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A multicentre cluster randomised controlled trial to evaluate the effectiveness and cost-effectiveness of a school-based peer-led drug prevention intervention (The FRANK friends study)

Lead Investigator

 Dr James White

Co Investigators

Dr Jemma Hawkins; Dr Kim Smallman; Dr Rebecca Cannings-John; Mr Steve Parrott; Mrs Julia Townson; Prof Christopher Bonell; Prof Laurence Moore; Prof Matthew Hickman; Prof Rona Campbell; Prof Simon Murphy


Reducing youth drug use is a public health priority. Despite significant declines since the 1990s, the latest 2016 UK data indicate the lifetime prevalence drug use in 11, 13 and 15 year olds is 11%, 21% and 37% respectively. Recent estimates suggest that more than 13,000 11 to 18-year-olds accessed drug treatment in the UK. There are short- as well as long-term public health threats arising from young people’s illicit drug use. As there is a social gradient in the prevalence of drug use among young people, these associations are could reinforce existing socioeconomic inequalities across the life course. There is limited evidence of effective drug prevention interventions. Three systematic reviews of school-based drug prevention found few interventions had an impact on drug use after 12 months. One review of school-based peer-led interventions found a small protective effect on cannabis use at >=12 months, suggesting a peer-led approach may be promising. In response, we adapted an effective school-based peer-led smoking intervention to deliver information from the UK national drug education website: In the pilot cRCT of this intervention, all criteria on the acceptability of the intervention and trial methods set by the NIHR panel and an independent steering committee required to progress to a full-scale cRCT were met. This study builds on this NIHR PHR funded study.

Aims and Objectives

To evaluate the effectiveness and cost-effectiveness of a school-based peer-led drug prevention intervention (FRANK friends) to prevent illicit drug use.

Study Design

Parallel-group, multicentre, two-arm, cluster RCT, with process and economic evaluations. Participants: UK year 9 students (aged 13-14 at baseline) The intervention: FRANK friends is a peer-led drug prevention intervention to prevent drug use in UK year 9 secondary school children. It has five stages: 1) nomination of peer supporters: students complete a questionnaire to identify influential peers. The 17.5% of students with the most nominations are invited to a recruitment meeting; 2) recruitment of peer supporters; 3) 2 days training out of school of peer supporters on the effects of drugs, minimising potential harms and the law from; 4) 10-week intervention where peer supporters have conversations with their peers on drug harms/risks with four follow-up visits made at school by intervention delivery staff; 5) all peer supporters get a certificate. The intervention will be delivered by health promotion specialists or youth workers.

Further information and publications

Start date

March 2019

End date

July 2022