Evaluation of Choice: A School-Based Substance Abuse Prevention Program in Ukraine

INTRODUCTION: Use of alcohol and tobacco are major problems for school-aged youth in Ukraine. Results of a school pre survey conducted among 249 eighth graders in November 2011 in Chernihiv indicated that 23.1% of the students (13-14 years old) used tobacco and 24% of them used alcohol (past 30 days use) for the intervention group. Given these findings, the second phase of research was conducted and CHOICE was implemented at five schools of Chernihiv. The primary goals were to evaluate effectiveness of CHOICE in preventing and postponing the onset of tobacco and alcohol use by adolescents and to provide data for program improvement. CHOICE consists of 10 sessions. Pedagogical University students conduct the Program for eighth graders. Evaluation of CHOICE includes both a process and outcome evaluation.

METHODS: Process evaluation was performed through a survey conducted among five class teachers and 30 school administration representatives. Another survey was conducted of 10 trainers of CHOICE. Results of CHOICE were evaluated through a post survey conducted in ten classes where five classes constituted the intervention group and the other five served as a control group. A 33-items questionnaire was administered to 232 eighth graders of five schools in May 2012.

RESULTS: Process evaluation results showed the amount of relevant information received by trainees (4.2), their satisfaction with classes (4.3), usefulness (4.7) and freshness (3.4) of information, class-room management (4.1). Average rating is 4.14 accordingly to scale where 5 is the highest rate. Assessment of sessions materials received an average rating of 8.9 (10 is the highest rate) and rate for each of 10 sessions. The required improvements are: to increase time for conducting, to add more video materials and practical examples for CHOICE sessions, to set universal weekday and time for all CHOICE classes at schools. Results of the post survey showed that 11.5% those in the intervention group reported use of tobacco and 13.8% use of alcohol during past 30 days. This is less than half than in the 6 month pre survey. For the control group, 13.7% reported having used tobacco and 14.7% alcohol, while six months ago there were 11.7% for tobacco use and 8.6% for alcohol. 

CONCLUSION: The findings demonstrate effectiveness of CHOICE due to change in use of tobacco and alcohol among 8th grade students. They allow improving CHOICE, thus it will be extended for implementation and studied in 10 schools during next phase of the research.