JMIR Publications

ABSTRACT

Background:

There are no available school-based alcohol and drug prevention programs with evidence of effectiveness among Aboriginal and Torres Strait Islander youth. To address this, we co-developed the Strong & Deadly Futures wellbeing and alcohol/drug prevention program in partnership with an Indigenous creative design agency, and four Australian schools.

Objective:

This paper presents the protocol to evaluate the effectiveness of Strong & Deadly Futures to reduce alcohol and other drug use, and improve wellbeing among Aboriginal and Torres Strait Islander youth.

Methods:

The target sample will be 960 Year 7 and/or 8 students from twenty-four secondary schools in Australia, of which approximately four in ten (n=384) identify as Aboriginal and/or Torres Strait Islander. A two-group, parallel cluster randomised controlled trial with allocation concealment. Recruited schools will be block randomised (ratio 1:1), stratified by geographical remoteness, by an independent statistician. Schools will be randomised to receive: i) Strong & Deadly Futures, a web-based alcohol and drug prevention and social and emotional wellbeing program, which delivers curriculum-aligned content over six lessons via an illustrated story, or ii) Health education as usual (control). Control schools will be supported to implement Strong & Deadly Futures following trial completion. Surveys at baseline, 6-weeks, 12-months and 24-months (primary endpoint) post-baseline. Primary outcomes are alcohol use (adapted from the National Drug Strategy Household Survey), tobacco use (Standard High School Youth Risk Behavior Survey), and psychological distress (Kessler-5 Psychological Distress Scale). Secondary outcomes are alcohol and drug knowledge and intentions, alcohol-related harms, binge drinking, cannabis use, wellbeing, empowerment, appreciation of cultural diversity and truancy.

Results:

The trial was funded by the National Health and Medical Research Council in Jan 2019, approved by the Human Research Ethics Committee of the University of Sydney (2020/039, Apr 2020), Aboriginal Health and Medical Research Council of New South Wales (1620/19, Feb 2020), Western Australian Aboriginal Health Ethics Committee (998, Oct 2021) and the ethics committees of each participating school including: the NSW Department of Education (2020170, Jun 2020), Catholic Education Western Australia (RP2020/39, Nov 2020), and QLD Department of Education (550/27/2390, Aug 2021). Projected dates of data collection are 2022-2024 and expected publishing of results in 2025. Twenty-four schools have been recruited as of submission of the manuscript.

Conclusions:

This will be the first cluster randomised controlled trial of a culturally-inclusive, school-based alcohol and drug prevention program for Aboriginal and Torres Strait Islander youth, and therefore has significant potential to address alcohol and other drug harms among Aboriginal and Torres Strait Islander youth. Clinical Trial: The trial has been prospectively registered with the Australian New Zealand Clinical Trials Registry (Registration number: ACTRN12620001038987, website: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380038&isReview=true)