Richard Midford

Drug education in victorian schools (DEVS): the study protocol for a harm reduction focused school drug education trial

BackgroundThis study seeks to extend earlier Australian school drug education research by developing and measuring the effectiveness of a comprehensive, evidence-based, harm reduction focused school drug education program for junior secondary students aged 13 to 15 years. The intervention draws on the recent literature as to the common elements in effective school curriculum. It seeks to incorporate the social influence of parents through home activities. It also emphasises the use of appropriate pedagogy in the delivery of classroom lessons.Methods/DesignA cluster randomised school drug education trial will be conducted with 1746 junior high school students in 21 Victorian secondary schools over a period of three years. Both the schools and students have actively consented to participate in the study. The education program comprises ten lessons in year eight (13-14 year olds) and eight in year nine (14-15 year olds) that address issues around the use of alcohol, tobacco, cannabis and other illicit drugs. Control students will receive the drug education normally provided in their schools. Students will be tested at baseline, at the end of each intervention year and also at the end of year ten. A self completion questionnaire will be used to collect information on knowledge, patterns and context of use, attitudes and harms experienced in relation to alcohol, tobacco, cannabis and other illicit drug use. Multi-level modelling will be the method of analysis because it can best accommodate hierarchically structured data. All analyses will be conducted on an Intent-to-Treat basis. In addition, focus groups will be conducted with teachers and students in five of the 14 intervention schools, subsequent to delivery of the year eight and nine programs. This will provide qualitative data about the effectiveness of the lessons and the relevance of the materials.DiscussionThe benefits of this drug education study derive both from the knowledge gained by trialling an optimum combination of innovative, harm reduction approaches with a large, student sample, and the resultant product. The research will provide better understanding of what benefits can be achieved by harm reduction education. It will also produce an intervention, dealing with both licit and illicit drug use that has been thoroughly evaluated in terms of its efficacy, and informed by teacher and student feedback. This makes available to schools a comprehensive drug education package with prevention characteristics and useability that are well understood.Trial registrationAustralia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12612000079842

Alcohol prevention: What can be expected of a harm reduction focused school drug education programme?

Aim: This pilot study investigated what alcohol prevention benefits could be achieved by a harm reduction focused school drug education intervention that addressed all drug use, both licit and illicit. Method: The study population comprised a cohort of 225 students in three intervention secondary schools and 93 students in a matched control school in Victoria, Australia. A classroom drug education programme, derived from evidence of effective practice and designed to reduce alcohol and other drug harm, was provided to the intervention students during years eight (13–14 year olds) and nine (14–15 year olds) by teachers trained in its delivery. The control students received the drug education programme normally provided by their school. Findings: The students, who received the intervention, were more knowledgeable about drug use issues, communicated more with their parents about alcohol, drank less, got drunk less, and experienced fewer alcohol related harms. They also remembered receiving more alcohol lessons. They were, however, no less likely to have tried alcohol. Conclusions: The findings are consistent with other studies that have demonstrated school alcohol education that focuses on harm reduction can be effective in reducing consumption, risk and harm. In this study, this was achieved even though the students were not persuaded against taking up drinking, and the intervention did not focus solely on alcohol. These findings have implications for both the goals and coverage of future school drug education programmes.

Influences on teachers' use of participatory learning strategies in health education classes

Objective: Participatory learning strategies are integral to the effectiveness of school-based health education programmes; however, use of such methods is not the norm in teaching. The omission of participatory learning strategies is a common form of programme breakdown leading to erosion of positive learning and behavioural outcomes. Based on a survey of 75 Australian high school health education teachers, the study’s objective is to examine teachers’ perspectives on the factors that influence their use of participatory learning strategies. Results: Whilst it is often presumed that training is the most significant factor, this study found that teachers identify understanding the educational rationale for the approach, student engagement, confidence in class control, and having positive relationships with the students, along with practicalities such as having time to adequately prepare a class, as the most significant influences on their pedagogical choices. Conclusion: The study concludes that a better understanding of the reasons why teachers make particular choices in their delivery of programmes gives valuable insight into what teachers need in order to support uptake or maintenance of such approaches. This understanding may in turn contribute to health education programmes being delivered with a higher fidelity and better outcomes for students.

Alcohol Prevention and School Students: Findings from an Australian 2-Year Trial of Integrated Harm Minimization School Drug Education.

The Drug Education in Victorian Schools program provided integrated education about licit and illicit drugs, employed a harm minimization approach that incorporated participatory, critical thinking and skill-based teaching methods, and engaged parental influence through home activities. A cluster-randomized, controlled trial of the program was conducted with a student cohort during Year 8 (13 years) and Year 9 (14 years). Twenty-one secondary schools in Victoria, Australia, were randomly allocated to the Drug Education in Victorian Schools program (14 schools, n = 1,163) or their usual drug education program (7 schools, n = 589). This study reports program effects for alcohol. There was a greater increase in the intervention students’ knowledge about drugs, including alcohol; there was a greater increase in communication with parents about alcohol; they recalled receiving more alcohol education; their alcohol consumption increased less; and they experienced a lesser increase in alcohol-related harms. Among intervention group risky drinkers, consumption and harm increased less. There were no differences between study groups in attitudes toward alcohol or in the proportion of drinkers or risky drinkers. While the program did not stop students taking up drinking, it did reduce their consumption and harm.

Cannabis and Harm Minimisation Drug Education: Findings from the Drug Education in Victorian Schools Study

Aims: To evaluate the effectiveness of an integrated harm minimisation focused school drug education programme in terms of reducing cannabis use and harm. Design and Methods: A cluster randomised controlled trial of the 18 lesson Drug Education in Victorian Schools (DEVS) drug education programme was undertaken with students during years eight and nine (13 and 14 years of age respectively), with follow up in year ten (15 years of age). The programme covered all drugs, employed a harm minimisation approach that used participatory, critical thinking and skills based teaching methods, and engaged parental influence through home activities. Twenty-one secondary schools in Victoria, Australia, were randomly allocated to receive the DEVS programme (14 schools) or the drug education usually provided by their schools (7 schools). In relation to cannabis, communication with parents, lessons remembered, responsible attitudes, whether used, frequency of use and associated harms were measured. Results: In comparison to controls, there was a significantly greater increase in the intervention students’ communication with parents about cannabis recall of cannabis lessons received, and responsible attitudes towards cannabis. While there were no significant differences between the two study groups in relation to the proportion of cannabis users, the increase in level of use by intervention students was significantly less and they experienced a lesser increase in associated harms. Conclusion: A harm minimisation focused school drug education programme reduced the level of cannabis use and associated harm. This supports harm minimisation education as an effective prevention strategy for school students.

Investigating the Stress Levels of Early Childhood, Primary and Secondary Pre-Service Teachers during Teaching Practicum.

Abstract This study investigated stress levels of pre-service teachers (PSTs) across three categories of teaching context: early childhood, primary and secondary. This paper focused on exploring the stressors in the completion of tasks in teaching practicum in the three categories of teaching context and an awareness of and access to support systems. The Perceived Stress Scale (PSS) and an online questionnaire were used to measure the nature and level of stress. Significant results were found in relation to the school climate and the stress levels of PSTs across the three different teaching contexts. These findings have implications in terms of understanding different PSTs’ stress levels across the three teaching contexts and ways they could be supported to reduce their stress level and achieve better study outcomes.

Smoking prevention: what benefits are indicated by a pilot school drug education programme that focuses on minimising harm?

Background: This pilot study investigated the smoking prevention benefits of a secondary school drug education programme for all-licit and illicit drugs. The programme took a harm minimisation approach and incorporated abstinence as one of a range of prevention strategies. Method: The study population comprised a cohort of 318 Victorian junior secondary school students (intervention N = 225 in three schools, control N = 93 in one school). During Years 8 (13–14-year-olds) and 9 (14–15-year-olds), the intervention students received a 22-lesson programme derived from evidence of effective practice and aimed at minimising the harm associated with drug use. Control students received the drug education programme normally provided by their school. Results: Students who received the intervention remembered receiving more lessons about smoking and were more knowledgeable about drug use issues overall. They were no less likely to take up smoking, but those who did smoke, reported smoking fewer cigarettes and experiencing fewer harms associated with their smoking. Conclusions: This pilot study suggests that a harm minimisation approach to smoking can complement, rather than threaten, the abstinence message for adolescents. A school drug education programme with a harm reduction focus does not increase initiation into smoking and can equip smokers with the understanding and skills to make better decisions regarding use.

Social and emotional education with Australian Year 7 and 8 middle school students: A pilot study

Objective: This pilot study sought to better understand what can be achieved by an evidence-based classroom social and emotional education programme. Design and Methods: A 10-lesson, classroom-based programme that taught about emotional literacy, personal strengths, coping and problem-solving strategies, stress management, emotional regulation and support seeking was provided to 56 students in Years 7 (13 years) and 8 (14 years) in an Australian middle school. Teachers were trained to deliver the programme, with participatory modelling of each activity. Before and after delivery of the programme, students were surveyed for their social and emotional wellbeing using the Kessler 10 (K10) instrument for non-specific psychological distress; the ‘Internal Assets’, ‘School Resources’ and ‘Cooperation and Communication’ questions from the Resilience and Youth Development Module (RYDM) of the California Healthy Kids Survey (CHKS); and questions developed for this study on class connectedness and social and emotional skills. Subsequent to programme completion, focus groups were conducted with teachers and participating students to gauge programme fidelity, utility and engagement. Results: There was an improvement in psychological distress that approached significance (t = 2, df = 42, p = .053), although the symptomatic score remained in the range indicative of medium-level distress. Cooperation and communication improved significantly (t = −2.34, df = 42, p = .024) as did class connectedness (t = −2.46, df = 43, p = .018). There was no change in individual resilience factors, school protective factors, or social and emotional skills. The focus groups were generally positive about the programme, but indicated fidelity was compromised, mainly because the lesson periods were too short. Conclusion: While this small-scale pilot study has a number of limitations, it does indicate the need to improve the psychological wellbeing of middle school students. The findings also provide evidence that brief social and emotional education programmes can have some positive effects.

Rejoinder to Dennis Gorman's critique of: “Preventing alcohol harm: Early results from a cluster randomised, controlled trial in Victoria, Australia of comprehensive harm minimisation school drug education”

As researchers seeking to contribute to better alcohol and other drug prevention we appreciate the need for critical reviews of intervention programs. Gormans critique of our recent paper is therefore welcome. It does identify some weaknesses in specificity, which in hindsight could have been better addressed. It also provides an opportunity to explain why certain choices were made in terms of reporting findings (Gorman, 2015; Midford et al., 2014).

The Western Australian School Health Project: Evaluation of participant change

AbstractThe Western Australian School Health (WASH) project operated over a 4-year period (1992–95), providing a year-long programme of training and support to successive groups of schools, so as to enable ‘in house’ development of suitable health promotion programmes. Impact evaluation was undertaken in the last 3 years of the project and this paper reports health promotion knowledge, attitude and behaviour change in full-term primary participants from all 3 years. The group comprised 91 teachers and 47 non-teachers who met certain participation criteria.Numerical data were analysed using paired t-tests. Categorical/rank data were analysed using the paired Wilcoxon Signed Rank test. Teacher participants demonstrated significant improvement in classroom health teaching knowledge (p<0.0001), time spent teaching health (p=0.026), use of health education teaching methodologies (p=0.0367), school health promotion knowledge (p<0.0001), and number of health promotion activities undertaken (p=0.0043). Non-teache...