Reaching adolescents who drink harmfully: Fitting intervention to developmental reality
ABSTRACT Alcohol use usually starts in early adolescence. While the greater proportion of young people develop adaptive patterns of drinking, many drink at harmful levels and may be at risk for future alcohol-related problems. Findings from the empirical literature suggest that universal prevention programs may delay onset of drinking among low-risk baseline abstainers; however, there is little evidence supporting their utility for at-risk adolescents. Further research is needed on how risk and protective factors interact to determine substance use trajectory, and intervention outcomes that take substance use trajectories into account may capture change more effectively than the use of absolute measures of substance use. Indicated prevention programs may benefit from modulations that account for adolescent individuation and identity formation. It is argued that motivational interviewing within a harm reduction framework is well suited to adolescents.
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ABSTRACT: Background: The study aimed to trial an adapted version of the School Health and Alcohol Harm Reduction Project (SHAHRP) in Northern Ireland. The intervention aims to enhance alcohol-related knowledge, create more healthy alcohol-related attitudes and reduce alcohol-related harms in 14–16-year-olds. Method: A non-randomised control longitudinal design with intervention and control groups assessed students at baseline and 12, 24 and 32 months after baseline. Students were from post-primary schools (high schools) in the Eastern Health Board Area in Northern Ireland. Two thousand three hundred and forty nine participants were recruited at baseline (mean age 13.84) with an attrition rate of 12.8%% at 32-month follow-up. The intervention was an adapted, culturally competent version of SHAHRP, a curriculum programme delivered in two consecutive academic years, with an explicit harm reduction goal. Knowledge, attitudes, alcohol consumption, context of use, harm associated with own alcohol use and the alcohol use of other people were assessed at all time points. Results: There were significant intervention effects on all measures (intervention vs. controls) with differential effects observed for teacher-delivered and outside facilitator-delivered SHAHRP. Conclusion: The study provides evidence of the cultural applicability of a harm reduction intervention (SHAHRP) for risky drinking in adolescents in a UK context.Journal of Substance Use 03/2012; 17(2). DOI:10.3109/14659891.2011.615884 · 0.48 Impact Factor
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ABSTRACT: While evidence has accumulated suggesting that prevention initiatives may have a limited impact on alcohol use behaviour, reviews suggest that interventions with most potential for behavioural change are interactive and developmental in design. The School Health and Alcohol Harm Reduction Project (SHAHRP) is an example of such an intervention. Researchers are increasingly attempting to understand the differential effects of programmes in population subgroups. The present study is a secondary analysis of data from a non-randomised trial of SHAHRP, a classroom-based alcohol education intervention, involving school children (aged 13-16 years old) in the United Kingdom. Results showed that there were significant positive changes in knowledge about and attitudes towards alcohol in baseline abstainers, supervised drinkers and unsupervised drinkers. Significant positive behavioural effects in terms of amounts consumed, frequency of drinking and self-reported alcohol related harms, were observed almost exclusively among baseline unsupervised drinkers. These behavioural effects support those previously observed in Australia and suggest that the intervention is a viable health promotion tool in the UK.Journal of Adolescence 08/2014; 37(7):1057-1067. DOI:10.1016/j.adolescence.2014.07.014 · 2.05 Impact Factor