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Promising Program Seal


Blueprints Program Rating: Promising

An alcohol prevention program designed to reduce teenage alcohol use through parent training.

Program Outcomes

  • Alcohol
  • Delinquency and Criminal Behavior

Program Type

  • Alcohol Prevention and Treatment
  • Parent Training

Program Setting

  • Community (e.g., religious, recreation)
  • School

Continuum of Intervention

  • Universal Prevention (Entire Population)


  • Early Adolescence (12-14) - Middle School


  • Male and Female


  • All Race/Ethnicity


  • Blueprints: Promising

Program Information Contact

Nikolaus Koutakis
Örebro University
School of Law, Psychology and Social Work
BSR: Psychology/Ctr for Developmental Research
S-701 82
Örebro, Sweden

Program Developer/Owner

  • Nikolaus Koutakis
  • Örebro University

Brief Description of the Program

EFFEKT (formerly the Örebro Prevention Program) seeks to reduce teenage alcohol use by changing the attitudes of their parents. Parents are encouraged to communicate zero-tolerance policies about alcohol use to their children. Information is disseminated to the parents at school meetings at the beginning of each semester and through regular letters sent home throughout the middle-school year. Parents are also sent catalogs detailing organized activities taking place in the community so that children have a constructive way to use their time.

See: Full Description


Swedish Study (Koutakis et al., 2008; Koutakis & Ozdemir, 2010):

  • At the end of the program, drunkenness and frequent drunkenness rates were lower in the intervention group than in the control group.
  • Among early starters in either drunkenness or delinquency, those in the control group experienced steeper rates of increases than those in the intervention group.
  • Delinquency rates were lower for intervention than control students.

Swedish replication (Bodin & Strandberg, 2011; Ozdemir & Stattin, 2012)

  • Analyses revealed a statistically significant program effect for only one of three drinking outcomes at the 12-month follow-up, which was not sustained at 30 months.
  • Re-analysis of the data using frequency measures showed a significant program effect on lifetime drunkenness and a marginal effect for past-month drunkenness over time.

Dutch Study (Koning et al., 2011)

  • At 34-month follow-up, only the combined student–parent intervention showed substantial and significant effects on heavy weekly and weekly drinking.
  • No intervention effects in the parent-only and student-only interventions.

Significant Program Effects on Risk and Protective Factors:

  • Changes in parental attitudes due to program intervention mediated program effects on alcohol use and delinquency outcomes (Swedish study and replication).
  • Parents in the intervention group maintained more strict attitudes toward youth drinking, while parents in the control group became more lenient over time (Swedish Study).

Risk and Protective Factors

Risk Factors
  • Family: Parental attitudes favorable to drug use*

*Risk/Protective Factor was significantly impacted by the program.

See also: EFFEKT Logic Model (PDF)

Training and Technical Assistance

Training to become a Presenter

A Presenter has the skill and authority to present the program to parents. Presenters are entitled to have access to the materials. The training takes two full working days and covers amongst others things the following topics: introduction to prevention science; theoretical and empirical background of program; the logic of the program; current knowledge about parenting research –preventive implications; program theory; treatment fidelity; prerequisites for a sustainable implementation; how to communicate professionally; and how to answer the most common questions from parents. The cost for the two day course including all materials is $5,200 US Dollars, plus a fixed overseas fee covering travel and accommodation at $1,530 US Dollars.

Training Certification Process

Training to become an Instructor

An experienced presenter, having at least 18 months of practical experience working with the program, can take an Instructor training course. The training takes two full working days and is focused on how to train presenters according to the program model. An authorized Instructor will pass an oral exam a few days after the training. The cost of the Instructor training is similar to the cost for the presenter training.

Brief Evaluation Methodology

Swedish Studies. The initial study (Koutakis et al., 2008) examined three types of communities (inner city, public housing, and small town). The intervention targeted parents who were contacted primarily through the schools. The eight schools were approached based on data concerning the alcohol use of students, thus they were not randomly selected. Junior high schools with students ages 13-16 were used. A group of matched control schools was recruited based on community size, type of school, and levels of alcohol use and delinquency. A baseline assessment was conducted at the beginning of 7th grade and follow-ups during implementation were conducted near the end of the spring terms, when youths were in 8th and 9th grades.

A second Swedish study (Bodin & Strandberg, 2011) assessed the Orebro program in 40 municipal schools in 13 counties in Sweden, which participated in a cluster-randomized trial, with schools assigned randomly to the ÖPP or no intervention. A total of 1752 students in the 7th grade and 1314 parents were assessed at baseline. Students' follow-up rates in the 8th and 9th grades were 92.1% and 88.4%, respectively. Classroom questionnaires to students and postal questionnaires to parents were administered before randomization and 12 and 30 months post-baseline.

Dutch Study (Koning et al. 2011): The Dutch study used a cluster RCT with random assignment to one of four conditions for comparing two active interventions separately (parent only, student only) and simultaneously (parent and child) with a control group. The sample consisted of 152 classes of 19 high schools in the Netherlands; 3,490 first-year high school students (M=12.6 years) and their parents. There were 2,937 students eligible for analyses in this study. The baseline data were collected at the beginning of the first year in high school (September/October 2006), before any intervention was carried out, and again 34 months later.

Peer Implementation Sites

Site 1. City of Malmoe
Contact person: Jimmy Pettersson
Title: School counselor and EFFEK coordinator

Site 2. City of Nynashamn
Contact person: Johnna Gilljam
Title: Assistand headmaster


Bodin, M. C., & Strandberg, A. K. (2011). The Orebro prevention programme revisited: A cluster-randomized effectiveness trial of programme effects on youth drinking. Addiction, 106, 2134-2143.

Koning, I. M., van der Eijnden, R. J., Verdurmen, J. E., Engels, R. C., & Vollebergh, W. A. (2011). Long-term effects of a parent and student intervention on alcohol use in adolescents: A cluster randomized controlled trial. American Journal of Preventive Medicine, 40(5): 541-547.

Koutakis, N., & Ozdemir, M. (2010). Latent growth curve analysis taking clustered data into account on a quasi experimental parent targeted intervention trial: The Orebro prevention program. Center for Development at the Research School of Law, Psychology, and Social Work, Orebro University, Orebro, Sweden.

Koutakis, N., Stattin, H., & Kerr, M. (2008). Reducing youth alcohol drinking through a parent-targeted intervention: the Örebro prevention program. Addiction, 103, 1629-1637.

Ozdemir, M., & Stattin, H. (2012). Does the Orebro prevention programme prevent youth drinking? Addiction, 107, 1705-1706.