- Title
- Effectiveness of universal school-based resilience interventions in reducing adolescent tobacco, alcohol and illicit substance use in adolescents
- Creator
- Hodder, Rebecca Kate
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2018
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Background: Tobacco, alcohol and illicit substance use initiation typically occurs during adolescence. Intervention in schools to reduce substance use and a universal approach to such interventions are recommended by governments and commonly implemented by schools. As both individual and environmental resilience protective factors have been reported to be inversely associated with adolescent substance use, increasing student resilience has been suggested to be a means of reducing such substance use. Evidence of the effectiveness of interventions specifically addressing these factors is however limited. Aims: The thesis aims were to: i) review the effectiveness of universal school-based resilience interventions in reducing adolescent substance use; ii) determine the effectiveness of such an intervention approach in reducing adolescent substance use overall and iii) by subgroup; and iv) explore the associations between individual and environmental resilience protective factors and adolescent substance use. Methods: A systematic review of the effectiveness of universal school-based interventions that addressed student ‘resilience’ in reducing adolescent substance use was conducted, as was a cluster-randomised controlled trial of a ‘resilience’ only focused intervention. The trial was conducted in 32 secondary schools and involved a cohort of 2105 students. Self-report substance use outcomes were measured before and after a 3-year intervention that addressed resilience protective factors delivered under ‘real-world’ conditions by schools. Investigation of the relative associations between the 14 resilience protective factors addressed by the intervention and seven measures of adolescent substance use was conducted. Key findings: The systematic review findings were equivocal, with interventions that included a focus on both resilience protective factors and other factors being found to be effective for reducing illicit substance use but not tobacco or alcohol use. The cluster-randomised trial found that the universal school-based resilience focused intervention was not effective in reducing adolescent substance use, or in increasing resilience protective factors, either for students overall or for student subgroups. Only two of the 14 resilience protective factors were consistently associated with all measures of adolescent substance use. Conclusion and implications for future research and practice: The thesis findings suggest that universal school-based resilience interventions alone are unlikely to reduce adolescent use of a range of substances. Based on these findings and related research, the following implications for future research and for policy and practice in this area were identified. First, to identify the most appropriate focus of future resilience focused interventions, further understanding is required of the longitudinal associations and interactions between substance use risk and protective factors, resilience protective factors and adolescent substance use. Second, to enhance the likelihood of a positive intervention effect on the prevalence of adolescent substance use, further investigation is required of the effectiveness of interventions that include both a universal and a selective intervention approach, and address both substance use risk and protective factors and resilience protective factors. Third, to enhance the benefit of government and school investment in substance use prevention initiatives, school substance use prevention programs/curriculum should be reviewed in terms of their alignment with evidence of effective intervention approaches and practical guidance provided to schools to facilitate their selection and delivery of evidence-based substance use prevention programs.
- Subject
- substance use prevention; resilience; school-based; adolescents
- Identifier
- http://hdl.handle.net/1959.13/1392708
- Identifier
- uon:33448
- Rights
- Copyright 2018 Rebecca Kate Hodder
- Language
- eng
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 26 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 1 MB | Adobe Acrobat PDF | View Details Download |