Importance Substance abuse preventive interventions frequently target middle school students and demonstrate efficacy to prevent early onset and use of alcohol and illicit drugs. However, evidence of sustained results to prevent later patterns of alcohol misuse and more serious alcohol abuse disorders has been lacking, particularly for US Latino populations.

Objective To test whether a universal middle school prevention program can reduce the frequency of alcohol misuse and rates of alcohol use disorder 5 years after implementation with a Mexican American sample.

Design, Setting, and Participants A previous randomized clinical trial was conducted with 516 Mexican American 7th graders and at least 1 parent who identified as having Mexican origin. Three annual cohorts of families were recruited from rosters of 4 middle schools and randomized to the 9-session Bridges/Puentes family-focused group intervention or a workshop control condition. Recruitment, screening, pretest, and randomization occurred in the same academic year for each cohort: 2003-2004, 2004-2005, and 2005-2006. Data acquisition for the follow-up assessments of late-adolescent alcohol misuse and abuse, which were not included in the initial randomized clinical trial, was conducted from September 2009 to September 2014; analysis was conducted between August 2016 and July 2017. In this assessment, 420 children (81.4%) of the sample were included, when the majority were in their final year of high school.

Interventions The 9-session Bridges/Puentes intervention integrated youth, parent, and family intervention sessions that were delivered in the spring semester at each school, with separate groups for English-dominant vs Spanish-dominant families. The control workshop was offered during the same semester at each school, also in English and Spanish.

Main Outcomes and Measures Primary outcomes were diagnostic assessment of lifetime alcohol use disorder in the 12th grade, 5 years after the intervention, based on the Diagnostic Interview Schedule for Children and past-year frequency of alcohol use, binge drinking, and drunkenness based on the 2001 Youth Risk Behavior Survey.

Results Of the 420 participants, 215 (51.2%) were girls (mean [SD] age, 17.9 [0.62] years). The intervention reduced the likelihood of having an alcohol use disorder (β = −.93; SE, 0.47; P = .047; odds ratio, 0.39). Intervention associations with past-year alcohol use frequency, binge drinking, and drunkenness were moderated by baseline substance use. The intervention reduced the frequency of alcohol use (β = −.51; SE, 0.24; P = .04; Cohen d = 0.43) and drunkenness (β = −.51; SE, 0.26; P = .049; Cohen d = 0.41) among youth who reported any previous substance use at baseline (T1 initiators) but not among those who had not initiated any substance use (T1 abstainers) at baseline. For past-year binge drinking, the intervention finding did not reach statistical significance among T1 initiators (β = −.40; SE, 0.23; P = .09) or T1 abstainers (β = .23; SE, 0.14; P = .11).

Conclusions and Relevance Study results support an association between a universal middle school intervention and alcohol misuse and alcohol use disorders among Mexican American high school students and implementation of universal middle school interventions to reach Latino communities.

重要性 预防药物滥用的干预措施经常针对中学生，并显示出预防早期发作和使用酒精和非法药物的功效。但是，一直缺乏持续的结果来防止以后的酒精滥用和更严重的酒精滥用疾病的证据，特别是对于美国拉丁裔人群。

目的 测试一项采用墨西哥裔美国人样本的通用中学预防计划是否可以在实施后5年内减少酒精滥用的频率和酒精使用障碍的发生率。

设计，设置和参与者 先前的随机临床试验是由516名墨西哥裔美国7年级学生和至少1名被确认具有墨西哥血统的父母进行的。从4所中学的花名册中招募了3个年度家庭，并将他们随机分为9堂，以Bridges / Puentes家庭为中心的小组干预或车间控制条件。每个队列的招募，筛选，预测试和随机化发生在同一学年：2003-2004、2004-2005和2005-2006。2009年9月至2014年9月进行了数据收集，用于后续青少年青春期滥用和滥用的评估，该评估未包括在初始随机临床试验中。分析于2016年8月至2017年7月进行。在这项评估中，样本中包括420名儿童（占81.4％），

干预措施 Bridge / Puentes的9个阶段的干预措施整合了每学年春季学期在每所学校举办的青年，家长和家庭干预措施，分为英语为主的家庭和西班牙为主的家庭的不同小组。在每所学校的同一学期都提供了控制讲习班，也有英语和西班牙语。

主要结果和措施 主要结果是干预后5年，对12年级终生饮酒障碍进行诊断性评估，其依据是《儿童诊断访谈时间表》以及根据过去一年的饮酒，暴饮和醉酒频率。 2001年青年风险行为调查。

结果 在420名参与者中，有215名（51.2％）是女孩（平均[SD]年龄，为17.9 [0.62]岁）。干预减少了饮酒障碍的可能性（β= -.93； SE为0.47；P  = .047；优势比为0.39）。过去一年的饮酒频率，暴饮暴食和醉酒的干预协会通过基线药物使用来缓解。干预减少了饮酒的频率（β= -.51; SE，0.24; P  = .04; Cohen d  = 0.43）和醉酒（β= -.51; SE，0.26; P  = .049; Cohen d = 0.41）在报告过基线之前曾使用过任何药物的年轻人中（T1引发者），但在基线时未曾进行过任何药物使用的青年中（T1戒酒者）则没有。对于过去一年的暴饮暴食，在T1发起者（β= -.40; SE，0.23; P  = .09）或T1弃权者（β= .23; SE，0.14; P  =。 11）。

结论和相关性 研究结果支持了墨西哥裔美国高中学生的普遍中学干预与酗酒和滥用酒精行为之间的关联，以及普及普通中学干预措施达到拉丁裔社区之间的关联。