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Systematic review of universal school-based ‘resilience’ interventions targeting adolescent tobacco, alcohol or illicit substance use: A meta-analysis
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posted on 2023-02-19, 22:52 authored by RK Hodder, M Freund, L Wolfenden, J Bowman, S Nepal, J Dray, M Kingsland, Serene YoongSerene Yoong, J WiggersUniversal school-based interventions that address adolescent ‘resilience’ may represent a means of reducing adolescent substance use, however previous systematic reviews have not examined the effectiveness of such an intervention approach. A systematic review was undertaken to 1) assess whether universal school-based ‘resilience’ interventions are effective in reducing the prevalence of tobacco, alcohol or illicit substance use by adolescents, and 2) describe such effectiveness per intervention characteristic subgroups. Eligible studies were peer-reviewed reports (1994–2015) of randomised controlled trials including participants aged 5–18 years that reported adolescent tobacco, alcohol or illicit substance use, and implemented a universal school-based ‘resilience’ intervention (i.e. those addressing both individual (e.g. self-esteem) and environmental (e.g. school connectedness) protective factors of resilience). Trial effects for binary outcomes were synthesised via meta-analyses and effect sizes reported as odds ratios. Subgroup (by intervention type, prevention approach, setting, intervention duration, follow-up length) and sensitivity analyses (excluding studies at high risk of bias) were conducted. Nineteen eligible studies were identified from 16,619 records (tobacco: n = 15, alcohol: n = 17, illicit: n = 11). An overall intervention effect was found for binary measures of illicit substance use (n = 10; OR: 0.78, 95%CI: 0.6–0.93, p = 0.007,Tau2 = 0.0, I2 = 0%), but not tobacco or alcohol use. A similar result was found when studies assessed as high risk of bias were excluded. Overall intervention effects were evident for illicit substance use within multiple intervention characteristic subgroups, but not tobacco and alcohol. Such results support the implementation of universal school-based interventions that address ‘resilience’ protective factors to reduce adolescent illicit substance use, however suggest alternate approaches are required for tobacco and alcohol use. PROSPERO registration: CRD42014004906.
History
Journal
Preventive MedicineVolume
100Pagination
248-268Location
United StatesPublisher DOI
ISSN
0091-7435eISSN
1096-0260Language
EnglishIssue
J. Drug Educ. 30 2 2000Publisher
ACADEMIC PRESS INC ELSEVIER SCIENCEUsage metrics
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Keywords
Science & TechnologyLife Sciences & BiomedicinePublic, Environmental & Occupational HealthMedicine, General & InternalGeneral & Internal MedicineSystematic reviewAdolescentSchoolsPsychological resilienceClinical trialsTobacco useAlcohol drinkingIllicit drugsSMOKING-PREVENTION PROGRAMRANDOMIZED CONTROLLED-TRIALDRUG-ABUSE PREVENTIONFRAMEWORK APPROACH ESFAPEER-LED INTERVENTIONTERM-FOLLOW-UPRESPONSIBILITY EDUCATION-PROGRAMSOCIAL-DEVELOPMENT INTERVENTIONCHARACTER DEVELOPMENT PROGRAMINTERNET-BASED PREVENTIONAlcohol DrinkingHumansRandomized Controlled Trials as TopicResilience, PsychologicalSubstance-Related DisordersTobacco UsePediatricDrug Abuse (NIDA Only)Clinical ResearchTobacco Smoke and HealthPreventionClinical Trials and Supportive ActivitiesBehavioral and Social ScienceTobaccoAlcoholism, Alcohol Use and HealthSubstance Abuse3 Prevention of disease and conditions, and promotion of well-being3.1 Primary prevention interventions to modify behaviours or promote wellbeingCardiovascularCancerMental healthOral and gastrointestinalStroke3 Good Health and Well BeingHuman Movement and Sports Science not elsewhere classifiedPublic Health and Health Services not elsewhere classified
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