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Effectiveness of Brief School-Based Interventions for Adolescents: A Meta-analysis of Alcohol Use Prevention Programs

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Abstract

To conduct a meta-analysis summarizing the effectiveness of school-based brief alcohol interventions (BAIs) among adolescents and to examine possible iatrogenic effects due to deviancy training in group-delivered interventions, a systematic search for eligible studies was undertaken, current through December 31, 2012. Studies were eligible for inclusion if they used an experimental/quasi-experimental design; focused on school-based BAIs; enrolled adolescent participants; and reported an alcohol-related outcome measure. Studies were coded for key variables, and outcome effect sizes were analyzed as standardized mean differences adjusted for small samples (Hedges’ g). Analyses were conducted using inverse-variance weighted mixed-effects meta-regression models. Sensitivity analyses were also conducted. Across all 17 studies eligible for inclusion, school-based BAIs were associated with significant improvements among adolescents, whereby adolescents in the BAI groups reduced their alcohol consumption relative to the control groups (ḡ = 0.34, 95 % CI [0.11, 0.56]). Subgroup analyses indicated that whereas individually-delivered BAIs were effective (ḡ = 0.58, 95 % CI [0.23, 0.92]), there was no evidence that group-delivered BAIs were associated with reductions in alcohol use (ḡ = −0.02, 95 % CI [−0.17, 0.14]). Delivery format was confounded with program modality, however, such that motivational enhancement therapy was the most effective modality, but was rarely implemented in group-delivered interventions. Some school-based BAIs are effective in reducing adolescent alcohol consumption, but may be ineffective if delivered in group settings. Future research should explore whether group-delivered BAIs that use motivational enhancement therapy components may yield beneficial outcomes like those observed in individually-delivered programs.

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Notes

  1. In most meta-analyses, the effect size indexes the relationship between two variables in a primary study (e.g., x = BAI delivery; y = post-intervention alcohol use). As such, variables used to predict the magnitude of effect sizes in a meta-analysis (e.g., z = intervention delivery format) are typically called moderators because they are hypothesized to modify the effect of the intervention on the outcome of interest (see Higgins and Green 2011; Lipsey and Wilson 2001). We use this standard meta-analysis terminology of “effect size moderators” in the current study.

  2. This estimate is based on data from the larger meta-analysis (Tanner-Smith and Lipsey 2014), using the average mean and standard deviation of post-intervention alcohol consumption among control group participants on items measuring frequency of alcohol consumption in the past 30 days using a timeline follow-back outcome measure.

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Acknowledgments

This work was supported by Award Number R01AA020286 from the National Institute on Alcohol Abuse and Alcoholism. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Alcohol Abuse and Alcoholism or the National Institutes of Health.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Peabody Research Institute, Vanderbilt University, 220 Appleton Place, Mayborn Building, Nashville, TN, 37203-5721, USA

    Emily E. Tanner-Smith

  2. Department of Human & Organizational Development, Peabody College, Vanderbilt University, 220 Appleton Place, Mayborn Building, Nashville, TN, 37203-5721, USA

    Emily A. Hennessy

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Correspondence to Emily A. Hennessy.

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Hennessy, E.A., Tanner-Smith, E.E. Effectiveness of Brief School-Based Interventions for Adolescents: A Meta-analysis of Alcohol Use Prevention Programs. Prev Sci 16, 463–474 (2015). https://doi.org/10.1007/s11121-014-0512-0

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