Sustained Prevention of Substance Use in Rural and Tribal Youth: Post High School Results From a Cluster Randomized Trial.

PURPOSE: Connect, a universal preventive intervention, effectively reduced substance use by the end of high school. The aim of this study is to examine substance use 6 months post high school graduation.

METHODS

Online survey of young adults (n = 410) who participated in a 2-arm cluster randomized trial from 2021 to 2024, with 10 high schools per condition on or near the Cherokee Nation Reservation.

RESULTS

We found statistically significantly lower odds of alcohol use (odds ratio [OR] = 0.48; 95% confidence interval [CI] = 0.29, 0.79; p = .004), binge drinking (OR = 0.52; 95% CI = 0.29, 0.94; p = .029), vaping cannabis (OR = 0.38; 95% CI = 0.17, 0.84; p = .016), and vaping nicotine (OR = 0.35; 95% CI = 0.17, 0.70; p = .003) in the past 30 days in the intervention condition as compared to the control condition at 6 months post high school graduation.

DISCUSSION: Connect sustained substance use reduction after high school.