A school-based programme for tobacco and alcohol prevention in special education: effectiveness of the modified 'healthy school and drugs' intervention and moderation by school subtype.

TOBACCO use; TEENAGERS; SPECIAL education; UNDERAGE drinking; EDUCATIONAL evaluation; DRUG abuse education in secondary schools; EDUCATIONAL programs; TEENAGERS with intellectual disabilities; SECONDARY education; EDUCATION; SMOKING prevention; SUBSTANCE abuse prevention; AFFECTIVE disorders; CONFIDENCE intervals; DEVELOPMENTAL disabilities; ALCOHOL drinking; CURRICULUM; HEALTH promotion; HIGH schools; LEARNING disabilities; RESEARCH methodology; MEDICAL cooperation; PEOPLE with intellectual disabilities; MOTIVATION (Psychology); PROBABILITY theory; QUESTIONNAIRES; RESEARCH; SCHOOL health services; SELF-efficacy; STUDENTS; TEACHERS; TOBACCO; PILOT projects; SOCIAL disabilities; BEHAVIOR disorders; HUMAN services programs; EVALUATION of human services programs; DATA analysis software; DESCRIPTIVE statistics; ODDS ratio; INTRACLASS correlation

Aims To test the effectiveness of the Healthy School and Drugs (HSD) programme on tobacco and alcohol use in Dutch secondary special education (SE) schools, and whether this depends upon subtypes of SE schools and the level of implementation. Design In a quasi-experimental design with baseline and post-treatment follow-up, 363 students were allocated arbitrarily or depending on teacher motivation to either intervention condition ( n = 205) or usual curriculum ( n = 158). Setting Thirteen secondary SE schools spread throughout the Netherlands. Participants Participants were recruited during the autumn of 2013 from three school subtypes: SE for adolescents with intellectual/physical disabilities (SEI; n = 13), behavioural/emotional difficulties (SEB; n = 136) and learning disabilities/developmental disorders (SEL; n = 214). Measurements Self-reported life-time smoking prevalence and life-time drinking frequency as outcomes, and school subtype (SEL/SEB) and implementation fidelity (high/low) as moderators. Findings No significant differences were found at follow-up in life-time smoking [odds ratio (OR) = 1.52; 95% confidence interval (CI) = 0.74-3.12] and drinking frequency ( d = 0.01; 95% CI = −0.16 to 0.18). Interaction analyses revealed adverse effects in SEB students for alcohol use ( d = 0.43; 95% CI = 0.16-0.69). Effect on tobacco refusal self-efficacy was moderated positively by implementation fidelity ( d = 0.35; 95% CI = 0.07-0.63). Conclusion The Healthy School and Drugs programme adapted for secondary special education in the Netherlands lacked clear evidence for effects on all outcomes. This pilot study suggests further that, within special education, substance use interventions may need to be targeted at school subtypes, as these may have harmful effects among students with behavioural difficulties. Finally, limited evidence was found that programme effectiveness may depend upon implementation fidelity. [ABSTRACT FROM AUTHOR]

Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)