A harm-reduction focus that acknowledges and builds on existing protective strategies may be a promising avenue for alcohol interventions.

Objectives To examine variable frequencies and relationships between students’ intentions and confidence with their intervention. Methods Incoming freshmen (509 of 1155 students responded) completed a survey 2 months into college. Results Most (75.2%) students intervened into others’ drinking, usually as a caretaker. Students reported more intention to intervene with others with whom they had more affiliation, and confidence with less intrusive intervention. Intention to intervene (b=0.36, SE=0.10, P<0.001) and intervention confidence (b=0.27, SE=0.06, P<0.001) correlated with intervention. Conclusions With education to enhance their intention and confidence to intervene, first-year college students might be encouraged to intervene into others’ social drinking.

Trials indicate that further reduction in adolescent alcohol use is possible with non-physicians as interventionists and perhaps physicians as interventionists, if physicians are supported by patient counseling guides and resources. Opportunities for personalized, interactive adolescent education with goal setting appears key to intervention success. The physician role that is tested in most trials is confined to a single brief encounter with little attention to: development of physician skills, systems-level resources, the parental role, or the impact of incorporating prevention into an ongoing adolescent-physician relationship.

Objective-Identify approaches for improving clinician provision of sexually transmitted diseases (STDs) prevention services among outpatient adolescents.Methods-Reviewed all peer-reviewed, published clinical trials identified through computerized searches (MEDLINE, PsychINFO) evaluating STD prevention services to outpatient adolescents by clinicians.Results-Five trials were identified examining changes in clinician provision of STD prevention services. Two of these trials resulted in adolescent self-reported risk reduction but neither of these trials effectively demonstrated reductions in objectively measured STD incidence. Nine clinical trials were identified that compared clinician with non-clinician provision of STD prevention services. Four of these trials resulted in adolescent self-reported risk reduction, and one of these trials demonstrated a reduction in objectively measured STD incidence.Conclusions-Trials indicate that improvement in outpatient adolescent STD incidence is possible with non-clinicians as interventionists, and perhaps clinicians as interventionists if clinicians are supported by other educational resources. Opportunities for personalized, interactive adolescent education appears key to intervention success. The clinician role that is tested in most trials is confined to a single brief encounter with little attention to: development of clinician skills, quality of psychosexual risk assessment and tailoring to meet individual adolescent need, systemslevel resources and supports, the parental role, or the impact of incorporating prevention into an ongoing adolescent-clinician relationship.