Screening and Brief Alcohol Interventions for Adolescents and Young Adults: What Works, Why and Why Not?

This Scientific Dialogue session brings together researchers from varied perspectives in intervention design and methodology, translation of neuroscience to prevention research, and implementation science.  Earlier age of onset of alcohol use is associated with increased risk of alcohol use disorders, and consequences including death, intentional and unintentional injury.  Screening and brief interventions are a promising approach for addressing heavy episodic alcohol consumption among adolescents and young adults. A large body of high-quality primary research on this topic has accumulated over the past decade, and several recent meta-analyses have quantitatively synthesized findings regarding their efficacy, reach to other drugs, and variability in effectiveness. While the efficacy of SBI is documented, aggregate effect sizes are modest and many effects weaken over time.  Even the most efficacious interventions do not benefit all recipients.  Several demographic and behavioral factors are associated with a lack of response to brief interventions (e.g., gender, permissive peer norms, strong alcohol-embedded beliefs/cultures, etc.).  Boosters may enhance duration of effects; however, their efficacy varies by target population and considerations of timing, content, and delivery modality are necessary.  Explicating individual differences in intervention response via a transdisciplinary research approach is essential for tailoring effective programs that can prevent or attenuate alcohol misuse. This approach requires that, for any given intervention, we consider individual-level moderators/mediators of treatment response, investigate interacting neurodevelopmental and social-contextual mechanisms that may be prerequisite to a favorable intervention response (e.g., ability to inhibit inappropriate behavioral responses, regulating emotions, engaging in positive social behavior, developing healthy relationships).  Clearly, refinement of intervention methods is needed for greater magnitude of intervention effects and sustainability to inform implementation practices.  In this Roundtable session the panelists and audience will discuss the role of moderators/mediators to optimize SBI intervention efficacy and sustainability, mechanisms underlying differential response and the importance of considering interacting neurodevelopmental and social-contextual mechanisms that may mediate outcomes, readiness for translation given the modest overall effects of SBIs, and the inclination for precision-based or personalized prevention approaches to implementation and scale-up to realize public health benefits.