Substance use prevention program for adolescents with intellectual disabilities on special education schools: a cluster randomised control trial.
PREPARED ON TIME e-learning alone gives only a weak knowledge bump—beef it up with practice and role-play.
01Research in Context
What this study did
Eussen et al. (2016) tested an e-learning program called PREPARED ON TIME. The goal was to teach middle-schoolers with intellectual disability about alcohol and smoking.
They ran a cluster randomized trial in special-education schools. Classes got the online lessons or usual health class.
What they found
Kids who took the e-learning module scored a bit higher on alcohol facts. One smoking belief also shifted.
No changes showed up in peer pressure feelings, refusal skills, or plans to use substances. The gains were small and narrow.
How this fits with other research
Rapp et al. (2017) ran almost the same program one year later. They also saw only a tiny nudge in peer modeling, nothing else. Together the two studies show the curriculum by itself is too thin.
Davidson et al. (2023) used a short virtual program to boost autism acceptance. They saw clear attitude gains. The difference: their lessons included live role-plays and teacher prompts. Those extras may explain the stronger outcome.
Wyman et al. (2020) found that social-skills classes helped special-ed teens only when teachers added real-life practice. Again, practice mattered more than slides.
Why it matters
If you plan to use PREPARED ON TIME, treat it as a starting frame, not the full meal. Add live role-plays, repeated drills, and teacher feedback to turn knowledge into usable refusal skills. Track peer attitudes weekly; if numbers stall, boost practice time before expecting real-world change.
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02At a glance
03Original abstract
BACKGROUND: Students without intellectual disability (ID) start experimenting with tobacco and alcohol between 12 and 15 years of age. However, data for 12- to 15-year old students with ID are unavailable. Prevention programs, like 'PREPARED ON TIME' (based on the attitude-social influence-efficacy model), are successful, but their efficacy has not been studied in students with ID. The objectives of this study were (1) to undertake a cluster randomised control trial to test the efficacy of the e-learning program among 12- to 15-year old students with mild and borderline ID in secondary special-needs schools and (2) to examine the tobacco and alcohol use for this population. METHODS: Five schools, randomly selected to be part of either the experimental group or the control group, participated in this study. Passive informed consent was used in which parents and their children can refuse to participate in the study, resulting in 111 students in the experimental group and 143 students in the control group. A total of 210 students completed both baseline and follow-up questionnaires. Primary outcome variables are the knowledge and attitude towards alcohol and tobacco use. This study is registered in the ISRCTN registry with number ISRCTN95279686. RESULTS: Baseline findings showed that a large proportion of all respondents had initiated smoking (49%) and drinking (75%), well above the expected numbers based on national figures. 'PREPARED ON TIME' did not affect the behavioural determinants (i.e. attitude, subjective norm and self-efficacy), except modelling on smoking. Additionally, alcohol-related knowledge of students in the experimental group increased after the completion of the program. CONCLUSIONS: To obtain effective results on behavioural outcomes from 'PREPARED ON TIME', a greater degree of flexibility (i.e. repetition, extension of the program, role playing, etc.) is required. Furthermore, prevention needs to be implemented at a younger age, as 6% of the students tried their first cigarette and 15% of the students drank alcohol at the age of 10 years or younger.
Journal of intellectual disability research : JIDR, 2016 · doi:10.1111/jir.12235