Adapting digital alcohol prevention strategies overseas

Student Spotlight: Lyra Egan

PhD title: Understanding and preventing poor diet, alcohol use, tobacco smoking and vaping among adolescents from low socioeconomic and remoteness areas through eHealth interventions

National survey data in the central American nation of Colombia has reported early alcohol use initiation among adolescents, yet standardised alcohol prevention programs are lacking in Colombian schools.

Existing prevention programs shown to be effective in reducing alcohol and other drug use, such as the Australian OurFutures web-based substance use prevention programs, offer an ideal basis to develop a prevention program for the Colombian context . OurFutures has been rigorously evaluated in eight controlled trials (292 schools, >26,000 students) and established evidence of effectiveness in improving knowledge, behaviours and wellbeing.

As a first step, it’s important to understand the acceptability of the OurFutures Alcohol Module in its current form as this can then help guide how to adapt the program. This is what Matilda Centre Research Assistant and PhD Candidate Lyra Egan set out to do.

In this edition of Student Spotlight, Lyra talks about her travels to Colombia, what led her there, and how spending time overseas has helped to develop and shape her research.

I began my academic journey at the University of Sydney, completing a BSc in Psychology and BA in Spanish & Latin American Studies and Germanic Studies in 2017, and then a Master of Public Health (MPH) in 2020. During the Masters, I worked as a Research Assistant at the Susan Wakil School of Nursing and Midwifery, which deepened my passion for research.

This interest aligned with an opportunity in 2020 to join the OurFutures project at the Matilda Centre as a Research Assistant.

Since then, I’ve contributed to various projects, including the OurFutures Vaping Trial. In 2021, I was awarded a Paul Ramsay Foundation PhD Scholarship for my research into preventing poor diet, alcohol use, tobacco smoking, and vaping among adolescents from low socioeconomic and geographically remote backgrounds through eHealth interventions.

Associate Professor Laura Ospina Pinillos from Pontificia Universidad Javeriana (PUJ) reached out to our Centre Director, Professor Maree Teesson, after reading one of the many publications on the effectiveness of the OurFutures programs. Laura was interested in exploring the possibility of adapting these programs to the Colombian context, starting with the OurFutures Alcohol Module.

As a first step, our team decided it was crucial to understand the individual, interpersonal, and cultural beliefs surrounding alcohol use in Colombia, and to gather feedback from local young people and teachers on the OurFutures Alcohol Module in its current form to guide its adaptation.

I was eager to contribute for two main reasons. First, my Colombian heritage—my mother is Colombian, and I have family in Colombia’s capital, Bogotá. This gave me a personal connection to the project. Second, I was passionate about exploring how to adapt and implement effective eHealth prevention interventions like OurFutures for disadvantaged adolescents, not only in Australia but also internationally.

In August 2023, I travelled to Colombia and co-facilitated in Spanish three 1.5hr focus groups with 26 adolescents and 10 1hr interviews and online surveys with teachers alongside Laura and Paula Ballen (Research Assistant at PUJ).

The feedback from students and teachers highlighted the significant impact of cultural and social factors on attitudes toward alcohol among young Colombians. Most teachers expressed a readiness to adopt evidence-based alcohol prevention programs like OurFutures with their students and they valued its preventive approach and potential to de-stigmatise discussions on alcohol.

Students also responded well to the OurFutures Alcohol Module, rating it highly and stating they liked the story, characters and learning via the cartoons. This feedback affirmed that OurFutures with its social influence and harm minimisation approach to prevention, is well-suited for addressing alcohol use among young people not only in Australia but also in Colombia.

Both students and teachers provided some valuable suggestions for contextualising the content including adjusting language, depicting alcohol in ways that resonate with Colombian culture, incorporating diverse and realistic characters, modifying narrative elements, and refining educational content for different age groups.

Our next steps involve incorporating participant feedback into the iterative adaptation of the OurFutures program and evaluating the feasibility of the program in Bogotá.

During my time in Bogotá, I was exposed to different methodologies and cross-cultural perspectives which expanded my understanding of how social and cultural contexts shape health behaviours. I paid close attention to the similarities and differences between Colombia and Australia particularly when it comes to the acceptability of prevention interventions and how critically important it is to have cultural sensitivity in developing effective prevention programs.

This experience also provided invaluable opportunities for professional and academic growth. Securing a $5000 PREMISE travel and career development grant, leading an international study, and contributing to the field through presenting on findings at conferences and a first-author publication have been crucial in building my academic career.

I’ve gained confidence in establishing collaborations, which I believe is essential for producing high-quality and impactful research. I am beyond grateful to Professor Maree Teesson, Associate Professor Laura Ospina Pinillos, Dr Lauren Gardner, Professor Nicola Newton and Dr Katrina Champion for their supervision and guidance throughout this process, to Laura and Paula for providing support for the study while I was in Bogotá, and to the Matilda Centre for fostering an environment where international collaboration and cultural sensitivity are prioritised.

Overall, this experience has strengthened my ability to contribute meaningfully to research aimed at addressing the needs of vulnerable populations and I am eager to continue learning and growing as a researcher.