The Large-Scale Deployment of a Program to Prevent the Use of Drugs in the Molds of a Brazilian Public Policy

The Brazilian Ministry of Health culturally adapted the program to prevent the use of drugs to students from 11-14 years, originally named UNPLUGGED, in Brazil named #TAMOJUNTO. During the dissemination process changes were made in the logic implementation, including components that would enable the large-scale deployment of the program as part of a national public policy. Therefore, it was incorporated a matrix model of responsibilities in which a team from the federal government would be responsible for retrofitting and maintain the fidelity of the program. The first amendment to the dissemination was the incorporation of a coach in the implementation process, named "multiplier", who is the one responsible for delivering the trainings and giving support to the teacher, every month in a one hour meeting. The second change was the revision of the guide of the three parents meetings where these would be responsibility of the health professionals together with the school professionals. The third modification was extent the training of teachers to training of professionals, once we have at the same time, teacher, school stakeholders, health professionals and, sometimes, local politicians being trained. The fourth improvement was to develop a logical matrix based on continuous formation, manualizing process and co-implantation. In addition monitoring instruments for professionals of different levels involved in the dissemination process were developed. The instruments are answering by federal politicians, federal multipliers, local multipliers, teachers and health professionals. In the first semester of 2013, we reached a number of 5664 students participating of #Tamojunto, 130 teachers delivering the program in 59 schools, 9 cities and 7 Brazilian states coordinated for a team of two supervisors and six multipliers, supported by two federal politicians coordinators. Added this numbers, most of the local politicians are satisfied with the program, asking for expansion, the teachers are well engaged (only 5 teachers gave up during the semester), the students are also engaged in the classes and are asking for extra #Tamojunto classes in the curriculum, the relations between health and education are stronger. The main challenges of this process has been the incorporation of #Tamojunto classes within the regular school curriculum and the release of healthcare and education professional to be trained as local multipliers. Our actions for the second semester are to develop mechanisms and trainings to empower the local partners as local multipliers, visualizing the dissemination of the program and the local ownership of #Tamojunto in sense of becoming their local public policy. Therefore, all efforts are direct to maintain the quality of program implementation in the expansion process on a large scale, while the essences components are identified for maintenance of actions for a sustainable program as a national public policy.