Patton, G. C., Sawyer, S. M., Santelli, J. S., Ross, D. A., Afifi, R., Allen, N. B., Arora, M., Azzopardi, P., Baldwin, W., Bonell, C., Kakuma, R., Kennedy, E., Mahon, J., McGovern, T., Mokdad, A. H., Patel, V., Petroni, S., Reavley, N., Taiwo, K., Waldfogel, J., Wickremarathne, D., Barroso, C., Bhutta, Z., Fatusi, A. O., Mattoo, A., Diers, J., Fang, J., Ferguson, J., Ssewamala, F., Viner, R. M.

Our future: a Lancet commission on adolescent health and wellbeing

Lancet, 387(10036) : 2423- 78

Onrust, S. A., Otten, R., Lammers, J., Smit, F.

School-based programmes to reduce and prevent substance use in different age groups: What works for whom? Systematic review and meta-regression analysis

Background: Findings from systematic reviews and meta-analyses about the effectiveness of school-based programmes to prevent or reduce substance abuse are inconclusive. We hypothesise that in order to be effective, programmes have to be aligned with the developmental stages of the intended target group (childhood, early, middle, or late adolescence). The present study provides an overview of universal and targeted programmes, while distinguishing four age groups and examining which intervention characteristics are the effective components for the respective groups. Methods: Databases were searched for controlled studies of school-based programmes, evaluating their effectiveness on either smoking, alcohol or drug use. Multivariate meta-regression analysis was used to analyse the associations between effects and programme characteristics. Results: Our meta- analysis evaluates 288 programmes with a total of 436,180 participants. The findings support our hypothesis that specific aspects of the school-based programmes are effective in some developmental stages, but not for other age groups. The differences in effectiveness are systematically related to psychological and cognitive needs and capacities. Discussion: Our findings highlight the importance of considering a developmental perspective when designing and offering school-based prevention programmes. The various developmental stages offer different possibilities and opportunities for the reduction and prevention of substance use. Copyright © 2015 The Authors.

Clinical Psychology Review, 44 : 45-59

Noel, V., Stanger, C., Budney, A. J.

Parent tobacco use, monitoring, and impulsive decision making: Predictors of post treatment youth substance use [conference abstract]

Aims: While contingency management (CM) interventions are effective in decreasing youth substance use, this effect is shortterm. Poor parent monitoring and tobacco use predict youth substance use but their role and the role of parent impulsive decision making in substance use relapse is unknown. This study examined the influence of parent impulsive decision making and tobacco use on parent monitoring and the treatment related changes in parent monitoring on post treatment youth substance use. Methods: Participants included 230 youths aged 12-18 years who abused either alcohol, marijuana or both, and their parent(s). Families participated in a 14-week randomized trial examining the efficacy of the addition of CM to MET/CBT intervention. Frequency of youth substance use was assessed using the Timeline Follow Back method. Parents self-reported their tobacco use and monitoring of youth behaviors. To measure impulsive decision making, parents completed a delay discounting task (degree of preference for smaller immediate over larger delayed rewards). Results: A latent growth model for youth substance use frequency at discharge, 3, 6, and 9months was fit. Five predictors were then added: parent monitoring at intake/discharge, treatment condition, parent delay discounting, and parent tobacco smoking status (smoker/non-smoker). The final model fit well (X2(18, N= 230) = 17.55, p = .49, RMSEA= .00). Poor parent monitoring at intake (B = .68) and higher parent delay discounting (B = .14) was associated with poor parent monitoring at discharge. Although treatment condition did not predict youth substance use post treatment, poor parent monitoring at discharge (B = .39) and parent tobacco use (B = .37) predicted the youth substance use intercept (more days of substance use during treatment) accounting for 31% of the variance. No variable predicted rate of change in substance use post treatment. Conclusions: Addressing parent substance use and impulsive decision making and targeting parent monitoring may be beneficial in improving the maintenance of parent monitoring and reducing youth substance use long-term.

Drug & Alcohol Dependence, 146 : e53

Oesterle, S., Hawkins, J., Kuklinski, M. R., Fagan, A. A., Fleming, C., Rhew, I. C., Brown, E. C., Abbott, R. D., Catalano, R. F.

Effects of communities that care on males' and females' drug use and delinquency 9 years after baseline in a community-randomized trial

This study tested sustained effects of the Communities That Care (CTC) prevention system on health-risking behaviors 9 years after baseline in a community-randomized trial involving 24 towns in seven states. Earlier analyses found sustained effects on abstinence from drug use and delinquency through Grade 12 in a panel of fifth graders. At age 19, 91 % (n = 3986) of the living panel completed the survey. Data were analyzed using generalized linear mixed models. The prevalence of lifetime and current substance use and delinquency were the primary outcomes. Secondary outcomes included substance use disorders, major depression, suicidality, educational attainment, and sexual risk behaviors. CTC had a significant overall effect across lifetime measures of the primary outcomes for males, but not for females or the full sample, although lifetime abstinence from delinquency in the full sample was significantly higher in CTC communities (ARR = 1.16). Males in CTC communities also continued to show greater lifetime abstinence from cigarette smoking (ARR = 1.22). CTC did not have a sustained effect on current substance use and delinquency nor did it improve the secondary outcomes at age 19 for either gender. Communities using CTC may need to extend their prevention planning to include the high school years to sustain effects on drug use and delinquency beyond high school for both genders. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (journal abstract).

American Journal of Community Psychology, 56(3- 4) : 217-228

Mason, M., Ola, B., Zaharakis, N., Zhang, J.

Text messaging interventions for adolescent and young adult substance use: A meta-analysis

Tobacco and alcohol use continues to be associated with negative health outcomes among adolescents and young adults. New technologies such as text messaging can increase access to substance use interventions and have now been established as an evidence-based, recommended approach towards substance use prevention. This review presents results from a meta-analysis examining the effectiveness of text message interventions for tobacco and alcohol cessation within adolescent and young adult populations. Results from 14 studies with effect sizes are ranging from -0.25 to 0.54. Combining the effect sizes across studies yielded a summary effect size of 0.25, indicating that in general, text interventions have a positive effect on reducing substance use behaviors. Results are discussed in the context of prevention opportunities and recommendations for future text messaging intervention research. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).

Prevention Science, 16(2) : 181- 188

Kouyoumdjian, F. G., McIsaac, K. E., Liauw, J., Green, S., Karachiwalla, F., Siu, W., Burkholder, K., Binswanger, I., Kiefer, L., Kinner, S. A., Korchinski, M., Matheson, F. I., Young, P., Hwang, S. W.

A systematic review of randomized controlled trials of interventions to improve the health of persons during imprisonment and in the year after release

We systematically reviewed randomized controlled trials of interventions to improve the health of people during imprisonment or in the year after release. We searched 14 biomedical and social science databases in 2014, and identified 95 studies. Most studies involved only men or a majority of men (70/83 studies in which gender was specified); only 16 studies focused on adolescents. Most studies were conducted in the United States (n?=?57). The risk of bias for outcomes in almost all studies was unclear or high (n?=?91). In 59 studies, interventions led to improved mental health, substance use, infectious diseases, or health service utilization outcomes; in 42 of these studies, outcomes were measured in the community after release. Improving the health of people who experience imprisonment requires knowledge generation and knowledge translation, including implementation of effective interventions.

American Journal of Public Health, 105(4) : e13- e33

Kirby, K. C., Meyers, K., Carpenedo, C. M., Bresani, E., Dugosh, K. L., Zentgraf, K., Zaslav, D.

Randomized, controlled trial of craft for parents of treatment-resistant adolescents and young adults: Interim results [conference abstract]

Aims: Little research has examined methods for helping parents with treatment-resistant adolescents (12-17 yrs) and young adults (18-25 yrs).Weadapted the Community Reinforcement and Family Training (CRAFT) program for treatment-resistant adults for use by parents dealing with treatment resistant youth (12-25 yrs) and evaluated the revised program on efficacy in facilitating treatment entry, reducing drug use, and reducing behavior problems. Methods: Parents (N= 56) were randomly assigned to receive 12 individual sessions of either CRAFT (n = 32) or Alanon/NarAnon Facilitation Training (AFT; n = 24) delivered at our Family Training Program (FTP). Youth treatment entry was monitored weekly and at 3- and 6-month follow-up assessments. Substance use and behavior problems were monitored through parent report at 3- and 6-month follow-up assessments. Results: Large differences were seen in the number of youth receiving a treatment referral with 75% of the CRAFT parents getting their child to FTP for a referral compared to 33% in the ANF group (2 = 9.722, p = .002). Rates of transfer for youth from FTP to specialty treatment in the community were lower: 41% vs 29% in CRAFT and ANF, respectively. Although not statistically significant, there were small to moderate effect sizes for a group by time interaction for drug use (d = .38) and for problem reduction (d = .36 for adolescents; d = .62 for young adults) favoring greater reductions in CRAFT. Conclusions: Preliminary results suggest that the modified CRAFT program is more efficacious than ANF in getting youth into treatment. Effects on drug use and problem behavior are not yet clear.

Drug & Alcohol Dependence, 156 : e112

Marsiglia, F. F., Kulis, S. S., Booth, J. M., Nuno-Gutierrez, B. L., Robbins, D. E.

Long-term effects of the keepin' it REAL model program in Mexico: Substance use trajectories of Guadalajara middle school students

In the face of rising rates of substance use among Mexican youth and rapidly narrowing gender differences in use, substance use prevention is an increasingly urgent priority for Mexico. Prevention interventions have been implemented in Mexico but few have been rigorously evaluated for effectiveness. This article presents the long term effects of a Mexico-based pilot study to test the feasibility of a linguistically specific (Mexican Spanish) adapted version of keepin'it REAL, a school-based substance abuse prevention model program. University affiliated researchers from Mexico and the US collaborated on the study design, program implementation, data collection, and analysis. Students and their teachers from two middle schools (secundarias) in Guadalajara participated in this field trial of Mantente REAL (translated to Spanish). The schools were randomly assigned to treatment and control conditions. The sample of 431 students reported last 30 day substance use at three times (one pretest and two posttests). Changes in substance use behaviors over time were examined using growth curve models. Long term desired intervention effects were found for alcohol and marijuana use but not for cigarettes. The intervention effects were greater for girls than for boys in slowing the typical developmental increase over time in alcohol use. Marijuana effects were based on small numbers of users and indicate a need for larger scale studies. These findings suggest that keepin' it REAL is a promising foundation for cultural program adaptation efforts to create efficacious school-based universal prevention interventions for middle school students in Mexico. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).

Journal of Primary Prevention, 36(2) : 93- 104

Gulliver, A., Farrer, L., Chan, J. K., Tait, R. J., Bennett, K., Calear, A. L., Griffiths, K. M.

Technology-based interventions for tobacco and other drug use in university and college students: a systematic review and meta-analysis

BACKGROUND: University students have high levels of tobacco and other drug use, yet they are unlikely to seek traditional care. Technology-based interventions are highly relevant to this population. This paper comprises a systematic review and meta-analysis of published randomized trials of technology-based interventions evaluated in a tertiary (university/college) setting for tobacco and other drug use (excluding alcohol). It extends previous reviews by using a broad definition of technology.\rMETHODS: PubMed, PsycInfo, and the Cochrane databases were searched using keywords, phrases, and MeSH terms. Retrieved abstracts (n = 627) were double screened and coded. Included studies met the following criteria: (1) the study was a randomized trial or a randomized controlled trial (RCT); (2) the sample was composed of students attending a tertiary (e.g., university, college) institution; (3) the intervention was either delivered by or accessed using a technological device or process (e.g., computer/internet, telephone, mobile short message services [SMS]); (4) the age range or mean of the sample was between 18 and 25 years; and (5) the intervention was designed to alter a drug use outcome relating to tobacco or other drugs (excluding alcohol).\rRESULTS: A total of 12 papers met inclusion criteria for the current review. The majority of included papers examined tobacco use (n = 9; 75%), two studies targeted marijuana use (17%); and one targeted stress, marijuana, alcohol, and tobacco use. A quantitative meta-analysis was conducted on the tobacco use studies using an abstinence outcome measure (n = 6), demonstrating that the interventions increased the rate of abstinence by 1.5 times that of controls (Risk Ratio [RR] = 1.54; 95% Confidence Interval [CI] = 1.20- 1.98). Across all 12 studies, a total of 20 technology-based interventions were reviewed. A range of technology was employed in the interventions, including stand-alone computer programs (n = 10), internet (n = 5), telephone (n = 3), and mobile SMS (n = 2).\rCONCLUSIONS: Although technological interventions have the potential to reduce drug use in tertiary students, very few trials have been conducted, particularly for substances other than tobacco. However, the improvement shown in abstinence from tobacco use has the potential to impact substantially on morbidity and mortality.

Addiction Science & Clinical Practice, 10 : 5

Himelstein, S., Saul, S., Garcia-Romeu, A.

Does mindfulness meditation increase effectiveness of substance abuse treatment with incarcerated youth? A pilot randomized controlled trial

A growing body of evidence suggests that mindfulness meditation is associated with a number of physiological and psychological benefits in both adult and juvenile populations. Research on mindfulness- based interventions among at-risk and incarcerated youth populations has also shown feasibility as a means of enhancing self-regulation and well- being. This randomized controlled trial examined an 8- to 12-week program in which participants received individual and group psychotherapy. Participants in the experimental condition received formal mindfulness training alongside psychotherapy, while those in the control condition received psychotherapy without mindfulness training. All participants received the group intervention. Participants were recruited from a court- mandated substance abuse group treatment program at a juvenile detention camp in the San Francisco Bay Area. Participants were 35 incarcerated youth (100 % male; 70 % Hispanic; mean age = 16.45). Of these, 27 provided complete pre- and post-treatment assessment data. Measures of mindfulness, locus of control, decision-making, self-esteem, and attitude toward drugs were administered before and after the intervention. Detention camp staff provided behavioral rating points for each participant in the week prior to beginning the study treatment and in the week after completing the intervention. Significant increases in self-esteem (p < 0.05) and decision-making skills (p < 0.01) were observed among the entire study sample. Between-group analyses found significantly greater increases in self-esteem (p < 0.05) and staff ratings of good behavior (p < 0.05) in the mindfulness treatment group, consistent with prior research. These results suggest a potentially important role for mindfulness-based interventions in improving well-being and decreasing recidivism among this at-risk population. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).

Mindfulness, 6(6) : 1472-1480

Hogue, A., Dauber, S., Henderson, C. E., Bobek, M., Johnson, C., Lichvar, E., Morgenstern, J.

Randomized trial of family therapy versus nonfamily treatment for adolescent behavior problems in usual care

A major focus of implementation science is discovering whether evidence-based approaches can be delivered with fidelity and potency in routine practice. This randomized trial compared usual care family therapy (UC-FT), implemented without a treatment manual or extramural support as the standard-of-care approach in a community clinic, to nonfamily treatment (UC-Other) for adolescent conduct and substance use disorders. The study recruited 205 adolescents (Mage = 15.7 years; 52% male; 59% Hispanic American, 21% African American) from a community referral network, enrolling 63% for primary mental health problems and 37% for primary substance use problems. Clients were randomly assigned to either the UC-FT site or one of five UC-Other sites. Implementation data confirmed that UC-FT showed adherence to the family therapy approach and differentiation from UC-Other. Follow-ups were completed at 3, 6, and 12 months postbaseline. There was no between-group difference in treatment attendance. Both conditions demonstrated improvements in externalizing, internalizing, and delinquency symptoms. However, UC-FT produced greater reductions in youth-reported externalizing and internalizing among the whole sample, in delinquency among substance-using youth, and in alcohol and drug use among substance-using youth. The degree to which UC-FT outperformed UC-Other was consistent with effect sizes from controlled trials of manualized family therapy models. Nonmanualized family therapy can be effective for adolescent behavior problems within diverse populations in usual care, and it may be superior to nonfamily alternatives. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).

Journal of Clinical Child & Adolescent Psychology, 44(6) : 954-969

Horigian, V. E., Feaster, D. J., Robbins, M. S., Brincks, A. M., Ucha, J., Rohrbaugh, M. J., Shoham, V., Bachrach, K., Miller, M., Burlew, A. K., Hodgkins, C. C., Carrion, I. S., Silverstein, M., Werstlein, R., Szapocznik, J.

A cross- sectional assessment of the long term effects of brief strategic family therapy for adolescent substance use

Background Young adult drug use and law- breaking behaviors often have roots in adolescence. These behaviors are predicted by early drug use, parental substance use disorders, and disrupted and conflict-ridden family environments. Aim To examine long-term outcomes of Brief Strategic Family Therapy (BSFT) compared to treatment as usual (TAU) in the rates of drug use, number of arrests and externalizing behaviors in young adults who were randomized into treatment conditions as adolescents. Design 261 of 480 adolescents who had been randomized to BSFT or TAU in the BSFT effectiveness study were assessed at a single time, 3-7 years post randomization. Methods Assessments of drug use, externalizing behaviors, arrests and incarcerations were conducted using Timeline Follow Back, Adult Self Report, and self-report, respectively. Drug use, arrests and incarcerations were examined using negative binomial models and externalizing behaviors were examined using linear regression. Results When compared with TAU, BSFT youth reported lower incidence of lifetime (IRR = 0.68, 95%CI [0.57, 0.81]) and past year (IRR = 0.54, 95%CI [0.40, 0.71]) arrests; lower rates of lifetime (IRR = 0.63, 95%CI [0.49, 0.81]) and past year (IRR = 0.70, 95%CI [0.53, 0.92]) incarcerations; and lower scores on externalizing behaviors at follow-up (B = -0.42, SE =.15, p =.005). There were no differences in drug use. Conclusions and Scientific Significance BSFT may have long term effects in reducing the number of arrests, incarcerations and externalizing problems. These effects could be explained by the improvements in family functioning that occurred during the effectiveness study. This study contributes to the literature by reporting on the long term outcomes of family therapy for adolescent drug abuse.

American Journal on Addictions, 24(7) : 637-645