Short-term effects of the strengthening families Program (SFP 10-14) in Brazil: a cluster randomized controlled trial.

INTRODUCTION: This study reports the evaluation of the short-term effects of the Strengthening Families Program (SFP 10-14), adapted as Famílias Fortes (Strong Families) in Brazil, on preventing adolescent drug use and improving parenting behaviors. METHODS: A two-arm, parallel cluster randomized controlled trial was conducted in 60 Social Assistance Reference Centers (SARC) from 12 Brazilian municipalities. In each city, the SARC were randomly assigned to the intervention or control group. A total of 805 families participated in the study, each contributing data from one parent or legal guardian and one adolescent totaling 1,610 participants. Data collection occurred before intervention implementation and 6 months after baseline collection. Data were analyzed using multilevel mixed-effects modeling with repeated measures in two different paradigms: Intention to Treat (ITT) and Per protocol (PP). The study was registered in the Brazilian Ministry of Health Register of Clinical Trials (REBEC), under protocol no. RBR-5hz9g6z. RESULTS: Considering the ITT paradigm, the program reduced the chance of parents and legal guardians being classified as negligent by 60% (95%CI 0.21; 0.78), increased the use of nonviolent discipline by caregivers (Coef 0.33, 95%CI 0.01; 0.64) and decreased the chance of adults exposing adolescents to their drunken episodes by 80% (95%CI 0.06; 0.54). No program effects were observed on outcomes related to adolescent drug use. Similar results were found for the PP paradigm. CONCLUSION: The positive effects on family outcomes suggest preventive potential of the program among the Brazilian population. Long-term evaluations are necessary to verify if the program can also achieve the drug use reduction goals not observed in the short term.

Mental health and behavioral problems associated with video game playing among Brazilian adolescents.

BACKGROUND: The problematic use of video games is linked to mental health and behavioral problems among adolescents. World reported averages for problematic use range from 1.3% to 19.3%. This is the first study to investigate these problems among Brazilian adolescents. OBJECTIVES: This study aimed to describe the prevalence of the non-problematic and problematic use of video games among Brazilian adolescents, and to assess mental health and behavioral problems associated with both types of use. METHODS: This study used the baseline data of a cluster randomized controlled trial that evaluated the effectiveness of the school-based program #Tamojunto2.0. The sample included 3,939 eighth-grade students who answered an anonymous self-report questionnaire. Video game use was investigated through a question, and problematic use was assessed using a scale. Weighted logistic regressions were used to investigate the associated factors. RESULTS: The results show that 85.85% of the children reported playing video games in the past year, 28.17% fulfilled our criteria for problematic use. Non-problematic video game use is associated with being male, younger ages, and bullying perpetration. Problematic video game use is associated with being male, tobacco and alcohol use, bullying perpetrators, and bullying victims, with abnormal levels of hyperactivity/inattention, social behavior problems, conduct problems, peer relationship problems, and emotional symptoms. CONCLUSION: Brazilian adolescents' self-reported use of video games is compatible with the world average, but the percentage of those who showed problematic use is higher than the world average. This study demonstrates the need for investigating how to prevent and intervene in this situation.

A cluster randomized controlled trial evaluating the effectiveness of the school-based drug prevention program #Tamojunto2.0.

AIMS: The study aimed to evaluate the effectiveness of the government school-based program #Tamojunto2.0, the third Brazilian version of the European drug prevention program, Unplugged, in preventing the use of alcohol and other drugs. DESIGN: A parallel, two-arm cluster randomized controlled trial was conducted in 205 classes in 73 public schools (37 intervention and 36 control) with a baseline assessment and follow-up after 9 months. SETTING: Schools in the cities of São Paulo, Fortaleza and Eusebio in Brazil. PARTICIPANTS: A total of 5208 students in the 8th grade with a mean age of 13.2 years (standard deviation = 0.8 years) and an equal gender ratio. INTERVENTION: In 2019, the intervention group attended 12 classes of the program #Tamojunto2.0, under the supervision of a team from the Ministry of Health. The control group did not receive any intervention to prevent alcohol and drug use. MEASUREMENTS: The primary outcome measured was prevalence of binge drinking (five or more doses of alcohol in an occasion) within the past month. Secondary outcomes were prevalence of initiation and use of alcohol, tobacco, inhalants, marijuana and cocaine within the past month. FINDINGS: A statistically significant difference was not found in the prevalence of binge drinking within the past month between intervention and control groups [odds ratio (OR) = 0.934; 95% confidence interval (CI) = 0.761-1.146]. However, students who were exposed to the program were less likely to initiate alcohol use than those in the control group (OR = 0.782; 95% CI = 0.636-0.961). The Bayes factor for reduction in binge drinking was 0.01, providing evidence in favor of the null hypothesis for this variable. CONCLUSIONS: The drug prevention program #Tamojunto 2.0 reduced alcohol initiation, but appeared not to reduce past-month binge drinking among 8th grade students in Brazil.