Effectiveness evaluation of the school-based drug prevention program #Tamojunto in Brazil: 21-month follow-up of a randomized controlled trial

Sanchez, Zila M.; Valente, Juliana Y.; Sañudo, Adriana; Pereira, Ana Paula Dias; Schneider, Daniela Ribeiro; Andreoni, Solange

doi:10.1016/j.drugpo.2018.07.006

Cited by 33 publications

(31 citation statements)

References 31 publications

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“…41 However, no official data exist in relation to the implementation costs of these programs; moreover, the effectiveness of only one of these programs, the #TamoJunto program, has been evaluated. Sanchez et al 42 In terms of the economic impact on the public healthcare system, the mean monthly direct costs per capita in our sample were almost 4.4 times greater than the mean per capita public healthcare expenditures in Brazil in 2015, while the costs for those who were both drug dependent and alcohol abusers were 7.5 times greater than national per capita healthcare expenditure in that year, according to data from the Organization for Economic Cooperation and Development. 49 According to another national survey developed…”

Section: Discussionmentioning

confidence: 46%

Direct healthcare costs and their relationships with age at start of drug use and current pattern of use: a cross-sectional study

Becker

Razzouk

2021

Sao Paulo Med. J.

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The prevalence and incidence of drug use in Brazil have increased over recent years, and the age at the start of use has become much lower than in the past. 1,2 The Second Brazilian National Survey on Alcohol and Drugs (Levantamento Nacional de Álcool e Drogas, LENAD) showed that among adolescents aged 14 to 17 years, 4.3% were frequent users of cannabis in the past year, 2.3% were frequent users of cocaine, 0.8% frequently used crack and 60% had used alcohol before their 15 th birthday. 2 Additionally, Brazil is ranked as the second largest cocaine market in the world, and national consumption accounts for 20% of the world's cocaine market. 3,4 Early drug use during adolescence is deleterious for the brain maturation process 5,6 and has both short and long-term health consequences, 5-9 including cognitive impairment, 10 substance use disorder, 9 reduced educational and occupational attainment 7,8 and engagement in illicit activities. 11,12 In this regard, preventive programs have been widely implemented for reducing drug use among adolescents and, consequently, for avoiding economic and social costs. 13-15 The great economic impact of substance-related disorders on individuals and society was demonstrated through a study on the burden of diseases in Brazil. 16 This showed that, among the diseases that contributed most to disability-adjusted life years (DALYs) in this country, disorders relating to use of alcohol and other drugs jumped from third place in 1990 to first in 2016 among men, and from tenth to seventh among women, over the same period. Furthermore, substance-related disorders have been indicated to be one of the costliest health conditions for a healthcare system, 17-19 especially regarding hospitalization. 20 In Brazil, there is a lack of data on the costs according to different drug users' profiles, especially considering their relationship to age at the start of use. The long-term economic impact

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Section: Discussionmentioning

confidence: 46%

Direct healthcare costs and their relationships with age at start of drug use and current pattern of use: a cross-sectional study

Becker

Razzouk

2021

Sao Paulo Med. J.

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“…In Brazil, the process was initiated in 2013 in an attempt by the federal government to invest in the dissemination of the Unplugged prevention program in Brazilian schools. A cluster RCT conducted in 2014 and 2015 showed an iatrogenic result for initiation of alcohol use after 9 [23] and 21 months of follow‐up [22].…”

Section: Discussionmentioning

confidence: 99%

A cluster randomized controlled trial evaluating the effectiveness of the school‐based drug prevention program #Tamojunto2.0

et al. 2021

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Aims The study aimed to evaluate the effectiveness of the government school‐based program #Tamojunto2.0, the third Brazilian version of the European drug prevention program, Unplugged, in preventing the use of alcohol and other drugs. Design A parallel, two‐arm cluster randomized controlled trial was conducted in 205 classes in 73 public schools (37 intervention and 36 control) with a baseline assessment and follow‐up after 9 months. Setting Schools in the cities of São Paulo, Fortaleza and Eusebio in Brazil. Participants A total of 5208 students in the 8th grade with a mean age of 13.2 years (standard deviation = 0.8 years) and an equal gender ratio. Intervention In 2019, the intervention group attended 12 classes of the program #Tamojunto2.0, under the supervision of a team from the Ministry of Health. The control group did not receive any intervention to prevent alcohol and drug use. Measurements The primary outcome measured was prevalence of binge drinking (five or more doses of alcohol in an occasion) within the past month. Secondary outcomes were prevalence of initiation and use of alcohol, tobacco, inhalants, marijuana and cocaine within the past month. Findings A statistically significant difference was not found in the prevalence of binge drinking within the past month between intervention and control groups [odds ratio (OR) = 0.934; 95% confidence interval (CI) = 0.761–1.146]. However, students who were exposed to the program were less likely to initiate alcohol use than those in the control group (OR = 0.782; 95% CI = 0.636–0.961). The Bayes factor for reduction in binge drinking was 0.01, providing evidence in favor of the null hypothesis for this variable. Conclusions The drug prevention program #Tamojunto 2.0 reduced alcohol initiation, but appeared not to reduce past‐month binge drinking among 8th grade students in Brazil.

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“…In 2013, Brazil’s Ministry of Health adopted internationally developed evidence-based drug abuse preventive programs focused on the school environment [ 2 , 3 , 4 ] and the family environment [ 5 ], in response to the lack of effective and scalable national preventive programs [ 6 ]. The Strengthening Families Program (SFP 10–14), or Programa Famílias Fortes , as it is known in Brazil, originally developed at the University of Utah in the United States [ 7 ], was one of the programs selected due to previous studies indicating its long-term effectiveness [ 8 , 9 ] in various countries [ 10 , 11 , 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Barriers and Facilitators in the Strengthening Families Program (SFP 10–14) Implementation Process in Northeast Brazil: A Retrospective Qualitative Study

Abdala

Murta

Menezes

et al. 2020

IJERPH

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This study analyzed contextual barriers and facilitators in the implementation of Strengthening Families Program (SFP 10–14), Brazilian version, a family-based preventive program focused on the prevention of risk behaviors for adolescent health. SFP 10–14 was implemented between 2016 and 2017 for socioeconomically vulnerable families in four Northeast Brazilian states as a tool of the National Drug Policy. A retrospective qualitative study was carried out in which 26 implementation agents participated. Data from 16 individual interviews and two group interviews were analyzed through content analysis. The most recurrent barriers were the group facilitators’ working conditions, weak municipal administration, precarious infrastructure, inadequate group facilitator training methodologies, low adherence of managers and professionals, and funding scarcity. The conditions highlighted as favorable to the implementation were proper intersectoral coordination, engagement of involved actors, awareness of public agency administrators, municipal management efficacy, and efficient family recruitment strategies. Favorable political contexts, engagement of implementation agents, and intersectoral implementation strategies were identified as central to the success of the implementation of SFP 10–14, especially in the adoption of the intervention, community mobilization, and intervention delivery stages. Further studies should combine contexts, mechanisms, and results for a broad understanding of the effectiveness of this intervention in the public sector.

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Effectiveness evaluation of the school-based drug prevention program #Tamojunto in Brazil: 21-month follow-up of a randomized controlled trial

Cited by 33 publications

References 31 publications

Direct healthcare costs and their relationships with age at start of drug use and current pattern of use: a cross-sectional study

Direct healthcare costs and their relationships with age at start of drug use and current pattern of use: a cross-sectional study

A cluster randomized controlled trial evaluating the effectiveness of the school‐based drug prevention program #Tamojunto2.0

Barriers and Facilitators in the Strengthening Families Program (SFP 10–14) Implementation Process in Northeast Brazil: A Retrospective Qualitative Study

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