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Randomized Controlled Trial
. 2025 Jan 28;25(1):349.
doi: 10.1186/s12889-025-21493-1.

A randomised controlled implementation trial of the feasibility and effectiveness of school staff delivery of a selective substance use and mental health program during the COVID-19 pandemic

Lucinda Grummitt  1 , Kirsty Rowlinson  2 , Joanne Cassar  2 , Chloe Conroy  2 , Louise Birrell  2 , Lexine Stapinski  2 , Emma Louise Barrett  2 , Julia Macauley  2 , Maree Teesson  2 , Nicola C Newton #  2 , Erin V Kelly #  2
Affiliations
Randomized Controlled Trial

A randomised controlled implementation trial of the feasibility and effectiveness of school staff delivery of a selective substance use and mental health program during the COVID-19 pandemic

Lucinda Grummitt et al. BMC Public Health. .

Abstract

Background: Preventure is a selective school-based personality-targeted program that has shown long-term benefits in preventing student alcohol use, internalising and externalising problems when delivered by psychologists. In this first Australian randomised controlled trial of school staff implementation of Preventure, we aimed to examine i) acceptability, feasibility, and fidelity and ii) effectiveness of Preventure on student alcohol use, internalising, and externalising symptoms.

Methods: A cluster-randomised controlled implementation trial was conducted in Sydney, Australia and was guided by the RE-AIM framework (Glasgow et al. 1999); which measures reach, effectiveness, adoption, implementation, and maintenance. Schools were randomly assigned to either the Preventure intervention or active control (health education as usual). Nominated school staff from intervention schools received training and delivered the program to students with elevated scores on one of four personality types targeted in the program. School staff completed surveys on RE-AIM measures, which were analysed using descriptive statistics and thematic analysis. Students completed surveys at baseline and six months post-intervention; mixed-effects regression examined intervention by time interactions on alcohol use, internalising and externalising problems, at six-month follow-up. The study was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12620000790943, registration date 6 August 2020).

Results: 553 students across 8 schools participated in the baseline survey. Of these, 40% had elevated scores on one of the four personality profiles, resulting in 220 students in the current study (102 students in intervention schools, 118 students in control schools; mean age 13.6, 45.7% female). Most RE-AIM domains showed high ratings, with school staff showing good adherence and confidence in delivery. However, teachers reported difficulties with feasibility, particularly a lack of time. Student outcomes: There were significant improvements in depression and conduct problems across both intervention and control across time. There were no significant main or interaction effects of the intervention on student alcohol use, internalising, or externalising problems.

Discussion: Teachers and students rated the program highly. However, concerns around feasibility may limit teacher-led application of the program in the Australian context. Alternative approaches, such as delivery by dedicated personnel within schools without a teaching load, may be critical in implementing such evidence-based interventions at scale.

Trial registration: The study was prospectively registered with the Australian New Zealand Clinical Trials Registry, registration number: ACTRN12620000790943, registration date: 6 August 2020.

Keywords: Alcohol use; Implementation; Mental health; Personality; Prevention; Randomised controlled trial; School; Selective.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: In accordance with the Declaration of Helsinki and Australian National Statement on Ethical Conduct in Human Research, ethical approval was obtained from the University of Sydney Human Research Ethics Committee (2019/792), and the approval body for New South Wales (NSW) public (state) schools (State Education Research Applications Process). Parents provided opt-out consent, and all students provided active informed consent. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Legend: * Did not respond, declined to participate, or were ineligible given study inclusion criteria. † Did not begin survey
See this image and copyright information in PMC

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