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Adolescent Substance Use Behavior Change Through School Intervention Is Improved by Teacher and School Implementation
Eric K Layland1,2, Linda L Caldwell3,4, Nilam Ram3,5
1The Pennsylvania State University, University Park, PA, USA. eric.layland@yale.edu.
Summary
Implementing both school and teacher support for the HealthWise South Africa intervention improved adolescent drinking and smoking behavior, especially for girls, over two years.
Area of Science:
- Public Health
- Adolescent Health
- Intervention Science
Background:
- The HealthWise South Africa intervention previously showed efficacy in preventing adolescent substance use.
- This study investigated how implementation support influenced behavior change in a subsequent trial.
Purpose of the Study:
- To examine the impact of different implementation support conditions on adolescent drinking and smoking behavior.
- To assess longitudinal changes in behavior across four support configurations and by gender.
Main Methods:
- A hybridized implementation-effectiveness trial involving 34 schools and 2175 students (Grades 8-10).
- Four implementation support conditions were tested: enhanced school environment, teacher consultation, both, and standard delivery.
- Configural frequency analysis was used to analyze longitudinal data.
Main Results:
- Schools receiving both support components showed sustained differences in smoking abstention and initiation compared to standard delivery, primarily in girls.
- For baseline drinkers/smokers in the 'both components' group, drinking changes were delayed until Grade 9 and smoking decreased by Grade 10.
- Combined school and teacher support synergistically improved outcomes immediately and two years post-intervention.
Conclusions:
- Multilevel implementation support strategies, combining school and teacher components, enhance intervention effectiveness for adolescent substance use prevention.
- Future interventions should consider such multilevel support for sustained positive outcomes.
- Further research is needed to optimize HealthWise effectiveness for adolescent boys.
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