The sampling frame comprised all mainstream post-primary schools in NI (n= 208) and Glasgow/Inverclyde
(n= 36). All schools in the sampling frame were initially assessed for satisfaction of the inclusion criteria and willingness to participate in the trial. Schools in the Eastern Health Board of NI, which included the capital city Belfast, were excluded, as the classroom component, SHAHRP, was already being delivered to some schools in that area by a non-governmental organisation independently of the trial.
Male and female students attending mainstream secondary schools in NI and Glasgow/Inverclyde were included. Schools were randomised into the trial and baseline data were collected when pupils were in school year 8 or S1, and the intervention was delivered when pupils were in school year 9 or S2 in the
academic year 2012–13 and aged 12–13 years.
Pupils not in the specified school year and age group, and pupils in non-mainstream and vocational education (e.g. pupil referral units, further education colleges) were excluded. Pupils with special educational needs in mainstream classrooms were excluded at the discretion of teachers, as the intervention materials had not been developed for use with this population.
In each participating school, all students in attendance at the time of data collection were asked to complete the project questionnaires. Questionnaires were administered to participants at the baseline time point (T0) in June 2012 and at three follow-up points: T1, T2 and T3.
Intervention
Students in the intervention condition received the SHAHRP,55as previously adapted and tested for use
in NI.60The parent(s) or carer(s) of intervention condition students were also invited to receive a brief
intervention. All intervention pupil parents/carers, regardless of attendance at the parents’ evenings, were
mailed a follow-up information leaflet.
Phase 1 of the NI SHAHRP classroom curriculum consisted of six lessons (with 16 activities) delivered to students in school year 9 or S2 (aged at least 12 years) by trained teachers. Phase 2 consisted of four
lessons (with 10 activities) delivered in school year 10 or S3 (aged 13–14 years) by trained teachers.
Training sessions for teachers took place annually in a neutral location and included an introduction to the concepts involved in alcohol harm reduction, rehearsal of delivery of each of the sessions in that phase of delivery and raising of awareness of potentially difficult issues/areas. Teachers were trained by the STAMPP trial manager prior to phase 1, and by the STAMPP trial manager, STAMPP research assistant and an alcohol worker from a local third-sector organisation before phase 2. Phase 1 was delivered between September and December 2012 and phase 2 was delivered between September and December 2013. Curriculum activities incorporated various strategies for interactive dissemination including delivery of utility information, skill rehearsal, individual and small group decision-making, and discussions based on scenarios suggested by
students. There was a particular emphasis on identifying alcohol-related harms in specific scenario-based exercises (e.g. a night out) and specific discussions on strategies that might be employed to reduce harms. Phase 1 lessons broadly examined myths about alcohol, reasons why people drink or do not drink alcohol, alcohol and the body, the relationship between amount consumed and behavioural consequences, alcohol and the media, and real-life situations. Phase 2 lessons focused on more specific adolescent drinking behaviours, real-life scenarios or potential experiences while in an environment in which alcohol is consumed. These lessons specifically examined peer pressure, similarities and differences between males and females in a drinking context, drink spiking, responsibilities towards friends, grading of risk
environments or situations and peer advice around alcohol.
Interactive involvement was a key feature of the lessons, and a workbook and compact disc (CD)
accompanied both phases of the project, allowing for more active learning. Further details of the SHAHRP
curriculum used in this study can be found elsewhere.60However, an important difference between the
present study and that of McKay et al.60is that the pupils in the present study were 1 year younger at both
intervention stages. The targeting of younger pupils in the current trial (i.e. ages 12–13 years) was justified
on the basis of survey data suggesting that the median age of initiation of alcohol use was< 13 years.20,21
In addition, the intervention was only delivered by teachers in the current study, whereas in the earlier work, both teachers and external facilitators (youth workers) were used. Pupils in Scotland received the SHAHRP curriculum but, when necessary, the materials were further refined for the cultural context. For example, information that was provided about emergency services related to the Scottish Ambulance Service rather than the Police Service of Northern Ireland.
The classroom component of STAMPP differed from the original Australian SHAHRP curriculum in a
number of ways. The Australian programme was targeted at pupils aged≥ 13 years in phase 1
(as was the original NI adaptation of the SHAHRP described in Chapter 1, Introduction to the intervention components of Steps Towards Alcohol Misuse Prevention Programme), the curriculum was longer
(17 activities delivered in 8–10 lessons in phase 1, and 12 activities delivered over 5–7 weeks in phase 2)
and Australian reference data were used in the lessons.
The brief intervention delivered to the parent(s)/carer(s) of children in the intervention comprised a short, standardised presentation delivered by a team of trained facilitators (independent of the trial team) at specially arranged parent evenings on school premises. The presentation included an overview of the
CMO’s 2009 guidelines for drinking in childhood,65information on alcohol prevalence in young people
and corrected (under)estimates of youth drinking rates, and it highlighted the importance of setting strict family rules around alcohol, with the recognition that children often model their own alcohol use
behaviour on that of their parent(s)/carer(s). The presentation was followed by a brief discussion on setting
and implementing authoritative family rules on alcohol. All intervention pupils’ parent(s)/carer(s) were
followed up by a mailed leaflet (March 2014) that provided a summary of the key information delivered over the course of the evening. The delivery of the parental intervention coincided with phase 2 of the SHAHRP between September and December 2013.
The parental/carer activity was developed by the research team for this trial, and was partly based on the
Dutch adaptation of the Swedish Örebro Prevention Programme undertaken by Koning et al.64These
researchers delivered a brief intervention to parents on setting strict rules around alcohol in combination with a school-based alcohol curriculum (the Dutch Healthy School and Drugs programme). The parental component in STAMPP differed from the Dutch intervention in a number of ways. First, the Dutch activity was delivered at two annual parent evenings as part of general school discussions; second, the intervention was delivered by a member of the Dutch research team; third, the content of the presentations used Dutch data and was orientated towards challenging societal alcohol norms; and, fourth, attendees set their own family alcohol rules through discussion with a classroom learning mentor, whereas in STAMPP rules were
based on the CMO’s guidance.65Both approaches utilised a follow-up mailed information leaflet.
METHODS
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The control group participants continued with EAN within their school, which would include standard personal, social and health education but would not be uniform across all such schools. Parents/carers of control students received no intervention. Provision of alcohol use education as part of statutory education or usual school activities (and, therefore, not able to be experimentally manipulated) was monitored through information collected as part of an online teacher questionnaire (see Chapter 4, Online survey with teachers). Please refer to Appendix 1 for the logic models underpinning the intervention.