Brief school-based interventions and behavioural outcomes for substance-using adolescents

Area of Science:

• Public Health
• Adolescent Psychology
• Intervention Science

Background:

• Adolescent substance use is a significant public health concern, often leading to long-term negative health and social consequences.
• Early intervention is crucial to prevent the escalation of substance use and associated problem behaviors in adolescents.
• Brief interventions (BIs) are recognized as potentially effective strategies, particularly for individuals with moderate substance use patterns, and can be implemented in school settings.

Purpose of the Study:

• To systematically evaluate the effectiveness of school-based brief interventions in reducing adolescent substance use.
• To assess the impact of these interventions on other behavioral outcomes, such as criminal activity and delinquent behaviors.
• To compare the efficacy of brief interventions against information provision and assessment-only control conditions.

Main Methods:

• A comprehensive literature search was conducted across 10 electronic databases and six websites, supplemented by reference list reviews and author/organization contact.
• Included studies were randomized controlled trials (RCTs) focusing on brief school-based interventions for adolescents with substance use issues.
• Primary outcomes included reduction or cessation of substance use, while secondary outcomes encompassed engagement in criminal and delinquent behaviors. Evidence quality was assessed using the GRADE approach.

Main Results:

• Six RCTs involving 1139 participants were analyzed. Evidence quality ranged from moderate to very low across comparisons.
• Compared to information provision alone, brief interventions showed no significant effect on overall substance use or delinquent behaviors.
• When compared to assessment-only conditions, brief interventions demonstrated some significant reductions in general substance use and specifically in cannabis frequency and quantity. However, evidence quality was generally low, with high heterogeneity observed.

Conclusions:

• Limited, low-quality evidence suggests brief school-based interventions may be more effective than assessment-only conditions but are similar to information provision in reducing adolescent substance use.
• There is some indication of effectiveness, particularly for reducing cannabis use, when compared to assessment-only controls.
• Further high-quality research, especially in low- and middle-income countries, is needed to definitively establish the effectiveness of brief school-based interventions for adolescent substance use and related behaviors.