Prevention Science

, Volume 16, Issue 3, pp 463–474 | Cite as

Effectiveness of Brief School-Based Interventions for Adolescents: A Meta-analysis of Alcohol Use Prevention Programs

  • Emily A. HennessyEmail author
  • Emily E. Tanner-Smith


To conduct a meta-analysis summarizing the effectiveness of school-based brief alcohol interventions (BAIs) among adolescents and to examine possible iatrogenic effects due to deviancy training in group-delivered interventions, a systematic search for eligible studies was undertaken, current through December 31, 2012. Studies were eligible for inclusion if they used an experimental/quasi-experimental design; focused on school-based BAIs; enrolled adolescent participants; and reported an alcohol-related outcome measure. Studies were coded for key variables, and outcome effect sizes were analyzed as standardized mean differences adjusted for small samples (Hedges’ g). Analyses were conducted using inverse-variance weighted mixed-effects meta-regression models. Sensitivity analyses were also conducted. Across all 17 studies eligible for inclusion, school-based BAIs were associated with significant improvements among adolescents, whereby adolescents in the BAI groups reduced their alcohol consumption relative to the control groups ( = 0.34, 95 % CI [0.11, 0.56]). Subgroup analyses indicated that whereas individually-delivered BAIs were effective ( = 0.58, 95 % CI [0.23, 0.92]), there was no evidence that group-delivered BAIs were associated with reductions in alcohol use ( = −0.02, 95 % CI [−0.17, 0.14]). Delivery format was confounded with program modality, however, such that motivational enhancement therapy was the most effective modality, but was rarely implemented in group-delivered interventions. Some school-based BAIs are effective in reducing adolescent alcohol consumption, but may be ineffective if delivered in group settings. Future research should explore whether group-delivered BAIs that use motivational enhancement therapy components may yield beneficial outcomes like those observed in individually-delivered programs.


Adolescents Brief alcohol interventions Meta-analysis School-based prevention 



This work was supported by Award Number R01AA020286 from the National Institute on Alcohol Abuse and Alcoholism. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Alcohol Abuse and Alcoholism or the National Institutes of Health.

Conflict of Interest

The authors declare that they have no conflict of interest.

Supplementary material

11121_2014_512_MOESM1_ESM.docx (42 kb)
ESM 1 (DOCX 42 kb)


References marked with an asterisk indicate studies included in the meta-analysis.

  1. Ang, R. P., & Hughes, J. N. (2001). Differential benefits of skills training with antisocial youth based on group composition: A meta-analytic investigation. School Psychology Review, 31, 164–185.Google Scholar
  2. Bailey, K. A., Baker, A. L., Webster, R. A., & Lewin, T. J. (2004). Pilot randomized controlled trial of a brief alcohol intervention group for adolescents. Drug and Alcohol Review, 23, 157–166. doi: 10.1080/09595230410001704136.CrossRefPubMedGoogle Scholar
  3. Barnett, E., Sussman, S., Smith, C., Rohrbach, L. A., & Spruijt-Metz, D. (2012). Motivational interviewing for adolescent substance use: A review of the literature. Addictive Behaviors, 37, 1325–1334. doi: 10.1016/jaddbeh.2012.07.001.PubMedCentralCrossRefPubMedGoogle Scholar
  4. Bien, T. H., Miller, W. R., & Tonigan, S. J. (1993). Brief interventions for alcohol problems: A review. Addiction, 88, 315–336.CrossRefPubMedGoogle Scholar
  5. Carney, T., & Myers, B. (2012). Effectiveness of early interventions for substance-using adolescents: Findings from a systematic review and meta-analysis. Substance Abuse Treatment, Prevention, and Policy, 7, 1–28. doi: 10.1186/1747-597X-7-25.CrossRefGoogle Scholar
  6. Center for Substance Abuse Research. (2013). Nearly two-thirds of U.S. adults are current drinkers; Majority are infrequent or light drinkers (CESAR Fax, Vol. 22, Issue 21). University of Maryland, College Park: Author.Google Scholar
  7. *Collins, D. L. (1990). A study of a brief alcohol education program (Unpublished master’s thesis). Francis Marion College, Florence, South Carolina.Google Scholar
  8. *Comeau, M. N. (2003). Framing solutions: Adolescent girls and their relationships with alcohol. Dissertation Abstracts International: Section B. Sciences and Engineering, 64, 4601.Google Scholar
  9. *Cruz, I. Y. (2006). Reducing alcohol consumption among high school students by challenging alcohol expectancies. Dissertation Abstracts International: Section B. Sciences and Engineering, 67.Google Scholar
  10. Currie, C., Zanotti, C., Morgan, A., Currie, D., de Looze, M., Roberts, C., & Barnekow, V. (2012). Social determinants of health and well-being among young people. Health behaviour in school-aged children (HBSC) study: International report from the 2009–2010 survey (Health Policy for Children and Adolescents, No. 6). Copenhagen: WHO Regional Office for Europe.Google Scholar
  11. *Dempster, M., Newell, G., Cowan, G., & Marley, J. (2006). Facing up to binge drinking: Reducing binge drinking in adolescent males. British Dental Journal, 201, 587–590; discussion 578. doi:  10.1038/sj.bdj.4814204.
  12. Dishion, T. J., & Dodge, K. A. (2005). Peer contagion in interventions for children and adolescents: Moving towards an understanding of the ecology and dynamics of change. Journal of Abnormal Child Psychology, 33, 395–400.PubMedCentralCrossRefPubMedGoogle Scholar
  13. Dishion, T. J., McCord, J., & Poulin, F. (1999). When interventions harm. Peer groups and problem behavior. American Psychologist, 54, 755–764.CrossRefPubMedGoogle Scholar
  14. Dishion, T. J., Burraston, B., & Poulin, F. (2001). Peer group dynamics associated with iatrogenic effects in group interventions among high-risk adolescents. In C. Erdley & D. W. Nangle (Eds.), Damon’s new directions in child development: The role of friendship in psychological adjustment (pp. 79–92). San Francisco: Jossey-Bass.Google Scholar
  15. DuPont, R. L., Caldeira, K. M., DuPont, H. S., Vincent, K. B., Shea, C. L., & Arria, A. M. (2013). America’s dropout crisis: The unrecognized connection to adolescent substance use. Rockville, MD: Institute for Behavior and Health, Inc. Retrieved from
  16. Foxcroft, D. R., & Tsertsvadze, A. (2011). Universal school-based prevention programs for alcohol misuse in young people. Cochrane Database of Systematic Reviews, Issue 5. Art. No.: CD009113. doi:  10.1002/14651858.CD009113.
  17. *Gmel, G., Venzin, V., Marmet, K., Danko, G., & Labhart, F. (2012). A quasi randomized group trial of a brief alcohol intervention on risky single occasion drinking among secondary school students. International Journal of Public Health, 57, 935–944. doi:  10.1007/s00038-012-0419-0.
  18. Gottfredson, D. C., & Wilson, D. B. (2003). Characteristics of effective school-based substance abuse prevention. Prevention Science, 4, 27–38.CrossRefPubMedGoogle Scholar
  19. Handwerk, M. L., Field, C. E., & Friman, P. C. (2001). The iatrogenic effects of group intervention for antisocial youth: Premature extrapolations? Journal of Behavioral Education, 10, 223–238.CrossRefGoogle Scholar
  20. Hanson, K. L., Medina, K. L., Padula, C. B., Tapert, S. F., & Brown, S. A. (2011). Impact of adolescent alcohol and drug use on neuropsychological functioning in young adulthood: 10-year outcomes. Journal of Child & Adolescent Substance Abuse, 20, 135–154. doi: 10.1080/1067828X.2011.55527.CrossRefGoogle Scholar
  21. Hedges, L. V. (1981). Distribution theory for glass’s estimator of effect size and related estimators. Journal of Educational Statistics, 6, 107–128.CrossRefGoogle Scholar
  22. Higgins, J. P. T., & Green, S. (Eds.). (2011). Cochrane handbook for systematic reviews of interventions (Version 5.1.0, updated March 2011). Chichester: Wiley.Google Scholar
  23. Higgins, J. P. T., Deeks, J. J., & Altman, D. G. (Eds.). (2008). Chapter 16: Special topics in statistics. In J. P. T. Higgins & S. Green (Eds.), Cochrane handbook for systematic reviews of interventions (pp. 481–529). Chichester, UK: John Wiley & Sons.Google Scholar
  24. Hipwell, A., Stepp, S., Chung, T., Durand, V., & Keenan, K. (2012). Growth in alcohol use as a developmental predictor of adolescent girls’ sexual risk taking. Prevention Science, 13, 118–128. doi: 10.1007/s11121-011-0260-3.PubMedCentralCrossRefPubMedGoogle Scholar
  25. Jensen, C. D., Cushing, C. C., Aylward, B. S., Craig, J. T., Sorell, D. M., & Steele, R. G. (2011). Effectiveness of motivational interviewing interventions for adolescent substance use behavior change: A meta-analytic review. Journal of Consulting and Clinical Psychology, 79, 433–440. doi: 10.1037/a0023992.CrossRefPubMedGoogle Scholar
  26. Kandel, D., Davies, M., Karus, D., & Yamaguchi, K. (1986). The consequences in young adulthood of adolescent drug involvement. Archives of General Psychiatry, 43, 746–754. doi: 10.1001/archpsyc.1986.0180008003200.CrossRefPubMedGoogle Scholar
  27. Lipsey, M. W., & Wilson, D. (2001). Practical meta-analysis (Applied Social Research Methods, Volume 49). Thousand Oaks: SAGE Publications, Inc.Google Scholar
  28. *Martínez Martínez, K. I., Pedroza Cabrera, F. J., de los Ángeles Vacío, M., Jiménez Pérez, A. L., & Salazar Garza, M. L. (2008a). Consejo breve para adolescentes escolares que abusan del alcohol. [School-based brief counseling for teenage drinkers]. Revista Mexicana de Análisis de la Conducta, 34, 245–262.Google Scholar
  29. *Martínez Martínez, K. I., Pedroza Cabrera, F. J., & Salazar Garza, M. L. (Eds.). (2008b). Resultados iniciales de la aplicación de consejo breve sobre el consumo de alcohol en adolescentes rurales de México [Initial results of the application of brief advice on alcohol consumption in rural teenagers from Mexico]. TIPICA: Boletín Electrónico de Salud Escolar, 4. Retrieved from:
  30. *Martínez Martínez, K. I., Pedroza Cabrera, F. J., Salazar Garza, M. L., & de los Ángeles Vacío, M. (2010). Evaluación experimental de dos intervenciones breves para la reducción del consumo de alcohol de adolescentes [Experimental evaluation of two brief interventions for the reduction of alcohol consumption in teenagers]. Revista Mexicana De Análisis De La Conducta, 36, 35–53. doi:  10.5514/rmac.v36.i3.03.
  31. *Martins, R. A. (2008). Aplicação de intervenção breve em estudantes de ensino médio que apresentam beber de risco. Paper presented at the meeting of the International Network on Brief Interventions for Alcohol Problems, Ribeirão Preto, Brazil.Google Scholar
  32. *Mushquash, C. J. (2011). Personality and motives for alcohol use in aboriginal adolescents: A culturally relevant approach to alcohol abuse early intervention (Unpublished Doctoral dissertation, Dalhousie University, Nova Scotia, Canada).Google Scholar
  33. National Institute on Alcohol Abuse and Alcoholism. (n.d.). Alcohol and Health. Underage drinking. Retrieved from
  34. *Quigley, C. F. (2010). A psychosocial model of drinking amongst young people and the effects of brief interventions (Doctoral dissertation, University of Sheffield, England). Available from ProQuest Dissertations and Theses database. (UMI No. U557325).Google Scholar
  35. Romer, D., & Hennessy, M. (2007). A biosocial-affect model of adolescent sensation seeking: The role of affect evaluation and peer-group influence in adolescent drug use. Prevention Science, 8, 89–101. doi: 10.1007/s11121-007-0064-7.CrossRefPubMedGoogle Scholar
  36. Rothstein, H. R., Sutton, A. J., & Borenstein, M. (2005). Publication bias in meta-analysis: Prevention, assessment and adjustments. West Sussex: Wiley.CrossRefGoogle Scholar
  37. Rundall, T. G., & Bruvold, W. H. (1988). A meta-analysis of school based smoking and alcohol use prevention programs. Health Education Quarterly, 15, 317–334.CrossRefPubMedGoogle Scholar
  38. Sánchez-Meca, J., Marín-Martínez, F., & Chacón-Moscoso, S. (2003). Effect-size indices for dichotomized outcomes in meta-analysis. Psychological Methods, 8, 448–467.CrossRefPubMedGoogle Scholar
  39. Tait, R. J., & Hulse, G. K. (2003). A systematic review of the effectiveness of brief interventions with substance using adolescents by type of drug. Drug and Alcohol Review, 22, 337–346. doi: 10.1080/0959523031000154481.CrossRefPubMedGoogle Scholar
  40. Tanner-Smith E. E., & Lipsey, M. W. (2014). Brief alcohol interventions for adolescents and young adults: A systematic review and meta-analysis. Journal of Substance Abuse Treatment.Google Scholar
  41. Tanner-Smith, E. E., Wilson, S. J., & Lipsey, M. W. (2013). The comparative effectiveness of outpatient treatment for adolescent substance abuse: A meta-analysis. Journal of Substance Abuse Treatment, 44, 145–158. doi: 10.1016/j.jsat.2012.05.006.PubMedCentralCrossRefPubMedGoogle Scholar
  42. Tripodi, S. J., Bender, K., Litschge, C., & Vaughn, M. G. (2010). Interventions for reducing adolescent alcohol abuse: A meta-analytic review. Archives of Pediatrics and Adolescent Medicine, 164, 85–91. doi: 10.1001/archpediatrics.2009.235.CrossRefPubMedGoogle Scholar
  43. Vasilaki, E. I., Hosier, S. G., & Cox, W. M. (2006). The efficacy of motivational interviewing as a brief intervention for excessive drinking: A meta-analytic review. Alcohol and Alcoholism, 41, 328–335. doi: 10.1093/alcalc/ag1016.CrossRefPubMedGoogle Scholar
  44. Werch, C. E., & Owen, D. M. (2002). Iatrogenic effects of alcohol and drug prevention programs. Journal of Studies on Alcohol, 63, 581–590.CrossRefPubMedGoogle Scholar
  45. *Werch, C. E., Anzalone, D. M., Brokiewicz, L. M., Felker, J., Carlson, J. M., & Castellon-Vogel, E. A. (1996). An intervention for preventing alcohol use among inner-city middle school students. Archives of Family Medicine, 5, 146–152.Google Scholar
  46. *Werch, C., Jobli, E., Moore, M. J., DiClemente, C. C., Dore, H., & Brown, C. H. (2005a). A brief experimental alcohol beverage-tailored program for adolescents. Journal of Studies on Alcohol, 66, 284–290.Google Scholar
  47. *Werch, C. E., Moore, M. M., Diclemente, C. C., Owen, D. M., Carlson, J. M., & Jobli, E. (2005b). Single vs. multiple drug prevention: Is more always better? A pilot study. Substance Use & Misuse, 40, 1085–1101. doi: 10.1081/ja-200030814.
  48. Wilson, D. B., Gottfredson, D. C., & Najaka, S. S. (2001). School-based prevention of problem behaviors: A meta-analysis. Journal of Quantitative Criminology, 17, 247–272.CrossRefGoogle Scholar
  49. *Winters, K. C., Fahnhorst, T., Botzet, A., Lee, S., & Lalone, B. (2012). Brief intervention for drug-abusing adolescents in a school setting: Outcomes and mediating factors. Journal of Substance Abuse Treatment, 42, 279–288. doi:  10.1016/j.jsat.2011.08.005.
  50. *Wooten, B. T. (1995). Challenging alcohol expectancies: An application to adolescents. Dissertation Abstracts International: Section B. Sciences and Engineering, 56(12-B), 706056. (UMI No. 9610329).Google Scholar
  51. *Zhang, Y. (2009). Effects of an alcohol education program for high school students in Wuhan, China. Dissertation Abstracts International: Section A. Humanities and Social Sciences, 70(30). (UMI No. 3350261).Google Scholar

Copyright information

© Society for Prevention Research 2014

Authors and Affiliations

  1. 1.Peabody Research InstituteVanderbilt UniversityNashvilleUSA
  2. 2.Department of Human & Organizational Development, Peabody CollegeVanderbilt UniversityNashvilleUSA

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