Using theatre to help prevent drug use among secondary school pupils in East Sussex (England)

ISRCTN	ISRCTN52466797
DOI	https://doi.org/10.1186/ISRCTN52466797
ClinicalTrials.gov (NCT)	Nil known
Clinical Trials Information System (CTIS)	Nil known
Protocol serial number	NIHR206768
Sponsors	University of Brighton, East Sussex County Council
Funder	National Institute for Health and Care Research

Submission date: 26/02/2025
Registration date: 24/04/2025
Last edited: 17/06/2025

Recruitment status: No longer recruiting
Overall study status: Completed
Condition category: Other

Prospectively registered

Protocol

Statistical analysis plan

Results

Individual participant data

Record updated in last year

Plain English summary of protocol

Background and study aims
This study is evaluating a Theatre-in-Education programme designed to help secondary school pupils make informed choices about substance use, including vaping, alcohol, and illicit drugs. The programme includes a live theatre performance followed by classroom activities, aiming to improve young people’s knowledge, confidence, and decision-making skills in situations involving substance use. The study will explore how well the programme works, how pupils engage with it, and how it influences their attitudes and behaviours.

Who can participate?
- Pupils in Years 8 and 9 (aged 12-15 years) from secondary schools in East Sussex that are delivering the theatre-in-education programme.
- School staff involved in planning or delivering the programme in their schools.
- Parents/carers who have attended a dedicated theatre performance for parents.

What does the study involve?
-Pupils will complete a survey before and after the intervention to assess changes in their knowledge and attitudes towards substance use. Some pupils will also participate in focus groups to discuss their experiences.
-School staff will take part in surveys and interviews about how the programme fits into their teaching and its impact on pupils.
-Parents/carers will join focus groups to share their views on the intervention and its impact on family discussions about substance use.
-Researchers will also observe theatre performances and Q&A sessions to understand how pupils engage with the intervention.

What are the possible benefits and risks of participating?
Potential benefits: Pupils may feel more confident in making informed decisions about substance use and managing peer pressure. The research findings may also help improve drug education programmes in schools.
Possible risks: Some discussions may involve sensitive topics related to substance use. However, trained researchers will ensure participants feel comfortable and can stop at any time if they feel uncomfortable. Schools will also provide support if needed.

Where is the study run from?
The study is being led by the University of Brighton, in partnership with East Sussex County Council, Public Health Department. It is taking place in secondary schools across East Sussex that are delivering the theatre-in-education programme.

When is the study starting and how long is it expected to run for?
September 2024 to October 2025

Who is funding the study?
National Institute for Health and Care Research (NIHR), Innovation Fund to Reduce Demand for Illicit Substances.

Who is the main contact?
Professor Jörg Huber, University of Brighton (J.Huber@brighton.ac.uk)
David Bishop, East Sussex County Council (David.Bishop@eastsussex.gov.uk)

Contact information

Prof Jörg Huber
Public, Scientific, Principal investigator

University of Brighton
Brighton
BN2 4AT
United Kingdom

ORCID ID	0000-0002-4446-5745
Phone	+44 1273 600900
Email	J.Huber@brighton.ac.uk

Mr David Bishop
Public, Scientific, Principal investigator

County Hall, St Anne's Crescent
Lewes
BN7 1UE
United Kingdom

Phone	+44 345 608 0190
Email	David.Bishop@eastsussex.gov.uk

Study information

Primary study design	Interventional
Study design	Multicentre interventional non-randomized pre-post evaluation study
Secondary study design	Evaluation study
Study type	Participant information sheet
Scientific title	Investigating the role of theatre-in-education in preventing illicit substance use in secondary school pupils in East Sussex, United Kingdom
Study acronym	TiE-PISU
Study objectives	Research Questions: 1. To what extent does the implementation of a school-based Theatre-in-Education (TiE) intervention effectively prevent and reduce illicit drug use (assessed through self-reports), and improve relevant social cognitions (antecedents) in years 8 and 9 secondary school pupils? 2a. How do pupils, teaching staff and other stakeholders, including parents, understand and engage with the theatre-in-education intervention and this specific dramatic form (e.g. with reference to aesthetic and emotional engagement)? 2b. What are the short-term outcomes related to nurturing engaged citizens, building positive coping strategies and associated identities for pupils, enhancing social capital, and increasing young people’s self-efficacy and self-worth? 3. How do pupils, teaching staff and other stakeholders, including parents, understand and engage with the theatre-in-education intervention, with reference to aesthetic and emotional engagement, and to outcomes related to nurturing engaged citizens, building positive coping strategies and associated identities for young people, enhancing social capital, and increasing young people’s self-efficacy and self-worth? 4. What are the economic benefits of the theatre-in-education intervention, considering costs, benefits and their conversion to monetary values, and robustness of the results? 5. To what extent does the intervention contribute to a reduction in health inequalities, focusing on the interplay of illicit drug use and demographics putting young people from disadvantaged areas or groups at higher risk?
Ethics approval(s)	Approved 03/03/2025, University of Brighton Research Ethics Committee (CREC) (University of Brighton, Brighton, BN2 4AT, United Kingdom; +44 1273 600900; l.redhead@brighton.ac.uk), ref: 15229 and 15238
Health condition(s) or problem(s) studied	Prevention of illicit substance use among secondary school pupils through a Theatre-in-Education intervention.
Intervention	This is a multicentre interventional pre-post study evaluating the impact of a theatre-in-education intervention on preventing substance use among secondary school pupils. The theatre-in-education intervention is an ongoing programme delivered by East Sussex County Council as part of the PSHE curriculum, and this study aims to evaluate its effectiveness. The established intervention consists of a live theatre performance and structured classroom activities designed to enhance knowledge, refusal self-efficacy, and social support related to substance use prevention. Data collection includes pre- and post-intervention surveys administered to pupils and school staff, as well as qualitative methods such as interviews with school staff and focus groups with pupils and parents/carers. Observations of theatre performances will also be conducted.
Intervention type	Behavioural
Primary outcome measure(s)	PUPIL SURVEYS 1. Audience Engagement with the Theatre-in-Education Performance measured using an adapted Theatre Audience Experience Questionnaire (TAEQ) & Audience Experience Index (AEI) (Radbourne et al., 2009; Au et al., 2017) at post-intervention only. 2. Knowledge and refusal self-efficacy of substance measured using an adapted Drug Knowledge Questionnaire (Hansen & Graham, 1991) and adapted Drug Abuse Treatment Outcome Study (DATOS) scale (Marsden et al., 1998) at pre- and post-intervention. 3. Social influence on substance use measured using the Social Media Influence Scale (SMIS) (adapted from Moreno et al., 2013), adapted Monitoring the Future Survey (Johnston et al., 2021), Social Norms Theory (Perkins & Berkowitz, 1986), and Monitoring the Future: National Survey on Drug Use (Johnston et al., 2021; Prinstein & Dodge et al., 2008) at pre- and post-intervention. 4. Attitudes and behavioural intentions to use substances measured using an adapted Theory of Planned Behaviour scale (Ajzen, 1991) and Reasons for Drug Use Scale (Boys et al., 2001) at pre- and post-intervention. 5. Substance use behaviour and triggers measured using an adapted Brief COPE Inventory (Carver, 1997), adapted Self-Reported Habit Index (SRHI), and a custom-developed questionnaire to capture context of substance use behaviour at pre- and post-intervention. SCHOOL STAFF SURVEYS 1. Effectiveness and ease of delivery of the theatre-in-education package: School staff will rate the perceived effectiveness of the intervention and its ease of delivery for pupils. Measured post-intervention. 2. Knowledge and confidence in delivering PSHE content on substance use: Measured at pre- and post-intervention to assess changes in staff knowledge and confidence in teaching about illegal substance use.
Key secondary outcome measure(s)	Pupils subjective psychological wellbeing measured using the WHO-5 Well-Being Index (World Health Organization, 1998) at pre- and post-intervention.
Completion date	30/10/2025

Eligibility

Participant type(s)	Learner/student, Other
Age group	Mixed
Lower age limit	12 Years
Upper age limit	15 Years
Sex	All
Target sample size at registration	5536
Total final enrolment	1553
Key inclusion criteria	ALL 1. Must provide informed consent 2. Must have sufficient English language proficiency to understand and complete the surveys and participate in focus groups or interviews. PUPILS 3. Participants must be secondary school pupils aged 12-15 years (Years 8 and 9). 4. Must be enrolled in a participating secondary school in East Sussex that is receiving the theatre-in-education intervention. 5. Must attend the theatre-in-education performance and associated classroom activities as part of the standard curriculum. 6. Must have parental/guardian consent (opt-out for surveys, opt-in for focus groups/interviews where required). SCHOOL STAFF 7. Must be involved in the delivery of the theatre-in-education intervention within participating schools (PSHE leads, teachers delivering PSHE, and school leadership). PARENT/CARERS 8. Must be a parent or carer of a pupil in a participating school who has attended a parent/carer theatre performance. 9. Must have attended the parent/carer's theatre-in-education performance.
Key exclusion criteria	1. Individuals who have not attended the theatre-in-education performance. 2. Pupils identified by teachers as at risk of distress due to the performance content – Teachers will assess whether individual pupils might be negatively impacted and should not take part in focus groups. 3. Individuals unable to provide informed consent. Participants must be able to understand and agree to take part in the study (parental consent also required for pupils).
Date of first enrolment	24/02/2025
Date of final enrolment	16/06/2025

Locations

Countries of recruitment

United Kingdom
England

Study participating centre

East Sussex Council Public Health

County Hall
St. Annes Crescent
Lewes
BN7 1UE
United Kingdom

Results and Publications

Individual participant data (IPD) Intention to share	No
IPD sharing plan summary	Not expected to be made available
IPD sharing plan	The datasets generated during and/or analysed during the current study are not expected to be made available due to ethical and legal restrictions related to safeguarding participants, as the study involves minors and sensitive topics such as substance use.

Study outputs

Output type	Details	Date created	Date added	Peer reviewed?	Patient-facing?
Participant information sheet	Participant information sheet	11/11/2025	11/11/2025	No	Yes

Editorial Notes

17/06/2025: The recruitment end date was changed from 01/06/2025 to 16/06/2025. Ethics approval details and total final enrolment added.
26/02/2025: Trial's existence confirmed by the National Institute for Health and Care Research (NIHR) (UK).