Delivering substance use prevention interventions for adolescents in educational settings: A scoping review

Table 1 Multiagent-based adolescent substance use interventions

Implementation subject	Intervention method	Specific measures
Based on social intervention measures	Clarifying the scope of legal substance use and adopting strict regulatory measures	Manage the age, sales timeframe, permissible quantities, and pricing of substances and regulate users[18]
		Levy taxes on the alcohol or tobacco content of goods and tie them to fluctuations in consumer pricing[19]
		Implement and enforce laws mandating a minimum age limit and raise the age threshold for young people to purchase alcoholic beverages[18,23]
		Create community-specific regulations concerning the issuance of tobacco and alcohol licenses to minors and promote their enforcement within localities[24]
Based on family intervention measures	Providing training courses for parents and teenagers	Strong African American Families-Teen program: Deliver skill-building courses and family training sessions spanning 10 h and comprising 5 sessions to both parents and teenagers[29]
		Creating lasting family connections: Offer a 20-wk facilitator training program for parents and teenagers[13]
	Developing intervention plans	Families preparing the new generation plus: Execute a 10-wk prevention plan for nutrition and material use while emphasizing healthy eating and parenting strategies[26]
		Familias Unidas: Enforce a set of intervention measures aimed at enhancing parents’ sense of efficacy and parenting skills (parent support networks), family meetings/home visits, parent-adolescent discussion circles, adolescent activity groups, supervised peer activities, and school counselor meetings)[27]
		Risk reduction therapy for adolescents: Intervention measures conducted by a professional therapist with a relevant master’s degree at an outpatient clinic. Caregivers are obligated to attend a weekly session lasting between 60 min and 90 min[28]
Based on community intervention measures	Providing community intervention programs	Community trials intervention to reduce high-risk drinking: To modify the community’s drinking behavior, offer responsible beverage service, reinforce law enforcement, and set up alcohol checkpoints[13]
		Deliver a 10-wk intervention plan for adolescents using the Health Rocks program and multiple disciplinary literacy strategies. Emphasize the effects of substance abuse on health and require adolescents to attend a one-hour theme-based instruction per week[30]
Based on technology intervention measures	Utilizing innovative intervention methods, such as the internet and big data	CLIMATE: Provide 6 lessons based primarily on social influence theories via CD-ROM and the Web. The lessons provide knowledge about how common substance use is as well as the negative outcomes it can lead to and teach methods to avoid substance use and the subsequent hazards[37]
		HeadOn: Require the involvement of students in decision-making related to substance use through interactive simulation scenarios[38]

Table 2 Curriculum interventions focusing on cognitive-behavioral skill enhancement

Ref.	Age/gender	Scope of application			Method	Content	Effect	Location
		Alcohol	Tobacco	Illicit drugs
Diaz Gomez et al[47], 2021	10-12 yr, all genders	Yes	Yes	-	Randomized controlled cluster study	Primavera is a prevention program that focuses on experiences and involves multiple modes of delivery. It spans several years and has a generic approach	Primavera is effective in decreasing alcohol consumption among school students	France
Kimber et al[48], 2009	Grades 7 to 9 (13-16 yrs), all genders	Yes	Yes	Yes	Nonrandomized five-year longitudinal design	Teachers offer weekly lessons on social and emotional training to students	A particular group of people derived benefits from the program	Sweden
Hecht et al[49], 2003	Grade 7, all genders	Yes	Yes	Yes	Randomized controlled trial	Interventions based on culture are conducted through 10 specific lessons and a media campaign utilizing a model of cultural resilience	The intervention had a considerable and noteworthy effect on individual consumption of alcohol, cigarettes, and cannabis	United States
Unger et al[50], 2004	Grade 6, all genders	-	Yes	-	Participatory research	The Project Fun Learning About Vitality, Origins, and Respect is a curriculum that promotes multicultural education	The project successfully stopped hispanic boys from starting smoking but had no impact on other groups	United States
Walker et al[51], 2011	14-19 yr (Grade 9-12), all genders	-	-	Yes	Randomized controlled trial	Motivational enhancement therapy, educational feedback control, and delayed feedback control	Participants stated that they used cannabis less frequently and experienced fewer negative outcomes	United States
Faggiano et al[52], 2010	12-14 yr, all genders	Yes	Yes	Yes	Cluster randomized controlled trial	The program involved a 12-h curriculum that was developed using a thorough social influence approach	Alcohol abuse and marijuana use showed a consistent improvement, whereas smoking displayed no change	Spain, Belgium, Germany, Sweden, Greece, Italy, and Austria
Dent et al[53], 2001	14-17 yr, all genders	Yes	Yes	Yes	Randomized controlled trial	Project Toward No Drug Abuse: Standard care and classroom education program	Over a period of one year after the program, this population saw statistically significant changes in alcohol and illicit drug use	United States
Hanewink et al[54], 2004	Grades 5 and 6 (mean age 11.4 yr), all genders	-	Yes	-	Randomized controlled trial	The smoking prevention program utilized a life-skills approach and included 21 sessions	The program did not have a distinct impact on the current smoking rate (percentage of people who smoked in the past 4 wk)	Austria, Denmark, Luxemboug, and Germany
Botvin et al[55], 2001	Grades 7 to 9, all genders	Yes	-	-	Randomized controlled trial	A proactive approach that educates individuals on resisting alcohol and drug consumption, promoting healthy social norms, and providing material to encourage personal and social skill-building	The prevention program was effective in protecting against episodes of excessive drinking	United States
Botvin et al[56], 1999	Grade 7 (mean age 12.9 yr), girls	-	Yes	-	Randomized controlled trial	This program consists of 15 sessions aimed at teaching social resistance skills within a broader initiative that aims to promote general personal and social competence skills	The number of urban minority girls who started smoking or increased their smoking habits was significantly reduced	United States
Shope et al[57], 1998	Grade 6 (mean age 12 yr), all genders	Yes	Yes	Yes	Participatory research	The students in the curriculum group were taught about alcohol, tobacco (including cigarettes and smokeless tobacco), marijuana, and cocaine	The curriculum achieved short-term effectiveness by considerably decreasing the rising rates of alcohol consumption and addiction, tobacco use, cocaine intake, and other types of substance abuse	United States
Sloboda et al[58], 2009	Between seventh and ninth grade, all genders	Yes	Yes	Yes	Randomized field trial	TCYL offers students essential life skills, which include communication, decision-making, assertiveness, and refusal skills	TCYL had a negative impact on students’ use of alcohol and tobacco as a result of medical treatment	United States

TCYL: Take charge of your life.

Table 3 Exercise interventions

Ref.	Age/gender	Scope of application			Method	Content	Effect	Location
		Alcohol	Tobacco	Illicit drugs
Werch et al[59], 2005	Ninth and eleventh grade, all genders	Yes	Yes	Yes	Randomized controlled trial	Project SPORT is a short intervention that promotes healthy habits by integrating physical activity and preventing alcohol use	After the treatment and after one year, it was anticipated that the project would have an impact on the drinking and smoking habits of adolescents	United States
Brick et al[60], 2017 and Velicer et al[61], 2013	Grade 6, all genders	Yes	Yes	-	Multiattribute utility measurement approach	An intervention aimed at preventing substance use and promoting a healthy energy balance through physical activity, consumption of fruits and vegetables, and decreasing sedentary behavior	The outcome of every action was a significant decrease in the prevalence of smoking and drinking compared to the existing rates reported by ninth-grade students	United States
Werch et al[62], 2003	Grade 8, all genders	Yes	-	-	Randomized experimental design	Consultation for Sports (Sport): A process of evaluating one’s health and fitness followed by discussion and recommendations	The program may boost the frequency of physical activity while decreasing alcohol consumption	United States
Goldberg et al[63], 2000	Grade 9 and grade 10, all genders	Yes	-	Yes	Randomized controlled trial	An education program centered on team collaboration and designed for a specific gender, which includes interactive classroom sessions and exercise training	The program was successful in stopping people from using alcohol and other prohibited drugs	United States
Butzer et al[64], 2017	Garde 7 (with a mean age of 12.64), all genders	-	Yes	-	Preliminary group randomized controlled trial	The curriculum of Kripalu Yoga in the Schools has a version that includes 32 sessions	Practicing yoga in schools can be helpful in reducing the inclination of both males and females towards smoking	United States
Fishbein et al[65], 2016	Grades 9 to 12 (mean age 12 yr), all genders	Yes	-	-	Pilot randomized controlled trial	A 20-session mindfulness yoga program created for students at risk of dropping out from school	The students who took part in yoga sessions showed a reduction in alcohol consumption	United States
Mathews et al[66], 2007	High school students, all genders	Yes	Yes	Yes	Randomized controlled trial	The project SPORT comprises of a brief interactive CD-ROM and a brief group consultation	The project received considerable acceptance among adolescent males and females and could be effective	United States
Horn et al[67], 2013	14-19 yr, all genders	-	Yes	-	Randomized group trial	The physical activity levels of participants in a smoking cessation program for teenagers improved with the addition of a physical activity component	Adolescents in good health are more likely to decrease their amount of smoking	United States

Table 4 Peer interventions and family-school cooperation

Ref.	Age/gender	Scope of application			Method	Content	Effect	Location
		Alcohol	Tobacco	Illicit drugs
Paquette et al[68], 2019	Ages 13-17, all genders	Yes	-	Yes	Randomized controlled trial	“Amplifying Our Futures (Amp)” is a temporary intervention program that consists of four phases. It is designed for adolescents who are at low to moderate risk of using substances and is facilitated by trained companions aged 18-28 years old	Young peer intervention was valuable in educational environments	United States
Botvin et al[69], 1990	Grade 7, all genders	Yes	Yes	Yes	Cluster randomized controlled trial	Life skills training is a program designed to improve cognitive and behavioral skills, which is led by both experienced students and teachers in a classroom setting for a total of 20 sessions	Preventative programs have had a quantifiable effect on behavior related to substance use	United States
Furr-Holden et al[70], 2004	Grades 1-8, all genders	Yes	Yes	Yes	Randomized prevention trial	The classroom-centered intervention and the family-school partnership intervention	Two interventions had a clear protective effect against tobacco use	United States
Zavela et al[71], 2004	Grades 4-8, all genders	Yes	Yes	Yes	Control experiments and follow-up questionnaire	Say Yes First-To Rural Youth and Family Alcohol/Drug Prevention: An educational and case management approach to drug prevention	The students who were part of the program consumed less alcohol, tobacco and other drugs and had a lower occurrence of marijuana use throughout their lifetime	United States
Winters et al[72], 2012	Ages 14-17, all genders	Yes	-	Yes	Randomized controlled trial	BIs: Therapists used the principle of motivational interviewing to conduct topical sessions with parents and students	BIs showed a connection with decreased drug usage, with a greater impact when parents were included	United States

Bis: Brief interventions.

Table 5 Electronic interventions

Ref.	Age/gender	Scope of application			Method	Content	Effect	Location
		Alcohol	Tobacco	Illicit drugs
Jennifer et al[73], 2006	Grade 7, all genders	Yes	Yes	Yes, marijuana	Randomized controlled trial	The usefulness of the Drug Resistance Strategies Project’s Keepin’ it REAL program aimed at preventing adolescent substance use was explored by studying students who participated in it through public service announcements and videotapes	Class videos influenced the use of drugs among teenagers, whereas PSAs did not have an impact	United States
Malmberg et al[74], 2014	11-15 yr, all genders	Yes	Yes	Yes	Randomized clustered trial	Healthy School and Drugs program: Digital modules for e-learning and comprehensive intervention	Both the e-learning and comprehensive intervention failed to prevent the initiation of alcohol, tobacco, or marijuana use	The Netherlands
Kiewik et al[75], 2017	12-16 yr, all genders	Yes	Yes	-	Pre-/post-intervention pilot study with a control group	“Prepared on time”: A digital training program that follows the attitude-social influence-efficacy model	This research demonstrated that an electronic learning prevention program is feasible for teenagers with mild or moderate intellectual disability	The Netherlands
Newton et al[76], 2010	13 yr, grade 8, all genders	Yes	-	Yes	Cluster-randomized controlled trial	Internet-based prevention programs for school-age children: The Climate Schools: Alcohol and Cannabis course	After finishing the programs, students’ understanding of alcohol and cannabis improved, and it also led to a decrease in the consumption of alcohol for up to twelve months	Australian
Buller et al[77], 2008	Grades 6 to 9, all genders	-	Yes	-	Randomized trials	Consider This: There were a total of 73 online activities divided into six modules: Introduction, media literacy, relationships, mind and body, decision making, and resistance strategies	The activities led to a decrease in smoking and/or a decrease in students’ expectations of smoking in the future	Australia and United States
Gordon et al[78], 2017	9-12 yr, all genders	Yes	-	-	Qualitative assessment	Alcohol media literacy programs: Providing children with the necessary skills to question and critically evaluate the information they receive from media sources	Using culturally specific advertisements as a means to educate about the effects of alcohol proved to be a potent strategy	Australia