title: Universal multi-component prevention programs for alcohol misuse in young people.
abstract: BACKGROUND
  Alcohol misuse in young people is a cause of concern for health services, policy makers, prevention workers, and criminal justice system, youth workers, teachers, and parents.
  
  
  OBJECTIVE
  To systematically review evidence on the effectiveness of universal multi-component prevention programs in preventing alcohol misuse in school-aged children up to 18 years of age. To update a part of a previously published Cochrane systematic review.
  
  
  METHODS
  Relevant evidence (up to 2002) was selected from the previous Cochrane review. Later studies, to July 2010, were identified from MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, Project CORK, and PsycINFO.
  
  
  METHODS
  Randomized trials evaluating universal multi-component prevention programs (intervention delivered in more than one setting) and reporting outcomes for alcohol use in students 18 years of age or younger were included. Two reviewers screened titles/abstracts and full text of identified records.
  
  
  METHODS
  Two reviewers extracted relevant data independently using an a priori defined extraction form. Risk of bias was assessed.
  
  
  RESULTS
  20 parallel-group trials were included. The reporting quality of trials was poor, only 25% and 5% of them reporting adequate method of randomisation and program allocation concealment, respectively. Incomplete data was adequately addressed in about half of the trials and this information was unclear for about 20% of the trials. Due to extensive heterogeneity across interventions, populations, and outcomes, the results were summarized only qualitatively.12 of the 20 trials showed some evidence of effectiveness compared to a control or other intervention group, with persistence of effects ranging from 3 months to 3 years. Of the remaining 8 trials, one trial reported significant effects using one-tailed tests and 7 trials reported no significant effects of the multi-component interventions for reducing alcohol misuse.Assessment of the additional benefit of multiple versus single component interventions was possible in 7 trials with multiple arms. Only one of the 7 trials clearly showed a benefit of components delivered in more than one setting.
  
  
  CONCLUSIONS
  There is some evidence that multi-component interventions for alcohol misuse prevention in young people can be effective. However, there is little evidence that interventions with multiple components are more effective than interventions with single components.
authors: School of Health and Social Care, Oxford Brookes University, Marston Road, Jack Straws Lane, Marston, Oxford, England, UK, OX3 0FL.
authors: David R
authors: DR
authors: Foxcroft
authors: Alexander
authors: A
authors: Tsertsvadze
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking / Q000517:prevention & control*; D019973:Alcohol-Related Disorders / Q000517:prevention & control*; D002648:Child; D006801:Humans; D011322:Primary Prevention / Q000379:methods*; D015397:Program Evaluation; D016032:Randomized Controlled Trials as Topic