Is universal prevention against youths' substance misuse really universal? Gender-specific effects in the EU-Dap school-based prevention trial
- 23 April 2009
- journal article
- research article
- Published by BMJ in Journal of Epidemiology and Community Health
- Vol. 63 (9), 722-728
- https://doi.org/10.1136/jech.2008.081513
Abstract
Background: Studies of effectiveness of school-based prevention of substance misuse have generally overlooked gender differences. The purpose of this work was to analyse gender differences in the effectiveness of a new European school-based curriculum for prevention of substance misuse among adolescents. Methods: The European Drug Abuse Prevention (EU-Dap) trial took place in seven European countries during the school year 2004–05. Schools were randomly assigned to either a control group or a 12-session standardised curriculum (“Unplugged”) based on a comprehensive social influence model. The analytical sample consisted of 6359 students (3324 boys and 3035 girls). The use of cigarettes, alcohol and illicit drugs, adolescents’ knowledge and opinions about substances, as well as social and personal skills were investigated through a self-completed anonymous questionnaire administered at enrolment and 3 months after the end of the programme. Adjusted Prevalence Odds Ratios were calculated as the measure of association between the intervention and behavioural outcomes using multilevel regression modelling. Results: At enrolment, boys were more likely than girls to have used cannabis and illicit drugs, whereas girls had a higher prevalence of cigarette smoking. At the follow-up survey, a significant association between the programme and a lower prevalence of all behavioural outcomes was found among boys, but not among girls. Age and self-esteem emerged as possible modifiers of these gender differences, but effects were not statistically significant. Conclusions: Comprehensive social influence school curricula against substance misuse in adolescence may perform differently among girls and boys, owing to developmental and personality factors.Keywords
This publication has 10 references indexed in Scilit:
- The effectiveness of a school-based substance abuse prevention program: EU-Dap cluster randomised controlled trialPreventive Medicine, 2008
- A Wakeup Call to the Prevention Field: Are Prevention Programs for Substance Use Effective for Girls?Substance Use & Misuse, 2008
- A cluster randomized controlled trial of school-based prevention of tobacco, alcohol and drug use: The EU-Dap design and study populationPreventive Medicine, 2007
- Salivary cotinine concentration versus self-reported cigarette smoking: Three patterns of inconsistency in adolescenceNicotine & Tobacco Research, 2006
- School-Based Drug Prevention Among At-Risk Adolescents: Effects of ALERT PlusHealth Education & Behavior, 2006
- Conceptualizing and testing random indirect effects and moderated mediation in multilevel models: New procedures and recommendations.Psychological Methods, 2006
- Validity of self reports in a cohort of Swedish adolescent smokers and smokeless tobacco (snus) usersTobacco Control, 2005
- Design and Analysis of Group-Randomized Trials: A Review of Recent Methodological DevelopmentsAmerican Journal of Public Health, 2004
- Self-reported cigarette smoking vs. serum cotinine among U.S. adolescentsNicotine & Tobacco Research, 2004
- Project Towards No Drug Abuse: two-year outcomes of a trial that compares health educator delivery to self-instructionPreventive Medicine, 2003