Article Text
Abstract
Objectives To evaluate the effectiveness of the online Climate Schools: Ecstasy and Emerging Drugs module over 2 years, and examine the impact of intervention dose on outcomes.
Design Cluster randomised controlled trial.
Setting Secondary schools in Australia.
Participants 1126 students (aged 14.9 years) from 11 schools.
Intervention Five schools were randomly allocated to the four-lesson internet-based Climate Schools: Ecstasy and Emerging Drugs module. This universal intervention uses cartoon storylines to deliver harm-minimisation information about ecstasy and new psychoactive substances (NPS). It was delivered during health education classes over 4 weeks. Six schools were randomised to the control group (health education as usual). Participants were not blinded to intervention allocation.
Outcomes measures Students completed self-report surveys at baseline, post-test, 6, 12 and 24 months post-baseline. Intentions to use ecstasy and NPS (including synthetic cannabis and synthetic stimulants), knowledge about ecstasy and NPS and lifetime use of ecstasy and NPS were assessed. This paper reports the results at 24 months post-baseline.
Analysis Mixed effects regressions were conducted to analyse intervention effects from baseline to 24 months. Post hoc analyses using Inverse Probability of Treatment Weighting compared controls with students who: i) completed all four lessons (‘full dose’) and ii) partially completed the intervention (≤three lessons, ‘incomplete dose’).
Results Primary analyses found that controls were significantly more likely to intend on using synthetic cannabis compared with intervention group students (OR=3.56, p=0.01). Results from the weighted analyses indicated that controls reported significantly lower knowledge about ecstasy (p=0.001) and NPS (p=0.04) compared with the full-dose group. No significant differences were observed between the incomplete dose and control groups.
Conclusions The online intervention was effective in modifying students’ intentions to use synthetic cannabis up to 24 months; however, this study highlights the importance of delivering prevention programmes in full to maximise student outcomes.
Trial registration number ACTRN12613000708752.
- preventive medicine
- mental health
- substance misuse
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Footnotes
Contributors KEC, NCN and MT designed the study. KEC coordinated data collection and intervention implementation in schools. KEC and LS led the statistical analysis. All authors read, edited and approved the final manuscript.
Funding This work was supported by the National Health and Medical Research Council (APP1056432) and the Australian Government Department of Health. NN and LS were supported by Society for Mental Health Research Early Career Fellowships.
Disclaimer The funding bodies had no role in the design of the study and collection, analysis and interpretation of data and in writing the manuscript.
Competing interests MT, NCN and KEC are the developers of the Climate Schools: Ecstasy and Emerging Drugs module. MT and NCN are Directors of Climate Schools Pty Ltd.
Patient consent Obtained.
Ethics approval The study was approved by the UNSW Sydney Human Research Ethics Committee (HREC HC13075).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The datasets generated and/or analysed during the current study are not publicly available, but are available from the corresponding author on reasonable request.