Resultados del programa de prevención escolar Unplugged sobre el uso del tabaco en la República Checa The Effect of the School-Based Unplugged Preventive Intervention on Tobacco Use in the Czech Republic

Autores/as

  • Michal Miovsky Charles University in Prague, First Faculty of Medicine, Department of Addictology of First Faculty of Medicine and General University Hospital. Enviar correspondencia a: Michal Miovsky Klinika adiktologie 1. LF UK a VFN v Praze, Apolinarska 4, 128 00 Prague 2, Czech Republic.
  • Petr Novak Charles University in Prague, First Faculty of Medicine, Department of Addictology of First Faculty of Medicine and General University Hospital.
  • Lenka Stastna Charles University in Prague, First Faculty of Medicine, Department of Addictology of First Faculty of Medicine and General University Hospital.
  • Roman Gabrhelik Charles University in Prague, First Faculty of Medicine, Department of Addictology of First Faculty of Medicine and General University Hospital.
  • Lucie Jurystova Charles University in Prague, First Faculty of Medicine, Department of Addictology of First Faculty of Medicine and General University Hospital.
  • Jiri Vopravil Charles University in Prague, First Faculty of Medicine, Department of Addictology of First Faculty of Medicine and General University Hospital.

DOI:

https://doi.org/10.20882/adicciones.92

Palabras clave:

adolescencia, prevención escolar, ensayo controlado aleatorio, tabaco, República Checa adolescent, school prevention, randomised controlled trial, tobacco use, Czech Republic

Resumen

Unplugged es un programa de prevención escolar que se desarrolla en diversos países europeos, y que cuenta ya con varias evaluaciones. En este caso se pretende medir el impacto de la intervención sobre el consumo de tabaco utilizando las prevalencias de por vida y los últimos 30 días, así como también verificar la duración del efecto mediante un seguimiento. El estudio se diseñó como un ensayo controlado aleatorio. La intervención se basa en el modelo de influencia social integral y se compone de 12 lecciones impartidas a los adolescentes checos en el año académico 2007-2008. Las prevalencias se calcularon para evaluar las diferencias entre el grupo experimental (N = 914) y control (n = 839) al cabo de 1, 3, 12, 15 y 24 meses después del final de la intervención. Los datos se recogieron utilizando la versión 2003 del cuestionario del proyecto ESPAD. En cuanto a haber fumado los últimos 30 días había diferencias significativas entre ambos grupos en favor de la experimental al finalizar la intervención. Dos años después de la finalización de la intervención de los grupos experimentales y de control de 30 días mostraron tasas de prevalencia de 26,7% y 33,1%, respectivamente (p = .01). La progresión en la prevalenciadurante los últimos 30-días dentro del grupo experimental fue significati- vamente más lenta que entre el grupo de control durante el período medido. Las diferencias en las tasas de prevalencia de vida no fueron sin embargo significativas. Por tanto la implementación del programa Unplugged resultó significativamente positiva en cuanto al consumo de tabaco entre los adolescentes checos.
Unplugged is a school prevention programme widely implemtend in Europe, with some positive evaluations. This research aims to measure the impact of this program on tobacco use by means of the lifetime and last-30-day tobacco use prevalence indicators and verify the duration of the intervention’s measurable effect over time. The study was designed as a randomised controlled prevention trial. The intervention is based on the Comprehensive Social Influence model and consists of 12 lessons delivered to Czech adolescents in the 2007-2008 academic year. The prevalence indicators were calculated to assess the differences between the experimental (N = 914) and control (N = 839) groups on each outcome 1, 3, 12, 15, and 24 months after the end of the intervention. Data were collected using the 2003 version of the ESPAD questionnaire. As regards the 30-day smoking prevalence indicator, the tests performed after the completion of the intervention showed statistically significant differences between both groups in favour of the experimental one. Two years after thecompletion of the intervention the experimental and control groups showed 30-day prevalence rates of 26.7% and 33.1%, respectively (p= .01). The progression of smoking in the 30-day prevalence among the experimental group was significantly slower than that among the control group over the period of time. The differences in the lifetime prevalence rates were not statistically significant. The implementation of Unplugged resulted in a statistically significant measurable positive effect on tobacco use in Czech adolescents.

Citas

Adamkova, T., Jurystova, L., Gabrhelik, R., Miovska, L. & Miovsky, M.

(2009). Primary Prevention in Schools Involved in the EUDAP 2 Project. Adiktologie, 9, 86–94.

Best, D., Rawaf, S., Rowley, J., Floyd, K., Manning V. & Strang, J. (2000).

Drinking and smoking as concurrent predictors of illicit drug use and positive drug attitudes in adolescents. Drug and Alcohol Dependence, 60, 319- 322.

Burkhart, G. (2011). Environmental drug prevention in the EU. Why is

it so unpopular? Adicciones, 23, 87-14. Calafat, A., Juan, M. & Duch, M. A. (2009). Preventive interventions in nightlife: A review. Adicciones, 21, 387-414.

Calafat, A., Amengual, M., Farres, C. & Palmer, A. (1985). Life-style and

drug use habits among secondary school students. Bulletin on Narcotics, 37, 113-123.

Campbell, R., Starkey, F., Holliday, J., Audrey, S., Bloor, M., Parry-Langdon, N., Moore, L. (2008). An informal school-based peer-led intervention for smoking prevention in adolescence (ASSIST): a cluster randomised trial. Lancet, 371, 1595-1602.

Crone, M . R., Reijneveld, S. A., Willemsen, M. C., van Leerdam, F. J.,

Spruijt, R. D. & Sing, R. A. (2003). Prevention of smoking in adolescents with lower education: a school-based intervention study. Journal of Epidemiology and Community Health, 57, 675-680.

Csemy, L. & Nespor, K. (2002). Zkušenost s alkoholem, tabákem a

marihuanou výrazn zvyšují riziko experimentovaní s heroinem a pervitinem [Having experiences with alcohol, tobacco and marijuana increases the risk of heroin and pervitin experiments]. ˇCeská aslovenská Psychiatrie, 98, 358-359.

Csemy, L. & Lejckova, P. (2005). Risk perception and attitudes of young

people towards drug use. Adiktologie, 5, 35-44.

Csemy, L., Lejckova, P. & Sadilek, P. (2007). Substance Use Among

Czech Adolescents: An Overview of Trends in the International Context. Journal of Drug Issues, 37, 119-132.

de Vries, H., Dijk, F., Wetzels, J., Mudde, A., Kremers, S., Ariza, C.,

Candel, M. (2006). The European Smoking prevention Framework Approach (ESFA): Effects after 24 and 30 months. Health Education Research, 21, 116-132.

Ellickson, P. L., Hays, R. D. & Bell, R. M. (1992). Stepping through the

drug use sequence: longitudinal scalogram analysis of initiation and regular use. Journal of Abnormal Psychology, 101, 441-451.

Ennett, S. T., Tobler, N. S., Ringwalt, C. L. & Flewelling, R. L. (1994). How

effective is Drug Abuse Resistance Education? A meta-analysis of Project DARE outcome evaluations. American Journal of Public Health, 84, 1394-1401.

Epstein, J. A., Botvin, G. J., Diaz, T., Toth, V. & Schinke, S. P. (1995).

Social and personal factors in marijuana use and intentions to use drugs among inner city minority youth. Journal of Developmental and Behavioral Pediatrics, 16, 14-20.

Faggiano, F., Richardson, C., Bohrn, K., Galanti, M. R., the EU-Dap Study Group. (2007). A cluster randomized controlled trial of school-based prevention of tobacco, alcohol and drugs use: the EU-Dap design and study population. Preventive Medicine, 44, 170-173.

Faggiano, F., Galanti, M. R., Bohrn, K., Burkhart, G., Cuomo, L., Vigna-

Taglianti, F.,… the EU-Dap Study Group. (2008). The effectiveness of a school-based substance abuse prevention program: EU-Dap Cluster Randomised Controlled Trial. Preventive Medicine, 47, 537-543.

Faggiano, F. (2010). Prevention of substance abuse: Randomised or

observational evaluation is absolutely needed. Adicciones, 22, 11-14.

Faggiano, F., Vigna-Tglianti, F., Burkhart, G., Bohrn, K., Cuomo, L., Gregori, D.,… the EU-Dap Study Group. (2010). The effectiveness of a school-based substance abuse prevention program: 18-Month follow-up of the EU-Dap cluster randomized controlled trial. Drug and Alcohol Dependence, 108, 56-64.

Flay B. R. (2009). School-based smoking prevention programs with the promise of long-term effects. Tobacco Induced Diseases, 5. doi:10.1186/1617-9625-5-6.

Flay, B. R., Biglan, A., Boruch, R. F., Castro, F. G., Gottfredson, D., Kellam,

S., et al. (2005). Standards of evidence: Criteria for efficacy, effectiveness and dissemination. Prevention Science, 6, 151-175.

Gabrhelik, R., Duncan, A., Miovsky, M., Furr-Holden, C.D.M., Stastna, L.

& Jurystova, L. (2012). ‘Unplugged’: A School-Based Randomized Control Trial to Prevent and Reduce Adolescent Substance Use in the Czech Republic. Drug and Alcohol Dependence. http://dx.doi.org/10.1016/j.drugalcdep.2011.12.010.

Gomez Cruz, G., Barrueco Ferrero, M., Aparicio Coca, I., Maderuelo,

J. A. & Torrecilla García, M. (2009). Program for the prevention of smoking in secondary school students. Archivos De Bronconeumologia, 45, 16-23.

Hanewinkel, R. & Asshauer, M. (2004). Fifteen-month followup results of a school-based life skills approach to smoking prevention. Health Education Research, 19, 125-137.

Hibell, B., Guttormosson, U., Ahlstrom, S., Balakireva, O., Bjarnasson, T.,

Kokkevi, A. & Kraus, L. (2009). The 2007 ESPAD Report: Substance Use Among Students in 35 European Countries. Stockholm: The Swedish Council for Information on Alcohol and Other Drugs.

Jessor, R., Turbin, M. S. & Costa, F. M. (1998). Protective Factors in

Adolescent Health Behavior. Journal of Personality and Social Psychology, 75, 788-800.

Jessor, R., Turbin, M. S., Costa, F. M., Dong, Q., Zhang, H. & Changhai,

W. (2003). Adolescent problem behavior in China and the United States: A cross-national study of psychosocial protective factors. Journal of Research on Adolescence, 13, 329-360.

Jha, P. & Chaloupka, F. J. (2000). Tobacco control in developing countries. Oxford: Oxford University Press.

Jimenez-Iglesias, A., Moreno, C., Oliva, A. & Ramos, P. (2010). An approach to the assessment of the effectiveness of a drug use prevention program in secondary education in Andalusia. Adicciones, 22, 253-265.

Jit, M., Aveyard, P., Barton, P. & Meads, C. A. (2010). Predicting the lifetime benefit of school-based smoking prevention programmes.

Addiction, 105, 1109-1116.

Josendal, O., Aaro, L. E., Torsheim, T. & Rasbash, J. (2005). Evaluation of

the school-based smoking-prevention program “BE smokeFREE”. Scandinavian Journal of Psychology, 46, 189-199.

Josendal, O., Aaro, L. E. & Bergh, I. (1998). Effects of a school-based

smoking prevention program among subgroups of adolescents. Health Education Research, 13, 215-224.

Jurystova, L., Gabrhelik, R. & Miovsky, M. (2009). “Unplugged” Primary

Prevention Programme – Evaluation of the Implementation Process by School Prevention Workers. Adiktologie, 9, 10-19.

Jurystova, L. & Miovsky, M. (2010). Vybrané aspekty organi zaˇcní a

odborné podpory pedagogu° pˇri realizaci metodiky Unplugged ve školách: Výsledky evaluace implementace projektu EUDAP [Selected Aspects of Organisational and Expert Support for Teachers and Other Education Professionals in Delivering the Unplugged Programme in Schools: Findings of the Evaluation of the Implementation of the EUDAP Project]. Adiktologie, 10, 147-153.

Lubman, D.I., Yücel, M., Hall, W.D. (2007). Substance use and the

adolescent brain: A toxic combination? J Psychopharmacol, 21(8),

-794.

McLellan, A. T., Lewis, D. C., O’Brien, C. P. & Kleber, H. D. (2000). Drug

dependence, a chronic medical illness: implications for treatment,

insurance, and outcomes evaluation. JAMA, 284, 1689-1695.

Miovska, L. (2005). Uzivani drog v narodnich mensinach v CR–Souhrn

dostupnych informaci. Drugs in Focus 2. [Drug use among ethnic

minorities in the Czech Republic-summary of the available information. Drugs in Focus 2.] Praha: Urad vlady CR.

Miovsky, M., Miovska, L., Rehan, V. & Trapkova, B. (2007). Substance

use in fifth- and seventh-grade basic school pupils: Review of results of quasi-experimental evaluation study. ˇCeskoslovenská psychologie, 103, 109-118.

Miovsky, M., Stastna, L., Gabrhelik, R. & Jurystova, L. (2011). Evaluation

of the Drug Prevention Interventions in the Czech Republic. Adiktologie, 11, 236–247.

Miovsky, M., Skacelova, L., Zapletalova, J. & Novak, P. (Eds.) (2010).

Primární prevence rizikového chování ve školství [Primary Prevention of Risk Behaviour within the School System]. Praha: SCAN, Univerzita Karlova v Praze & Togga.

Montes-Santiago, J. & Castro-Rial, M. L. (2009). Alcoholism prevention

and alcohol advertising investment in Spain: David versus Goliath.

Adicciones, 21, 203-206.

Nilsson, M., Stenlund, H., Weinehall, L., Bergström, E. & Janlert, U.

(2009). “I would do anything for my child, even quit tobacco”: Bonus effects from an intervention that target adolescent tobacco use. Scandinavian Journal of Psychology, 50, 341-345.

Novak, P., Miovsky, M. & Stastna, L. (2010). The media portrayal of addictive substances users and its social psychological perspective. Lekársky obzor, 59, 80-84.

Novak, P., Miovsky, M. & Stastna, L. (2009). The media portrayal of

cannabis in relation to criminal activities. Adiktologie, 9, 196-203.

Peterson, A. V., Kealey, K. A., Mann, S. L. Marek, P. M. & Sarason, I.

G. (2000). Hutchinson Smoking Prevention Project: Long-term randomized trial in school-based tobacco use prevention – Results on smoking. Journal of the National Cancer Institute, 92, 1979-1991.

Sanchez-Martinez, F., Cardenal, A .A., Gimenez, A. P., Ferrer, M. D.,

Medina, M. J. L. & Adell, M. N. (2010). Process evaluation of the school-based cannabis use prevention program “xkpts.com” in adolescents from Barcelona in 2006. Adicciones, 22, 217-226.

Skara S. & Sussman S. (2003) A review of 25 long-term adolescent

tobacco and other drug use prevention program evaluations. Preventive Medicine, 37, 451-474.

Sovinova, H., Csemy, L., Warren, C. W., Lee, J. & Lea, V.(2008). Changes

in tobacco use among 13-15-year-olds in the Czech Republic – 2002 and 2007. Cent Eur J Public Health, 16, 199-204.

Sussman, S., Earleywine, M., Wills, T., Cody, C., Biglan, T., Dent, C. W.

& Newcomb, M. D. (2004). The motivation, skills, and decisionmaking

model of “drug abuse” prevention. Substance Use & Misuse, 39, 1971-2016.

Sussman, S. (2002). Effects of sixty-six adolescent tobacco use cessation trials and seventeen prospective studies of self-initiated quitting. Tobacco Induced Diseases, 1, 35-81.

Thomas, R. & Perera, R. (2006). School-based programmes for preventing smoking. The Cochrane Database of Systematic Reviews (3), doi:10.1002/14651858, Art. No.: CD001293.

Tobler, N. S., Roona, M. R., Ochshorn, P. M., Diana, G., Streke, A. V. &

Stackpole, K. M. (2000). School-based adolescent drug prevention programmes: 1998 meta-analysis. Journal of Primary Prevention, 20, 275-336.

UNICRI. (2003). School-Based Drug Education: a guide for practitioners

and the wider community. Vienna: United Nations Office for Drug Control and Crime Prevention.

Van der Kreeft, P., Wiborg, G., Galanti, M. R., Siliquini, R., Bohrn, K.,

Scatigna, M.,… the EU-Dap Study Group. (2009). Unplugged”: a new European school program against substance abuse. Drugs Education Prevention and Policy, 16, 167-181.

Vega, W. A. (2005). Revisiting drug progression: long-range effects of

early tobacco use. Addiction, 100, 1358-69.

Wakefield, M., Flay, B., Nichter, M. & Giovino, G. (2003). Role of the

media in influencing trajectories of youth smoking. Addiction, 98, 79-103.

Wiehe, S. E., Garrison, M. M., Christakis, D. A., Ebel, B. E. & Rivara, F. P.

(2005). A systematic review of school-based smoking prevention trials with long-term follow-up. Journal of Adolescent Health, 36, 162-169.

World Health Organisation. (2008). WHO report on the global tobacco

epidemic, 2008. Geneva: WHO.

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Publicado

2012-09-01

Número

Vol. 24 Núm. 3 (2012)

Sección

Originales