Main Points

• After the education program about addiction, there was an increase in the awareness levels of the participants regarding addiction measured using the Substance Addiction Awareness Scale.
• The scores of the participants of this study on the Substance Addiction Knowledge Test increased significantly after the education program, indicating that they had higher levels of knowledge about substance addiction.
• While the awareness levels of the religious officials in the context of aid and legal regulations, the symptoms and effects of substance usage, and factors causing addiction increased, their personal attitudes and opinions did not significantly change after the education program.

Introduction

As addiction is a chronic mental disorder that is difficult to treat and has a recurrent course, efforts to prevent addiction are becoming increasingly important every passing day (Dabaghi, 2016). The importance of education as an intervention method in the prevention of addiction is emphasized today (Khydyrova, 2015).

Substance abuse is among the risky behaviors that are prevalently seen in adolescents. Substance abuse poses a great threat to the present and future well-being of adolescents. The appropriate follow-up of adolescents is useful in the early identification of substance abuse before the development of addiction. In this context, it was reported that referring adolescents to the relevant institutions had a healing effect (Harris et al., 2014). It was stated that preventive programs against substance abuse could be expanded to all areas in which dependable adults interact with adolescents (e.g., sports, counseling programs, child protection units) (Nelson et al., 2022).

It was argued that the prevention of addiction through education is more important than treatment, and this plays an important role in improving welfare (Taghipour et al., 2023). The importance of developing preventive programs increases because the personnel working at healthcare institutions do not have sufficient education on addiction (Englander et al., 2019), studies on early intervention have mostly involved interventions carried out with parents or teachers at schools (Dusenbury et al., 1997; Gorman, 1998), and there is a need for protective and preventive measures (Yoldaş & Demircioğlu, 2020). In addition to these, it is believed that equipping members of professions working at these institutions or civil society organizations with educational activities regarding addiction is also an important field. Intervention programs that have been proven effective in scientific studies and made sustainable through institutionalization may allow practitioners to reduce substance abuse and addiction rates. Hence, the development of preventive, protective, and supportive psychoeducation programs prepared by considering the characteristics of the target audience and with content that is universally valid can contribute to the protection of children and youth from risks (Yoldaş & Demircioğlu, 2020).

In light of all this information, it was considered that it is important to assess an education program developed for religious officials, who are a significant professional group that is in contact with young people. In this study, the aim was to measure the effects of such an education program on the knowledge and awareness levels of religious officials regarding addiction.

Material and Methods

Design and Participants

This single-group quasi-experimental study was carried out with a pretest-posttest design to measure the effects of an addiction-related education program on the knowledge and awareness levels of religious officials regarding addiction.

The target audience of the study included religious officials who contacted individuals in person in the field. In this context, the sample of the study consists of religious officials working in a district of Izmir province in Türkiye. A total of 232 religious officials are employed in this district. The study was carried out with the participation of 94 voluntary participants.

In this study, the sample size was calculated prior to data collection using the “G*Power 3.1.9.2” software with a confidence level of 80%. Based on this, the effect size of the study was determined to be 0.30; with an alpha level of 0.05 and a power of 0.80, the minimum required sample size was calculated as 71. To prevent data loss, this number was exceeded, and a total of 94 participants were included in the study.

Inclusion and Exclusion Criteria

The inclusion criteria were being voluntary to participate in the study and working as a religious official in the designated district of Izmir. The exclusion criteria were refusing to participate in the study and being off duty, on sick leave, or stationed at another institution during the study period.

Procedure

The education program that was prepared for the study was held with the participants in a conference room in the District Governor’s Office building in a district of Izmir on June 15, 2023. Two hundred thirty-two religious officials working in a district of Izmir were invited to participate in the study via an official letter after obtaining ethics committee approval and institutional permissions. Because 40 religious officials working at the Office were off duty, on sick leave, or stationed at another institution during the study period, 192 religious officials were reached. Ninety-four religious officials agreed to participate in the education program and the study. Within the scope of the study, first, general information was provided about the education program. Then, the pretest data collection forms were distributed to the participants, the participants were asked to fill out the forms, and the forms were collected after giving them enough time to complete them. The participants were included in the education program whose contents included information about the period of adolescence and its general characteristics, general information about addiction, legal regulations about addiction, and communication with individuals who are addicted or at risk of addiction. Each session of the program lasted 45 minutes, and the program consisted of four sessions. After the completion of the program, the posttest data collection process was carried out. Following the completion of the education program and the posttest measurements, the participants were given information about counseling, support, and treatment centers for addiction, a list of appropriate institutions to which they could refer individuals who are addicted or at risk of addiction, and the contact information of these institutions. The study was completed after receiving the questions and feedback of the participants and thanking them for their participation. The content of the education program is presented in Table 1.

Hypotheses

H1: The posttest scores of the participants on the Substance Addiction Awareness Scale (SAAS) will be statistically significantly higher than their pretest scores.

H2: The posttest scores of the participants on the Substance Addiction Knowledge Test (SAKT) will be statistically significantly higher than their pretest scores.

Data Collection Tools

Personal Information Form: This form included questions on the demographic characteristics of the participants, including gender, age, education status, marital status, job characteristics, and institutional information.

Substance Addiction Awareness Scale: The scale, which was developed by Köse et al. (2017), consists of four dimensions named aid and legal regulations, symptoms and effects of substance usage, personal attitudes and opinions, and factors causing addiction. The 4-point Likert-type scale has 27 items. Cronbach alpha internal consistency coefficient for the scale was calculated as 0.88. The scale was used in the study conducted by Baysan Arabacı and Yurtsever (2021) with adults, and its Cronbach’s alpha coefficient was found to be highly adequate (α = 0.86).

Substance Addiction Knowledge Test: The test, which was developed by Köse et al. (2017), consists of 30 items with the response options of true, false, and do not know. The KR-20 reliability coefficient of the test was calculated as 0.88. The test was used in the study conducted by Baysan Arabacı and Yurtsever (2021) with adults, and the authors reported that the discriminatory power of each item on the test was at the desired level. The KR-20 reliability coefficient of the test was calculated as 0.85.

Data Analysis

The IBM SPSS Statistics 26.00 (IBM SPSS Corp.; Armonk, NY, USA) program was utilized to analyze the data collected in the study. The pretest and posttest data collection form responses of the 94 participants who took part in the education program were reviewed, and after the exclusion of the participants who filled out the forms incompletely, the analyses were carried out on the data of 87 participants. Descriptive statistics were calculated for the demographic characteristics of the participants. It was analyzed whether the scores of the SAAS and SAKT were normally distributed. It was found that the data were normally distributed. The differences between the pretest and posttest scale scores of the participants were tested using the paired-samples t-test method.

Ethical Considerations

The ethics committee approval was obtained for the initiation and completion of the study from Ege University (Approval No.: 23-3T/54; Date: March 9, 2023). The institutional permission was obtained for the implementation of the educational intervention. The participants were informed about the study before their participation, and they signed the informed consent form.

Results

Demographic Characteristics

It was determined that 35 (40.2%) of the participants were women, and 52 (59.8%) of them were men. One (1.1%) of the participants was literate (with no formal degree), two (2.3%) were high school graduates, 76 (87.4%) had undergraduate university degrees, and 8 (9.2%) had graduate university degrees. It was found that 72 (82.8%) of the participants were married, and 15 (17.2%) were single. Fifty-seven (65.5%) participants were Quran Course instructors, one (1.1%) was a clerk, one (1.1%) was a teacher, and 28 (32.2%) were muadhdhins. The youngest participant was 19 years old, the oldest participant was 62 years old, and the mean age of the participants was 39.09 ± 8.58. The mean working duration of the participants was 12.72 ± 9.36 years. The demographic information of the participants is presented in Table 2.

Pretest and Posttest Score Comparisons

Substance Addiction Awareness Scale Total and Subscale Scores

The results of the comparisons of the pretest and posttest SAAS total and subscale scores of the participants are given in Table 3.

The paired-samples t-test showed a statistically significant difference between the participants’ pretest and posttest total SAAS scores [t(86) = 7.10, p < .001]. The total SAAS scores of the participants significantly increased after the education program.

The paired-samples t-test for the SAAS aid and legal regulations subscale revealed a statistically significant difference between the pretest and posttest scores [t(86) = 3.08, p < .05]. The scores significantly increased after the education program.

For the SAAS symptoms and effects of addiction subscale, there was a statistically significant difference between pretest and posttest scores [t(86) = 8.65, p < .001]. The SAAS symptoms and effects of addiction subscale scores of the participants significantly increased after the education program.

There was no statistically significant difference between the pretest and posttest in the SAAS personal attitudes and opinions subscale scores of the participants [t(86) = 1.05, p > .05].

The paired-samples t-test for the SAAS factors causing addiction subscale showed a statistically significant difference between pretest and posttest scores [t(86) = 3.76, p < .001].

Substance Addiction Knowledge Test Total Scores

The paired-samples t-test for total SAKT scores found a statistically significant difference between pretest and posttest scores [t(86) = 7.90, p < .001]. The total SAKT scores significantly increased after the education program. The results of the analysis are presented in Table 4.

Discussion

Social interventions, which are among the strategies used to prevent addiction, include practices such as education programs addressing all parts of society, public information programs, and programs to establish values against substance abuse in the public sphere. The active participation of society in addiction prevention efforts is achieved through collaborations with professional groups that are in contact with society, gatekeepers, activists, stakeholders, or volunteers (Ögel, 2018). In this context, this study was carried out to raise the knowledge and awareness of religious officials, who constitute one of the groups of professionals who are in contact with society, regarding addiction.

The results of the study showed that after the education program, there was an increase in the awareness levels of the participants regarding addiction measured using SAAS. In the study conducted by Altın (2021), religious leaders were provided with training as educators in the fight against substance addiction, and after the training program, there was an increase in the SAAS scores of the participants. Bağcı Taylan et al. (2019) emphasized that education programs on awareness of substance addiction have an important role in the fight against addiction. Epstein et al. (2002) compared the awareness levels of individuals with addictions and those without addictions and found higher levels of addiction in the latter than in the former. In this sense, an increase in the awareness levels of religious officials, who constitute a group of professionals who are in contact with the public, regarding addiction could be interpreted as them becoming more conscious about preventing addiction and referring individuals at risk of addiction to treatment.

In this study, after the education program, the scores of the participants in the SAAS dimension of aid and legal regulations increased significantly compared to their scores before the program. Individuals with addictions or those in their social circles hesitate to apply for treatment because they fear being reported to the authorities. However, Clause 4 of Article 192 of the Turkish Criminal Code (TCK) states that “where a person who uses narcotics or psychotropic substances makes an application to the authorities with a request to receive treatment before the commencement of any investigation arising from their purchase, receipt, or possession of said narcotics or psychotropic substances, no penalty shall be imposed” (TCK 192). With this clause, the legislator allows the addicted individual to receive treatment and facilitates their reintegration into society by involving persons whose relatives/friends are addicts as influential and persuasive parties (Turan, 2019). Considering the significance of religious officials in Turkish society, it may be argued that increasing their awareness regarding aid and legal regulations would substantially contribute to the fight against addiction.

In comparison to the scores of the participants of this study in the SAAS dimensions of symptoms and effects of substance use and factors causing addiction before the education program, their scores after the education program were significantly higher. In the drama-based education program organized by Stephens-Hernandez et al. (2007) for the prevention of substance addiction, the awareness levels of the participants regarding substance addiction significantly increased after the drama-based intervention. Altın (2021) provided training to religious leaders as educators in the fight against addiction and after the training program, they found higher levels of awareness regarding factors causing addiction in the experimental group compared to the control group. In the study conducted with university students by Bekircan et al. (2022), high levels of awareness were observed among the participants in the context of “symptoms and effects of addiction” and “factors causing addiction.” In this study, there were increases in the awareness levels of the participants in the context of these dimensions. On the other hand, the scores of the participants of this study in the SAAS dimension of personal attitudes and opinions did not vary significantly after the education program. It is difficult to change personal attitudes and opinions, and it is believed that longer interventions and follow-ups are needed in this sense.

The scores of the participants of this study on SAKT increased significantly after the education program, indicating that they had higher levels of knowledge about substance addiction. The contents of the education program in this study included detailed explanations of the topics “addiction, addictive substances, and their effects,” “legal regulations about addiction,” “communication with addicted individuals,” and “adolescence,” and the knowledge levels of the participants in this context increased after their participation in the program. Theou et al. (2015) provided 53 university students with education on awareness regarding substance addiction, and as a result of the education program, the rate of students who had sufficient knowledge of substance addiction and its consequences increased from 7% to 52.8%. Following the Cigarette, Alcohol, and Substance Addiction Treatment Program (SAMBA) provided to individuals with addictions by Ögel et al. (2016), —which is a structured treatment program designed for cigarette, alcohol, and substance addiction—it was observed that the knowledge levels of the participants regarding addiction increased. Not only the results of this study but also those of other studies in the literature demonstrate that education programs about the fight against addiction increase the knowledge levels of individuals regarding the issue.

In this study, which was carried out to determine the change created by an education program provided to religious officials, who constitute a group of professionals who are in direct contact with the public, in the addiction-related knowledge and awareness levels of these individuals, it was observed that the education program was functional. While the awareness levels of the religious officials in the context of aid and legal regulations, the symptoms and effects of substance usage, and factors causing addiction increased, their personal attitudes and opinions did not significantly change after the education program. In the study, an increase in the awareness levels of a group that is in direct contact with the public regarding the issue in question was facilitated by providing them with education. Nevertheless, it is not clear how these education programs will be reflected in individuals who experience these problems. For future studies, researchers are recommended to provide addiction-related education to other groups of professionals who are in contact with the public and conduct follow-ups.

Limitations

A limitation of this study was that no sample selection method was used, and those who volunteered to participate were included in the sample. This may indicate that the participants were already sensitive to or interested in the issue of substance addiction, which could limit the generalizability of the results. Another limitation was that no follow-up measurements were made after the posttest measurements made right after the education program. The immediate administration of the measurements may have led to high scores based on short-term recall of the learning material. Therefore, it is recommended that future studies include follow-up assessments to evaluate the long-term effects.

Acknowledgements

We would like to thank the Karabağlar District Governorship and Karabağlar District Mufti’s Office for their contributions in the conduct of this study.

Author contributions

Conception and design: Y.A., S.A., Y.S.D., Z.Y., İ.Ö.; Data acquisition: Y.A., S.A., İ.Ö.; Data analysis: Y.A., S.A.; Data interpretation: Y.A., S.A., Y.S.D., Z.Y.; Drafting of the manuscript: Y.A., S.A., Y.S.D.; Critical revision of the manuscript: Y.A., S.A., Z.Y., İ.Ö. All authors reviewed the results, approved the final version of the manuscript, and agreed to be accountable for all aspects of this study.

Ethical approval

This study was approved by the Ege University (Date: March 9, 2023, Decision/Protocol No: 23-3T/54). Informed consent was obtained from all participants involved in this study.

Data availability statement

The data supporting the findings of this study are not publicly available due to ethical restrictions and participant confidentiality requirements.

Conflict of interest

The authors declare that this study was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Funding

The authors declare that this study received no funding.

Generative AI statement

The authors declare that no generative AI or AI-assisted technologies were used in the writing or preparation of this study.