Development and acceptability of a co-produced online intervention to prevent alcohol misuse in adolescents: A think aloud study

Background: The prototype willingness model (PWM) may offer an appropriate basis for explaining and preventing adolescent alcohol misuse. An intervention was developed using a co-production approach, and consisted of an online quiz featuring 10 questions linked to the PWM. Objective: This study sought to determine the acceptability and relevance of the intervention content to young people, to incorporate their feedback into a final version. Methods: A qualitative think aloud study with follow-up semistructured interviews was undertaken with 16 young people aged 11-15 (50%). Transcripts were analyzed using thematic analysis. Results: The following 3 main themes relating the acceptability of the intervention were identified: “challenging expectations of alcohol education”; “motivations for drinking or not drinking,” and “the inevitability of drinking.” Participants found the intervention appealing because it was counter to their expectations. The content appeared to reflect their experiences of social pressure and drinking encounters. There was evidence that a focus on drinker/nondrinker prototypes was too narrow and that because adolescents perceived drinking as inevitable, it would be challenging to enact any plans to resist pressure to drink. Conclusions: An online intervention based on the PWM has the potential to engage and interest adolescents. A wide range of alcohol prototypes should be targeted and a focus on short-term harms should ensure that the intervention is credible to young people

The effectiveness of brief personalized normative feedback in reducing alcohol-related problems amongst University students: protocol for a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Studies have shown that university/college students tend to have an exaggerated view of the quantities of alcohol being consumed by their peers. Making students aware of this misperception may help change behaviour and reduce problem drinking.</p> <p>Methods/Design</p> <p>A Solomon Three Group Design will be used. There is one intervention group and two control groups, controlling separately for measurement and for intervention effects. Recruitment, consent, randomisation and data collection are all on-line. The primary outcomes are AUDIT Score, weekly consumption, perceived social norms, and alcohol related problems; secondary outcomes include alcohol expectancies and other health behaviours.</p> <p>Discussion</p> <p>This trial will provide information on the effectiveness of an on-line personalized normative feedback intervention for alcohol misuse in university students.</p> <p>Trial registration</p> <p>International Standard Randomised Controlled Trial Number: ISRCTN30784467</p

Universal family-based prevention programs for alcohol misuse in young people

Background Alcohol misuse in young people is a cause of concern for health services, policy makers, prevention workers, and criminal justice system, youth workers, teachers, and parents. Objectives To systematically review evidence on the effectiveness of universal family-based prevention programs in preventing alcohol misuse in school-aged children up to 18 years of age. To update a part of a previously published Cochrane systematic review. Search strategy Relevant evidence ( up to 2002) was selected from the previous Cochrane review. Later studies, to July 2010, were identified from MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, Project CORK, and PsycINFO. Selection criteria Randomized trials evaluating universal family-based prevention programs and reporting outcomes for alcohol use in students 18 years of age or younger were included. Two reviewers screened titles/abstracts and full text of identified records. Data collection and analysis Two reviewers extracted relevant data independently using an a priori defined extraction form. Risk of bias was assessed. Main results 12 parallel-group trials were included. The reporting quality of trials was poor, only 20% of them reporting adequate method of randomisation and program allocation concealment. Incomplete data was adequately addressed in about half of the trials and this information was unclear for about 30% of the trials. Due to extensive heterogeneity across interventions, populations, and outcomes, the results were summarized only qualitatively. 9 of the 12 trials showed some evidence of effectiveness compared to a control or other intervention group, with persistence of effects over the medium and longer-term. Four of these effective interventions were gender-specific, focusing on young females. One study with a small sample size showed positive effects that were not statistically significant, and two studies with larger sample sizes reported no significant effects of the family-based intervention for reducing alcohol misuse. Authors' conclusions In conclusion, in this Cochrane systematic review we found that that the effects of family-based prevention interventions are small but generally consistent and also persistent into the medium- to longer-term

Universal school-based prevention programs for alcohol misuse in young people

Background Alcohol misuse in young people is cause of concern for health services, policy makers, prevention workers, criminal justice system, youth workers, teachers, parents. This is one of three reviews examining the effectiveness of (1) school-based, (2) family-based, and (3) multi-component prevention programs. Objectives To review evidence on the effectiveness of universal school-based prevention programs in preventing alcohol misuse in school-aged children up to 18 years of age. Search strategy Relevant evidence (up to 2002) was selected from the previous Cochrane review. Later studies, to July 2010, were identified from MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, Project CORK, and PsycINFO. Selection criteria Randomized trials evaluating universal school-based prevention programs and reporting outcomes for alcohol use in students 18 years of age or younger were included. Two reviewers screened titles/abstracts and full text of identified records. Data collection and analysis Two reviewers extracted relevant data independently using an a priori defined extraction form. Risk of bias was assessed. Main results 53 trials were included, most of which were cluster-randomised. The reporting quality of trials was poor, only 3.8% of them reporting adequate method of randomisation and program allocation concealment. Incomplete data was adequately addressed in 23% of the trials. Due to extensive heterogeneity across interventions, populations, and outcomes, the results were summarized only qualitatively.Six of the 11 trials evaluating alcohol-specific interventions showed some evidence of effectiveness compared to a standard curriculum. In 14 of the 39 trials evaluating generic interventions, the program interventions demonstrated significantly greater reductions in alcohol use either through a main or subgroup effect. Gender, baseline alcohol use, and ethnicity modified the effects of interventions. Results from the remaining 3 trials with interventions targeting cannabis, alcohol, and/or tobacco were inconsistent. Authors' conclusions This review identified studies that showed no effects of preventive interventions, as well as studies that demonstrated statistically significant effects. There was no easily discernible pattern in characteristics that would distinguish trials with positive results from those with no effects. Most commonly observed positive effects across programs were for drunkenness and binge drinking. Current evidence suggests that certain generic psychosocial and developmental prevention programs can be effective and could be considered as policy and practice options. These include the Life Skills Training Program, the Unplugged program, and the Good Behaviour Game. A stronger focus of future research on intervention program content and delivery context is warranted. PLAIN LANGUAGE SUMMARY Psychosocial and Development Alcohol Misuse Prevention in Schools can be effective We conducted a Cochrane systematic review of 53 well-designed experimental studies that examined the effectiveness of school-based universal programs for the prevention of alcohol misuse in young people. The studies were divided into two major groups based on the nature of the prevention program: 1) programs targeting specifically prevention or reduction of alcohol misuse and 2) generic programs with wider focus for prevention (e. g., other drug use/abuse, antisocial behavior). In the review we found studies that showed no effects of the preventive program, as well as studies that demonstrated statistically significant effects. There was no easily discernible pattern in program characteristics that would distinguish studies with positive results from those with no effects. Most commonly observed positive effects across programs were for drunkenness and binge drinking. In conclusion, current evidence suggests that certain generic psychosocial and developmental prevention programs can be effective and could be considered as policy and practice options. These include the Life Skills Training Program, the Unplugged program, and the Good Behaviour Game

Poor health knowledge and behaviour is a risk for the spread of antibiotic resistance: survey of higher secondary school students in Goa, India

Aims: We assessed antibiotic knowledge and practice among youth in India, where antibiotics are widely available without prescription. Methods: Randomly selected school questionnaire survey representing four regions in Goa, India, with students (n = 773) aged 16–17. Results: Most students (67%) were unaware of the problem of antibiotic resistance, with around half (49%) mistakenly thinking that bacteria cause cold or flu. Around one-fifth (19%) said they frequently self-medicate with antibiotics, 57% would discontinue antibiotics when symptoms alleviated and 24% stored unused antibiotics at home. Generalised linear mixed models (GLMM) showed that females consistently had poorer antibiotic knowledge than males. Especially notable were the higher odds in females for reporting incorrectly that antibiotics kill harmful viruses (odds ratio (OR) = 1.93; 99.5% confidence interval (CI) = 1.09–3.41) and for reporting incorrectly that antibiotics do not kill harmless bacteria (OR = 2.02; 99.5% CI = 1.16–3.51). Poor antibiotic practice was not clearly differentiated between males and females. In terms of poor antibiotic practice, one model showed notable results for educational stream: both arts and commerce students were more likely than science students to say they would discontinue antibiotics when symptoms alleviated and before the antibiotic course of treatment was finished (arts: OR = 2.76; 99.5% CI = 1.58–4.82 and commerce: OR = 1.79; 99.5% CI = 1.06–3.04). Conclusion: Young adults in India had poor antibiotic knowledge and practice. Efforts to improve antibiotic health knowledge and safe practice are required to help prevent the spread of antibiotic resistance

Alcohol-Related Collateral Harm, the unseen dimension? Survey of students aged 16-24 in Southern England

Aim: To ascertain young adults’ experience of alcohol-related collateral harm (ARC harm). Methods: An on-line survey collected quantitative and qualitative data from a convenience sample of students (N=450) aged 16-24 in Southern England. Questions and analyses focused on harms they had experienced as a result of alcohol consumption by other people in their family or social circle. Findings: 64% of participants experienced ARC harm, including 50% of non-drinkers. In logistic regression analysis, ARC harms were associated with being female (OR=1.62, 95% CI 1.01-2.62) family members who drank every day (OR=2.65, 95% CI 1.49-4.69) being influenced by others’ drinking (OR=2.03, 95% CI 1.32-3.10) being older (OR=2.61 95% CI 1.57-4.34). No significant associations were found with high or low self-reported levels of alcohol consumption. Using qualitative descriptors, the ARC harms reported were classified into a novel taxonomy comprising eight categories: Nuisance/frustration/exasperation, Tolerance/adjustment/accommodation, Pressure into unwanted situations, Unsought/inappropriate responsibility, Psychological harm; Physical harm/acute risk of physical harm, Relationship harm, and Undisclosed harm. Conclusions: A high level of ARC harm was reported and experience of ARC harm was linked to several predictors. Further work is required to validate the proposed taxonomy, and to promote consideration of the phenomenon of ARC harm in alcohol policy

Development of an adolescent alcohol misuse intervention based on the Prototype Willingness Model: A Delphi study

Purpose of the paper: The purpose of this paper is to report on the use of the Delphi method to gain expert feedback on the identification of behaviour change techniques (BCTs) and development of a novel intervention to reduce adolescent alcohol misuse, based on the Prototype Willingness Model (PWM) of health risk behaviour. Methodology: Four BCTs based on the PWM were identified and incorporated into a draft intervention that aimed to change alcohol prototypes and enable adolescents to deal with social pressure. Using the Delphi process, successive questionnaires were distributed to 20 international experts to build consensus on the theoretical validity of the intervention. Findings: Fifteen experts completed round one and eleven completed round two of the Delphi study. A high level of consensus was achieved. Four priority areas were identified to improve the intervention: 1) incorporating extra techniques to address social pressure, 2) increasing intensity, 3) providing incentives, and 4) addressing credibility. Limitations: The sample of experts was self-selected and four participants were lost between the first and second round of the study. Implications: The effectiveness of the identified BCTs will be evaluated within an intervention to reduce alcohol misuse in adolescents. Further work should build towards a more unified approach to developing interventions based on the PWM. The Delphi method is likely to be particularly useful when there is no existing consensus about which BCTs to use that reflect certain theoretical constructs or that best target a specific population or behaviour. Originality/ value: This paper is the first to address the identification of specific BCTs based on the PWM and thus makes an important contribution to the application of this model to interventions. This novel application of the Delphi method also makes a useful addition to the growing field of intervention development and design

Effectiveness of the Strengthening Families Programme 10–14 in Poland for the prevention of alcohol and drug misuse: protocol for a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Alcohol and other drug use and misuse is a significant problem amongst Polish youth. The SFP10-14 is a family-based prevention intervention that has positive results in US trials, but questions remain about the generalizability of these results to other countries and settings.</p> <p>Methods/Design</p> <p>A cluster randomized controlled trial in community settings across Poland. Communities will be randomized to a SFP10-14 trial arm or to a control arm. Recruitment and consent of families, and delivery of the SFP10-14, will be undertaken by community workers. The primary outcomes are alcohol and other drug use and misuse. Secondary (or intermediate) outcomes include parenting practices, parent–child relations, and child problem behaviour. Interview-based questionnaires will be administered at baseline, 12 and 24 months.</p> <p>Discussion</p> <p>The trial will provide information about the effectiveness of the SFP10-14 in Poland.</p> <p>Trial registration</p> <p>International Standard Randomised Controlled Trial Number: ISRCTN89673828</p