Validation of a Tool to Evaluate Drug Prevention Programs Among Students.

Background: School-based prevention programs have been implemented worldwide with the intention of reducing or delaying the onset of alcohol and drug use among adolescents. However, their effects need to be evaluated, being essential to use validated and reliable questionnaires for this purpose. This study aimed to verify the semantic validity and reliability of an instrument developed to evaluate the results of a government drug prevention program for schoolchildren called #Tamojunto2.0. Methods: This is a mixed methods study with quantitative (test-retest, confirmatory factor analysis and non-response evaluation) and qualitative analyses (focus group and field cards). The self-administered questionnaires were used for a sample of 262 eighth-grade students (elementary school II) in 11 classes of four public schools in the city of São Paulo. Results: The level of agreement was substantial (Kappa 0.60-0.79) or almost perfect (Kappa > 0.8) for almost all questions about the use of marijuana, alcohol, cigarettes, cocaine, crack, and binge drinking. The model fit indices, for almost all secondary outcomes, indicated that the modls underlying each scale, constituted by observed and latent variables, had a good fit adjustument. The focus groups and field cards provided high-quality information that helped the researchers identify the main difficulties in applying and understanding the questions. Conclusion: The questionnaire showed high factorial validity, reliability and understanding by adolescents. After the necessary changes, identified in this study, the questionnaire will be suitable to evaluate the results of the #Tamojunto2.0 program in a randomized controlled trial.

Effectiveness of the Elos 2.0 prevention programme for the reduction of problem behaviours and promotion of social skills in schoolchildren: study protocol for a cluster-randomized controlled trial.

BACKGROUND: Early interventions benefit the mental health, academic performance and productivity of children and adolescents throughout their life. The present study protocol will evaluate the effectiveness of the Elos 2.0 Programme, which is a version adapted for Brazil by the Ministry of Health, in reducing problem behaviours (e.g., disruptiveness, aggressivity and shyness) and promoting social skills in the school context in children 6 to 10 years of age. The Elos Programme is based on the Good Behaviour Game, which is widely used and prevents and/or reduces students' disruptive behaviours by establishing cooperation contingencies. METHOD: A cluster-randomized controlled trial will be performed in 30 schools in three cities (15 controls and 15 in the experimental group), with a total of 3800 children participating in the test (1900 in the control group and 1900 in the intervention group). Data will be collected by having teachers in the control and experimental classes complete the Teacher Observation of Classroom Adaptation (TOCA) questionnaire, which is an instrument used to observe children's behaviour in the classroom. We will collect data before and after the intervention period in the same year. Due to the hierarchical structure of the data, multilevel analysis will be performed to detect simultaneous differences in prevalence over time and across groups to control for sociodemographic variables. DISCUSSION: The current study will examine the effectiveness of the Elos 2.0 Programme in reducing problem behaviours (e.g., disruptiveness, aggressivity and shyness) and promoting social skills in the school context. The findings of this school-based prevention programme for children will influence the development and implementation of similar programmes for schools and educational policymakers by identifying mechanisms that are central to achieving positive outcomes for participants. TRIAL REGISTRATION: Registry of Clinical Trials of the Ministry of Health RBR-86c6jp . Registered February 2, 2019.

A cluster randomized controlled trial evaluating the effectiveness of the school-based drug prevention program #Tamojunto2.0.

AIMS: The study aimed to evaluate the effectiveness of the government school-based program #Tamojunto2.0, the third Brazilian version of the European drug prevention program, Unplugged, in preventing the use of alcohol and other drugs. DESIGN: A parallel, two-arm cluster randomized controlled trial was conducted in 205 classes in 73 public schools (37 intervention and 36 control) with a baseline assessment and follow-up after 9 months. SETTING: Schools in the cities of São Paulo, Fortaleza and Eusebio in Brazil. PARTICIPANTS: A total of 5208 students in the 8th grade with a mean age of 13.2 years (standard deviation = 0.8 years) and an equal gender ratio. INTERVENTION: In 2019, the intervention group attended 12 classes of the program #Tamojunto2.0, under the supervision of a team from the Ministry of Health. The control group did not receive any intervention to prevent alcohol and drug use. MEASUREMENTS: The primary outcome measured was prevalence of binge drinking (five or more doses of alcohol in an occasion) within the past month. Secondary outcomes were prevalence of initiation and use of alcohol, tobacco, inhalants, marijuana and cocaine within the past month. FINDINGS: A statistically significant difference was not found in the prevalence of binge drinking within the past month between intervention and control groups [odds ratio (OR) = 0.934; 95% confidence interval (CI) = 0.761-1.146]. However, students who were exposed to the program were less likely to initiate alcohol use than those in the control group (OR = 0.782; 95% CI = 0.636-0.961). The Bayes factor for reduction in binge drinking was 0.01, providing evidence in favor of the null hypothesis for this variable. CONCLUSIONS: The drug prevention program #Tamojunto 2.0 reduced alcohol initiation, but appeared not to reduce past-month binge drinking among 8th grade students in Brazil.

Effectiveness evaluation of the school-based drug prevention program #Tamojunto2.0: protocol of a cluster randomized controlled trial.

BACKGROUND: The European school-based drug addiction prevention program Unplugged was adapted to the Brazilian context by the Ministry of Health and renamed #Tamojunto. Its first implementations, in the form of a public policy in Brazil, showed contradictory and different effects from those observed in Europe. Adaptations were made to #Tamojunto in 2018 to reintroduce the essential content of the original program. METHODS: A parallel, two-arm, randomized controlled trial (RCT) will be conducted to evaluate the effectiveness of the new version of the school-based government program #Tamojunto2.0 for the prevention of drug use among 8th grade middle school students from 70 public schools in three Brazilian cities, totaling approximately 6.300 participating students distributed in 210 classes. For intervention, the experimental group will receive the 12 lessons of the #Tamojunto2.0 program under the supervision of a Brazilian Ministry of Health team. The control group will not receive any intervention. Information will be collected from the students at three time points: preintervention and 9 and 18 months postintervention. Multilevel analyses will be performed using the Gllamm Stata program to assess simultaneous differences in prevalence, in time and among groups for the outcomes of interest. Structural equation modeling will be used to evaluate the effectiveness of the intervention in changing the behavioral patterns of the adolescents through latent transition analysis. The effect of the mediators involved in the program effectiveness outcomes will also be analyzed. The program doses applied in all classes of the intervention group will be collected using a form completed by the teacher at the end of each lesson, indicating the activities taught and not taught in each lesson. DISCUSSION: This study will show whether the #Tamojunto2.0 program can be expanded as a public policy for all schools with the aim of preventing drug use among Brazilian students. TRIAL REGISTRATION: Brazilian Clinical Trials Registry (RBR-8cnkwq) under the name "Avaliação do Efeito do Programa de Prevenção Escolar ao Uso de Drogas #Tamojunto2.0, Versão 2018", on August 30th, 2018 ( http://www.ensaiosclinicos.gov.br/rg/RBR-8cnkwq/ ).

Grupo cognitivo-comportamental com famílias de crianças com déficits em habilidades sociais e acadêmicas / Cognitive-behavioral group with families of children with lack of social skills and academic deficits

A equipe de pesquisa das autoras, por anos, desenvolve estudos com um objetivo comum: encontrar formas alternativas para ajudar as famílias desprivilegiadas socialmente. Este trabalho é um dessa série e descreve uma intervenção envolvendo a família e a escola de 13 crianças com déficits sociais e acadêmicos. Para prevenir a evasão a intervenção foi massiva: pais e crianças receberam atendimento psicológico na escola pública das crianças, em grupos diferenciados e no mesmo período, as professoras foram treinadas na condução de um programa de educação sócio-afetiva. Cbcls dos pais, e Trfs das professoras do grupo de crianças com déficits e de grupo de crianças que, conforme as professoras prescindiam do atendimento (grupo de validação), foram avaliados antes e depois da intervenção e demonstram mudanças positivas nas percepções de pais e professores do grupo de crianças atendidas, tanto em comparação com seu desempenho ao início da pesquisa quanto em relação ao grupo de validação.(AU)

For a long time the research team of the authors have cnducted studies with a common objective: to find alternative forms to help underprivileged families. The present work reports one of the studies, where the team tried to find better ways to work with 13 children with social and academic deficits, and their families. To prevent the attrition rate the families were helped massively for a short period of time throughout psychological sessions with parents and with the children at school. At the same time teachers were trained to develop an affective education program for their children. CBCLs and the teachers' TRFs were compared with the ones from the group of social validation (suitable children according to teachers as those that could spare psychological attendance). The perceptions of the parents, observers and the teachers and of the students of the first group of children were more positive after the intervention.(AU)

A psicologia clínica e os programas preventivos de intervenção comunitária / Clinical psychology and community preventive programs

Este estudo busca discutir algumas relações entre a Psicologia Clínica e os programas de intervenção clínica comunitários de caráter terapêutico e preventivo. Primeiro faz uma caracteriza dos tipos de programas de intervenção comunitários. Em seguida, mostra a evolução da Psicologia Comunitária americana cujos programas hoje, independente do tipo, são predominantemente empíricos e preventivos. Finalmente, tanto a caracterização quanto a análise evolutiva promovidas dão margem ao exame de alguns estudos de intervenção clínica comunitária produzidos no Brasil, a partir dos anos 80, cuja maioria deles se situa dentro de um referencial teórico de concepção da prevenção como fenômeno biopsicossocial(AU)

A psicologia clínica e os programas preventivos de intervenção comunitária / Clinical psychology and community preventive programs

Este estudo busca discutir algumas relações entre a Psicologia Clínica e os programas de intervenção clínica comunitários de caráter terapêutico e preventivo. Primeiro faz uma caracteriza dos tipos de programas de intervenção comunitários. Em seguida, mostra a evolução da Psicologia Comunitária americana cujos programas hoje, independente do tipo, são predominantemente empíricos e preventivos. Finalmente, tanto a caracterização quanto a análise evolutiva promovidas dão margem ao exame de alguns estudos de intervenção clínica comunitária produzidos no Brasil, a partir dos anos 80, cuja maioria deles se situa dentro de um referencial teórico de concepção da prevenção como fenômeno biopsicossocial