Adolescent alcohol use and misuse : the influence of perceived family socialization factors

Alcohol-related problems are a worldwide phenomenon and, in the latter part of the twentieth century, have generated substantial academic interest. Some of this research has focussed on the alcohol use and misuse of young people. The present thesis falls squarely into this area, bringing to the investigation of adolescent drinking behaviour an emphasis on family environment from recent studies into problem drinking. The aim of this study, therefore, was to increase understanding of the formation of early drinking patterns by investigating perceived family socialization factors associated with self-reported adolescent alcohol use and misuse. The results should have implications for alcohol education and intervention strategies in the U.K.. Research into problem drinking and drug use/misuse, previous adolescent drinking research, developmental psychology, social psychology, family psychology, family systems and the sociology of deviance all informed this thesis, by contributing to the development of a theoretical model of family socialization influences on adolescent drinking behaviour. Two main areas of family environmental influence are outlined in this model, and demographic and structural variables form a third component of the model. In this study, family process behaviours are viewed as those aspects of family relationships and interactional styles which are important in the socialization of adolescent behaviours and the internalization of norms, are non-alcohol specific, and are characterized by two major dimensions of family functioning - support and control. Underlying the role of alcohol-specific family behaviours in the development of adolescent drinking is family social learning, which is characterized by family models and social reinforcement for drinking. The main study involved administering a fully piloted questionnaire to a large, cross-sectional, random sample of school students, aged 11-18, in Humberside (N=4386). In addition, a small number of semi-structured interviews were carried out, and each written up as a case study, to supplement the quantitative questionnaire data. Data from the questionnaire were analyzed on three levels. Descriptive statistics are presented and comparisons made with information from previous studies. ANOVA's tested for disordinal interactions and for nonlinear effects of family socialization variables on adolescent drinking behaviour. As no marked non-linear patterns or disordinal interactions were found a third level of analysis was carried out, involving structural equation modelling techniques. The main results from the study are summarized below: (i)As expected, both heavy drinkers and non/very light drinkers were more likely to report extreme patterns of family socialization behaviours. Low support and control, indifferent parents and more frequent family drinking were all linked with more self-reported adolescent drinking, whilst high support and control, disapproving parents and non/light family drinking were all linked with less adolescent drinking. The family profile linked with normative levels of adolescent drinking was moderate support and control, a moderating parental attitude, and moderate (mid-range) family drinking. (ii)Multivariate analyses pointed to the predominantly independent and additive effect of each family socialization variable on adolescent drinking behaviour. (iii)On the whole, family social learning variables, particularly parental attitude, were more important statistical predictors of adolescent drinking behaviour than family process variables. (iv)Contrary to predictions, when each school year/sex group was examined separately, an interesting transitional effect was found. For younger males and females, family social learning variables were significant predictors of drinking behaviour, but family process variables were not. However, in older year groups, the effect of family support and control on , drinking behaviour increased whilst, in a complementary fashion, the effect of family models and, in particular, parental attitude, decreased. (v)As expected, knowledge of friends' drinking predicted the respondent's drinking behaviour, but the impact and pattern of family socialization influences on drinking behaviour was not moderated by this peer influence variable. In addition, knowledge of friends' drinking was not as important, statistically, as family social learning influences. The thesis concludes by discussing the above findings and commenting on the generalizability of the results and the implications of the results for current alcohol education paradigms and for future research. The value of the family socialization model for the investigation of other adolescen

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

The classification and organisation of alcohol misuse prevention with a focus on environmental prevention

Purpose of Review. Classifying prevention as universal, selective or indicated only considers the form of interventions. This is limited as it fails to explain the function, or purpose, of interventions. This paper discusses a taxonomy for alcohol misuse prevention that considers both the form and function of prevention interventions. It adds to the previous literature by incorporating subcategories of classification for environmental prevention. Recent Findings. Within each taxonomy category there are interventions which are more, and less effective, but not one single category has comprehensive evidence of efficacy. Environmental prevention may have the greatest potential to deliver interventions that are efficient, cost effective and reduce health inequalities. However, comprehensive, systems oriented, prevention coverage should combine all three functional approaches. Summary. This taxonomy can be used to organise and classify alcohol misuse prevention interventions and to determine where alcohol misuse prevention strategies and research is warranted. Furthermore, it can help practitioners and researchers to consider the subcategories of environmental prevention: an area that is rapidly gaining traction in the prevention field

The effect of alcohol strength on alcohol consumption: a randomised controlled cross-over pilot trial

Background: Effective interventions are required to reduce alcohol consumption and its associated harms at the population level. Reducing the alcohol content of beverages has the potential to reduce alcohol consumption through non-conscious processes. Before implementing a randomised controlled trial (RCT) to assess the effect of alcohol strength on alcohol consumption its feasibility needs to established. This study aims to pilot a RCT and obtain data to estimate key parameters required when designing a RCT. These key parameters include the direction and size of the intervention effect, the efficacy and efficiency of the study processes, and the rates of licensed premises recruitment, participant recruitment and attrition. Methods: A double blind randomised controlled cross-over pilot trial comparing the number of units of reduced strength lager consumed and the number of units of regular strength lager consumed in a single drinking occasion within licensed premises in the UK. Descriptive statistics will report the efficacy and efficiency of the study processes, and the rates of licensed premises recruitment, participant recruitment and attrition. Mean and 95% confidence intervals will be used to compare the consumption of alcohol, and the duration of participation in study sessions, between the intervention arm and the control arm. The mean and standard deviation of UK units of alcohol consumed will be used to calculate a sample size for a definitive RCT. Discussion: This is the first naturalistic experimental study to assess the effect of alcohol strength on alcohol consumption in a single drinking occasion within licensed premises. Results from this pilot study will establish the feasibility of, and inform key data parameters for, a larger-scale study

The effect of alcohol strength on alcohol consumption: Findings from a randomised controlled cross-over pilot trial.

Background. Reducing the alcohol content of drinks has the potential to reduce alcohol consumption. Aims: (1) test the feasibility of a randomised controlled trial (RCT) to assess the effect of alcohol strength on alcohol consumption within licensed premises in the United Kingdom (UK), (2) provide data to estimate key parameters for a RCT. Methods. Double-blind randomised controlled cross-over pilot trial based within four licensed premises in the UK. Participants (n=36) purchased and consumed ad libitum a 3.5% lager and a 4.8% lager during two separate study sessions. Descriptive statistics reported the efficacy and efficiency of the study processes, and the rates of licensed premises recruitment, and participant recruitment and attrition. Mean and the 95% confidence interval (CI) compared alcohol consumption between conditions. The mean, standard deviation (SD) and CI of UK units of alcohol consumed were used to calculate a sample size for a RCT. Responses to participant questionnaires and duration of participation in study sessions between conditions were analysed. Results. Components of the study protocol were effective and efficient. The venue recruitment rate was less than anticipated. The participant recruitment rate was greater than anticipated. The rate of attrition was 23% and varied by less than 1% according to the arm of the trial. There was a reduction of alcohol consumed under the intervention conditions. Estimated mean difference, and 95% CI (UK units): -3.76 (-5.01 to -2.52). The sample size required for a RCT is 53. Participants did not find one lager more pleasant in taste: (on a scale of one to 10) -0.95 (-2.11 to 0.21). Participants found the reduced-strength lager less enjoyable: (on a scale of one to 10) -1.44 (-2.64 to -0.24) and they perceived themselves to be less intoxicated after consuming it: (on a scale of one to 10) -1.00 (-1.61 to -0.40). Conclusion. A RCT is feasible with minor alterations to the study protocol and scoping work to establish different brands of alcohol that are more alike and more enjoyable than the products used in the pilot trial

Developmental trajectories of adolescent risky drinking: Predictors from the Drug Education in Victoria Schools (DEVS) study

With alcohol misuse one of the leading causes of disability among young Australians, determination of potential predictors of risky drinking trajectories of young people is crucial. This study aimed to identify risky drinking trajectories from early to mid-adolescence and to determine if membership of a harm minimization intervention, alcohol knowledge, attitudes towards alcohol and prevalence of alcohol harms would predict trajectory group membership. Longitudinal data from 1,746 students were used to identify alcohol consumption trajectory groups for both intervention and control students. Higher baseline knowledge predicted a higher, increasing, consumption trajectory for controls, whereas, safer attitudes at baseline was not associated with a higher, increasing trajectory. All other alcohol harms at baseline were strongly associated with higher consumption trajectories. The intervention group had fewer increasing trajectories and a lower level of consumption at the end of the program, suggesting the drug education program reduced the number of students who substantially increased their consumption over time, while at the same time reducing their level of consumption in relative terms. The consistency of better intervention student outcomes across all trajectories provides evidence that the drug education program was influential with all types of student drinkers and is suitable for universal deliver

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

Effectiveness of the Strengthening Families Programme 10–14 in Poland: cluster randomized controlled trial

Background: The Strengthening Families Programme for youth aged 10-14 and parents/carers (SFP10-14) is a family-based prevention intervention with positive results in trials in the United States. We assessed the effectiveness of SFP10-14 for preventing substance misuse in Poland. Methods: Cluster randomized controlled trial with 20 communities (511 families; 614 young people) were allocated to SFP10-14 or a control arms. Primary outcomes were alcohol, smoking and other drug use. Secondary outcomes included parenting practices, parent–child relations, and child problem behaviour. Interview-based questionnaires were administered at baseline and at 12- and 24-months post-baseline, with respective 70.4% and 54.4% follow-up rates. Results: In Bayesian regression models with complete case data we found no effects of SFP10-14 for any of the primary or secondary outcomes at either follow-up. For example at 24-months, posterior odds ratios and 95% credible intervals for past year alcohol use, past month binge drinking, past year smoking, and past year other drug use, were 0.83 (0.44-1.56), 0.83 (0.27-2.65), 1.94 (0.76-5.38), and 0.74 (0.15-3.58), respectively. Although moderate to high attrition rates, together with some evidence of systematic attrition bias according to parent education and family disposable income, could have biased the results, the results were supported in further analyses with propensity score matched data and 40 multiple imputed datasets. Conclusion: We found no evidence for the effectiveness of SFP10-14 on the prevention of alcohol or tobacco use, parenting behaviour, parent-child relations or 4 child problem behaviour at 12- or 24-month follow-up in a large cluster randomised controlled trial in Poland

Testing socioeconomic status and family socialization hypotheses of alcohol use in young people: A causal mediation analysis

Introduction: The effect of socioeconomic status on adolescent substance abuse may be mediated by family socialization practices. However, traditional mediation analysis using a product or difference method is susceptible to bias when assumptions are not addressed. We aimed to use a potential outcomes framework to assess assumptions of exposure‐mediator interaction and of no confounding of the results. Method: We revisited a traditional mediation analysis with a multiple mediator causal mediation approach using data from 17,761 Norwegian young people (13–18 years), 51% female. Data were collected through a print questionnaire. Socioeconomic status was operationalized as parental education and employment status (employed or receiving welfare); drinking behavior as the frequency of alcohol consumption and frequency of intoxication in the past year; and socialization practices as general parenting measures, alcohol‐related parental permissiveness, and parent drinking behavior. Results: There was no consistent evidence of exposure‐mediator interaction. Formal sensitivity analysis of mediator‐outcome confounding was not possible in the multiple mediator model, and this analysis supported the hypothesis that socioeconomic status effects on adolescent substance abuse are fully mediated by family socialization practices, with apparently stronger effects in younger age groups observed in plots. Conclusion: We found that the effect of socioeconomic status on adolescent substance abuse was fully mediated by family socialization practices. While our analysis provides more rigorous support for causal inferences than past work, we could not completely rule out the possibility of unmeasured confounding

Motivational interviewing for the prevention of alcohol misuse in young adults

Background Alcohol use and misuse in young people is a major risk behaviour for mortality and morbidity. Motivational interviewing (MI) is a popular technique for addressing excessive drinking in young adults. Objectives To assess the effects of motivational interviewing (MI) interventions for preventing alcohol misuse and alcohol‐related problems in young adults. Search methods We identified relevant evidence from the Cochrane Central Register of Controlled Trials (CENTRAL) (2015, Issue 12), MEDLINE (January 1966 to July 2015), EMBASE (January 1988 to July 2015), and PsycINFO (1985 to July 2015). We also searched clinical trial registers and handsearched references of topic‐related systematic reviews and the included studies. Selection criteria We included randomised controlled trials in young adults up to the age of 25 years comparing MIs for prevention of alcohol misuse and alcohol‐related problems with no intervention, assessment only or alternative interventions for preventing alcohol misuse and alcohol‐related problems. Data collection and analysis We used the standard methodological procedures expected by Cochrane. Main results We included a total of 84 trials (22,872 participants), with 70/84 studies reporting interventions in higher risk individuals or settings. Studies with follow‐up periods of at least four months were of more interest in assessing the sustainability of intervention effects and were also less susceptible to short‐term reporting or publication bias. Overall, the risk of bias assessment showed that these studies provided moderate or low quality evidence. At four or more months follow‐up, we found effects in favour of MI for the quantity of alcohol consumed (standardised mean difference (SMD) −0.11, 95% confidence interval (CI) −0.15 to −0.06 or a reduction from 13.7 drinks/week to 12.5 drinks/week; moderate quality evidence); frequency of alcohol consumption (SMD −0.14, 95% CI −0.21 to −0.07 or a reduction in the number of days/week alcohol was consumed from 2.74 days to 2.52 days; moderate quality evidence); and peak blood alcohol concentration, or BAC (SMD −0.12, 95% CI −0.20 to 0.05, or a reduction from 0.144% to 0.131%; moderate quality evidence). We found a marginal effect in favour of MI for alcohol problems (SMD −0.08, 95% CI −0.17 to 0.00 or a reduction in an alcohol problems scale score from 8.91 to 8.18; low quality evidence) and no effects for binge drinking (SMD −0.04, 95% CI −0.09 to 0.02, moderate quality evidence) or for average BAC (SMD −0.05, 95% CI −0.18 to 0.08; moderate quality evidence). We also considered other alcohol‐related behavioural outcomes, and at four or more months follow‐up, we found no effects on drink‐driving (SMD −0.13, 95% CI −0.36 to 0.10; moderate quality of evidence) or other alcohol‐related risky behaviour (SMD −0.15, 95% CI −0.31 to 0.01; moderate quality evidence). Further analyses showed that there was no clear relationship between the duration of the MI intervention (in minutes) and effect size. Subgroup analyses revealed no clear subgroup effects for longer‐term outcomes (four or more months) for assessment only versus alternative intervention controls; for university/college vs other settings; or for higher risk vs all/low risk participants. None of the studies reported harms related to MI. Authors' conclusions The results of this review indicate that there are no substantive, meaningful benefits of MI interventions for preventing alcohol use, misuse or alcohol‐related problems. Although we found some statistically significant effects, the effect sizes were too small, given the measurement scales used in the included studies, to be of relevance to policy or practice. Moreover, the statistically significant effects are not consistent for all misuse measures, and the quality of evidence is not strong, implying that any effects could be inflated by risk of bias.info:eu-repo/semantics/publishedVersio