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Combined universal and selective prevention for adolescent alcohol use: a cluster randomized controlled trial

Published online by Cambridge University Press:  22 February 2017

M. Teesson ,
N. C. Newton ,
T. Slade ,
N. Carragher ,
E. L. Barrett ,
K. E. Champion ,
E. V. Kelly ,
N. K. Nair ,
L. A. Stapinski  and
P. J. Conrod
M. Teesson*
Affiliation:
NHMRC Centre of Research Excellence in Mental Health and Substance Use (CREMS), National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
N. C. Newton
Affiliation:
NHMRC Centre of Research Excellence in Mental Health and Substance Use (CREMS), National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
T. Slade
Affiliation:
NHMRC Centre of Research Excellence in Mental Health and Substance Use (CREMS), National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
N. Carragher
Affiliation:
NHMRC Centre of Research Excellence in Mental Health and Substance Use (CREMS), National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia Office of Medical Education, University of New South Wales, Sydney, NSW, Australia
E. L. Barrett
Affiliation:
NHMRC Centre of Research Excellence in Mental Health and Substance Use (CREMS), National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
K. E. Champion
Affiliation:
NHMRC Centre of Research Excellence in Mental Health and Substance Use (CREMS), National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
E. V. Kelly
Affiliation:
NHMRC Centre of Research Excellence in Mental Health and Substance Use (CREMS), National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
N. K. Nair
Affiliation:
NHMRC Centre of Research Excellence in Mental Health and Substance Use (CREMS), National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
L. A. Stapinski
Affiliation:
NHMRC Centre of Research Excellence in Mental Health and Substance Use (CREMS), National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
P. J. Conrod
Affiliation:
Department of Psychiatry, Université de Montréal, Montréal, Quebec, Canada Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
*
*Address for correspondence: M. Teesson, B.Psych. (Hons), Ph.D., NHMRC Centre of Research Excellence in Mental Health and Substance Use (CREMS), National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW 2052, Australia. (Email: m.teesson@unsw.edu.au)
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Abstract

Background

No existing models of alcohol prevention concurrently adopt universal and selective approaches. This study aims to evaluate the first combined universal and selective approach to alcohol prevention.

Method

A total of 26 Australian schools with 2190 students (mean age: 13.3 years) were randomized to receive: universal prevention (Climate Schools); selective prevention (Preventure); combined prevention (Climate Schools and Preventure; CAP); or health education as usual (control). Primary outcomes were alcohol use, binge drinking and alcohol-related harms at 6, 12 and 24 months.

Results

Climate, Preventure and CAP students demonstrated significantly lower growth in their likelihood to drink and binge drink, relative to controls over 24 months. Preventure students displayed significantly lower growth in their likelihood to experience alcohol harms, relative to controls. While adolescents in both the CAP and Climate groups demonstrated slower growth in drinking compared with adolescents in the control group over the 2-year study period, CAP adolescents demonstrated faster growth in drinking compared with Climate adolescents.

Conclusions

Findings support universal, selective and combined approaches to alcohol prevention. Particularly novel are the findings of no advantage of the combined approach over universal or selective prevention alone.

Keywords

Alcoholpreventionschool-based programmesselective preventionuniversal prevention.
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 10 , July 2017 , pp. 1761 - 1770
Copyright
Copyright © Cambridge University Press 2017 

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Footnotes

†

Equally credited authors.

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