Alcohol Interventions For Adolescents Research Articles

Meta-analysis with Robust Variance Estimation: Expanding the Range of Working Models.

In prevention science and related fields, large meta-analyses are common, and these analyses often involve dependent effect size estimates. Robust variance estimation (RVE) methods provide a way to include all dependent effect sizes in a single meta-regression model, even when the exact form of the dependence is unknown. RVE uses a working model of the dependence structure, but the two currently available working models are limited to each describing a single type of dependence. Drawing on flexible tools from multilevel and multivariate meta-analysis, this paper describes an expanded range of working models, along with accompanying estimation methods, which offer potential benefits in terms of better capturing the types of data structures that occur in practice and, under some circumstances, improving the efficiency of meta-regression estimates. We describe how the methods can be implemented using existing software (the "metafor" and "clubSandwich" packages for R), illustrate the proposed approach in a meta-analysis of randomized trials on the effects of brief alcohol interventions for adolescents and young adults, and report findings from a simulation study evaluating the performance of the new methods.

Interventions for adolescent alcohol consumption in Africa: protocol for a scoping review including an overview of reviews

BackgroundHarmful alcohol use is a leading risk to the health of populations worldwide. Within Africa, where most consumers are adolescents, alcohol use represents a key public health challenge. Interventions to prevent or substantially delay alcohol uptake and decrease alcohol consumption in adolescence could significantly decrease morbidity and mortality, through both immediate effects and future improved adult outcomes. In Africa, these interventions are urgently needed; however, key data necessary to develop them are lacking as most evidence to date relates to high-income countries. The purpose of this review is to examine and map the range of interventions in use and create an evidence base for future research in this area.MethodsIn the first instance, we will conduct a review of systematic reviews relevant to global adolescent alcohol interventions. We will search the Cochrane Database of Systematic Reviews, MEDLINE (Ovid), CINAHL, Web of Science, Global Health and PubMed using a broad search. In the second instance we will conduct a scoping review by drawing on the methodological framework proposed by Arksey and O’Malley. We will search for all study designs and grey literature using the Cochrane Database of Systematic Reviews, MEDLINE (Ovid), CINAHL, Web of Science and Global Health, Google searches and searches in websites of relevant professional bodies and charities. An iterative approach to charting, collating, summarising and reporting the data will be taken, with the development of charting forms and the final presentation of results led by the extracted data. In both instances, the inclusion and exclusion criteria have been pre-defined, and two reviewers will independently screen abstracts and full text to determine eligibility of articles.DiscussionIt is anticipated that our findings will map intervention strategies aiming to reduce adolescent alcohol consumption in Africa. These findings are likely to be useful in informing future research, policy and public health strategies. Findings will be disseminated widely through peer-reviewed publication and in various media, for example, conferences, congresses or symposia.Protocol RegistrationThis protocol was submitted to the Open Science Framework on May 03, 2021. www.osf.io/qnvba

Single-Parent Families: An Underserved Population for Adolescent Alcohol Interventions?

Adolescent drinking continues to be a significant concern in the U.S. national epidemiological studies, which suggest that there are substantial increases among 16- to 17-year-olds for the past 30-day use (22.7%), heavy episodic drinking (HED; ≥5 drinks, 13.1%), and heavy use (>5 HED occasions, 2.7%) [1]. This is concerning, as the consequences for adolescents, the people around them, and society as a whole have been well documented [2].

Brief Alcohol Interventions for Adolescents and Young Adults in Emergency Department Settings: A Descriptive Review and Meta-analysis

Brief interventions have shown promise for reducing alcohol use among adolescents and young adults. However, research on the efficacy of these programs has largely ignored one potentially useful approach—interventions which take place in emergency department settings. The current study combines quantitative and descriptive approaches to synthesize the available literature examining the efficacy of brief interventions for alcohol usage among adolescents and young adults in emergency department settings. One-hundred-thirty-eight effect sizes from 11 studies contributed to an overall weighted average effect size as well as effect sizes for variations related to participant demographics, study characteristics (recruitment, instrumentation, and assessment delay) and intervention details (personnel, focal modality, and intervention components). Descriptive analyses examined many of these variations in more detail. Overall, quantitative summary provided little evidence supporting the efficacy of brief interventions in emergency department settings while descriptive analyses revealed primarily a lack of consistency, especially in the definition of adolescence and operationalization of alcohol usage. In many cases, a lack of detailed enough reporting prevented the identification of patterns which might have been present. The discussion includes a call for more agreement in the field regarding operationalization of adolescence and drinking behavior.

When and How Do Brief Alcohol Interventions in Primary Care Reduce Alcohol Use and Alcohol-Related Consequences among Adolescents?

To systematically describe when and how brief alcohol interventions delivered to adolescents in primary care settings reduce alcohol use and alcohol-related consequences among adolescents, using realist review methodology. Eleven electronic databases, gray literature, and reference screening were searched up to June 2016; 11 brief interventions published in 13 studies met inclusion criteria. Intervention design components (delivery context and intervention mechanisms) underlying brief alcohol interventions for adolescents were extracted and linked to alcohol use and related consequences. Brief interventions had either an indicated context of delivery (provided to adolescent patients with low-to-moderate risk for alcohol problems) or universal context of delivery (provided to general adolescent patient population). Interventions that used motivational interviewing in an indicated delivery context had 2 potential mechanisms-eliciting and strengthening motivation to change and providing direction through interpretation. These interventions resulted in clinically significant reductions in alcohol use and associated consequences. Peer risk also was identified among universal and indicated brief interventions as a potential mechanism for changing alcohol-related outcomes among adolescents who received the intervention. None of the studies tested the processes by which interventions were expected to work. The current evidence base suggests that both indicated and universal delivery of brief alcohol interventions to adolescents in primary care settings can result in clinically important changes in alcohol-related outcomes. Studies that test brief intervention processes are now necessary to better understand how brief interventions work with adolescents in primary care settings.

Simulating drinking in social networks to inform alcohol prevention and treatment efforts.

Adolescent drinking influences, and is influenced by, peer alcohol use. Several efficacious adolescent alcohol interventions include elements aimed at reducing susceptibility to peer influence. Modeling these interventions within dynamically changing social networks may improve our understanding of how such interventions work and for whom they work best. We used stochastic actor-based models to simulate longitudinal drinking and friendship formation within social networks using parameters obtained from a meta-analysis of real-world 10th grade adolescent social networks. Levels of social influence (i.e., friends affecting changes in one's drinking) and social selection (i.e., drinking affecting changes in one's friendships) were manipulated at several levels, which directly impacted the degree of clustering in friendships based on similarity in drinking behavior. Midway through each simulation, one randomly selected heavy-drinking actor from each network received an "intervention" that either (a) reduced their susceptibility to social influence, (b) reduced their susceptibility to social selection, (c) eliminated a friendship with a heavy drinker, or (d) initiated a friendship with a nondrinker. Only the intervention that eliminated targeted actors' susceptibility to social influence consistently reduced that actor's drinking. Moreover, this was only effective in networks with social influence and social selection that were at higher levels than what was found in the real-world reference study. Social influence and social selection are dynamic processes that can lead to complex systems that may moderate the effectiveness of network-based interventions. Interventions that reduce susceptibility to social influence may be most effective among adolescents with high susceptibility to social influence and heavier-drinking friends. (PsycINFO Database Record

A meta-analysis of brief alcohol interventions for adolescents and young adults: variability in effects across alcohol measures

ABSTRACTBackground: Brief alcohol interventions are one approach for reducing drinking among youth, but may vary in effectiveness depending on the type of alcohol assessments used to measure effects. Objectives: To conduct a meta-analysis that examined the effectiveness of brief alcohol interventions for adolescents and young adults, with particular emphasis on exploring variability in effects across outcome measurement characteristics. Method: Eligible studies were those using an experimental or quasi-experimental design to examine the effects of a brief alcohol intervention on a post-intervention alcohol use measure for youth aged 11–30. A comprehensive literature review identified 190 unique samples that were included in the meta-analysis. Taking a Bayesian approach, we used random-effects multilevel models to estimate the average effect and model variability across outcome measurement types. Results: Brief alcohol interventions led to significant reductions in self-reported alcohol use among adolescents ( = 0.25, 95% credible interval [CrI 0.13, 0.37]) and young adults ( = 0.15, 95% CrI [0.12, 0.18]). These results were consistent across outcomes with varying reference periods, but varied across outcome construct type and assessment instruments. Among adolescents, effects were larger when measured using the Timeline Followback; among young adults, effects were smaller when measured using the Alcohol Use Disorders Identification Test. Conclusion: The strength of the beneficial effects of brief alcohol interventions on youth’s alcohol use may vary depending upon the outcome measure utilized. Nevertheless, significant effects were observed across measures. Although effects were modest in size, they were clinically significant and show promise for interrupting problematic alcohol use trajectories among youth.

Brief alcohol intervention trials conducted by higher prestige authors and published in higher impact factor journals are cited more frequently

ObjectiveTo examine the relationships between study quality, author prestige, journal impact factors, and citation rates of trials and to examine whether journal impact factors mediated the relationships between study quality and author prestige on citation rates. Study Design and SettingWe used bibliometric data from 128 controlled trials included in a recent meta-analysis on brief alcohol interventions for adolescents and young adults. We obtained the number of citations from ISI Web of Knowledge and Google Scholar; journal impact factors were obtained from ISI Web of Knowledge. Linear regression models were used to examine the direct and indirect effects of interest. ResultsThe results indicated that studies were published in journals with higher impact factors when first authors had higher h-indices and studies were funded, but this was largely because those studies were of higher quality. Studies were cited more frequently when first authors had higher h-indices and studies were funded, even after adjusting for study quality proxies. The observed associations between study quality and author prestige on citation rates were also partly mediated through journal impact factors. ConclusionWe conclude that studies conducted by more established authors and reported in more prestigious journal outlets are more likely to be cited by other scholars, even after controlling for various proxies of study quality.

Sociodemographic risk factors of alcohol drinking in Hong Kong adolescents

BackgroundAdolescent drinking in Western countries has been associated with older age and high socioeconomic status, but the association with family structure was inconsistent.MethodsIn a 2012–2013 school-based survey in Hong Kong,...

Linked randomised controlled trials of face-to-face and electronic brief intervention methods to prevent alcohol related harm in young people aged 14-17 years presenting to Emergency Departments (SIPS junior).

BackgroundAlcohol is a major global threat to public health. Although the main burden of chronic alcohol-related disease is in adults, its foundations often lie in adolescence. Alcohol consumption and related harm increase steeply from the age of 12 until 20 years. Several trials focusing upon young people have reported significant positive effects of brief interventions on a range of alcohol consumption outcomes. A recent review of reviews also suggests that electronic brief interventions (eBIs) using internet and smartphone technologies may markedly reduce alcohol consumption compared with minimal or no intervention controls.Interventions that target non-drinking youth are known to delay the onset of drinking behaviours. Web based alcohol interventions for adolescents also demonstrate significantly greater reductions in consumption and harm among ‘high-risk’ drinkers; however changes in risk status at follow-up for non-drinkers or low-risk drinkers have not been assessed in controlled trials of brief alcohol interventions.Design and methodsThe study design comprises two linked randomised controlled trials to evaluate the effectiveness and cost-effectiveness of two intervention strategies compared with screening alone. One trial will focus on high-risk adolescent drinkers attending Emergency Departments (Eds) and the other will focus on those identified as low-risk drinkers or abstinent from alcohol but attending the same ED.Our primary (null) hypothesis is similar for both trials: Personalised Feedback and Brief Advice (PFBA) and Personalised Feedback plus electronic Brief Intervention (eBI) are no more effective than screening alone in alcohol consumed at 12 months after randomisation as measured by the Time-Line Follow-Back 28-day version. Our secondary (null) hypothesis relating to economics states that PFBA and eBI are no more cost-effective than screening alone.In total 1,500 participants will be recruited into the trials, 750 high-risk drinkers and 750 low-risk drinkers or abstainers. Participants will be randomised with equal probability, stratified by centre, to either a screening only control group or one of the two interventions: single session of PFBA or eBI. All participants will be eligible to receive treatment as usual in addition to any trial intervention. Individual participants will be followed up at 6 and 12 months after randomisation.DiscussionThe protocol represents an ambitious innovative programme of work addressing alcohol use in the adolescent population.Trial registrationISRCTN45300218. Registered 5th July 2014.

A retrospective analysis of dissemination biases in the brief alcohol intervention literature.

This study examined dissemination and reporting biases in the brief alcohol intervention literature. We used retrospective data from 179 controlled trials included in a meta-analysis on brief alcohol interventions for adolescents and young adults. We examined whether the magnitude and direction of effect sizes were associated with publication type, identification source, language, funding, time lag between intervention and publication, number of reports, journal impact factor, and subsequent citations. Results indicated that effect sizes were larger for studies that had been funded (b = 0.14, 95% confidence interval [CI] [0.04, 0.23]), had a shorter time lag between intervention and publication (b = -0.03, 95% CI [-0.05, -.001]), and were cited more frequently (b = 0.01, 95% CI [+0.00, 0.01]). Studies that were cited more frequently by other authors also had greater odds of reporting positive effects (odds ratio = 1.10, 95% CI [1.02, 1.18]). Results indicated that time lag bias has increased recently: Larger and positive effect sizes were published more quickly in recent years. We found no evidence, however, that the magnitude or direction of effects was associated with location source, language, or journal impact factor. We conclude that dissemination biases may indeed occur in the social and behavioral science literature, as has been consistently documented in the medical literature. As such, primary researchers, journal reviewers, editors, systematic reviewers, and meta-analysts must be cognizant of the causes and consequences of these biases, and commit to engage in ethical research practices that attempt to minimize them. (PsycINFO Database Record

Can brief alcohol interventions for youth also address concurrent illicit drug use? results from a meta-analysis.

Brief interventions aimed at reducing alcohol use among youth may interrupt a possible developmental progression to more serious substance use if they can also affect the use of other illicit drugs. This meta-analysis examined the findings of recent research on the effects of brief alcohol interventions for adolescents and young adults on both alcohol and illicit drug use. Eligible studies were those using randomized or controlled quasi-experimental designs to examine the effects of brief alcohol interventions on illicit drug use outcomes among youth. A comprehensive literature search identified 30 eligible study samples that, on average, included participants age 17, with 57% male participants and 56% White youth. Three-level random-effects meta-analyses were used to estimate mean effect sizes and explore variability in effects. Overall, brief interventions targeting both alcohol and other drugs were effective in reducing both of these substances. However, the brief interventions that targeted only alcohol had no significant secondary effects on untargeted illicit drug use. The evidence from current research, therefore, shows modest beneficial effects on outcomes that are targeted by brief interventions for youth, but does not show that those effects generalize to untargeted illicit drug use outcomes.

Brief Alcohol Interventions for Adolescents and Young Adults: A Systematic Review and Meta-Analysis

This study reports findings from a meta-analysis summarizing the effectiveness of brief alcohol interventions for adolescents (age 11–18) and young adults (age 19–30). We identified 185 eligible study samples using a comprehensive literature search and synthesized findings using random-effects meta-analyses with robust standard errors. Overall, brief alcohol interventions led to significant reductions in alcohol consumption and alcohol-related problems among adolescents (g¯ = 0.27 and g¯ = 0.19) and young adults (g¯ = 0.17 and g¯ = 0.11). These effects persisted for up to 1year after intervention and did not vary across participant demographics, intervention length, or intervention format. However, certain intervention modalities (e.g., motivational interviewing) and components (e.g., decisional balance, goal-setting exercises) were associated with larger effects. We conclude that brief alcohol interventions yield beneficial effects on alcohol-related outcomes for adolescents and young adults that are modest but potentially worthwhile given their brevity and low cost.

Automatic Processes and the Drinking Behavior in Early Adolescence: A Prospective Study

This study examined the bi-directional prospective link between automatic alcohol-approach tendencies and alcohol use in a group of young adolescents (mean age = 13.6 years). The adolescents in the present study were assumed to be at-risk of early alcohol use and later problem drinking. It was hypothesized that alcohol use and automatic approach tendencies would reinforce one another particularly in the absence of well-developed inhibition skills. A total of 347 adolescents (N = 279 at follow-up) from special secondary education, a risk group for the development of substance use problems, participated in the study. Automatic approach tendencies were assessed with the alcohol-approach avoidance task, inhibition skills were assessed with the Stroop task, and alcohol used was measured using a self-report measure. Zero-inflated Poisson analysis revealed a significant effect of automatic approach tendencies predicting alcohol use 6 months later, although only for adolescents with weaker inhibition skills. Automatic approach tendencies predict future drinking behavior of young adolescents with relatively weak inhibition skills. The findings of the present study have important implications for alcohol interventions for adolescents. Results are discussed in terms of risk factors for the development of problematic alcohol use in young adolescents.

Peer selection and influence effects on adolescent alcohol use: a stochastic actor-based model.

BackgroundEarly adolescent alcohol use is a major public health challenge. Without clear guidance on the causal pathways between peers and alcohol use, adolescent alcohol interventions may be incomplete. The objective of this study is to disentangle selection and influence effects associated with the dynamic interplay of adolescent friendships and alcohol use.MethodsThe study analyzes data from Add Health, a longitudinal survey of seventh through eleventh grade U.S. students enrolled between 1995 and 1996. A stochastic actor-based model is used to model the co-evolution of alcohol use and friendship connections.ResultsSelection effects play a significant role in the creation of peer clusters with similar alcohol use. Friendship nominations between two students who shared the same alcohol use frequency were 3.60 (95% CI: 2.01-9.62) times more likely than between otherwise identical students with differing alcohol use frequency. The model controlled for alternative pathways to friendship nomination including reciprocity, transitivity, and similarities in age, gender, and race/ethnicity. The simulation model did not support a significant friends’ influence effect on alcohol behavior.ConclusionsThe findings suggest that peer selection plays a major role in alcohol use behavior among adolescent friends. Our simulation results would lend themselves to adolescent alcohol abuse interventions that leverage adolescent social network characteristics.

Interventions for adolescent alcohol use

Adolescent alcohol use is a considerable public health problem, contributing to the leading causes of adolescent morbidity and mortality. Additionally, adolescent alcohol use is a major risk factor for adult alcohol use disorders. Successful prevention of and interventions for adolescent alcohol use may thus have significant public health impact. This article reviews the current literature on adolescent alcohol prevention and intervention strategies. Systematic reviews and meta-analyses find that a variety of adolescent alcohol interventions are effective at reducing adolescents' alcohol use, as well as harmful behaviors associated with alcohol use. Long-term treatment is not necessarily superior, as brief interventions have been found to have a large effect size. Additionally, universal interventions (i.e., those that target all families within a group) may be more successful than selective interventions (i.e., those that target only certain families within a group). Intervention effects tend to wane 6-12 months after the cessation of treatment. The results of prevention interventions are more mixed. Many different intervention modalities have been shown to be effective, particularly family-based interventions, as have both universal and targeted interventions. A wide range of interventions are effective at reducing the harm of adolescent alcohol use. It is unclear which intervention(s) is/are optimal or most efficacious. Additionally, further research is needed on how to maintain long-term intervention effects. It is less clear which prevention strategies are most efficacious. Family-based interventions appear to be most promising.