Integrating Health Literacy into a Theory-Based Drug-Use Prevention Program: A Quasi-Experimental Study Among Junior High Students in Taiwan.

Abstract BackgroundIn Taiwan, illegal drug use is a critical health problem during adolescence. Schools play a vital role in preventing students’ illegal drug use. Accordingly, we developed and evaluated a school-based, drug-use prevention program integrating the theory of planned behavior (TPB) and health literacy for junior high school students.MethodsWe recruited 648 junior high school students from 14 selected schools: N= 323 in the experimental group, N= 325 in the comparison group. The experimental group received ten 45-minute sessions of a theory-based drug-use prevention program. The comparison group received traditional didactic teaching and drug refusal skill training. We used a generalized estimating equation (GEE) to analyze data.ResultsResults of paired t-tests indicated that drug-use health literacy and TPB-related variables improved in the experimental group. The GEE analyses indicated that participants in the experimental group also demonstrated significantly improved health literacy (p < 0.001) compared to the comparison group, especially for functional (p< 0.001) and critical health literacy (p = 0.017). The experimental group also showed significant post-intervention improvement in terms of subjective norm scores (p = 0.024). ConclusionStudy results demonstrated the effectiveness of a drug-use prevention program on health literacy and subjective norm by integrating the TPB and health literacy. These results could support the future implementation of drug-use prevention programs for junior high school students on a larger scale.