Primary Substance Use Prevention Programs for Children and Youth: A Systematic Review

Pediatrics. 2020 Sep;146(3):e20192747. doi: 10.1542/peds.2019-2747. Epub 2020 Aug 7.


Context: An updated synthesis of research on substance abuse prevention programs can promote enhanced uptake of programs with proven effectiveness, particularly when paired with information relevant to practitioners and policy makers.

Objective: To assess the strength of the scientific evidence for psychoactive substance abuse prevention programs for school-aged children and youth.

Data sources: A systematic review was conducted of studies published up until March 31, 2020.

Study selection: Articles on substance abuse prevention programs for school-aged children and youth were independently screened and included if they met eligibility criteria: (1) the program was designed for a general population of children and youth (ie, not designed for particular target groups), (2) the program was delivered to a general population, (3) the program only targeted children and youth, and (4) the study included a control group.

Data extraction: Two reviewers independently evaluated study quality and extracted outcome data.

Results: Ninety studies met eligibility criteria, representing 16 programs. Programs evaluated with the largest combined sample sizes were Drug Abuse Resistance Education, Project Adolescent Learning Experiences Resistance Training, Life Skills Training (LST), the Adolescent Alcohol Prevention Trial, and Project Choice.

Limitations: Given the heterogeneity of outcomes measured in the included studies, it was not possible to conduct a statistical meta-analysis of program effectiveness.

Conclusions: The most research has been conducted on the LST program. However, as with other programs included in this review, studies of LST effectiveness varied in quality. With this review, we provide an updated summary of evidence for primary prevention program effectiveness.

Publication types

  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Adolescent
  • Child
  • Humans
  • Primary Prevention / methods
  • Primary Prevention / standards*
  • Program Evaluation / methods
  • Program Evaluation / standards*
  • Substance-Related Disorders / diagnosis
  • Substance-Related Disorders / prevention & control*
  • Substance-Related Disorders / psychology