Il programma di prevenzione Unplugged riduce le diseguaglianze nella salute?

[Machine translation] Objectives: Evaluate whether the Unplugged school program for the prevention of tobacco, alcohol and substance use among adolescents reduces health inequalities Methods: Unplugged is a school program for the prevention of tobacco, alcohol, and substance use among teenagers. It was evaluated through a randomized, controlled trial in the European eu-DAP project, and its effectiveness in preventing the initiation of use has been amply demonstrated. The application model of the program involves the training of the operators of the Prevention Departments or SERTs, who become Unplugged trainers and in turn train the teachers of the schools in their territory to apply the program. To assess whether the program has an effect of reducing inequalities, the program's effectiveness analyses, conducted through adjusted multilevel models, have been stratified by a variable of the socio-economic status of the school to which the children belong. Results: Due to the cascading nature of the process, an effect of selecting schools and teachers is possible, and this can even generate health inequalities. However, analyses stratified by socio-economic level of the school to which they belong show that the program has a greater potential for effectiveness on children from schools with the lowest socio-economic level. Students from schools with low socioeconomic status reported episodes of drunkenness more frequently at the baseline. Program participation among children with low socioeconomic status is associated with a reduced risk of getting drunk in the 30 days prior to the administration of the follow-up questionnaire (OR = 0.60, 95% CI = 0.44-0.83). Conclusions: By implementing measures to limit the selection of schools participating in the program, or by selecting schools with a disadvantaged socio-economic level, the potential for generating inequalities of the Unplugged program is eliminated. The program also has a greater effect on the most disadvantaged children and can therefore reduce health inequalities.