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Effective school-based preventive interventions for alcohol use in Africa: a systematic review
Authors:Sachi Tomokawa  Kimihiro Miyake  Takeshi Akiyama  Yuka Makino  Akihiro Nishio  Jun Kobayashi  Masamine Jimba  Irene Ayi  Sammy M Njenga  Takashi Asakura
Abstract:
BackgroundDespite recognition of the risks of alcohol use and importance of prevention from an early age, the effectiveness of school-based interventions in Africa has not been clarified.ObjectiveWe aimed to identify effective school-based alcohol use prevention interventions in Africa.MethodsWe searched eight databases for peer-reviewed articles published until February 3, 2019 that reported on randomized controlled trials, cluster randomized controlled trials, controlled clinical trials, pre-post quasi-experimental studies, cohort studies, and case-control studies. The full-texts of relevant studies were searched.ResultsFour of 2797 papers met our eligibility criteria. All reported interventions targeted secondary school students in South Africa and were incorporated in the school curriculum. The interventions comprised multi-component activities with participatory and peer educational methods, and applied modified programs originally developed in the US. However, intervention effects were inconsistent among studies, although the interventions tended to have a positive effect on non-drinkers at baseline, with stronger effects in girls.Conclusioninterventions had positive effects on students that were non-drinkers at baseline, especially girls. Although we could not find robust evidence that school-based interventions changed attitudes, frequency/quantity of drinking, and intentions to use alcohol, one intervention showed an increase in students'' alcohol refusal self-efficacy.
Keywords:School-based preventive interventions   alcohol use   Africa   systematic review
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