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Abstract
Objectives To assess the effectiveness of a combined classroom curriculum and parental intervention (the Steps Towards Alcohol Misuse Prevention Programme (STAMPP)), compared with alcohol education as normal (EAN), in reducing self-reported heavy episodic drinking (HED) and alcohol-related harms (ARHs) in adolescents.
Setting 105 high schools in Northern Ireland (NI) and in Scotland.
Participants Schools were stratified by free school meal provision. Schools in NI were also stratified by school type (male/female/coeducational). Eligible students were in school year 8/S1 (aged 11–12 years) at baseline (June 2012).
Intervention A classroom-based alcohol education intervention, coupled with a brief alcohol intervention for parents/carers.
Primary outcomes (1) The prevalence of self-reported HED in the previous 30 days and (2) the number of self-reported ARHs in the previous 6 months. Outcomes were assessed using two-level random intercepts models (logistic regression for HED and negative binomial for number of ARHs).
Results At 33 months, data were available for 5160 intervention and 5073 control students (HED outcome), and 5234 and 5146 students (ARH outcome), respectively. Of those who completed a questionnaire at either baseline or 12 months (n=12 738), 10 405 also completed the questionnaire at 33 months (81.7%). Fewer students in the intervention group reported HED compared with EAN (17%vs26%; OR=0.60, 95% CI 0.49 to 0.73), with no significant difference in the number of self-reported ARHs (incident rate ratio=0.92, 95% CI 0.78 to 1.05). Although the classroom component was largely delivered as intended, there was low uptake of the parental component. There were no reported adverse effects.
Conclusions Results suggest that STAMPP could be an effective programme to reduce HED prevalence. While there was no significant reduction in ARH, it is plausible that effects on harms would manifest later.
Trial registration number ISRCTN47028486; Post-results.
- alcohol
- school based intervention
- prevention
- alcohol related harm
- universal prevention
- adolescents
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Footnotes
Contributors HS had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. MM wrote the first draft of the manuscript and subsequent versions and submitted the final version; HS was project PI, contributed to the first draft and subsequent iterations of the manuscript and prepared the final version of the manuscript; AP conducted the statistical analysis and contributed to manuscript drafts; AA, DF, JC, LM, PD and SH all contributed to drafts and approved the submission.
Funding This trial was funded by the National Institute of Health Research (NIHR) Public Health Research (PHR) programme (project number 10/3002/09). The Public Health Agency of NI and Education Boards of Glasgow/Inverclyde provided some intervention costs. Diageo provided funds to print classroom workbooks for use only in the Glasgow local authority area. Remaining intervention costs were internally funded.
Disclaimer The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the NIHR-PHR, NIHR, NHS or the Department of Health. The research and intervention funders had no involvement in intervention design; design and conduct of the study; collection, management, analysis and interpretation of the data; and preparation, review or approval of the manuscript.
Competing interests The sponsor university (LJMU) received and administered a payment from the alcohol industry for printing of student workbooks in the Glasgow trial site only. AP reported that he has previously received funding from the European Foundation of Alcohol Research (ERAB) in relation to the development of statistical models for longitudinal data (2008–2010). DF reported that his department has previously received funding from the alcohol industry for unrelated prevention programme training work. HS reported that his department has previously received funding from the alcohol industry (indirectly via the industry funded Drinkaware charity) for unrelated primary research.
Patient consent Obtained.
Ethics approval The research was approved by Liverpool John Moores University Research Ethics Committee (11/HEA/097).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Availability of data and materials: the datasets generated during and/or analysed during the current study are not yet publicly available due to the authors undertaking additional analyses and follow-on studies but are available from the corresponding author on reasonable request.