Activity 2: Systemic review of prevention practices

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In this activity, we review three Cochrane systematic reviews by Foxcroft and Tsertsvadze (2011). Alexander Tsertsvadze is a Canadian researcher working in Ottawa. These three reviews evaluate the effectiveness of universal approaches to substance use by considering (1 school-based, (2 family-based, and (3 multi-component prevention programs.

Although the full documents are huge, the purpose of including them here is to look at how they are constructed and focus on the main findings of the studies (the background through to the authors’ conclusions, which usually are covered in the first 15 pages or so of each review).

The reasons for considering these three systematic reviews are: 1) Systematic reviews are the highest level of evidence for informing practice decisions, 2) Systematic reviews are actual experiments with defined methodologies that authors must follow if they hope to derive scientifically valid (low bias) results, 3) If you become familiar with their methodology, you will be able to distinguish systematic reviews from non-systematic reviews (which are of much lower validity), and 4) These reviews provide excellent updates on the state of universal prevention.

Since the Cochrane Systematic Reviews are often huge (more than 100 pages), most clinicians don’t have the time to read them and are not interested in reviewing the breakdown of each study considered in the review. For these people, summary documents are produced (i.e., like Coles Notes). Foxcroft and Tsertsvadze (2012) provide a synopsis of all three of their larger 2011 articles. So scan the systematic reviews to gain a greater perspective on the methods used in their construction, and peruse the synopses to gain some condensed knowledge and direction. Additionally, Lipp (2011) provides a review of the Foxcroft and Tsertsvadze (2011) school-based systematic review.

You may or may not be shocked by what these reviews conclude. Similar to the review of treatment programs, also pay attention to what hasn’t shown effectiveness. Also, turn your focus to programs that traditionally have been associated with prevention, such as education programs and scare tactics. Does the evidence suggest that these programs are effective?


  1. Read the following:
  2. This is a great deal of often complex information to synthesize. From each summary, try and write out two or three key points that you want to remember, and would be important if you were working or advocating for a prevention program. Pay attention to conceptual points, rather than specific detail. For example, are educational program and scare tactics effective or ineffective? How about social influence programs or competency enhancement skill training programs—are they effective or ineffective?
  3. How do the programs your agency or communities provide measure up to the evidence-based programs?