Prevention of alcohol and drug misuse in adolescents: An overview of systematic reviews
Sammanfattning
BACKGROUND - Systematic reviews have evaluated a wide variety of programmes aiming to
prevent, reduce or delay substance use in adolescents. This paper presents an overview of recent
systematic reviews, summarising the evidence on the effectiveness of prevention strategies which
target adolescents misusing alcohol and/or drugs. METHODS - We performed a comprehensive
search in major electronic databases, consulted websites and checked reference lists of relevant
articles. Studies that met our inclusion criteria were critically appraised using the AMSTAR
instrument. The findings from the included systematic reviews were synthesised using a vote
counting procedure. RESULTS - Twenty-one systematic reviews were identified. Ten of these were
rated as of high quality. There was little overlap between reviews in terms of the target group,
intervention, setting and outcome measures. The components or mechanisms of the prevention
programmes were poorly described. Ten reviews evaluated school-based prevention. The effects of
these prevention programmes are promising, while effects of community-based, family-based and
multifaceted programmes were less convincing. CONCLUSION - Based on the current evidence, there
is a small but consistent positive effect of school-based prevention programmes, but it is less clear
what the "active ingredient" is. For example, which group should one target, in which setting and in
which circumstances? A set of standardised process and outcome measures would allow us to better
compare and statistically pool the results of original studies and reviews. This overview of reviews,
like similar other overviews, should encourage researchers to increase uniformity and consistency
between studies. This would improve the comparability of evidence, which is needed to formulate
valid recommendations for practice.