2023 · Study · English

Contextual effects of community capacity as a predictor for adolescent alcohol, tobacco, and illicit drug use: A multi-level analysis

Birgel, V., Röding, D., Reder, M., Soellner, R., & Walter, U.

Birgel, V., Röding, D., Reder, M., Soellner, R., & Walter, U. (2023). Contextual effects of community capacity as a predictor for adolescent alcohol, tobacco, and illicit drug use: A multi-level analysis. SSM - Population Health, 24, 101521. doi.org/10.1016/j.ssmph.2023.101521

Summary

Cross-sectional multilevel analysis of baseline data from the German CTC-EFF trial, linking community capacity for prevention to the four-week prevalence of adolescent substance use. In 28 communities, 7,210 pupils in grades 5 to 11 reported tobacco, alcohol and other-drug use and binge drinking, and 158 local key informants rated ten capacity domains (commitment, knowledge and skills, resources, leadership, inclusiveness, prevention collaboration, sectoral collaboration, cohesion, problem-solving and needs orientation), which were also combined into a total score. Higher total capacity was associated with lower odds of any substance use (OR 0.28; 95% CI 0.12–0.56), alcohol use (OR 0.30) and tobacco use (OR 0.09); for binge drinking and illicit drug use the associations were not significant. Community size was unrelated to any outcome, and community type mattered only for binge drinking. Being cross-sectional, the study cannot establish causation, but it supports the premise of capacity-building systems such as CTC that stronger local prevention structures go with less youth substance use.