Clarifying Brief Interventions for Hazardous and Harmful Alcohol Use by Youth: A Realist Review

Alcohol misuse among Canadian youth is a significant public health problem. Alcohol dependence is more common among young adults (aged 18 to 24 years) than in all other age groups. Helping youth before alcohol dependence occurs is thus important. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a widely suggested approach to reducing alcohol misuse. With SBIRT, individuals are assessed by health care professionals to detect alcohol misuse. A brief intervention (BI), which involves 1 or 2 contacts, is given to individuals who are misusing alcohol, but who do not need immediate treatment. Many studies have found that BIs work well to reduce alcohol misuse by young adults, but we still need to study how well BIs work with youth under the age of 18. Existing studies with younger youth are difficult to compare because researchers have used different BIs, different ways to measure alcohol misuse, different levels of alcohol misuse in study participants, and different settings for delivery of BIs. One strategy to understand how an intervention works is to carry out a realist review, asking what works and why it works in a particular situation. Our team of will conduct a realist review to begin to explain 1) how and why BIs are effective or not effective with youth under the age of 18, 2) which parts of BI treatment are likely to have the greatest impact, and 3) which types of youth may be best treated with different BI approaches.