Brief Preventive Communications for Youth, Theory, Research, and Practice Center for Research on Sub

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IV. Research Studies
Brief Preventive Communications for Youth,
Theory, Research, and Practice Center for
Research on Substance Abuse College of Health
University of North Florida
Table I Project Avoiding Harm Results
Project Avoiding Harm
METHODS Program Type A brief,
alcohol-beverage tailored selective
preventive intervention for drinking
adolescents Components 5-item screen,
22-minute one-on-one risk reduction consult,
risk reduction tip sheet, feedback/tailored to
gender beverage type used Underlying
Theory/Model FRAMES CBST Research Design
Randomized controlled trial, 232 11th and 12th
grade drinking students, baseline and 4-month
post-intervention data collections Results See
Table I Conclusion Significantly lower use of
malt liquor and high-proof liquor for
intervention participants

• Alcohol and Drug Abuse Among Children
• and Adolescents

I. Introduction to Brief Prevention
Communications
CDCs Behavioral Risk Factors for Youth
Morbidity and Mortality (2002)

• Minimal contact with a health professional to
  help
• client reduce risk
• Time-limited, patient-centered counseling
  focusing on
• changing behavior

STARS for Families
Table II STARS for Families Results
METHODS Program Type A brief, multi-component
universal alcohol preventive intervention for
middle school-age youth Components Alcohol
screen, 20-minute nurse alcohol consult
student contract, 8-key fact parent/guardian
postcards, 4-weekly take home lessons Underlying
Theory/Model McMos/multiple CB
theories Research Design Randomized controlled
trial within schools, 650 6th grade students
from 2 schools, baseline and 3-month second-year
post-intervention data collections Results
See Table II Conclusion Significantly less
heavy alcohol consumption and initiation of
alcohol use for intervention participants in
magnet school

• Behaviors causing intentional or unintentional
  injury
• 2. Substance use
• 3. Early/unprotected sexual activity
• 4. Tobacco use
• 5. Poor nutrition
• 6. Low levels of physical activity

ProjectSPORT
Table III ProjectSPORT Results
Posttest YES/NO Consumption and
Exercise Measures by Experiment Group
Group Measure Intervention
Control n292 n292
p value n
n Alcohol Measures 30-Day Alcohol
Frequency 23.3 68 33.9 99
0.005 30-Day Alcohol Quantity 24.3 71 35.3
103 0.004 Heavy Drinking
5.8 17 15.8 46 0.000 Length of Alcohol
Use 34.6 101 42.3 123
0.057 Drug Measures 30-Day Cigarette
Frequency 10.3 30 17.8 52
0.009 30-Day Marijuana Frequency 12.0 35 18.2
53 0.037 Exercise Measures Vigorous
Physical Activity 92.4 269 88.0 257
0.072 Moderate Physical Activity 86.6
253 77.0 224 0.002
Youth Binge Drinking
METHODS Program Type A brief, fitness-based
universal preventive intervention for high
school-aged youth Components 7-item
fitness/health behavior screen, 13-minute fitness
specialist multi-health behavior consult, youth
contract fitness flyer Underlying Theory/Model
McMos/Marketing Communications Positive Youth
Development Research Design Randomized
controlled trial 604 9th and 11th grade students,
baseline and 3-month post-intervention data
collection Results See Table III Conclusion
Significantly less alcohol and drug use and
more Moderate exercise for intervention
participants

• (5 or more beverages in one setting)

History

• 12 for 8th graders
• (Johnson, OMalley Bachman, 2002)
• 32 for high school students
• (Johnson, OMalley Bachman, 2002)
• 44 among college students
• (Wechsler, et al., 1994)

• 1. Oxford, Oppenheimer Edwards (1976) study
  of brief
• contact with a physician for alcoholism vs.
  inpatient
• hospitalization
• Institute of Medicine (IOM) report (1990) on
  stepped care
• approach for alcohol problem treatment
• Bien, Miller, Tonigan (1993) early review of
  brief interventions
• for alcohol problems
• 4. WHO Brief Interventions Study Group (1996)
• Brief interventions for smoking cessation,
  dietary behavior
• change, cancer prevention, exercise promotion
  HIV prevention

III. Conceptual/Theoretical Bases for Brief
Interventions
V. Practice Conclusions Our Experience in a Nut
Shell

• Conclusions The Future for Brief Preventive
• Communication

• A. Motivational Interviewing (MI) (Miller, 1983
  Miller
• Rollnick, 1991)
• B. Transtheoretical Model/Stages of Change
• (Prochaska DiClemente, 1983)
• C. The FRAMES Model Feedback, Responsibility,
  Advice,
• Menu, Empathy, Self-Efficacy (Miller
  Sanchez, 1004)
• D. Cognitive Behavioral Skills Training (CBST),
  e.g. BASICS
• (Dimeff, et al., 1999)
• E. Multi-component Motivational Stages (McMOS)
  Prevention
• Model (Werch DiClemente, 1994)

Formats
Theory There is a need to unravel the
mechanisms associated with efficacy and
safety Research There is a need to study
methods for enhancing the strength and
sustainability of effects, and differential
effects, across health behaviors and
populations Practice There is a need to
document program implementation quality and
evaluate outcomes

• Brief screening and counseling in primary care
  settings for
• at-risk drinkers (Fleming Manwell, 1999)
• Emergency room alcohol screening and feedback
• (Forsberg, et al., 2000)
• Skills building and harm reduction for heavy
  drinking
• college students (Dimeff, et al., 1999)
• Tailored feedback via print communications for
  heavy drinkers
• and other health behaviors (Agostinelli,
  Brown Miller, 1995
• Kreuter, et al., 2000)
• 5. Brief screens and tailored structured
  consultations for
• preventing youth alcohol abuse (Werch, et
  al., 2000)

• Targeting, Tailoring, and Timing (Moderation
  Mediation
• Seriously consider all 3 in program development
  implementation
• B. Recruitment and Retention Approaches
• Apply personal contacts incentives at
  various levels
• C. Collecting Baseline and Post-Intervention
  Outcome and Process Data
• Document program implementation quality,
  and measure key
• mediational and behavioral outcomes
• Randomizing Participants
• Randomize at the participant level within
  settings, grades,
• drinking levels stages
• Training Implementers
• Training for 2-days is necessary, even for
  brief interventions
• Implementation Protocols
• Use protocols to ensure quality program
  implementation and
• evaluation

Contact Information Chudley (Chad)Werch,
PhD Center for Research on Substance Abuse,
University of North Florida E-mail
cwerch_at_unf.edu Acknowledgement This research
was supported by grants from the National
Institute on Alcohol Abuse and Alcoholism (Grant
AA09283 and Grant AA13570)