THE EFFECTIVENESS OF A COMMUNITY- DRIVEN PREVENTION PROGRAM OF SUBSTANCE USE IN ADOLESCENTS: 5 YEARS FOLLOW-UP

Background and Aim : Adolescents substance use constitutes a growing health problem for most of societies in the world and also in Iran. As such, a single targeted approach to preventing substance use in a community is unlikely to be sufficient, the primary focus of this article is on an innovative, comprehensive, community-driven prevention intervention based on MAPP model as a frame work and social cognitive theory as a strategic plan for behavioral changes.Methods : To evaluate the effectiveness of the developed community-driven substance use prevention program after 5 years in two counties participated in the study; 140 adolescents (70 adolescents from Ghahjavarestn as an intervention group and 70 adolescents from Gavart as a control group) were filled our questioners in may2019 for the fifth times. This protocol was implemented in, 6 distinct phases. The goal of the first and second phase was to organize the program and increase stakeholder’s participation and to determine the vision of the program, respectively. The Third phase provided a comprehensive picture of a community by four assessments. The Fourth and Fifth phases identified strategies for the program based on social cognitive theory and the Sixth phase dealt with the action cycle. Results : All of the constructs included knowledge, outcome expectancies, self-efficacy and perceived social support had significant changes in the intervention group compared with the control group after 5 years (p<0.001). Persisting beneficial program effects were also found for cigarette after 5 years (p<0.001, F=9.9, ES=0.15). Of course, it should be noted that this difference was more due to the increase in the number of smokers in the control group than to the decrease of smoker in the intervention group. Baseline non-smokers that participated in the program progressed in tobacco consumption to a lower extent than those in the control condition, but no significant difference was detected in the proportion of quitters or reducers among baseline daily smokers and there wasn’t any significant different in alcohol and other drug use between two groups.Conclusion : The experimental evaluation of the community driven prevention program in adolescents indicated persistent positive effects over 5 years by preventing of emergence of new substance users in the intervention group in comparison with control group.