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Background
With the largest population of adolescents globally (253 million), India is witnessing an increasing burden of substance use and mental health concerns. The age of substance use initiation is declining, with early risk taking and substance use behaviors being linked to substance use disorders and poor psychosocial outcomes later in adulthood. Despite this, there is a dearth of accessible and engaging prevention strategies that can effectively tackle adolescent substance use, highlighting need for contextually relevant and innovative interventions.
Objectives and method
Our study describes the systematic development and pilot implementation of MeWeSports – an innovative prevention program that leverages community sports to delay substance use initiation and promote mental wellbeing in adolescents. The intervention uses a three-pronged approach to integrate sports-agnostic activities (WeAct) with knowledge-building (WeLearn) and experiential group reflections (WeReflect).
It is delivered by non-specialist community coaches and has been co-developed through participatory methods, including formative qualitative research with adolescents, counsellors and other stakeholders to understand substance use experiences, patterns, perpetuating and precipitating factors, prevention priority areas, synthesis of global evidence, and consultative workshops with local and international experts through youth, sports and scientific advisory groups.
Using a mix-methods pre-post design, we aimed to evaluate the acceptability, feasibility and preliminary impact of three pilot delivery models of MeWeSports by implementing it across schools and community sports settings in Goa and Bhubneshwar, engaging over 1000+ adolescents aged 12-15 years. Data was collected using in-depth interviews, semi-structured field observations, quantitative outcomes assessments and process indicators.
Results
Upon triangulation of qualitative and process data, we found high acceptability and strong engagement amongst adolescents with the sports-based learning modality. Participants reported improvement in mix-gender peer relationships, self-confidence, sports participation, and adoption of healthy coping strategies. Implementation insights show the importance of sustaining healthy relationship with participants, integrating locally games in program design, addressing contextual gender inclusion challenges, continuous competency development for facilitators and adapting the program delivery to school schedules and local contexts.
Conclusion
Our findings demonstrate the potential of non-specialists led universal substance use prevention intervention and offer lessons on how to adapt and implement them in low- and middle-income countries.
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