Effectiveness of a School-Based Alcohol Preventive Intervention in Norway

Introduction:

Evaluation of preventive programs is necessary in order to determine a program’s effectiveness and to support the implementation of evidence-based policy and practice. The Unge & Rus program is an intervention aimed at preventing the use of alcohol and drugs, with a focus on teenager’s attitudes towards alcohol and alcohol use. The target groups of the program are high schools students, teachers and parents. The main purpose of the program is to develop students’ knowledge about alcohol and the ability to think critically about its use, strengthen attitudes against the use of alcohol and reinforce the ability to say no to alcohol.

Methods

The effectiveness of the program was tested using a longitudinal quasi-experimental control group design. We assessed changes in the outcome measures according to the program aims, using multilevel analysis and generalized multilevel analysis. A total of 41 schools participated with a total of 2,020 students and 1,662 parents. Data were collected with online questionnaires. The intervention was implemented by the local teachers and data were collected from them to examine the implementation fidelity.

Results:

The baseline response rate was 78% and 70% respectively. The Unge & Rus program had a short-term effect on student’s alcohol expectancies whereas the adolescents in the control group had significantly higher alcohol expectancies (t = 2.20, p = .03) compared to the intervention group. However, the overall effectiveness on other outcomes for students such as alcohol-related attitudes, alcohol-related knowledge, and perceived behavior control were non-significant. Parent’s attitudes, rules and discussions of alcohol limits with other parents did not change significantly differently over time between the intervention and the control group. The parents who received the intervention talked more with their adolescents about the dangers of using alcohol (F = 15.21, p < .001) compared to parents in the comparison group. Analyses of implementation fidelity were conducted to explore if the lack of program effectiveness was due to low fidelity.

Conclusions

Universal school-based prevention programs that aim to prevent the use of alcohol have in general been criticized for poor outcomes and low effectiveness. This study showed an overall lack of effectiveness for both adolescents and parents, according to the program’s defined objectives. The question is whether we can expect significant effects of universal school-based interventions targeting all adolescents where the majority has not had their onset of alcohol drinking. Implementation of more specific interventions targeted towards selected groups and families could be more effective than the use of universal preventive school-based programs.