{ "schema_version": "uw.editorial_geo.v1", "representation_profile": "lossless_source_sections", "local_stage_only": true, "catalog_id": "DEP-25-N08", "article_index": "DEP-25-N08", "language": "en", "headline": "How to tell whether prevention helps: beyond the lecture count", "description": "How to tell whether prevention helps: beyond the lecture count", "short_answer": "A programme has held many meetings, attracted an audience and received thanks. Those are facts about work carried out. Assessing prevention calls for another question: what changed for people, over what period, and why is the change attributed to this programme? A good report can honestly document useful work without yet establishing reduced substance use or harm.\n\nEvaluation must not delay help. For **new sudden confusion**, contact the local emergency medical service immediately: that sign alone is enough. For **suspected poisoning**, make contact immediately, even before symptoms. Do not wait for a questionnaire, an admission or the end of follow-up. [NHS guidance on confusion](https://www.nhs.uk/symptoms/confusion/) and [poisoning](https://www.nhs.uk/conditions/poisoning/) describes UK routes; identify the appropriate local service. An immediate threat to life also requires emergency contact.", "short_answer_source": { "kind": "opening_after_h1", "role": "lead", "start_utf16": 66, "end_utf16": 975, "sha256_utf8": "d7baa74dbc7a474b356329aca8e286f183b14e59954fd2b27217484858dbfe42" }, "headline_source": { "role": "h1_heading", "start_utf16": 2, "end_utf16": 64, "sha256_utf8": "63efb837c66ce4867bc858529c454ff38da367202728361dcbe92be10f8eb890" }, "entities": [], "questions": [ { "q": "What outcome is being called a success?", "a": "A report may count people invited, attending, completing a course or answering a survey. “Reach” without a definition does not reveal which count it means. Knowledge concerns what a person can explain or do in a learning situation. Starting use, frequency, harm, seeking help and disorder symptoms are other outcomes. One does not automatically establish the others. A strong reaction after a meeting does not tell us what happens six months later.\n\nAsk the organiser to name the specific goal, population and time period. If the aim is to make a route to help clearer, assess that. If the claim is reduced use or harm, a knowledge test alone is insufficient. The [CDC Program Evaluation Framework](https://www.cdc.gov/evaluation/php/evaluation-framework/index.html) treats evaluation as a way to obtain useful, transparent and ethically gathered information for decisions. Its page does not demonstrate a course's effectiveness or certify an original evaluation plan.", "source_spans": [ { "role": "h2_heading", "start_utf16": 980, "end_utf16": 1019, "sha256_utf8": "7241d2c97b1d928e438abf001fb08fb6e7a5a2fde2fae928f2baf2b7f79f1347" }, { "role": "h2_answer", "start_utf16": 1021, "end_utf16": 1989, "sha256_utf8": "b9a2d0fbea3c3a055abe848b70c4b4d2c3e4a95c27148bc1d188a693e4e982cf" } ], "block_ids": [ "p0005", "p0006" ], "source_segment_index": 1 }, { "q": "What was the change compared with?", "a": "Sales rules, group composition, substance availability, family circumstances or other treatment may have changed at the same time as the programme began. A before-and-after comparison establishes the sequence of measurements, but does not on its own separate these explanations from the programme's contribution. Even an obvious improvement does not allow a preferred cause to be selected without examination.\n\n[NCCIH explains comparative design](https://www.nccih.nih.gov/health/know-science/how-to-make-sense-of-a-scientific-journal-article/methods/design-of-the-study) through clinical-study examples. The general question can be applied to prevention: how well do the groups and conditions support an assessment of the intervention's contribution? This is a methodological application, not research on this particular session. Random allocation may help, but a design label cannot repair poor measurement, substantial participant loss or an irrelevant outcome. Other justified designs exist too; the article cannot replace an evaluation specialist's work.\n\nThe [WHO page for the 2018 prevention standards](https://www.who.int/publications/i/item/international-standards-for-drug-use-prevention-second-edition-2018) links to a [PDF marked PRE-EDITING / PRE-PUBLICATION](https://cdn.who.int/media/docs/default-source/substance-use/standards-180412.pdf?download=true&sfvrsn=a49fa11f_2). The identified Research and planning section stresses evaluation of a particular programme and its adaptation. Resemblance to a known format does not automatically transfer its result to another school, country or age group. The complete document and included studies were not read here.", "source_spans": [ { "role": "h2_heading", "start_utf16": 1994, "end_utf16": 2028, "sha256_utf8": "6eaa65c743b885b5759891ae43dbc9d0ea7dd9588100eeb9a8470ee21f41b38e" }, { "role": "h2_answer", "start_utf16": 2030, "end_utf16": 3705, "sha256_utf8": "a96ca767604945334b490a32c7a7713f67c72de7ae3a92e6d990df27b14cd06a" } ], "block_ids": [ "p0008", "p0009", "p0010" ], "source_segment_index": 2 }, { "q": "Who appears in the number, and who was lost to follow-up?", "a": "Consider a **wholly invented arithmetic example**, not a study. One hundred people attend; forty later answer a survey, and thirty-two report improvement. That is 80% of respondents. It cannot be reported as “80% of all participants improved because of the programme.” There are no data for sixty nonrespondents, a report is not yet a verified outcome, and no causal effect has been established. Describe who answered and what they reported, together with the limitation.\n\nAsk about the original group, reasons for declining or dropping out, and whether the survey was accessible in the person's language and through the contact method used. People in difficult circumstances may be underrepresented. That is a possible source of bias, not permission to invent their results. A person should not be forced to disclose substance use to improve a report.\n\n[NCCIH's results page](https://www.nccih.nih.gov/health/know-science/how-to-make-sense-of-a-scientific-journal-article/results) discusses practical effect size and comparison with other research. An impressive number without a denominator, outcome and time period is hard to interpret. Correctly calculated statistical significance does not guarantee a meaningful benefit in daily life. A current lack of convincing evidence establishes neither effectiveness nor complete uselessness.", "source_spans": [ { "role": "h2_heading", "start_utf16": 3710, "end_utf16": 3767, "sha256_utf8": "da350a1bfa83d6b6f5e4813334b3cb627d8a79929772d016f6ecd82f201438c0" }, { "role": "h2_answer", "start_utf16": 3769, "end_utf16": 5107, "sha256_utf8": "32c1427901b5204ad89efc994c9be26fac548c89fb52a7fc4486ff4e8582fe2b" } ], "block_ids": [ "p0012", "p0013", "p0014" ], "source_segment_index": 3 }, { "q": "What happened to safety and access?", "a": "Check whether the evaluation looked for unwanted consequences: shame, exclusion, disclosure risks or delayed help. Ask who cannot access the format and which resources it requires. Neither a low session cost nor a high price establishes effectiveness. Someone who attended but could not participate safely should remain visible in the account.\n\nData collection requires a clear purpose, the minimum necessary information, and understandable local consent and access rules. Do not promise complete anonymity when an answer can be linked to a name or a small group. Do not publish personal stories merely to make a report persuasive without appropriate grounds. A child must not collect information about adults' use, keep medicines or interpret medical discussions. Where essential care is compromised, a capable adult must already be present and providing it; otherwise the appropriate urgent local help route is needed. Violence requires a separate safe protection channel.\n\nMedical care must not be withheld to create a “clean” comparison group. Do not independently change prescribed medicines to measure an outcome; [RCPsych's antidepressants information](https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/antidepressants) distinguishes physical adaptation, withdrawal and addiction. Treatment decisions remain individual, and research arrangements require appropriate professional and ethical assessment. This article does not propose a home experiment.", "source_spans": [ { "role": "h2_heading", "start_utf16": 5112, "end_utf16": 5147, "sha256_utf8": "215ab6866856e326746d59d6e2b5837fba97c77504b98ecd8b493cbb400c1e8e" }, { "role": "h2_answer", "start_utf16": 5149, "end_utf16": 6622, "sha256_utf8": "cc78ec5a888fd6ce31a9aee3905607bb5f92d8315efd2570445c1768aae00195" } ], "block_ids": [ "p0016", "p0017", "p0018" ], "source_segment_index": 4 }, { "q": "What conclusion is justified, and what decision does it change?", "a": "A useful conclusion may be modest: sessions were delivered; participants could locate help more easily; a change in use was associated with participation; or the data do not support a causal conclusion yet. Each statement has its own scope. “Proven” cannot be added because the programme matters or its organisers worked hard.\n\nOne practical step is to ask for a brief explanation: which outcome, for whom, when, with what comparison, who is missing, and which limits are known? Then ask which decision the evaluation will change: continuing, adapting, investigating further or removing a particular component. There is no need for a verdict on every programme. The useful link is between the claim, available evidence and the next action.", "source_spans": [ { "role": "h2_heading", "start_utf16": 6627, "end_utf16": 6690, "sha256_utf8": "fe4208c28a28ce2b111132ec7756acee6f14fd72d9f6969830f3dcac76fd0e93" }, { "role": "h2_answer", "start_utf16": 6692, "end_utf16": 7431, "sha256_utf8": "034a4f83b074f0e0f0c2df59b08b1fd6a0aec60b7464146d40ac288ce6f3915f" } ], "block_ids": [ "p0020", "p0021" ], "source_segment_index": 5 }, { "q": "Sources and limits", "a": "- [CDC Program Evaluation Framework](https://www.cdc.gov/evaluation/php/evaluation-framework/index.html) — United States, page dated 20 August 2024; overview read, not the full framework, Action Guide or detailed tools.\n- [WHO: International Standards for Drug Use Prevention, second edition](https://www.who.int/publications/i/item/international-standards-for-drug-use-prevention-second-edition-2018) — page dated 7 December 2018; publication information.\n- [Attached WHO/UNODC PDF](https://cdn.who.int/media/docs/default-source/substance-use/standards-180412.pdf?download=true&sfvrsn=a49fa11f_2) — marked PRE-EDITING / PRE-PUBLICATION; identified Research and planning passages read, not the full document or every review.\n- [NCCIH: Design of the Study](https://www.nccih.nih.gov/health/know-science/how-to-make-sense-of-a-scientific-journal-article/methods/design-of-the-study) — US educational page, edition date not established; general methods, not a prevention-programme trial.\n- [NCCIH: Results](https://www.nccih.nih.gov/health/know-science/how-to-make-sense-of-a-scientific-journal-article/results) — US educational page, edition date not established; identified passages about interpreting results.\n- [NHS: Sudden confusion](https://www.nhs.uk/symptoms/confusion/) — reviewed 28 May 2024; immediate help for new sudden confusion.\n- [NHS: Poisoning](https://www.nhs.uk/conditions/poisoning/) — reviewed 12 June 2025; immediate contact on suspicion, before symptoms.\n- [RCPsych: Antidepressants](https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/antidepressants) — March 2025 edition; prescribed care, physical adaptation and withdrawal.\n\nThe questions and numerical example are original, not a ready-made validated instrument. Sources are briefly summarised; complete pages, forms, scales, charts and protocols were not reproduced. No particular programme or local rules were evaluated here. Clinical, native Thai, legal and human acceptance have not taken place.", "source_spans": [ { "role": "h2_heading", "start_utf16": 7436, "end_utf16": 7454, "sha256_utf8": "f91f16500d95114ea5dd62762b302ab95f247ca4f49fe0affb04993b09f0a299" }, { "role": "h2_answer", "start_utf16": 7456, "end_utf16": 9444, "sha256_utf8": "62e58fc4277bb40c5d5cd6b83ee9cb661d58b93dc6be702775fbaf1c489353da" } ], "block_ids": [ "p0023", "p0024" ], "source_segment_index": 6 }, { "q": "Tags", "a": "prevention, programme evaluation, outcomes, comparison, causation, reach, attrition, research literacy, safety, confidentiality, adolescents, decision-making", "source_spans": [ { "role": "h2_heading", "start_utf16": 9449, "end_utf16": 9453, "sha256_utf8": "1331275bc537b4c2bf1e46f7275677967515342e30b572e6852fa6f51b831fe8" }, { "role": "h2_answer", "start_utf16": 9455, "end_utf16": 9612, "sha256_utf8": "67943821b4cba7a1f6ac4728b234e68673074c44fdb8bb300bf94856580a6831" } ], "block_ids": [ "p0026" ], "source_segment_index": 7 }, { "q": "About the authors", "a": "Andrey Zarinsh — author and founder of United Wisdom. He explores inner transformation, the unity of traditions, intercultural dialogue, and contemporary spiritual discipline. Instagram: @andrey.zarinsh.\n\nMaria Evilkut — co-author of United Wisdom. Alongside her research, she seeks to test these ideas in practice and observe how principles of unity and mutual understanding work in real life between people and cultures. Instagram: @ilkutki.", "source_spans": [ { "role": "h2_heading", "start_utf16": 9617, "end_utf16": 9634, "sha256_utf8": "e120452a2b9952200310f55df00e52d0bbd068d32bba8a322511ed65e3d4967d" }, { "role": "h2_answer", "start_utf16": 9636, "end_utf16": 10079, "sha256_utf8": "a909a5be3206496a5832c139d32d3d32c2d2720a0cd4d5a3c8cd4f315e84ac24" } ], "block_ids": [ "p0028", "p0029" ], "source_segment_index": 8 }, { "q": "Content date", "a": "15 October 2026. English version.", "source_spans": [ { "role": "h2_heading", "start_utf16": 10084, "end_utf16": 10096, "sha256_utf8": "0b4439ddd5cf5901a6626e46431a42b0114014556a963f1537c3e62581bca78e" }, { "role": "h2_answer", "start_utf16": 10098, "end_utf16": 10131, "sha256_utf8": "b4e735d6d15c79b3c9e320265c4af7a828ee6131981d3479ef95403933cfe376" } ], "block_ids": [ "p0031" ], "source_segment_index": 9 } ], "claims": [], "claims_policy": "no_reclassified_claims", "sources": [ { "id": "src_6740eb80d2b869e3", "title": "NHS: Sudden confusion", "url": "https://www.nhs.uk/symptoms/confusion/", "source_spans": [ { "role": "markdown_link", "start_utf16": 728, "end_utf16": 795, "sha256_utf8": "4e31a608d13aa94e28e33272fd1209eb63571085968838638211ec04196b6ed4" }, { "role": "markdown_link", "start_utf16": 8668, "end_utf16": 8731, "sha256_utf8": "d2b8c330d3e322a0f009ef20c85c9f931a6e9d86f3333149554113df7bd4c5b1" } ], "read_scope": "- [NHS: Sudden confusion](https://www.nhs.uk/symptoms/confusion/) — reviewed 28 May 2024; immediate help for new sudden confusion.", "read_scope_kind": "verbatim_bibliography_entry", "read_scope_span": { "role": "bibliography_entry", "start_utf16": 8666, "end_utf16": 8796, "sha256_utf8": "9dc8ae82bb63ed6b150588fe10f0e57b09656d3a2058e89e322afeae4c098960" }, "shared_entry_urls": [] }, { "id": "src_10790fb1fab48f9a", "title": "NHS: Poisoning", "url": "https://www.nhs.uk/conditions/poisoning/", "source_spans": [ { "role": "markdown_link", "start_utf16": 800, "end_utf16": 853, "sha256_utf8": "143af5bdc2270954afc004f0baad53cf5c3e3eb46b2edf3fa0ebae623aa775d3" }, { "role": "markdown_link", "start_utf16": 8799, "end_utf16": 8857, "sha256_utf8": "d11f2b5b840044e49f6718a906aec79a03c23553e6efec8cd01cdedd9150efd7" } ], "read_scope": "- [NHS: Poisoning](https://www.nhs.uk/conditions/poisoning/) — reviewed 12 June 2025; immediate contact on suspicion, before symptoms.", "read_scope_kind": "verbatim_bibliography_entry", "read_scope_span": { "role": "bibliography_entry", "start_utf16": 8797, "end_utf16": 8931, "sha256_utf8": "402fff363855def0a458783b24f403efc6ed2fac09222802ed864b897636c0ef" }, "shared_entry_urls": [] }, { "id": "src_77da557a62597bd7", "title": "CDC Program Evaluation Framework", "url": "https://www.cdc.gov/evaluation/php/evaluation-framework/index.html", "source_spans": [ { "role": "markdown_link", "start_utf16": 1685, "end_utf16": 1787, "sha256_utf8": "8d67da98b4e16cef95a08a93ffc018542cadba80a3079db7d7816f136ed11b45" }, { "role": "markdown_link", "start_utf16": 7458, "end_utf16": 7560, "sha256_utf8": "8d67da98b4e16cef95a08a93ffc018542cadba80a3079db7d7816f136ed11b45" } ], "read_scope": "- [CDC Program Evaluation Framework](https://www.cdc.gov/evaluation/php/evaluation-framework/index.html) — United States, page dated 20 August 2024; overview read, not the full framework, Action Guide or detailed tools.", "read_scope_kind": "verbatim_bibliography_entry", "read_scope_span": { "role": "bibliography_entry", "start_utf16": 7456, "end_utf16": 7675, "sha256_utf8": "00b2f2e840281b0417e435ff4ef2850ddaf36ef3f94300b6c8cbda7aac4e7a74" }, "shared_entry_urls": [] }, { "id": "src_9099012dd51a2a17", "title": "NCCIH: Design of the Study", "url": "https://www.nccih.nih.gov/health/know-science/how-to-make-sense-of-a-scientific-journal-article/methods/design-of-the-study", "source_spans": [ { "role": "markdown_link", "start_utf16": 2441, "end_utf16": 2601, "sha256_utf8": "9d66802c6ff053a9743048c43ccc8f007fe9586f37f3f99512e48581fe816c80" }, { "role": "markdown_link", "start_utf16": 8183, "end_utf16": 8336, "sha256_utf8": "65883a2a16fc9ff06b5db0adf8360db834b4c39bc317ff0350eb1bf2bb124f54" } ], "read_scope": "- [NCCIH: Design of the Study](https://www.nccih.nih.gov/health/know-science/how-to-make-sense-of-a-scientific-journal-article/methods/design-of-the-study) — US educational page, edition date not established; 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