The social impact of Life Education: estimating drug use prevalence among Victorian primary school students and the statewide effect of the Life Education programme.
Evaluations of drug education programmes focus on the effect on participating students. Although this is appropriate, where programmes are institutionalized the wider population impact should also be considered. This paper examines this argument and provides a practical methodology for examining programme impacts on populations. It illustrates this using the example of the Life Education (LE) programme-a mature early intervention programme operating internationally-on the Victorian (Australia) population of Year 6 schoolchildren. Data from a recent evaluation of Life Education in Victoria, Australia, were re-analysed enabling estimation of adjusted attributable risk percentage (which provide an estimate of programme effect among those who are exposed to it), population prevalence estimates and population attributable risk percentage (which provide estimates of programme impacts on the entire population). In 1992 when the data were collected LE operated in 43% of all Victorian primary schools. The findings showed that within LE-schools 43% of girls' and 35% of boys' recent smoking was attributable to participation in the LE-programme. For drinking within LE-schools, while there was no apparent effect on girls, the programme was associated with 40% of boys' recent drinking. When the data were extrapolated to the state-wide smoking and drinking estimates, these showed that of all smoking among Year 6 schoolchildren, 25% of girls' and 19% of boys' smoking could be attributed to participation in Life Education, as could 22% of all boys' recent drinking. This re-analysis showed there was no preventive effect associated with the programme, at either the school or the population level. The findings suggest that intervention programmes should be thoroughly evaluated prior to widespread implementation, and that such evaluations should include reference to the community-wide impacts of such programmes.
Hawthorne
G
G
Centre for Health Program Evaluation, University of Melbourne, Australia.
D000293:Adolescent; D000437:Alcoholism / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015994:Incidence; D008297:Male; D012307:Risk Factors; D012931:Social Environment; D012951:Socialization; D013334:Students / Q000523:psychology / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology