Effective Parenting Interventions to Reduce Youth Substance Use: A Systematic Review

Abstract

Context: Parenting interventions may prevent adolescent substance use; however, questions remain regarding the effectiveness of interventions across substances and delivery qualities contributing to successful intervention outcomes.

Objective: To describe the effectiveness of parent-focused interventions in reducing or preventing adolescent tobacco, alcohol, and illicit substance use and to identify optimal intervention targeted participants, dosage, settings, and delivery methods.

Data sources: PubMed, PsycINFO, ERIC, and CINAHL.

Study selection: Randomized controlled trials reporting adolescent substance use outcomes, focusing on imparting parenting knowledge, skills, practices, or behaviors.

Data extraction: Trained researchers extracted data from each article using a standardized, prepiloted form. Because of study heterogeneity, a qualitative technique known as harvest plots was used to summarize findings.

Results: A total of 42 studies represented by 66 articles met inclusion criteria. Results indicate that parenting interventions are effective at preventing and decreasing adolescent tobacco, alcohol, and illicit substance use over the short and long term. The majority of effective interventions required ≤12 contact hours and were implemented through in-person sessions including parents and youth. Evidence for computer-based delivery was strong only for alcohol use prevention. Few interventions were delivered outside of school or home settings.

Limitations: Overall risk of bias is high.

Conclusions: This review suggests that relatively low-intensity group parenting interventions are effective at reducing or preventing adolescent substance use and that protection may persist for multiple years. There is a need for additional evidence in clinical and other community settings using an expanded set of delivery methods.

FIGURE 1

Study flow diagram. From Moher D, Liberati A, Tetzlaff J, Altman DG; The PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. Ann Intern Med. 2009;151(4):264–269.

FIGURE 2

Tobacco, alcohol, and illicit substance use, initiation, and intention outcomes according to length of participant follow-up. Black, substance use; gray, substance use initiation; white, substance use intention. Taller columns represent studies with lower risk of bias. Numbers indicate study ID. X_score, number of studies needed to be null (NNN).

FIGURE 3

Tobacco use at the longest follow-up time according to dose of intervention, setting, primary delivery method, and program duration. White columns, ≤12 months of follow-up; dotted columns, 12.1–24 months of follow-up; horizontal stripe columns, 24.1–48 months of follow-up; black, >48 months of follow-up. Taller columns represent studies with lower risk of bias. Numbers indicate study ID. X_score, number of studies needed to be null (NNN).

FIGURE 4

Alcohol use at the longest follow-up time according to dose of intervention, setting, primary delivery method, and program duration. White columns, ≤12 months of follow-up; dotted columns, 12.1–24 months of follow-up; horizontal stripe columns, 24.1–48 months of follow-up; black columns, >48 months of follow-up. Taller columns represent studies with lower risk of bias. Numbers indicate study ID. X_score, number of studies needed to be null (NNN).

FIGURE 5

Illicit substance use at the longest follow-up time according to dose of intervention, setting, primary delivery method, and program duration. White columns, ≤12 months of follow-up; dotted columns, 12.1–24 months of follow-up; horizontal stripes, 24.1–48 months of follow-up; black columns, >48 months of follow-up. Taller columns represent studies with lower risk of bias. Numbers indicate study ID. X_score, number of studies needed to be null (NNN).