Alcohol misuse prevention programmes: reviews show some may work, but we need better trials

Here in the European Union, we drink more alcohol than anywhere else in the world (11 litres of pure alcohol per adult each year) and this makes for huge problems in terms of health and wellbeing. It’s staggering to learn that more than one in four deaths amongst men aged 15-29 and one death in ten in young women in the EU are alcohol-related. We certainly need to know how to help prevent the misuse of alcohol and the authors of three Cochrane reviews on alcohol misuse prevention programmes for children and adolescents have now summarised their findings in a paper published in the peer-reviewed journal ‘Perspectives in Public Health’.

The reviewers identified 85 randomised trials suitable for inclusion in the reviews of school-based (53 trials), family (12 trials) and multi-component (20 trials) programmes, with most coming from North America. The studies varied too much for data to be combined in meta-analyses. Here’s what they found:

  • Studies were at high risk of bias, with a number of problems relating to study design and reporting
  • Some generic psychosocial and life skills school-based programmes (Life Skills Training programme, Unplugged programme, Good Behaviour Game) were effective in reducing alcohol use
  • Most family-based programmes were effective in reducing alcohol use. Results were small but consistent and continued into the medium to longer term
  • There was insufficient evidence to conclude that multiple interventions provided additional benefit over single interventions

The authors concluded:

“Some school, family or multi-component prevention programmes were shown to be effective in reducing alcohol misuse in youths. However, these results warrant a cautious interpretation, since bias and/or contextual factors may have affected the trial results. Further research should replicate the most promising studies…and pay particular attention to content and context factors through rigorous evaluation.”

The authors note that whilst the quality of trials of alcohol misuse prevention has improved over the past 15 years, serious problems in the conduct and reporting of these trials remain. This needs to change if systematic reviewers are to find meaningful answers to critical questions relating to our health and wellbeing. In relation to this particular topic, the authors provide further recommendations for researchers in this paper.

Links:

Foxcroft D, Tsertsvadze A. Universal alcohol misuse prevention programmes for children and adolescents: Cochrane systematic reviews. Perspectives in Public Health May 2012 vol. 132 no. 3 128-134

Foxcroft  DR, Tsertsvadze  A. Universal school-based prevention programs for alcohol misuse in young people. Cochrane Database of Systematic Reviews  2011, Issue 5. Art. No.: CD009113. DOI: 10.1002/14651858.CD009113

Foxcroft  DR, Tsertsvadze  A. Universal school-based prevention programs for alcohol misuse in young people. Cochrane Database of Systematic Reviews  2011, Issue 5. Art. No.: CD009113. DOI: 10.1002/14651858.CD009113.

Foxcroft  DR, Tsertsvadze  A. Universal multi-component prevention programs for alcohol misuse in young people. Cochrane Database of Systematic Reviews  2011, Issue 9. Art. No.: CD009307. DOI: 10.1002/14651858.CD009307

 

 

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Sarah Chapman

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My name is Sarah Chapman. I have worked on systematic reviews and other types of research in many areas of health for the past 17 years, for the Cochrane Collaboration and for several UK higher education institutions including the University of Oxford and the Royal College of Nursing Institute. I also have a background in nursing and in the study of the History of Medicine.

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