Disorders - Substance Use Disorders
Schinke, Steven P., Fang, Lin, Cole, Kristin C.
Objective: Methods: Results: Conclusions: To test a computer-delivered program for preventing substance use among adolescent girls.Randomly, 916 girls aged 12.76+/-1.0 years and their mothers were assigned to an intervention arm or to a test-only control arm. Intervention-arm dyads engaged in exercises to improve the mother-daughter relationship, build girls' substance use prevention skills, and reduce associated risk factors. Study outcomes were girls' and mothers' substance use and mediator variables related to girls' substance use risk and protective factors. The study was conducted between September 2006 and February 2009 with participants from greater New York City, including southern Connecticut and eastern New Jersey.At 2-year follow-up and relative to control-arm girls, intervention-arm girls reported lower relevant risk factors and higher protective factors as well as less past 30-day use of alcohol (p<0.006), marijuana (p<0.016), illicit prescription drugs (p<0.03), and inhalants (p<0.024). Intervention-arm mothers showed more positive 2-year outcomes than control-arm mothers on variables linked with reduced risks of substance use among their daughters, and mothers reported lower rates of weekly alcohol consumption (p<0.0001).A computer-delivered prevention program for adolescent girls and their mothers was effective in changing girls' risk and protective factors and girls' and mothers' substance use behavior.
Preventive Medicine, 49(5) : 429-435
- Year: 2009
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Skills training, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Schinke, Steven P., Fang, Lin, Cole, Kristin C.
This study tested a computerized gender-specific, parent-involvement intervention program grounded in family interaction theory and aimed at preventing substance use among adolescent girls. Following program delivery and 1 year later, girls randomly assigned to the intervention arm improved more than girls in a control arm on variables associated with reduced risks for substance use, including communication with their mothers, knowledge of family rules about substance use, awareness of parental monitoring of their discretionary time, non-acceptance of peer substance use, problem-solving skills, and ability to refuse peer pressure to use substances. Relative to control-arm girls, those in the intervention arm also reported less 30-day use of alcohol and marijuana and lower intentions to smoke, drink, and take illicit drugs in the future. Girls' mothers in the intervention arm reported greater improvements after the program and relative to control-arm mothers in their communication with their daughters, establishment of family rules about substance use, and monitoring of their daughters' discretionary time. Study findings lend support to the potential of gender-specific, parent-involvement, and computerized approaches to preventing substance use among adolescent girls.
Addictive Behaviors, 34(12) : 1060-1064
- Year: 2009
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Skills training, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Spoth, Richard, Guyll, Max, Shin, Chungyeol
Objectives: Methods: Results: Conclusions: We examined universal preventive intervention effects on adolescents' exposure to opportunities for substance use and on illicit substance use in the long term.Public schools (N = 22) were randomly assigned to the Iowa Strengthening Families Program (ISFP) or a control condition. We used odds ratio (OR) calculations and structural modeling to test the effects of the ISFP in the 6th grade on exposure to substance use across adolescence, as well as on 12th-grade illicit substance use occurring via reductions in exposure.The ISFP was associated with reduced exposure to illicit substance use (1.25 < or = OR < or = 2.37) that was, in turn, associated with reduced 12th-grade substance use (2.87 < or = OR < or = 6.35). The ISFP also reduced the rate of increase in exposure across adolescence (B = -0.37; P < .001), which was associated with the likelihood of 12th-grade illicit substance use (B = 0.30; P = .021), with a significant indirect effect (B = -0.11; P = .048).The ISFP in the 6th grade reduced substance use through a "protective shield" of reduced exposure. The relative reduction rate was 49%, which suggests that universal prevention shields can contribute to significant reductions in illicit substance use among adolescents.
American Journal of Public Health, 99(11) : 2026-2033
- Year: 2009
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
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Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Spoth, Richard, Trudeau, Linda, Guyll, Max, Shin, Chungyeol, Redmond, Cleve
In this article, the authors examine whether delayed substance initiation during adolescence, achieved through universal family-focused interventions conducted in middle school, can reduce problematic substance use during young adulthood. Sixth-grade students enrolled in 33 rural midwestern schools and their families were randomly assigned to 3 experimental conditions. Self-report questionnaires provided data at 7 time points for the Iowa Strengthening Families Program (ISFP), Preparing for the Drug Free Years (PDFY), and control groups through young adulthood. Five young adult substance frequency measures (drunkenness, alcohol-related problems, cigarettes, illicit drugs, and polysubstance use) were modeled as distal outcomes affected by the average level and rate of increase in substance initiation across the adolescent years in latent growth curve analyses. Results show that the models fit the data and that they were robust across outcomes and interventions, with more robust effects found for ISFP. The addition of direct intervention effects on young adult outcomes was not supported, suggesting long-term effects were primarily indirect. Relative reduction rates were calculated to quantify intervention-control differences on the estimated proportion of young adults indicating problematic substance use; they ranged from 19% to 31% for ISFP and from 9% to 16% for PDFY.
Journal of Consulting & Clinical Psychology, 77(4) : 620-632
- Year: 2009
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
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Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Sloboda, Zili, Stephens, Richard C., Stephens, Peggy C., Grey, Scott F., Teasdale, Brent, Hawthorne, Richard D., Williams, Joseph, et-al
Objectives: Methods: Results: Conclusions: The purpose of the study was to determine whether a universal school-based substance abuse prevention program, Take Charge of Your Life (TCYL), prevents or reduces the use of tobacco, alcohol, or marijuana.Eighty-three school clusters (representing school districts) from six metropolitan areas were randomized to treatment (41) or control (42) conditions. Using active consenting procedures, 19,529 seventh graders were enrolled in the 5-year study. Self-administered surveys were completed by the students annually. Trained Drug Abuse Resistance Education (D.A.R.E.) police officers presented TCYL in seventh and ninth grades in treatment schools. Analyses were conducted with data from 17,320 students who completed a baseline survey. Intervention outcomes were measured using self-reported past-month and past-year use of tobacco, alcohol, and marijuana when students were in the 11th grade.Main effect analyses show a negative program effect for use of alcohol and cigarettes and no effect for marijuana use. Subgroup analyses indicated that the negative effect occurred among nonusers at baseline, and mostly among white students of both genders. A positive program effect was found for students who used marijuana at baseline. Two complementary papers explore the relationship of the targeted program mediators to the use of alcohol, tobacco, and marijuana and specifically for students who were substance-free or who used substances at baseline.The negative impact of the program on baseline nonusers of alcohol and tobacco indicate that TCYL should not be delivered as a universal prevention intervention. The finding of a beneficial effect for baseline marijuana users further supports this conclusion. The programmatic and methodological challenges faced by the Adolescent Substance Abuse Prevention Study (ASAPS) and lessons learned offer insights for prevention researchers who will be designing similar randomized field trials in the future.
Drug & Alcohol Dependence, 102(1-3) : 1-10
- Year: 2009
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation, Skills training
Ringwalt, Christopher L., Clark, Heddy Kovach, Hanley, Sean, Shamblen, Stephen R., Flewelling, Robert L.
Objective: Design: Setting: Participants: Main Outcome Measures: Results: Conclusion: To evaluate the effects of Project ALERT on adolescents' lifetime and 30-day use of cigarettes, alcohol, marijuana, and inhalants.Cluster randomized trial.Schools from 11 states were enrolled in 2 successive cohorts from 2004 to 2008.All public schools in the United States that included grades 6 through 8 and enrolled at least 100 students in sixth grade were recruited. Of the 40 schools that began the study, 34 (17 per condition) completed it. Data were analyzed from 5883 unique participants. Intervention Project ALERT, a manualized classroom-based substance use prevention curriculum for the middle grades, was taught to sixth and seventh graders.Students were surveyed before the onset of the intervention, as sixth graders, and after the completion of the 2-year intervention, as seventh graders. Outcome measures included lifetime and 30-day use of cigarettes, alcohol, marijuana, and inhalants.At baseline, students in the intervention condition were slightly to moderately more likely to report use for each of the 8 measures examined than were students in the control condition. For all measures except lifetime use of cigarettes, these differences were less pronounced at follow-up and therefore were in the direction of favorable program effects. These changes were statistically significant, however, for only 1 outcome measure, past 30-day use of alcohol (reduction in the adjusted odds ratio from 2.07 at baseline to 1.32 at follow-up; P = .006).Project ALERT was not effective when delivered to the sixth grade population we targeted.
Archives of Pediatrics & Adolescent Medicine, 163(7) : 625-632
- Year: 2009
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
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Stage: Universal prevention
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Treatment and intervention: Psychological Interventions (any)
, Psychoeducation, Skills training
Teesson, M., Newton, N. C., Vogl, L. E., Andrews, G.
Aims: To establish the efficacy and feasibility of the Climate Schools: Alcohol and Cannabis course, an internet based prevention program for alcohol and cannabis use in adolescents. Design: A cluster randomised control trial. Intervention and control groups were assessed at baseline, immediately post and at six months follow-up. Participants: They were 764, 13-year old from ten secondary schools in Sydney, Australia. Half the schools were randomly allocated to the computerised prevention program (n=397 students), and half to their usual health classes (n=367 students). Intervention: Computerised, evidence based, curriculum consistent lessons were developed to reduce alcohol and cannabis use. The 6 lessons on alcohol were given at the beginning of the year and the 6 lessons on alcohol and cannabis use were given 6 months later. Measures: Alcohol and cannabis knowledge, expectancies and attitudes, alcohol consumption (frequency, quantity and binging), frequency of cannabis use, and harms associated with one's use of alcohol and cannabis were assessed at baseline, the end of the course and six month follow-up. Results: There were significant improvements in knowledge regarding alcohol and cannabis use at end of course and at the 6 month follow-up. Frequency of drinking to excess was reduced immediately after the intervention, and average weekly alcohol consumption and frequency of cannabis use was reduced at the 6 month follow-up. No differences between groups were found on alcohol expectancies, cannabis attitudes, or harms related to alcohol and cannabis use. Conclusions: The Climate Schools: Alcohol and Cannabis course is acceptable and scalable, and fidelity is ensured. It increased knowledge regarding alcohol and cannabis, and decreased use of these drugs. Support: The development of the Climate Schools: Alcohol and Cannabis course was funded by the Australian Government Department of Health and Ageing, and the Alcohol Education and Rehabilitation Foundation.
Alcoholism: Clinical & Experimental Research, 33 : 43A
- Year: 2009
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Psychoeducation, Skills training, Technology, interventions delivered using technology (e.g. online, SMS)
Riggs, N. R., Chou, C. P., Pentz, M. A.
Aim The aim of the current study was to examine the long-term effect of an early adolescent substance abuse prevention program on trajectories and initiation of amphetamine use into early adulthood. Design Eight middle schools were assigned randomly to a program or control condition. The randomized controlled trial followed participants through 15 waves of data, from ages 11-28 years. This longitudinal study design includes four separate periods of development from early adolescence to early adulthood. Setting The intervention took place in middle schools. Participants A total of 1002 adolescents from one large mid-western US city were the participants in the study. Intervention The intervention was a multi-component community-based program delivered in early adolescence with a primary emphasis on tobacco, alcohol and marijuana use. Measures At each wave of data collection participants completed a self-report survey that included questions about life-time amphetamine use. Findings Compared to a control group, participants in the Midwestern Prevention Project (MPP) intervention condition had reduced growth (slope) in amphetamine use in emerging adulthood, a lower amphetamine use intercept at the commencement of the early adulthood and delayed amphetamine use initiation. Conclusions The pattern of results suggests that the program worked first to prevent amphetamine use, and then to maintain the preventive effect into adulthood. Study findings suggest that early adolescent substance use prevention programs that focus initially on the 'gateway' drugs have utility for long-term prevention of amphetamine use. (copyright) 2009 Society for the Study of Addiction.
Addiction, 104(10) : 1691-1699
- Year: 2009
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
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Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
O'Leary-Barrett, M, Al-Khudhairy, N., Conrod, P.
Context: Preventure (Conrod, Castellanos and Mackie, 2008) has been found to be effective in reducing drinking and binge drinking in adolescents attending mainstream schools. Objective: To determine whether educational professionals such as teachers, mentors or individuals in a pastoral role, who are trained in carrying out the Preventure personality-targeted interventions will be similarly effective in reducing alcohol use and misuse in a group of adolescents. Participants: 3096 adolescents (mean age 13.7 years) in 21 schools across London. Schools were randomly assigned to control or intervention condition, and students in intervention schools who met the criteria for any of the 4 personality risk subscales of the Substance Use Risk Profile Scale (Negative Thinking, Anxiety Sensitivity, Sensation Seeking and Impulsivity) were invited to participate in a personality-targeted intervention by trained members of staff from their schools. 1409 students met the criteria for personality risk for substance abuse, of which 609 were in school assigned to the intervention condition and received interventions. Intervention: A randomised control trial of a brief, personality-targeted intervention carried out by educational staff such as teachers, mentors or individuals in a pastoral role. Main Outcome Measures: The main outcome measures of this ongoing trial are drinking status, binge drinking status and illicit drug use at 6, 12, 18 and 24-months post-baseline in students meeting the personality risk criteria for substance use. Secondary measures will include psychiatric symptoms and reckless behaviours. This paper will present 6-month drinking outcomes. Results: Preliminary analyses indicate a significant effect of the intervention on quantity by frequency (QF) of alcohol use over 6 months, with the intervention condition associated with less growth in QF of drinking. F(1,843)=5.910, p=0.015. Results also indicate a trend for the intervention to prevent the growth of binge drinking over a 6-month period, (chi)2(1,N=896)=3.286, p=0.070. This is especially pronounced in teenagers who reported having consumed alcohol at baseline, (chi)2(1,N =357)=4.977, p=0.026, NNT=8.3. Conclusions: These findings provide preliminary evidence demonstrating that educational professionals can be successfully trained in the delivery of a brief personality-targeted substance misuse prevention programme, and have wider implications for the delivery and sustained use of such programmes in schools.
Alcoholism: Clinical & Experimental Research, 33 : 42A
- Year: 2009
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
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Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Newton, Nicola C., Andrews, Gavin, Teesson, Maree, Vogl, Laura E.
Objective: Method: Results: Conclusions: To establish the efficacy of an internet based prevention program to reduce alcohol and cannabis use in adolescents.A cluster randomised controlled trial was conducted with 764 13-year olds from ten Australian secondary schools in 2007-2008. Half the schools were randomly allocated to the computerised prevention program (n=397), and half to their usual health classes (n=367). The Climate Schools: Alcohol and Cannabis prevention course is facilitated by the internet and consists of novel, evidence-based, curriculum consistent lessons aimed at reducing alcohol and cannabis use. Participants were assessed at baseline, immediately post, and at six months following the intervention.Compared to the control group, students in the intervention group showed significant improvements in alcohol and cannabis knowledge at the end of the course and the six month follow-up. In addition, the intervention group showed a reduction in average weekly alcohol consumption and frequency of cannabis use at the six month follow-up. No differences between groups were found on alcohol expectancies, cannabis attitudes, or alcohol and cannabis related harms.The course is acceptable, scalable and fidelity is assured. It increased knowledge regarding alcohol and cannabis, and decreased use of these drugs.
Preventive Medicine, 48(6) : 579-584
- Year: 2009
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Psychoeducation, Skills training, Technology, interventions delivered using technology (e.g. online, SMS)
Moore, M. J., Werch, C.
This article reports the efficacy of a brief substance use preventive reintervention for suburban high school students funded by NIAAA. Participants were randomly assigned to receive a brief consultation or control brochure in Fall 2002. Significant positive effects at the 3- and 12-month follow-up have been reported elsewhere. A total of 346 10th- and 12th-grade students were recruited from the original sample for the reintervention study in Fall 2003. Students remained in their originally assigned group and received a brief iterative consultation or control brochure. The same survey was used to collect information on ATOD use and risk/protective factors at all data points. MANCOVAs revealed no group differences 18 months after the initial study baseline. Analysis examining interactions between substance users and nonusers by treatment group indicated significant positive effects for substance-using adolescents who received reintervention. Study limitations, implications, and suggestions for future research are discussed. (copyright) 2009 Informa UK Ltd All rights reserved.
Substance Use & Misuse, 44(7) : 1009-1020
- Year: 2009
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Pan, Wei, Bai, Haiyan
The Drug Abuse Resistance Education (D.A.R.E.) program is a widespread but controversial school-based drug prevention program in the United States as well as in many other countries. The present multivariate meta-analysis reviewed 20 studies that assessed the effectiveness of the D.A.R.E. program in the United States. The results showed that the effects of the D.A.R.E. program on drug use did not vary across the studies with a less than small overall effect while the effects on psychosocial behavior varied with still a less than small overall effect. In addition, the characteristics of the studies significantly explained the variation of the heterogeneous effects on psychosocial behavior, which provides empirical evidence for improving the school-based drug prevention program.
International Journal of Environmental Research & Public Health, 6(1) : 267-277
- Year: 2009
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
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Stage: Universal prevention
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Treatment and intervention: Psychological Interventions (any)
, Psychoeducation, Skills training