Pathways to prevention: The effectiveness of universal and selective prevention in altering the developmental pathways to alcohol related harms in young adults

image - Cap
Date Commenced:
01/2017
Expected Date of Completion:
12/2019
Drug Type:
Project Members: 
image - Maree Teesson Square
Professor
Ph EA Jasmin Bartlett: 02 9385 0167 / j.bartlett@unsw.edu.au
image - Lexine Stapinski 2015 Square
Senior Lecturer
Ph 02 9385 0422
image - 1314158714 Tim Slade 007
Associate Professor
Ph 9385 0267
image - 1314149452 Emma Barrett 010
Senior Research Fellow
Ph 02 9385 0164
image - 1314679218 Catherine Chapman 05 0
Senior Research Fellow
Ph 02 9385 0317
image - K. Champion
NHMRC Early Career Research Fellow
Ph 02 9385 0333
image - Anna Smout
Research Assistant
Ph 0423 746 835
image - Marius Mather
Research Assistant
Ph 02 9385 0269
Project Main Description: 

The Climate and Preventure (CAP) study was initiated in 2011 by Nicola Newton, Maree Teesson, Tim Slade and Patricia Conrod as a school-based prevention initiative targeting alcohol and drug use. The CAP study was the first ever randomised control trial of a comprehensive prevention approach combining both universal (Climate; delivered to all students) and selective (Preventure; delivered to high-risk students) intervention techniques. Twenty-six schools and 2,190 year 8 participants were recruited to the CAP trial in 2012, and randomised to one of four conditions: (1) Control (health education as usual), (2) Climate (universal prevention for all), (3) Preventure (selective prevention delivered only to 43% of students with high-risk personality profiles), or (4) Climate and Preventure (both universal and selective approaches). All students were followed up for 3 years post baseline. Results at 3 years have shown the effectiveness of universal and selective approaches in preventing harmful alcohol use among low- and high-risk adolescents. The CAP long-term follow up is an opportunistic extension of the landmark CAP study, whereby follow up of this cohort will extend beyond the completion of secondary school and into the critical transition period of early adulthood.

The investigators will extend longitudinal follow-up for a further 3 years, inviting the participants to take part in an online survey assessing demographic information, drinking and drug use habits, and behavioural and personality inventories. This $465,967 NHMRC funded long-term follow up project will be the first in the world to examine whether combining universal and selective drug prevention strategies enhances durability of effects in the longer-term, over a 7-year period from adolescence to early adulthood. The findings will inform policy nationally and internationally, as economic modelling suggests substantial societal benefit can be gained from even modest reductions in drug and alcohol use.

Project Collaborators: External: 

Professor Patricia Conrol

Assistant Professor Natalie Castellanous-Ryan

Rationale: 

The Climate and Preventure (CAP) study was initiated in 2011 by A/Prof Nicola Newton, Prof Maree Teesson, A/Prof Tim Slade and Prof Patricia Conrod as a school-based prevention initiative targeting alcohol and drug use [1]. The CAP study was the first ever randomised control trial of a comprehensive prevention approach combining both universal (Climate; delivered to all students) and selective (Preventure; delivered to high-risk students) intervention techniques. Twenty-six schools and 2,190 year 8 participants were recruited to the CAP trial in 2012, and randomised to one of four conditions: (1) Control (health education as usual), (2) Climate (universal prevention for all), (3) Preventure (selective prevention delivered only to 43% of students with high-risk personality profiles), or (4) Climate and Preventure (both universal and selective approaches). All students were followed up for 3 years post baseline. Results at 3 years have shown the effectiveness of universal and selective approaches in preventing harmful alcohol use among low- and high-risk adolescent years [2, 3]. In 2017, the initial investigator team along with CIs Lexine Stapinski, Emma Barrett, Katrina Champion and Cath Chapman were awarded a $465, 967 NHMRC project grant to conduct a long-term follow up of the CAP study cohort. The study is an opportunistic extension of the landmark CAP study, whereby follow up of this cohort will extend beyond the completion of secondary school and into the critical transition period of early adulthood.

Aims: 

This project will be the first in the world to examine whether combining universal and selective drug prevention strategies enhances durability of effects in the longer-term, over a 7-year period from adolescence to early adulthood. The specific aims of the study are 1) to assess the long-term effectiveness of universal, selective and combined alcohol and drug prevention into early adulthood, 2) to assess whether selective and universal alcohol and drug prevention are effective in reducing aggressive behaviour and violent offending into early adulthood, and 3) to discern the mechanisms of change underlying the intervention effects.

Design and Method: 

The investigators will extend longitudinal follow-up for a further 3 years, inviting the participants to take part in an online survey assessing demographic information, drinking and drug use habits, and behavioural and personality inventories. Participants will complete surveys online via the CAP study website (www.capstudy.org.au), and their responses will be linked over time using their unique identification code.

 

 

Progress/Update: 

The researchers are currently finalising the follow-up survey and website for administration over the next 3 years.

Findings: 

Early adulthood is an important transitional period with unique challenges and increased susceptibility to alcohol and cannabis use and related harms. This study aims to answer critical questions about the potential benefits of these approaches in reducing alcohol and drug-related violence during the high-risk transition period of emerging adulthood. Further, it will provide crucial information about the underlying mechanisms of change and inform future refinements to achieve even more powerful prevention effects.

Benefits: 

As it stands, very little is currently known about the effectiveness of school-based prevention programs beyond age 17. This world-first study addresses this crucial knowledge gap, and we hope the findings will indicate which prevention approaches are most sustainable long-term. This knowledge is vital to inform policy nationally and internationally, as economic modelling suggests substantial societal benefit can be gained from even modest reductions in drug and alcohol use [4].

 

 

1.         Newton, N.C., et al., 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, 2012. 12(1): p. 118.

2.         Teesson, M., et al., Effectiveness of universal, selective personality-targeted and combined prevention for adolescent alcohol use and misuse: A cluster randomized controlled trial. Psychological Medicine, In Press. Accepted 19th January 2017.

3.         Newton, N.C., et al., The long-term effectiveness of a selective, personality-targeted prevention program in reducing alcohol use and related harms: A cluster randomised controlled trial. Journal of Clinical Psychology and Psychiatry, 2016. 57: p. 1056-1065.

4.         Nherera, L. and P. Jacklin, A model to assess the cost-effectiveness of alcohol education developed for NICE public health guidance on personal, social, health and economic (PSHE) education. 2009, National Collaborating Centre for Women's and Children's Health: London.

 

Drug Type: 
Project Status: 
Current