NHMRC Centre of Research Excellence in Mental Health and Substance Use (CREMS), National Drug and Alcohol Research Centre, University of New South Wales,Sydney, NSW,Australia.
Department of Psychiatry,Université de Montréal,Montréal,Quebec,Canada.
Psychol Med. 2017 Jul;47(10):1761-1770. doi: 10.1017/S0033291717000198. Epub 2017 Feb 22.
No existing models of alcohol prevention concurrently adopt universal and selective approaches. This study aims to evaluate the first combined universal and selective approach to alcohol prevention.
A total of 26 Australian schools with 2190 students (mean age: 13.3 years) were randomized to receive: universal prevention (Climate Schools); selective prevention (Preventure); combined prevention (Climate Schools and Preventure; CAP); or health education as usual (control). Primary outcomes were alcohol use, binge drinking and alcohol-related harms at 6, 12 and 24 months.
Climate, Preventure and CAP students demonstrated significantly lower growth in their likelihood to drink and binge drink, relative to controls over 24 months. Preventure students displayed significantly lower growth in their likelihood to experience alcohol harms, relative to controls. While adolescents in both the CAP and Climate groups demonstrated slower growth in drinking compared with adolescents in the control group over the 2-year study period, CAP adolescents demonstrated faster growth in drinking compared with Climate adolescents.
Findings support universal, selective and combined approaches to alcohol prevention. Particularly novel are the findings of no advantage of the combined approach over universal or selective prevention alone.
目前尚无同时采用普遍预防和选择性预防方法的酒精预防模式。本研究旨在评估首个同时采用普遍预防和选择性预防方法的酒精预防模式。
共有 26 所澳大利亚学校的 2190 名学生（平均年龄：13.3 岁）被随机分为以下 4 组：普遍预防组（气候学校项目）、选择性预防组（预防项目）、综合预防组（气候学校项目和预防项目；CAP）和常规健康教育组（对照组）。主要结局指标为 6、12 和 24 个月时的饮酒、狂饮和与酒精相关伤害情况。
与对照组相比，在 24 个月期间，气候学校项目、预防项目和 CAP 学生的饮酒和狂饮可能性增长显著更低。与对照组相比，预防项目学生的酒精伤害体验可能性增长显著更低。尽管在 2 年研究期间，CAP 组和气候组的青少年饮酒量增长速度均比对照组慢，但 CAP 组青少年的饮酒量增长速度快于气候组。
研究结果支持采用普遍预防、选择性预防和综合预防方法来预防酒精滥用。特别新颖的是，综合预防方法并不优于单独采用普遍预防或选择性预防方法。
