Palavras-chave Avaliação de programas, Políticas públicas, Drogas

AimsTo investigate the mediating effects of normative beliefs of drug use on the effects of the #Tamojunto school-based prevention program (Unplugged).DesignSecondary analysis of a cluster randomized controlled trial.SettingBrazil. Participants: A total of 6,391 adolescents (12.68 y.o) from 72 public schools in 6 Brazilian cities. Intervention: Schools were assigned to an experimental condition (#Tamojunto curriculum) or a control condition (no prevention program). Measurements: Baseline data were collected prior to program implementation, and follow-up data were collected 9 and 21 months later. The substances examined were alcohol (including binge drinking), tobacco, marijuana and inhalants. Five in-parallel mediation models evaluated whether the positive and negative beliefs were mediators of the likely effects of the intervention on drug use.FindingsLack of evidences regarding differences in normative beliefs or drug use were found between the intervention and control groups. However, there was a clear association between negative drug beliefs and lower consumption (i.e. OR = 0.78; 95% CI 0.70; 0.87, for cannabis use) as well as between positive drug beliefs and higher consumption (i.e. OR = 1.77; 95% CI 1.56; 2.02, for cannabis use) independent of the assigned group.ConclusionsThese results suggest that there is a lack of evidence that the program impact the normative beliefs, as proposed by the theoretical model of the program, suggesting that modifications are needed to produce the intended effect of the program. Negative normative beliefs seem to be a potential protective factor for drug use, but the program’s effect itself on drug use via normative beliefs was not found to be statistically significant. Program activities intended to affect normative beliefs should be improved.

This study aimed to estimate the prevalence of binge drinking and other alcohol consumption patterns and analyze the sociodemographic characteristics associated with binge drinking among Brazilian adolescents aged 15 to 17 years. A cross-sectional household survey including 2,315 adolescents from the 2019 Brazilian National Health Survey who answered a questionnaire on alcohol consumption (weekly frequency, average amount consumed in a drinking day, and binge drinking). A descriptive analysis of alcohol consumption by sociodemographic characteristics and a multivariable logistic regression model were performed. The prevalence of binge drinking (past 30 days) was 8.1% (95%CI: 6.2-10.3). Adolescents who did not attend school (OR = 2.8; 95%CI: 1.6-5.0) had greater odds of binge drinking than adolescents attending school. Higher socioeconomic status (measured via wealth score) was also associated with higher odds of binge drinking compared with lower socioeconomic status (e.g., 5th quintile vs. 1st quintile: OR = 2.9; 95%CI: 1.1-7.7). Girls had lower odds of binge drinking (OR = 0.5; 95%CI: 0.2-0.8) than boys. The prevalence of binge drinking among adolescents, especially boys, who did not attend school and had higher socioeconomic status was high. Monitoring alcohol consumption patterns in adolescents may provide important information on policies or actions to prevent binge drinking.

ResumoO objetivo do presente estudo foi investigar as percepções da comunidade escolar sobre o programa Unplugged, implantado pelo Ministério da Saúde em escolas públicas brasileiras de ensino fundamental II. A metodologia utilizada foi a qualitativa e envolveu coleta de dados através de 11 grupos focais de professores (n=13), alunos (n=54) e administradores escolares (n=11) em 8 escolas de 3 cidades brasileiras. Análise de conteúdo permitiu a identificação de 3 eixos temáticos. As facilidades identificadas estiveram relacionadas com o suporte técnico para implantação da metodologia, como a formação e supervisão recebida, além do suporte dos administradores das escolas. As dificuldades apontadas estiveram relacionadas ao tempo das aulas, a obtenção de materiais de suporte para as aulas e ao cumprimento adequado do currículo regular. Como potencialidade, identificou-se a melhoria das relações de convivência. Os resultados aqui alcançados permitem o aprimoramento da implantação do programa Unplugged nas escolas brasileiras. Palavras-chave:Prevenção do abuso de drogas; educação; pesquisa qualitativa. School community perceptions on implementation of the unplugged program in schools AbstractThe aim of the present study was to investigate the perceptions of the school community about the Unplugged program, implemented by the Ministry of Health in Brazilian public elementary school. The methodology used was qualitative and involved data collection through 11 focus groups of teachers (n = 13), students (n = 54) and school administrators (n = 11) in 8 schools in 3 Brazilian cities. The content analysis allowed the identification of 3 thematic axes. The facilities identified were related to the technical support for the implementation of the methodology, such as the training and supervision received, and the support of the school administrators. The difficulties pointed out were related to class time, obtaining support materials for classes and adequate fulfillment of the regular curriculum. As potentiality, the improvement of the relations of coexistence was identified. The results obtained here allow the improvement of the implementation of the Unplugged program in Brazilian schools.Keywords: Drug abuse prevention; education; qualitative research. Percepciones de la comunidad escolar sobre la implantación del programa unplugged en escuelas ResumenEl objetivo del presente estudio fue investigar las percepciones de la comunidad escolar sobre el programa Unplugged, implantado por el Ministerio de la Salud en escuelas públicas brasileñas de enseñanza primaria II. Se utilizó la metodología cualitativa e involucró recolecta de datos por intermedio de 11 grupos focales de profesores (n=13), alumnos (n=54) y administradores escolares (n=11) en 8 escuelas de 3 ciudades brasileñas. El análisis de contenido permitió la identificación de 3 ejes temáticos. Las facilidades identificadas estuvieron relacionadas con el soporte técnico para implantación de la metodología, como la formación y supervisión recibida, además del soporte de ...

This article aims to present the experience of implementing ‘Street Outreach Teams’ in the city of Recife-PE as a strategy for HIV/AIDS prevention and Harm Reduction (HR) associated with the use of alcohol, crack, and other drugs. Although the review of the history of this process reveals tensions, volatility, and alternations in the care models implemented by the city management, the analysis points out the importance of reaffirming, in the current context, the practices and experiences in that field, anchored in HR and in the defense of civil and human rights. Street outreach teams have been found to help strengthen the practice of HR in the Unified Health System, as a public health strategy to reduce vulnerabilities to Sexually Transmitted Infections (STI) and AIDS associated with the use of alcohol, crack, and other drugs. The experience has expanded the promotion of the line of care for people who use alcohol, crack, and other drugs and reduced the vulnerabilities of STI/AIDS associated with such use. However, it seems that it is necessary to invest and maintain permanent training processes, in addition to epidemiological studies and research demonstrating the results achieved in different contexts.