A Systematic Review of Parent-Based Interventions for Adolescent Alcohol Use

Purpose: This study examines the effects of parent-based interventions for preventing or reducing adolescent alcohol use. We also aim to explore how participants’ characteristics (e.g., age, gender, baseline level of alcohol use, etc.) and intervention characteristics (e.g., the main component, duration, delivery mode, etc.) would affect effects of the interventions.

Background: Alcohol use is one of the most common health risk behaviors among adolescents and young adults. Early initiation and excessive alcohol use are associated with increased risk of serious health consequences. Parent-based interventions have unique merits compared to interventions directly provided to adolescents due to their results of sustaining exposure to positive parenting behaviors. Existing reviews on family-based interventions always included multicomponent treatment rather than standalone parent treatment (i.e., parent interventions that do not have separate adolescent component), and focused on overall treatment effects only. It is unclear whether standalone parent-based interventions are effective and whether the treatment effects vary across different groups of the target population and/or different modes of intervention. Thus, it is warranted to conduct a systematic review and meta-analysis to further unveil the effects of parent-based interventions on alcohol use and potential moderators of the effects.

Methods: We searched the Cochrane Central Register of Controlled Trials, MEDLINE (PubMed), PsycINFO (Ovid), Embase, CINAHL, SocINDEX, Social Services Abstracts, Sociological Abstracts, Web of Science, and ClinicalTrials.gov for eligible studies published before March 2017. We reviewed randomized controlled trials investigating the efficacy or effectiveness of parent-based interventions for alcohol use outcomes (i.e., drinking frequency, binge drinking, lifetime alcohol use, future drinking intentions) among adolescent up to 18 years old. Two reviewers independently conducted screening, data extraction, and risk of bias assessment. The results are narratively summarized in this abstract. The effect sizes will be synthesized by using mixed-effects model. The relationship between the intervention effects and the characteristics of participants and intervention will be examined by meta-regression analysis.     

Results: A comprehensive search yielded 1948 records among which 24 studies fulfilled the inclusion criteria. Fourteen out of the 24 studies found short and/or long-term significant effect in at least one of the drinking outcomes: six out of 10 studies reporting drinking frequency found significant effect favoring the intervention group (60%); three out of eight studies found significant effect in reducing binge drinking frequency relative to the control conditions (38%); three out of 11 studies found significant effect in reducing lifetime alcohol use (27%); three out of six studies found significant effect in lowering future intentions to alcohol use (50%); and one out of three studies using alcohol use composite index found significant effect favoring the intervention group (33%). Home-based interventions with self-guide materials are more likely to find significant effects than parent sessions led by clinicians.

Conclusions and Implications: This systematic review found some evidence of parent-based interventions in preventing or reducing adolescent alcohol use. Interventions in this field are recommended to include parental component. Future reviews examining the effects of standalone parent-based interventions versus combined parent-adolescent interventions are needed.