***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: 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 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 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 OBJECTIVE To determine whether the addition of a parental monitoring intervention ( Informed Parents and Children Together [ ImPACT ] ) alone or with " boosters " could enhance ( either broaden or sustain or both ) the effect of a small group , face-to-face adolescent risk reduction intervention Focus on Kids ( FOK ) . METHODS A longitudinal , r and omized , community-based cohort study was conducted of 35 low-income , community-based , in-town setting s. A total of 817 black youths aged 12 to 16 years at baseline were studied . After completion of baseline measures , youths were r and omized to receive a face-to-face intervention alone ( FOK only ) , a face-to-face intervention and a parental monitoring intervention ( FOK plus ImPACT ) , or both of the above plus boosters ( FOK plus ImPACT plus boosters ) .  Risk and protective behaviors were assessed at 6 and 12 months after intervention . RESULTS At 6 months ' follow-up , youths in families that were assigned to FOK plus ImPACT reported significantly lower rates of sexual intercourse , sex without a condom , alcohol use , and cigarette use and marginally lower rates of " risky sexual behavior " compared with youths in families that were assigned to FOK only . At 12 months after intervention , rates of alcohol and marijuana use were significantly lower and cigarette use and overall risk intention were marginally lower among FOK plus ImPACT youths compared with FOK only youths . With regard to the boosters delivered at 7 and 10 months , 2 risk behaviors -- use of crack/cocaine and drug selling -- were significantly lower among the youths who were assigned to receive the additional boosters compared with youths without the boosters . The rates of the other risk behaviors and intentions did not differ significantly . CONCLUSIONS The results of this r and omized , controlled trial indicate that the inclusion of a parental monitoring intervention affords additional protection from involvement in adolescent risk behaviors 6 and 12 months later compared with the provision of an intervention that targets adolescents only . At the same time , the results of the present study do not provide sufficient evidence that booster sessions further improve targeted behaviors enough to include them in a combined parent and youth intervention Project Northl and is a r and omized community trial initially implemented in 24 school districts and communities in northeastern Minnesota , with goals of delaying onset and reducing adolescent alcohol use using community-wide , multiyear , multiple interventions . The study targets the Class of 1998 from the 6th to 12th grade s ( 1991 - 1998 ) . The early adolescent phase of Project Northl and has been completed , and reductions in the prevalence of alcohol use at the end of 8th grade were achieved . Phase II of Project Northl and , targeting 11th- and 12th- grade students , uses five major strategies : ( 1 ) direct action community organizing methods to encourage citizens to reduce underage access to alcohol , ( 2 ) youth development involving high school students in youth action teams , ( 3 ) print media to support community organizing and youth action initiatives and communicate healthy norms about underage drinking ( e.g. , providing alcohol to minors is unacceptable ) , ( 4 ) parent education and involvement , and ( 5 ) a classroom-based curriculum for 11th- grade students . This article describes the background , design , implementation , and process measures of the intervention strategies for Phase II of Project Northl and OBJECTIVE To provide a review of the evidence from 3 experimental trials of Project Towards No Drug Abuse ( TND ) , a senior-high-school-based drug abuse prevention program . METHODS Theoretical concepts , subjects , design s , hypotheses , findings , and conclusions of these trials are presented . A total of 2,468 high school youth from 42 schools in southern California were surveyed . RESULTS The Project TND curriculum shows reductions in the use of cigarettes , alcohol , marijuana , hard drugs , weapon carrying , and victimization . Most of these results were replicated across the 3 trials . CONCLUSION Project TND is an effective drug and violence prevention program for older teens , at least for one-year follow-up This study reports findings on a combined family and school-based competency-training intervention from an in-school assessment 2.5 years past baseline , as a follow-up to an earlier study of substance initiation . Increased rates of observed alcohol use and an additional wave of data allowed evaluation of regular alcohol use and weekly drunkenness , with both point-in-time and growth curve analyses . Thirty-six rural schools were r and omly assigned to ( a ) a combined family and school intervention condition , ( b ) a school-only condition , or ( c ) a control condition . The earlier significant outcome on a substance initiation index was replicated , and positive point-in-time results for weekly drunkenness were observed , but there were no statistically significant outcomes for regular alcohol use . Discussion focuses on factors relevant to the mix of significant longitudinal results within a consistent general pattern of positive intervention-control differences to test early  nutritional interventions  and prospect i ve observational cohorts . RCTs are generally accepted as method ologically the best approach for informing health policy . They can equalise unknown as well as known confounding factors and so can demonstrate causation ; they permit estimation of effect size and so can be used to assess likely A r and omized experimental test of the implementation feasibility and the efficacy of a culturally adapted Parent Management Training intervention was conducted with a sample of 73 Spanish-speaking Latino parents with middle-school-aged youth at risk for problem behaviors . Intervention feasibility was evaluated through weekly parent satisfaction ratings , intervention participation and attendance , and overall program satisfaction . Intervention effects were evaluated by examining changes in parenting and youth adjustment for the intervention and control groups between baseline and intervention termination approximately 5 months later . Findings provided strong evidence for the feasibility of delivering the intervention in a larger community context . The intervention produced benefits in both parenting outcomes ( i.e. , general parenting , skill encouragement , overall effective parenting ) and youth outcomes ( i.e. , aggression , externalizing , likelihood of smoking and use of alcohol , marijuana , and other drugs ) . Differential effects of the intervention were based on youth nativity status This study used Complier Average Causal Effect analysis ( CACE ; see G. Imbens & D. Rubin , 1997 ) to examine the impact of an adaptive approach to family intervention in the public schools on rates of substance use and antisocial behavior among students ages 11 - 17 . Students were r and omly assigned to a family-centered intervention ( N = 998 ) in 6th grade and offered a multilevel intervention that included ( a ) a universal classroom-based intervention , ( b ) the Family Check-Up ( selected ; T. J. Dishion & K. Kavanagh , 2003 ) , and ( c ) family management treatment ( indicated ) . All services were voluntary , and approximately 25 % of the families engaged in the selected and indicated levels . Participation in the Family Check-Up was predicted by 6th- grade teacher ratings of risk , youth reports of family conflict , and the absence of biological fathers from the youths ' primary home . Relative to r and omized matched controls , adolescents whose parents engaged in the Family Check-Up exhibited less growth in alcohol , tobacco , and marijuana use and problem behavior during ages 11 through 17 , along with decreased risk for substance use diagnoses and police records of arrests by age 18 This study evaluated the impact of two targeted family sessions focused on driving issues delivered within the context of the Raising Healthy Children project . The Raising Healthy Children project began in the fall of 1993 , drawing students in the 1st or 2nd grade s from 10 schools . Schools were assigned to an intervention or control condition , and the school-wide , family- and student-focused preventive intervention to address developmentally salient risk and protective factors was delivered during elementary and middle school . The family driving sessions were administered to families in the intervention condition prior to and after teenagers received their driver 's license . The first session consisted of a home visit with families design ed to help parents and their children improve decision-making skills concerning driving and to develop clear st and ards and expectations regarding driving-related behavior . A second session , at the time of licensure , was design ed to help parents and teens develop a written contract that stated family expectations , a plan for monitoring compliance with these expectations , and consequences for compliance or non-compliance . Consistent with the study 's group-r and omized design , intervention effects were assessed with multi-level logistic regression models in which students were grouped by their original school assignment . These models assessed specific effects of the driving sessions by adjusting 
    Output:
    
There is some evidence that multi-component interventions for alcohol misuse prevention in young people can be effective .
However , there is little evidence that interventions with multiple components are more effective than interventions with single components