The CLIMATE schools combined study: a cluster randomised controlled trial of a universal Internet-based prevention program for youth substance misuse, depression and anxiety

Background: Anxiety, depressive and substance use disorders account for three quarters of the disability attributed to mental disorders and frequently co-occur. While programs for the prevention and reduction of symptoms associated with (i) substance use and (ii) mental health disorders exist, research is yet to determine if a combined approach is more effective. This paper describes the study protocol of a cluster randomised controlled trial to evaluate the effectiveness of the CLIMATE Schools Combined intervention, a universal approach to preventing substance use and mental health problems among adolescents. Methods/design: Participants will consist of approximately 8400 students aged 13 to 14-years-old from 84 secondary schools in New South Wales, Western Australia and Queensland, Australia. The schools will be cluster randomised to one of four groups; (i) CLIMATE Schools Combined intervention; (ii) CLIMATE Schools - Substance Use; (iii) CLIMATE Schools - Mental Health, or (iv) Control (Health and Physical Education as usual). The primary outcomes of the trial will be the uptake and harmful use of alcohol and other drugs, mental health symptomatology and anxiety, depression and substance use knowledge. Secondary outcomes include substance use related harms, self-efficacy to resist peer pressure, general disability, and truancy. The link between personality and substance use will also be examined.Discussion: Compared to students who receive the universal CLIMATE Schools - Substance Use, or CLIMATE Schools - Mental Health or the Control condition (who received usual Health and Physical Education), we expect students who receive the CLIMATE Schools Combined intervention to show greater delays to the initiation of substance use, reductions in substance use and mental health symptoms, and increased substance use and mental health knowledge

A Value-Based Approach to Smoking Prevention with Immigrants from Latin America

The article describes the findings of outcome and process evaluations of a value-based approach to smoking prevention. The program was conducted with a community of immigrants from Latin America living in Canada. The approach is based on participatory community planning, sensitivity to cultural diversity, and on a comprehensive philosophy of health. Qualitative and quantitative methods were used to assess outcomes and processes. Quantitative measures indicate that when compared to a control group, program children, ages 8 to 14, engaged in more community activism and showed a decrease in intentions to smoke; however, no difference was found in knowledge regarding tobacco use. The qualitative evaluation indicated that parents, children, and staff were highly satisfied with the impact of the program as well as with the processes employed to deliver it. Implications for improving the program and a value-based model for program development and evaluation are discussed