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Preventing Adolescent Substance Use Through an Evidence-Based Program: Effects of the Italian Adaptation of Life Skills Training

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Evidence-based preventive interventions for adolescent substance use, violence, and mental health issues are increasingly being adapted and disseminated internationally. In the present paper, we report the results of an effectiveness study that was part of a comprehensive initiative by a coalition of health promotion organizations in the Lombardy region of Italy to select, culturally adapt, implement, evaluate, and sustain an evidence-based drug abuse prevention program developed in the USA. Findings are presented from a large-scale effectiveness study of the Life Skills Training prevention program among over 3000 students attending 55 middle schools in Italy. The prevention program taught drug refusal skills, antidrug norms, personal self-management skills, and general social skills. Relative to comparison group students, students who received the prevention program were less likely to initiate smoking at the post-test and 2-year follow-up, and less likely to initiate weekly drunkenness at the 1-year follow-up. The program had direct positive effects on several cognitive, attitudinal, and skill variables believed to play a protective role in adolescent substance use. The findings from this study show that a drug abuse prevention program originally designed for adolescents in the USA is effective in a sample of Italian youth when a rigorous and systematic approach to cultural adaptation is followed that incorporates the input of multiple stakeholders.

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The authors want to thank all health professionals and teachers who have been involved in the project and who make it possible. A special thanks to Alayne MacArthur for her support and feedback.

Gruppo LST Lombardia is made up of the regional staff of the project and the representatives of each organization involved:

Regional staff: Corrado Celata, Veronica Velasco, Mariella Antichi, Francesca Mercuri, Elena Paganini, Sandro Brasca, Elena Giovanetti, and Riccardo Valenti

Health Units and Regional Network for Addiction Prevention representatives: Luca Biffi, Margherita Marella, Walter De Agostini, Leone Lisè, Carlo Pellegrini, Celeste Zagheno, Valter Drusetta, Paola Duregon, Alessandra Meconi, Ornella Perego, Elisabetta Mauri, Valentina Salinetti, Laura Randazzo, Manuel Benedusi, and Marina Salada

Health Units local managers: Barbara Lamera, Stefania Vizzardi, Lisa Impagliazzo, Adelia Corbani, Rosa Pancera, Sandro Brasca, Elena Bertolini, and Sandra Lunari

Regional School Department: Bruna Baggio

Local School Departments: Antonella Giannellini, Federica Di Cosimo, Laura Peruzzo, Tullia Guerrini Rocco, Jessica Sala, Claudia Zoppi, Barbara Artioli, Laura Stampini, Giulia Fontana, Emanuela Farina, Daniela Marchesi, Linda Casalini

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Correspondence to Veronica Velasco.

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The project was funded and supported by the Lombardy Region. The project was managed by the Regional Observatory on Drug Addiction (OReD) in collaboration with the Health Units and the Schools Department of the Region.

Conflict of Interest

Dr. Botvin has a financial interest in the Life Skills Training (LST) program and he is the president of National Health Promotion Associates (NHPA), which provides teacher training and technical assistance for LST. Dr. Griffin is a senior research scientist with NHPA. Other authors declare that they have no conflict of interest.

Ethical Approval

The project and all activities were approved by the Regional Educational Authority of the National Ministry of Education, Universities and Research, which monitors and approves local policies, research projects, and initiatives in Lombardy. Moreover, each school principal consented to participate in the study and the project was approved by school collective bodies which are tasked with monitoring and approving activity and research in each school. Finally, the assessment was managed by health professionals of the public Health System and by teachers in accordance with their professional ethics. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

The procedure for research at school defined by the Italian Data Protection Authority (2016) was followed. Informed consent was obtained from all school principals and school collective bodies. Each school decided on whether to use active or passive parental consent procedures in accordance with their own autonomous policies. The confidential nature of the survey was preserved and students could refuse to participate to the study at any time.

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Velasco, V., Griffin, K.W., Botvin, G.J. et al. Preventing Adolescent Substance Use Through an Evidence-Based Program: Effects of the Italian Adaptation of Life Skills Training. Prev Sci 18, 394–405 (2017).

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