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Background: Brief motivational interventions (BMIs) are one of the most effective individually focused alcohol intervention strategies for college students. Despite the central theoretical role of motivation for change in BMIs, it is unclear whether BMIs increase motivation to change drinking behavior. We conducted a two‐step meta‐analysis of individual participant data (IPD) to examine whether BMIs increase motivation for change. N = 5903;59% women, 72% White) from Project INTEGRATE. The BMIs included individually delivered motivational interviewing with personalized feedback (MI + PF), stand‐alone personalized feedback (PF), and group‐based motivational interviewing (GMI). Methods: We included 15 trials of BMI (N = 5903;59% women, 72% White) from Project INTEGRATE. The BMIs included individually‐delivered motivational interviewing with personalized feedback (MI + PF), stand‐alone personalized feedback (PF), and group‐based motivational interviewing (GMI). Different measures and responses used in the original trials were harmonized. Effect size estimates were derived from a model that adjusted for baseline motivation and demographic variables for each trial (step 1) and subsequently combined in a random‐effects meta‐analysis (step 2). Results: The overall intervention effect of BMIs on motivation for change was not statistically significant (standard mean difference [SMD]: 0.026, 95% CI: [−0.001, 0.053], p = 0.06, k = 19 comparisons). Of the three subtypes of BMIs, GMI, which tended to provide motivation‐targeted content, had a statistically significant intervention effect on motivation, compared with controls (SMD: 0.055, 95% CI: [0.007, 0.103], p = 0.025, k = 5). By contrast, there was no evidence that MI + PF (SMD = 0.04, 95% CI: [−0.02, 0.10], k = 6, p = 0.20) nor PF increased motivation (SMD = 0.005, 95% CI: [−0.028, 0.039], k = 8, p = 0.75), compared with controls. Post hoc meta‐regression analysis suggested that motivation sharply decreased each month within the first 3 months postintervention (b = −0.050, z = −2.80, p = 0.005 for k = 14). Conclusions: Although BMIs provide motivational content and normative feedback and are assumed to motivate behavior change, the results do not wholly support the hypothesis that BMIs improve motivation for change. Changing motivation is difficult to assess during and following interventions, but it is still a theoretically important clinical endpoint. Further, the evidence cautiously suggests that changing motivation may be achievable, especially if motivation‐targeted content components are provided. [ABSTRACT FROM AUTHOR]

Objective: Dually diagnosed adolescents are a high-risk population for experiencing suicidal thoughts and behavior. Given that research suggests risk factors for suicidal ideation and suicide attempts may be different, this study examined whether internalizing disorder severity, frequency of substance use, and the interaction between them differentiated adolescents who attempted suicide from those who ideated. Methods: Baseline data from 287 adolescents who received formal substance use disorder (SUD) treatment were used in this analysis. Major depressive disorder (MDD) and generalized anxiety disorder (GAD) severity as well as past-3 month use of alcohol, cannabis, and other illicit drugs were considered. The outcome of interest was a three-category measure of suicide risk: no reported suicidal ideation or attempts, suicidal ideation only, and suicide attempts. Results: Over half of the sample disclosed prior suicidal ideation (30.0%) or attempts (27.9%). Multinomial logistic regression models indicated more severe MDD and GAD symptomology differentiated ideators from non-suicidal adolescents, but internalizing disorder severity did not differ between ideators and attempters. Substance use frequency did not differ between suicide risk groups. MDD severity and frequency of alcohol use interacted to increase the risk of attempts, yet the effects were minimal. Instead, prior weapon violence victimization and sexual abuse were the largest differentiators between attempters and ideators. Conclusions: Findings suggest that internalizing disorder severity and prior traumatic experiences put adolescents with SUD histories at higher risk of suicidal thoughts and behaviors. Thus, integrating evidence-based suicide prevention and intervention efforts into SUD treatment is critical, particularly for dually diagnosed adolescents who meet these risk profiles. Psychotherapy and medication may help curtail the development of ideation by reducing symptoms of MDD and GAD, whereas adolescents with prior traumatic experiences may benefit from additional treatments shown to lower risk of suicide attempts. [ABSTRACT FROM AUTHOR]

Aims To illustrate a machine learning-based approach for identifying and investigating moderators of alcohol use intervention effects in aggregate-data meta-analysis. Methods We illustrated the machine learning technique of random forest modeling using data from an ongoing meta-analysis of brief substance use interventions implemented in general healthcare settings. A subset of 40 trials testing brief alcohol interventions (BAIs) was used; these trials provided 344 estimates of post-intervention effects on participants' alcohol use as well as data on 20 potential moderators of intervention effects. These candidate moderators included characteristics of trial methodology and implementation, intervention design and participant samples. Results The best-fitting random forest model identified 10 important moderators from the pool of 20 candidate moderators. Meta-regression utilizing the selected moderators found that inclusion of prescriptive advice in a BAI session significantly moderated BAI effects on alcohol use. Observed effects were also significantly moderated by several methodological characteristics of trials, including the type of comparison group used, the overall level of attrition and the strategy used to address missing data. In a meta-regression model that included all candidate moderators, fewer coefficients were found to be significant, indicating that the use of a preliminary data reduction technique to identify only important moderators for inclusion in final analyses may have yielded improved statistical power to detect moderation. Conclusions Machine learning methods can be valuable tools for clarifying the influence of trial, intervention and sample characteristics on alcohol use intervention effects, in particular when numerous candidate moderators are available. [ABSTRACT FROM AUTHOR]

• The prior attempt risk group reported significantly higher rates of interpersonal violence than the ideation only group. • Teacher support, peer interactions, and neighborhood social connection buffered the association between sexual abuse and prior attempts. • Neighborhood social connection buffered the association between physical abuse and prior suicide attempts. • Tailored efforts to enhance social connectedness in youth exposed to violence could be a promising secondary suicide prevention strategy. Exposure to interpersonal violence is associated with elevated suicide risk. Preventing suicide among high-risk adolescents is most often discussed from a clinical treatment perspective, resulting in a gap in research examining whether school and community connectedness can buffer the relationships between forms of interpersonal violence and suicide risk in clinical samples of adolescents. Baseline data from 294 adolescents who received substance use treatment were analyzed to help fill this gap in research. Adolescents in this sample were at greater risk for suicidal thoughts and behaviors given their histories of substance use disorders and high rates of interpersonal violence, with 57% reporting experiencing at least one form of abuse/violence. Independent variables included lifetime exposure to physical abuse, sexual abuse, and weapon violence; moderators included various measures of school and community connectedness. Multinomial logistic regression models were estimated to examine the main and interaction effects predicting a three-category measure of suicide risk: non-suicidal, suicidal ideation only, and prior suicide attempts. Sexual abuse survivors had the highest predicted probability of a prior suicide attempt when reporting lower levels of teacher support, school-based positive peer interactions, or neighborhood social connection, but at higher levels of these protective factors, their predicted probability was similar to those not exposed to sexual abuse. The same protective pattern was observed for physical abuse survivors with high neighborhood social connection. The buffering effects observed in this study identified dimensions of school and community social connectedness as protective factors for youth exposed to abuse. Although promoting social connectedness is often cited as a universal suicide prevention approach, tailored efforts to enhance connectedness within this population may also be a promising secondary prevention strategy. Thus, in addition to clinical treatment, more emphasis should be placed on systems-level approaches to reducing risk among youth most vulnerable to suicide. [ABSTRACT FROM AUTHOR]

Social control and procedural justice theories indicate that informal social control reduces problem behaviors. However, many schools have implemented formal control mechanisms such as school security measures. This study examines the association between school security measures (security personnel, metal detectors, and surveillance cameras) and students' perceptions of informal social control (relationships with teachers, other school adults, and the fairness and consistency of school rules). We used structural equation modeling to examine these relationships in a nationally representative sample of 6,547 secondary students surveyed as part of the School Crime Supplement to the National Crime Victimization Survey (M age = 14.94; 51% male, 60% White non-Hispanic, 14% Black non-Hispanic, 20% Hispanic). The results indicated that the presence of security personnel in schools was associated with poorer student relationships with teachers. Findings for the other school security measures were nonsignificant or inconsistent across models. Implications for theory and practice are discussed. [ABSTRACT FROM AUTHOR]

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Due to evidence linking education and development, funding has been invested in interventions relevant to getting youth into school and keeping them there. This article reports on a systematic review of impact studies of these school enrollment interventions. Reports were identified through electronic searches of bibliographic databases and other methods. To be eligible, studies (1) assessed impact on primary or secondary school enrollment outcomes; (2) used a rigorous design; (3) were conducted in a low- or middle-income nation; (4) included at least one quantifiable measure of enrollment or related outcomes; (5) were available before December 2009; and (6) included data on participants post-1990. A coding instrument extracted data on study characteristics from each report. Standardized mean difference effect sizes were computed for the first effect reported. The sample includes 73 evaluations. The average effect size was positive across all outcomes. However, the results varied. Studies that focused on building new schools and other infrastructure interventions reported the largest average effects. [ABSTRACT FROM PUBLISHER]

Collegiate Recovery Programs (CRPs) are campus-based support programs for substance use and recovery needs among college students. These CRPs utilize a variety of program activities and components aimed at promoting healthy development and sobriety while encouraging college retention among participants. Describe the types of activities and administrative structures used in CRPs, examine the characteristics of students involved in this sample, and explore changes in students' outcomes after they have enrolled in a CRP. This multi-site study collected de-identified data from six CRPs on participating students' sociodemographic characteristics, academic performance, substance use, and socioemotional well-being. One CRP administrator from each participating site completed a survey on CRP programming. Data were harmonized across sites and descriptively summarized. Participating CRPs had been in operation since 2007 to 2012. Five of the six sites provided individual-level student data for a total of 861 students (56% male, 89% White, 91% undergraduate). Student histories indicated the majority had received treatment for a substance use disorder (82%) or mental health concern (77%), 56% had criminal justice involvement, and the majority were in recovery less than five years. Student GPA improved in three of the four sites that provided student GPA data. CRPs collect diverse types of data on participating students, but more effort is needed to focus on systematic data collection. Findings from this study suggest that CRPs play an important role in providing needed services for this vulnerable population of college students. • Program level data were collected from six collegiate recovery programs (CRPs). • Five of these CRPs provided de-identified student data representing 861 students. • 82% of CRP students had received treatment for a substance use disorder and most were in recovery less than 5 years. • Student GPA improved in three of four CRPs. • Colleges and CRPs need to engage in systematic data collection. [ABSTRACT FROM AUTHOR]