Foxcroft David R, Tsertsvadze Alexander
School of Health and Social Care, Oxford Brookes University, Marston Road, Jack Straws Lane, Marston, Oxford, England, UK, OX3 0FL.
Cochrane Database Syst Rev. 2011 Sep 7(9):CD009307. doi: 10.1002/14651858.CD009307.
Alcohol misuse in young people is a cause of concern for health services, policy makers, prevention workers, and criminal justice system, youth workers, teachers, and parents.
To systematically review evidence on the effectiveness of universal multi-component prevention programs in preventing alcohol misuse in school-aged children up to 18 years of age. To update a part of a previously published Cochrane systematic review.
Relevant evidence (up to 2002) was selected from the previous Cochrane review. Later studies, to July 2010, were identified from MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, Project CORK, and PsycINFO.
Randomized trials evaluating universal multi-component prevention programs (intervention delivered in more than one setting) and reporting outcomes for alcohol use in students 18 years of age or younger were included. Two reviewers screened titles/abstracts and full text of identified records.
Two reviewers extracted relevant data independently using an a priori defined extraction form. Risk of bias was assessed.
20 parallel-group trials were included. The reporting quality of trials was poor, only 25% and 5% of them reporting adequate method of randomisation and program allocation concealment, respectively. Incomplete data was adequately addressed in about half of the trials and this information was unclear for about 20% of the trials. Due to extensive heterogeneity across interventions, populations, and outcomes, the results were summarized only qualitatively.12 of the 20 trials showed some evidence of effectiveness compared to a control or other intervention group, with persistence of effects ranging from 3 months to 3 years. Of the remaining 8 trials, one trial reported significant effects using one-tailed tests and 7 trials reported no significant effects of the multi-component interventions for reducing alcohol misuse.Assessment of the additional benefit of multiple versus single component interventions was possible in 7 trials with multiple arms. Only one of the 7 trials clearly showed a benefit of components delivered in more than one setting.
AUTHORS' CONCLUSIONS: There is some evidence that multi-component interventions for alcohol misuse prevention in young people can be effective. However, there is little evidence that interventions with multiple components are more effective than interventions with single components.
青少年酒精滥用问题引发了卫生服务部门、政策制定者、预防工作者、刑事司法系统、青年工作者、教师及家长的关注。
系统评价旨在预防18岁及以下学龄儿童酒精滥用的多成分通用预防项目的有效性证据。对之前发表的Cochrane系统评价的一部分内容进行更新。
相关证据（截至2002年）选自之前的Cochrane评价。检索了MEDLINE、Cochrane对照试验中央注册库、EMBASE、CORK项目及PsycINFO，以获取截至2010年7月的后续研究。
纳入评估多成分通用预防项目（在多个场所实施干预）并报告18岁及以下学生饮酒情况结局的随机试验。两名评价员筛选了所识别记录的标题/摘要及全文。
两名评价员使用预先定义的提取表独立提取相关数据。评估偏倚风险。
纳入了20项平行组试验。试验的报告质量较差，分别仅有25%和5%的试验报告了充分的随机化方法和项目分配隐藏措施。约一半的试验对不完整数据进行了适当处理，约20%的试验该信息不明确。由于干预措施、研究人群及结局存在广泛异质性，结果仅进行了定性总结。20项试验中有12项显示出与对照组或其他干预组相比有一定有效性证据，效果持续时间从3个月至3年不等。其余8项试验中，1项试验使用单尾检验报告了显著效果，7项试验报告多成分干预对减少酒精滥用无显著效果。在7项有多组的试验中评估了多成分干预与单成分干预的额外益处。7项试验中只有1项明确显示在多个场所实施干预措施有好处。
有证据表明多成分干预措施预防青少年酒精滥用可能有效。然而，几乎没有证据表明多成分干预措施比单成分干预措施更有效。
