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A national effectiveness trial of an eHealth program to prevent alcohol and cannabis misuse: responding to the replication crisis

Published online by Cambridge University Press:  17 June 2020

Nicola C. Newton*
Affiliation:
The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
Cath Chapman
Affiliation:
The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
Tim Slade
Affiliation:
The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
Louise Birrell
Affiliation:
The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
Annalise Healy
Affiliation:
The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
Marius Mather
Affiliation:
The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
Nyanda McBride
Affiliation:
National Drug Research Institute, Curtin University, Perth, WA, Australia
Leanne Hides
Affiliation:
Centre for Youth Substance Abuse Research, University of Queensland, Brisbane, Australia
Steve Allsop
Affiliation:
National Drug Research Institute, Curtin University, Perth, WA, Australia
Louise Mewton
Affiliation:
Centre for Healthy Brain Ageing, The University of NSW, Sydney, Australia
Gavin Andrews
Affiliation:
The Clinical Research Unit for Anxiety and Depression, The University of NSW, Sydney, Australia
Maree Teesson
Affiliation:
The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
*
Author for correspondence: Nicola C. Newton, E-mail: nicola.newton@sydney.edu.au

Abstract

Background

The burden of disease attributable to alcohol and other drug (AOD) use in young people is considerable. Prevention can be effective, yet few programs have demonstrated replicable effects. This study aimed to replicate research behind Climate Schools: Alcohol and Cannabis course among a large cohort of adolescents.

Methods

Seventy-one secondary schools across three States participated in a cluster-randomised controlled trial. Year 8 students received either the web-based Climate Schools: Alcohol and Cannabis course (Climate, n = 3236), or health education as usual (Control, n = 3150). Outcomes were measured via self-report and reported here for baseline, 6- and 12-months for alcohol and cannabis knowledge, alcohol, cannabis use and alcohol-related harms.

Results

Compared to Controls, students in the Climate group showed greater increases in alcohol- [standardised mean difference (SMD) 0.51, p < 0.001] and cannabis-related knowledge (SMD 0.49, p < 0.001), less increases in the odds of drinking a full standard drink[(odds ratio (OR) 0.62, p = 0.014], and heavy episodic drinking (OR 0.49, p = 0.022). There was no evidence for differences in change over time in the odds of cannabis use (OR 0.57, p = 0.22) or alcohol harms (OR 0.73, p = 0.17).

Conclusions

The current study provides support for the effectiveness of the web-based Climate Schools: Alcohol and Cannabis course in increasing knowledge and reducing the uptake of alcohol. It represents one of the first trials of a web-based AOD prevention program to replicate alcohol effects in a large and diverse sample of students. Future research and/or adaptation of the program may be warranted with respect to prevention of cannabis use and alcohol harms.

Type
Original Article
Copyright
Copyright © The Author(s) 2020. Published by Cambridge University Press

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Footnotes

*

Equally accredited first authors.

References

Australian Institute of Health and Welfare. (2011). 2010 National Drug Strategy Household Survey report. Retrieved from https://www.aihw.gov.au/reports/illicit-use-of-drugs/2010-ndshs/contents/summaryGoogle Scholar
Australian Institute of Health and Welfare. (2014). National Drugs Strategy Household Survey Detailed Report 2013. Retrieved from https://www.aihw.gov.au/reports/illicit-use-of-drugs/2013-ndshs-detailed/contents/table-of-contentsGoogle Scholar
Bandura, A., Barbaranelli, C., Caprara, G. V., & Pastorelli, C. (1996). Multifaceted impact of self-efficacy beliefs on academic functioning. Child Development, 67(3), 12061222. doi: 10.1111/j.1467-8624.1996.tb01791.xCrossRefGoogle ScholarPubMed
Behrendt, S., Wittchen, H., Hofler, M., Lieb, R., & Beesdo, K. (2009). Transitions from first substance use to substance use disorders in adolescence: Is early onset associated with a rapid escalation? Drug and Alcohol Dependence, 99, 6878. doi: 10.1016/j.drugalcdep.2008.06.014CrossRefGoogle ScholarPubMed
Botvin, G. J., & Griffin, K. W. (2016). Prevention of substance abuse. APA Handbook of Clinical Psychology: Applications and Methods, 3, 485509.Google Scholar
Bumbarger, B., & Perkins, D. (2008). After randomised trials: Issues related to dissemination of evidence-based interventions. Journal of Children's Services, 3(2), 5564. doi: https://doi.org/10.1108/17466660200800012CrossRefGoogle Scholar
Champion, K. E., Newton, N. C., Barrett, E. L., & Teesson, M. (2013). A systematic review of school-based alcohol and other drug prevention programs facilitated by computers or the internet. Drug & Alcohol Review, 32(2), 115123. doi: 10.1111/j.1465-3362.2012.00517.xCrossRefGoogle ScholarPubMed
Champion, K. E., Newton, N. C., Stapinski, L., Slade, T., Barrett, E. L., & Teesson, M. (2015). A cross-validation trial of an internet-based prevention program for alcohol and cannabis: Preliminary results from a cluster randomised controlled trial. Australian & New Zealand Journal of Psychiatry, 50(1), 6473. doi: 10.1177/0004867415577435CrossRefGoogle ScholarPubMed
Champion, K. E., Newton, N. C., & Teesson, M. (2016). Prevention of alcohol and other drug use and related harm in the digital age: What does the evidence tell us? Current Opinion in Psychiatry, 29(4), 242249. doi: 10.1097/YCO.0000000000000258CrossRefGoogle ScholarPubMed
Cossu, G., Cantone, E., Pintus, M., Cadoni, M., Pisano, A., Otten, R., … Carta, M. G. (2015). Integrating children with psychiatric disorders in the classroom: A systematic review. Clinical Practice and Epidemiology in Mental Health, 11(Suppl 1 M3), 4157. doi:10.2174/1745017901511010041CrossRefGoogle ScholarPubMed
Das, J. K., Salam, R. A., Arshad, A., Finkelstein, Y., & Bhutta, Z. A. (2016). Interventions for adolescent substance abuse: An overview of systematic reviews. Journal of Adolescent Health, 59(4S), S61S75. doi: 10.1016/j.jadohealth.2016.06.021CrossRefGoogle ScholarPubMed
Department of Health. (2017). National drug strategy. Australian Government Department of Health. Retrieved from https://www.health.gov.au/resources/publications/national-drug-strategy-2017-2026Google Scholar
Dusenbury, L., Brannigan, R., Falco, M., & Hansen, W. B. (2003). A review of research on fidelity of implementation: Implications for drug abuse prevention in school settings. Health Education Research, 18(2), 237256.CrossRefGoogle ScholarPubMed
Erskine, H. E., Moffitt, T. E., Copeland, W. E., Costello, E. J., Ferrari, A. J., Patton, G., … Scott, J. G. (2015). A heavy burden on young minds: The global burden of mental and substance use disorders in children and youth. Psychological Medicine, 45(7), 15511563. doi: 10.1017/S0033291714002888CrossRefGoogle Scholar
Flay, B. R., Biglan, A., Boruch, R. F., Castro, F. G., Gottfredson, D., Kellam, S., … Ji, P. (2005). Standards of evidence: Criteria for efficacy, effectiveness and dissemination. Prevention Science, 6(3), 151175. doi: 10.1007/s11121-005-5553-yCrossRefGoogle ScholarPubMed
Foxcroft, D. R., & Tsertsvadze, A. (2012). Universal alcohol misuse prevention programmes for children and adolescents: Cochrane systematic reviews. Perspectives in Public Health, 132(3), 128134. doi: 10.1177/1757913912443487CrossRefGoogle ScholarPubMed
Foxcroft, D. R., & Tsertsvadze, A. (2012). Universal alcohol misuse prevention programmes for children and adolescents: Cochrane systematic reviews. Perspectives in Public Health, 132(3), 128134. https://doi.org/10.1177/1757913912443487.CrossRefGoogle ScholarPubMed
Giles, S., Jackson-Newsom, J., Pankratz, M. M., Hansen, W. B., Ringwalt, C. L., & Dusenbury, L. (2008). Measuring quality of delivery in a substance use prevention program. Journal of Primary Prevention, 29(6), 489501. doi: 10.1007/s10935-008-0155-7CrossRefGoogle Scholar
Gottfredson, D. C., Cook, T. D., Gardner, F. E. M., Gorman-Smith, D., Howe, G. W., Sandler, I. N., & Zafft, K. M. (2015). Standards of evidence for efficacy, effectiveness, and scale-up research in prevention science: Next generation. Prevention Science, 16(7), 893926. doi: 10.1007/s11121-015-0555-xCrossRefGoogle ScholarPubMed
Guerin, N., & White, V. (2018). ASSAD 2017 Statistics & Trends: Australian Secondary Students’ Use of Tobacco, Alcohol, Over-the-counter Drugs, and Illicit Substances. Retrieved from https://www.health.gov.au/resources/publications/secondary-school-students-use-of-tobacco-alcohol-and-other-drugs-in-2017Google Scholar
Hall, W. D., Patton, G., Stockings, E., Weier, M., Lynskey, M., Morley, K. I., & Degenhardt, L. (2016). Why young people's substance use matters for global health. The Lancet Psychiatry, 3(3), 265279. doi: 10.1016/s2215-0366(16)00013-4CrossRefGoogle ScholarPubMed
Heo, M., & Leon, A. C. (2009). Sample size requirements to detect an intervention by time interaction in longitudinal cluster randomized clinical trials. Statistics in Medicine, 28, 10171027. doi: 10.1002/sim.3527CrossRefGoogle ScholarPubMed
Hox, J. (2010). Multilevel analysis: Techniques and applications (2nd ed.). New York: Routledge.CrossRefGoogle Scholar
Kaur, N., Keyes, K. M., Hamilton, A., Chapman, C., Livingston, M., Slade, T., & Swift, W. (under review). Trends in cannabis use and attitudes towards legalization and use among Australians from 2001-2016: An age-period-cohort analysis, Addiction.Google Scholar
Kraus, L., Seitz, N.-N., Piontek, D., Molinaro, S., Siciliano, V., Guttormsson, U., … Hibell, B. (2018). ‘Are The Times A-Changin’? Trends in adolescent substance use in Europe. Addiction, 113(7), 13171332. doi: 10.1111/add.14201CrossRefGoogle ScholarPubMed
Lee, N. K., Cameron, J., Battams, S., & Roche, A. (2016). What works in school-based alcohol education: A systematic review. Health Education Journal, 75(7), 780798. doi: 10.1177/0017896915612227CrossRefGoogle Scholar
Livingston, M., Raninen, J., Slade, T., Swift, W., Lloyd, B., & Dietze, P. (2016). Understanding trends in Australian alcohol consumption—an age–period–cohort model. Addiction, 111(9), 15901598. doi: 10.1111/add.13396CrossRefGoogle ScholarPubMed
Marel, C., Sunderland, M., Mills, K. L., Slade, T., Teesson, M., & Chapman, C. (2019). Conditional probabilities of substance use disorders and associated risk factors: Progression from first use to use disorder on alcohol, cannabis, stimulants, sedatives and opioids. Drug and Alcohol Dependence, 194, 136142. doi: 10.1016/j.drugalcdep.2018.10.010CrossRefGoogle ScholarPubMed
Marsch, L. A., Bickel, W. K., & Badger, G. J. (2007). Applying computer technology to substance abuse prevention science: Results of a preliminary examination. Journal of Child & Adolescent Substance Abuse, 16(2), 6994.CrossRefGoogle Scholar
McBride, N., Farringdon, F., Muleners, L., & Midford, R. (2006). School health and alcohol harm reduction project: Details of intervention development and research procedures. Perth, WA: National Drug Research Institute, Curtin University of Technology.Google Scholar
Miller, E. T., Neal, D. J., Roberts, L. J., Baer, J. S., Cressler, S. O., Metrik, J., & Marlatt, G. A. (2002). Test-retest reliability of alcohol measures: Is there a difference between internet-based assessment and traditional methods? Psychology of Addictive Behaviors, 16(1), 56.CrossRefGoogle Scholar
Mohr, D. C., Schueller, S. M., Riley, W. T., Brown, C. H., Cuijpers, P., Duan, N., … Cheung, K. (2015). Trials of intervention principles: Evaluation methods for evolving behavioral intervention technologies. Journal of Medical Internet Research, 17(7), e166. doi: 10.2196/jmir.4391CrossRefGoogle ScholarPubMed
Newton, N. C., Teesson, M., Barrett, E. L., Slade, T., & Conrod, P. J. (2012). The CAP study, evaluation of integrated universal and selective prevention strategies for youth alcohol misuse: Study protocol of a cluster randomized controlled trial. BMC Psychiatry, 12, 118. doi: 10.1186/1471-244X-12-118CrossRefGoogle ScholarPubMed
Newton, N. C., Teesson, M., Mather, M., Champion, K. E., Barrett, E. L., Stapinski, L., … Slade, T. (2018). Universal cannabis outcomes from the Climate and Preventure (CAP) study: A cluster randomised controlled trial. Substance Abuse Treatment, Prevention, and Policy, 13(1), 34. doi: 10.1186/s13011-018-0171-4CrossRefGoogle ScholarPubMed
Newton, N. C., Teesson, M., Vogl, L. E., & Andrews, G. (2010). Internet-based prevention for alcohol and cannabis use: Final results of the climate schools course. Addiction, 105(4), 749759. doi: 10.1111/j.1360-0443.2009.02853.xCrossRefGoogle ScholarPubMed
Newton, N. C., Vogl, L., Teesson, M., & Andrews, G. (2011). Developing the climate schools: Alcohol and Cannabis module: A harm-minimization, universal drug prevention program facilitated by the internet. Substance Use & Misuse, 46(13), 16511663. doi: 10.3109/10826084.2011.613441CrossRefGoogle ScholarPubMed
Newton, N. C., Vogl, L. E., Teesson, M., & Andrews, G. (2009). CLIMATE schools: Alcohol module: Cross-validation of a school-based prevention programme for alcohol misuse. Australian & New Zealand Journal of Psychiatry, 43(3), 201207. doi: 10.1080/00048670802653364CrossRefGoogle ScholarPubMed
Onrust, S. A., Otten, R., Lammers, J., & Smit, F. (2016). School-based programmes to reduce and prevent substance use in different age groups: What works for whom? Systematic review and meta-regression analysis. Clinical Psychology Review, 44, 4559. doi: 10.1016/j.cpr.2015.11.002CrossRefGoogle ScholarPubMed
Pape, H., Rossow, I., & Brunborg, G. S. (2018). Adolescents drink less: How, who and why? A review of the recent research literature. Drug & Alcohol Review, 37 Suppl 1(S1), S98S114. doi: 10.1111/dar.12695CrossRefGoogle Scholar
Parcel, G. S., & Basen-Engquist, K.. (2000). The School as a Setting. Settings for health promotion: Linking theory and practice. In MFD, Polanyi, JW, Frank, HS, Shannon, TJ, Sullivan, & JN, Lavis (Eds.), Promoting the Determinants of Good Health in the Workplace (pp. 86137).Google Scholar
Peacock, A., Leung, J., Larney, S., Colledge, S., Hickman, M., Rehm, J., … Degenhardt, L. (2018). Global statistics on alcohol, tobacco and illicit drug use: 2017 status report. Addiction, 113(10), 19051926. doi: 10.1111/add.14234CrossRefGoogle ScholarPubMed
Schoenwald, S. K., Garland, A. F., Chapman, J. E., Frazier, S. L., Sheidow, A. J., & Southam-Gerow, M. A. (2011). Toward the effective and efficient measurement of implementation fidelity. Administration and Policy in Mental Health, 38(1), 3243. doi: 10.1007/s10488-010-0321-0CrossRefGoogle ScholarPubMed
Shrout, P. E., & Rodgers, J. L. (2018). Psychology, science, and knowledge construction: Broadening perspectives from the replication crisis. Annual Review Psychology, 69, 487510. doi: 10.1146/annurev-psych-122216-011845CrossRefGoogle ScholarPubMed
Slade, T., Newton, N. C., Mather, M., Barrett, E. L., Champion, K. E., Stapinski, L., … Teesson, M. (under review). The long-term effectiveness of universal, selective and combined prevention for alcohol use during adolescence: 36-month outcomes from a cluster randomized controlled trial. Addiction, Under review.Google Scholar
Spoth, R. L., Randall, G. K., Trudeau, L., Shin, C., & Redmond, C. (2008). Substance use outcomes 5 1/2 years past baseline for partnership-based, family-school preventive interventions. Drug and Alcohol Dependence, 96(1-2), 5768. doi: 10.1016/j.drugalcdep.2008.01.023CrossRefGoogle ScholarPubMed
StataCorp. (2017). Stata statistical software: Release 15. College Station, TX: StataCorp LLC.Google Scholar
Teesson, M., Newton, N. C., Slade, T., Carragher, N., Barrett, E. L., Champion, K. E., … Conrod, P. J. (2017). Combined universal and selective prevention for adolescent alcohol use: A cluster randomized controlled trial. Psychological Medicine, 47(10), 17611770. doi: 10.1017/S0033291717000198CrossRefGoogle ScholarPubMed
Teesson, M., Newton, N. C., Slade, T., Chapman, C., Birrell, L., Mewton, L., … Andrews, G. (2020). Combined prevention for substance use, depression, and anxiety in adolescence: A cluster-randomised controlled trial of a digital online intervention. The Lancet Digital Health, 2(2), e74e84. doi: https://doi.org/10.1016/S2589-7500(19)30213-4CrossRefGoogle ScholarPubMed
Valentine, J. C., Biglan, A., Boruch, R. F., Castro, F. G., Collins, L. M., Flay, B. R., … Schinke, S. P. (2011). Replication in prevention science. Prevention Science, 12(2), 103117. doi: 10.1007/s11121-011-0217-6CrossRefGoogle ScholarPubMed
White, H. R., & Labouvie, E. W. (1989). Towards the assessment of adolescent problem drinking. Journal of Studies on Alcohol, 50(1), 3037. doi: 10.15288/jsa.1989.50.30CrossRefGoogle ScholarPubMed
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