Haggerty, K. P., Skinner, M. L., Catalano, R. F., Abbott, R. D., Crutchfield, R.D.

Long-term effects of Staying Connected with Your Teen on drug use frequency at age 20

Drug prevention interventions frequently target early adolescents in order to stop or delay initiation of substance use. However, the prevalence and frequency of drug use escalate and then peak during emerging adulthood, making it important to determine whether drug use prevention efforts in adolescence have lasting effects into adulthood. Additionally, given differences in drug use frequency between ethnic groups, intervention effects by race should be examined when possible. This study evaluates the efficacy of a family-focused prevention program, Staying Connected with Your Teen, delivered to parents and teens in the 8th grade, on family stressors during 9th and 10th grades, 10th- grade drug use (as potential mediators), and drug use frequency at age 20. Families (N = 331; Black = 163, White = 168) were randomly assigned to three conditions: parent-adolescent group-administered (PA), self-administered with telephone support (SA), and no-treatment control (Haggerty et al. Prevention Science, 8: 249-260, 2007). The impact of the intervention was assessed using latent variable structural equation models. Age 20 drug use frequency was significantly higher among Whites than Blacks as expected. The PA intervention had direct effects on reducing drug use frequency for both Blacks and Whites. The SA intervention had an impact on family stressors during adolescence for Whites, but not for Blacks. Results suggest that both formats for delivery were modestly efficacious for Whites, but only direct delivery was modestly efficacious for Blacks. Given the substantial savings in cost of the self-administered program over the group-administered format, improving the efficacy of self-administered programming for Blacks is recommended. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).

Prevention Science, 16(4) : 538-549

Guo, J. L., Lee, T. C., Liao, J. Y., Huang, C. M.

Prevention of illicit drug use through a school-based program: Results of a longitudinal, cluster-randomized controlled trial

Purpose: To evaluate the long-term effects of an illicit drug use prevention program for adolescents that integrates life skills into the theory of planned behavior. Methods: We conducted a cluster-randomized trial in which 24 participating schools were randomized to either an intervention group (12 schools, n = 1,176 students) or a control group (12 schools, n = 915 students). Participants were grade 7 students. The intervention comprised a main intervention of 10 sessions and two booster interventions. Booster 1 (four sessions) and booster 2 (two sessions) were performed at 6 months and 12 months, respectively, after completion of the main intervention. Assessments were made at baseline, after the main intervention, and after each booster session using specific questionnaires for measuring participants' attitudes, subjective norms, perceived behavioral control, and life skills. Results: Retention rates were 71.9% (845/1,176) in the intervention group and 90.7% (830/915) in the control group after the 12-month follow-up. A significantly lower proportion of intervention group participants reported illicit drug use after the first and second booster sessions compared with control group participants (.1% vs. 1.7% and .2% vs. 1.7%, respectively; both p < .05). Attitudes, subjective norms, perceived behavioral control, life skills, and behavioral intention scores of the intervention group were significantly higher than those of control group after the first and second booster sessions (all p < .001), suggesting that intervention group students tended to avoid drug use. Conclusions: A drug use prevention program integrating life skills into the theory of planned behavior may be effective for reducing illicit drug use and improving planned behavior-related constructs in adolescents. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).

Journal of Adolescent Health, 56(3) : 314-322

Estrada, Y., Rosen, A., Huang, S., Tapia, M., Sutton, M., Willis, L., Quevedo, A., Condo, C., Vidot, D. C., Pantin, H., Prado, G.

Efficacy of a brief intervention to reduce substance use and human immunodeficiency virus infection risk among Latino youth

Journal of Adolescent Health, 57(6) : 651-657

Durand, Z., Cook, A., Konishi, M., Nigg, C.

Alcohol and substance use prevention programs for youth in Hawaii and Pacific Islands: A literature review

This article provides a literature review of recent programs to prevent alcohol and substance use in Hawaii and Pacific Islander youths. Five programs for alcohol and substance use prevention among Hawaii and Pacific Islander youths were found in peer-reviewed literature. Of these, two focused on Native Hawaiians and/or other Pacific Islanders and three focused on overall youths in Hawaii. The main themes of these programs were increasing cultural pride, character development through personal efficacy and integrity, connecting youth to family and community, and being school- or community-centered. Two studies showed a decrease in substance use, one showed a change in knowledge, and two did not published outcomes. This review highlights a lack of evidence-based culturally appropriate options for preventing substance use by Native Hawaiian and Pacific Islander youth. Dialogue about best practices is needed and should be supported through publication of program evaluations.

Journal of Ethnicity in Substance Abuse, : 1- 12

Emmers, E, Bekkering, G. E., Hannes, K.

Prevention of alcohol and drug misuse in adolescents: An overview of systematic reviews

Background: Systematic reviews have evaluated a wide variety of programmes aiming to prevent, reduce or delay substance use in adolescents. This paper presents an overview of recent systematic reviews, summarising the evidence on the effectiveness of prevention strategies which target adolescents misusing alcohol and/or drugs. Methods: We performed a comprehensive search in major electronic databases, consulted websites and checked reference lists of relevant articles. Studies that met our inclusion criteria were critically appraised using the AMSTAR instrument. The findings from the included systematic reviews were synthesised using a vote counting procedure. Results: Twenty-one systematic reviews were identified. Ten of these were rated as of high quality. There was little overlap between reviews in terms of the target group, intervention, setting and outcome measures. The components or mechanisms of the prevention programmes were poorly described. Ten reviews evaluated school-based prevention. The effects of these prevention programmes are promising, while effects of community-based, family-based and multifaceted programmes were less convincing. Conclusion: Based on the current evidence, there is a small but consistent positive effect of school-based prevention programmes, but it is less clear what the \"active ingredient\" is. For example, which group should one target, in which setting and in which circumstances? A set of standardised process and outcome measures would allow us to better compare and statistically pool the results of original studies and reviews. This overview of reviews, like similar other overviews, should encourage researchers to increase uniformity and consistency between studies. This would improve the comparability of evidence, which is needed to formulate valid recommendations for practice. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).

Nordic Studies on Alcohol & Drugs, 32(2) : 183- 198

Espada-Sanchez, J. P., Hernandez-Serrano, Olga.

Effects of the Saluda prevention program: A review of controlled evaluation studies

The objective of the present study is to review the evidence on the effectiveness concerning the Saluda program, a school-based substance use prevention protocol used amongst adolescents. We provide a description of the program content and the results from nine controlled trials evaluating the program effectiveness. Participants were Spanish students aged between 12 and 16 years old. The program was created on the basis of the results from a quantitative review focused on Spanish programs, in which the most effective components were identified. Early trials compared their results with respect to a proven-effectiveness program and an unspecific health- promotion intervention, showing positive effects. Subsequent studies focused on the effects of the program according to the type of applicant, the age of participants, and attitudinal and cognitive aspects. Recent studies focused on analysing the program components effectiveness, as well as the contribution of the assigned tasks. This study summarizes strong empiric evidence concerning the program effectiveness on both risk and protective variables, at the time that further lines to improve the program effectiveness and efficiency are established. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).

Electronic Journal of Research in Educational Psychology, 13(1) : 171- 188

Flynn, A. B., Falco, M., Hocini, S.

Independent evaluation of middle school-based drug prevention curricula a systematic review

IMPORTANCE Lack of robust program evaluation has hindered the effectiveness of school-based drug abuse prevention curricula overall. Independently evaluated randomized controlled trials (RCTs) of universal, middle school-based drug abuse prevention curricula are the most useful indicators of whether such programs are effective or ineffective. OBJECTIVE To conduct a systematic review identifying independently evaluated RCTs of universal, middle school-based drug abuse prevention curricula; extract data on study quality and substance use outcomes; and assess evidence of program effectiveness. EVIDENCE REVIEW PsycInfo, Educational Resources Information Center, Science Citation Index, Social Science Citation Index, Cumulative Index to Nursing and Allied Health Literature, MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews were searched between January 1, 1984, and March 15, 2015. Search terms included variations of drug, alcohol, tobacco, and marijuana use, as well as school, prevention, and effectiveness. Studies included in the review were RCTs carried out by independent evaluators of universal school-based drug prevention curricula available for dissemination in the United States that reported alcohol, tobacco, marijuana, or other drug use outcomes. Two researchers extracted data on study quality and outcomes independently using a data extraction form and met to resolve disagreements. FINDINGS A total of 5071 publications were reviewed, with 13 articles meeting final inclusion criteria. Of the 13 articles, 6 RCTs of 4 distinct school-based curricula were identified for inclusion. Outcomes were reported for 42 single-drug measures in the independent RCTs, with just 3 presenting statistically significant (P <.05) differences between the intervention group and the control group. One program revealed statistically significant positive effects at final follow-up (Lions-Quest Skills for Adolescence). CONCLUSIONS AND RELEVANCE The results of our review demonstrate the dearth of independent research that appropriately evaluates the effectiveness of universal, middle school-based drug prevention curricula. Independent evaluations show little evidence of effectiveness for widely used programs. New methods may be necessary to approach school-based adolescent drug prevention.

JAMA Pediatrics, 169(11) : 1046-1052

Dakof, G. A., Henderson, C. E., Rowe, C.L., Boustani, M., Greenbaum, P. E., Wang, W., Hawes, S., Linares, C., Liddle, H. A.

A randomized clinical trial of family therapy in juvenile drug court

Unlabelled: The objective of this article is to examine the effectiveness of 2 theoretically different treatments delivered in juvenile drug court--family therapy represented by multidimensional family therapy (MDFT) and group-based treatment represented by adolescent group therapy (AGT)--on offending and substance use. Intent-to-treat sample included 112 youth enrolled in juvenile drug court (primarily male [88%], and Hispanic [59%] or African American [35%]), average age 16.1 years, randomly assigned to either family therapy (n = 55) or group therapy (n = 57). Participants were assessed at baseline and 6, 12, 18 and 24 months following baseline. During the drug court phase, youth in both treatments showed significant reduction in delinquency (average d = .51), externalizing symptoms (average d = 2.32), rearrests (average d = 1.22), and substance use (average d = 4.42). During the 24-month follow-up, family therapy evidenced greater maintenance of treatment gains than group-based treatment for externalizing symptoms (d = 0.39), commission of serious crimes (d = .38), and felony arrests (d = .96). There was no significant difference between the treatments with respect to substance use or misdemeanor arrests. The results suggest that family therapy enhances juvenile drug court outcomes beyond what can be achieved with a nonfamily based treatment, especially with respect to what is arguably the primary objective of juvenile drug courts: reducing criminal behavior and rearrests. More research is needed on the effectiveness of juvenile drug courts generally and on whether treatment type and family involvement influence outcomes.; Trial Registry Name: Clinical Trials.gov, Identified NCT01668303.; (c) 2015 APA, all rights reserved).

Journal of Family Psychology, 29(2) : 232- 241

Dodge, K. A., Bierman, K. L., Coie, J. D., Greenberg, M. T., Lochman, J. E., McMahon, R. J., Pinderhughes, E. E.

Impact of early intervention on psychopathology, crime, and well-being at age 25

Objective: This randomized controlled trial tested the efficacy of early intervention to prevent adult psychopathology and improve well-being in early-starting conduct-problem children. Method: Kindergarteners (N=9,594) in three cohorts (1991-1993) at 55 schools in four communities were screened for conduct problems, yielding 979 early starters. A total of 891(91%) consented (51% African American, 47% European American; 69% boys). Children were randomly assigned by school cluster to a 10-year intervention or control. The intervention goal was to develop social competencies in children that would carry them throughout life, through social skills training, parent behavior-management training with home visiting, peer coaching, reading tutoring, and classroom social-emotional curricula. Manualization and supervision ensured program fidelity. Ninety-eight percent participated during grade 1, and 80% continued through grade 10. At age 25, arrest recordswere reviewed (N=817, 92%), and condition-blinded adults psychiatrically interviewed participants (N=702; 81% of living participants) and a peer (N=535) knowledgeable about the participant. Results: Intent-to-treat logistic regression analyses indicated that 69% of participants in the control arm displayed at least one externalizing, internalizing, or substance abuse psychiatric problem (based on self- or peer interview) at age 25, in contrast with 59% of those assigned to intervention (odds ratio=0.59, CI=0.43-0.81; number needed to treat=8). This pattern also held for self-interviews, peer interviews, scores using an \"and\" rule for self- and peer reports, and separate tests for externalizing problems, internalizing problems, and substance abuse problems, as well as for each of three cohorts, four sites, male participants, female participants, African Americans, European Americans, moderate-risk, and high-risk subgroups. Intervention participants also received lower severity-weighted violent (standardized estimate=-0.37) and drug (standardized estimate=-0.43) crime conviction scores, lower risky sexual behavior scores (standardized estimate=-0.24), and higher well-being scores (standardized estimate=0.19). Conclusions: This study provides evidence for the efficacy of early intervention in preventing adult psychopathology among high-risk early-starting conduct-problem children.

American Journal of Psychiatry, 172(1) : 59- 70

Antonio, M. C., Chung-Do, J. J.

Systematic review of interventions focusing on indigenous adolescent mental health and substance use

Mental health and substance use are pressing public health concerns among Indigenous adolescent populations. This systematic review analyzed interventions focusing on mental health and substance use that utilize the Positive Youth Development (PYD) framework, incorporate culturally tailored programs, and are geared toward Indigenous adolescents. In total, 474 articles were retrieved from PSYCInfo and PubMed databases. Eight articles were eligible for analysis, with six focusing on AI/AN populations in the U.S. Most programs reported positive or expected outcomes. All the programs incorporated PYD variables, while all but one were culturally grounded or included deep structure adaptations. Implications are further discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (journal abstract).

American Indian & Alaska Native Mental Health Research, 22(3) : 36-56

Agabio, R., Trincas, G., Floris, F., Mura, G., Sancassiani, F., Angermeyer, M. C.

A systematic review of school-based alcohol and other drug prevention programs

Background: Alcohol use in adolescents constitutes a major public health concern. Europe is the heaviest drinking region of the world. Several school-based alcohol prevention programs have been developed but it is not clear whether they are really effective. The present study was aimed at identifying the typology with the best evidence of effectiveness in European studies. Methods: A systematic search of meta-analyses and/or randomized controlled trials (RCTs) on interventions school-based prevention programs aimed at preventing alcohol consumption or changing the attitudes to consume alcohol. Results: A meta-analysis published in 2011 and 12 RCTs more recently published were identified. The meta-analysis evaluated 53 RCTs but only 11.3% of them were conducted in Europe. Globally, 23 RCTs (43.4%) showed some evidence of effectiveness, and 30 RCTs (56.6%) did not find significant difference between the groups. According to the conclusions of the meta-analysis, the Unplugged program should be considered as a practice option in Europe. Among the other 12 RCTs, 42% were conducted in Europe. Globally, 7 studies (58.3%) achieved positive results, and 5 studies (41.7%) did not find significant differences or produced a mixed pattern of results. Three of the 5 European trials (60%) used the Unplugged program with positive results. Conclusion: Even if further studies should be conducted to confirm these results, Unplugged appears to be the prevention project with the best evidence of effectiveness in European studies.

Clinical Practice & Epidemiology in Mental Health, 11 : 102- 112

Allara, E, Ferri, M., Bo, A., Gasparrini, A., Faggiano, F.

Are mass-media campaigns effective in preventing drug use? A Cochrane systematic review and meta-analysis

Objective: To determine whether there is evidence that mass-media campaigns can be effective in reducing illicit drug consumption and the intent to consume.; Design: Systematic review of randomised and non-randomised studies.; Methods: We searched four electronic databases (MEDLINE, EMBASE, ProQuest Dissertations & Theses A&I and CENTRAL) and further explored seven additional resources to obtain both published and unpublished materials. We appraised the quality of included studies using standardised tools. We carried out meta-analyses of randomised controlled trials and a pooled analysis of interrupted time-series and controlled before-and-after studies.; Results: We identified 19 studies comprising 184,811 participants. Pooled analyses and narrative synthesis provided mixed evidence of effectiveness. Eight interventions evaluated with randomised controlled trials leaned towards no evidence of an effect, both on drug use (standardised mean difference (SMD) -0.02; 95% CI -0.15 to 0.12) and the intention to use drugs (SMD -0.07; 95% CI -0.19 to 0.04). Four campaigns provided some evidence of beneficial effects in preventing drug use and two interventions provided evidence of iatrogenic effects.; Conclusions: Studies were considerably heterogeneous in type of mass-media intervention, outcome measures, underlying theory, comparison groups and design. Such factors can contribute to explaining the observed variability in results. Owing to the risk of adverse effects, caution is needed in disseminating mass-media campaigns tackling drug use. Large studies conducted with appropriate methodology are warranted to consolidate the evidence base.; Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

BMJ Open, 5(9) : e007449-e007449