Prevention of alcohol use in young people: a meta-analysis of efficacy according to the theoretical model of intervention

Background Alcohol consumption during adolescence constitutes a significant risk factor for the development of long-term problems, underscoring the need for effective preventive strategies. Objective To analyze the effectiveness of alcohol prevention programs among young populations based on the underlying theoretical model of intervention. Methods A systematic review was conducted following PRISMA 2020 guidelines. A total of 52 articles reporting 83 randomized controlled trials involving individuals aged 12 to 25 were included. Random-effects models, sensitivity analyses, and meta-analyses of effect sizes were performed to compare the theoretical models employed. Results Motivational Interviewing emerged as the most consistent and effective theoretical model (d = 0.39; I² = 24.51%) with no evidence of publication bias. Its application in face-to-face modalities showed greater effectiveness compared to web-based formats. Sensitivity analysis reduced initial heterogeneity (I² = 18.01% for web-based; I² = 41% for in-person), highlighting the need for methodological standardization to enhance the reliability and replicability of interventions. Conclusion Theoretical models such as Motivational Interviewing and the Theory of Planned Behavior demonstrate strong efficacy and consistency. Integrating these with complementary approaches—such as Cognitive Behavioral Therapy, Social Learning Theory, and Social Norms Systems—within hybrid delivery formats (combining in-person methods with digital tools) may enhance program standardization and amplify their preventive impact.