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Abstract: Aims: In order to quantify the effectiveness of family interventions in reducing adolescent drinking, we conducted a meta-analysis of randomized controlled trials. Methods: We searched the Cochrane Database of Systematic Reviews, ERIC (Educational Research Information Center), Medline and PsycInfo for studies published between 1995 and September 2006. Summary estimates (OR and Cohen''s d) were derived from the difference in changed alcohol consumption between family intervention and control group. Random effect models were used to estimate the overall effect and heterogeneity among studies. Eighteen papers describing nine independent trials were eligible for inclusion in this meta-analysis. Results: The overall effect of family interventions in reducing alcohol initiation (OR: 0.71; 95% CI: 0.54, 0.94) and frequency of alcohol use (d: −0.25; 95% CI: −0.37, −0.12) show the success of these programs. There was heterogeneity between studies reporting on alcohol initiation (p-heterogeneity: <0.001; I 2: 78.6%). Yet, the most successful interventions continued to be effective in reducing alcohol initiation even at 48 months follow-up (pooled estimate (OR): 0.53; 95% CI: 0.38, 0.75). Conclusion: The results from this meta-analysis suggest that the overall effect of family interventions on adolescent alcohol use is small, yet consistent and effective even at 48 months. [Copyright &y& Elsevier]

Background: The COVID-19 pandemic disrupted access to treatment for substance use disorders (SUDs), while alcohol and cannabis retail sales increased. During the pandemic, we tested a tailored digital health solution, Woebot-SUDs (W-SUDs), for reducing substance misuse.Methods: In a randomized controlled trial, we compared W-SUDs for 8 weeks to a waitlist control. U.S. adults (N = 180) who screened positive for substance misuse (CAGE-AID>1) were enrolled June-August 2020. The primary outcome was the change in past-month substance use occasions from baseline to end-of-treatment (EOT). Study retention was 84%. General linear models tested group differences in baseline-to-EOT change scores, adjusting for baseline differences and attrition.Results: At baseline, the sample (age M = 40, SD = 12, 65% female, 68% non-Hispanic white) averaged 30.2 (SD = 18.6) substance occasions in the past month. Most (77%) reported alcohol problems, 28% cannabis, and 45% multiple substances; 46% reported moderate-to-severe depressive symptoms. Treatment participants averaged 920 in-app text messages (SD = 892, Median = 701); 96% of completed lessons were rated positively; and 88% would recommend W-SUDs. Relative to waitlist, W-SUDs participants significantly reduced past-month substance use occasions (M = -9.1, SE = 2.0 vs. M = -3.3, SE = 1.8; p = .039). Secondary substance use and mood outcomes did not change significantly by group; however, reductions in substance use occasions correlated significantly with increased confidence and fewer substance use problems, cravings, depression and anxiety symptoms, and pandemic-related mental health effects (p-value<.05).Conclusions: W-SUDs was associated with significant reductions in substance use occasions. Reduction in substance use occasions was associated with better outcomes, including improved mental health. W-SUDs satisfaction was high. [ABSTRACT FROM AUTHOR]