Implementing school-based substance abuse interventions: methodological dilemmas and recommended solutions.
OBJECTIVE
To review current knowledge about the most effective school-based interventions for child and adolescent problems, and to present dilemmas and potential solutions in mounting and evaluating school-based interventions for adolescent alcohol and other drug (AOD) use problems.


METHODS
Two literature reviews were conducted: (1) a broad and encompassing review of English-language articles published from 1990 to the present concerning school-based interventions for child and adolescent problems and (2) an exhaustive review of articles concerning Student Assistance Programs, which are the most popular approach to school-based AOD intervention in the United States.


RESULTS
Ten key components of effective school-based interventions were identified. In addition, six pervasive dilemmas in school-based AOD intervention research were discussed. Examples of potential solutions to these dilemmas were gleaned from an ongoing randomized clinical trial of a Student Assistance Program.


CONCLUSIONS
School-based AOD interventions have several potential advantages over more traditional clinic-based AOD interventions. Nonetheless, there are many challenges and dilemmas to conducting and evaluating interventions in school settings. With patience and guidance, these challenges can be addressed successfully.
Community-based Intervention Research Group, Florida International University, FL 33199, USA. Eric.Wagner@fiu.edu
Eric F
EF
Wagner
Jonathan G
JG
Tubman
Andrés G
AG
Gil
D000293:Adolescent; D006293:Health Promotion; D006801:Humans; D010353:Patient Education as Topic / Q000379:methods*; D012574:Schools; D019966:Substance-Related Disorders / Q000628:therapy*; D016896:Treatment Outcome