Universal school-based alcohol prevention programs

Universal school-based alcohol prevention programs provide all students with the information and skills needed to prevent underage alcohol use, without screening for risk level. Such programs can be delivered as a specific curriculum that is part of school lessons or as a component of classroom behavior management. Programs can focus on raising awareness of the potential dangers of alcohol use, development of norm setting and peer resistance skills, or a combination of these approaches (Cochrane-Foxcroft 2011*).

Expected Beneficial Outcomes (Rated)

  • Reduced underage drinking

Evidence of Effectiveness

There is some evidence that universal school-based alcohol prevention programs reduce alcohol use among adolescents (Cochrane-Foxcroft 2011*, Onrust 2016*, Strom 2014, Hennessy 2015); such programs appear more effective for younger adolescents than older adolescents (Onrust 2016*). Additional evidence is needed to confirm effects and determine the characteristics of the most effective programs (Cochrane-Foxcroft 2011*, Onrust 2016*).

Internet- or computer-based programs (Champion 2013*) and individually-delivered brief interventions that last fewer than 5 hours (Hennessy 2015, Mogro-Wilson 2017*) have been shown to reduce alcohol use among adolescents. Programs that target alcohol use and other risk behaviors such as tobacco use, illicit drug use, and antisocial behavior can also reduce adolescent alcohol use (Cochrane-Foxcroft 2011*, Hale 2014*); such programs may be more effective than programs that focus on alcohol alone (Cochrane-Foxcroft 2011*). Programs that also focus on developing peer resistance and other skills (i.e., psychosocial programs) appear more likely to have positive effects than alcohol-focused programs alone (Cochrane-Foxcroft 2011*).

Universal school-based alcohol prevention programs that combine student and parent interventions may reduce students’ alcohol use (Newton 2017*). Researchers suggest that program content consider adolescents’ psychological and cognitive developmental stage for different age groups (Onrust 2016*). 

Impact on Disparities

No impact on disparities likely

Implementation Examples

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) provides the Cool Spot, curricular materials of interactive alcohol prevention lessons that are designed for middle school students (NIAAA-Cool Spot). There are also many universal school-based alcohol prevention programs, such as LifeSkills Training program (LST), the Unplugged program (Unplugged), SPORT Prevention Plus Wellness program (SPORT PPW), and the PAX Good Behavior Game (PAX GBG).

Implementation Resources

NIAAA-Cool Spot - The National Institute on Alcohol Abuse and Alcoholism (NIAAA). The Cool Spot: Teacher & volunteer corner.

LST - Botvin LifeSkills Training (LST). LST overview.

Unplugged - European Drug Addiction Prevention trial (EU-Dap). Unplugged: Curriculum and workbook.

PAX GBG - Paxis Institute. PAX Good Behavior Game (PAX GBG).

NIDA-Preventing drug use - Robertson EB, David SL, Rao SA. Preventing drug use among children and adolescents. Bethesda: National Institutes of Health (NIH), US Department of Health and Human Services (US DHHS); 2003.

Citations - Evidence

* Journal subscription may be required for access.

Cochrane-Foxcroft 2011* - Foxcroft DR, Tsertsvadze A. Universal school-based prevention programs for alcohol misuse in young people. Cochrane Database of Systematic Reviews. 2011;(5):CD009113.

Onrust 2016* - Onrust SA, Otten R, Lammers J, Smit F. School-based programmes to reduce and prevent substance use in different age groups: What works for whom? Systematic review and meta-regression analysis. Clinical Psychology Review. 2016;44:45-59.

Strom 2014 - Strom KK, Adolfsen F, Fossum S, Kaiser S, Martinussen M. Effectiveness of school-based preventive interventions on adolescent alcohol use: A meta-analysis of randomized controlled trials. Substance Abuse: Treatment, Prevention, and Policy. 2014;9:48.

Hennessy 2015 - Hennessy EA, Tanner-Smith EE. Effectiveness of brief school-based interventions for adolescents: A meta-analysis of alcohol use prevention programs. Prevention Science. 2015;16(3):463-474.

Champion 2013* - Champion KE, Newton NC, Barrett EL, Teesson M. A systematic review of school-based alcohol and other drug prevention programs facilitated by computers or the internet. Drug and Alcohol Review. 2013;32(2):115-23.

Mogro-Wilson 2017* - Mogro-Wilson C, Allen E, Cavallucci C. A brief high school prevention program to decrease alcohol usage and change social norms. Social Work Research. 2017;41(1):53-62.

Hale 2014* - Hale N, Picklesimer AH, Billings DL, Covington-Kolb S. The impact of Centering Pregnancy group prenatal care on postpartum family planning. American Journal of Obstetrics and Gynecology. 2014;210(1):50.e1-50.e7.

Newton 2017* - Newton NC, Champion KE, Slade T, et al. A systematic review of combined student- and parent-based programs to prevent alcohol and other drug use among adolescents. Drug and Alcohol Review. 2017;36(3):337-351.

Citations - Implementation Examples

* Journal subscription may be required for access.

NIAAA-Cool Spot - The National Institute on Alcohol Abuse and Alcoholism (NIAAA). The Cool Spot: Teacher & volunteer corner.

LST - Botvin LifeSkills Training (LST). LST overview.

Unplugged - European Drug Addiction Prevention trial (EU-Dap). Unplugged: Curriculum and workbook.

SPORT PPW - Prevention Plus Wellness. SPORT Prevention Plus Wellness (SPORT PPW).

PAX GBG - Paxis Institute. PAX Good Behavior Game (PAX GBG).

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