Efektívnosť a kvalita implementácie školského programu prevencie užívania návykových látok v kontexte líderstva v škole
Authors: Orosová Oľga , Majdanová Marcela 
Published: May 2022

Monitoring the effectiveness and quality of implementing data‑based prevention interventions in real life is a challenge for researchers, teachers and leaders of these programs alike. Qualitative implementation indicators of school‑based drug preventio programs are related to the extent to which teachers are prepared to serve as program leaders for their pupils during the implementation phase, how ready they are to cooperate with the school community and reach the goals of prevention programs with the support of their schools. Furthermore, exploration of program implementation fidelity focused on the leadership of the teachers would allow greater insight into the successes and failures of reaching the goals of the respective prevention programs. The aim of this study was to explore the effectiveness of the Unplugged program and quality of its implementation (exposure, sensitivity) on smoking as reported by school children. This was analysed immediately after implementing the program within a Solomon four group design. A school randomized control trial using the Unplugged pro‑ gram was carried out among schoolchildren at 24 primary schools. Twelve schools were assigned to the experimental group (EG, n = 798, n = 401EG no pre‑test, n = 397EG pre‑test) while another 12 schools were assigned to the control group (CG, n = 622, n = 298CG no pre‑test, n = 333CG pre‑test). The mean age of the schoolchildren was 13.5 years, SD = 0.59; 47.5 % girls. The sample consisted of 1420 schoolchildren in total. The data collection was carried out im‑ mediately before implementing the program (experimental and control group with a pre‑test) and then in all the groups immediately after implementation. The consumption of alcohol and smoking during the last 30 days (Hibbel et al., 2012) was dichotomized for the purposes of a binary logistic regression in the analysis. Exposure was measured by the attendance of the program lessons (there were 12 lessons in total). Sensitivity (experience of school children with the program) was assessed by the scale YES 2.0 (Youth experience survey; Hansen & Larson, 2005) which was adapted for the purposes of this study (Štefaňáková, 2020). The results have not supported a direct effect of the Unplugged program on smoking among schoolchildren. However, the results have shown a moderated effect of alcohol use on smoking. 30.8 % of schoolchildren in the control group and 19.6 % of schoolchildren in the experimental group reported both smoking and alcohol use immediately after implementing the program. Alcohol use increased the chance of smoking by 15 times. The effect of a pre‑test on smoking was statistically significant and the inverted value of OR showed a double increase in the probability of smoking when the groups without and with a pre‑test were compared. The effect of the Unplugged program on smoking in schoolchildren was not found to be moderated by the pre‑test. A lower level of exposure increased the probability of reported smoking immediately after implementing the program. Finally, an effect was found regarding a higher level of novelty seeking on the probability of smoking among the schoolchildren who had taken part in the Unplugged program. The results support the importance of considering the co‑occurrence of smoking and alcohol consumption. They further bring attention to the importance of exposure to prevention activities in relation to program effectiveness as well as the importance of the effect of a pre‑test. The findings further show that the dimension of novelty seeking is a great challenge for teachers in the context of drug use prevention programs and that it is important to support this dimension in aprotective manner. Finally, an evaluation of the effectiveness of prevention programs carried out in schools which focuses on fidelity, quality of implementation and teachers’ leadership, clarifies and refines the requirements for school administrations regarding the personal and organizational support needed for prevention activities.