Differential intervention effectiveness of a universal school-based resilience intervention in reducing adolescent substance use within student subgroups: exploratory assessment within a cluster-randomised controlled trial

Hodder, Rebecca K; Freund, Megan; Bowman, Jenny; Wolfenden, Luke; Campbell, Elizabeth; Dray, Julia; Lecathelinais, Christophe; Oldmeadow, Christopher; Attia, John; Wiggers, John

doi:10.1136/bmjopen-2017-021047

Cited by 4 publications

(39 citation statements)

References 58 publications

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“…Two publications reported on economic outcomes only, addressing RQ4 89,196 and one publication reported on theory, processes, outcomes and economic outcomes, addressing all RQs. 167 Twelve interventions were examined in outcome evaluations only, 87,[161][162][163][164]169,170,[174][175][176][177][178][180][181][182][183][184][185][186][187][188]197,198,200 two were examined in process evaluations only 189,193 and six were examined in both outcome and process evaluations. 52,61,63,64,[66][67][68][69]73,85,103,[108][109][110]113,115,117,123,…”

Section: Overviewmentioning

confidence: 99%

“…Included reports were published between 1986 and 2021, with only three reports (4%) published before 2000, 164,174,193 18 (28%) published between 2000 and 2009 63,64,[66][67][68]85,87,103,115,117,162,163,173,177,182,183,190,198 and 44 (68%) published from 2010 onwards. 52,61,69,71,73,80,88,89,98,[108][109][110]113,123,124,161,[165][166][167][168][169][170][171][172]175,176,[178][179][180][181]…”

Section: Rate Of Report Publicationmentioning

confidence: 99%

“…52,61,69,71,73,80,88,89,98,[108][109][110]113,123,124,161,[165][166][167][168][169][170][171][172]175,176,[178][179][180][181][184][185][186][187][188][189]191,192,[194][195][196][197]199,200 Twenty-three of the reports included in the review (35%) were published in 2018 or later. 89,98,113,161,[165][166][167]…”

Section: Rate Of Report Publicationmentioning

confidence: 99%

“…Of the 27 studies included in the review, 13 (48%) were conducted in the USA, 52,61,63,64,85,87,103,[108][109][110]117,123,124,[161][162][163][164]173,174,177,179,182,183,[185][186][187][188][189][190]193,198 7 (26%) were conducted in Australia [66][67][68]115,[169][170][171]175,176,191,192,197,199 and 4 (14%) were conducted in the UK. 69,71,73,88,113,[165]…”

Section: Geographical Location Of Studiesmentioning

confidence: 99%

“…Of the 23 studies of 20 interventions included in the review of outcome evaluations, 18 were RCTs 52,61,64,67,68,80,87,89,103,108,109,115,117,123,124,161,[165][166][167][168][169][170][171][172][175][176][177][178][179][180][181][182][183][184][185][186][187][188]196,197,199,200 and 5 used quasi-experimental designs. 69,85,[162][163][164]173,174,198 Of the 16 reports covering 13 stud...…”

Section: Study Designsmentioning

confidence: 99%

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Whole-school interventions promoting student commitment to school to prevent substance use and violence, and improve educational attainment: a systematic review

Ponsford,

Melendez-Torres,

Miners

et al. 2024

Public Health Res

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Background Whole-school interventions modify the school environment to promote health. A subset of these interventions promotes student commitment to school to prevent substance (tobacco, alcohol, other drugs) use and/or violence. A previous review identified the theory of human functioning and school organisation as a comprehensive theory of such interventions, and found evidence that these interventions reduce substance use and/or violence. Objectives The objectives were to search for, appraise and synthesise evidence to address the following questions: (1) What whole-school interventions promoting student commitment to school to prevent substance use and/or violence have been evaluated, what intervention subtypes are apparent and how closely do these align with the theory of human functioning and school organisation? (2) What factors relating to setting, population and intervention affect implementation? (3) What are the effects on student substance use, violence and educational attainment? (4) What is the cost-effectiveness of such interventions? (5) Are intervention effects mediated by student commitment to school or moderated by setting or population? Data sources A total of 56 information sources were searched (in January 2020), then an updated search of 48 of these was carried out (in May 2021). Reference lists were also searched and experts were contacted. Review methods Eligible studies were process/outcome evaluations of whole-school interventions to reduce student violence or substance use among students aged 5–18 years attending schools, via actions aligning with the theory of human functioning and school organisation: modifying teaching to increase engagement, enhancing student–staff relationships, revising school policies, encouraging volunteering or increasing parental involvement. Data extraction and quality assessments used existing tools. Theory and process reports were synthesised qualitatively. Outcome and economic data were synthesised narratively; outcome data were meta-analysed. Results Searches retrieved 63 eligible reports on 27 studies of 22 interventions. We identified four intervention subtypes focused on student participation in school-wide decisions, improving staff–student relationships, increasing engagement in learning and involving parents. The theories of change of most intervention subtypes aligned closely with the theory of human functioning and school organisation, and informed refinement of an intervention theory of change. Theories of change for interventions increasing learning engagement did not align with this theory, aiming instead to increase school commitment primarily via social skills curricula. Factors influencing the implementation included whether or not interventions were tailorable, workable and well explained. Interventions with action groups comprising staff/students, etc. and providing local data were well implemented. Implementation was also affected by whether or not schools accepted the need for change and staff had the resources for delivery. Meta-analyses suggest small, but significant, intervention effects in preventing violence victimisation and perpetration, and substance use. There was sparse and inconsistent evidence of moderation and some evidence of mediation by student commitment to school. Two economic evaluations suggested that there is the potential for the interventions to be cost-effective. Limitations The quality of the studies was variable and the economic synthesis was limited to two studies. Conclusions Whole-school interventions aiming to promote student commitment to school share similar theories of change and factors affecting implementation. They have the potential to contribute to preventing violence and substance use among young people. Future trials should aim to optimise intervention effectiveness by better theorisation, and assess implementation and effect moderators and mediators. Study registration This study is registered as PROSPERO CRD42019154334. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: 17/151/05) and is published in full in Public Health Research; Vol. 12, No. 2. See the NIHR Funding and Awards website for further award information.

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Section: Overviewmentioning

confidence: 99%

Section: Rate Of Report Publicationmentioning

confidence: 99%

Section: Rate Of Report Publicationmentioning

confidence: 99%

Section: Geographical Location Of Studiesmentioning

confidence: 99%

Section: Study Designsmentioning

confidence: 99%

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Whole-school interventions promoting student commitment to school to prevent substance use and violence, and improve educational attainment: a systematic review

Ponsford,

Melendez-Torres,

Miners

et al. 2024

Public Health Res

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Whole-school interventions promoting student commitment to school to prevent substance use and violence: a systematic review

et al. 2023

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Neuroscience-Informed Classification of Prevention Interventions in Substance Use Disorders: An RDoC-based Approach

Rezapour

Rafei

Baldacchino

et al. 2022

Preprint

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Neuroscience has contributed to uncover the mechanisms underpinning substance use disorders (SUD). The next frontier is to leverage these mechanisms as active ingredients to create more effective interventions for SUD. Recent large-scale cohort studies are generating multiple levels of neuroscience-based information with potential to inform the development and refinement of future preventive strategies. However, there is still no available well-recognized frameworks to guide the integration of these complex datasets into prevention trial protocols. The Research Domain Criteria (RDoC) provides a neuroscience-based multi-system framework that is well suited to facilitate translation of neurobiological mechanisms into behavioural domains amenable to preventative interventions. We propose a novel RDoC-based framework for prevention science that organizes and advances the integration of technologies and findings from neuroscience into the refinement of current and construction of future preventive and early interventions. This neuroscience-informed framework categorizes addiction risk factors within the dysfunction of the five major RDoC constructs (Negative Valence Systems, Positive Valence Systems, Cognitive Systems, Arousal and Regulatory Systems, and Social Processes). We adapted the framework for the existing preventive interventions and categorized their components using RDoC constructs. From a systematic review of randomized controlled trials using a person-centered drug/alcohol preventive approach for adolescents (13-18 years), we identified 98 trials on 37 preventive interventions. We categorized them within this framework based on their potential target(s). By using this neuroscience-informed framework, distinct neurocognitive trajectories which have been recognized as precursors or risk factors for SUDs, can be targeted, and more importantly, the change processes can be evaluated to inform causal hypotheses. This framework can also inform individualized assessment, intervention development and outcome measurement in preventive interventions.

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Differential intervention effectiveness of a universal school-based resilience intervention in reducing adolescent substance use within student subgroups: exploratory assessment within a cluster-randomised controlled trial

Cited by 4 publications

References 58 publications

Whole-school interventions promoting student commitment to school to prevent substance use and violence, and improve educational attainment: a systematic review

Whole-school interventions promoting student commitment to school to prevent substance use and violence, and improve educational attainment: a systematic review

Whole-school interventions promoting student commitment to school to prevent substance use and violence: a systematic review

Neuroscience-Informed Classification of Prevention Interventions in Substance Use Disorders: An RDoC-based Approach

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