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The behavioural findings of SHAHRP have made an important contribution to the science and evidence base in the field, affording the SHAHRP project recognition as world leading in this area. This recognition demonstrated in four replications of the study, repeated identification in Cochrane reviews, and over 2000 citations of the key study publications.

Several replications of the SHAHRP longitudinal study have occurred, including:

• University of Liverpool, Northern Ireland replication of SHAHRP. A non-randomised controlled longitudinal trial.
• Liverpool John Moore’s University, National Institute of Health funding (UK), SHAHRP Alcohol Misuse Prevention Program. School-based cluster randomised controlled trial.
• Universidade Federal de São Paulo, The SHAHRP adaptation and replication conducted in secondary schools in Brazil. A non-randomised controlled trial.

The SHAHRP survey instrument was purposely developed and tested to measure young people's knowledge, attitudes, patterns of use, context of use, harm associated with the young people own use of alcohol and harm associated with other people’s use of alcohol. The conceptual basis of the measures included in the SHAHRP survey draws on several studies, interventions and student generated data. In addition, several measures of harm were identified and defined by young people during focus groups conducted in the formative year of SHAHRP.

The anonymous, self-completion surveys were completed by study students under the guidance of trained researchers who instructed students and responded to questions following a set procedure. In addition, the survey protocol involved providing a verbal summary of the study and its design to both intervention and control students and teachers. In line with local Education Department policy classroom teachers were in attendance, however, they were requested to refrain from moving about the room to limit any possible influence on student’s responses.

Parametric assessment – validity and reliability

Extensive pre-testing of the SHAHRP questionnaire was undertaken during the formative period of the study. Validity measures included the assessment of face and content validity, using expert review, target group review (young people and teachers) and statistical review of the survey. Internal consistency and test-retest procedures were used to determine the reliability of the SHAHRP survey. The test-retest procedure was conducted with four classes of year nine students (approx. 120, 14-year-old students) from the pilot schools. These students completed the survey on two occasions, separated by two weeks. If the test-retest analysis indicated that an individual item was likely to be unreliable, then that item was excluded from the analysis and was not reported in the results. However, these items were maintained; as scale or index items such as face validity, content validity and internal consistency would be compromised with their exclusion.

Data analysis: Four scales/indices were developed to assess overall change. These were: knowledge index (19 items; internal consistency: 0.73); attitude scale (six items; internal consistency: 0.64); harm associated with own use of alcohol index (17 items; internal consistency: 0.9); and harm associated with others’ use of alcohol index (six items; internal consistency: 0.70). The knowledge index represents actual number of correct answers to knowledge questions; the attitude scale was a sum of the six attitude variables with lower scores representing safer alcohol related attitudes; and the harm indices measure number of harms experienced. Consumption was measured using two variables related to how often alcohol was consumed and how much alcohol was consumed per occasion. Risky drinking was also assessed. Context of use was measured using six variables related to situation of use to define non-drinkers, supervised drinkers and unsupervised drinkers. Multilevel modelling procedures were used to analyse the results of the study.

Citation

Details of and citation for the SHAHRP survey and parametric testing details (https://www.springer.com/us/book/9789811010095). University libraries will have free downloads of the book and chapter.

McBride, N. (2016). Assessment phase of the Intervention Research Framework: The measurement instrument and data collection (129-147). In: Intervention Research. A practical guide for developing evidence-based school prevention programmes. Springer: Singapore.

The SHAHRP intervention is comprised of 13 harm minimisation classroom lessons, over a two-year period. The SHAHRP lessons assist young people by enhancing their ability to identify and use strategies that will reduce the potential for harm in drinking situations and that will assist in reducing the impact of harm once it has occurred.

Teacher training

Teacher training is ideally conducted before each phase of the SHAHRP intervention. During Phase One, teachers are provided with two days of training that provides an overview of the study behaviour outcomes, evidence-based components, and interactive modelling of each Phase One activity. Phase Two training is conducted over two days for teachers new to SHAHRP. On the first day of training, these teachers are briefed on the research aspects of SHAHRP and Phase One intervention activities. On day two, all teachers participate in interactive modelling of Phase Two activities. Teachers who are experienced in interactive techniques are recommended as SHAHRP teachers.

Teacher manual

The SHAHRP Teacher Manual provides specific written guidance for teachers. The manual included detailed and structured lesson plans for eight 60-minute lessons in the First Phase and five 50-minute lessons in the Second Phase. Each lesson plan includes sample questions to help facilitate discussion and processing of activities and to focus on activity intention, coaching points to aid in the management of the activities, and background information about alcohol-related issues. Additional coaching points have been included in the teacher manual and are based on feedback from teachers who have previously taught the program.

Student workbooks

The SHAHRP program is largely activity based, however, student workbooks are available for each phase to stimulate and engage students’ interest, provide information, encourage young people to further explore issues and to record what they have learned to consolidate practical activities. Qualitative results from the SHAHRP study show that young people and teachers think the books are appealing and great to use as reinforcement to the interactive activities.

Trigger Visual

A Trigger Visual is used in Phase Two of SHAHRP. The video features scenarios that young people may experience in alcohol use situations to prompt discussion about how to minimise the harms associated with alcohol use.

The SHAHRP Intervention Components may be downloaded from the Resources page.

Skills basis

The SHAHRP activities incorporate various strategies for interaction including delivery of utility information; skill rehearsal; individual and small group decision making; and discussions based on scenarios suggested by young people, with an emphasis on identifying alcohol-related harm and strategies to reduce harm. Interactive involvement is emphasized, with two-thirds of activities being primarily interactive and another 15% requiring some interaction between young people. Interactive involvement between young people provides important practice in reducing harm associated with alcohol use that is relevant and acceptable to young people, and this is a critical aspect of lessons using an evidence-based approach.

Ages for delivery

The SHAHRP Randomised Controlled Trial indicates that implementation should be based on local prevalence data. Phase One of SHAHRP is designed to be implemented in the year prior to prevalence data indicating that experimentation has started to occur. Phase Two of SHAHRP is designed to be implemented when the prevalence data indicates that young people are starting to experiment with alcohol. In Australia, prevalence data has been consistent overtime and indicates that implementation should occur in year eight (12/13 year’s old) and year nine (13/14 year’s old) of secondary school.

Dose and fidelity of implementation

To maximise effectiveness when using the SHAHRP program, it is important to teach the program as closely as possible to how it is documented in the teacher manual. The student behaviour changes that came during the SHAHRP Randomised Controlled Trial were based on teaching the program to at least 80% as documented. During the SHAHRP Randomised Controlled Trial study teachers also received training in the delivery of the program to students. Two days of training were conducted for Phase One of the SHAHRP program, and one day of training for Phase Two (two days for those new to SHAHRP). The training involved an overview of the research background and program development. In addition, teachers participated in each activity to model how the activity should be taught and allowed teachers to assess implementation and management requirements.

Training is recommended for teachers new to SHAHRP or new to an interactive teaching style. Ideally SHAHRP is taught by teachers in the school who know and have an ongoing relationship with the students. Teachers from both the English and Health Education teaching areas have taught SHAHRP.

Training in SHAHRP is not readily available. As a research institute the National Drug Research Institute does not have the capacity to provide training. However, several Australian educators are registered as SHAHRP training facilitators. The National Drug Research Institute has links to this consortium of trainers who have been trained as SHAHRP facilitators but who work full time elsewhere.

If you are interested in having a trainer conduct a SHAHRP training workshop, please submit your request via the Feedback form. This will be forwarded to the SHAHRP training consortium to see if anyone is available to facilitator your training. Training is provided at cost recovery so this would include airfares and accommodation as well as other cost (venue hire, catering, trainer fee, equipment etc.) Cost items would need to be negotiated with the SHAHRP training consortium staff.

Australian SHAHRP Study (original Randomised Controlled Trial)

1. McBride, N. (2016). Research. A practical guide for developing evidence-based school prevention programmes. Springer: Singapore. ISBN 978-981-10-1011-8
2. Midford, R., McBride, N., and Munro G. (2009). Harm reduction in school drug education: Developing an Australian approach. Drug and Alcohol Review; 17 (3): 319-327. https://doi.org/10.1080/09595239800187151
3. McBride, N., Farringdon, F., and Kennedy, C. (2007). Research to Practice - Formal Dissemination of the School Health Harm Reduction Project (SHAHRP) in Australia. Drug and Alcohol Review, 26, (6), pp. 665-672. https://doi.org/10.1080/09595230701613510
4. McBride, N., Farringdon, F., Meuleners, L., and Midford, R. (2006). The School Health and Alcohol Harm Reduction Project. Details of Intervention Development and Research Procedures. National Drug Research Institute, Monograph, Perth, Western Australia. ISBN: 1 74067 469 3.
5. McBride, N., Farringdon, F., Meuleners, L. and Midford, R., and Phillips, M. (2006). The School Health and Alcohol Harm Reduction Project and SHAHRP 2000. Monograph No 6. National Drug Research Institute, Perth, Western Australia.
6. McBride, N. (2005). The evidence base for school drug education interventions. In Stockwell, T.R., Gruenewald, P., Toumbourou, J. and Loxley, W. (eds.) Preventing harmful substance use: The evidence base for policy and practice. John Wiley and Sons, Chichester.
7. McBride, N. (2004). School drug education: A developing field and one element in a community approach to drugs and young people. Addiction, 99, pp. 292-298. https://doi.org/10.1111/j.1360-0443.2004.00681.x
8. McBride, N., Farringdon, F., Midford, R., Meuleners, L., and Philip, M. (2004). Harm Minimisation in School Drug Education. Final Results of the School Health and Alcohol Harm Reduction Project (SHAHRP). Addiction, 99, pp. 278-291. https://doi.org/10.1111/j.1360-0443.2003.00620.x
9. McBride, N., Farringdon, F., Midford, R., Meuleners, L., & Phillips, M. (2004). Erratum: Harm minimisation in schools. Final results of the School Health and Alcohol Harm Reduction Project (SHAHRP) (Addiction (2004) 99 (278-291). Addiction, 99 (4): 528. https://doi.org/10.1111/j.1360-0443.2004.00738.x
10. Farringdon, F., and McBride, N. (2004). School Health and Alcohol Harm Reduction Project. Changing 13-16 year old students alcohol-related behaviours by providing three phases of alcohol harm reduction lessons during secondary school in Western Australia. Education and Health, 22(2): 19-23.
11. McBride, N. (2003). A systematic review of school drug education. Health Education Research Theory and Practice, 18, (6), pp. 729-742. https://doi.org/10.1093/her/cyf050
12. McBride, N., Farringdon, F., Midford, R., Meuleners, L., and Phillips, M. (2003). Early unsupervised drinking - reducing the risks. The School Health and Alcohol Harm Reduction Project. Drug and Alcohol Review, 22, (3), pp. 263-276. https://doi.org/10.1080/0959523031000154409
13. McBride, N., and Scott, K. (2002). Australian education system: Procedures and process for the adoption of new programs. Preliminary SHAHRP Dissemination Study. National Drug Research Institute: Perth, Western Australia.
14. McBride, N. (2002). School Health and Alcohol Harm Reduction Project: Reducing Alcohol Related Harms in Young People. PhD thesis. Curtin University: Perth, Western Australia.
15. McBride, N. (2002). Systematic literature review of school drug education. National Drug Research Institute. NDRI Monograph No. 5. Curtin University of Technology, Perth, Western Australia. ISBN: 1 74067 188 0.
16. McBride, N., Farringdon, F., and Midford, R. (2002). Implementing a school drug education program: Reflections on fidelity. International Journal of Health Promotion and Education, 40, (2), pp. 40-50. https://doi.org/10.1080/14635240.2002.10806196
17. Midford, R., Munro, G., McBride, N., Snow, P., and Ladzinski, U. (2002). Principles that underpin effective school-based drug education. Journal of Drug Education; 32, (4): 363-386. https://doi.org/10.2190%2FT66J-YDBX-J256-J8T9
18. Midford, R. and McBride, N. (2001). Alcohol Education in Schools. In: Heather, N., Peters, T. and Stockwell, T. Handbook of alcohol dependence and related problems (pp 785-804). ISBN: 0 471 98375 6. John Wiley and Sons: Chichester, England.
19. Farringdon, F., McBride, N., and Midford, R. (2000). The fine line: Students perceptions of drinking, having fun and losing control. Youth Studies Australia, 19, (3), pp. 33-38.
20. McBride, N., Farringdon, F., and Midford, R. (2000). What harms do young Australians experience in alcohol use situations. Australian and New Zealand Journal of Public Health, 21, (1), pp. 54-59. https://doi.org/10.1111/j.1467-842X.2000.tb00723.x
21. McBride, N., Midford, R., and Farringdon, F. (2000). Alcohol harm reduction education in schools: Planning an efficacy study in Australia. Drug and Alcohol Review, 19, (1), pp. 83-93. https://doi.org/10.1080/09595230096183
22. McBride, N., Midford, R., Farringdon, F., and Phillips, M. (2000). Early results from a school alcohol harm minimisation study. Addiction, 95, (7), pp. 1021-1042. https://doi.org/10.1046/j.1360-0443.2000.95710215.x
23. Farringdon, F., McBride, N., and Midford, R. (1999). School Health and Alcohol Harm Reduction Project: Formative development of intervention materials and processes. Journal of the Institute of Health Education, 37, (4), pp. 137-143. https://doi.org/10.1080/14635240.1999.10806116
24. McBride, N., Midford, R., Farringdon, F. (1998). Alcohol harm reduction education in schools: An Australian efficacy study. In Stockwell, T. Drug trials and tribulations: Lessons for Australian drug policy (pp 70-101). Monograph No 1. National Centre for Research into the Prevention of Drug Abuse: Perth, Western Australia.

Northern Ireland SHAHRP replication study

1. McKay, M., Sumnall, H., McBride, N., and Harvey, S. (2014) The differential impact of a classroom-based, alcohol harm reduction intervention, on adolescents with different alcohol use experiences: A multi-level growth modelling analysis. Journal of Adolescence; 37: 1057-1067. https://doi.org/10.1016/j.adolescence.2014.07.014
2. McBride, N., McKay, M. & Sumnall, H. (2013). SHAHRP: School Health and Alcohol Harm Reduction Project – Developments in Australia and the UK. Education and Health, 31, 79-83. http://hdl.handle.net/20.500.11937/20482
3. McKay, M., McBride, N., Sumnall, H. and Cole, J. (2012). Reducing the harm from adolescent alcohol consumption: Results from an adapted version of SHAHRP in Northern Ireland. Journal of Substance Use; 17(2), 98-12 1Early Online: 1-24. ISSN 1465-9891 print/ISSN 1475-9942 online. https://doi.org/10.3109/14659891.2011.615884
4. McKay, M., Cole, J., and Sumnall, H. (2011). Teenage thinking on teenage drinking: 15-16 year olds’ experiences of alcohol in Northern Ireland. Drugs: Education Prevention and Policy; 18(5): 323-332. https://doi.org/10.3109/09687637.2010.507559

United Kingdom SHAHRP replication study

1. Agus, A, McKay, M., Cole, J., Doherty, P., Foxcroft, D., Harvey, S., Murphy, L., Percy, A., and Sumnall, H. (2019). Cost-effectiveness of a combined classroom curriculum and parental intervention: economic evaluation of data from the Steps Towards Alcohol Misuse Prevention Programme cluster randomised controlled trial. BMJ Open; 9:e027951. https://doi.org/10.1136/bmjopen-2018-027951
2. Percy, A., Agus, A., Cole, J., Doherty, P., Foxcroft, D., Harvey, S., McKay, M., Murphy, L., and Sumnall, H. (2019). Recanting of previous reports of alcohol consumption within a large-scale clustered randomised control trial. Prevention Science; https://doi.org/10.1007/s11121-019-0981-2
3. Sumnall, H, Agus, A, Cole, JC, Doherty, P, Foxcroft, D, Harvey, S, McKay, MT, Murphy, L and Percy, A (2017) Steps Towards Alcohol Misuse Prevention Programme (STAMPP): a school- and community-based cluster randomised controlled trial. Public Health Research, 5 (2). https://doi.org/10.3310/phr05020
4. McKay M, Agus A, Cole J, Doherty, P., Foxcroft, D., Harvey, S., Murphy, L., Percy, A., and Sumnall, H. (2017). Steps Towards Alcohol Misuse Prevention Programme (STAMPP): a school-based and community-based cluster randomised controlled trial. BMJ Open 2018;8:e019722. https://doi.org/10.1136/bmjopen-2017-019722
5. McKay, M., Sumnall, H., Harvey, S., and Cole, J. (2017). Perceptions of school-based alcohol education by educational and health stakeholders: ‘Education as usual’ compared to a randomised controlled trial. Drugs: Education, Prevention and Policy; 25 (1): 77-87. https://doi.org/10.1080/09687637.2016.1273316
6. McKay, M., and Harvey, S. (2014). ‘Drink doesn’t mess with your head . . .you only get a hangover’: Adolescents’ views on alcohol and drugs, and implications for Education, Prevention and Intervention. Education and Health; 32 (1): 35-39. https://sheu.org.uk/sheux/EH/eh321mm.pdf

Brazil SHAHRP replication study

1. Amato, T., Opaleye, E., McBride, N. and Noto, A. (2021). Reducing alcohol-related risks among adolescents: a feasibility study of the SHAHRP program in Brazilian school. Ciencia & Saude Coletiva; 26(08): 3005-3018 Aug 2021. https://doi.org/10.1590/1413-81232021268.13472020