program against substance use on the frequency of alcohol consumption and alcohol-related problem behaviors among European students.

Methods

During the school year 2004–2005, a total of 7,079 students aged 12–14 years from 143 schools in seven European countries participated in this cluster randomized controlled trial. Schools were randomly assigned to either control (65 schools, 3,532 students) or to a 12-session standardized program based on the comprehensive social influence model (78 schools, 3,547 students). Alcohol use and frequency of alcohol-related problem behaviors were investigated through a self-completed anonymous questionnaire at baseline and 18 months thereafter. The association between intervention and changes in alcohol-related outcomes was expressed as odds ratio (OR), estimated by multilevel regression model.

Results

The preventive program was associated with a decreased risk of reporting alcohol-related problems (OR = .78, 95% confidence intervals [CI] = .63–.98), although this reduction was not statistically significant in the subgroup of 743 current drinkers at baseline. The risk for alcohol consumption was not modified by exposure to the program (OR = .93, 95% CI = .79–1.09). In the intervention group, nondrinkers and occasional drinkers at baseline progressed toward frequent drinking less often than in the control group.

Conclusions

School curricula based on the comprehensive social-influence model can delay progression to frequent drinking and reduce occurrence of alcohol-related behavioral problems in European students. These results, albeit moderate, have potentially useful implications at the population level.

Section snippets

Methods

The EU-Dap trial took place simultaneously in seven European countries: Austria, Belgium, Germany, Greece, Italy, Spain, and Sweden. The research protocol was approved by the Ethical Boards at the respective study centers.

Results

The baseline characteristics of the study sample are shown in Table 1.

Despite the randomization procedures, certain characteristics at baseline were unbalanced between the experimental arms, with the control group having a higher proportion of older students and of students with reports of behavioral problems related to their drinking.

Discussion

In this trial, European students who attended a new substance abuse prevention program in school were less likely to experience alcohol-related behavioral problems than students attending usual school education.

The overall frequency of alcohol consumption, however, was not affected by participation in the curriculum. A previous report from this study showed that the program was associated with a reduced frequency of recent episodes of drunkenness [21]. Taken together, these data suggest that

Acknowledgments

We acknowledge teachers and students who volunteered in this study and all colleagues who participated in the field work.

The following authors contributed significantly to the work: F.F. and M.R.G. designed the study. M.P.C. and M.R.G. drafted the paper. F.F. and R.B. contributed to revising the paper. M.P.C. and R.B. analyzed the data. The members of the EU-Dap Study Group carried out the intervention and collected the data. M.P.C. had overall responsibility for the paper. All authors

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