title: The #Tamojunto Drug Prevention Program in Brazilian Schools: a Randomized Controlled Trial.
abstract: A randomized controlled trial was conducted in 2014 with 7th and 8th grade students from 72 public schools in 6 Brazilian cities. This trial aimed to evaluate the effects of an adapted European school-based drug prevention program Unplugged, called #Tamojunto in Brazil, which was implemented by the Ministry of Health as part of public policy. The experimental group (n = 3340) attended 12 classes in the #Tamojunto program, and the control group (n = 3318) did not receive a school prevention program. Baseline data were collected prior to program implementation, and follow-up data were collected 9 months later, allowing a matching of 4213 adolescents in both waves. The substances examined were alcohol, tobacco, marijuana, inhalants, cocaine, and crack. Multilevel analyses were used to evaluate the changes in consumption of each drug between time points and between groups. The intervention and control groups had similar baseline characteristics. The mean age of the adolescents was 12.5 ± 0.7 years, and 51.3% were female. The program seemed to increase alcohol use initiation (first alcohol use); students in the experimental group had a 30% increased risk of initiating alcohol use during the 9-month follow-up (aRR = 1.30, 95% confidence interval (95%CI) 1.13-1.49, p < 0.001) compared to the control group. The opposite was found for the first inhalant use: the risk of using inhalants for the first time after baseline was lower in the experimental group (aRR = 0.78, 95%CI 0.63-0.96, p = 0.021) than the control group. The results of the #Tamojunto program suggest that the content and lessons regarding alcohol may enhance curiosity about its use among adolescents. We suggest a re-evaluation of the expansion of the #Tamojunto program in schools while analyzing why the program's effects were inconsistent with those of previous European studies.
authors.affiliation: Department of Preventive Medicine, Section of Epidemiology, Universidade Federal de São Paulo, Rua Botucatu, 740, 4th floor, São Paulo, SP, 04023-900, Brazil. zila.sanchez@unifesp.br.
authors.forename: Zila M
authors.initials: ZM
authors.lastname: Sanchez
authors.affiliation: Department of Preventive Medicine, Section of Epidemiology, Universidade Federal de São Paulo, Rua Botucatu, 740, 4th floor, São Paulo, SP, 04023-900, Brazil.
authors.forename: Juliana Y
authors.initials: JY
authors.lastname: Valente
authors.affiliation: Department of Preventive Medicine, Section of Biostatistics, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Adriana
authors.initials: A
authors.lastname: Sanudo
authors.affiliation: Department of Preventive Medicine, Section of Epidemiology, Universidade Federal de São Paulo, Rua Botucatu, 740, 4th floor, São Paulo, SP, 04023-900, Brazil.
authors.forename: Ana Paula D
authors.initials: APD
authors.lastname: Pereira
authors.affiliation: Department of Preventive Medicine, Section of Epidemiology, Universidade Federal de São Paulo, Rua Botucatu, 740, 4th floor, São Paulo, SP, 04023-900, Brazil.
authors.forename: Joselaine I
authors.initials: JI
authors.lastname: Cruz
authors.affiliation: Department of Psychology, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil.
authors.forename: Daniela
authors.initials: D
authors.lastname: Schneider
authors.affiliation: Department of Preventive Medicine, Section of Biostatistics, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Solange
authors.initials: S
authors.lastname: Andreoni
mesh_terms: D000293:Adolescent; D001938:Brazil; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D011314:Preventive Health Services / Q000458:organization & administration*; D012572:School Health Services / Q000458:organization & administration*; D012574:Schools; D019966:Substance-Related Disorders / Q000517:prevention & control*
keywords: Adolescents; Drugs; Intervention; Prevention; School