***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: AIMS Despite widespread prevention efforts to decrease adolescent risk-taking , substance use and driving after drinking ( DD ) are prevalent in the United States . The current study compared the efficacy of an abbreviated version of Drug Abuse and Resistance Education ( DARE-A ) to a new Risk Skills Training Program ( RSTP ) . DESIGN Adolescent participation in drinking , drug use , DD and riding with a drunk driver was examined longitudinally . After baseline assessment s , adolescents were r and omly assigned to the RSTP . DARE-A or a no intervention control group and then completed 2-month post-test and 6-month follow-up assessment s. SETTING Adolescents attended a mid-sized suburban high school . PARTICIPANTS The sample ( N = 300 ) was comprised of 58 % females and the age range was 14 - 19 years . INTERVENTION The RSTP was developed to target several risk behaviors and to examine the feasibility of conducting a brief personalized prevention program in a group setting . DARE-A focused on increasing knowledge and underst and ing the deleterious effects of substance use . MEASUREMENTS Risk-taking behavior , perception of peer risk-taking and positive and negative alcohol expectancies were assessed . FINDINGS RSTP participants decreased participation in several risk behaviors at post-test , but reductions were not maintained at 6-month follow-up . The control and DARE-A groups increased their positive and decreased their negative alcohol expectancies . The control group increased their alcohol consumption . CONCLUSIONS Results suggest that a brief , personalized , group prevention program is a feasible approach to reducing adolescent risk-taking . Strategies must be developed to solidify these positive changes so that they are longer-lasting OBJECTIVE To evaluate the effect of the middle and junior high school Drug Abuse Resistance Education ( D.A.R.E. ) and D.A.R.E. Plus programs on drug use and violence . DESIGN R and omized controlled trial of 24 schools , with 3 conditions : D.A.R.E. only , D.A.R.E. Plus , and delayed program control . SETTING Schools and neighborhoods , primarily in Minneapolis-St Paul . PARTICIPANTS All seventh- grade students in 24 schools in the academic year 1999 - 2000 ( N = 6237 at baseline , 67.3 % were white , and there was 84.0 % retention at final follow-up ) . INTERVENTIONS The middle and junior high school D.A.R.E. curriculum in the 16 schools that received D.A.R.E. only and D.A.R.E. Plus . In the 8 schoolts that received D.A.R.E. Plus , additional components included a peer-led parental involvement classroom program called " On the VERGE , " youth-led extracurricular activities , community adult action teams , and postcard mailings to parents . The interventions were implemented during 2 school years , when the cohort was in the seventh and eighth grade s. MAIN OUTCOME MEASURES Self-reported tobacco , alcohol , and marijuana use ; multidrug use ; violence ; and victimization , assessed at the beginning and end of seventh grade and at the end of eighth grade . Growth curve analytic methods were used to assess changes over time by condition . RESULTS There were no significant differences between D.A.R.E. only and the controls ; significant differences among boys between D.A.R.E. Plus and controls for tobacco , alcohol , and multidrug use and victimization ; significant differences among boys between D.A.R.E. Plus and D.A.R.E. only in tobacco use and violence ; and no significant behavioral differences among girls . CONCLUSION D.A.R.E. Plus significantly enhanced the effectiveness of the D.A.R.E. curriculum among boys and was more effective than the delayed program controls , underscoring the potential for multiyear , multicomponent prevention programs and demonstrating sex differences in response to intervention programs This study examined the effects of the  Iowa Strengthening Families Program ( ISFP ) and the Preparing for the Drug-Free Years program ( PDFY ) on young adolescent transitions from nonuse of substances to initiation and progression of substance use . Analyses incorporated 3 waves of data collected over a 2.5-year period from 329 rural young adolescents . Outcomes were analyzed by using log-linear models that incorporated substance use status frequencies derived from latent transition analyses . Effects on delayed substance use initiation were shown for both the ISFP and the PDFY at a 2-year follow-up . Also at this follow-up , the PDFY showed effects on delayed progression of use among those previously reporting initiation This study examined long-term follow-up data from a large-scale r and omized trial to determine the extent to which participation in a school-based drug abuse prevention program  during junior high school led to less risky driving among high school students .  Self-report data collected from students in the 7th , 10th , and 12th grade s were matched by name to students ' department of motor vehicles ( DMV ) records at the end of high school . The DMV data included the total number of violations on students ' driving records as well as the number of “ points ” that indicate the frequency and severity of the violations . A series of logistic regression analyses revealed that males were more likely to have violations and points on their driving records than females , and regular alcohol users were more likely to have violations and points than those who did not use alcohol regularly . Controlling for gender and alcohol use , students who received the drug prevention program during junior high school were less likely to have violations and points on their driving records relative to control group participants that did not receive the prevention program . Findings indicated that antidrinking attitudes mediated the effect of the intervention on driving violations , but not points . These results support the hypothesis that the behavioral effects of competence-enhancement prevention programs can extend to risk behaviors beyond the initial focus of intervention , such as risky driving Abstract . Objective : The authors assessed short-term effectiveness of a Web-based alcohol education program on entering freshmen . Participants : 3,216 incoming first-year students were r and omized to a control or intervention group . Methods : Controls completed a survey and knowledge test the summer before college ; 4 to 6 weeks after arrival on campus , they completed a follow-up survey of behaviors and harms followed by an invitation to complete the online course . Intervention students completed the precourse survey and test , the online course , and final exam prior to coming to campus . This was followed by a survey 4 to 6 weeks after arrival on campus . Results : Although the intervention group showed significantly higher alcohol-related postcourse knowledge compared to the control group , protective behavior , risk-related behavior , high-risk drinking , and alcohol-related harm did not favor the intervention group , with the sole exception of playing drinking games . Conclusions : Alcohol knowledge alone was insufficient to mitigate alcohol-related high-risk behaviors in this student population AIM To evaluate the effectiveness of a school-based substance abuse prevention program developed in the EU-Dap study ( EUropean Drug Addiction Prevention trial ) . MATERIAL S AND METHODS Cluster R and omized Controlled Trial . Seven European countries participated in the study ; 170 schools ( 7079 pupils 12 - 14 years of age ) were r and omly assigned to one of three experimental conditions or to a  control condition during the school year 2004/2005 . The program consisted of a 12-h curriculum based on a comprehensive social influence approach . A pre-test  survey assessing past and current substance use was conducted before the implementation of the program , while a post-test survey was carried out about 18 months after the pre-test . The association between program condition and change in substance use at post-test was expressed as adjusted prevalence odds ratio ( POR ) , estimated by multilevel regression models . RESULTS Persisting beneficial program effects were found for episodes of drunkenness ( any , POR=0.80 ; 0.67 - 0.97 ; frequent , POR=0.62 ; 0.47 - 0.81 ) and for frequent cannabis use in the past 30 days ( POR=0.74 ; 0.53 - 1.00 ) , whereas daily cigarette smoking was not affected by the program as it was at the short-term follow-up . Baseline non-smokers that participated in the program progressed in tobacco consumption to a lower extent than those in the control condition , but no difference was detected in the proportion of quitters or reducers among baseline daily smokers . CONCLUSION The experimental evaluation of an innovative school curriculum based on a comprehensive social influence approach , indicated persistent positive effects over 18 months for alcohol abuse and for cannabis use , but not for cigarette smoking We report the results of a growth model analysis of the impact of a Family Empowerment Intervention ( FEI ) on the heavy drinking over a 36-month follow-up period among youths processed at the Hillsborough County Juvenile Assessment Center . Families involved in the project were r and omly assigned to either receive an Extended Services Intervention ( ESI ) or the FEI . Families in the ESI group received monthly phone contacts and , if indicated , referral information ; FEI families received three one-hour , home-based meetings per week for approximately 10 weeks from a clinician-trained paraprofessional . By seeking to improve family functioning by empowering parents , it was hypothesized that target youths ' behavior and psychosocial functioning would improve . Although the difference between FEI and ESI was not significant , the reported frequency of getting very high or drunk on alcohol declined more over time for FEI completers than FEI noncompleters . The results provide support for the impact of the FEI services Abstract Preparing for the Drug-Free Years ( PDFY ) is a curriculum design ed to help parents learn skills to consistently communicate clear norms against adolescent substance use , effectively and proactively manage their families , reduce family conflict , and help their children learn skills to resist antisocial peer influences . This study examined the effects of PDFY on the trajectories of these factors , as well as on the trajectory of alcohol use from early to mid adolescence . The sample consisted of 424 rural families of sixth grade rs from schools r and omly assigned to an intervention or a  control condition . Data were collected from both parents and students at pretest , posttest , and 1- , 2- and 3 $ $ \frac{1}{2}$$ -year follow-ups . Latent growth models were examined . PDFY significantly reduced the growth of alcohol use and improved parent norms regarding adolescent alcohol use over time . Implication s for prevention and evaluation are discussed This study examined whether the efficacy of keepin ’ it REAL , a model program for substance use prevention in schools , was moderated by gender , ethnicity , and acculturation . Gender differences in program efficacy may arise through boys ' higher risk of drug use , inadequate attention to girls ' developmental issues , or cultural factors like polarized gender expectations . Data came from a r and omized trial in 35 Phoenix , Arizona , middle schools involving 4,622 mostly Latino 7th grade rs . Using multi-level mixed models and multiple imputation missing techniques , results for the total sample showed no gender differences in program effects on recent substance use , but the program was more effective in fostering boys ' than girls ' anti-drug norms . Subgroup analyses demonstrated several more beneficial program effects for boys than girls ( less alcohol and cigarette use and stronger anti-drug norms ) , but only among less acculturated Latinos . There were no gender differences in program effects among more acculturated Latinos , nor among non-Latino whites The authors evaluated the efficacy of a brief image-based prevention intervention and assessed current drug use as a moderator of intervention effects . In a clinical trial , 416 high school-age adolescents were r and omized to either the brief intervention or usual care control , with data collected at baseline and 3-month follow-up . The brief intervention consisted of a tailored in-person communication and a series of parent/guardian print material s based on the behavior-image model .  Health behavior goal setting increased for participants receiving the brief intervention , with an effect size in the small range ( d = 0.33 ) . Overall effect sizes for cigarette smoking frequency and quantity and alcohol use frequency and quantity were small ( ds = 0.16 - 0.21 ) and in favor of the brief intervention . However , adolescents reporting current substance use who received the brief intervention reduced their frequency and heavy use of alcohol , frequency and quantity of cigarette smoking , and reported fewer alcohol/drug problems , with larger effects ranging from small to approaching medium in size ( ds = 0.32 - 0.43 , ps < .01 ) . This study suggests that brief image-based messages may increase health behavior goal setting and reduce substance use , particularly among drug-using older adolescents PURPOSE School-based substance abuse prevention programs are widespread but are rarely evaluated in Europe . We aim ed to evaluate the effect of a new school-based prevention program against substance use on the frequency of alcohol consumption and alcohol-related problem behaviors among European students . METHODS During the school year 2004 - 2005 , a total of 7,079 students aged 12 - 14 years from 143 schools in seven European countries participated in this cluster r and omized controlled trial . Schools were r and omly assigned to either control ( 65 schools , 3,532 students ) or to a 12-session st and ardized program based on the comprehensive social influence model ( 78 schools , 3,547 students ) . Alcohol use and frequency of alcohol-related problem behaviors were investigated through a self-completed anonymous question naire at baseline and 18 months thereafter . The association between intervention and changes in alcohol-related outcomes was expressed as odds ratio ( OR ) , estimated by multilevel regression model . RESULTS The preventive program was associated with a decreased risk of reporting alcohol-related problems ( OR = .78 , 95 % confidence intervals [ CI ] = .63-.98 ) , although this reduction was 
    Output:
    
In 14 of the 39 trials evaluating generic interventions , the program interventions demonstrated significantly greater reductions in alcohol use either through a main or subgroup effect .
Gender , baseline alcohol use , and ethnicity modified the effects of interventions .
This review identified studies that showed no effects of preventive interventions , as well as studies that demonstrated statistically significant effects .
There was no easily discernible pattern in characteristics that would distinguish trials with positive results from those with no effects .
Most commonly observed positive effects across programs were for drunkenness and binge drinking .
Current evidence suggests that certain generic psychosocial and developmental prevention programs can be effective and could be considered as policy and practice options .