{"title":"对预防或减少酒精和其他药物危害的综合性社区举措的审查进行系统审查。","authors":"Peter John Gates, Andrea C Zocco, Sara Farnbach","doi":"10.1111/add.70153","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and aims: </strong>Comprehensive community initiatives (CCI) aimed at reducing or preventing alcohol or other drug (AOD) harms incorporate multiple initiatives delivered to whole communities to effect community-level change on sociocultural and environmental factors. CCIs have gained in popularity and have been subject to extensive research; however, CCIs comprise multiple initiatives and evidence for effectiveness by substance type has been mixed. This umbrella review aimed to synthesise information from published reviews to describe the combination of CCIs with the most consistent evidence for impact for each substance type.</p><p><strong>Method: </strong>We searched Embase/Medline, PsycINFO, Cochrane Database of Systematic Reviews, two online registries and hand searched references for English language reviews without date restriction and conducted an umbrella review using mixed methods synthesis (PROSPERO CRD42023432567). We considered all types of reviews focused on CCIs and addressing AOD use or harms. Two reviewers independently screened all articles and conducted full text review. Extraction of main results relating to CCI impact and quality assessment using AMSTAR-2 and SANRA was completed by two independent reviewers and corrected covered area analysis conducted.</p><p><strong>Results: </strong>We identified 87 reviews spanning three decades; 14 were rated high quality. Most reviews considered individual substances [alcohol (43 reviews) or tobacco (35 reviews) and rarely illicit drugs (16 reviews)], and some limited scope to 'at-risk' community members [young people (26 reviews) and First Nations (8 reviews)]. Although the evidence did not meet criteria for consistent impact, communities should consider implementing school-based (supported by 36 of 50 reviews) and parenting-related (29 of 37 reviews) activities that are supported by media campaign where feasible (29 of 51 reviews). CCIs have the most consistent impact on alcohol (supported by 24 of 32 reviews) and tobacco-related outcomes (22 of 35 reviews), though illicit drugs are yet to be adequately assessed.</p><p><strong>Conclusions: </strong>Although the available evidence regarding comprehensive community initiatives is largely inconsistent, the addition of parenting-related activities to existing school-based education campaigns is likely to improve effectiveness. A media campaign may extend their reach to those outside school settings. Future evaluation of CCIs should measure impact of activities in isolation where possible and incorporate process measures to gauge community engagement and empowerment.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3000,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A systematic review of reviews on comprehensive community initiatives to prevent or reduce alcohol and other drug harms.\",\"authors\":\"Peter John Gates, Andrea C Zocco, Sara Farnbach\",\"doi\":\"10.1111/add.70153\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and aims: </strong>Comprehensive community initiatives (CCI) aimed at reducing or preventing alcohol or other drug (AOD) harms incorporate multiple initiatives delivered to whole communities to effect community-level change on sociocultural and environmental factors. CCIs have gained in popularity and have been subject to extensive research; however, CCIs comprise multiple initiatives and evidence for effectiveness by substance type has been mixed. This umbrella review aimed to synthesise information from published reviews to describe the combination of CCIs with the most consistent evidence for impact for each substance type.</p><p><strong>Method: </strong>We searched Embase/Medline, PsycINFO, Cochrane Database of Systematic Reviews, two online registries and hand searched references for English language reviews without date restriction and conducted an umbrella review using mixed methods synthesis (PROSPERO CRD42023432567). We considered all types of reviews focused on CCIs and addressing AOD use or harms. Two reviewers independently screened all articles and conducted full text review. Extraction of main results relating to CCI impact and quality assessment using AMSTAR-2 and SANRA was completed by two independent reviewers and corrected covered area analysis conducted.</p><p><strong>Results: </strong>We identified 87 reviews spanning three decades; 14 were rated high quality. Most reviews considered individual substances [alcohol (43 reviews) or tobacco (35 reviews) and rarely illicit drugs (16 reviews)], and some limited scope to 'at-risk' community members [young people (26 reviews) and First Nations (8 reviews)]. Although the evidence did not meet criteria for consistent impact, communities should consider implementing school-based (supported by 36 of 50 reviews) and parenting-related (29 of 37 reviews) activities that are supported by media campaign where feasible (29 of 51 reviews). CCIs have the most consistent impact on alcohol (supported by 24 of 32 reviews) and tobacco-related outcomes (22 of 35 reviews), though illicit drugs are yet to be adequately assessed.</p><p><strong>Conclusions: </strong>Although the available evidence regarding comprehensive community initiatives is largely inconsistent, the addition of parenting-related activities to existing school-based education campaigns is likely to improve effectiveness. A media campaign may extend their reach to those outside school settings. Future evaluation of CCIs should measure impact of activities in isolation where possible and incorporate process measures to gauge community engagement and empowerment.</p>\",\"PeriodicalId\":109,\"journal\":{\"name\":\"Addiction\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.3000,\"publicationDate\":\"2025-07-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Addiction\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/add.70153\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Addiction","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/add.70153","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
A systematic review of reviews on comprehensive community initiatives to prevent or reduce alcohol and other drug harms.
Background and aims: Comprehensive community initiatives (CCI) aimed at reducing or preventing alcohol or other drug (AOD) harms incorporate multiple initiatives delivered to whole communities to effect community-level change on sociocultural and environmental factors. CCIs have gained in popularity and have been subject to extensive research; however, CCIs comprise multiple initiatives and evidence for effectiveness by substance type has been mixed. This umbrella review aimed to synthesise information from published reviews to describe the combination of CCIs with the most consistent evidence for impact for each substance type.
Method: We searched Embase/Medline, PsycINFO, Cochrane Database of Systematic Reviews, two online registries and hand searched references for English language reviews without date restriction and conducted an umbrella review using mixed methods synthesis (PROSPERO CRD42023432567). We considered all types of reviews focused on CCIs and addressing AOD use or harms. Two reviewers independently screened all articles and conducted full text review. Extraction of main results relating to CCI impact and quality assessment using AMSTAR-2 and SANRA was completed by two independent reviewers and corrected covered area analysis conducted.
Results: We identified 87 reviews spanning three decades; 14 were rated high quality. Most reviews considered individual substances [alcohol (43 reviews) or tobacco (35 reviews) and rarely illicit drugs (16 reviews)], and some limited scope to 'at-risk' community members [young people (26 reviews) and First Nations (8 reviews)]. Although the evidence did not meet criteria for consistent impact, communities should consider implementing school-based (supported by 36 of 50 reviews) and parenting-related (29 of 37 reviews) activities that are supported by media campaign where feasible (29 of 51 reviews). CCIs have the most consistent impact on alcohol (supported by 24 of 32 reviews) and tobacco-related outcomes (22 of 35 reviews), though illicit drugs are yet to be adequately assessed.
Conclusions: Although the available evidence regarding comprehensive community initiatives is largely inconsistent, the addition of parenting-related activities to existing school-based education campaigns is likely to improve effectiveness. A media campaign may extend their reach to those outside school settings. Future evaluation of CCIs should measure impact of activities in isolation where possible and incorporate process measures to gauge community engagement and empowerment.
期刊介绍：
Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines.
Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries.
Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.
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