No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Efficacy of the eCHECKUP TO GO for High School Seniors: Sex Differences in Risk Factors, Protective Behavioral Strategies, and Alcohol Use
Abstract
Objective:
The purpose of this randomized controlled study was to examine sex as a moderator of the efficacy of a brief, web-based personalized feedback intervention (eCHECKUP TO GO) on decreasing cognitive risk factors for alcohol use, increasing protective behavioral strategies, and reducing alcohol use among high school seniors.
Method:
Participants (n = 311) were high school seniors randomized by class period to the eCHECKUP TO GO intervention or assessment-only control group. Participants completed online surveys at baseline and 30-day follow-up (91.0%; n = 283).
Results:
Students in the intervention group reported a significant reduction in normative perceptions of peer drinking, positive alcohol expectancies, and alcohol use relative to those in the control group. Intervention effects for perceptions of frequency of peer drunkenness and frequency of alcohol use were moderated by sex, with results favoring females. In contrast, we did not find evidence for sex as a moderator of intervention effects for normative perceptions of peer drinking frequency, sex-specific perceptions of peer heavy episodic drinking, positive alcohol expectancies, or peak drinking quantity. Further, we did not find significant intervention or moderator effects for protective behavioral strategies.
Conclusions:
Results of this study extend the literature by demonstrating the efficacy of the eCHECKUP TO GO for both males and females on reducing cognitive risk factors and alcohol use, although results were significant for a broader range of variables for females. Results also indicate that program content regarding normative feedback and protective behavioral strategies may need modification to be more effective for this age group.
... males only), whereas for the remaining 50%, behavior changes were recorded across all participant subgroups. For 17.5% of programs in Group 1, behavior change occurred in conjunction with changes in knowledge and/or attitudes [31][32][33][34][35][36][37], indicating the 'gold standard' for alcohol education outcomes. The remaining programs in Group 1 did not impact participants' knowledge and/or attitudes, or these aspects were not reported. ...
... The remaining programs in Group 1 did not impact participants' knowledge and/or attitudes, or these aspects were not reported. Programs in Group 2 only reported knowledge and/or attitude changes, for example: increased awareness of harm-reduction techniques to minimize negative effects of alcohol, such as alternating alcoholic and non-alcoholic drinks [37]; further awareness of alcohol overdose [38]; and, reductions in perceptions of peer drinking, that is, estimations of how much alcohol their peers consumed [39]. Among programs only changing knowledge and/or attitudes (Group 2), 83% reported that they aimed to change behavior among participants, but failed to do so. ...
... A further improvement for program developers to consider is the importance of transparency and detailed guidance, for those wishing to replicate programs and/or adapt the programs to be applied in other contexts. For example, within this review, e-CHUG was utilized for 10 separate projects by five different lead authors between 2008 and 2020 [37,[58][59][60][61][62][63][64][65][66] and each produced different results and outcomes. Generally, the quality scores increased as time progressed (scores ranged from 3 to 5) but there was no obvious improvement in behavioral outcomes over this time. ...
Numerous education programs have addressed young peoples’ alcohol use. To date, no peer-reviewed publication has evaluated the effectiveness of such programs delivered across a range of contexts to change alcohol-related behaviors, attitudes and/or knowledge. This systematic review aimed to identify alcohol education programs addressing young people, and determine whether they changed alcohol-related behavior, knowledge and attitudes; and, ascertain components of successful programs. Studies were identified, guided by the PRISMA review process, from the earliest records until June 2020. Included studies (N = 70) comprised an alcohol education program which focused on young people (15–24 years). Forty programs reported behavior changes, and these programs were the highest quality. Others impacted attitudes and/or knowledge only (n = 12); or reported no impacts (n = 17). Recent programs were more likely than older programs to feature online delivery and report behavior changes. To enhance alcohol education, future programs should include the identified quality criteria, alongside process and long-term outcome evaluations, to better monitor effectiveness. Findings indicated some education programs have capacity to positively change alcohol-related behavior; however, outcome consistency varied even in high-quality programs. Alcohol education programs should be designed alongside health education/promotion models and best-practice recommendations, to improve the likelihood of desirable behavior-related outcomes.
... Several studies are available on the use of PBS in the context of alcohol drinking by mostly underage high school students. Among them was one cross-sectional study on predictors of adolescent risky drinking from the United States [94], two publications reporting the results of a longitudinal research project among students in the United States and Sweden [95,96] as well as two experimental studies testing the effectiveness of brief, online PBS-based intervention involving assessment (online survey) and personalised feedback on, among other things, drinking pattern, risk status and recommendations for PBS use (e.g., avoiding alcohol games, taking as long a break as possible between drinking alcohol) [97,98]. The results of these studies point to the protective role of PBS in reducing alcohol consumption and related consequences in this age group. ...
... wzoru picia, statusu ryzyka oraz rekomendacji stosowania PBS (np. unikanie gier alkoholowych, robienie jak najdłuższych przerw pomiędzy piciem alkoholu) [97,98]. Wyniki tych badań wskazują na ochronną rolę PBS w ograniczaniu spożywania alkoholu i związanych z tym konsekwencji w tej grupie wiekowej. ...
... Ready4life (Haug et al., 2021) Substance-related knowledge and attitudes, normative expectations, and skills for resisting media and peer influences to use, personal selfmanagement (decision-making and problem-solving ability, skills for identifying, analyzing, interpreting, and resisting media influences, skills for coping with negative emotions (e.g., anxiety, anger, and frustration), basic principles of personal behavior change and self-improvement (e.g., goalsetting, self-monitoring, and selfreinforcement) and social skills (communication, initiating social interactions, conversation, complimenting, skills related to malefemale relationships, and verbal and nonverbal assertive skills) eCHECKUP TO GO (Doumas et al., 2020) Personalized normative feedback on peer drinking, positive alcohol beliefs, and positive alcohol expectancies, as perceptions of peer drinking and cognitions about alcohol, protective behavioral strategies (e.g., social activities instead of partying) ALERT, Alerta Alcohol program ( Martinez-Montilla et al.,2020) Change students' beliefs about drug norms and the social, emotional, and physical consequences of using drugs; help them identify and resist pro-drug pressures from parents, peers, the media, and others; build resistance selfefficacy, the belief that one can successfully resist pro-drug influences Kripalu Yoga in the Schools (KYIS) curriculum (Butzer et al.,2017) Stress management, emotion regulation, self-appreciation, confidence, and strong peer relationships The GOOD life (Stock et al.,2016;Vallentin-Holbech et al., 2018) Social Norms Intervention (social norm and attitude) Brief alcohol intervention (Giles et al., 2016; Personalized feedback about the individual student's drinking behavior and attitude, behavior change counselling, advice about the health and social consequences of continued risky alcohol consumption Preventure (Barrett et al., 2015;Conrod, 2016) Psycho-education (personality profile), behavioral and cognitive coping skills (e.g., goal setting, cognitive restructuring), motivational interviewing MobileCoach Alcohol (Haug et al., 2014) Social norm interventions, outcome expectations, self-efficacy, planning processes Saluda program (Hernández-Serrano et al., 2013) Information on alcohol and illicit drugs, and their effects; information on causal factors (motivations) for drinking and taking pills among adolescents; advertising analysis; social skills and assertiveness skills; information on healthy leisure offers existing in the city; abilities in problem solving and decision making; public commitment to non-abuse of alcohol and synthetic drugs Motivational interviewing-oriented brief alcohol interventions (Gmel et al., 2012) Knowledge, attitude, motivation ...
... Coping skills for negative emotions (e.g., skills for coping with anxiety), Positive Valence Systems (PVS) includes Motivation to change behavior (e.g., self-reinforcement), Drug-free activities (e.g., information on healthy leisure offers existing in the city), Knowledge about drug reward (e.g., immediate rewards against personal values), Social Processes (SP) includes Social skills (e.g., communication skills), Social attitudes and selfperception for drugs (e.g., modifying attitude towards using drug), Social norms (e.g., personalized normative feedback), Social pressure resisting skills (e.g., refusal skills), Changing self/other perspective (perception of self and other), Self-related awareness and self-efficacy skills (e.g., belief in one's ability to overcome drug temptation), Self-monitoring (e.g., personal self-management), Drug effects on body and brain (e.g., accurate insight towards harmful effects of substances), Cognitive System (CS) includes Cognitive-management skills (e.g., problem solving), Cognitive empowerment skills (e.g., goal-setting), Cognitive-control skills (e.g., self-control skills), Arousal and Regulatory Systems (ARS) includes Stress management (e.g., coping skills for stress) References (In alphabetical order of the interventions): Alerta Alcohol program (Martinez-Montilla et al., 2020), Alcohol Misuse Prevention Study (AMPS) (Shope et al., 2001), Brief alcohol intervention (Giles et al., 2016;, WISEteens (Brief intervention for poly-drug use) (Arnaud et al., 2012), Climate Schools (now known as OurFutures) (Vogl et al., 2009;Slade et al., 2021), CognitionMotivation-Emotional Intelligence-Resistance Skills (CMER) (Guo et al., 2010), Drug education program (Midford et al., 2012), eCHECKUP TO GO (Doumas et al., 2020), IPSY (Spaeth et al., 2010), keepin' it REAL (Kulis et al., 2007), Kripalu Yoga in the Schools (KYIS) curriculum (Butzer et al., 2017), Life skills training (LST) (Seal, 2006;Botvin et al., 1990), Motivational interviewing-oriented brief alcohol interventions (MIBAI) (Gmel et al., 2012), MobileCoach Alcohol (Haug et al., 2014), Preventure (Barrett et al., 2015;Conrad, 2016), Project Toward No Drug Abuse (TND) (Sussman et al., 2011) Ready4life (Haug et al., 2021), Reconnecting Youth (Hallfors et al., 2006), RealTeen (Schwinn et al., 2010), these risk factors show some specificity in reducing risk for substance misuse and clinically significant levels of anxiety disorders and major depression (O'Leary- Barrett et al., 2013). The other example of a multi-dimensional program is life skill programs (LSPs) which target intra-and interpersonal skills (e.g., communication skills, empathy, assertiveness, problem solving and decision-making skills, coping with emotions and stress), as well as training substance-related skills (e.g., resistance skills), changing attitude, and improving substance-related knowledge (e.g., norms) (Wenzel et al., 2009). ...
... Ready4life (Haug et al., 2021) Substance-related knowledge and attitudes, normative expectations, and skills for resisting media and peer influences to use, personal self-management (decisionmaking and problem-solving ability, skills for identifying, analyzing, interpreting, and resisting media influences, skills for coping with negative emotions (e.g., anxiety, anger, and frustration), basic principles of personal behavior change and self-improvement (e.g., goal-setting, self-monitoring, and selfreinforcement) and social skills (communication, initiating social interactions, conversation, complimenting, skills related to male-female relationships, and verbal and nonverbal assertive skills) eCHECKUP TO GO (Doumas et al., 2020) Personalized normative feedback on peer drinking, positive alcohol beliefs, and positive alcohol expectancies, as perceptions of peer drinking and cognitions about alcohol, protective behavioral strategies (e.g., social activities instead of partying) ALERT, Alerta ...
... Behavioral interventions have shown promise in reducing both adolescent and young adult substance use, and many of these interventions include peer group components (Doumas et al., 2020a, b;Steele et al., 2020). We have conducted a series of randomized trials testing a peer network counseling (PNC) intervention targeting adolescent and young adult substance use. ...
The current study describes an individual participant data meta-analysis (IPDMA) testing the efficacy of a peer-network counseling (PNC) intervention for preventing substance use escalation in adolescents and young adults. PNC has shown
efficacy in reducing substance use among adolescents and young adults across small-scale randomized controlled trials (RCTs). Identifying expected large-scale effects and moderators is an important next step in guiding use of PNC in practice.
To this end, we combine three small-scale RCTs to test PNC intervention effects on substance use change in a combined sample of 421 adolescents and young adults (50% intervention, 55% female, 69% Black/African-American, M age [SD]=17.3
[2.2] years). Our approach combines latent change score modeling in a structural equation modeling (SEM) framework with study-level fixed effects to obtain (a) a more generalizable PNC effect than we could obtain with each constituent sample
and (b) greater power and precision for individual-level moderation of treatment effects. We found that although PNC main effects on substance use outcomes (past 30-day cannabis, alcohol, tobacco, and drug use) were not significant, PNC effects
were moderated by individual-level pre-intervention substance use frequency. PNC more strongly reduced drug use at the 1-month follow-up and cannabis use at the 3-month follow-up among participants who showed higher baseline use of these
substances. Implications of our approach and findings for prevention researchers are discussed.
The Youthful Offenders Program for Telementalhealth (YOP‐T) is a synchronous brief intervention for alcohol harm reduction and the virtual application of the Youthful Offenders Program. This study aims to provide psychometric support for use of the protective behavioral measurements Safe Drinking Practices and Avoid Risky Behaviors in telementalhealth and to provide preliminary evidence for the effectiveness of YOP‐T in eliciting alcohol use and related harm reductions and increases in protective strategy utilization ( N = 302). Reliability and validity for measurements were observed, and preliminary support for program effectiveness was established. Recommendations to improve psychometric properties and generalizability are discussed.
Neuroscience has contributed to uncover the mechanisms underpinning substance use disorders (SUD). The next frontier is to leverage these mechanisms as active targets to create more effective interventions for SUD treatment and prevention. Recent large-scale cohort studies from early childhood are generating multiple levels of neuroscience-based information with the potential to inform the development and refinement of future preventive strategies. However, there are still no available well-recognized frameworks to guide the integration of these multi-level datasets into prevention interventions. The Research Domain Criteria (RDoC) provides a neuroscience-based multi-system framework that is well suited to facilitate translation of neurobiological mechanisms into behavioral domains amenable to preventative interventions. We propose a novel RDoC-based framework for prevention science and adapted the framework for the existing preventive interventions. From a systematic review of randomized controlled trials using a person-centered drug/alcohol preventive approach for adolescents, we identified 22 unique preventive interventions. By teasing apart these 22 interventions into the RDoC domains, we proposed distinct neurocognitive trajectories which have been recognized as precursors or risk factors for SUDs, to be targeted, engaged and modified for effective addiction prevention.
Objective:
Personalized feedback interventions are effective in reducing alcohol consumption and related problems. However, little is known about the role of choice in outcomes. The current study sought to (a) characterize individuals who opt in for brief alcohol-related feedback, (b) assess participants' consistency in that choice over two time points, and (c) evaluate changes in peak alcohol consumption among those who did and did not receive feedback.
Method:
Participants reporting past-12-month alcohol consumption were recruited through Prolific. At the outset of the survey, participants were asked if they would like to receive feedback on their drinking at the end of the survey ("opt in"). Participants at Time 1 (T1; N = 732) were 41% female, 91% White, and 8% Hispanic (mean age = 36, SD = 12.25, range: 18-80). A subset was invited back for a 30-day retest (Time 2 [T2]; n = 234).
Results:
Those reporting higher maximum drinks and more drug use were more likely to opt in to feedback than those with lower use. Further, 85% of participants were consistent in their choice of whether to receive feedback across T1 and T2 (κ = .65). Among heavy drinking participants with T1 and T2 data (n = 163), there was an effect of feedback on intensity of consumption at T2.
Conclusions:
Individuals who engage in heavy alcohol use are more likely to opt in to personalized alcohol feedback, and most do so consistently. Among heavy drinkers, feedback at T1 reduced intensity of consumption at T2, but the effect was small and requires future replication in more diverse samples.
This study analyzed the effects of various alcohol prevention programs on the drinking behavior of adolescents. There were seven electronic databases used for the literature search. A systematic review and meta-analysis are employed for works published in Korean and English from January 2010 to April 2021, with strict inclusion criteria yielding 12 papers in the review. The type of alcohol prevention interventions included educational and motivational interventions. Six studies had more than 500 participants each, and five studies had more than 10 participating schools. The programs did not effectively reduce the frequency of drinking or binge drinking of adolescents but significantly reduced the amount of alcohol consumed. Based on the results of this study, when planning alcohol prevention programs for adolescents, it is necessary to adopt a multi-level approach, including the engagement of parents and the community.
Abstrac
Alcohol misuse is more prevalent, frequent, and severe among young adults who use cannabis. Treatment of dual alcohol and cannabis users may have mixed results, with some studies reporting that alcohol misuse increases when cannabis use decreases (substance substitution), others report that alcohol misuse decreases along with decreasing cannabis use (treatment spillover), while others report no association. Additionally, little research tests whether gender differences are found in treatment of dual alcohol and cannabis users, which may be expected given previous alcohol-focused treatments showing larger effects for females. In the current study, we present a secondary analysis of a randomized clinical trial testing a text message-delivered cannabis use disorder (CUD) treatment (peer network counseling text or PNC-txt). The trial included 101 young adults ages 18–25 who met criteria for CUD. We tested whether alcohol use and binge drinking frequency (4+/5+ drinks for women/men) decreased in response to the PNC-txt treatment, which has previously shown effectiveness in reducing cannabis use days. Latent growth models tested PNC-txt effects on the monthly rate of change in alcohol use and binge drinking across three months. In the full sample, we found no evidence of significant treatment effects on alcohol use (d = −0.07) or binge drinking (d = −0.10). Moderation analyses, however, indicated the PNC-txt effect on both alcohol use and binge drinking differed significantly by gender. PNC-txt led to significantly larger decreases in alcohol use (d = −0.53) and binge drinking days (d = −0.43) across the three months for females, whereas the study saw opposite (but nonsignificant) effects for males (d = 0.30 and 0.16 for alcohol use and binge drinking, respectively). We found no evidence that reductions in alcohol use and binge drinking were associated with cannabis use decreases, arguing against direct substitution or spillover effects. These results provide evidence that treatments focused on cannabis use may have secondary beneficial effects for young-adult alcohol misuse, although such effects may be limited to women.
High school athletes are at risk for heavy alcohol use, which is associated with consequences that may negatively impact performance and eligibility to participate in sports. This study evaluated the efficacy of a web-based personalized normative feedback intervention on reducing alcohol use among high school athletes in their senior year. Class periods were randomized to the intervention or an assessment-only control group. Athletes completed surveys at baseline and at a 6-week follow-up. They were classified as high-risk or low-risk drinkers based on baseline reports of binge drinking. Results indicated that for athletes classified as high-risk drinkers, those in the intervention group reported significantly greater reductions in quantity of weekly drinking and peak drinking quantity compared with those in the assessment-only control group. There were no significant intervention effects for frequency of alcohol use. Findings support the efficacy of web-based personalized normative feedback intervention for reducing alcohol use among high school senior athletes.
Despite the escalation of alcohol use through high school, the majority of research on school‐based alcohol interventions has been conducted with junior high students or first and second‐year high school students. Preliminary research indicates a brief, web‐based personalized feedback intervention developed for college students (eCHECKUP TO GO) may be a promising program for high school seniors. Although these studies demonstrate positive intervention effects, there is some evidence for greater program efficacy for females in this age group. The current study investigates sex differences in program acceptability of the eCHECKUP TO GO and its relationship to short‐term alcohol outcomes among high school seniors (N = 135). Overall, the majority of students reported they found the program to be acceptable (i.e., user‐friendly and useful). However, contrary to our hypothesis, results indicated that male students reported significantly higher perceptions of program acceptability than females. Although we did not find sex differences in alcohol outcomes, program user‐friendliness was related to reductions in alcohol use for males. The results of this study add to the literature supporting the eCHECKUP TO GO for high school seniors and highlight the importance of program user‐friendliness for males. Implications for implementing the program as a school‐based intervention are discussed.
Background:
We tested the effect of initiating marijuana and alcohol use at varying frequencies on academic indices.
Methods:
In a sample of 26,475 grade 9-12 students with at least 2 years of linked longitudinal data from year 1 (Y1: 2012-2013), year 2 (Y2: 2013-2014), and year 3 (Y3: 2014-2015) of the COMPASS study, separate multinomial generalized estimating equations models tested the likelihood of responses to measures of academic goals, engagement, preparedness, and performance when shifting from never using alcohol or marijuana at baseline to using them at varying frequencies at follow -up.
Results:
Students who began using alcohol or marijuana were less likely to attend class regularly, complete their homework, achieve high marks, and value good grades, relative to their abstaining peers. Changing from abstaining to rare/sporadic-to-weekly drinking or rare/sporadic marijuana use predicted aspirations to continue to all levels of higher education, and initiating weekly marijuana use increased the likelihood of college ambitions, while more regular marijuana use reduced the likelihood of wanting to pursue graduate/professional degrees, over high school.
Conclusions:
The importance of delaying or preventing substance use is evident in associations with student performance and engagement. The influence on academic goals varied by substance and frequency of initiated use.
Excessive drinking in college leads to serious harms, but students who use protective behavioral strategies (PBS) avoid negative consequences by drinking in a safer manner. This study aimed to increase the content validity of the Serious Harm Reduction (SHR) subscale of the most widely used measure of PBS, the Protective Behavioral Strategies Scale (PBSS: Martens et al., 2005). An initial item pool was developed from literature on college student drinking, existing lists of drinking control strategies, and an online pilot survey of college students (N = 1,832). Items were also evaluated by focus groups of experts and members of the target population. Next, 1,376 students (57.9% women; Mage = 18.5 years; 86.3% White) completed questionnaires online. A subset (n = 170; 12.4%) completed a second survey 4–6 weeks later to examine test–retest reliability and criterion-related validity. The remaining students (n = 1,206) were divided into equal development and validation samples. Analyses included exploratory and confirmatory factor analysis of the development sample, factor structure replication, and gender invariance testing in the validity sample. Results of this process produced the PBSS-20, with an expanded SHR scale of eight items. The revised SHR scale demonstrated improved internal consistency and was associated with a broader range of alcohol-related negative consequences at follow-up. Given its focus on reducing serious harms, the SHR scale is arguably the most clinically relevant PBSS factor, and those who use this measure will benefit from the expanded breadth of SHR content and improved psychometric properties of the PBSS-20.
Preventive interventions for adolescents are an important priority within school systems. Several interventions have been developed, but the effectiveness of such interventions varies considerably between studies. The purpose of this study was to assess the effectiveness of universal school-based prevention programs on alcohol use among adolescents by using meta-analytic techniques.
A systematic literature search in the databases, PubMed (Medline), PsycINFO (Ovid), EMBASE (Ovid) and WEB of Science (ISI) was conducted to search for empirical articles published in the period January 1990 to August 2014.
In total, 28 randomized controlled studies with 39,289 participants at baseline were included. Of these 28 articles, 12 studies (N = 16279) reported continuous outcomes (frequency of alcohol use and quantity of alcohol use), and 16 studies (N = 23010) reported categorical data (proportion of students who drank alcohol). The results of the random effects analyses showed that the overall effect size among studies reporting continuous outcomes was small and demonstrated a favorable effect from the preventive interventions (Hedges' g = 0.22, p < .01). The effect size among studies reporting categorical outcomes was not significant (OR = 0.94, p = .25). The level of heterogeneity between studies was found to be significant in most analyses. Moderator analyses conducted to explore the heterogeneity showed neither significant difference between the different school levels (junior high schools and high schools), nor between the varied program intensities (low, medium and high intensity programs). The meta-regression analyses examining continuous moderators showed no significant effects for age or gender.
The findings from this meta-analysis showed that, overall, the effects of school-based preventive alcohol interventions on adolescent alcohol use were small but positive among studies reporting the continuous measures, whereas no effect was found among studies reporting the categorical outcomes. Possible population health outcomes, with recommendations for policy and practice, are discussed further in this paper.
In previous research using timeline follow-back methods to closely monitor drinking and related variables over the first year of college (9 months), we showed that drinking varied considerably over time in accord with academic requirements and holidays. In a new community sample (N = 576) of emerging adults (18- and 19-year-olds who reported having begun drinking prior to recruitment), we used similar methods to compare drinking patterns in college and noncollege individuals over a full calendar year (including summer). To reduce the extreme distortion in computations of average drinking over restricted time spans (i.e., 1 week) that arise because large numbers of even regular drinkers may not consume any alcohol, we analyzed data using recently developed two-part latent growth curve modeling. This modeling distinguished consumption levels from numbers of individuals drinking in a given period. Results showed that drinking levels and patterns generally did not differ between college and noncollege drinkers, and that both groups responded similarly to even those contexts that may have seemed unique to one (i.e., spring break). We also showed that computation of drinking amounts without accounting for "zero drinkers" could seriously distort estimates of mean drinking on some occasions; for example, mean consumption in the total sample appeared to increase on Thanksgiving, whereas actual average consumption for those who were drinking diminished.
Alcohol expectancies are strong concurrent predictors of alcohol use and problems, but the current study addressed their unique power to predict from adolescence to midlife.
Long-term longitudinal data from the national British Cohort Study 1970 (N = 2146, 59.8% female) were used to predict alcohol use and misuse in the mid-30s by alcohol expectancies reported in adolescence.
Cohort members with more positive alcohol expectancies at age 16 reported greater alcohol quantity concurrently, increases in alcohol quantity relative to their peers between ages 16 and 35, and a higher likelihood of lifetime and previous year alcohol misuse at age 35, independent of gender, social class in family of origin, age of alcohol use onset, adolescent delinquent behavior and age 16 exam scores.
Alcohol expectancies were strong proximal predictors of alcohol use and predicted relative change in alcohol use and misuse across two decades into middle adulthood.
No systematic review has focused on parental consenting procedures used in adolescent substance abuse treatment outcomes research. To address this gap, we examined parental consenting procedures in adolescent outcome studies (n = 34) published between 1980 and 2007. Although parental consent was required in 89% of adolescent treatment outcome studies we reviewed, consenting procedures were not routinely reported. We argue that parental consenting procedures should be routinely reported as a methodological feature of adolescent treatment outcome studies and, given concerns about sample bias in adolescent risk behavior research when parental consent is required, encourage outcomes researchers in this area to prospectively study the impact of consenting procedures on both the study participation rates and substance use reporting.
This study evaluated perceptions of same-sex and opposite-sex gender-specific versus gender-nonspecific drinking norms among college students (115 men, 111 women). This research is consistent with previous findings that college students overestimate the quantity and frequency of drinking among their gender-nonspecific peers and demonstrates that both men and women overestimate the quantity and frequency of the drinking of their same-sex peers. The findings suggest that perceived same-sex norms are more strongly associated with problematic drinking than are gender-nonspecific norms and that perceived same-sex drinking norms are stronger predictors of alcohol consumption for women than for men. Results suggest that interventions incorporating normative feedback should be framed differently for women than for men.
Objective:
The purpose of this randomized controlled study was to examine the efficacy of a brief, web-based personalized feedback intervention (the eCHECKUP TO GO) on alcohol use and alcohol-related consequences among high school seniors.
Method:
Participants (n = 221) were high school seniors randomized by class period to either a brief, web-based personalized feedback intervention (the eCHECKUP TO GO) or an assessment-only control group. Participants completed online surveys at baseline and at a 6-week follow-up.
Results:
Students participating in the eCHECKUP TO GO intervention reported a significant reduction in weekly drinking quantity, peak drinking quantity, and frequency of drinking to intoxication relative to those in the control group. Intervention effects were moderated by high-risk status (one or more episodes of heavy episodic drinking in the past 2 weeks reported at baseline) such that intervention effects were significant for high-risk students only. Results for alcohol-related consequences were not significant.
Conclusions:
Providing a brief, web-based personalized feedback intervention in the school setting is a promising approach for reducing problem alcohol use among high school seniors who report recent heavy episodic drinking.
The eCHECKUP TO GO is identified as a highly effective, low-cost individually-focused alcohol intervention by the NIAAA CollegeAIM guide. The research on the eCHECKUP TO GO for High School is less consistent, suggesting that the program content, originally designed for college students, may need modification for this age group. This randomized controlled study examined the effectiveness of the eCHECKUP TO GO for High School on shifting risk and protective factors for alcohol use targeted by the program at a 4–6 week follow-up. Female high school students in the intervention group reported a reduction in perceptions of peer drinking, beliefs about alcohol, and positive alcohol expectancies, compared to students in the control group. There were no group differences in risk factors for males or in protective behavioral strategies for either males or females. Results indicate the eCHECKUP TO GO for High School may be more effective for females and that program content targeting protective behavioral strategies may need modification for this age group.
Objective:
Adolescence is a period of neuromaturation concomitant with increased substance involvement. Most substance use studies of adolescents have focused on categorical classifications (e.g., dependent vs. nondependent), but little is known about the influence of specific substance use behaviors on cognitive functioning in youth.
Method:
This study prospectively evaluated the quantitative effects of different substance use behaviors on neuropsychological functioning. A cognitive test battery was administered at baseline (ages 12-14 years), before substance use initiation, and at follow-up (M = 4.0 years, SD = 2.0) to evaluate changes in verbal memory, visuospatial ability, psychomotor speed, processing speed, and working memory. Robust regressions examined substance use behaviors as predictors of neuropsychological functioning (N = 234).
Results:
Several substance use behaviors predicted follow-up neuropsychological functioning above and beyond effects of baseline performance on the same measure (ps < .05). Specifically, more alcohol use days predicted worse verbal memory (β = -.15) and visuospatial ability (β = -.19). More postdrinking effects (β = -.15) and greater drug use (β = -.11) predicted worse psychomotor speed. Processing speed was not predicted by substance involvement (ps > .05). Unexpectedly, more alcohol use predicted better working memory performance (β = .12).
Conclusions:
The frequency and intensity of adolescent alcohol use may be more intricately linked to neuropsychological outcomes than previously considered. The low prevalence of substance use disorder in the sample suggests that subdiagnostic users may still experience adverse effects to verbal memory, visuospatial functioning, and psychomotor speed after initiating intense or frequent alcohol use.
Interventions to reduce college student drinking, although efficacious, generally yield only small effects on behavior change. Examining mechanisms of change may help to improve the magnitude of intervention effects by identifying effective and ineffective active ingredients. Informed by guidelines for establishing mechanisms of change, we conducted a systematic review of alcohol interventions for college students to identify (a) which constructs have been examined and received support as mediators, (b) circumstances that enhance the likelihood of detecting mediation, and (c) the extent of evidence for mechanisms of change. We identified 61 trials that examined 22 potential mediators of intervention efficacy. Descriptive norms consistently mediated normative feedback interventions. Motivation to change consistently failed to mediate motivational interviewing interventions. Multiple active ingredient interventions were not substantially more likely to find evidence of mediation than single ingredient interventions. Delivering intervention content remotely reduced likelihood of finding support for mediation. With the exception of descriptive norms, there is inadequate evidence for the psychosocial constructs purported as mechanisms of change in the college drinking literature. Evidence for mechanisms will be yielded by future studies that map all active ingredients to targeted psychosocial outcomes and that assess potential mediators early, inclusively, and at appropriate intervals following interventions.
Copyright © 2015 Elsevier Ltd. All rights reserved.
Aims: Childhood expectancies about alcohol are present long before drinking begins. We examined the relationship between alcohol expectancies in childhood and onset of drinking, binge drinking, and drunkenness in adolescence and the influence of drinking onset on development of alcohol expectancies.
Design: A prospective, longitudinal study of children assessed for alcohol expectancies and drinking at 4 time points between ages 6 and 17.
Setting: Community study of families at high risk for alcoholism conducted in a 4-county area in the Midwest.
Participants: The study involved 614 children; 460 were children of alcoholics and 70% were male.
Measurements: Expectancies about effects of alcohol were measured using the Beverage Opinion Questionnaire and child???s drinking was measured using the Drinking and Drug History - Youth Form.
Findings: Partial factor invariance was found for expectancy factors from age 6 to age 17. Survival analysis showed that social/relaxation expectancies in childhood predicted time to onset of binge drinking and first time drunk (Wald chi-square, 1 d.f. = 3.8, p < .05 and 5.1, p < .05, respectively). The reciprocal effect was also present; when adolescents began drinking, there was an increase in social/relaxation expectancy and a concomitant increase in slope of the expectancy change lasting throughout adolescence.
Conclusions: A reciprocal relationship exists between childhood alcohol expectancies and involvement with alcohol. Higher expectancies for positive effects predict earlier onset of problem drinking. Onset of use, in turn, predicts an increase in rate of development of positive expectancies.
To examine the longitudinal associations between moral disengagement, alcohol related expectancies, perceived self-regulatory efficacy and alcohol use amongst adolescents.
A total of 367 students (mean age=13.1, SD=0.51; 65% male) from five schools across Sydney, Australia took part in this longitudinal study. Participants completed a self-report questionnaire at four time points across an 18month period which assessed their alcohol use, levels of moral disengagement, alcohol related expectancies and perceived self-regulatory efficacy to resist peer pressure to engage in transgressive behaviours.
Over time, rates of binge drinking in the past three months significantly increased, but rates of drinking any alcohol in the past three months remained stable. As hypothesised, all three cognitions were independently and consistently associated with adolescent alcohol use and binge drinking over time, with the exception of perceived self-regulatory efficacy which was not associated with an increased risk of drinking any alcohol in the past three months when controlling for moral disengagement, alcohol expectancies, gender and age.
The current study is the first study to longitudinally map three distinct cognitive factors associated with adolescent alcohol use. Considering the alarming number of adolescents drinking at levels that place them at risk of significant harm, this study has provided important implications about cognitive factors that can be targeted to increase the accuracy of assessment and efficacy of prevention for alcohol misuse amongst adolescents.
Alcohol use increases substantially during the transition from middle school to high school. This study tested a brief, web-based personalized feedback program aimed at reducing risk factors for drinking, alcohol use, and alcohol-related consequences among 9th grade students. At a 3-month follow-up, students in the intervention group showed positive results relative to those in the control group on variables associated with reduced risk, including positive alcohol expectancies and positive beliefs about alcohol. Students in the intervention group also reported a reduction in drinking frequency and alcohol-related consequences relative to those in the control group. There were, however, no differences in normative beliefs regarding peer drinking or quantity of weekly drinking between the two groups. Results indicate that a brief, web-based personalized normative feedback program delivered in the school setting is a promising approach to reducing alcohol use and the associated consequences among 9th grade students.
Issues:
The use of alcohol and drugs amongst young people is a serious concern and the need for effective prevention is clear. This paper identifies and describes current school-based alcohol and other drug prevention programs facilitated by computers or the Internet.
Approach:
The Cochrane Library, PsycINFO and PubMed databases were searched in March 2012. Additional materials were obtained from reference lists of papers. Studies were included if they described an Internet- or computer-based prevention program for alcohol or other drugs delivered in schools.
Key findings:
Twelve trials of 10 programs were identified. Seven trials evaluated Internet-based programs and five delivered an intervention via CD-ROM. The interventions targeted alcohol, cannabis and tobacco. Data to calculate effect size and odds ratios were unavailable for three programs. Of the seven programs with available data, six achieved reductions in alcohol, cannabis or tobacco use at post intervention and/or follow up. Two interventions were associated with decreased intentions to use tobacco, and two significantly increased alcohol and drug-related knowledge.
Conclusion:
This is the first study to review the efficacy of school-based drug and alcohol prevention programs delivered online or via computers. Findings indicate that existing computer- and Internet-based prevention programs in schools have the potential to reduce alcohol and other drug use as well as intentions to use substances in the future. These findings, together with the implementation advantages and high fidelity associated with new technology, suggest that programs facilitated by computers and the Internet offer a promising delivery method for school-based prevention.
Blood alcohol concentrations (BACs) in children after consumption of different numbers of standard drinks of alcohol have not been estimated previously. The goal was to determine the number of drinks at each age that led to a BAC of > or =80 mg/dL, the National Institute on Alcohol Abuse and Alcoholism criterion for binge drinking.
The updated Widmark equation to estimate BAC was modified to take account of the differing body composition (total body water) and accelerated rates of ethanol elimination of children. The modified formula was used with 1999-2002 National Health and Nutrition Examination Survey data to estimate BACs for >4700 children and adolescents from 9 through 17 years of age, for intake levels of 1 to 5 standard drinks.
The estimated BACs for children after consumption of just 3 standard drinks within a 2-hour period were between 80 and 139 mg/dL for boys 9 to 13 years of age and for girls 9 to 17 years of age, indicating substantial potential alcohol impairment. With 5 drinks within 2 hours (the level used to define binge drinking among college students), children 9 to 13 years of age were estimated to have BACs 2 to 3 times the adult legal limit for intoxication of 80 mg/dL.
Binge drinking should be defined as > or =3 drinks for 9- to 13-year-old children, as > or =4 drinks for boys and > or =3 drinks for girls 14 or 15 years of age, and as > or =5 drinks for boys and > or =3 drinks for girls 16 or 17 years of age.
The present study surveyed 930 high school students regarding self-reported alcohol use, their perceptions of parents and peers, and the negative consequences of drinking. Two-fifths of males and one-fifth of females reported frequent problem (binge) drinking. Problem drinkers reported more negative consequences associated with drinking. In addition, problem drinkers reported greater susceptibility to peer pressure, perceived their peers as drinking more, and reported less parental monitoring and more use of alcohol by parents. The results demonstrate the importance of both parent and peer variables in adolescent substance use and highlight the negative consequences of drinking reported by high school students.
Underage drinking contributes to the 3 leading causes of death (unintentional injury, homicide, and suicide) among persons aged 12 to 20 years. Most adverse health effects from underage drinking stem from acute intoxication resulting from binge drinking. Although binge drinking, typically defined as consuming > or = 5 drinks on an occasion, is a common pattern of alcohol consumption among youth, few population-based studies have focused specifically on the characteristics of underage binge drinkers and their associated health risk behaviors.
We analyzed data on current drinking, binge drinking, and other health risk behaviors from the 2003 National Youth Risk Behavior Survey. Prevalence estimates and 95% confidence intervals were calculated by using SAS and SUDAAN statistical software. Logistic regression was used to examine the associations between different patterns of alcohol consumption and health risk behaviors.
Overall, 44.9% of high school students reported drinking alcohol during the past 30 days (28.8% binge drank and 16.1% drank alcohol but did not binge drink). Although girls reported more current drinking with no binge drinking, binge-drinking rates were similar among boys and girls. Binge-drinking rates increased with age and school grade. Students who binge drank were more likely than both nondrinkers and current drinkers who did not binge to report poor school performance and involvement in other health risk behaviors such as riding with a driver who had been drinking, being currently sexually active, smoking cigarettes or cigars, being a victim of dating violence, attempting suicide, and using illicit drugs. A strong dose-response relationship was found between the frequency of binge drinking and the prevalence of other health risk behaviors.
Binge drinking is the most common pattern of alcohol consumption among high school youth who drink alcohol and is strongly associated with a wide range of other health risk behaviors. Effective intervention strategies (eg, enforcement of the minimum legal drinking age, screening and brief intervention, and increasing alcohol taxes) should be implemented to prevent underage alcohol consumption and adverse health and social consequences resulting from this behavior.
The epidemiological features of underage drinking and evidence of its social, health, and economic consequences suggest compelling reasons for the development and dissemination of effective preventive interventions. To clarify the nature and extent of the current evidence base on preventive interventions addressing underage drinking, a review of the literature was conducted through extensive searches of the research literature on outcome evaluations, existing reviews of this body of outcome research (N = 25), and summary reports of evidence on specific interventions. More than 400 interventions were identified and screened, and the evidence for 127 was reviewed. Criteria for the evaluation of evidence were established for intervention studies with alcohol-specific outcome measures for 3 developmental periods (< 10, 10-15, and 16 to > or = 20 years of age). Ultimately, 12 interventions met criteria for "most promising" evidence and 29 met criteria for "mixed or emerging" evidence. Conducting this review revealed clear advances in the number of evidence-based interventions available and the quality of outcome research; however, much work remains to achieve greater public health impact through evidence-based interventions. This work should consider (1) the great need for intervention research related to understudied developmental phases, intervention domains (eg, family, school, community, and media), and populations (eg, early tweens, late teens, young adults not attending college, and nonmajority populations); (2) the critical importance of addressing key issues in research design and methods (eg, limited longitudinal studies, replication studies, and dissemination research); and (3) the need for improved consistency in application of evidence and reporting standards. Finally, we recommend the application of emerging consumer-oriented and community-participatory models for intervention development and research, designed to increase the likelihood of "real-world" public health impact through improved translation of intervention science into practice.