Georgie J MacArthur, Sean Harrison, Deborah M Caldwell, Matthew Hickman, Rona Campbell
School of Social and Community Medicine, University of Bristol, Bristol, UK.
Addiction. 2016 Mar;111(3):391-407. doi: 10.1111/add.13224.
Peer-led interventions may offer a beneficial approach in preventing substance use, but their impact has not yet been quantified. We conducted a systematic review to investigate and quantify the effect of peer-led interventions that sought to prevent tobacco, alcohol and/or drug use among young people aged 11-21 years.
Medline, EMBASE, PsycINFO, CINAHL, ERIC and the Cochrane Library were searched from inception to July 2015 without language restriction. We included randomized controlled trials only. Screening and data extraction were conducted in duplicate and data from eligible studies were pooled in a random effects meta-analysis.
We identified 17 eligible studies, approximately half of which were school-based studies targeting tobacco use among adolescents. Ten studies targeting tobacco use could be pooled, representing 13,706 young people in 220 schools. Meta-analysis demonstrated that the odds of smoking were lower among those receiving the peer-led intervention compared with control [odds ratio (OR) = 0.78, 95% confidence interval (CI) = 0.62-0.99, P = 0.040]. There was evidence of heterogeneity (I(2) = 41%, χ(2) 15.17, P = 0.086). Pooling of six studies representing 1699 individuals in 66 schools demonstrated that peer-led interventions were also associated with benefit in relation to alcohol use (OR = 0.80, 95% CI = 0.65-0.99, P = 0.036), while three studies (n = 976 students in 38 schools) suggested an association with lower odds of cannabis use (OR = 0.70, 0.50-0.97, P = 0.034). No studies were found that targeted other illicit drug use.
Peer interventions may be effective in preventing tobacco, alcohol and possibly cannabis use among adolescents, although the evidence base is limited overall, and is characterized mainly by small studies of low quality.
同伴主导的干预措施可能是预防物质使用的一种有益方法，但其影响尚未得到量化。我们进行了一项系统综述，以调查和量化同伴主导的干预措施对11至21岁年轻人预防烟草、酒精和/或药物使用的效果。
检索了Medline、EMBASE、PsycINFO、CINAHL、ERIC和Cochrane图书馆，检索时间从建库至2015年7月，无语言限制。我们仅纳入随机对照试验。筛选和数据提取由两人独立进行，符合条件的研究数据汇总进行随机效应荟萃分析。
我们确定了17项符合条件的研究，其中约一半是针对青少年烟草使用的学校研究。针对烟草使用的10项研究可以汇总，涉及220所学校的13706名年轻人。荟萃分析表明，与对照组相比，接受同伴主导干预的人群吸烟几率较低[比值比（OR）=0.78，95%置信区间（CI）=0.62 - 0.99，P = 0.040]。有证据表明存在异质性（I(2)=41%，χ(2)=15.17，P = 0.086）。对66所学校1699名个体的6项研究进行汇总表明，同伴主导的干预措施在酒精使用方面也有好处（OR = 0.80，95% CI = 0.65 - 0.99，P = 0.036），而3项研究（38所学校976名学生）表明与大麻使用几率较低有关（OR = 0.70，0.50 - 0.97，P = 0.034）。未发现针对其他非法药物使用的研究。
同伴干预可能对预防青少年烟草、酒精和可能的大麻使用有效，尽管总体证据基础有限，且主要以低质量的小型研究为特征。
