Linlin Luo, Heidrun Stoeger
Developing eminence in STEMM: An interview study with talent development and STEMM experts
Annals of the New York Academy of Sciences
engagement multiple risk behaviours adverse consequences health childhood adolescence later life yet little known impact different types interventions target multiple risk behaviours children young people differential impact universal versus targeted approaches findings systematic reviews mixed effects interventions quantitatively estimatedto examine effects interventions implemented 18 years age primary secondary prevention multiple risk behaviours among young peoplewe searched 11 databases australian education index british education index campbell library cumulative index nursing allied health literature cinahl cochrane central register controlled trials central cochrane library embase education resource information center eric international bibliography social sciences medline psycinfo sociological abstracts three occasions 2012 2015 14 november 2016 conducted handsearches reference lists contacted experts field conducted citation searches searched websites relevant organisationswe included randomised controlled trials rcts including cluster rcts aimed address least two risk behaviours participants children young people 18 years age andor parents guardians carers long intervention aimed address involvement multiple risk behaviours among children young people 18 years age however studies could include outcome data children 18 years age time followup specificallywe included studies outcomes collected eight 25 years age included studies combined intervention followup period six months longer excluded interventions aimed individuals clinically diagnosed disorders along clinical interventions categorised interventions according whether conducted individual level family level school levelwe identified total 34680 titles screened 27691 articles assessed 424 fulltext articles eligibility two review authors independently assessed studies inclusion review extracted data assessed risk biaswe pooled data metaanalyses using randomeffects dersimonian laird model revman 53 outcome included subgroups related study type individual family school level universal targeted approach examined effectiveness 12 months followup longer term 12 months assessed quality certainty evidence using grades recommendation assessment development evaluation grade approachwe included review total 70 eligible studies substantial proportion universal schoolbased studies n 28 40 studies conducted usa n 55 79 average studies aimed prevent four primary behaviours behaviours frequently addressed included alcohol use n 55 drug use n 53 andor antisocial behaviour n 53 followed tobacco use n 42 studies aimed prevent selfharm gambling alongside behavioursevidence suggests multiple risk behaviours universal schoolbased interventions beneficial relation tobacco use odds ratio 077 95 confidence interval ci 060 097 n 9 studies 15354 participants alcohol use 072 95 ci 056 092 n 8 studies 8751 participants moderatequality evidence compared comparator interventions may effective preventing illicit drug use 074 95 ci 055 100 n 5 studies 11058 participants lowquality evidence engagement antisocial behaviour 081 95 ci 066 098 n 13 studies 20756 participants lowquality evidence 12 months followup although evidence moderate substantial heterogeneity 49 69 moderatequality evidence also showed multiple risk behaviour universal schoolbased interventions improved odds physical activity 132 95 ci 116 150 0 n 4 studies 6441 participants considered observed effects public health importance applied population level evidence less certain effects multiple risk behaviour interventions cannabis use 079 95 ci 062 101 p 006 n 5 studies 4140 participants 0 moderatequality evidence sexual risk behaviours 083 95 ci 061 112 p 022 n 6 studies 12633 participants 77 lowquality evidence unhealthy diet 082 95 ci 064 106 p 013 n 3 studies 6441 participants 49 moderatequality evidence important note evidence supported positive effects universal schoollevel interventions three risk behavioursfor outcomes individual familylevel targeted universal interventions moderate lowquality evidence suggests little effect although caution warranted interpretation studies available comparison n 4 studies outcomeseven studies reported adverse effects involved evidence suggestive increased involvement risk behaviour among participants receiving intervention compared participants given control interventionswe judged quality evidence moderate low outcomes primarily owing concerns around selection performance detection bias heterogeneity studiesavailable evidence strongest universal schoolbased interventions target multiple risk behaviours demonstrating may effective preventing engagement tobacco use alcohol use illicit drug use antisocial behaviour improving physical activity among young people preventing risk behaviours results review provide strong evidence benefit family individuallevel interventions across risk behaviours studied however poor reporting concerns around quality evidence highlight need highquality multiple risk behaviour intervention studies strengthen evidence base field