Published by the Journal of the American Academy of Child & Adolescent Psychiatry, the study led by Associate Professor Nicola Newton of the University of Sydney’s Matilda Centre, followed the effects of school-based alcohol prevention and the drinking habits of 2,190 Australian students over seven years from year 8 through to early adulthood (19-20 years).
To date, only 6.6% of similar interventions have evaluated their effectiveness beyond 24 months. "Considering the majority of alcohol prevention interventions are aimed at 13-15 years, little is known about their effectiveness into adulthood when the legal age of drinking comes into play," says Associate Professor Newton. This led the research team to ask the question: can the effectiveness of universal and selective alcohol prevention programs continue through to adulthood?
The researchers employed a universal (Climate Schools) and selective (PreVenture) intervention to establish whether these programs had long-lasting effects and how the trajectories differ from 'health education as usual'.
Climate Schools is a universal school-based prevention program designed to prevent and reduce alcohol and (other drug use) and related harms among adolescents. The program delivers information via cartoon-based storylines underpinned by the social influence approach to drug prevention that are designed to be delivered online in a classroom setting embedded within the school 'health' curriculum.
PreVenture is a selective school-based program designed to target four different personality-specific motivational pathways to risky alcohol use in adolescence. Students that are identified as higher risk for feelings of hopelessness, anxiety sensitivity, impulsivity and sensation seeking, are allocated to one of four intervention groups. In small groups (4-8 students) the students are then guided through two 90-minute skills-based sessions with a trained facilitator and co-facilitator.
The researchers followed up the students at 6 months, 12months, 2 years, 3 years, 5.5 years, and 7 years.
At 7-years post program delivery, students who received Climate Schools or PreVenture interventions reported significant benefits of up to:
reduced odds of hazardous alcohol use*
reduced odds of experiencing alcohol-related harms*
less likely to use alcohol weekly*
less likely to report binge-drinking *
* compared to students who received only 'health education as usual'.
These results show that universal and selective interventions can vastly improve the trajectories of alcohol use and related harms compared to 'health education as usual', not only in the short-term (1-2 years), but after seven years into early adulthood. "Changing the trajectories of alcohol use in middle adolescence can have a knock-on effect for alcohol use behaviours in young adulthood, highlighting the importance of preventing early," says Associate Professor Newton.
Overall, both the Climate Schools and PreVenture interventions were found to be significantly more effective than the current 'health education as usual'. By updating 'health education as usual' to embed evidence-based interventions like Climate Schools and PreVenture we can vastly change the trajectories of risky drinking behaviour and related harms of our future generations.
The researchers are now conducting modelling on the overall economic and health benefits of rolling out these interventions in all Australian schools.
The study was funded through a project grant from the National Health and Medical Research Council (NHMRC; APP1124958). Prof Maree Teesson and Assoc Prof Nicola Newton are two of the developers of the Climate Schools programs and Prof Patricia Conrad is the developer of the PreVenture program. Prof Teesson and Assoc Prof Newton are directors of Climate Schools Pty Ltd, a social enterprise established in 2015 to distribute the Climate Schools programs and maximise social well-being.