I mediatori dell’efficacia a breve termine del programma di prevenzione Unplugged

[Machine translation] Intro The study of the mechanisms of effectiveness through mediation analysis makes it possible to identify the intermediate factors responsible for the observed effects, and identifies the “targets” of the intervention that can most contribute to the preventive effect or to the reduction of behaviors to risk. Objectives Identify, through mediation analysis, the mediators of the effects of the Unplugged school program on tobacco use, episodes of drunkenness, and short-term use of cannabis. Methods Unplugged is a school program for the prevention of tobacco, alcohol and substance use among adolescents, based on the Social Influences model. It was evaluated in the trial randomized and controlled European eu-DAP, in which 7079 children from 143 schools in seven European countries (Italy, Greece, Spain, Austria, Germany, Belgium, Sweden) participated. The mediation analysis of the effects observed in the short term (3 months after the end of the program) was carried out through multilevel mediation models, separately for the three outcomes. Results Among the children who participated in the program, compared to the children in the control group, there was a statistically significant reduction in positive attitudes towards substances, positive beliefs about cigarettes, alcohol and cannabis, and the perception of the use of tobacco and cannabis among peers; there is also an increase statistically significant negative beliefs about tobacco, knowledge and ability to reject all substances. Positive attitudes towards substances, rejection skills, and the perception of peer use were found to mediate the effect of the program. Conclusions The results of this study confirm the theories that school programs based on Social Influences have their preventive effect by modifying the attitudes, the abilities of rejection and regulatory perception, and they identify these three factors as particularly important for the effectiveness of this type of program.