Substance-use outcomes at 18 months past baseline - The PROSPER community-university partnership trial
Substance-use outcomes at 18 months past baseline - The PROSPER community-university partnership trial
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DOI：
10.1016/j.amepre.2007.01.014
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发表时间：
2007-05-01
影响因子：
5.5
通讯作者：
Feinberg, Mark
中科院分区：
文献类型：
--
作者：
Spoth, Richard;Redmond, Cleve;Feinberg, Mark
背景：这项研究的目的是检验从菜单中选择的“真实世界”、以社区为基础的普遍预防干预措施的效果，包括对高风险和低风险亚样本的特定影响。设计：根据大小和位置选择学区，然后按队列顺序设计随机分配到对照条件或实验条件。地点/参与者：研究包括爱荷华州和宾夕法尼亚州的28个公立学区，这些学区位于农村城镇和小城市，规模从6975到44,510。干预：动员了社区小组；每个小组分别为6年级和7年级学生实施了三项循证、以家庭为重点的干预措施(5至12次)和三次循证学校干预措施(11至15次)之一。主要结果测量：结果包括学生报告过去一个月、过去一年和酒精、香烟、大麻、甲基苯丙胺、摇头丸和吸入剂的终生使用情况，以及在18个月前和18个月后的跟踪评估中的入门指数和非法物质起始指数。结果：意向治疗分析显示对物质起始有显著影响(大麻、吸入剂、甲基苯丙胺、摇头丸、入门指数、非法使用指数)，以及过去一年的大麻和吸入剂的使用，所有被测量的物质的积极趋势。在三种结果中，高危学生的干预效果强于低危学生。结论：以社区为基础实施针对普通人群的简明通用干预措施，可能通过减少青少年的药物使用而对公共卫生产生影响。
Background: The study's objective was to examine the effects of "real-world," community-based implementation of universal preventive interventions selected from a menu, including effects specific to higher- and lower-risk subsamples.Design: School districts were selected based on size and location, and then randomly assigned to a control condition or to an experimental condition in a cohort sequential design.Setting/Participants: The study included 28 public school districts in Iowa and Pennsylvania that were located in rural towns and small cities, ranging in size from 6975 to 44,510. Sixth and seventh graders in these school districts participated in the study.Intervention: Community teams were mobilized; each team implemented one of three evidence-based, family-focused interventions (5 to 12 sessions) and one of three evidence-based school interventions (11 to 15 sessions), for 6th and 7th graders, respectively. Observations showed that interventions were implemented with fidelity.Main Outcomes Measures: Outcomes included student reports of past month, past year, and lifetime use of alcohol, cigarettes, marijuana, methamphetamines, ecstasy, and inhalants, as well as indices of gateway and illicit substance initiation, at pretest and at a follow-up assessment 18 months later.Results: Intent-to-treat analyses demonstrated significant effects on substance initiation (marijuana, inhalants, methamphetamines, ecstasy, gateway index, illicit-use index), as well as past-year use of marijuana and inhalants, with positive trends for all substances measured. For three outcomes, intervention effects were stronger for higher-risk students than lower-risk students.Conclusions: Community-based implementation of brief universal interventions designed for general populations has potential for public health impact by reducing substance use among adolescents.