Program characteristics for universal uni-modal programs.

<p><i>Note</i>. LST = Life Skills Training, TND = Towards No Drug Abuse, CSM = Climate Schools Model. NT = No Treatment, TU = Treatment as usual, DI = Delayed Intervention, MC = Minimal Contact Control. PL = Peer Leader, T = Teacher, HE = Health Educator, HP = Health Professional. NA = Not applicable/Not available.</p>a<p>This intervention assessed differential training for teachers: the E1 condition utilised a 1-day teacher workshop with implementation feedback, and the E2 condition utilised a videotape providing no feedback.</p>b<p>This intervention assessed differential training for teachers: the IMP-support refers to comprehensive implementation support, and the REGULAR refers to regular workshop training only.</p>c<p>Results were collapsed across comparison groups and analyses were treated as all intervention versus control.</p>d<p>Cohen's d calculated using F value.</p>e<p>Cohen's d calculated using odds ratio.</p>f<p>Cohen's d calculated by converting standard error to standard deviation.</p>*<p>Statistically significant as 95% CI does not contain zero.</p

Flow-diagram presenting the process of identification for study eligibility.

<p>Flow-diagram presenting the process of identification for study eligibility.</p

Primary Prevention of Cannabis Use: A Systematic Review of Randomized Controlled Trials

<div><p>A systematic review of primary prevention was conducted for cannabis use outcomes in youth and young adults. The aim of the review was to develop a comprehensive understanding of prevention programming by assessing universal, targeted, uni-modal, and multi-modal approaches as well as individual program characteristics. Twenty-eight articles, representing 25 unique studies, identified from eight electronic databases (EMBASE, MEDLINE, CINAHL, ERIC, PsycINFO, DRUG, EBM Reviews, and Project CORK), were eligible for inclusion. Results indicated that primary prevention programs can be effective in reducing cannabis use in youth populations, with statistically significant effect sizes ranging from trivial (0.07) to extremely large (5.26), with the majority of significant effect sizes being trivial to small. Given that the preponderance of significant effect sizes were trivial to small and that percentages of statistically significant and non-statistically significant findings were often equivalent across program type and individual components, the effectiveness of primary prevention for cannabis use should be interpreted with caution. Universal multi-modal programs appeared to outperform other program types (i.e, universal uni-modal, targeted multi-modal, targeted unimodal). Specifically, universal multi-modal programs that targeted early adolescents (10–13 year olds), utilised non-teacher or multiple facilitators, were short in duration (10 sessions or less), and implemented boosters sessions were associated with large median effect sizes. While there were studies in these areas that contradicted these results, the results highlight the importance of assessing the interdependent relationship of program components and program types. Finally, results indicated that the overall quality of included studies was poor, with an average quality rating of 4.64 out of 9. Thus, further quality research and reporting and the development of new innovative programs are required.</p> </div

Significant and non-significant outcome data and quality ratings, as a function of program design for program duration.

<p><i>Note</i>. Sig = significant, Non = non-significant, <i>n₁</i> = number of studies, <i>n₂</i> = number of outcome measures, Qual = quality.</p

Significant and non-significant outcome data and quality ratings, as a function of program design for booster sessions.

<p><i>Note.</i> Sig = significant, Non = non-significant, <i>n₁</i> = number of studies, <i>n₂</i> = number of outcome measures, Qual = quality.</p

Significant and non-significant outcome data and quality ratings, as a function of program design for participant age.

<p><i>Note</i>. Sig = significant, Non = non-significant, <i>n₁</i> = number of studies, <i>n₂</i> = number of outcome measures, Qual = quality.</p

Program characteristics for universal multi-modal programs.

<p><i>Note</i>. GP = Gatehouse Project, EU-DAP = European Drug Abuse Prevention, MPP: Midwestern Prevention Program, ISFP = Iowa Strengthening Families Program, PDFY = Preparing for the Drug Free Years, LST = Life Skills Training, SFP 10–14 = Strengthening Families Program: For Parents and Youth 10–14. U = Unclear/Unspecified, TU = Treatment as usual, NT = No Treatment, MC = Minimal Contact Control. T = Teacher, PL = Peer Leader, P = Parent, NA = Not applicable/Not available, PW = Project Worker, HP = Health Professional.</p>a<p>This is a CD-Rom based intervention program facilitator is thus not applicable.</p>b<p>Cohen's d calculated using odds ratio.</p>c<p>Results were collapsed across comparison groups and analyses were treated as all intervention versus control.</p>d<p>Cohen's d was reported by study authors.</p>e<p>Cohen's d calculated using chi-square.</p>*<p>Statistically significant as 95% CI does not contain zero.</p

Program characteristics for targeted multi-modal programs.

<p><i>Note.</i> Programs: BRAVE = Building Resiliency and Vocational Excellence, BASICS = Brief Alcohol Screening and Intervention for College Students, R.E.A.L = Refuse, Explain, Avoid, Leave. NT = No Treatment, DI = Delayed Intervention, TU = Treatment as usual. CRM = Community Role Model, PL = Peer Leader, T = teacher. NA = Not applicable/Not available.</p>a<p>This project assessed 3 cultural versions of an intervention (1) Mexican American, (2) Black/White, and (3) a multicultural version which incorporated aspects of the first two.</p>b<p>Cohen's d calculated from F-value.</p>*<p>Statistically significant as 95% CI does not contain zero.</p

Program characteristics for targeted uni-modal programs.

<p><i>Note</i>. HC: MET = Healthy Choices: Motivational Enhancement Therapy, PALS = Positive Adolescent Life Skills, RT = Real Teen, ImPACT = Informed Parents and Children Together, FOL = Facts of Life, FOK = Focus on Kids. TU = Treatment as usual, MC = Minimal Contact Control, DI = Delayed Intervention, NA = Not applicable/Not available, NT = No Treatment. HP = Health Professional, PL = Peer Leader, P = Parent, PW = Project Worker. Other: TLFB = Timeline Follow-back.</p>a<p>Participants defined as high-risk personalities if they scored 1 standard deviation higher than the school mean on 1 of 4 subscales of the Substance Use Risk Profit Scale: hopelessness, anxiety sensitivity, impulsivity, or sensation seeking.</p>b<p>High-risk females were defined as pregnant adolescents who were using drugs OR who were at risk for using drugs, and for non-pregnant adolescents who were either using drugs OR at risk for using drugs AND who were at risk for pregnancy, where risk was determined using the Problem Oriented Survey Instrument for Teenagers (POSIT).</p>c<p>The authors did not employ a “true” control group for ethical reasons, i.e. not providing an adequate level of standard care to all participants. Thus, the study design compared the new treatment of interest (ImPACT) to an established treatment (FOK: Focus on Kids).</p>d<p>The authors did not employ a “true” control group to minimize the possibility of a Hawthorn Effect. Thus, the study compared the new treatment (PALS) to an established normative education treatment (FOL: Fast of Life).</p>e<p>This is a computer based prevention program, program facilitators are thus not applicable.</p>f<p>Cohen's d reported by author.</p>g<p>Results were collapsed across comparison groups and analyses were treated as all intervention versus control.</p>h<p>Cohen's d calculated from odds ratio.</p>i<p>Cohen's d calculated from F-value.</p>*<p>Statistically significant as 95% CI does not contain zero.</p

Significant and non-significant outcome data and quality ratings, as a function of program design for program facilitator.

<p><i>Note</i>. Sig = significant, Non = non-significant, <i>n₁</i> = number of studies, <i>n₂</i> = number of outcome measures, Qual = quality. Two studies were excluded from this analysis of program facilitators as they collapsed their results across groups in their statistical analyses.</p