Department of Psychiatry, Universite de Montreal, Centre Hospitalier et Universitaire Ste Justine, Montreal, Quebec, Canada.
JAMA Psychiatry. 2013 Mar;70(3):334-42. doi: 10.1001/jamapsychiatry.2013.651.
Selective school-based alcohol prevention programs targeting youth with personality risk factors for addiction and mental health problems have been found to reduce substance use and misuse in those with elevated personality profiles.
To report 24-month outcomes of the Teacher-Delivered Personality-Targeted Interventions for Substance Misuse Trial (Adventure trial) in which school staff were trained to provide interventions to students with 1 of 4 high-risk (HR) profiles: anxiety sensitivity, hopelessness, impulsivity, and sensation seeking and to examine the indirect herd effects of this program on the broader low-risk (LR) population of students who were not selected for intervention.
Cluster randomized controlled trial.
Secondary schools in London, United Kingdom.
A total of 1210 HR and 1433 LR students in the ninth grade (mean [SD] age, 13.7 [0.33] years).
Schools were randomized to provide brief personality-targeted interventions to HR youth or treatment as usual (statutory drug education in class).
Participants were assessed for drinking, binge drinking, and problem drinking before randomization and at 6-monthly intervals for 2 years.
Two-part latent growth models indicated long-term effects of the intervention on drinking rates (β = -0.320, SE = 0.145, P = .03) and binge drinking rates (β = -0.400, SE = 0.179, P = .03) and growth in binge drinking (β = -0.716, SE = 0.274, P = .009) and problem drinking (β = -0.452, SE = 0.193, P = .02) for HR youth. The HR youth were also found to benefit from the interventions during the 24-month follow-up on drinking quantity (β = -0.098, SE = 0.047, P = .04), growth in drinking quantity (β = -0.176, SE = 0.073, P = .02), and growth in binge drinking frequency (β = -0.183, SE = 0.092, P = .047). Some herd effects in LR youth were observed, specifically on drinking rates (β = -0.259, SE = 0.132, P = .049) and growth of binge drinking (β = -0.244, SE = 0.073, P = .001), during the 24-month follow-up.
Findings further support the personality-targeted approach to alcohol prevention and its effectiveness when provided by trained school staff. Particularly novel are the findings of some mild herd effects that result from this selective prevention program.
clinicaltrials.gov Identifier: NCT00776685.
针对具有成瘾和心理健康问题人格风险因素的青少年的选择性学校为基础的酒精预防计划，已被证明可减少具有升高人格特征的人群中的物质使用和滥用。
报告教师实施的针对物质滥用的人格靶向干预试验（冒险试验）的 24 个月结果，其中学校工作人员接受了培训，为具有 4 种高风险（HR）特征之一的学生提供干预措施：焦虑敏感性，绝望感，冲动性和寻求刺激，并检验该计划对未选择干预的更广泛低风险（LR）学生群体的间接群体效应。
集群随机对照试验。
英国伦敦的中学。
共有 1210 名 HR 和 1433 名 LR 九年级学生（平均[SD]年龄，13.7 [0.33]岁）。
学校被随机分配给 HR 青年提供简短的人格靶向干预措施，或进行常规治疗（课堂上的法定药物教育）。
参与者在随机分组之前和 2 年内每 6 个月进行一次饮酒，狂欢饮酒和问题饮酒评估。
两部分潜增长模型表明干预对饮酒率（β= -0.320，SE = 0.145，P =.03）和狂欢饮酒率（β= -0.400，SE = 0.179，P =.03）以及狂欢饮酒（β= -0.716，SE = 0.274，P =.009）和问题饮酒（β= -0.452，SE = 0.193，P =.02）的长期影响。在 HR 青年中，还发现他们在 24 个月的随访期间，干预措施可使饮酒量（β= -0.098，SE = 0.047，P =.04），饮酒量的增长（β= -0.176，SE = 0.073，P =.02）和狂欢饮酒频率的增长（β= -0.183，SE = 0.092，P =.047）受益。在 24 个月的随访中，LR 青少年也观察到了一些群体效应，特别是在饮酒率（β= -0.259，SE = 0.132，P =.049）和狂欢饮酒的增长（β= -0.244，SE = 0.073，P =.001）方面。
这些发现进一步支持了针对酒精预防的人格靶向方法，以及当由受过培训的学校工作人员提供时的有效性。特别新颖的是，从这个选择性预防计划中产生了一些轻度的群体效应的发现。
clinicaltrials.gov 标识符：NCT00776685。
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