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

Area of Science:

• Public Health
• Adolescent Health
• Substance Use Prevention

Background:

• Adolescent substance use is a significant public health issue, acting as a precursor to other problem behaviors and leading to adverse long-term health and social consequences.
• Early intervention is crucial to prevent the escalation of substance use and its associated problems in adolescents.
• Brief interventions (BIs) are recognized as potentially effective strategies for addressing moderately risky substance use patterns in school settings.

Purpose of the Study:

• To systematically evaluate the effectiveness of brief school-based interventions in reducing adolescent substance use and other behavioral outcomes.
• To compare the impact of BIs against alternative interventions or 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 communications, covering studies from 1966 to February 2015.
• Included 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, with secondary outcomes encompassing criminal activity and problem behaviors related to substance use. Methodological quality was assessed using the GRADE approach.

Main Results:

• Six RCTs involving 1176 adolescents were included. Compared to information provision only, BIs showed no significant effect on substance use or delinquent behaviors.
• When compared to assessment-only controls, low- to very low-quality evidence indicated that BIs reduced cannabis frequency at short-term follow-up and alcohol and cannabis use at medium-term follow-up.
• One study reported sustained reductions in alcohol and cannabis use at long-term follow-up with BIs compared to assessment-only, though overall evidence quality for this comparison was low.

Conclusions:

• Low- to very low-quality evidence suggests brief school-based interventions may be more effective than assessment-only conditions in reducing alcohol and cannabis use, with sustained effects.
• Moderate-quality evidence indicates BIs likely have no significant effect on substance use outcomes when compared to information provision alone.
• Further high-quality research is needed to definitively establish the effectiveness of BIs for adolescent substance use and related problem behaviors, especially in diverse global settings.