Preventing heavy alcohol use in adolescents (PAS): cluster randomized trial of a parent and student intervention offered separately and simultaneously

Aims   To evaluate the effectiveness of two preventive interventions to reduce heavy drinking in first- and second-year high school students.
Design and setting   Cluster randomized controlled trial using four conditions for comparing two active interventions with a control group from 152 classes of 19 high schools in the Netherlands.
Participants   A total of 3490 first-year high school students (mean 12.68 years, SD = 0.51) and their parents.
Intervention conditions   (i) Parent intervention (modelled on the Swedish Örebro Prevention Program) aimed at encouraging parental rule-setting concerning their children's alcohol consumption; (ii) student intervention consisting of four digital lessons based on the principles of the theory of planned behaviour and social cognitive theory; (iii) interventions 1 and 2 combined; and (iv) the regular curriculum as control condition.
Main outcome measures   Incidence of (heavy) weekly alcohol use and frequency of monthly drinking at 10 and 22 months after baseline measurement.
Findings   A total of 2937 students were eligible for analyses in this study. At first follow-up, only the combined student–parent intervention showed substantial and statistically significant effects on heavy weekly drinking, weekly drinking and frequency of drinking. At second follow-up these results were replicated, except for the effects of the combined intervention on heavy weekly drinking. These findings were consistent across intention-to-treat and completers-only analyses.
Conclusions   Results suggest that adolescents as well as their parents should be targeted in order to delay the onset of drinking, preferably prior to onset of weekly drinking.