Short Term Effect of an Empowerment Education Intervention on Substance Use among Adolescents Living in Peri-urban Communities, Abuja, Nigeria

Physiological and emotional changes during adolescence increases their vulnerability to the adoption of risky behaviour such as substance use. Hence, adolescence has been reported to be a critical risk period for initiating the use of substances [1]. In Nigeria, research has shown a high prevalence of substance use among adolescents [2 & 3]. Empowerment education intervention is a type of empowerment intervention with the potential to prevent and reduce adolescent substance use. This intervention involves a three-step methodology – listen, dialogue, and action to empower participants. This type of intervention has been reported to improve self-esteem, critical thinking, problem solving, community connectedness, and social support of the participants [4]. However, studies using the empowerment education intervention to prevent adolescent substance use are few in developing countries [5]. This study was, therefore, conducted to determine the short-term effect of an empowerment education intervention aimed at preventing adolescent substance use among adolescents living in peri-urban communities in Nigeria. This study involved a quasi-experimental design, conducted in Abuja with communities as the unit of randomization. Using G-power, the total sample size obtained was 300. Two peri-urban communities each were randomly assigned to the intervention and control groups, and adolescents from these communities who expressed interest in the project were enrolled for the study. All adolescents who were enrolled were aged between 11 to 19 years old, in secondary schools, and had basic reading and writing skills. Participants who were involved in similar programme were not included in the current study. The intervention group received weekly sessions for 12 weeks according to the Teen Heroes curriculum; an empowerment education curriculum developed according to Friere’s principles, which required some form of community action from the participants. The curriculum contains sessions on teamwork, alcohol and tobacco use, drug use, and planning a substance use project in the community. The sessions are mainly interactive, using problem posing method of education, interspersed with group activities and presentation.  For the control group, monthly sessions on bullying and personal hygiene were conducted. Short-term post-intervention data was collected two weeks after the intervention. Data was collected on quantity of substance use as well as other risk and protective factors (delinquency, self-esteem, self-efficacy, attitude to substance use, peer support, behavioural conduct, social competence, depression and delinquency) identified in the problem behaviour theory. An independent t-test was conducted to determine if there was a significant difference in the mean quantity of substance use, as well as other risk and protective factors among the intervention and control groups. A p-value of less than 0.05 was considered significant. Data was collected from two hundred and fifty-six participants, with 131 in the intervention group and 125 participants in the control group. Majority (62.1%) of the respondents were females, while 37.9% were males. Data analysis showed no significant effect of the intervention on the quantity of substances used by the participants two weeks post intervention. Perhaps, the nature of the substances did not allow for the effect of the intervention to be observed after two weeks. Additionally, the intervention did not address parental and familial factors of substance use which may have had a stronger effect on adolescent substance use. However, there was a significant mean difference in peer support, social competence and self-efficacy between the intervention and control groups. The effect observed on their peer support and social competence could be due to the interactive and social nature of the intervention, as it required lots of teamwork, discussions and project planning, while their self-efficacy could have been improved due to the practical nature of the intervention, as participants were expected to carry out a project for the community. This finding was supported by Thulin et al [6].  Other risk and protective variables were not significantly associated with the intervention. The findings are different from the studies conducted by Zimmerman et al. in 2018 [7], and Thulin et al. in 2022 [6] which found the intervention influenced delinquency, and prosocial behaviour. There is a need to conduct more medium- and longer-term studies to determine any delayed effect of the intervention on substance use, and other risk and protective factors. Conclusively, the intervention had no short-term effect on substance use, however an effect could be seen on social competence, peer support and self-efficacy.