Selective prevention programs for substance and behavioral addictions in adolescents: a systematic review

Abstract

Justification: Selective prevention of substance use among adolescents and young people is a key strategy for reducing risks in vulnerable populations. However, there is a notable lack of systematization and scientific validation of the programs implemented in this field. The aim of this systematic review was to identify existing selective prevention programs, describe their main characteristics, and assess their effectiveness based on the available evidence. Method: A comprehensive search was conducted in scientific databases (Web of Science, PubMed/MEDLINE, Scopus, and Cochrane Library) and in best practice repositories (Xchange, EDDRA, Portal BBPP Adicciones), following PRISMA criteria and using the MMAT tool for methodological quality assessment. The review was registered in PROSPERO (CRD42024555838). Results: A total of 20 studies were included, analyzing 24 programs, of which only a portion showed robust evidence according to criteria adapted from the GRADE system. Preventure, Trampoline, ASSIST, and Project TND stood out for their theoretical foundations, methodological quality, and sustained positive outcomes. Nevertheless, significant limitations were identified: heterogeneity in study designs, limited evaluation in Southern European contexts, and a lack of gender perspective and cultural adaptation. Conclusions: The findings reveal a gap between practical implementation and empirical research, as many programs lack evaluation of their effectiveness through empirical studies. There is a pressing need to develop rigorously evaluated selective interventions, tailored to sociocultural contexts and aligned with clear quality standards.