Substance use is highly prevalent among Chilean adolescents. There are no validated instruments to assess risk and protective factors for this population in Chile, which is essential for evaluating future prevention interventions. We are conducting a large study to assess the effectiveness of the culturally adapted Unplugged program in Chile (known as “Yo Sé Lo Que Quiero” ["I Know What I Want"]). In order to have robust results coming from this evaluation, we need to have a validated instrument, so we decided to use the same questionnaire as in Europe and Brazil, to be able to do future comparisons between countries. Therefore, the aims of this study were: (1) culturally adapt the EU-Dap questionnaire among early adolescents in Chile; (2) assess the validity of internal factor structure of the subscales contained in the questionnaire evaluating risk and protective factors; (3) assess the reliability of these subscales and (4) assess possible relationships between all risk and protective factors measured by the questionnaire and substance use.Substance use and drug related disorders are important public health problems. Alcohol and illicit drug use account for 5.4% of the total burden of disease and the peak has been found in early adulthood (between ages 20 and 30 years). Substance use is one of the leading problems among Chilean adolescents. One out of four 8th to 12th graders have smoked cigarettes in the last month. A 35.6% of students (37%, girls; 34.2%, boys) between Year 8 and Year 12 have reported any alcohol use during the last month. It is worrying that a third of 14 years old students report using alcohol in the last month in Chile. Furthermore, two out of three who are using alcohol, report regularly using 5 or more drinks in a row during the last month. Cannabis use among young Chileans has increased in recent years. Today, one out of five students between Year 8 and Year 12 referred cannabis use during the last 30 days. Almost a 20% of students in Year 8 have used cannabis in the last year. Therefore, is urgent to provide evidence-based drug preventive interventions to the Chilean population, specifically to school students, to tackle this problem and reduce the risk for a more dramatic future health scenario. The aim of this study is to develop a culturally appropriate version of the Unplugged program to the Chilean culture, and to test its effectiveness among early adolescents in low-income primary schools in Santiago, Chile. This project involves two stages: first, formative work, where the research team will review, adapt and pilot the Spanish version of the program to Chile; and second, the culturally adapted version of Unplugged program will be tested in a single-blind two-arm cluster randomized controlled trial. At the end of the intervention, investigators expect that students in schools receiving the Chilean version of Unplugged will have a lower proportion of substance use and a lower proportion of students passing from experimental use to regular use of tobacco, alcohol, and cannabis, than in control schools.

A cross-sectional study was carried out in 13 schools belonging to the city of Santiago de Chile. The sample was 2261 adolescents aged between 10 and 14 years. Linguistic and cultural adaptation was assessed using focus groups, construct validity with confirmatory factor analysis along with measures of its reliability, and finally, associations regarding risk and protective factors with substance use were explored. All evaluation data was collected in accordance with the Declaration of Helsinki, with the approval of the ethics committee of the Universidad de los Andes (CEC201734, august 7th 2018). Participation in the study involved three stages: school authorities were first informed about the study and written confirmation was requested to participate. The parents were then sent a letter with the study information and with a written and informed consent. Finally, the students were informed about the study and asked to sign an assent, confirming their participation. Confidentiality was assured throughout the study, as well as the freedom to withdraw from it at any time. An anonymous code was generated to protect the identity of the participants. The data was collected between August and December 2018 by research assistants, who were trained by the study coordinator. During the application of the questionnaire, the research assistants explained the objectives of the study, clarified doubts of the students, and then asked for the assent. No teachers form the schools were involved during the assessment.