Objective: Among individuals with a mental health condition co‐occurring alcohol use disorders are common, but less is known about alcohol consumption in excess of recommended drinking guidelines. This study investigated the prevalence of lifetime risky drinking (>2 drinks daily) and single occasion risky drinking (>4 drinks on one occasion) among individuals with mental health conditions of different severities. Methods: Data from representative cross‐sectional population surveys among South Australians aged ≥15 years (n=11,761) were utilised. Logistic regression models assessed associations between risky alcohol consumption, presence of a mental health condition and demographic characteristics. Results: Prevalence of lifetime risky drinking was greater among both males and females with a mental health condition (p>0.001). Single occasion risky drinking was more prevalent among males with a severe mental health condition (p=0.01). Adjusted logistic regressions showed that only females with a mental health condition had greater odds of exceeding lifetime risky drinking levels (OR=1.39, CI 1.11 to1.75). Conclusions: There are sex‐specific relationships between risky alcohol consumption and mental health conditions. Implications for public health: Risky alcohol consumption, in excess of guidelines, is of concern among those with a mental health condition and requires attention at an individual and population level.

BACKGROUND To prevent adolescents from initiating alcohol and other drug (AOD) use, and reduce associated harms, effective strategies need to be implemented. Despite their availability, effective school-based programs and evidence informed parental guidelines are not consistently implemented. The Positive Choices drug prevention initiative and website was launched to address this research and practice gap. The intended end users were school staff, parents, and school students. An 8-month post-launch evaluation of the website showed that end users generally had positive feedback on the website’s usability, and following its use the majority would consider the evidence-base and effectiveness of drug education resources. The current study extends this initial evaluation by examining the effectiveness and impact of the Positive Choices initiative over a three-year period. OBJECTIVE Guided by the five dimensions of the RE-AIM framework i.e., reach, effectiveness, adoption, implementation, and maintenance, the study assesses the impact and effectiveness of the Positive Choices initiative in increasing awareness and implementation of evidence-based drug prevention. METHODS Data was collected between 2017 and 2019 using online website evaluation and community awareness surveys. Data from the surveys was merged to examine reach, effectiveness, adoption, implementation, and maintenance, via descriptive statistics. Google Analytics was used to further understand the reach of the website. The System Usability Scale was used to measure website usability. Additionally, inductive analysis was employed to assess participants’ feedback about Positive Choices. RESULTS Five years post-launch, the Positive Choices website has reached >2 million users. A national Australian campaign increased awareness from 8% to 14% post campaign among school staff, and from 15% to 22% among parents. Following a brief interaction with the website the majority of participants, who were not already following recommended strategies, reported an intention to shift towards evidence-based practices. The System Usability Scale score for the website was ‘good’, for both user groups. The participants intended to maintain their use of the Positive Choices website in the future. Both user groups reported a high level of confidence in communicating about AOD related topics. Participants’ suggestions for improvement informed a recent website update. CONCLUSIONS The Positive Choices website has the capacity to be an effective strategy for disseminating evidence-based drug prevention information and resources widely. The findings highlight the importance of investing in ongoing maintenance of, and promotion to enhance awareness of health websites. With the increased use and acceptability of health education websites, teams should ensure that websites are easy to navigate, engaging, use simple language, contain evidence-informed resources, and are supported by ongoing promotional activities.

Background To prevent adolescents from initiating alcohol and other drug use and reduce the associated harms, effective strategies need to be implemented. Despite their availability, effective school-based programs and evidence-informed parental guidelines are not consistently implemented. The Positive Choices alcohol and other drug prevention initiative and website was launched to address this research and practice gap. The intended end users were school staff, parents, and school students. An 8-month postlaunch evaluation of the website showed that end users generally had positive feedback on the website’s usability, and following its use, most of them would consider the evidence base and effectiveness of drug education resources. This study extends this initial evaluation by examining the effectiveness and impact of the Positive Choices initiative over a 3-year period. Objective Guided by the five dimensions of the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework, the study assessed the impact of the Positive Choices initiative in increasing awareness and implementation of evidence-based drug prevention. Methods Data were collected between 2017 and 2019, using web-based evaluation and community awareness surveys. Data from the surveys were merged to examine reach, effectiveness, adoption, implementation, and maintenance using descriptive statistics. Google Analytics was used to further understand the reach of the website. The System Usability Scale was used to measure website usability. In addition, inductive analysis was used to assess the participants’ feedback about Positive Choices. Results A total of 5 years after launching, the Positive Choices website has reached 1.7 million users. A national Australian campaign increased awareness from 8% to 14% among school staff and from 15% to 22% among parents after the campaign. Following a brief interaction with the website, most participants, who were not already following the recommended strategies, reported an intention to shift toward evidence-based practices. The System Usability Scale score for the website was good for both user groups. The participants intended to maintain their use of the Positive Choices website in the future. Both user groups reported high level of confidence in communicating about topics related to alcohol and other drugs. Participants’ suggestions for improvement informed a recent website update. Conclusions The Positive Choices website has the capacity to be an effective strategy for disseminating evidence-based drug prevention information and resources widely. The findings highlight the importance of investing in ongoing maintenance and promotion to enhance awareness of health websites. With the increased use and acceptability of health education websites, teams should ensure that websites are easy to navigate, are engaging, use simple language, contain evidence-informed resources, and are supported by ongoing promotional activities.

IntroductionAdolescent onset substance use is associated with neurodevelopmental, social and psychological harms. Thus, alcohol and other drug prevention programmes are essential to promote health and well-being during this period. Schools are uniquely positioned to deliver such prevention programmes. The last decade has seen a large expansion of school-based alcohol and drug prevention programmes in Australia, warranting an update of the comprehensive review conducted by Teessonet alin 2012. This proposed review aims to (1) identify school-based substance use prevention programmes that have been trialled in Australia since 2011, (2) evaluate their efficacy and (3) identify intervention components associated with effectiveness. This will assist schools in identifying and adopting effective evidence-based programmes and inform future programme development, evaluation and policy.Methods and analysisStudies published from 2011 will be identified by searching the electronic databases PubMed, PsycINFO, Medline, Embase, ProQuest and Cochrane Library in addition to grey literature searches. Eligible studies will be controlled trials (including randomised controlled trials, cluster randomised controlled trials and quasi-experimental trials) of programmes measuring drug and alcohol related outcomes that are conducted in a school setting and have been trialled within Australia. Records will be independently screened for eligibility by two review authors, with disagreements being resolved by consensus or a third review author where necessary. Data extraction, risk of bias and study quality will also be completed independently by two review authors. A qualitative synthesis of all eligible studies will be presented. In addition, if there are sufficient data to combine studies, a random-effects meta-analysis will be conducted.Ethics and disseminationThis research is exempt from ethics approval as no primary data are collected, with work instead being carried out on published documents. The findings of this proposed review will be disseminated in a peer-reviewed journal and at conferences.PROSPERO registration numberCRD42021272959.