Faculty of Health and Life Sciences, Oxford Brooks University, Oxford, UK.
Perspect Public Health. 2012 May;132(3):128-34. doi: 10.1177/1757913912443487.
Alcohol misuse by young people causes significant health and social harm, including death and disability. Therefore, prevention of youth alcohol misuse is a policy aim in many countries. Our aim was to examine the effectiveness of (1) school-based, (2) family-based and (3) multi-component universal alcohol misuse prevention programmes in children and adolescents.
Three Cochrane systematic reviews were performed: searches in MEDLINE, EMBASE, PsycINFO, Project CORK and the Cochrane Register of Controlled Trials up to July 2010, including randomised trials evaluating universal alcohol misuse prevention programmes in school, family or multiple settings in youths aged 18 years or younger. Two independent reviewers identified eligible studies and any discrepancies were resolved via discussion.
A total of 85 trials were included in the reviews of school (n = 53), family (n = 12) and multi-component (n = 20) programmes. Meta-analysis was not performed due to study heterogeneity. Most studies were conducted in North America. Risk of bias assessment revealed problems related to inappropriate unit of analysis, moderate to high attrition, selective outcome reporting and potential confounding. Certain generic psychosocial and life skills school-based programmes were effective in reducing alcohol use in youth. Most family-based programmes were effective. There was insufficient evidence to conclude that multiple interventions provided additional benefit over single interventions.
In these Cochrane reviews, some school, family or multi-component prevention programmes were shown to be effective in reducing alcohol misuse in youths. However, these results warrant a cautious interpretation, since bias and/or contextual factors may have affected the trial results. Further research should replicate the most promising studies identified in these reviews and pay particular attention to content and context factors through rigorous evaluation.
年轻人酗酒会导致严重的健康和社会危害，包括死亡和残疾。因此，预防青少年酗酒是许多国家的政策目标。我们的目的是检验（1）基于学校、（2）基于家庭和（3）多组分通用的青少年酗酒预防计划在儿童和青少年中的有效性。
进行了三项 Cochrane 系统评价：截至 2010 年 7 月，在 MEDLINE、EMBASE、PsycINFO、Project CORK 和 Cochrane 对照试验登记处进行了检索，包括评估在学校、家庭或多个环境中对 18 岁以下年轻人进行通用酗酒预防计划的随机试验。两名独立审查员确定了合格的研究，任何差异均通过讨论解决。
共有 85 项试验被纳入学校（n = 53）、家庭（n = 12）和多组分（n = 20）计划的综述。由于研究异质性，未进行荟萃分析。大多数研究在北美进行。偏倚风险评估显示出与不适当的分析单位、中度至高度失访、选择性结果报告和潜在混杂有关的问题。某些通用的心理社会和生活技能学校计划在减少青少年饮酒方面是有效的。大多数基于家庭的计划是有效的。没有足够的证据可以得出结论，多种干预措施比单一干预措施提供额外的益处。
在这些 Cochrane 综述中，一些基于学校、家庭或多组分的预防计划被证明可以有效减少青少年的酗酒行为。然而，由于偏倚和/或背景因素可能影响了试验结果，这些结果需要谨慎解释。进一步的研究应该复制这些综述中确定的最有希望的研究，并通过严格的评估特别注意内容和背景因素。
