Comprehensive community-based programmes targeting high-risk youth

Comprehensive approaches involving community and school, were found effective in a systematic review (Jones et al., 2006, 222 studies - 14 systematic reviews; 103 RCTs; 52 Controlled non-randomized studies; 18 CBA; 35 BA) at preventing/delaying/reducing:

• all substances when compared with community-only programmes and school-community programmes targeting high-risk youth (SMD = 0.38 and 0.36 respectively), and in high-risk individuals when compared with low-risk individuals (SMD = 0.42 and 0.08);
• tobacco when compared with community-only programmes and school-community programmes targeting high-risk youth (SMD = 0.46 and 0.48), and in high-risk individuals when compared with low-risk individuals (SMD = 0.49 and 0.03);
• alcohol when compared with community-only programmes and school-community programmes targeting high-risk youth (SMD = 0.49 and 0.49), and in high-risk individuals when compared with low-risk individuals (SMD = 0.56 and 0.05);
• cannabis when compared with community-only programmes and school-community programmes targeting high-risk youth (SMD = 0.82 and 0.79), and in high-risk individuals when compared with low-risk individuals (SMD = 0.84 and 0.22);
• all illicit drugs when compared with community-only programmes and school-community programmes targeting high-risk youth (SMD = 0.56 and 0.54), and in high-risk individuals when compared with low-risk individuals (SMD = 0.65 and 0.05).

There was no difference in effectiveness between ‘school-community’ programmes and ‘community-only’ programmes. Moreover, low risk population effect sizes were significantly greater across all types of interventions (‘comprehensive’, ‘school-community’, ‘community-only’) for tobacco (SMD = 0.05, SMD = 0.13); and cannabis (SMD = 0.04, SMD = 0.10). No other significant differences were reported.