Newton NC, Stapinski LA, Slade T, Sunderland M, Barrett EL, Champion KE, Chapman C, Smout A, Lawler SM, Mather M, Debenham J, Castellanos-Ryan N, Conrod PJ, Teesson M. J. Am. Acad. Child Adolesc. Psychiatry 2021; ePub(ePub): ePub.
OBJECTIVE: Alcohol use is a leading cause of burden of disease among young people. Prevention strategies can be effective in the short-term, however little is known about their longer-term effectiveness. The aim of this study was to examine the sustainability of universal, selective and combined alcohol use prevention across the critical transition period from adolescence into early adulthood.
METHOD: In 2012, 2,190 students (mean age: 13.3 years) from 26 Australian high schools participated in a cluster randomized controlled trial and were followed up for 3-years post baseline. Schools were randomly assigned to deliver: i) universal web-based prevention for all students (Climate Schools); ii) selective prevention for high-risk students (Preventure); iii) combined universal and selective prevention (Climate Schools and Preventure; CAP); iv) or health education as usual (control). This study extends the follow-up period to 7-years post baseline. Primary outcomes were self-reported; 1) frequency of alcohol consumption and binge drinking; 2) alcohol-related harms; and 3) hazardous alcohol use, at the 7-year follow-up.
RESULTS: At 7-year follow-up, students in all three intervention groups reported reduced odds of alcohol-related harms compared to the control group (ORs=0.13-0.33), and the Climate (OR=0.04) and Preventure (OR=0.17) groups reported lower odds of hazardous alcohol use. The Preventure group also reported lower odds of weekly alcohol use compared to the control group (OR=0.17), and the Climate group reported lower odds of binge-drinking (OR=0.12), holding mean baseline levels constant.
CONCLUSION: This study demonstrated that both universal and selective preventive interventions delivered in schools can have long lasting effects and reduce risky drinking and related harms into adulthood. No added benefit was observed by delivering the combined interventions.