The CAP study: Combining effective universal and targeted approaches to drug prevention

Date Commenced:
01/2011
Expected Date of Completion:
12/2015
Project Supporters:

NHMRC Project Grant: APP1004744

Drug Type:
image - 1317259689 P20 Caps Words
Project Members
image - Maree Teesson Square
Professor
Ph EA Christopher Pruze: 02 9385 0167 / c.pruze@unsw.edu.au
image - Nicola Newton Square
Senior Research Fellow
Ph 9385 0159
image - 1314158714 Tim Slade 007
Associate Professor
Ph 9385 0267
image - K. Champion
Research Associate
Ph 02 9385 0333
Miss Natasha Nair
Research Assistant
image - 1314149452 Emma Barrett 010
Aus Postdoc R/Fellow (NH&MRC)
Ph 02 9385 0164
image - Erins Photo Test 2
Casual Academic
Ph 02 8936 1238
Ms Julia Rosenfeld
Psychologist
Dr Natacha Carragher
Senior Lecturer
image - Lexine Stapinski 2015 Square
Senior Lecturer
Ph 02 9385 0422
Project Collaborators: External

A/Professor Patricia Conrod
King’s College University, London, UK & University of Montreal, Canada

Project Main Description

More than one quarter of Australian teenagers put themselves at risk of short-term alcohol-related harm at least once a month and 17% use an illicit drug at least once a year. As such, the need for prevention is clear. Although an array of school-based prevention programs exist, the majority show minimal effects in reducing drug use and related harms, and some have even report iatrogenic effects. Given that school–based drug prevention is the primary means by which drug education is delivered, it is essential to focus on increasing program efficacy. Ideally, preventive interventions should aim to delay onset in both adolescents with low-risk profiles who may be influenced to take up substances due to peer influence and social conformity, and adolescents with high-risk profiles whose underlying vulnerability to psychopathology can lead to substance misuse. Yet, there appear to be no models of well implemented programs that do this. The current proposal addresses this gap by developing and evaluating a comprehensive approach to preventing substance use and related harms in adolescents by combining effective ‘universal’ and ‘targeted’ school-based prevention programs. The proposed model, known as the CAP (Climate and Preventure) intervention, builds on our unique success in this area through developing the effective universal Climate, and targeted Preventure programs.

Aims

To modify the targeted Preventure program for use in Australia and to evaluate the effects of the combining this program with the effective ‘universal’ Climate program (the CAP intervention) in preventing substance use and related harms in Australian adolescents.

Design and Method

Stage 1: Modifying the targeted Preventure program for Australia

The first stage in the research will be to modify the Preventure program for Australia. To do this, we will conduct focus groups with students, and interviews with teachers and health professionals to ensure the content and scenarios of Preventure are relevant to Australia, and to ensure the program is age and context appropriate and fits within the Australian school curriculum.

Stage 2: Evaluation of the ‘CAP intervention’

Following the modification of Preventure which will be combined with Climate to make up the CAP intervention, we seek to demonstrate the effectiveness of the intervention by running a cluster RCT in schools in Australia. Schools will be randomly allocated to one of four groups; (1) the ‘Control’ condition (CO), (2) the ‘Climate only’ condition (CL), (3) the ‘Preventure only’ condition (PR), or (4) the ‘Climate and Preventure’ condition (CAP). All students will be assessed via an online self-report questionnaire at baseline, immediately-post, and 6, 12, 18 and 24 months after the intervention on their levels of drug knowledge, drug use, related harms, intentions to use drugs and mental health.

Progress/Update

The CAP study project manager and research assistant were hired in 2011 and the two research psychologists were hired in early 2012. In 2011 ethics approval was obtained from UNSW along with support from both the Catholic Education Office Sydney and the NSW Department of Education and Communities. This was the first time NDARC has obtained approval to invite NSW public schools to take part in research.  As a result, over 3000 Year 8 students (aged 13-14 yrs) from 27 schools in NSW and Victoria (18 private and 9 public schools) were recruited to take part in the CAP study.

The comprehensive CAP intervention was successfully implemented in participating schools in 2012. The universal internet-based Climate Schools program was delivered to approximately 1200 students by teachers. Feedback from teachers and students confirm the ease of implementation and acceptability of the program, as evidenced by their very positive evaluations.  In addition, our research psychologists delivered a total of 162 90-minute group sessions of the ‘targeted’ Preventure program to over 350 ‘high-risk’ students. These students provided very positive feedback, with 89% reporting they found the skills they learnt were very helpful in their lives. Students completed a post-intervention survey in 2012 and a 12-month follow-up survey was conducted in 2013.

Students at participating schools completed the 24-month follow-up survey in 2014, with 79% of the original baseline sample completing the questionnaire, and the 36-month follow-up survey was conducted in 2015 (72%). Analyses of the data are currently underway.

Output

Since 2011, findings from the CAP Study have been presented more than 60 times, at both national and international conferences. A total of 7 papers have been published in peer-reviewed journals and a further three manuscripts are currently under review.

Peer reviewed publications:

Newton, N., Barrett, E., Castellaneous-Ryan, N., Kelly, E,. Champion., K., Stapinski, L., Conrod, P., Slade, T., Nair, N, Slade, T., & Teesson,. M. (2016). Validity of the Substance Use Risk Profile Scale (SURPS) amongst Australian adolescents. Addictive Behaviors, accepted 27th October.

Carragher, N., Teesson, M., Sunderland, M., Newton, N., Krueger, R., Conrod, P., Barrett, E., Champion, K., Nair, N & Slade, T. (2015). The structure of adolescent self-report psychopathology: A symptom-level analysis. Psychological Medicine, accepted 24th September.

Champion, K.E., Newton, N.C., Stapinski, L., Slade, T., Barrett, E.L & Teesson, M. (2015). A cross-validation trial of an Internet-based prevention program for alcohol and cannabis: results from a cluster randomised controlled trial. Australian & New Zealand Journal of Psychiatry, March 23. pii: 0004867415577435. [Epub ahead of print]

Kelly, E. V., Newton, N. C., Stapinski, L. A., Slade, T., Barrett, E. L., Conrod, P. J., & Teesson, M. (2015). Suicidality, internalizing problems and externalizing problems among adolescent bullies, victims and bully-victims. Preventive Medicine, 73, 100-105. doi: 10.1016/j.ypmed.2015.01.020

Kelly, E. V., Newton, N. C., Stapinski, L. A., Slade, T., Barrett, E. L., Conrod, P. J., & Teesson, M. (2015). Concurrent and prospective associations between bullying victimization and substance use among Australian adolescents. Drug and Alcohol Dependence, available online 19 June 2015 doi:10.1016/j.drugalcdep.2015.06.012

Barrett, E. L., Newton, N. C., Teesson, M., Slade, T., & Conrod, P. (2013). Adapting the personality-targeted Preventure program to prevent substance use and associated harms among high-risk Australian adolescents. Early Intervention in Psychiatry, accepted 26th October 2013. Doi:10.1111/eip.12114

Newton, N. C., Teesson, M., Barrett, E. L., Slade, T. & Conrod, P. (2012). The CAP study, evaluation of integrated universal and selective prevention strategies for youth alcohol misuse: Study protocol of a cluster randomized controlled trial. BMC Psychiatry, 12 (118), 1-10. DOI: 10.1186/1471-244X-12-118

Other publications:

Kelly E, Barrett EL, Newton NC, Rosenfeld J, Champion K, Conrod P, & Teesson M. (2012) Duty of care procedure for Preventure, Australia. NDARC Technical Report No. 323. National Drug and Alcohol Research Centre, University of New South Wales, Sydney.

Teesson, M., Newton, N., Conrod, P., & Slade, T. (2011). The CAP intervention: A comprehensive model for drug prevention. National Drug Strategy - Centerlines, 29, 6.

Conference presentations:

Newton, N.C., Conrod, P., Slade, T., Carragher, N., Stapinski, L., Champion, K., Barrett, E., Kelly, E., Nair, N., Stapinski, L. & Teesson, M. The effectiveness of a selective, personality-targeted prevention program in reducing alcohol use and related harms over three years: a cluster randomized controlled trial. Symposium presentation at the Society for Mental Health Research 2015 Conference, Brisbane, December 2015.

Stapinski, L., Newton, N., Slade, T., Champion, K., Barrett, E., Kelly, E., Barrett, E., Nair, N., Conrod, P. & Teesson, M.  Adolescent Motives for Drinking: Relationship to Mental Health and Prospective Associations with Harmful Alcohol Use. Symposium presentation at the Society for Mental Health Research 2015 Conference, Brisbane, December 2015.

Teesson, M., Newton, N., Barrett, E., Castellanos-Ryan, N., Kelly, E., Champion, K.E., Stapinski, Slade, T., Nair, N & Conrod, P. Validity of the Substance Use Risk Profile Scale (SURPS) amongst Australian adolescents. Symposium presentation at the Society for Mental Health Research 2015 Conference, Brisbane, December 2015.

Champion, K.E., Newton, N.C., Stapinski, L., Slade, T., Barrett, E.L. & Teesson, M. Internet-based prevention for alcohol, cannabis, ecstasy and new psychoactive substances: outcomes from two cluster randomised controlled trials. Third National Cannabis Conference, Melbourne, 9th October 2015 (Invited Presentation).

Birrell, L., Slade, T., Newton, N., Champion, K., Barrett, E., Kelly, E., Nair, N., Conrod, P., Teesson, M. A developmental perspective on comorbidity: anxiety, mood disorders and alcohol use in adolescence. The 15th Congress of the International Federation for Psychiatric Epidemiology, Bergen, Norway, October, 2015 (Oral presentation).

Newton, N.C., Teesson, M., Slade, T., Carragher, N., Stapinski, L., Champion, K., Kelly, E., Nair, N., Barrett. E. L. & Conrod, P.       Three-year outcomes of a selective, personality-targeted prevention program: Reducing alcohol use, alcohol related-harms, internalising and externalising problems among adolescents.            National Drug and Alcohol Research Centre Annual Symposium, UNSW, Sydney, 15th September 2015 (Oral presentation)

L. Birrell, T. Slade, N. Newton, K.E. Champion, E.L. Barrett, E.V. Kelly, N. Nair, P. Conrod & M. Teesson. Trajectories of anxiety, depression and alcohol use in early adolescence: a longitudinal study. National Drug and Alcohol Research Centre Annual Symposium. Sydney, September 2015 (Poster)

Stapinski, L., Newton, N., Slade, T., Champion, K., Barrett, E., Nair, N., Carragher, N., Conrod, P. & Teesson, M.  Pathways to drinking: A developmental examination of internalising and externalising symptoms and motives for drinking in adolescence. National Drug and Alcohol Research Centre Annual Symposium, UNSW, Sydney, 15th September 2015 (Oral presentation).

Nair, N., Newton, N. C. Teesson, M., Slade, T., Barrett, E., Champion, K., & Conrod, P. Internalising/externalizing symptoms and alcohol misuse: 36 month follow-up data from an Australian adolescent population. National Drug and Alcohol Research Centre Annual Symposium, UNSW, Sydney, 15th September 2015 (Poster)

Nair, N., Newton, N. C. Teesson, M., Slade, T., Barrett, E., Champion, K. E. & Conrod, P. Are internalising symptoms a risk or protective factor for alcohol misuse in adolescence? NHMRC Centre of Research Excellence in Mental Health and Substance Use annual colloquium, Canberra, 25th August 2015. (E-poster)

Birrell, L., Slade, T., Newton, N., Champion, K., Barrett, E., Kelly, E., Conrod, P., Teesson, M., Spotlight on the Development of Anxiety, Depression and Alcohol use in adolescence. Postgraduate Research Symposium, The Kirby Institute, UNSW, Sydney, August, 2015 (Oral poster presentation).

Carragher N, Teesson M, Newton N, Champion K, Kelly E, Nair N, Barrett E, Conrod P, Sunderland M, Slade T.  Modelling psychopathology structure: a developmental perspective.  Society for Mental Health Research Annual Conference. Adelaide, 5 Dec 2014

Kelly, E.*, Newton, N. C., Stapinski, L., Slade, T., Barrett, E., Conrod, P. & Teesson, M. .  at the , Adelaide, Australia, 2014. Substance use and related harms among adolescent bullies, victims and bully-victims. Australasian Professional Society on Alcohol and Other Drugs Conference, Adelaide, 12th Nov 2014

Kelly, E.*, Newton, N. C., Stapinski, L., Slade, T., Barrett, E., Conrod, P. & Teesson, M. Longitudinal associations between bullying involvement and substance use. National Drug and Alcohol Research Centre Annual Symposium, Sydney, September 2014

Kelly, E.*, Newton, N. C., Stapinski, L., Slade, T., Barrett, E., Conrod, P. & Teesson, M. Substance use among adolescent bullies, victims and bully-victims.Inaugural Postgraduate Research Symposium, University of NSW, Sydney, 29th August 2014

N.C. Newton, M. Teesson, P. Conrod, T. Slade*, K. Champion, N. Nair, E. Kelly, N. Carragher & E.L. Barrett. An integrated approach to preventing substance use in adolescents: 12-month outcomes of the CAP (Climate and Preventure) intervention, National Drug and Alcohol Research Centre Annual Symposium            Sydney, September 2014

Kelly, E.*, Teesson, M., Newton, N. C., Slade, T., & Conrod, P. Improving social and academic outcomes for adolescent bullies, victims and bully-victims. Australian Psychological Society Educational and Developmental Psychology Conference, Melbourne, March 2014

N.C. Newton, M. Teesson*, P. Conrod, T. Slade, K. Champion, N. Nair, E. Kelly, N. Carragher & E.L. Barrett         An integrated approach to preventing substance use in adolescents: 12-month outcomes of the CAP (Climate and Preventure) intervention. Australasian Professional Society on Alcohol and Other Drugs Conference, Adelaide, 11th Nov 2014

Newton, N.C., M. Teesson, P. Conrod, T. Slade, K. Champion*, N. Nair, E. Kelly*, N. Carragher., E. Barrett. Innovative interventions to prevent substance use and mental health concerns: A comprehensive intervention to prevent substance use and associated harms in Australian adolescents. NHMRC Substance use and mental health’ pre-conference workshop, Australasian Professional Society on Alcohol and Other Drugs Conference, Adelaide, 9th Nov 2014, Invited presentation

Barrett EL*, Newton NC, Teesson M, Slade T, Conrod P, Champion K, Kelly E, Rosenfeld J, Swaffield L. The CAP study: Preventing substance use and related harms among Australian adolescents. NHMRC National Centre of Research Excellence in Mental Health and Substance Use (CREMS) Conference, Melbourne, August 2014

K.E. Champion*, N.C. Newton, L. Stapinksi, T. Slade, E.L. Barrett & M. Teesson. Delivering Internet-based prevention for alcohol and cannabis: results from a cluster randomised controlled trial. Inaugural Postgraduate Research Symposium, University of NSW, Sydney, 29th August 2014

K.E. Champion*, N.C. Newton, L. Stapinksi, T. Slade, E.L. Barrett & M. Teesson. A cross-validation trial of a universal prevention program for alcohol and cannabis: 6-month outcomes. National Drug and Alcohol Research Centre Annual Symposium, Sydney, September 2014

Nair, N*., Newton, N.C., Teesson, M., Slade, T., Barrett, E., Champion, K., & Conrod, P. (2013). Do internalising and externalising symptoms predict early or late alcohol consumption in adolescence. Poster presented at the Australasian Professional Society on Alcohol and other Drugs Conference, Brisbane, Australia, November, 2013.

Teesson, M*., Newton, N.C., Slade, T., & Conrod, P. (2013). An integrated approach to preventing substance use in adolescents: Developing the CAP intervention. Presented at the 43rd Annual Congress for the European Association for Behavioural and Cognitive Therapies (EABCT), Marrakech, Morocco, September 2013.

Kelly, E*., Teesson, M., Newton, N.C. Slade, T., & Conrod, P. (2013). Bullies, victims and bully-victims: Should we care more about the bullies?National Drug and Alcohol Research Centre Annual Symposium, Sydney, Australia, September 2013.

Champion, K.E*., Newton, N.C., Teesson, M., Barrett, E. L. & Slade, T.(2013). A Cross-Validation Trial of the Internet-Based Climate Schools: Alcohol and Cannabis Course. Poster presented at the National Drug and Alcohol Research Centre Annual Symposium, Sydney, Australia, September 2013.

Teesson, M*., Newton, N.C., Slade, T., Conrod, P., Champion, K., Barrett, E., Nair, N., & Kelly, E, (2013). The CAP intervention: A comprehensive model for substance use prevention.  Poster presented at the 36th Annual Research Society on Alcoholism Meeting, Orlando Florida, United States, June 2013.

Kelly, E., Newton, N. C., Barrett, E., Teesson, M., Slade, T & Conrod, P. (2013). Secondary effects of a personality-targeted substance misuse prevention program: Does the Preventure program reduce bullying?Poster presented at the 21st annual meeting for the Society for Prevention Research, San Francisco, United States, May 2013.

Champion, K., Newton, N. C., Teesson, M., Barrett, E. L. & Slade, T.(2013). A cross-validation trial of the internet-based Climate Schools: Alcohol and Cannabis course in Sydney, Australia.Poster presented at the 21st annual meeting for the Society for Prevention Research, San Francisco, United States, May 2013.

K.E. Champion, N.C. Newton, M. Teesson, E.L. Barrett, & T. Slade. (2013). Preliminary results from a cross-validation trial of the internet-based Climate Schools: Alcohol and Cannabis course. Australasian Society for Behavioural Health and Medicine 10th Annual Scientific Conference, Newcastle, Australia, February 2013.

Barrett E.L., Newton N.C, Teesson, M., Conrod, P., Slade, T., Champion, K., Kelly, E., Rosenfeld, J. (2012). Personality risk factors for substance use: Prevalence in Australian adolescents and the personality-targeted ‘Preventure’ intervention.  Presented at the Australasian Professional Society on Alcohol and Other Drugs conference, Melbourne, Australia, Nov 2012.

Newton N.C, Teesson M, Conrod P, Slade T, Barrett EL, Champion K. An integrated approach to preventing substance use in adolescents: Developing the CAP intervention and baseline characteristics of the sample.  Presented at the Australasian Professional Society on Alcohol and Other Drugs conference, Melbourne, Australia, Nov 2012.

Champion K, Newton N.C, Teesson M, Barrett EL, Slade T. Preliminary results from a cross-validation trial of the internet-based Climate Schools: Alcohol and Cannabis course. Presented at the Australasian Professional Society on Alcohol and Other Drugs conference, Melbourne, Australia, Nov 2012.

Kelly E, Barrett EL, Newton N.C, Champion KE, Rosenfeld J, Teesson M, Slade T, Conrod P. Adolescent bullying and personality type: Risk factors for substance use. Poster presented at the Australasian Professional Society on Alcohol and Other Drugs conference, Melbourne, Australia, Nov 2012.

Rosenfeld J, Newton N.C, Teesson M, Conrod P, Slade T, Champion KE, Kelly E, Barrett EL. Preventing adolescent substance use using the targeted ‘Preventure’ intervention: What do Australian students think? Poster presented at the Australasian Professional Society on Alcohol and Other Drugs conference, Melbourne, Australia, Nov 2012.

Champion, K., Newton, N.C., Barrett, E. L., & Teesson, M. (2012). A systematic review of school-based alcohol and other drug prevention programs facilitated by computers or the internet. Poster presented at the First Biennial Australian Implementation conference, Melbourne, Australia, Oct 2012.

Newton, N. C. (2012). Can we really prevent drug and alcohol problems in young people? Invited speaker at Advances in Public Health and Health Services Research at UNSW: 2012 Annual Research Symposium, Sydney, Australia, Sept 21st 2012.

Newton, N. C. (2012). An integrated approach to prevention in schools.Invited speaker at the National Drug and Alcohol Research Centre Annual Symposium, Sydney, Australia, August 28th 2012.

Champion, K., Newton, N.C., Barrett, E. L., & Teesson, M. (2012). A systematic review of school-based alcohol and other drug prevention programs facilitated by computers or the internet. Poster presented at the National Drug and Alcohol Research Centre Annual Symposium, Sydney, Australia, August 28th 2012.

Newton, N. C. (2012). New Research On Personality-Targeted Interventions For Adolescent Alcohol And Substance Misuse: New Populations, Broader Outcomes And Comparisons With Universal Approaches. Session Chair at the 35th Research Society on Alcoholism Conference, San Francisco, United States, June 27th 2012.

Barrett, E., Newton, N. C., Teesson, M., Slade, T., & Conrod, P. (2012). Modifying the personality-targeted ‘Preventure’ program for use with Australian adolescents.Presented at the 35th Research Society on Alcoholism Conference, San Francisco, United States, June 27th 2012.

Newton, N. C., Teesson, M., Conrod, P., Slade, T., & Barrett, E. (2012). Developing the CAP intervention: A comprehensive model to alcohol and other drug prevention.Presented at the 35th Research Society on Alcoholism Conference, San Francisco, United States, June 27th 2012.

Newton, N. C., Teesson, M., Conrod, P., Slade, T., Andrews, G. (2011). The CAP intervention: A comprehensive model to substance use prevention.  Poster presented at EABCT conference, Iceland, September 2011. 

Benefits

It is expected that the schools who receive the combined intervention will have significantly greater reductions in substance use uptake than the schools who receive stand-alone programs or their usual health curriculum.

Project Supporters

NHMRC Project Grant: APP1004744

Project Status
Current
Back to Top