Title: Alcohol Use and Misuse Prevention Strategies with Minors
1Alcohol Use and Misuse Prevention Strategies with
Minors
- William B. Hansen
- Linda Dusenbury
- Tanglewood Research
- Prepared for the Institute of Medicine
- Workshop on Underage Drinking
- October 2002
2Focus
Interventions designed to reach youth in
- Schools
- Families
- Communities
3Interventions to be Discussed
Those that seek to change
- Psychological characteristics
- Sociological characteristics
- Immediate social environment
4School-Based Programs
5Large Scale Alcohol-Specific School-Based Studies
- Alcohol Misuse Prevention Trial AMPS (Dielman et
al. University of Michigan) - Adolescent Alcohol Prevention Trial AAPT (Hansen
et al. University of Southern California and
Tanglewood Research) - Project Northland (Perry et al. University of
Minnesota)
6AMPS Intervention
- Two trials (original and enhanced)
- Focused on teaching students to refuse peer
pressure to use alcohol - Intervention included a 5th grade program plus a
6th grade booster
7AMPS Outcomes
- Program effects were not observed for
non-drinking students - Program effects were observed for students who
had previously used alcohol - Mediating variable analysis revealed no effect
for resistance skills increase but an effect for
normative beliefs
8AAPT Interventions
- Four groups
- Information only
- Resistance Skills Training
- Normative Education
- Combined (Resistance Skills plus Normative
Education - Targeted 7th grade students
9AAPT Outcomes
- Resistance Skills Training and Information only
were not effective in reducing alcohol use - Normative Education was effective in reducing
alcohol use - Normative Educations effects were long-lasting
but not permanent
10Adolescent Alcohol Prevention Trial Results
11Project Northland Intervention
- Intervention for 6th 7th and 8th grades
- Create a non-drinking norm for teens
- Provide positive role models
- Decrease opportunities to get alcohol
- Self-efficacy to resist social influences
- Reinforce value of non-drinking
12Project Northland Outcomes
- By 8th grade students participating in Project
Northland reduced - Weekly alcohol consumption
- Monthly alcohol consumption
- Their tendency to drink
- Effects disappeared by 10th grade
13Project Northland Drinking Prevalence Outcomes
14Norms
- Refers to two concepts
- How common a behavior is
- How acceptable a behavior is
- Can be applied
- To an entire society
- To generational cultural religious ethnic and
friendship sub-groups within society
15How Do Different Groups of Drinkers Estimate
Prevalence
16School-Based Norm Setting Approaches
- Correct erroneous perceptions of the norm among
individuals - Build positive norms among the peer group
- Reinforce positive norms within the community
17Family-Based Approaches
18Family-Based Studies
- Family Matters (Bauman et al. University of
North Carolina) - Preparing for the Drug Free Years (Hawkins et
al. University of Washington) - Project Northland (Perry et al. University of
Minnesota) - Nurse Home Visits (Olds et al. University of
Houston)
19Family Matters
- Families with 12-14 year olds
- Four booklets with follow-up phone calls
- Parental monitoring
- Parent-child communication
- Family policies
- Conflict resolution
- Resistance skills training
20Family Matters Outcomes
- Reductions in tobacco and alcohol use in the 12
months following the program - Increased rule setting in families about tobacco
and alcohol use
21Project Northland
- Informational packets and homework activities to
be completed by parents and children together. - Focus on
- Family policies
- Family meetings
- Communicating with teens
22Project Northland Outcomes
- By 6th grade more parents had spoken to students
about drinking - By 8th grade more families had rules about
drinking
23Preparing for the Drug Free Years
- Five session program for parents of children 8-14
- Focuses on risk and protective factors
- Communication
- Family management skills
- Resistance skills
24Preparing for the Drug Free Years Outcomes
- Increased communication between parents and
children - Improved quality of parent-child relationship
- Improved parents norms concerning alcohol
- Reduced the onset of alcohol use
- Savings of 5.85 in alcohol-use disorder costs
for every dollar spent
25Nurse Home Visits
- Targets low-income women
- Addresses
- Maternal health
- Child development and parenting
- Support by family and friends
- Linkages to services
- Focuses on
- Mothers use of alcohol and drugs
- Quality of care of child
- Mothers adjustment
26Nurse Home Visits Outcomes15-Year Follow-up
- Improved childrens I.Q. scores.
- Reduced risk for substance use by children and
parents. - 79 fewer incidents of child abuse or neglect
- 69 fewer arrests of the mother
- 44 reduction in behavioral problems due to
alcohol and drug abuse
27Family Factors that Reduce Alcohol Use and Misuse
- Parental monitoring
- Parental support of childs involvement in
positive alternatives - Positive family norms
- Clear family policies and rules
28Community-Based Approaches
29Large Scale Community-Based Studies
- Project Northland (Perry et al. University of
Minnesota) - Community Trials Intervention (Holder et al.
PIRE)
30Project Northland
- Mobilized community-wide task forces
- Promoted awareness and provided alcohol-free
recreational activities - Peer participation program (T.E.E.N.S.) students
planned alcohol-free activities
31Project Northland Outcomes
- 16 of students participated in planning an
activity for their peers - 50 attended at least one activity
- Student planners reduced their levels of alcohol
use in 7th grade - Five alcohol-related ordinances and three
resolutions were passed - Local ordinances required responsible beverage
service training
32Community Trials Intervention
- Three pairs of communities in California and
South Carolina. - Focuses on
- Organization mobilization
- Responsible beverages service
- Drinking and driving
- Availability to underage drinkers
- Zoning and municipal control.
33Community Trials Interventions Youth Outcomes
- Reduced sales to minors
- Off-premises outlets were half as likely to sell
to underage drinkers - Greater adoption of responsible serving policies
- Institutionalization
34Community-Based Approaches
- Build coalitions and partnerships that have the
goal of establishing positive norms - Limit access to alcohol
- Provide positive alternatives
35Conclusions
Youth-centered interventions should
- Be multi-component and integrated
- Be sufficient in dose and follow-up
- Promote positive norms
- Promote parental monitoring
- Limit access to alcohol
- Be interactive
- Be implemented with fidelity
