|
Abstract
|
AIMS: To test effectiveness of the Healthy School and Drugs (HSD) program on tobacco and alcohol use in Dutch secondary special education (SE) schools, and whether this depends on subtypes of SE-schools and the level of implementation.
DESIGN: In a quasi-experimental design with baseline and post-treatment follow-up 35 classes (N = 363) 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: Recruited during the Fall of 2013 from 3 school subtypes: SE for adolescents with intellectual/physical disabilities (SEI; N = 13), behavioral/emotional difficulties (SEB; N = 136), and learning disabilities/developmental disorders (SEL; N = 214). MEASUREMENTS: Self-reported lifetime smoking prevalence and lifetime 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 lifetime smoking (OR = 1.52; 95% CI = 0.74-3.12) and drinking frequency (d = 0.01; 95% CI = -0.16-0.18). 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 positively moderated by implementation fidelity (d = 0.35; 95% CI = 0.07-0.63).
CONCLUSION: The Healthy School and Drugs program adapted for secondary special education in the Netherlands lacked clear evidence for effects on all outcomes. This pilot study further suggests that within special education substance use interventions may need to be targeted at school subtypes, as these may have harmful effects among students with behavioral difficulties. Finally, limited evidence was found that program effectiveness may depend on implementation fidelity.
This article is protected by copyright. All rights reserved.
Language: en |