School Health and Alcohol Harm Reduction Project (SHAHRP)/Steps Towards Alcohol Misuse Prevention Programme (STAMPP) - life skills training to reduce alcohol use and harms
At a glance
Country of origin
- United Kingdom
The School Health and Alcohol Harm Reduction Project (SHAHRP) aims to decrease the harmful consequences of drinking, rather than advocating abstinence. It uses education, skills training, small-group decision making, and discussion and activities to encourage positive behavioural change as a result of a better understanding of the negative outcomes of drinking. It is delivered in two phases, over two academic years, in classrooms. The first phase consists of six sessions (16 activities) and is delivered in year 10 (ages 13-14); the second is delivered in year 11 and consists of four sessions (10 activities). It can be delivered by trained teachers or outside facilitators such as community-based drug and alcohol workers.
Keywords
No dataLinks to this programme in other registries
Implementation Experiences
Read the experiences of people who have implemented this programme.Contact details
Dr Michael Thomas McKay
School of Psychology, University of Liverpool, United Kingdom
Email: Michael.McKay[a]liverpool.ac.uk
Overview of results from the European studies
Studies overview
The SHAHRP programme has been evaluated in one quasi-experimental study in Northern Ireland, UK, involving children aged 13-15 years. At post-test, there were statistically significant effects favouring the intervention on alcohol consumption and self-reported alcohol-related knowledge, attitude and harm.
The British multi-level growth modelling analysis, secondary analysis of the data from non-randomised controlled trial of SHAHRP (2014) showed the differential impact of a programme on adolescents with different alcohol use experiences. The study involved school children aged 13 to 16 years old. The results showed that there were significant positive changes in knowledge about and attitudes towards alcohol in baseline abstainers, supervised drinkers and unsupervised drinkers. Significant behavioural effects in terms of amounts consumed, frequency of drinking and self-reported alcohol related harms were observed most exclusively among baseline unsupervised drinkers. These behavioural effects support those previously observed in Australia and suggest that the intervention is a viable health promotion tool in the United Kingdom.
McKay et al 2018: A cluster randomised controlled trial assessed the effectiveness of the STAMPP classroom curriculum and parental intervention (STAMPP) in reducing self-reported heavy episodic drinking and alcohol-related harms in adolescents. It was conducted among 105 high schools in Northern Ireland and in Scotland. The students were ages 11-12 years at baseline. The Intervention group received a classroom-based education intervention with a brief alcohol intervention for parents/carers, and the control group received education as normal. The results were available at 12 months and 33 months. Fewer students in the intervention group reported heavy episodic drinking (17% versus 26%), however there was no significant difference in the number of self-reported alcohol related harms. The uptake of the parental component had a low participation rate.
Cole et al. 2021: A follow-up study of the STAMPP trial (Sumnall et al. 2017; McKay et al. 2018) was conducted among 5029 of the initial 12739 students included in the sample. The retention rate in this 54 months follow-up of students was low (36%) due to the termination of mandatory education before the follow-up was conducted. There are no parent reported outcomes provided. No significant differences in heavy episodic drinking were detected between the control and intervention groups 54 months after baseline. The study concludes that STAMPP is an effective short-term intervention. Nevertheless, it should be extended across the lifetime of school life, either by means of further structured lessons or booster sessions. Moreover, the hypothesis of the ‘delayed’ effect on alcohol-related harms (formulated in McKay et al 2017) was not supported in this study.
Padgett et al. 2021: A secondary analysis used multinomial logistic regression in the STAMPP sample (Sumnall et al. 2017; MacKay et al. 2018) to subdivide participants into 5 trajectory classes labelled low, late onset, early onset, delayed onset and unstable concerning heavy episodic drinking and alcohol-related harm. Extracted classes were related to school intervention participation. The intervention was not statistically significant to any of the determined classes. The only exception was with classes constructed with alcohol related harm only, the ‘delayed onset’ class (only 7% of the complete sample) was significantly related to the intervention. It was not possible within this study to disentangle the effect on student outcomes of parental participation in the intervention. These results support the finding in both the studies of Cole et al. 2021 and McKay et al. 2018.
Countries where evaluated
- United Kingdom
Characteristics
Protective factor(s) addressed
- Individual and peers: clear morals and standards of behaviour
- Individual and peers: refusal skills and decision making
Risk factor(s) addressed
- Individual and peers: favourable attitude towards alcohol/drug use
Outcomes targeted
- Alcohol use
- Use of illicit drugs
Description of programme
The School Health and Alcohol Harm Reduction Project (SHAHRP) adopts a harm reduction approach, that is, it aims to decrease the harmful consequences of drinking, rather than advocating abstinence. It uses education, skills training, small-group decision making, and discussion and activities to encourage positive behavioural change as a result of a better understanding of the negative outcomes of drinking. The programme rationale is that social competence, problem-solving, autonomy and a sense of purpose are key attributes of resilience which in turn reinforces the importance of interactive and applied learning strategies.
There is an emphasis on identifying alcohol-related harms in specific scenarios (e.g. a night out) and discussions on strategies to reduce harm. It is conducted in two phases, over two academic years, in classrooms. The first phase consists of six sessions (16 activities) and is delivered in year 10 (ages 13-14); the second is delivered in year 11 and consists of four sessions (10 activities). It can be delivered by trained teachers or outside facilitators such as community-based drug and alcohol workers. The teachers are trained over two days in each of the two years of the programme.
As in other life skill approaches, the curriculum uses learning strategies which aim to enhance knowledge and negotiation skills; involve pupils in rehearsing problem-solving and problem-prevention strategies; and engage them in deconstructing social pressures to use substances and beliefs about how common substance use is among their peers. Joint home activities are intended to engage parents in the learning process. An expectation of this non-directive approach is that an interactive discovery process which promotes responsible substance use would reinforce ownership and adoption of that behaviour.
Intervention variation
The SHAHRP intervention was tested in a cluster randomized controlled trial: Steps Towards Alcohol Misuse Prevention Programme (STAMPP). STAMPP is an adapted version of SHAHRP, which besides the usual classroom component also included a (voluntary) parental component – brief alcohol intervention for parents and carers.
The parental component of STAMPP was developed by the trial team, delivered at bespoke events in the school setting, and was based on earlier work by Koutakis, Stattin, and Kerr (2008), who found that giving advice to parents about setting strict rules around alcohol consumption reduced drunkenness and delinquency in 13-16 year olds in Sweden (the Örebro Prevention Programme). However, parental participation in this component was very low. Future delivery of STAMPP is therefore likely to focus on the classroom component alone.
Moreover, a health economic analysis of STAMPP is currently under review. In addition, a further 2 years of data are being collected, which will provide data on long term follow-up and programme mediators.
