A cluster randomized controlled trial evaluating the effectiveness of the school‐based drug prevention program #Tamojunto2.0

Abstract

Aims The study aimed to evaluate the effectiveness of the government school‐based program #Tamojunto2.0, the third Brazilian version of the European drug prevention program, Unplugged, in preventing the use of alcohol and other drugs. Design A parallel, two‐arm cluster randomized controlled trial was conducted in 205 classes in 73 public schools (37 intervention and 36 control) with a baseline assessment and follow‐up after 9 months. Setting Schools in the cities of São Paulo, Fortaleza and Eusebio in Brazil. Participants A total of 5208 students in the 8th grade with a mean age of 13.2 years (standard deviation = 0.8 years) and an equal gender ratio. Intervention In 2019, the intervention group attended 12 classes of the program #Tamojunto2.0, under the supervision of a team from the Ministry of Health. The control group did not receive any intervention to prevent alcohol and drug use. Measurements The primary outcome measured was prevalence of binge drinking (five or more doses of alcohol in an occasion) within the past month. Secondary outcomes were prevalence of initiation and use of alcohol, tobacco, inhalants, marijuana and cocaine within the past month. Findings A statistically significant difference was not found in the prevalence of binge drinking within the past month between intervention and control groups [odds ratio (OR) = 0.934; 95% confidence interval (CI) = 0.761–1.146]. However, students who were exposed to the program were less likely to initiate alcohol use than those in the control group (OR = 0.782; 95% CI = 0.636–0.961). The Bayes factor for reduction in binge drinking was 0.01, providing evidence in favor of the null hypothesis for this variable. Conclusions The drug prevention program #Tamojunto 2.0 reduced alcohol initiation, but appeared not to reduce past‐month binge drinking among 8th grade students in Brazil.

Implementation fidelity of a Brazilian drug use prevention program and its effect among adolescents: a mixed-methods study

“…The attrition analysis found no significant difference between groups and between sex. As expected, however, students who missed the 9-month follow-up showed a significantly higher prevalence of substance use at baseline, especially among 7th graders [ 42 ]. Table 2 presents the descriptive results of drug use at follow-up according to group and level of implementation fidelity.…”

“…An anonymous, self-administered audio-guided questionnaire was applied to students using smartphones by researchers in the classroom without a teacher. This instrument has been employed in previous studies to evaluate school-based drug prevention programs in Brazil [ 41 , 42 ]. It was designed based on the European Drug Addiction Prevention Trial (EU-DAP) questionnaire [ 43 ], translated and adapted into Brazilian Portuguese.…”

Evaluation of the Implementation Process of the #Tamojunto2.0 Prevention Program in Brazilian Schools

“…The RCT sample consisted of 5,371 eighth grade students (mean age = 13.20 ±0.84) from 73 public schools (37 in the intervention group and 36 in the control group) from three Brazilian cities: São Paulo (SP), Eusébio (CE) and Fortaleza (CE). The results of this study are described in Sanchez et al (2021).…”

Body dissatisfaction, drug use, and associated factors among adolescents in three Brazilian cities

“…This study used a sample of a randomized controlled trial (RCT) whose initial objective was to evaluate the effectiveness of a drug use prevention program for 8th grade adolescents 16 . Then, the RCT with two parallel groups (intervention and control) was conducted with among 8th grade students from public schools in three Brazilian cities (São Paulo/SP, Fortaleza/CE, and Eusébio/CE).…”