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					                      São Paulo State University
                      Campus of São José do Rio Preto




BRIEF INTERVENTION APPLIED BY TEACHERS
IN RISK-DRINKING ADOLESCENTS: 4-MONTH
               FOLLOW-UP

           6th International Conference of INEBRIA


                    Raul Aragão Martins



Funding:                  - São Paulo State Research Agency
Drug use is a vast and striking topic that has been
provoking debate and concern in practically all the
Brazilian society.

One of the most vulnerable segments of the population to
the use of psychoactive substances is of teenagers.

     This group is exposed to three types of problems.
 Social problems          Legal problems        Health problems
   Non-fulfillment of     Beer and cigarettes   associated with the
school assignments,        are prohibited to     early use of such
  the involvement in         children and          substances
 risky situations and         teenagers
   difficulty of family
         relations
Epidemiology of alcohol use among elementary and
            high school students in Brazil



Yearly usage ranging              Monthly usage of
   from 75-85%                      about 64%


Brazilian national survey on the use of drugs carried out
in the 107 biggest Brazilian cities:

           2001                           2005
 48.3% of teenagers have           7,0 % are already
  already used alcohol in              addicted
life and 5.2% are already
         addicted
                   Objectives


This research has as objective to train teachers in
service from a high school to indentify and apply
brief intervention to risk-drinking adolescents.


Results of initial screening and Brief Intervention
(DIMEFF et al., 1999).


Results of 4-months follow-up
          Training of the teachers team

Research local: a public high school situated in a city of São
Paulo state with 430.000 inhabitants (about 280 miles from
São Paulo city).

Teachers team: principal, vice-principal and seven teachers.

30 hours course taught by the research team (Topics:
epidemiology, alcohol use among adolescents, screening and
interview, and brief intervention);

Weekly meeting (two hours).

Teachers’ financial help: the teachers team received about US
$ 170 for month to participate in the research. This aid was
paid by the sponsor of the research.
                 Research Design

The research comprised four stages:
1) Training of the teachers team from the participant
   school;
2) Screening;
3) Brief intervention;
4) Four-month follow-up.

         Group 1                        Group 2
Students with AUDIT  8       It was sorted among all
score were classified as      students a general group
positive.                     with the same number of
                              the students of the group 1.
             Measures and Procedures

                         Measures
Screening: sociodemographic       Interview and four-month
variables, religion, AUDIT and    follow-up: sociodemographic
evaluation of family history on   variables,   assessment  of
alcoholic beverage abuse.         alcohol consumption.
                        Procedures
The intervention follows the procedure described in the book
BASICS - Brief Alcohol Screening and Intervention for College
Students. A Harm Reduction Approach (DIMEFF et al., 1999). The
student receives information on his/her intake pattern, the risks
and problems associated with alcohol use, and the student’s
alcoholic beverage intake rate is compared with the mean of the
students of the school he attends. After the interview, the student
takes with him/her a summary of the information received, as
well as tips and suggestions of moderation in alcohol
consumption.
                           Participants
Students enrolled in 2008                 N = 550 (100%)
Students of initial screening             N = 481 (87,5%)
Age mean (standard deviation)               16.37 (1.55)

% female gender                               49.5%
Interview
  Group 1 (Risky group)                     68 (14,2%)
  Group 2 (General group)                   71 (14,8%)
4 month follow-up
  Group 1 (Risky group)                     53 (77,9%)
  Group 2 (General group)                   64 (90,1%)
Socio economic level
   D + C2                                      13.4%
   C1                                          27.6%
   B2                                          37.2%
   B1                                          15.4%
   A1 + A2                                     6.5%
                         Screening results
Frequency and percentage of AUDIT scores by period, grade, gender, SEL and
religion


                                      0-7                   8 - 40
                                 f           %       f               %
 Period
    Morning                     292         88.8     37          11.2
    Evening                     120         80.0     21          20.0
 Grade
    1a                          152         87.4     22          12.6
    2a                          142         82.1     31          17.9
    3a                          118         89.4     14          10.6
 Gender
    Female                      213         89.9     24          10.1
    Male                        199         82.2     43          17.8
 Socio-econonic level
    D + CE                       59         95.2     3           4.8
    C1                          113         86.3     18          13.7
    B2                          158         89.3     19          10.7
    B1                           54         73.0     20          27.0
    A1 + A2                      24         77.4     7           22.6
 Religion
    Catholics                   198         83.9     38          16.1
    Evangelicals                114         92.7     9           7.3
    Others                       21         77.8     6           22.2
    None                         79         84.9     14          15.1
                            Screening results
Frequency and percentage of Amount of doses, Frequency and Binge drinking
(last month)


 Amount of doses
                    No drinking         Drinking 1 to 4 doses   Drinking 5 or more
                                                                       doses
                    f              %        f           %          f          %
 Audit
  0 to 7 score     275           66.7     116          28.2       21           5.1
  8 to 40 score     7            10.4     19           28.4       41          61.2

 Frequency
                    No drinking          Drinking up to 3x      Drinking weekly or
                                              month                    more
                    f              %       f          %            f         %
 Audit
  0 to 7 score     281           68.2     113          27.4       18           4.4
  8 to 40 score     7            10.4     28           4148       32          47.8

 Binge drinking
                         Avarege                 SD                      P
 Audit                                                                 .005
  0 to 7 score            1.95                  1.46
  8 to 40 score           3.91                  2.28
             4-month follow-up results
 Comparisons between Groups 1 and 2




                         Amount of doses
Time: p = .002;
Time X Group: p = .042
             4-month follow-up results
 Comparisons between Groups 1 and 2




                         Frequency
Time: p = .887;
Time X Group: p = .441
             4-month follow-up results
 Comparisons between Groups 1 and 2




                         Binge drinking
Time: p = .356;
Time X Group: p = .424
             4-month follow-up results
 Comparisons between Groups 1 and 2




                         Audit score
Time: p = .001;
Time X Group: p = .002
                       Discussion

The results for the “Amount of doses” and “Audit score” show
significant effect for the interaction time per group in the
comparison between Group 1, which received intervention, and
Group 2, the control.
We can interpret these results as they maintain the frequency of
drinking but in these occasions they drink less.
The risky group maintain the binge drinking. We need to explore
more these behavior.

These results altogether suggest a good effect for BASICS Brief
Intervention (DIMEFF et al., 1999) in the format applied, which
was developed for college students.

AUDIT is deemed to be appropriate for the screening process
among high school students.
                    Research team

Raul Aragão Martins
Luciana Ap. Nogueira da Cruz
Izabella Alvarenga Silva
Antonio José Manzatto
Patrícia S. Teixeira
Teachers team from the participant school


UNESP - São Paulo State University
Campus of São José do Rio Preto
São Paulo, Brazil
e-mail: raul@ibilce.unesp.br
Phone: 55 17 3221 2317

				
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