COMMUNITY IN FOCUS: AN EVALUATION OF THE IMPLEMENTATION AND EFFECTS OF A COMMUNITY-BASED INTERVENTION FOR PREVENTING ALCOHOL USE AMONG ADOLESCENTS

• Grant number: 23/14565-1
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)
• Start date: December 01, 2023
• End date: May 31, 2027
• Field of knowledge: Health Sciences - Collective Health - Epidemiology
• Agreement: Global Alliance for Chronic Diseases (GACD)
• Principal Investigator: Zila van der Meer Sanchez Dutenhefner
• Grantee: Matheus de Carlos Silva Oliveira
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil
• Associated research grant: 22/03145-9 - Reducing alcohol use among adolescents through a community-based multicomponent intervention: an implementation research approach, AP.TEM

Abstract

Working to prevent alcohol consumption in adolescence is essential in reducing the overall burden of non-communicable chronic diseases. Epidemiological studies have shown that community-based interventions promote more consistent and long-term effects in reducing alcohol use among adolescents than isolated, one-time prevention programs. These strategies are typically multicomponent and generally consist of a school-based prevention program (for adolescents), a family program (for families), and integrated environmental strategies (for the community). Another key characteristic is that these interventions are conducted in a context where stakeholders play an active role in the implementation strategy and have a central role in all stages of the process. However, interventions of this complexity have never been tested in Brazil. Thus, implementing a multicomponent community-based intervention that can integrate programs already evaluated in Brazil (such as #Tamojunto2.0 and Famílias Fortes) with environmental strategies that have been effective in various countries is essential for reducing alcohol consumption among adolescents. An implementation research will be conducted with a hybrid design, considering the implementation-effectiveness dyad. The study will use a type 2 hybrid trial approach to evaluate the effect of the intervention to be developed based on the integration of data from a controlled trial and fidelity and adherence variables. Through the co-creation of the intervention and evaluation, results for the following indicators will be generated: readiness, suitability, acceptability, feasibility, fidelity, adoption, reach, and effectiveness in a real-life context. The implementation results will provide insights into the best way to implement the intervention, identify the factors and barriers that may affect implementation and its effects, and explore how to reach the target population and address possible differences in access, considering sociodemographic aspects. The proposal will involve two small municipalities (one for intervention and one for control) in the interior of the State of São Paulo, with the involvement of local stakeholders.