Long-term Effects of Universal Preventive Interventions on Methamphetamine Use Among Adolescents

Partnerships in Prevention Science Institute, Iowa State University, Ames, USA.
Archives of Pediatrics and Adolescent Medicine (Impact Factor: 5.73). 10/2006; 160(9):876-82. DOI: 10.1001/archpedi.160.9.876
Source: PubMed


To examine the long-term effects of universal preventive interventions on methamphetamine use by adolescents in the general population during their late high school years.
Two randomized, controlled prevention trials.
Public schools in the Midwest from 1993 to 2004.
Study 1 began with 667 sixth grade students from 33 rural public schools; the follow-up included 457 students. Study 2 began with 679 seventh grade students from 36 rural public schools; the follow-up assessment included 597 students.
In study 1, schools were assigned to the Iowa Strengthening Families Program (ISFP), Preparing for the Drug Free Years, or a control condition. In study 2, schools were assigned to a revised ISFP (SFP 10-14) plus Life Skills Training (SPF 10-14 + LST), LST alone, or a control condition.
Self-reports of lifetime and past-year methamphetamine use were collected at 6(1/2) years past baseline (study 1) and at 4(1/2) and 5(1/2) years past baseline (study 2). In study 1, the ISFP past-year rate was 0.0% compared with 3.2% in the control condition (P = .04). In study 2, SFP 10-14 + LST showed significant effects on lifetime and past-year use at the 4(1/2) year follow-up (eg, 0.5% lifetime use in the intervention condition vs 5.2% in the control condition, P = .006); both SFP 10-14 + LST and LST alone had significant lifetime use effects at the 5(1/2) year follow-up.
Brief universal interventions have potential for public health impact by reducing methamphetamine use among adolescents.

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    • "The revised SFP 10–14 is a seven week universal programme targeting young people aged 10 to 14 years and their parents [27]. SFP 10–14 has been reported to be effective over a six-year follow-up period in promoting family integration, delaying the onset of alcohol use, reducing uptake of smoking, the incidence of harder drug use (methamphetamine) [28-31] and substance use at 10 year follow-up (aged 21) [32]. Delaying the age of initiation of substance use is an important goal, since epidemiological research has indicated that later onset of alcohol and drug use is associated with reduced lifetime prevalence of alcohol and drug problems [33-35]. "
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    ABSTRACT: Prevention of alcohol, drug and tobacco misuse by young people is a key public health priority. There is a need to develop the evidence base through rigorous evaluations of innovative approaches to substance misuse prevention. The Strengthening Families Programme 10-14 is a universal family-based alcohol, drugs and tobacco prevention programme, which has achieved promising results in US trials, and which now requires cross-cultural assessment. This paper therefore describes the protocol for a randomised controlled trial of the UK version of the Strengthening Families Programme 10-14 (SFP 10-14 UK).Methods/design: The trial comprises a pragmatic cluster randomised controlled effectiveness trial with families as the unit of randomisation, with embedded process and economic evaluations. Participating families will be randomised to one of two treatment groups - usual care with full access to existing services (control group), or usual care plus SFP 10-14 UK (intervention group). The trial has two primary outcomes - the number of occasions that young people report having drunk alcohol in the last 30 days, and drunkenness during the last 30 days, both dichotomised as 'never' and '1-2 times or more'. The main follow-up is at 2 years past baseline, and short-term and intermediate outcomes are also measured at 9 and 15 months. The results from this trial will provide evidence on the effectiveness and cost-effectiveness of an innovative universal family-based substance misuse prevention programme in a UK context.Trial registration: Current Controlled Trials ISRCTN63550893.
    Full-text · Article · Jan 2014 · BMC Public Health
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    • "PYMU rates were used to calculate the intervention effectiveness by subtracting the intervention condition rates from the control condition rate to estimate the number of instances of PYMU prevented per youth. As reported in a previous publication (Spoth et al., 2006), ISFP, LST only, and LST + SFP10–14 PYMU rates were 0% (90% CI [0%, 1.65%]), 1.44% (90% CI [0.43%, 3.81%]), and 2.12% (90% CI [0.75%, 5.06%]), respectively. By comparison, the average control condition PYMU rate was 3.90%. "
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    ABSTRACT: The goal of this research was to evaluate economically three interventions designed to prevent substance use in general populations of adolescents, specifically focusing on the prevention of methamphetamine use and its subsequent benefits to employers. In a randomized, controlled trial, three preventive interventions were delivered to 6th- or 7th-grade youth in 58 Iowa school districts, with 905 of these youth (449 girls) providing follow-up assessments as 12th graders. Intervention conditions included the family-focused Iowa Strengthening Families Program (ISFP), the school-based Life Skills Training (LST) program, and a combined condition of both the Strengthening Families Program: For Parents and Youth 10-14 (SFP10- 14; an ISFP revision) plus LST (LST + SFP10-14). Analyses based on intervention costs, 12th-grade methamphetamine use rates, and methamphetamine- related employer costs yielded estimates of intervention cost, cost-effectiveness, benefit-cost ratio, and net benefit. The ISFP lowered methamphetamine use by 3.9%, cost $25,385 to prevent each case, and had a benefit-cost ratio of 3.84, yielding a net benefit of $2,813 per youth. The LST program reduced methamphetamine use by 2.5%, required $5,122 per prevented case, and had a benefit-cost ratio of 19.04, netting $2,273 per youth. The combined LST + SFP10-14 prevention condition lowered methamphetamine use rates by 1.8%, cost $62,697 to prevent each case, had a benefit-cost ratio of 1.56, and netted $620 per youth. Findings were robust after varying a number of key parameters across a range of plausible values. Substance use prevention programming is economically feasible, particularly for effective interventions that have lower per person treatment delivery costs.
    Full-text · Article · Jul 2011 · Journal of studies on alcohol and drugs
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    • "l . , 1999 ; Lederman , Chan , & Roberts - Gray , 2008 ; Riesch et al . , 1993 ) , it is considered difficult and not likely unless all family members are recipients of the intervention . In other studies that report positive results from the SFP 10 – 14 , the program was delivered in schools , not community settings ( Gottfredson et al . , 2006 ; Spoth , Shin , et al . , 2006 ) ."
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    ABSTRACT: This study examined whether parent-youth dyads participating in the Strengthening Families Program 10-14 (SFP 10-14) would demonstrate greater postprogram family cohesion, communication, involvement, and supervision and if youth would report less alcohol, tobacco, and other drugs involvement in contrast to a comparison group. From 16 randomly selected schools, we recruited 167 parent-youth dyads: 86 from intervention and 81 from comparison schools. The intention-to-treat analysis found one significant change in family environment. Considering dose, it was found that among dyads receiving a full dose, all the outcomes were in the expected direction and effect sizes were moderate. Among dyads receiving a partial dose, 10 of 18 outcomes were in the direction opposite that expected. Youth participation in alcohol, tobacco, and other drugs was very low and did not differ postprogram. Although the expected outcomes were not realized, findings descriptive of dosage effects make a valuable contribution to the field. Study of factors that distinguish intervention completers from noncompleters is recommended.
    Full-text · Article · Mar 2011 · Western Journal of Nursing Research
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