Nyanda McBride

Principles That Underpin Effective School-Based Drug Education.

This study identifies the conceptual underpinnings of effective school-based drug education practice in light of contemporary research evidence and the practical experience of a broad range of drug education stakeholders. The research involved a review of the literature, a national survey of 210 Australian teachers and others involved in drug education, and structured interviews with 22 key Australian drug education policy stakeholders. The findings from this research have been distilled and presented as a list of 16 principles that underpin effective drug education. In broad terms, drug education should be evidence-based, developmentally appropriate, sequential, and contextual. Programs should be initiated before drug use commences. Strategies should be linked to goals and should incorporate harm minimization. Teaching should be interactive and use peer leaders. The role of the classroom teacher is central. Certain program content is important, as is social and resistance skills training. Community values, the social context of use, and the nature of drug harm have to be addressed. Coverage needs to be adequate and supported by follow-up. It is envisaged that these principles will provide all those involved in the drug education field with a set of up-to-date, research-based guidelines against which to reference decisions on program design, selection, implementation, and evaluation.

What harms do young Australians experience in alcohol-use situations?

Objective : An insight into the alcohol‐related experiences of young students in Perth, Western Australia, with particular emphasis to alcohol‐related harm.

Reducing the harm from adolescent alcohol consumption: results from an adapted version of SHAHRP in Northern Ireland

Background: The study aimed to trial an adapted version of the School Health and Alcohol Harm Reduction Project (SHAHRP) in Northern Ireland. The intervention aims to enhance alcohol-related knowledge, create more healthy alcohol-related attitudes and reduce alcohol-related harms in 14–16-year-olds. Method: A non-randomised control longitudinal design with intervention and control groups assessed students at baseline and 12, 24 and 32 months after baseline. Students were from post-primary schools (high schools) in the Eastern Health Board Area in Northern Ireland. Two thousand three hundred and forty nine participants were recruited at baseline (mean age 13.84) with an attrition rate of 12.8%% at 32-month follow-up. The intervention was an adapted, culturally competent version of SHAHRP, a curriculum programme delivered in two consecutive academic years, with an explicit harm reduction goal. Knowledge, attitudes, alcohol consumption, context of use, harm associated with own alcohol use and the alcohol use of other people were assessed at all time points. Results: There were significant intervention effects on all measures (intervention vs. controls) with differential effects observed for teacher-delivered and outside facilitator-delivered SHAHRP. Conclusion: The study provides evidence of the cultural applicability of a harm reduction intervention (SHAHRP) for risky drinking in adolescents in a UK context.

The CLIMATE schools combined study: a cluster randomised controlled trial of a universal internet-based prevention program for youth substance misuse, depression and anxiety

BackgroundAnxiety, depressive and substance use disorders account for three quarters of the disability attributed to mental disorders and frequently co-occur. While programs for the prevention and reduction of symptoms associated with (i) substance use and (ii) mental health disorders exist, research is yet to determine if a combined approach is more effective. This paper describes the study protocol of a cluster randomised controlled trial to evaluate the effectiveness of the CLIMATE Schools Combined intervention, a universal approach to preventing substance use and mental health problems among adolescents.Methods/designParticipants will consist of approximately 8400 students aged 13 to 14-years-old from 84 secondary schools in New South Wales, Western Australia and Queensland, Australia. The schools will be cluster randomised to one of four groups; (i) CLIMATE Schools Combined intervention; (ii) CLIMATE Schools - Substance Use; (iii) CLIMATE Schools - Mental Health, or (iv) Control (Health and Physical Education as usual).The primary outcomes of the trial will be the uptake and harmful use of alcohol and other drugs, mental health symptomatology and anxiety, depression and substance use knowledge. Secondary outcomes include substance use related harms, self-efficacy to resist peer pressure, general disability, and truancy. The link between personality and substance use will also be examined.DiscussionCompared to students who receive the universal CLIMATE Schools - Substance Use, or CLIMATE Schools - Mental Health or the Control condition (who received usual Health and Physical Education), we expect students who receive the CLIMATE Schools Combined intervention to show greater delays to the initiation of substance use, reductions in substance use and mental health symptoms, and increased substance use and mental health knowledge.Trial registrationThis trial is registered with the Australian and New Zealand Clinical Trials registry, ACTRN12613000723785.

The differential impact of a classroom-based, alcohol harm reduction intervention, on adolescents with different alcohol use experiences: a multi-level growth modelling analysis.

While evidence has accumulated suggesting that prevention initiatives may have a limited impact on alcohol use behaviour, reviews suggest that interventions with most potential for behavioural change are interactive and developmental in design. The School Health and Alcohol Harm Reduction Project (SHAHRP) is an example of such an intervention. Researchers are increasingly attempting to understand the differential effects of programmes in population subgroups. The present study is a secondary analysis of data from a non-randomised trial of SHAHRP, a classroom-based alcohol education intervention, involving school children (aged 13-16 years old) in the United Kingdom. Results showed that there were significant positive changes in knowledge about and attitudes towards alcohol in baseline abstainers, supervised drinkers and unsupervised drinkers. Significant positive behavioural effects in terms of amounts consumed, frequency of drinking and self-reported alcohol related harms, were observed almost exclusively among baseline unsupervised drinkers. These behavioural effects support those previously observed in Australia and suggest that the intervention is a viable health promotion tool in the UK.

Reducing alcohol use during pregnancy: listening to women who drink as an intervention starting point

Objectives. This study assesses factors that contribute to alcohol consumption during pregnancy and identifies potential intervention strategies to reduce consumption. Methods. The study sample includes 142 pregnant women who attended a public hospital for prenatal health care in Perth, Western Australia. All participants returned a self-completion survey. Results. Women who discontinued drinking during pregnancy were significantly more likely to be engaged in full time home duties and had completed less formal education. Women who continued to drink were more likely to have drunk in previous pregnancies and during the preconception period. Nearly 40% of high risk women reported a negative comment in response to their drinking. One-third of women in the risky group were advised by a health professional not to drink alcohol. Women were most likely to drink in their own home or at the home of a friend. Conclusions. Participatory research with women who drink while pregnant can assist in identifying potential intervention strategies that have resonance with this group and therefore more potential for creating behaviour change. Implications. The World Health Organization recognises, and has done for over 10 years, that alcohol use during pregnancy which results in Foetal Alcohol Spectrum Disorder is the leading cause of environmental-related birth defects and mental retardation in the Western world.

Research to practice—formal dissemination of the School Health and Alcohol Harm Reduction Project (SHAHRP) in Australia

INTRODUCTION AND AIMS This paper discusses the formal dissemination of the School Health and Alcohol Harm Reduction Project (National SHAHRP Dissemination Project) in Australia. The original SHAHRP research programme (SHAHRP study) was assessed previously for effectiveness during a longitudinal research study which followed the student participants over 32 months post-intervention. The SHAHRP study focused on evaluating the behavioural impact of the programme and the results indicated that wider dissemination would be of value. DESIGN AND METHODS The National SHAHRP Dissemination Project involved key decision makers of drug education in the Government, Catholic and Independent schools sectors, in targeted states, agreeing to disseminate the SHAHRP Project through teacher educators and teachers in their sector and regions. Process, reach and project satisfaction were assessed. RESULTS The Dissemination Project conducted two workshops for 35 teacher educators. Fifteen teacher educators subsequently conducted 21 workshops for teachers between August 2003 and June 2004. One hundred and seventy schools and nearly 300 (294) teachers were involved in this training. DISCUSSION AND CONCLUSIONS The advantages and barriers of researcher-led dissemination, as illustrated in this study, suggest that methods other than publication in scientific journals and presentation at conferences may be useful for the transfer of effective intervention research programmes to practice. There may be some benefit to identifying and testing other research-initiated pathways leading to evidence-based policy and practice which, in combination with practitioner-led transfer, can help to bridge the gap between research and practice in the future.

The Psychometric Properties of the Kessler Psychological Distress Scale (K6) in a General Population Sample of Adolescents.

The 6-item Kessler Psychological Distress Scale (K6; Kessler et al., 2002) is a screener for psychological distress that has robust psychometric properties among adults. Given that a significant proportion of adolescents experience mental illness, there is a need for measures that accurately and reliably screen for mental disorders in this age group. This study examined the psychometric properties of the K6 in a large general population sample of adolescents (N = 4,434; mean age = 13.5 years; 44.6% male). Factor analyses were conducted to examine the dimensionality of the K6 in adolescents and to investigate sex-based measurement invariance. This study also evaluated the K6 as a predictor of scores on the Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997). The K6 demonstrated high levels of internal consistency, with the 6 items loading primarily on 1 factor. Consistent with previous research, females reported higher mean levels of psychological distress when compared with males. The identification of sex-based measurement noninvariance in the item thresholds indicated that these mean differences most likely represented reporting bias in the K6 items rather than true differences in the underlying psychological distress construct. The K6 was a fair to good predictor of abnormal scores on the SDQ, but predictive utility was relatively low among males. Future research needs to focus on refining and augmenting the K6 scale to maximize its utility in adolescents. (PsycINFO Database Record

Evaluation of a national school drug education program in Australia

Abstract The National Initiatives in Drug Education (NIDE) project was an initiative of the Australian Commonwealth government, to enhance school drug education in all Australian jurisdictions. The project was implemented in collaboration with States and Territories and primarily involved professional training for teachers of drug education and the development of teaching resources. The project was evaluated towards the end of its implementation period. An essentially descriptive approach was adopted, using several different investigative techniques to confirm the strength of evidence and build a global picture. While there are inherent limitations to such a retrospective approach, considerable insight was gained as to the achievements of the project. In an overall sense, people in all jurisdictions, at all levels of involvement in drug education, considered NIDE a beneficial project. NIDE increased the quantity and quality of drug education. The teaching resource materials developed by NIDE were generally well regarded. The process of implementation was respectful and empowering. State and Territory representatives felt part of a coherent national project. The harm minimisation premise of the project was well accepted. NIDE also had a number of limitations, but it has contributed in a major way to the ongoing evolution of school drug education in Australia.

Association of parental supply of alcohol with adolescent drinking, alcohol-related harms, and alcohol use disorder symptoms: a prospective cohort study

BACKGROUND Some parents supply alcohol to their children, reportedly to reduce harm, yet longitudinal research on risks associated with such supply is compromised by short periods of observation and potential confounding. We aimed to investigate associations between parental supply and supply from other (non-parental) sources, with subsequent drinking outcomes over a 6-year period of adolescence, adjusting for child, parent, family, and peer variables. METHODS We did this prospective cohort study using data from the Australian Parental Supply of Alcohol Longitudinal Study cohort of adolescents. Children in grade 7 (mean age 12 years), and their parents, were recruited between 2010 and 2011 from secondary schools in Sydney, Perth, and Hobart, Australia, and were surveyed annually between 2010 and 2016. We examined the association of exposure to parental supply and other sources of alcohol in 1 year with five outcomes in the subsequent year: binge drinking (more than four standard drinks on a drinking occasion); alcohol-related harms; and symptoms of alcohol abuse (as defined by Diagnostic and Statistical Manual of Mental Disorders, 4th edition [DSM-IV]), alcohol dependence, and alcohol use disorder (as defined by DSM-5). This trial is registered with ClinicalTrials.gov, number NCT02280551. FINDINGS Between September, 2010, and June, 2011, we recruited 1927 eligible parents and adolescents (mean age 12·9 years [SD 0·52]). Participants were followed up until 2016, during which time binge drinking and experience of alcohol-related harms increased. Adolescents who were supplied alcohol only by parents had higher odds of subsequent binge consumption (odds ratio [OR] 2·58, 95% CI 1·96-3·41; p<0·0001), alcohol-related harm (2·53, 1·99-3·24; p<0·0001), and symptoms of alcohol use disorder (2·51, 1·46-4·29; p=0·0008) than did those reporting no supply. Parental supply of alcohol was not significantly associated with the odds of reporting symptoms of either alcohol abuse or dependence, compared with no supply from any source. Supply from other sources was associated with significant risks of all adverse outcomes, compared with no supply, with an even greater increased risk of adverse outcomes. INTERPRETATION Providing alcohol to children is associated with alcohol-related harms. There is no evidence to support the view that parental supply protects from adverse drinking outcomes by providing alcohol to their child. Parents should be advised that this practice is associated with risk, both directly and indirectly through increased access to alcohol from other sources. FUNDING Australian Research Council, Australian Rotary Health, Foundation for Alcohol Research and Education, National Drug and Alcohol Research Centre.