The goal of this group randomized trial was to test the effectiveness of an adapted alcohol-use preventive intervention for urban, low-income, and multi-ethnic settings.
A total of 51 public schools in Chicago were recruited to participate in this study. The schools were grouped into neighborhood study units and assigned randomly to intervention or 'delayed program' control condition. The study sample of 5,812 students was primarily African American, Hispanic, and from low-income families. Beginning in sixth grade (age 12 years), students received 3 years of intervention strategies (curricula, family interventions, youth-led community service projects, and community organizing). Students participated in yearly classroom-based surveys to measure their alcohol use and related risk and protective factors. Additional evaluation components included a parent survey, a community leader survey, and alcohol purchase attempts. Overall, the intervention compared with the control condition of 'prevention as usual', was not effective in reducing alcohol use, drug use, or any hypothesized mediating variables (i.e., related risk and protective factors). There was a non-significant trend (P = 0.066) that suggested the ability to purchase alcohol by youthful-appearing buyers was reduced in the intervention communities compared to the control communities, but this could be due to chance. Secondary outcome analyses that assessed the effects of each intervention component indicated that the home-based programs were associated with reduced alcohol, marijuana, and tobacco use combined (P = 0.01), with alcohol use alone approaching statistical significance (P = 0.06). Overall, the study results show the importance of conducting evaluations of previously validated programs in contexts that differ from the original study sample. Also, the findings highlight the need for further research with urban, low-income adolescents from different ethnic backgrounds to identify effective methods for preventing and reducing alcohol use. (publisher abstract modified)