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Abstract
Alcohol and cannabis are the two most commonly used licit and illicit drugs in most developing countries including Australia. The burden of disease, social costs and harms associated with the use of these drugs is considerable. As such, the need for prevention is clear. Although an array of school-based drug prevention programs exist, the majority of these show minimal effects in reducing actual drug use. The most common impediments to their success concern obstacles to implementation and dissemination of programs, and a lack of sequential and developmentally appropriate messages.
The aim of this thesis was to address these limitations by developing and evaluating an integrated school-based prevention program to reduce alcohol and cannabis use. The innovative program known as the Climate Schools: Alcohol and Cannabis Course is founded on current evidence-based research, adopts a harm-minimisation approach to drug prevention and is embedded within the school health curriculum. The core content of the program is delivered over the internet using novel cartoon storylines to engage students.
The early development of the course consisted of a cross-validation trial to test the feasibility and generalisability of an existing Climate Schools program for alcohol prevention. Extensive collaboration with teachers, students and health professionals was later conducted to extend and modify the Climate Schools framework to include the prevention of cannabis use. To date, this is the first time an internet-based harm-minimisation cannabis prevention program has been developed for use in schools.
To establish the efficacy of the comprehensive Climate Schools: Alcohol and Cannabis Course, a cluster randomised controlled trial was conducted with 10 schools in Sydney (n = 764). Results from this trial demonstrated the innovative course to be effective in increasing knowledge regarding alcohol and cannabis use, and in decreasing the use of these drugs six months following the intervention.
This novel approach was found to be acceptable to students and teachers as a means of delivering drug education in schools. This thesis provides support for the more widespread dissemination of the Climate Schools model in schools. The barriers to dissemination require further research and are discussed.