Engagement with a theatre-in-education intervention and change in knowledge, refusal self-efficacy, and substance use likelihood

Background Universal school-based substance use prevention programmes typically show mixed effects. Theater-in-Education aims to influence early predictors of substance use, such as beliefs or behavioral intentions, through live performance. However, few quantitative studies have examined whether pupils’ engagement with the performance predicts change in these outcomes. Methods This study evaluated Time Out, a multi-component Theater-in-Education intervention delivered during the spring term of 2025 to pupils aged 12–14 in secondary schools in East Sussex, England. Matched pupil surveys (n = 488) were completed at baseline (0–16 days preperformance) and follow-up (6–30 days post-performance). Multiple linear regression models tested whether attentional engagement, narrative relatability, cognitive engagement, and emotional engagement predicted change in substance-related knowledge, refusal self-efficacy, and likelihood of substance use. Results Engagement indicators were not associated with change in knowledge or refusal self-efficacy. For likelihood of use, including engagement variables improved model fit beyond baseline likelihood of use. Greater narrative relatability was associated with slightly higher likelihood of use (B = 0.11, p=.002), while other indicators were not associated. Conclusions Engagement with the live theater performance was not uniformly associated with short-term improvements. Narrative relatability showed a small positive association with likelihood of use, highlighting the complexity of identification processes within universal prevention contexts.