DataSheet3_The Impact of Place-Based Approaches Addressing Mental Health and Substance Use Among Adolescents: A Systematic Review of the Literature.docx

ObjectivesWe systematically appraised peer reviewed evidence assessing the impact of “place-based approaches” (PBAs) – those requiring multi-sectoral action within localities to address complex health challenges – on mental health outcomes among adolescents.
MethodsWe searched six databases from inception to May 2023. We defined PBAs as at least two sectors (e.g., local government, health) working collaboratively within a locality. Studies reporting mental health and substance-use among young people (aged 10–24) were included. Two authors independently assessed study quality using MMAT. Heterogeneity in PBAs, study design and outcomes prevented meta-analysis; results were narratively synthesised.
ResultsThirty-three publications presented data from 22 PBA evaluations; 6 evaluations assessed mental health or wellbeing, 16 appraised substance use. Higher quality evaluations found no impact on mental health outcomes (n = 4), and some evidence for delayed initiation (n = 4) and reduced point-in-time use (n = 10) of alcohol. Evidence for impact on binge-drinking and drug use was mixed.
ConclusionBased on very few published studies of mixed quality, PBAs have not improved mental health or wellbeing among adolescents. More evidence exists to suggest PBAs can improve certain alcohol use outcomes in young people.

研究目标
本研究系统评价了同行评议的相关证据，旨在评估“基于场所的干预措施（place-based approaches, PBAs）”对青少年心理健康结局的影响——此类干预措施要求在地方层面开展多部门协作，以应对复杂的健康挑战。

研究方法
本研究检索了6个数据库自建库至2023年5月的文献。本研究将基于场所的干预措施定义为：至少两个部门（如地方政府、卫生部门）在某一地方辖区内开展协同合作。本研究纳入了报告10~24岁青少年心理健康与物质使用情况的研究。两名研究者采用MMAT独立评估了研究质量。由于基于场所的干预措施、研究设计与结局指标均存在异质性，无法开展元分析，因此研究结果采用叙述性整合方式进行分析。

研究结果
共33篇文献报告了22项基于场所的干预措施评估项目的数据；其中6项评估针对心理健康或福祉状况，16项评估针对物质使用情况。高质量评估未发现该类干预对青少年心理健康结局存在影响（n=4），且有部分证据表明该类干预可延迟青少年首次饮酒的年龄（n=4），并减少其时点饮酒行为（n=10）。关于干预对狂饮（binge drinking）与药物使用的影响，现有证据结论不一。

研究结论
基于为数不多且质量参差不齐的已发表研究，基于场所的干预措施并未改善青少年的心理健康或福祉状况。现有更多证据表明，该类干预可改善青少年的部分饮酒相关结局。