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Published in: Substance Abuse Treatment, Prevention, and Policy 1/2016

Open Access 01-12-2016 | Research

Process evaluation of the implementation of the Unplugged Program for drug use prevention in Brazilian schools

Authors: Pollyanna F. P. Medeiros, Joselaine I. Cruz, Daniela R. Schneider, Adriana Sanudo, Zila M. Sanchez

Published in: Substance Abuse Treatment, Prevention, and Policy | Issue 1/2016

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Abstract

Background

Most Brazilian schools do not have a continuous program for drug use prevention. To address this gap, the Ministry of Health adapted the European evidence-based program Unplugged to improve the drug use prevention efforts of Brazilian public schools. The aim of this study was to evaluate the process of program implementation in three Brazilian cities among middle school students between 6th and 9th grade (11 to 14 years old).

Methods

Mixed methods were used in this process evaluation study, including focus groups, fidelity forms, and satisfaction questionnaires. Study participants included 36 teachers, 11 school administrators, 6 coaches, 16 stakeholders, and 1267 students from 62 classes in 8 schools.

Results

The 12 Unplugged lessons were all implemented in 94 % of the classes. However, only 57 % of the classes were completed as described in the program's manual. The decision to exclude activities because of time constraints was made without a common rationale. Teachers reported difficulties due to the amount of time necessary to plan the lessons and implement the activities. In addition, they mentioned that the lack of support from school administrators was an obstacle to proper program implementation. The majority of students and teachers responded positively to the program, reporting changes in the classroom environment and in personal skills or knowledge.

Conclusions

The Unplugged program can be feasibly implemented in Brazilian public schools. However, it is necessary to reduce the number of activities per class and to restructure the format of the standard teaching schedule to ensure that the normal academic content is still taught while Unplugged is being implemented.
Literature
2.
go back to reference Carlini E, Noto A, Sanchez Z, Carlini C, Locatelli D, Amato T. VI Levantamento nacional sobre o consumo de drogas psicotrópicas entre estudantes do ensino fundamental e médio das redes públicas e privadas de ensino nas 27 capitais brasileira. São Paulo: CEBRID - Centro Brasileiro de Informações sobre Drogas Psicotrópicas; 2010. Carlini E, Noto A, Sanchez Z, Carlini C, Locatelli D, Amato T. VI Levantamento nacional sobre o consumo de drogas psicotrópicas entre estudantes do ensino fundamental e médio das redes públicas e privadas de ensino nas 27 capitais brasileira. São Paulo: CEBRID - Centro Brasileiro de Informações sobre Drogas Psicotrópicas; 2010.
3.
go back to reference Laranjeira R, Madruga C, Pinsky I, Caetano R, Ribeiro M, Mitsuhiro S. II Levantamento Nacional de Álcool e Drogas - Consumo de Álcool no Brasil: Tendências entre 2006/2012. São Paulo: INPAD – Instituto Nacional de Ciência e Tecnologia para Políticas Públicas de Álcool e Outras Drogas; 2013. Laranjeira R, Madruga C, Pinsky I, Caetano R, Ribeiro M, Mitsuhiro S. II Levantamento Nacional de Álcool e Drogas - Consumo de Álcool no Brasil: Tendências entre 2006/2012. São Paulo: INPAD – Instituto Nacional de Ciência e Tecnologia para Políticas Públicas de Álcool e Outras Drogas; 2013.
4.
go back to reference Ribeiro W. Drogas na escola: Prevenir educando. Belo Horizonte: Annablume; 2005. Ribeiro W. Drogas na escola: Prevenir educando. Belo Horizonte: Annablume; 2005.
5.
go back to reference Ferreira TCD, Sanchez ZM, Ribeiro LA, Oliveira LG, Nappo SA. Perceptions and attitudes among public school teachers towards the topic of drugs. Interface-Comunicação, Saúde, Educação. 2010;14(34):551–62.CrossRef Ferreira TCD, Sanchez ZM, Ribeiro LA, Oliveira LG, Nappo SA. Perceptions and attitudes among public school teachers towards the topic of drugs. Interface-Comunicação, Saúde, Educação. 2010;14(34):551–62.CrossRef
6.
go back to reference Moreira FG, Silveira DX, Andreoli SB. Situations related to drug misuse in public schools in the city of Sao Paulo, Brazil. Rev Saude Publica. 2006;40:810–7.PubMedCrossRef Moreira FG, Silveira DX, Andreoli SB. Situations related to drug misuse in public schools in the city of Sao Paulo, Brazil. Rev Saude Publica. 2006;40:810–7.PubMedCrossRef
7.
go back to reference Kreeft PVD, Wiborg G, Galanti MR, Siliquini R, Bohrn K, Scatigna M, et al. 'Unplugged': A new European school programme against substance abuse. Drugs: Education, Prevention, and Policy. 2009;16(2):167–81. Kreeft PVD, Wiborg G, Galanti MR, Siliquini R, Bohrn K, Scatigna M, et al. 'Unplugged': A new European school programme against substance abuse. Drugs: Education, Prevention, and Policy. 2009;16(2):167–81.
8.
9.
go back to reference Sussman S, Arriaza B, Grigsby TJ. Alcohol, tobacco, and other drug misuse prevention and cessation programming for alternative high school youth: a review. J Sch Health. 2014;84(11):748–58.PubMedCrossRef Sussman S, Arriaza B, Grigsby TJ. Alcohol, tobacco, and other drug misuse prevention and cessation programming for alternative high school youth: a review. J Sch Health. 2014;84(11):748–58.PubMedCrossRef
10.
go back to reference Gabrhelik R, Duncan A, Miovsky M, Furr-Holden CDM, Stastna L, Jurystova L. “Unplugged”: A school-based randomized control trial to prevent and reduce adolescent substance use in the Czech Republic. Drug Alcohol Depend. 2012;124(1):79–87.PubMedCrossRef Gabrhelik R, Duncan A, Miovsky M, Furr-Holden CDM, Stastna L, Jurystova L. “Unplugged”: A school-based randomized control trial to prevent and reduce adolescent substance use in the Czech Republic. Drug Alcohol Depend. 2012;124(1):79–87.PubMedCrossRef
11.
go back to reference Faggiano F, Galanti MR, Bohrn K, Burkhart G, Vigna-Taglianti F, Cuomo L, et al. The effectiveness of a school-based substance abuse prevention program: EU-Dap cluster randomised controlled trial. Prev Med. 2008;47(5):537–43.PubMedCrossRef Faggiano F, Galanti MR, Bohrn K, Burkhart G, Vigna-Taglianti F, Cuomo L, et al. The effectiveness of a school-based substance abuse prevention program: EU-Dap cluster randomised controlled trial. Prev Med. 2008;47(5):537–43.PubMedCrossRef
12.
go back to reference Faggiano F, Vigna-Taglianti F, Burkhart G, Bohrn K, Cuomo L, Gregori D, et al. The effectiveness of a school-based substance abuse prevention program: 18-month follow-up of the EU-Dap cluster randomized controlled trial. Drug Alcohol Depend. 2010;108(1–2):56–64.PubMedCrossRef Faggiano F, Vigna-Taglianti F, Burkhart G, Bohrn K, Cuomo L, Gregori D, et al. The effectiveness of a school-based substance abuse prevention program: 18-month follow-up of the EU-Dap cluster randomized controlled trial. Drug Alcohol Depend. 2010;108(1–2):56–64.PubMedCrossRef
13.
go back to reference Saunders RP, Evans MH, Joshi P. Developing a process-evaluation plan for assessing health promotion program implementation: a how-to guide. Health Promot Pract. 2005;6(2):134–47.PubMedCrossRef Saunders RP, Evans MH, Joshi P. Developing a process-evaluation plan for assessing health promotion program implementation: a how-to guide. Health Promot Pract. 2005;6(2):134–47.PubMedCrossRef
14.
go back to reference Cook T, Campbell D. Quasi-Experimentation. Design & Analysis Issues for Field Settings. Boston: Houghton Mifflin Company; 1979. Cook T, Campbell D. Quasi-Experimentation. Design & Analysis Issues for Field Settings. Boston: Houghton Mifflin Company; 1979.
15.
go back to reference Orwin RG. Assessing program fidelity in substance abuse health services research. Addiction. 2000;95 Suppl 3:S309–27.PubMedCrossRef Orwin RG. Assessing program fidelity in substance abuse health services research. Addiction. 2000;95 Suppl 3:S309–27.PubMedCrossRef
16.
go back to reference Rohrbach LA, Dent CW, Skara S, Sun P, Sussman S. Fidelity of implementation in Project Towards No Drug Abuse (TND): a comparison of classroom teachers and program specialists. Prev Sci. 2007;8(2):125–32.PubMedPubMedCentralCrossRef Rohrbach LA, Dent CW, Skara S, Sun P, Sussman S. Fidelity of implementation in Project Towards No Drug Abuse (TND): a comparison of classroom teachers and program specialists. Prev Sci. 2007;8(2):125–32.PubMedPubMedCentralCrossRef
17.
go back to reference Contandriopoulos A-P, Champagne F, Denis J-L, Pineault R. Avaliação em Saúde: Dos Modelos Conceituais à Prática na Análise da Implantação de Programas. A avaliação na área de saúde: Conceitos e Métodos. Rio de Janeiro: Editora FioCruz; 1997. p. 29–47. Contandriopoulos A-P, Champagne F, Denis J-L, Pineault R. Avaliação em Saúde: Dos Modelos Conceituais à Prática na Análise da Implantação de Programas. A avaliação na área de saúde: Conceitos e Métodos. Rio de Janeiro: Editora FioCruz; 1997. p. 29–47.
18.
go back to reference Hartz Z, Vieira-da-Silva L. Avaliação em saúde: dos modelos teóricos à prática na avaliação de programas e sistemas de saúde. Salvador: EDUFBA/Rio de Janeiro: FIOCRUZ; 2005. p. 275. Hartz Z, Vieira-da-Silva L. Avaliação em saúde: dos modelos teóricos à prática na avaliação de programas e sistemas de saúde. Salvador: EDUFBA/Rio de Janeiro: FIOCRUZ; 2005. p. 275.
19.
go back to reference McDavid JC, Huse I, Hawthorn LR. Program evaluation and performance measurement: An introduction to practice. Thousand Oaks: Sage Publications; 2013. McDavid JC, Huse I, Hawthorn LR. Program evaluation and performance measurement: An introduction to practice. Thousand Oaks: Sage Publications; 2013.
20.
go back to reference Donabedian A. The seven pillars of quality. Arch Pathol Lab Med. 1990;114(11):115–8. Donabedian A. The seven pillars of quality. Arch Pathol Lab Med. 1990;114(11):115–8.
21.
go back to reference Beasley LO, Silovsky JF, Owora A, Burris L, Hecht D, DeMoraes-Huffine P, et al. Mixed-methods feasibility study on the cultural adaptation of a child abuse prevention model. Child Abuse Negl. 38. England: Published by Elsevier Ltd; 2014. p. 1496–507. Beasley LO, Silovsky JF, Owora A, Burris L, Hecht D, DeMoraes-Huffine P, et al. Mixed-methods feasibility study on the cultural adaptation of a child abuse prevention model. Child Abuse Negl. 38. England: Published by Elsevier Ltd; 2014. p. 1496–507.
22.
go back to reference Goenka S, Tewari A, Arora M, Stigler MH, Perry CL, Arnold JP, et al. Process evaluation of a tobacco prevention program in Indian schools--methods, results and lessons learnt. Health Educ Res. 2010;25(6):917–35.PubMedPubMedCentralCrossRef Goenka S, Tewari A, Arora M, Stigler MH, Perry CL, Arnold JP, et al. Process evaluation of a tobacco prevention program in Indian schools--methods, results and lessons learnt. Health Educ Res. 2010;25(6):917–35.PubMedPubMedCentralCrossRef
23.
go back to reference Sanchez Z, Sanudo A, Schneider D. Efficacy evaluation of the school program Unplugged for drug use prevention among Brazilian adolescents: a quasi-experimental study. 6th International Conference and Members’ Meeting of the European Society for Prevention Research. Liubliana; 2015. p. 56. Sanchez Z, Sanudo A, Schneider D. Efficacy evaluation of the school program Unplugged for drug use prevention among Brazilian adolescents: a quasi-experimental study. 6th International Conference and Members’ Meeting of the European Society for Prevention Research. Liubliana; 2015. p. 56.
24.
go back to reference Creswell J. Research design: Qualitative, Quantitative, and mixed methods approaches. USA: SAGE Publications, Incorporated; 2009. Creswell J. Research design: Qualitative, Quantitative, and mixed methods approaches. USA: SAGE Publications, Incorporated; 2009.
25.
go back to reference Patton MQ. Qualitative research and evaluation methods. 3rd ed. Thousand Oaks: Sage Publications; 2002. Patton MQ. Qualitative research and evaluation methods. 3rd ed. Thousand Oaks: Sage Publications; 2002.
26.
go back to reference EU-Dap. EU-Dap Consortium - European Drugs Addiction Prevention Trial Study Group. Study Instruments - Process Monitoring. 2004. EU-Dap. EU-Dap Consortium - European Drugs Addiction Prevention Trial Study Group. Study Instruments - Process Monitoring. 2004.
27.
go back to reference EU-Dap. EU-Dap Consortium - Preventing Substance Abuse among Students: A guide to successful implementation of Comprehensive Social influence curricula in schools. Turin: OED - Observatorio Epidemiologico Delle Dipendenze; 2008. EU-Dap. EU-Dap Consortium - Preventing Substance Abuse among Students: A guide to successful implementation of Comprehensive Social influence curricula in schools. Turin: OED - Observatorio Epidemiologico Delle Dipendenze; 2008.
28.
go back to reference Kreeft PVD, Jongbloet J, Van Havere T. Factors Affecting Implementation: Cultural Adaptation and Training. Defining Prevention Science: Springer; 2014:315–34. Kreeft PVD, Jongbloet J, Van Havere T. Factors Affecting Implementation: Cultural Adaptation and Training. Defining Prevention Science: Springer; 2014:315–34.
29.
go back to reference Glaser BG, Strauss AL, Strutzel E. The discovery of grounded theory: strategies for qualitative research. New York: Aldine de Gruyter; 1967. 364 p. Glaser BG, Strauss AL, Strutzel E. The discovery of grounded theory: strategies for qualitative research. New York: Aldine de Gruyter; 1967. 364 p.
30.
go back to reference Strauss AL, Corbin J. Pesquisa qualitativa: técnicas e procedimentos para o desenvolvimento de teoria fundamentada. Porto Alegre: Brasil: Artmed; 2008. Strauss AL, Corbin J. Pesquisa qualitativa: técnicas e procedimentos para o desenvolvimento de teoria fundamentada. Porto Alegre: Brasil: Artmed; 2008.
31.
go back to reference Charmaz K. A construção da teoria fundamentada: guia prático para análise qualitativa: Bookman. 2009. Charmaz K. A construção da teoria fundamentada: guia prático para análise qualitativa: Bookman. 2009.
32.
go back to reference Gibbs G. Qualitative Data Analysis: Explorations with NVivo New York Open University Press. 2009. Gibbs G. Qualitative Data Analysis: Explorations with NVivo New York Open University Press. 2009.
33.
go back to reference Monroe-DeVita M, Teague GB, Moser LL. The TMACT: a new tool for measuring fidelity to assertive community treatment. J Am Psychiatr Nurses Assoc. 2011;17:17–29.PubMedCrossRef Monroe-DeVita M, Teague GB, Moser LL. The TMACT: a new tool for measuring fidelity to assertive community treatment. J Am Psychiatr Nurses Assoc. 2011;17:17–29.PubMedCrossRef
34.
go back to reference Taylor JA, Phillips R, Cook E, Georgiou L, Stallard P, Sayal K. A qualitative process evaluation of classroom-based cognitive behaviour therapy to reduce adolescent depression. Int J Environ Res Public Health. 2014;11(6):5951–69.PubMedPubMedCentralCrossRef Taylor JA, Phillips R, Cook E, Georgiou L, Stallard P, Sayal K. A qualitative process evaluation of classroom-based cognitive behaviour therapy to reduce adolescent depression. Int J Environ Res Public Health. 2014;11(6):5951–69.PubMedPubMedCentralCrossRef
35.
go back to reference Sloboda Z, Bukoski WJ. Handbook of drug abuse prevention: Theory, Science and Practice. New York: Springer; 2006.CrossRef Sloboda Z, Bukoski WJ. Handbook of drug abuse prevention: Theory, Science and Practice. New York: Springer; 2006.CrossRef
36.
go back to reference Brasil. Política de Atenção Integral aos usuários de álcool e outras drogas. [Policy for the attention of alcohol and Drug users], 2003. Brasil. Política de Atenção Integral aos usuários de álcool e outras drogas. [Policy for the attention of alcohol and Drug users], 2003.
37.
go back to reference Deschesnes M, Martin C, Hill AJ. Comprehensive approaches to school health promotion: how to achieve broader implementation? Health Promot Int. 2003;18(4):387–96.PubMedCrossRef Deschesnes M, Martin C, Hill AJ. Comprehensive approaches to school health promotion: how to achieve broader implementation? Health Promot Int. 2003;18(4):387–96.PubMedCrossRef
38.
go back to reference Tobler NS, Roona MR, Ochshorn P, Marshall DG, Streke AV, Stackpole KM. School-based adolescent drug prevention programs: 1998 meta-analysis. J Prim Prev. 2000;20(4):275–336.CrossRef Tobler NS, Roona MR, Ochshorn P, Marshall DG, Streke AV, Stackpole KM. School-based adolescent drug prevention programs: 1998 meta-analysis. J Prim Prev. 2000;20(4):275–336.CrossRef
39.
go back to reference Sanchez ZM, Oliveira LG, Ribeiro LA, Nappo SA. O papel da informação como medida preventiva ao uso de drogas entre jovens em situação de risco. Ciência & Saúde Coletiva. 2010;15(3):699–708.CrossRef Sanchez ZM, Oliveira LG, Ribeiro LA, Nappo SA. O papel da informação como medida preventiva ao uso de drogas entre jovens em situação de risco. Ciência & Saúde Coletiva. 2010;15(3):699–708.CrossRef
40.
go back to reference Spooner C, Hall W. Preventing drug misuse by young people: we need to do more than 'just say no'. Addiction. 2002;97(5):478–81.PubMedCrossRef Spooner C, Hall W. Preventing drug misuse by young people: we need to do more than 'just say no'. Addiction. 2002;97(5):478–81.PubMedCrossRef
Metadata
Title
Process evaluation of the implementation of the Unplugged Program for drug use prevention in Brazilian schools
Authors
Pollyanna F. P. Medeiros
Joselaine I. Cruz
Daniela R. Schneider
Adriana Sanudo
Zila M. Sanchez
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Substance Abuse Treatment, Prevention, and Policy / Issue 1/2016
Electronic ISSN: 1747-597X
DOI
https://doi.org/10.1186/s13011-015-0047-9

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