Il programma di prevenzione scolastica “Unplugged” in Nigeria: lo studio di valutazione

[Machine translation] Introduction. Unplugged is a school program for the prevention of tobacco, alcohol and substance use developed and evaluated in Europe in the eu-DAP (European Drug addiction prevention trial) study. It has been adopted by schools in many countries around the world because of its proven effectiveness in reducing the use of tobacco and cannabis and episodes of drunkenness in adolescents between 12 and 14 years old. In 2015, it was included in a project coordinated by the UNODC and funded by the European Union to promote healthy lifestyles in schools, families and communities in Nigeria. Objectives. The study aims to evaluate the effectiveness of the program in Nigeria, through a randomized cluster trial. Methods. The project stems from the collaboration between the United Nations Office for Drug Control and Crime Prevention in Nigeria (UNODC), the Federal Ministry of Education, the National Agency for Drug Law Enforcement (NDLEA) and the National Food and Drug Administration (FDA). For the evaluation study, a necessary sample size of 1943 children per group (total 3886) was estimated, corresponding to 14 schools in the intervention arm and 14 in the control arm, assuming an alpha error of 0.05 (two tails), power 80%, prevalence in the control arm 14.6% and in the intervention arm 10.2%, 45 students per class, intraclass correlation coefficient 0.025. However, it was decided to randomize 16 schools (total 32 schools) to the intervention and control group to limit the risk of reducing the sample due to the non-participation of a part of the schools. The pilot phase was conducted in 5 schools in the spring of 2015. Results. The Federal Ministry of Education has provided a list of 60 federal schools distributed in 7 areas of the country: 12 in the North-Central zone, 8 in the North-East, 10 in the North-West, 6 in the Southeast, 10 in the South-South, 11 in the South-West, 3 in the Territory of the Federal Capital. The randomization was carried out centrally by the Epidemiological Observatory of Addiction, stratifying by area and taking into account the number of inhabitants: 4 schools in the North-Central area, 4 in the North-East, 6 in the North-West, 4 in the Southeast, 4 in the South-South, 8 in the South-West (including 2 in Lagos), 2 in the Federal Capital Territory. The first questionnaire was administered between November 2015 and January 2016 to 4075 children. The follow-up questionnaire will be administered between June and July 2016. For each school, three classes participated. Conclusions. This is the first large-scale experimental study conducted in Nigeria to evaluate the effectiveness of a school prevention program. There are many cultural, political and geographical critical issues, however, the institutions involved in the project have enthusiastically welcomed the opportunity and collaborated since the pilot phase. With these premises, good results are expected from the project.