Universal Family Drug Prevention Programs. A Systematic Review

Current evidence and opportunities in child and adolescent public mental health: a research review

BACKGROUND

A public mental health lens is increasingly required to better understand the complex and multifactorial influences of interpersonal, community and institutional systems on the mental health of children and adolescents.

METHODS

This research review (1) provides an overview of public mental health and proposes a new interactional schema that can guide research and practice, (2) summarises recent evidence on public mental health interventions for children and adolescents, (3) highlights current challenges for this population that might benefit from additional attention and (4) discusses methodological and conceptual hurdles and proposes potential solutions.

RESULTS

In our evidence review, a broad range of universal, selective and indicated interventions with a variety of targets, mechanisms and settings were identified, some of which (most notably parenting programmes and various school-based interventions) have demonstrated small-to-modest positive effects. Few, however, have achieved sustained mental health improvements.

CONCLUSIONS

There is an opportunity to re-think how public mental health interventions are designed, evaluated and implemented. Deliberate design, encompassing careful consideration of the aims and population-level impacts of interventions, complemented by measurement that embraces complexity through more in-depth characterisation, or 'phenotyping', of interpersonal and environmental elements is needed. Opportunities to improve child and adolescent mental health outcomes are gaining unprecedented momentum. Innovative new methodology, heightened public awareness, institutional interest and supportive funding can enable enhanced study of public mental health that does not shy away from complexity.

Dual alcohol and cannabis use in male and female adolescents: Relationships with family variables

Family dynamics influence adolescents' use of alcohol and other substances, such as cannabis. The aim of this study was to understand the relationship between family variables and alcohol use, dual use of alcohol and cannabis, and non-use in adolescents according to sex. A cross-sectional study was conducted. The sample comprised 879 adolescents (56.4 % boys; M(SD)age = 14.25 (1.88) years). Multinomial regression analysis showed that for boys, the presence of family conflict increased the likelihood of being an alcohol (OR = 1.19) and dual (OR = 1.23) user rather than a non-user. For girls, communication reduced the probability of being an alcohol user (OR = 0.88), and the presence of consequences for breaking rules reduced the probability of being a dual user rather than a non-user (OR = 0.83) or an alcohol user (OR = 0.84). These findings highlight the importance of family prevention of adolescents' substance use, bearing in mind the participants' sex.

A Review of the Prevention of Drug Addiction: Specific Interventions, Effectiveness, and Important Topics

BACKGROUND

This study was a narrative review on prevention of addictive behaviors with an effort to clarify the major concepts of prevention and its dimensions.

METHODS

The PsycInfo and MedInfo databases were used to identify prevention. Α total of 65 articles were found 46 of which were included in the review. Τhe data were analyzed using content analysis.

FINDINGS

For a better understanding of the results, it was deemed advisable to categorize them into: (a) the types of major interventions and the theoretical approaches on which they were based, (b) the results of the review articles according to (1) variables and factors concerning the prevention proved important through the review and (2) a number of more general important topics which arose in the prevention of addictive behaviors.

CONCLUSION

The results highlighted the greater effectiveness of community-based programs, applied primarily in broader contexts but also secondarily in high-risk groups. Τhe results were discussed based on the combination of the emerged factors with each other and prevention experience.

Prevention of Alcohol Consumption Programs for Children and Youth: A Narrative and Critical Review of Recent Publications

Background

Youth substance use is a public health problem globally, where alcohol is one of the drugs most consumed by children, and youth prevention is the best intervention for drug abuse.

Objective

Review the latest evidence of alcohol use prevention programs in empirical research, oriented to all fields of action among children and youth.

Methods

A narrative and critical review was carried out within international databases (PsychInfo, Pubmed, Web of Science, and Scopus) in August 2021 and was limited to empirical studies that appeared in the last five years (2017-2021). A flow diagram was used according to the PRISMA statements. Empirical research articles in English with RCTs and quasi-experimental design that included alcohol, children, and young people up to 19 years of age (universal, selective, or indicated programs) were included. The authors examined the results and conceptual frameworks of the Prevention programs by fields of action.

Results

Twenty-two articles were found from four fields of action: school (16), family (2), community (2), and web-based (2), representing 16 alcohol prevention programs. School-based alcohol prevention programs are clinically relevant [Theory of Planned Behavior, Refuse, Remove, Reasons, Preventure, The GOOD Life, Mantente REAL, Motivational Interviewing (BIMI), Primavera, Fresh Start, Bridges/Puentes], they are effective in increasing attitudes and intentions toward alcohol prevention behavior, while decreasing social norms and acceptance of alcohol, reducing intoxication, and increasing perceptions with regards to the negative consequences of drinking.

Discussion

This narrative and critical review provides an updated synthesis of the evidence for prevention programs in the school, family, community, and web-based fields of action, where a more significant number of programs exist that are applied within schools and for which would have greater clinical relevance. However, the prevention programs utilized in the other fields of action require further investigation.

Roles and responsibilities in substance use prevention in the school setting: views among Finnish school personnel representatives

OBJECTIVE

This study explores the views of Finnish school personnel representatives regarding substance use prevention responsibilities.

DESIGN

Twenty-two focus groups were conducted within the scope of a regional intervention study in 2019. Qualitative content analysis was performed.

SETTING

Focus group interviews were conducted in the school setting.

SUBJECTS

Focus group participants included representatives for educational personnel and student welfare personnel working in basic education, general upper secondary education or vocational education settings.

MAIN OUTCOME MEASURES

Views and experiences concerning roles and responsibilities in primary prevention of substance use.

RESULTS

Findings highlight the need for intersectoral efforts and intra-school collaboration in primary prevention efforts, but also in mental health promotion - on which the informants placed great emphasis. The health promotion leadership in schools, structural guidelines and the school curriculum could both challenge and support school personnel in their roles. An increased need to focus on the early years of life and related responsibilities of the homes was emphasized, along with the need to place more emphasis on health education in the first years of basic education, and responsibilities related to early risk identification.

CONCLUSION

The findings highlight a need to develop structures and role clarity among school personnel, which can advance further development of intra-school and inter-sectoral collaboration in primary substance use prevention and mental health promotion. In the Finnish context, the successful implementation of relevant legislation, which some school representatives view as unclear or contravening, could be further supported.Key pointsViews regarding responsibilities in primary substance use prevention in the school setting have been less researched in the Nordic countries:The importance of inter-sectoral and intra-school collaboration is emphasized among school personnel representatives, including the role of the homesPrimary prevention and mental health promotion responsibilities are viewed as less clear than secondary and tertiary prevention responsibilitiesStructural guidelines concerning e.g. confidentiality aspects and curriculum features can both support and challenge school representatives in their roles.

The Influence of the Competences of the Professionals in Charge of Family Evidence-Based Programmes on Internalizing and Externalizing Symptoms in Adolescents

This study analyses the influence of trainers’ intrapersonal and group management competences on the effectiveness of the Universal Strengthening Families Program 11-14 (SFP 11-14). More specifically, it assesses the effect of these competences on internalizing and externalizing symptoms in adolescents. The analysed data is made up of ratings given by the 174 mothers participating in SFP 11-14. The results confirm the effectiveness of SFP 11-14 in reducing internalizing and externalizing symptoms in adolescents. Using linear regression models, evidence is provided of the influence of the trainers’ expertise, in terms of their competences, in improving internalizing symptoms in adolescents (through a reduction in levels of anxiety, depression, and somatization and in the global internalization scale). Emphasis is placed on how trainer competences can impact on the effectiveness of evidence-based programmes, stressing that this should be taken into account by the public authorities and other stakeholders in the assessment and design of family evidence-based programmes.