Trial reportBMJ open2017
Effectiveness of a pragmatic school-based universal resilience intervention in reducing tobacco, alcohol and illicit substance use in a population of adolescents: cluster-randomised controlled trial.
Trial report in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Systematic Review and Meta-analysis of the Effectiveness of Whole-school Interventions Promoting Mental Health and Preventing Risk Behaviours in Adolescence.Journal of youth and adolescence · 2025Pooled it
- Strategies for enhancing the implementation of school-based policies or practices targeting diet, physical activity, obesity, tobacco or alcohol use.The Cochrane database of systematic reviews · 2024Pooled it
- Strategies for enhancing the implementation of school-based policies or practices targeting diet, physical activity, obesity, tobacco or alcohol use.The Cochrane database of systematic reviews · 2022Pooled it
- Assessing the Pragmatic Effectiveness and Implementation of Click City: Tobacco: A School-Based Prevention Program Targeting Youth Cigarette and E-cigarette Use.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2024Trial
- Trial
- Effectiveness of School-Based Integrated Mental Health and Substance Use Prevention Programs for Adolescents: A Systematic Review and Meta-Analysis.Behavioral sciences (Basel, Switzerland) · 2026Review
- Review of the Characteristics of School-Based Integrated Mental Health and Substance Use Prevention Programs for Adolescents Evaluated Through Clinical Trials Between 2016 and 2026.Children (Basel, Switzerland) · 2026Review
- School-Based Alcohol and Tobacco Prevention Strategies: A Scoping Review and the Missing Role of School Nurses.Children (Basel, Switzerland) · 2026Review
- A Scoping Review of School Connectedness Interventions for Adolescents.The Journal of school health · 2025Article
- Addressing student substance use in Canadian schools: an exploration of administrators' perspectives.Health promotion international · 2025Article
- Evidence and Gap Map of Whole-School Interventions Promoting Mental Health and Preventing Risk Behaviours in Adolescence: Programme Component Mapping Within the Health-Promoting Schools Framework: An evidence and gap map.Campbell systematic reviews · 2025Article
- Transforming stress program on medical students' stress mindset and coping strategies: a quasi-experimental study.BMC medical education · 2023Article
- Prevention of Alcohol Consumption Programs for Children and Youth: A Narrative and Critical Review of Recent Publications.Frontiers in psychology · 2022Review
- A scoping review of school-based indigenous substance use prevention in preteens (7-13 years).Substance abuse treatment, prevention, and policy · 2020Article
- Update on How School Environments, Social Networks, and Self-Concept Impact Risky Health Behaviors.Academic pediatrics · 2019Article
- The interRAI Suite of Mental Health Assessment Instruments: An Integrated System for the Continuum of Care.Frontiers in psychiatry · 2019Review
- Smoking, alcohol consumption, and illicit substances use among adolescents in Poland.Substance abuse treatment, prevention, and policy · 2018Article
- Association of Substance Use Pattern and Family Factors With Use-Related Problems According to Arabic Drug Abuse Screening Test-10: A Cross-Sectional Study.Substance use : research and treatmentArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesInitiation of tobacco, alcohol and illicit substance use typically occurs during adolescence, with the school setting recommended to reduce adolescent substance use. Strengthening individual (eg, problem solving) and environmental (eg, caring relationships at school) resilience protective factors of adolescents has been suggested as a strategy for reducing substance use by adolescents; however, few studies have examined this potential. A study was conducted to investigate the effectiveness of a pragmatic school-based universal 'resilience' intervention in reducing the prevalence of tobacco, alcohol and illicit substance use, and increasing the individual and environmental protective factors of students.
designA cluster-randomised controlled trial.
settingThirty-two Australian secondary schools (20 intervention; 12 control).
participantsCohort of grade 7 students followed-up in grade 10 (2014; aged 15-16 years).
interventionA pragmatic intervention involving school staff selection and implementation of available programmes and resources targeting individual and environmental 'resilience' protective factors for all grade 7-10 students was implemented in schools (2012-2014). School staff were provided implementation support. MEASUREMENTS: An online survey collected baseline and follow-up data for primary outcomes: tobacco (ever, recent) and alcohol (ever, recent, 'risk') use, and secondary outcomes: marijuana and other illicit substance use, and individual (six-factor subscales, aggregate) and environmental (three-factor subscales, aggregate) protective factor scores. Generalised and linear mixed models examined follow-up differences between groups.
resultsFollow-up data from 2105 students (intervention=1261; control=844; 69% of baseline cohort) were analysed. No significant differences were found between intervention and control students for any primary (ever tobacco: OR 1.25, 95% CI 0.92 to 1.68, p=0.14; recent tobacco: OR 1.39, 95% CI 0.84 to 2.31, p=0.19; recent ever alcohol: OR 1.11, 95% CI 0.83 to 1.48, p=0.46; alcohol: OR 1.13, 95% CI 0.78 to 1.62, p=0.51; 'risk' alcohol: OR 0.98, 95% CI 0.70 to 1.36, p=0.89) or secondary outcomes (marijuana: OR 1.12, 95% CI 0.74 to 1.68, p=0.57; other illicit substance: OR 1.19, 95% CI 0.67 to 2.10, p=0.54; individual protective factors: MD=0, 95% CI -0.07 to 0.06, p=0.89; environmental protective factors: MD: -0.02, 95% CI -0.09 to 0.06, p=0.65).
conclusionsThe universally implemented pragmatic school-based intervention was not effective in reducing the prevalence of tobacco, alcohol or illicit substance use, or in increasing the protective factors of students.
trial registrationAustralia and New Zealand Clinical Trials Register reference: ACTRN12611000606987.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.