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AKTION GLASKLAR

Evidence level:
Best PracticePromising PracticeEmergent Practice
 
Evidence of Effectiveness:
?-0+++
Transferability:
?-0+
Enduring Impact:
?-0+
Review criteria and process

Recommendation Pillars

Put in place mechanisms that promote children’s participation in decision making that affect their lives

Countries that have implemented practice

Germany

Age Groups

Teenagers (age 13 to 19)

Target Groups

Children/teenagers with behavioural problems, Parents, Children

Years in Operation

2006  - still operating

Type of Organization Implementing Practice

Private Health Care Organization

Practice Overview

Aktion Glasklar is an intervention program to combat youth drinking in Germany. It was first implemented in the state of Schleswig-Holstein in early 2006 and has since been continued under the leadership of Deutsche Angestellten Krankenkasse (DAK) all throughout Germany. The focus of the program is to interact with students and to actively deter them from consuming alcohol at a young age.

Overview

Aktion Glasklar is an intervention program to combat youth drinking in Germany. It was first implemented in the state of Schleswig-Holstein in early 2006 and has since been continued under the leadership of Deutsche Angestellten Krankenkasse (DAK) all throughout Germany. The focus of the program is to interact with students and to actively deter them from consuming alcohol at a young age.

The program consists of four specified class units, a booklet for students and a parent booklet. The materials are designed for students under the age of 16 years and attempts to convey an abstinence message to minors. Each teaching unit follows a standard curriculum which an overarching theme, the main objectives and a list of materials. 

Transferability

Program materials are comprehensive and readily available, but the program has not been replicated and evaluated among a second population.

Evidence of Effectiveness

This study examines a school-based program to combat underage drinking in Germany, specifically in the pilot region of Schleswig-Holstein. In order to do so, a number of widely accepted outcomes such as knowledge and attitudes towards alcohol consumption, as well as self-reported levels of binge drinking and frequency of alcohol consumption are compared between a treatment and control group at multiple stages before and after the intervention. In addition, the study accounted for several covariate risk factors such as family environment and smoking.

Morgenstern, M., Wiborg, G., Isensee, B., Hanewinkel, R., “School-based alcohol education: results of a cluster-randomized controlled trial”, Addiction 104, 2009, p. 402 – 412

 Summary of Results 

 

 

 

Outcome

Treatment Group

Control Group

 

Outcomes improved (statistically significant)

 

 

 

Knowledge quiz – correct answers out of 7

(at 4 month assessment)

4.6 (0.082)

4.17 (0.066)

 

Knowledge quiz – correct answers out of 7

(at 12 month follow-up)

4.61 (0.068)

4.34 (0.064)

 

Attitude index 0-3, where 3=negative towards drinking (at 4 month assessment)

1.37 (0.051)

1.21 (0.053)

 

Lifetime binge drinking – yes/no

(at 4 month assessment)

The odds that students in the treatment group have ever engaged in binge drinking are 0.56 times the likelihood of students in the control group at the post-test measurement.

 

Lifetime binge drinking – yes/no

(at 12 month follow-up)

The odds that students in the treatment group have ever engaged in binge drinking are 0.74 times the likelihood of students in the control group at follow-up.

 

Outcomes with no effect

 

 

 

Attitude index (at 12 month follow-up)

1.31 (0.041)

1.29 (0.042)

 

Future use (at 4 months)

1.07 (0.050)

1.06 (0.052)

 

Future use (at 12 months)

1.36 (0.058)

1.42 (0.069)

 

Refusal intentions (at 4 months)

1.95 (0.045)

2.01 (0.047)

 

Refusal intentions (at 12 months)

1.67 (0.048)

1.66 (0.048)

 

Past month alcohol use (at 4 months)

0.81 (0.046)

0.89 (0.044)

 

Past month alcohol use (at 12 months)

0.89 (0.075)

0.98 (0.081)

 

Lifetime alcohol use – yes/no (at 4 months)

The odds that students in the treatment group have ever consumed alcohol are 0.81 times the likelihood of students in the control group at the post-test measurement.

 

Lifetime alcohol use – yes/no (at 12 months)

The odds that students in the treatment group have ever consumed alcohol are 0.9 times the likelihood of students in the control group at follow-up.

 

Lifetime drunkenness– yes/no (at 4 months)

The odds that students in the treatment group have ever been drunk are 0.7 times the likelihood of students in the control group at the post-test measurement.

 

Lifetime drunkenness – yes/no (at 12 months)

The odds that students in the treatment group have ever been drunk are 0.77 times the likelihood of students in the control group at follow-up.

 

Issue to consider

The study points out that while there were standard operating procedures for the intervention, there was no way to verify that protocol was actually followed in classrooms. 

Contact Information

Name

 Dr. Barbara Isensee, Prof. Dr. Reiner Hanewinkel 

Title

 

Organization

 Institut für Therapie- und Gesundheitsforschung, IFT-Nord    

Address

 Harmsstraße 2, 24114 Kiel, Germany

Phone

 +49-431-570-29-70

Email

 aktionglasklar@ift-nord.de

Website

Available Resources

http://www2.dak.de/content/aktionglasklar/downloads.html

Evaluation Details

The study reported here (Morgenstern et al, 2009) was a group-randomized trial with three measurements over a one year period.  

To establish baseline measures of key characteristics, students in both cohorts were presented with questionnaires in February of 2006. These baseline outcomes were then used to establish the appropriate statistical controls and to ensure comparability of treatment and control going forward. After this initial assessment, students in the treatment group received the treatment over a period of 3 months, consisting of four instructional lessons on alcohol consumption, as well as brochures for both kids and parents. At program completion, in May and June of 2006, a second round of questionnaires was administered in order to show immediate treatment effects on key variables related to youth drinking. Furthermore, a follow-up assessment was conducted in February 2007, looking at medium-term effects of the program and its sustainability.

Key outcomes

• Overall, the study is concerned with investigating program effects on alcohol-related knowledge, attitudes and intentions, as well as general drinking behavior. 

o Knowledge is measured by the number of correct answers on a test with seven true/false questions.

o To assess attitudes and intentions, students were asked to rank several sets of statements on a 0-3 scale with higher values as the desired outcome (negative attitude towards alcohol, low likelihood of usage).

o Students were further asked to report their past month alcohol use on a scale from 0-6 where 0 means none and 6 means more than once a week. 

• In addition, students were presented with a number of yes/no questions on their drinking prevalence to assess the magnitude of the issue for the study population. 

• Furthermore, a number of covariates such as social environment, school performance, smoking prevalence and upbringing were considered in the analysis.

Bibliography

Morgenstern, M., Wiborg, G., Isensee, B., Hanewinkel, R., “School-based alcohol education: results of a cluster-randomized controlled trial”, Addiction 104, 2009, p. 402-412

Enduring Impact

This study shows program effects over a period of one year, but no additional evaluation has been done in excess of this initial study period.