For Whom Do Parenting Interventions to Prevent Adolescent Substance Use Work?

INTRODUCTION: Adolescent substance use continues to be a significant public health problem. Parent training interventions are effective preventive strategies to reduce youth substance use. However, little is known about differences in effectiveness for youth across demographic characteristics. This review assessed the effectiveness of parent training programs at reducing adolescent substance use by participant gender, age, and race/ethnicity.

METHODS: Pubmed/MEDLINE, ERIC, CINAHL, and PsycINFO databases were searched from database origin to October 31, 2016. We included randomized controlled trials that evaluated parent training interventions; reported youth initiation or use of tobacco, alcohol, or other illicit substances; and included adolescents aged 10 to 19. Two independent reviewers extracted data. Disagreements were resolved by consensus or a third researcher. Data were synthesized using harvest plots stratified by participant demographics. In these plots, each intervention is represented by a vertical bar, and the properties of the bar represent characteristics of the study (efficacy/effectiveness, risk of bias, length of follow-up). This qualitative method of data synthesis is particularly useful for “complex interventions” as it allows examining the distribution of the findings in the literature that otherwise is difficult to rate in a narrative synthesis. In addition, likelihood of obtaining observed distributions were calculated using binomial tests of proportions for each plot.

RESULTS: A total of 1,806 publications were identified and reviewed; 38 unique studies were included. Risk of bias of included studies was high. No studies targeted male teens or youth in late adolescence. Few studies targeted Asian-American, Black/African-American, or Hispanic/Latino adolescents. No study focused in American Indians/Native Americans. Overall, interventions including male and female youth and youth in early adolescence (age 10 to 14 or in 5th to 8th grade) were more beneficial than interventions including female-only or both young and older adolescents. Programs tailored to specific racial/ethnic groups, as well as programs designed for youth from multiple races/ethnic groups were effective.

CONCLUSIONS: Current evidence supports the benefits of offering parenting guidance to all families with adolescent children, regardless of the gender, age, or race/ethnicity of the adolescent.