Scaling up access to personality-targeted interventions for youth at risk of substance use disorders in Canada: A hybrid effectiveness/ implementation-facilitation trial.

Despite having made great strides in reducing adolescent binge-drinking rates, illicit substance use remains a significant problem for many Canadian youth. There is also an emerging crisis of prescription drug misuse and related overdose deaths in North America. Targeted brief cognitive-behavioural interventions delivered in schools to adolescents with personality-risk factors for substance use disorders (e.g., impulsivity, sensation seeking, hopelessness), have been shown to be effective in reducing and preventing the uptake of illicit substances and binge drinking by 30%-80%. We now propose a randomised trial of brief, school-based, personality-targeted interventions when implemented more broadly across communities in Canada. The proposed hybrid trial will test effectiveness of the intervention on cannabis use and other illicit substances in high risk adolescents, with prescription drug use outcomes as a new outcome. This trial will also evaluate quality of programme implementation. Local expert trainers based at a different sites across Canada will assist in recruiting 9 schools each, to be randomised to one of three intervention conditions: treatment as usual (TAU); standard Preventure training (PT); or Preventure training with an implementation facilitation package (PT+IF). Local expert trainers will train high school staff to deliver personality-targeted interventions to high-risk students and will then follow-up students every one and two years later on drug misuse outcomes. We anticipante a 30-80% réduction in rates of illicit substance use and misuse in high risk youth attending schools that delivered the programme. This study will also identify factors that faciliate high quality implementation of school-based interventions and their longer-term sustainability.