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

Caria, Maria Paola; Faggiano, Fabrizio; Bellocco, Rino; Galanti, Maria Rosaria; EU-Dap Study Group,

doi:10.1016/j.jadohealth.2010.06.003

« Previous Next »Journal of Adolescent Health
Volume 48, Issue 2 , Pages 182-188, February 2011

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

Maria Paola Caria, M.Sc.
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical and Experimental Medicine, Avogadro University, Novara, Italy
- Address correspondence to: Maria Paola Caria, M.Sc., Department of Clinical and Experimental Medicine, Avogadro University, Via Solaroli 17, 28100 Novara, Italy
Fabrizio Faggiano, M.D., Ph.D.
- Department of Clinical and Experimental Medicine, Avogadro University, Novara, Italy
- Piedmont Centre for Drug Addiction Epidemiology, Grugliasco, Turin, Italy
Rino Bellocco, Sc.D.
- Department of Statistics, University of Milano-Bicocca, Milan, Italy
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
Maria Rosaria Galanti, M.D., Ph.D.
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
EU-Dap Study Group

Received 11 November 2009; accepted 2 June 2010. published online 31 August 2010.

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.

Keywords: School-based prevention, Alcohol abuse, Randomized controlled trial, Comprehensive social influence model, Program evaluation