This systematic review and meta-analysis aims to synthesize the efficacy of culturally sensitive prevention programs for substance use outcomes among U.S. adolescents of color (aged 11 to 18 years old) and explore whether the intervention effects vary by participant and intervention characteristics. Eight electronic databases and grey literature were searched for eligible randomized controlled trials through September 2022. Robust variance estimation in meta-regression was used to synthesize treatment effect size estimates and to conduct moderator analysis. After screening, 30 unique studies were included. The average treatment effect size across all substance use outcomes (including 221 effect sizes) was Hedges’s g = −0.20, 95% CI = [−0.24, −0.16]. The synthesized effect sizes were statistically significant across types of substances (alcohol, cigarette, marijuana, illicit and other drugs, and unspecified substance use), racial/ethnic groups (Hispanic, Black, and Native American), and different follow-ups (0–12 months, >12 months). Very few studies reported substance use consequences as outcomes and the synthesized effect size was non-significant. Meta-regression findings suggest that the intervention effects may vary based on the type of substance. This meta-analysis found supportive evidence of culturally sensitive prevention programs’ efficacy in preventing or reducing substance use among Black, Hispanic, and Native American adolescents. More substance use prevention efforts and evidence is needed for Asian American, Pacific Islander, and multiracial adolescents.

这项系统回顾和荟萃分析旨在综合文化敏感预防计划对美国有色人种青少年（11 至 18 岁）物质使用结果的功效，并探讨干预效果是否因参与者和干预特征而异。截至 2022 年 9 月，检索了八个电子数据库和灰色文献，寻找符合条件的随机对照试验。元回归中的稳健方差估计用于综合治疗效果大小估计并进行调节分析。筛选后，纳入了 30 项独特的研究。所有物质使用结果（包括 221 种效应大小）的平均治疗效应大小为 Hedges g = -0.20，95% CI = [-0.24，-0.16]。综合效应大小在物质类型（酒精、香烟、大麻、非法和其他药物以及未指明的物质使用）、种族/族裔群体（西班牙裔、黑人和美洲原住民）和不同的随访（0 –12 个月，>12 个月）。很少有研究报告物质使用后果作为结果，而且综合效应大小并不显着。元回归结果表明，干预效果可能因物质类型而异。这项荟萃分析发现了支持性证据，证明文化敏感的预防计划在预防或减少黑人、西班牙裔和美洲原住民青少年物质使用方面的功效。亚裔美国人、太平洋岛民和多种族青少年需要更多的药物滥用预防工作和证据。