Situational Analysis and Planning of a Community-Based Multicomponent Intervention to Prevent Adolescent Alcohol Use: The Prev.Action Study.

Abstract

Alcohol consumption among adolescents is a critical public health concern, leading to numerous adverse health, social, and economic consequences, which underscores the need for effective prevention strategies. This study aimed to conduct a situational analysis and produce a knowledge synthesis in the initial phase of the Prev.Action study, a multicomponent co-produced community intervention aimed at reducing alcohol use among Brazilian adolescents. This mixed-methods study conducted a comprehensive situational analysis to assess adolescent alcohol use in a Brazilian municipality, corresponding to Phase 1 of the Implementation Research Cycle. We employed three types of triangulation: data source, methodological, and investigator. Data were collected from five sources: a school-based survey (1,210 adolescents), focus groups (144 adolescents), semi-structured interviews with stakeholders (26 participants), a community web-based survey (516 participants), and stakeholder workshops (20 participants). Quantitative data were analyzed using descriptive statistics, whereas qualitative data underwent thematic analysis, ensuring a thorough understanding of community needs and intervention barriers. Key findings revealed that 54% of middle school and 73% of high school students had experimented alcohol. In addition, 13% of students reported binge drinking in the last 30 days. The primary methods of alcohol acquisition were self-purchase (30%) or receipt from parents (40%). Priority issues identified by the community, such as easy access to alcohol, cultural acceptance, and inadequate law enforcement, were key in designing a three-arm multicomponent intervention: school-based programs, family programs, and environmental strategies. The Prev.Action study underscores the importance of community involvement and tailored strategies to reduce adolescent alcohol consumption effectively.