<![CDATA[Background: Adolescents in border regions may face heightened substance-use risks, while school-based prevention often emphasizes cognitive knowledge rather than structured spiritual self-efficacy and refusal skills. This study evaluated changes in spiritual self-efficacy and drug prevention behavior following a six-week APROKSI module among adolescents in an Indonesian border region. Methods: This quasi-experimental nonequivalent control group pretest-posttest study, reported according to TREND, included 150 Grade X–XI students purposively assigned to intervention and control groups (75 each). The intervention group received the six-week APROKSI module, comprising four 60–90-minute sessions, while the control group received printed health leaflets. Drug prevention behavior was measured using a 25-item questionnaire (Cronbach’s α = 0.892), and spiritual self-efficacy using an 8-item scale (Cronbach’s α = 0.842); paired and independent t-tests were performed. Results: Among 150 adolescents, drug prevention behavior increased from 64.25 to 84.44 in the intervention group (mean difference=20.19; p<0.001) and from 63.75 to 64.96 in the control group (mean difference=1.21; p=0.001). Spiritual self-efficacy increased from 18.41 to 28.71 in the intervention group (mean difference=10.30; p<0.001) and from 18.43 to 19.07 in the control group (mean difference=0.64; p=0.001). Posttest scores differed significantly between groups for drug-prevention behavior and spiritual self-efficacy (both p < 0.001). Conclusion: The APROKSI module was associated with greater improvements in drug prevention behavior and spiritual self-efficacy than leaflet-based education among adolescents in this single-school quasi-experimental study. Further multicenter research with longer follow-up is needed to assess the durability and generalizability of these findings.]]>
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