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Peer van der Kreeft & Annemie CooneUniversity College Ghent, Belgium

For The EUSPR 2016

Cultural adaptation of the Unplugged evidence based 

intervention 

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2Researchers meet practicioners

RCT 7.079 pupils143 schools7 EU countries°2008 Further Analysis & Studies

Comprehensive Social Influence CSI

12‐14 year12 lessons

Manual  & TrainingAdaptation & TOT

BrasilNigeriaPakistan

UnpluggedImam stav I have attitudeNecenzurat Uncensored

I know what I wantYour choiceReflection

Odpojeno UnpluggedIzštekani UnpluggedGyvai Vividly#Tamojunto All together

United Kingdom

Adaptationissuesinthereport: 

1. Alcopopsarenotknown2. InKaduma,inclasseswhereitiscommonthatboyssitononesideoftheclassroomand

girlsontheotherside,itisnotpossibletomixboysandgirlsinsubgroups.3. SometeachershadtoshifttheUnpluggedlessonstotheeveningbreakoranotherbreak

timeintheschedule.4. 45minutesseemsnottobeenoughtodeliverthelessonappropriately5. Sittingarrangementsarehardtochange,inorderto

putthepupilsinacircleorinsubgroups.Tablesaresometimesveryheavyorfixedtotheground.Someteachersdeliveredthelessonintheassemblyhallordininghalls,whichisverydistinctfromtheclassroomsetting.

6. Parentsshouldbeinvolved.TheSSIinKadunarevealedthatalcoholbecomingasubjectthestudentathome,raisedanissue.InformingthefamiliesabouttheclassstartingwithUnpluggedwas,eventhoughitwasrecommendedinthetraining,apparentlynotdoneinthisschool.

7. Pupilsremarkedinthefocusgroupsthattheyexpectclearordersfromteachersconsideringe.g.alcoholdrinkingissues.Theyreportedsurpriseandconfusionthatteacherraisedtheissuethattheymightdrinkalcoholinfuture.

Nigeriaadaptation

Replace“Hewaswalkinghisdog”with“Seeadog:runaway!”

Nigeria adaptation example report

… In another quiz card, a girl is offered an ecstasy pill. Pupils are invited to discuss what are the possible effects. In The Russian adaptation process it was proposed to explicitly mention ‘if she takes the pill’. We believe however that from the three possible answers, it is clear she has accepted the pill. In that case, didactically inciting positive social influence in a group, it is recommended to let pupils come with a possible fourth answer from their own, i.e. that she could also choose not take the pill. They discuss reasons why to refuse, correcting perceived positive effects and methods how to refuse, based on positive social influence.

Russia adaptation example

Adaptation in Arab region

Some role-play instructions for boy–girl relations were replaced by single–sex friendship relations.

But taking … into account, the party-related situation was replaced with a homework-related one, thus complying with the boy–girl communication.

Another change that was proposed by the Arabic adapters was to refer to the illegality of alcohol when this substance was mentioned.

But… the saturation effect of implicit warnings is one reason to counter this, but a more important motivation is that Unplugged focuses on risk factors that are close to the lifestyle and immediate concerns of young people: financial cost, aesthetics, and social risks. The number of references to the illegal status of alcohol was considerably reduced in the Arabic versions

Ghanim Bibi, adaptator. Arab Resource Collective, ARC. Transformation (and adaptation) of knowledge 2011

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EU-Dap network guidelines for adaptation

1. Start with literal translation2. No report on simple changes3. No need for a full back‐translation4. Overview on changes made regarding 

a. Drug informationb.Methodological structure of the lessonsc. More substantial changes in content.

5. Carry the EU‐Dap label: inform OED Italy of implementing6. Agree on changes through the mandated EU‐Dap Faculty at HoGent Belgium7. OED has the copyright on all versions; the materials are in the public domain

Expert literature expert group    training process     monitoring forms     site visits     focus groups

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Adaptation levelsSurface Structure:

• Language and idioms• Places• Food, music• Technical 

Deep Structure:

• Risk factors• Gender roles• Family and community life• Legal system• Norms and values• Didactic or pedagogic...

Questionnaire sent to 28 countries

• responded by10 countries

• alternative sources for10 additional countries

Sweden, United Arab Emirates, Lebanon, Brazil, UK, France, Kyrgyzstan, Russia, India, Belgium, Romania, Poland, Lithuania, Croatia, Czech Republic, Slovenia, Nigeria, Pakistan, Spain, Italy

Searched for adaptation topics• Teacher handbook • Pupil workbook • Quiz cards

15892

Adaptation survey

culture24%

drugs20%

content16%

technical28%

value12%

UNPLUGGED BOOKS: 158 ADAPTATIONS

culture18%

drugs24%

content8%

technical34%

value16%

UNPLUGGED QUIZ CARDS: 92 ADAPTATIONS

Preliminary conclusionsAfter analysing 158+92 adaptation topics in 20 countries

1. Majority of technical and cultural superficial level adaptations2. Legality and gender more visible issues concerning values & norms3. Drug related adaptations are mostly replacing substances and in somecountries explicitly reducing focus on heroin, cocain or alcohol, basedon prevalence

4. Number and volume of adaptations is not high

Discussion

• Negotiation process secures core components like normative beliefsand reducing positive attitude (implying opening peer‐to‐peer debate on desired positive effects)

• Process shows high expectation of # adaptations at kick‐off, but important decrease after class level implementation experiences

• Training is crucial vehicle for wise adaptation at school or class level

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Effectivity 3 mths post

Daily smoking 30% reductionRecent drunkenness 28% reductionExperimenting cannabis 23% reduction

has a preventive effect on early onset of drug use and on the transition of experimental to frequent use. The effect is bigger for boys than for girls.

www.eudap.net

°Faggiano et al, Preventive Medicine 2008

Mediators with a proven lead to effect:

Positive attitude towards drugs

Normative beliefs on #use and approval

Refusal skills

Other mediators in Unplugged measured:

Negative attitude towards drugs

Positive beliefs

Negative beliefs

Knowledge

Perception of positive class climate

1opening

2 group

3 risks

4 reality

5 smoke

6 express

7 assertive

9 drugs

8 contact

10 coping

11 problem

12 goals

Mediators linked to lessons

• Evaluators: focus more on last and local steps • Designers: distinguish core and adaptable components• Trainers: document your expertise

Adaptation at country and at school level

• Training adaptation study• France 3 year co‐teaching with preventionworker• UK two step workshops integrated in Healthy Life 19 days training• Brazil Trainer Formadore + Health WorkerMultiplicadore around schools• Brazil ‘reference to behaviorism’ associated with dictatorship eera

• Further analysis and conclusions towards operational level of training and class level implementation

• Further study on mediator analysis connected to activities in order toadd to training quality

Future steps (cu LXAddictions 24-26 oct 2017)

Thank you

EU‐Dap study group

www.eudap.net peer.vanderkreeft@hogent.beannemie.coone@hogent.be