Preventing heavy alcohol use in adolescents (PAS): cluster randomized trial of a parent and student intervention offered separately and simultaneously

Abstract

AimsTo evaluate the effectiveness of two preventive interventions to reduce heavy drinking in first-and second-year high school students. Design and setting Cluster randomized controlled trial using four conditions for comparing two active interventions with a control group from 152 classes of 19 high schools in the Netherlands. Participants A total of 3490 first-year high school students (mean 12.68 years, SD = 0.51) and their parents. Intervention conditions (i) Parent intervention (modelled on the Swedish Örebro Prevention Program) aimed at encouraging parental rule-setting concerning their children's alcohol consumption; (ii) student intervention consisting of four digital lessons based on the principles of the theory of planned behaviour and social cognitive theory; (iii) interventions 1 and 2 combined; and (iv) the regular curriculum as control condition. Main outcome measures Incidence of (heavy) weekly alcohol use and frequency of monthly drinking at 10 and 22 months after baseline measurement. Findings A total of 2937 students were eligible for analyses in this study. At first follow-up, only the combined student-parent intervention showed substantial and statistically significant effects on heavy weekly drinking, weekly drinking and frequency of drinking. At second follow-up these results were replicated, except for the effects of the combined intervention on heavy weekly drinking. These findings were consistent across intention-to-treat and completers-only analyses.Conclusions Results suggest that adolescents as well as their parents should be targeted in order to delay the onset of drinking, preferably prior to onset of weekly drinking.

A test of the efficacy of a brief, web-based personalized feedback intervention to reduce drinking among 9th grade students

“…Additionally, students in the intervention condition reported a significantly greater reduction in alcohol-related consequences relative to students in the control group. These findings are consistent with the growing body of research indicating web-based interventions are effective in reducing drinking and alcohol-related consequences in adolescents (Koning et al, 2009;Newton et al, 2009;Schwinn et al, 2010).…”

“…The web-based interventions used in these studies were also lengthy, including 4 -12 modules or sessions, with each session taking up to 40 minutes. Additionally, only two of these studies evaluated a school-based program (Koning et al, 2009;Newton et al, 2009). School-based interventions have several potential advantages over clinic-based interventions (Wagner et al, 2004).…”

“…Additionally, web-based interventions can be infused into the school curriculum and can improve program fidelity (Schinke, Di Noia, & Glassman, 2004). A growing number of controlled studies indicate that web-based programs delivered to adolescents (Newton, Andrews, Teeson, & Vogl, 2009;Schwinn, Schinke, & Di Nola, 2010) or adolescents and their parents (Koning et al, 2009;) are effective in reducing drinking and alcoholrelated consequences in adolescents. Although research indicates web-based interventions are promising for this age group, the majority of these studies examined online interventions with adolescent females only Schwinn et al, 2010).…”

Does the Örebro Prevention Programme Prevent Youth Drinking? A Response to Özdemir & Stattin

“…. have achieved a major shift in the consensus' on effects of advertising bans, citing Saffer & Dave [8] and Saffer & Chaloupka [9]. The first study ignores other alcohol policies, so the effect of advertising bans is statistically biased [10].…”

“…Finally, rather than adopting a one-sided search for reasons why this trial failed to replicate the effects identified in the first study, we point to the need for an independent evaluation which takes into account the total evidence base of all three studies. Meta-analytical procedures and the thorough assessment of risk of bias in the initial study, as well as in the two subsequent trials [1,8] would improve the basis for the effect estimates, and provide guidance on the degree of confidence to place in them.…”