Universal multi-component prevention programs for alcohol misuse in young people

Foxcroft, David; Tsertsvadze, Alexander

doi:10.1002/14651858.cd009307

Cited by 74 publications

(70 citation statements)

References 102 publications

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“…Put simply, those who possess an underlying vulnerability to alcohol problems may also be likely to start drinking early. Further support for the marker hypothesis may be inferred from the lack of strong evidence for the long-term effectiveness of interventions which aim to reduce alcohol related harm by preventing underage drinking 12 30 31. These reviews suggest that delaying AFD does not impact on long-term problems.…”

Section: Discussionmentioning

confidence: 99%

Age of first drinking and adult alcohol problems: systematic review of prospective cohort studies

Maimaris

McCambridge

2013

J Epidemiol Community Health

101

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BackgroundAlcohol policies around the world seek to delay the initiation of drinking. This is partly based on the influential idea that earlier initiation is likely to cause adult alcohol problems. This study synthesises robust evidence for this proposition.MethodsSystematic review of prospective cohort studies in which adolescent measurement of age of first drink in general population studies was separated by at least 3 years from adult alcohol outcomes. EMBASE, Medline, PsychINFO and Social Policy and Practice were searched for eligible studies, alongside standard non-database data collection activities. Data were extracted on included study methods and findings. Risk of bias and confounding was assessed for individual studies and a narrative synthesis of findings was performed.ResultsThe main finding was the meagre evidence base available. Only five studies were eligible for inclusion in this review. The existence of effects of age of first drink on adult drinking and related problems were supported, but not at all strongly, in some included studies, and not in others. Rigorous control for confounding markedly attenuates or eliminates any observed effects.ConclusionsThere is no strong evidence that starting drinking earlier leads to adult alcohol problems and more research is needed to address this important question. Policy makers should, therefore, reconsider the justification for delaying initiation as a strategy to address levels of adult alcohol problems in the general population, while also addressing the serious acute harms produced by early drinking.

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Section: Discussionmentioning

confidence: 99%

Age of first drinking and adult alcohol problems: systematic review of prospective cohort studies

Maimaris

McCambridge

2013

J Epidemiol Community Health

101

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“…Finally, recent Cochrane systematic reviews report that multicomponent, school-based, and family based alcohol misuse prevention programs for youth have yielded promising results (Tsertsvadze A. Foxcroft DR, 2011a, 2011b; Tsertsvadze A. Foxcroft DR, 2011)…”

Section: Risk Behavior Prevalence and Interventionsmentioning

confidence: 99%

Fostering multiple healthy lifestyle behaviors for primary prevention of cancer.

Spring

King

Pagoto³

et al. 2015

American Psychologist

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Synopsis The odds of developing cancer are increased by specific lifestyle behaviors (tobacco use, excess energy and alcohol intakes, low fruit and vegetable intake, physical inactivity, risky sexual behaviors, and inadequate sun protection). These behaviors are largely absent in childhood, emerge and tend to cluster over the lifespan, and show an increased prevalence among those disadvantaged by low education or income or minority status. Even though risk behaviors are modifiable, few are diminishing in the population over time. We review the prevalence and population distribution of these behaviors and apply an ecological model to describe effective or promising healthy lifestyle interventions targeted to the individual, the sociocultural context, or environmental and policy influences. We suggest that implementing multiple health behavior change interventions across several ecological levels could substantially reduce the prevalence of cancer and the burden it places on the public and the health care system. We note important still unresolved questions about which behaviors can be intervened upon simultaneously in order to maximize positive behavioral synergies, minimize negative ones, and effectively engage underserved populations. We conclude that interprofessional collaboration is needed to appropriately evaluate and convey the value of primary prevention of cancer and other chronic diseases.

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“…Given the prevalence of MI approaches, understanding their effectiveness is clearly important for the field. The review authors have a notable history of producing systematic reviews instrumental to understanding the effectiveness of various alcohol preventive interventions for young people 6, 7, 8, 9, 10, 11, 12. Similarly, Cochrane is methodologically exemplary in setting international standards for conducting systematic reviews 13.…”

Section: Introductionmentioning

confidence: 99%

Reviewing and interpreting the effects of brief alcohol interventions: comment on a Cochrane review about motivational interviewing for young adults

et al. 2015

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BackgroundCochrane recently published a systematic review on motivational interviewing (MI) for alcohol misuse in young adults. The review authors concluded that ‘there are no substantive, meaningful benefits of MI interventions for the prevention of alcohol misuse’ (p. 2), as effect sizes were ‘small and unlikely to be of any meaningful benefit in practice’ (p. 27). As most of these interventions were quite brief, we wish to open a dialogue about interpreting effect sizes in this review and of (brief) alcohol interventions more generally.AnalysisWe analyze four methodological aspects of the review that likely influenced the author's conclusions about intervention effects: (1) risk of bias assessments, (2) search strategies, (3) assessing the quality of the body of evidence and (4) definitions of sustainability and clinical significance.ConclusionsWe interpret the effect sizes found in this review to indicate modest yet beneficial and potentially meaningful effects of these interventions, given their brevity and low cost. This interpretation is consistent with other reviews on brief, MI‐based interventions and brief interventions more generally. We therefore encourage the field to re‐open dialogue about the clinical importance of the effects of MI on alcohol misuse by young adults. Rather than dismissing interventions with small effects, we believe a more fruitful way forward for the field would be to catalogue effect sizes for various alcohol interventions. Such a catalogue would help stakeholders themselves to choose which interventions meet their minimum desired impact, and thus may be suitable given their targeted populations, setting and resources.

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Universal multi-component prevention programs for alcohol misuse in young people

Cited by 74 publications

References 102 publications

Age of first drinking and adult alcohol problems: systematic review of prospective cohort studies

Age of first drinking and adult alcohol problems: systematic review of prospective cohort studies

Fostering multiple healthy lifestyle behaviors for primary prevention of cancer.

Reviewing and interpreting the effects of brief alcohol interventions: comment on a Cochrane review about motivational interviewing for young adults

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