Laura Vogl

Internet-based prevention for alcohol and cannabis use: final results of the Climate Schools course

AIMS To establish the long-term efficacy of a universal internet-based alcohol and cannabis prevention programme in schools. METHODS A cluster-randomized controlled trial was conducted to assess the effectiveness of the Climate Schools: Alcohol and Cannabis Course. The evidence-based course, aimed at reducing alcohol and cannabis use, is facilitated by the internet and consists of 12 novel and curriculum consistent lessons delivered over 6 months. PARTICIPANTS A total of 764 year 8 students (13 years) from 10 Australian secondary schools were allocated randomly to the internet-based prevention programme (n = 397, five schools), or to their usual health classes (n = 367, five schools). MEASURES Participants were assessed at baseline, immediately post, and 6 and 12 months following completion of the intervention, on measures of alcohol and cannabis knowledge, attitudes, use and related harms. RESULTS This paper reports the final results of the intervention trial, 12 months following the completion of the Climate Schools: Alcohol and Cannabis Course. The effectiveness of the course 6 months following the intervention has been reported previously. At the 12-month follow-up, compared to the control group, students in the intervention group showed significant improvements in alcohol and cannabis knowledge, a reduction in average weekly alcohol consumption and a reduction in frequency of drinking to excess. No differences between groups were found on alcohol expectancies, cannabis attitudes or alcohol- and cannabis-related harms. The course was found to be acceptable by teachers and students as a means of delivering drug education in schools. CONCLUSIONS Internet-based prevention programs for school-age children can improve students knowledge about alcohol and cannabis, and may also reduce alcohol use twelve months after completion.

Delivering prevention for alcohol and cannabis using the Internet: a cluster randomised controlled trial.

OBJECTIVE To establish the efficacy of an internet based prevention program to reduce alcohol and cannabis use in adolescents. METHOD A cluster randomised controlled trial was conducted with 764 13-year olds from ten Australian secondary schools in 2007-2008. Half the schools were randomly allocated to the computerised prevention program (n=397), and half to their usual health classes (n=367). The Climate Schools: Alcohol and Cannabis prevention course is facilitated by the internet and consists of novel, evidence-based, curriculum consistent lessons aimed at reducing alcohol and cannabis use. Participants were assessed at baseline, immediately post, and at six months following the intervention. RESULTS Compared to the control group, students in the intervention group showed significant improvements in alcohol and cannabis knowledge at the end of the course and the six month follow-up. In addition, the intervention group showed a reduction in average weekly alcohol consumption and frequency of cannabis use at the six month follow-up. No differences between groups were found on alcohol expectancies, cannabis attitudes, or alcohol and cannabis related harms. CONCLUSIONS The course is acceptable, scalable and fidelity is assured. It increased knowledge regarding alcohol and cannabis, and decreased use of these drugs.

A computerized harm minimization prevention program for alcohol misuse and related harms: Randomized controlled trial

AIMS Hazardous alcohol use is a leading cause of death among adolescents and young adults world-wide, yet few effective prevention interventions exist. This study was the first to examine a computerized harm minimization intervention to reduce alcohol misuse and related harms in adolescents. DESIGN Cluster randomized controlled trial of a six-session curriculum-integrated harm minimization prevention program. The intervention was delivered by computer in the form of a teenage drama, which provided education through alcohol-related scenarios to which young people could relate. SETTING Schools in Australia. PARTICIPANTS A total of 1466 year 8 students (13 years) from 16 high schools in Australia were allocated randomly to a computerized prevention program (n = 611, eight schools) or usual classes (n = 855, eight schools). MEASUREMENTS Change in knowledge, alcohol use, alcohol-related harms and alcohol expectancies. FINDINGS A computerized prevention program was more effective than usual classes in increasing alcohol-related knowledge of facts that would inform safer drinking choices and decreasing the positive social expectations which students believed alcohol may afford. For females it was effective in decreasing average alcohol consumption, alcohol-related harms and the frequency of drinking to excess (more than four standard drinks; 10 g ethanol). For males the behavioural effects were not significant. CONCLUSIONS A harm minimization approach is effective in educating young people about alcohol-related risks and is effective in reducing risky drinking and harms among girls. Reduction of problems among boys remains a challenge.

CLIMATE Schools: alcohol module: cross-validation of a school-based prevention programme for alcohol misuse

Objective: The aim of the present study was to conduct a cross-validation trial of the efficacy of a computerized school-based intervention for alcohol misuse in adolescents. Method: A cluster randomized control trial was carried out. Intervention and control groups were assessed at baseline, immediately after and 6 months after the intervention. A total of 764 Year 8 students from 10 independent secondary schools in Sydney, Australia participated in the study. Half of the schools were randomly allocated to the computerized prevention programme (n=397), and half to their usual classes (n=367). The six-lesson computerized intervention was evidence and curriculum based while having a focus on harm-minimization. Knowledge, expectancies, alcohol consumption (frequency, quantity and binging), patterns of use, and harms associated with ones own use of alcohol were assessed. Results: There were significant improvements in knowledge regarding alcohol use at immediate and 6 month follow up. Average weekly alcohol consumption was reduced immediately after the intervention. No differences between groups were found on alcohol expectancies, frequency of drinking to excess and harms related to alcohol use over time. Conclusions: The present results support the Climate Management and Treatment Education (CLIMATE) Schools: alcohol module as an effective intervention in increasing alcohol knowledge and reducing alcohol use in the short term.

Psychometric properties of the general well-being index.

There is a growing interest in the measurement of quality of life as an important marker of health outcomes. The General Well-Being Index (GWBI) is a quality of life measure that has been specifically designed to assess psychological distress rather than physical incapacitation. Previous studies using the GWBI have mainly focussed on clinical samples (e.g., depressed patients). The aim of the current study was to examine the psychometric properties of the GWBI in a non-clinical population. Using data gathered from 447 first year University students, the GWBI was found to have excellent psychometric properties. Both internal consistency and test–retest reliability were high, and the concurrent and construct validity of the measure were sound. Factor analysis revealed three significant factors, which were labelled ‘general mood/affect’, ‘life satisfaction/vitality’, and ‘poor physical health/somatic complaints’. Limitations to the present study are further discussed.

Developing the Climate Schools: Alcohol and Cannabis Module: A Harm-Minimization, Universal Drug Prevention Program Facilitated by the Internet

The Climate Schools: Alcohol and Cannabis Module is a universal harm-minimization school-based prevention program for adolescents aged 13–15 years. The core content of the program is delivered over the Internet using cartoon storylines to engage students, and teacher-driven activities reinforce the core information. The program is embedded within the school health curriculum and is easy to implement with minimal teacher training required. The program was developed in 2007 through extensive collaboration with teachers, students, and health professionals (N = 24) in Sydney, Australia and has since been evaluated (N = 764). This article describes the formative research and process of planning that formed the development of the program and the evidence base underpinning the approach. The studys limitations are noted.

Development of a short cannabis problems questionnaire for adolescents in the community.

The widespread and harmful use of cannabis amongst young people in the community has been well established. In order to assist in identifying young people at risk of harm for their cannabis use, the present paper documents the development of a short 12-item cannabis problems measure--the Cannabis Problems Questionnaire for Adolescents, Short form (CPQ-A-S). The CPQ-A-S was derived from the 27-item Cannabis Problems Questionnaire for Adolescents (CPQ-A) which had been shown in an earlier study to be a reliable and valid indicator of cannabis problems in adolescents. Tetrachoric correlations amongst items were examined and the more redundant items removed. Psychometrics of the shorter scale were then evaluated through factor analysis, and logistic regression used to demonstrate scale validity. This is the first short scale of cannabis problems derived for adolescents and it should prove a useful tool in both research and community applications.