Background Interventions aimed at preventing risky behaviour in adolescence and young adulthood have largely focused on single risk behaviours and a limited number of underlying predictors. Interventions that take a broader approach to reducing risk behaviour may more effectively and efficiently reduce multiple risk behaviours.
Methods We performed a systematic review to identify experimental studies of interventions to reduce risk behaviour in adolescents or young adults and that reported on any substance (alcohol, tobacco and illicit drug) use and sexual risk behaviour outcomes.
Results From 1129 articles, 18 experimental studies met our inclusion criteria, which were heterogeneous in nature and design. Study results were mixed, with programmes generally impacting on some outcome measures, but not others. The most promising interventions addressed multiple domains (individual and peer, family, school and community) of risk and protective factors for risk behaviour. There was some evidence that intervening in the early- to mid childhood school years has a high impact on later risk behaviour.
Conclusions We found few studies that demonstrated a consistent, significant and sustained impact on risk behaviours. However, there is some evidence that programmes can have a long-term impact on multiple risk behaviours, with the most promising interventions addressing multiple domains of risk and protective factors. Complex interventions therefore need to be developed in the context of effective cross-sector engagement and collaboration. Furthermore, the current focus on investing in pre-school “early years” programmes should be extended to include the early- to mid-childhood school years.