The long-term effectiveness of a selective, personality-targeted prevention program in reducing alcohol use and related harms: a cluster randomized controlled trial
It is estimated that at least 240 million adults worldwide suffer from an alcohol use disorder and that early initiation to drinking is associated with an increased risk of developing a disorder. Given that for each year we delay the onset of drinking we reduce the odds of developing alcohol dependence by 9%, effective prevention is critical if we wish to reduce the substantial disability, harm, and social costs caused by alcohol misuse.
Systematic reviews have shown that universal school-based programs, delivered to entire groups regardless of the level of risk, can produce small to moderate effects on behavior change. Selective prevention programs, targeted to individuals at greater risk for developing problems with alcohol, generally yield larger effects; however, such programs have often been overlooked due to practical limitations and the possibility of stigmatisation.
The authors used a cluster randomized control trial design to assess the impact of one targeted approach, Preventure, which has shown promise and compare it with a universal approach over a three year period.
Preventure adopts a personality-targeted approach to prevention by specifically targeting youth with one of four personality traits linked to alcohol misuse: proneness to depression (negative thinking), anxiety sensitivity, impulsivity, and sensation seeking. Preventure is the first selective program proven to be effective among adolescents in Canada and the United Kingdom in preventing and reducing drinking rates and problematic drinking up to 2 years following the interventions.
438 high-risk adolescents from 14 Australian schools were recruited to the study and completed baseline assessments. The students were assessed at five points, including baseline, over a three years period and assessed on frequency of drinking, binge drinking, and alcohol-related harms.
.Relative to high-risk Control students, high-risk Preventure students displayed significantly reduced growth in their likelihood to consume alcohol to binge drink and to experience alcohol-related harms over 36 months.
The authors report that study supports the use of selective personality-targeted preventive interventions in reducing the uptake of alcohol, alcohol misuse, and related harms over the long term. This trial is the first to demonstrate the effects of a selective alcohol prevention program over a 3-year period and the first to demonstrate the effects of a selective preventive intervention in Australia.