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Evaluating Non-response Bias in a Parent-Based College Alcohol Intervention
Substance Use & Misuse
Abstract
Background: The purpose of this study was to address a dearth in the literature on non-response bias in parent-based interventions (PBIs) by investigating parenting constructs that might be associated with whether a parent volunteers to participate in a no-incentive college drinking PBI. Method: Incoming first-year students (N = 386) completed an online questionnaire that included items assessing plausible predictors of participation in a PBI (students' drinking, perceptions of parents' harm-reduction and zero-tolerance alcohol communication, whether parents allowed alcohol, and changes in parents' alcohol rules). Four months later, all parents of first-year students at the study university were invited to join the PBI, which was described as a resource guide to teach them how to help their student navigate the college transition and prepare them for life at their university. Results: Parents who signed up for the intervention used greater harm-reduction communication than those who did not sign up, were more likely to have allowed alcohol use, and signing up was significantly associated with student reports that fathers became less strict toward drinking after high school. Students' drinking and zero-tolerance communication did not significantly differ between the groups. Conclusion: Results indicate that non-response bias can be an issue when utilizing a real-world, non-RCT recruitment approach to invite parents into a PBI (i.e., non-incentivized, inviting all parents). Findings suggest that more comprehensive recruitment strategies may be required to increase parent diversity in PBIs.
... parents who were invited but did not sign-up) had students who were found to be higher risk for drinking during the transition to college (e.g., parents were less likely to be zero-tolerance). 46 Results also revealed that students with parents randomized to FITSTART+ PBI decreased their peak number of drinks consumed in the past month relative to students with parents randomized to FITSTART+ Control. 36 Further, students who moved out of their parents' home and who had a parent in the intervention application were found to have a greater likelihood of not drinking during a typical week than students in the control condition who moved out of their parents' home. ...
... These results are in line with our previous study that suggests parents who sign up to participate in FITSTART+ typically have children who are at higher risk for alcohol use during college. 46 No other significant differences were detected between students with and without a parent who volunteered to participate. Students who completed at least one follow-up reported significantly lower peak drinking (t(77.40) ...
... Thus, if FITSTART+ were to be promoted by universities through incoming parent portals, they could expect engagement rates in line with or better than what was found here. Further, our data across two studies now reveal that the parents who needed a PBI the most signed up (i.e., those whose students were at greater risk for heavy drinking and consequences), 46 giving more credence to this approach. ...
Objective: This study evaluated FITSTART+, a parent-based intervention (PBI), for preventing risky drinking among first-year college students. Participants: Participants were traditional first-year students aged between 17 and 20. Method: In total, 391 eligible students completed a baseline survey and their parents were then invited to use the FITSTART+ PBI or Control web-applications. 266 students had a parent who created a profile in the app (FITSTART+ PBI, n = 134; FITSTART+ Control, n = 132). Additionally, 58 parents randomized to the FITSTART+ PBI did not complete the personalized normative feedback (PNF) component of the intervention. Results: No significant effect on drinking or related consequences was detected between Intervention and Control groups. However, exploratory analyses revealed that completing PNF in the FITSTART+ PBI condition was associated with a greater likelihood of remaining zero on consequences at follow-ups. Conclusion: The PNF component of the FITSTART+ PBI showed potential in preventing risky drinking, warranting further research.
... Based on past work [10], we also expected that not communicating due to concerns that a child would be unresponsive would be associated with lower relational closeness. Given that parents' reluctance to talk about alcohol could have important implications for PBI content and recruitment, the study also adds to the limited research examining factors associated with willingness to participate in a PBI [20]. We expected that parents who believed they lacked the skills to discuss alcohol use might be more open to participating in a PBI than those who avoided conversations because they believed they were futile or because of privacy concerns. ...
... While PBIs for parents of EAs have been shown to be an effective approach to reducing alcohol risk [3e5]. There is limited research examining if there are specific groups of parents that are more likely to engage with these programs [20]. The current results suggest that parents who report not communicating due to using indirect methods of communication may be most open to participating in an alcohol-related PBI. ...
Purpose:
It is unclear why parents avoid discussing alcohol use with their emerging adult (EA) children. Understanding parents' reasons for not communicating could inform parent-based interventions (PBIs) aimed at encouraging constructive discussions. The current study adds to the literature by examining common reasons parents avoid discussing alcohol use with their EA children.
Methods:
Parents of EAs completed a web-based survey that included items assessing reasons for not communicating about alcohol, as well as measures of alcohol communication intentions, parenting self-efficacy, relationship quality, and interest in participating in an alcohol PBI.
Results:
Results from the Exploratory Factor Analysis revealed five core reasons why parents do not communicate about alcohol: (1) they lack the skills or resources to communicate; (2) they believe their child is a nondrinker; (3) they believe their child is an independent, trustworthy decision maker; (4) they can teach their child how to drink through modeling; (5) they believe communication is futile. Believing that an EA could and should make their own alcohol decisions was the most common reason for not communicating. In multivariate analyses, this reason for not communicating was associated with greater levels of parental self-efficacy and perceiving a child to drink less alcohol. Further, this reason for not communicating was associated with lower intentions to communicate about drinking and less interest in taking part in a PBI.
Discussion:
Most parents reported barriers to communication. Understanding why parents are reluctant to discuss alcohol use could inform PBI efforts.
... At the end of the baseline questionnaire, students were asked to provide their parents' information to invite them into the study (N = 2,867). Since mothers are more likely to volunteer to participate in this type of research (Morgan et al., 2022;Napper et al., 2022;Va rvil-Weld et al., 2013) and findings suggest that associations between mother-child communication and child alcohol use and other risk behavior are stronger than those with father-child communication (Abar et al., 2009;Cleveland et al., 2014;Turrisi et al., 1994), we invited all participants' mothers and we randomly invited 30% of fathers of students whose mothers agreed to be in the study. There was also a small percentage of students who did not report having a mother (<3%). ...
Objective:
Whether college students' reports of their parents' behaviors are as reliable a predictor of student drinking as their parents' own reports remains an open question and a point of contention in the literature. To address this, the current study examined concordance between college student and mother/father reports of the same parenting behaviors relevant to parent-based college drinking interventions (relationship quality, monitoring, and permissiveness), and the extent to which student and parent reports differed in their relation to college drinking and consequences.
Method:
The sample consisted of 1,429 students and 1,761 parents recruited from three large public universities in the United States (814 mother-daughter, 563 mother-son, 233 father-daughter, and 151 father-son dyads). Students and their parents were each invited to complete four surveys over the course of the students' first four years of college (one survey per year).
Results:
Paired samples t-tests revealed that parent reports of parenting constructs were typically more conservative than student reports. Intraclass correlations revealed moderate associations between parent and student reports on quality of parenting, general monitoring, and permissiveness. The associations between parenting constructs and drinking and consequences were also consistent when using parent and student reports of permissiveness. Results were generally consistent for all four types of dyads, and at each of the four time points.
Conclusions:
Taken together, these findings provide additional support for the use of student reports of parental behaviors as a valid proxy of parents' actual reports and as a reliable predictor of college student drinking and consequences.
Parent-based interventions (PBIs) and living at home with one’s parents both have been shown to mitigate alcohol risk associated with the first year of college. The current study extends these findings by examining the independent and interactive effects of these two constructs on first-year drinking. The sample included 82 parent-student dyads. Parents were randomized to receive an online PBI that either did (intervention; n=44) or did not (n=38) include alcohol-related content in December 2020. Students completed online surveys assessing college residence and drinking (typical weekly and peak) in August 2020 (T1) and February 2021 (T2). Hierarchical zero-inflated Poisson models assessed the main and interaction effects of having a parent in the intervention group (vs. control) and living with parents (vs. without) on drinking outcomes, controlling for T1 alcohol use. Results revealed that living with parents predicted decreases in typical weekly drinking and having a parent in the intervention predicted decreases in the number of drinks consumed on one’s peak drinking occasion at T2. Treatment*residence was also significantly associated with typical weekly drinking in the inflated model. These results suggest that moving out was associated with a greater likelihood of not drinking during a typical week if students had a parent in the intervention and a lower likelihood of not drinking during a typical week if they had parent in the control application. Together, findings support continued exploration of this online PBI as it appears to reduce peak drinking during the first year of college and reduces the odds of students drinking during a typical week when they move out of their parents’ home.
Background
In spring 2020, U.S. universities closed campuses to limit the transmission of COVID‐19, resulting in an abrupt change in residence, reductions in social interaction, and in many cases, movement away from a heavy drinking culture. The present mixed‐methods study explores COVID‐19‐related changes in college student drinking. We characterize concomitant changes in social and location drinking contexts and describe reasons attributed to changes in drinking.
Methods
We conducted two studies of the impact of the COVID‐19 pandemic on drinking behavior, drinking context, and reasons for both increases and decreases in consumption among college students. Study 1 (qualitative) included 18 heavy‐drinking college students (Mage = 20.2; 56% female) who completed semi‐structured interviews. Study 2 (quantitative) included 312 current and former college students who reported use of alcohol and cannabis (Mage = 21.3; 62% female) and who completed an online survey.
Results
In both studies, COVID‐19‐related increases in drinking frequency were accompanied by decreases in quantity, heavy drinking, and drunkenness. Yet, in Study 2, although heavier drinkers reduced their drinking, among non‐heavy drinkers several indices of consumption increased or remained stable . Both studies also provided evidence of reductions in social drinking with friends and roommates and at parties and increased drinking with family. Participants confirmed that their drinking decreased due to reduced social opportunities and/or settings, limited access to alcohol, and reasons related to health and self‐discipline. Increases were attributed to greater opportunity (more time) and boredom and to a lesser extent, lower perceived risk of harm and to cope with distress.
Conclusion
This study documents COVID‐19‐related changes in drinking among college student drinkers that were attributable to changes in context, particularly a shift away from heavy drinking with peers to lighter drinking with family. Given the continued threat of COVID‐19, it is imperative for researchers, administrators, and parents to understand these trends as they may have lasting effects on college student drinking behaviors.
This study examined the efficacy of a personalized normative feedback (PNF) alcohol intervention for parents of students transitioning into college. A sample of 399 parent–student dyads were recruited to take part in the intervention during the summer prior to matriculation. Parents were randomly assigned to receive either normative feedback regarding student drinking and other college parents’ alcohol-related communication or general college health norm information. Students completed measures of alcohol use, alcohol consequences, and parent–child alcohol-specific communication both 1 and 6 months after matriculation. The results indicated that in comparison with the control condition parents who received PNF reported immediate changes in their perceptions of other parents’ behaviors; however, these changes in parent perceived norms did not translate into long-term changes in student drinking behaviors or parent–child communication. Findings highlight the need to consider content beyond normative feedback for parent based alcohol intervention.
A randomized controlled trial tested an interactive normative feedback-based intervention—codenamed“FITSTART”—delivered to groups of 50–100 parents of matriculating college students. The 60-minsession motivated parents to alter their alcohol-related communication by correcting normative misperceptions
(e.g., about how approving other parents are of student drinking) with live-generated data. Then,tips were provided on discussing drinking effectively. Incoming students (N � 331; 62.2% female)completed baseline measures prior to new-student orientation. Next, at parent orientation in June, thesestudents’ parents were assigned to either FITSTART or a control session. Finally, 4 months later, students
completed a follow-up survey. Results revealed that students whose parents received FITSTART duringthe summer consumed less alcohol and were less likely to engage in heavy episodic drinking (HED)
during the first month of college. These effects were mediated by FITSTART students’ lower perceptionsof their parents’ approval of alcohol consumption. Further, FITSTART students who were not drinkersin high school were less likely to initiate drinking and to start experiencing negative consequences duringthe first month of college, where FITSTART students who had been drinkers in high school experiencedfewer consequences overall and were significantly more likely to report that they did not experience anyconsequences whatsoever during the first month of college. Importantly, FITSTART is the first parentbasedintervention to impact HED, one of the most well-studied indicators of risky drinking. Thus, interactive group normative feedback with parents is a promising approach for reducing college alcohol risk.
Keywords: parent-based intervention, alcohol, college, normative feedback
Recent efforts to reduce college student heavy episodic drinking have examined parental influences, with the goal of continually refining parent-based interventions (PBIs). This research has primarily relied on student-reported data, which is often cited as a methodological limitation although the degree to which parent- and student-reported data on parenting behaviors correspond is unknown. The goals of the present study were to assess the level of consistency between parent- and student-reported data for commonly examined parenting constructs and compare their associations with college student drinking. Data were collected from a sample of 145 parent-student dyads using a longitudinal design. At baseline, parents and students reported on parental monitoring, approval of light and moderate/heavy drinking, and permissiveness. At a 10-month follow up, students reported on their typical weekly drinking and consequences. Parents' and students' reports of parenting behavior at baseline were compared and their associations with student drinking and consequences at follow up were assessed. Agreement between parents' and students' reports of parenting was fair to moderate, with intraclass correlation coefficients ranging from .34 to .61. Student-reported data were more reliably associated with student drinking at follow up. Studies examining parent influences on college student drinking, including research on PBIs, do not appear to be limited by using student-reported data. Implications for future research are discussed.
Parental beliefs and rules regarding their teen's use of alcohol influence teen decisions regarding alcohol use. However, measurement of parental rules regarding adolescent alcohol use has not been thoroughly studied. This study used qualitative interviews with 174 parents of older teens from 100 families. From open-ended questions, themes emerged that describe explicit rules tied to circumscribed use, no tolerance, and "call me." There was some inconsistency in explicit rules with and between parents. Responses also generated themes relating to implicit rules such as expectations and preferences. Parents described their methods of communicating their position via conversational methods, role modeling their own behavior, teaching socially appropriate use of alcohol by offering their teen alcohol, and monitoring their teens' social activities. Findings indicate that alcohol rules are not adequately captured by current assessment measures.
Objective:
The study evaluated the timing and dosage of a parent-based intervention to minimize alcohol consumption for students with varying drinking histories.
Method:
First-year students (N = 1,900) completed Web assessments during the summer before college (baseline) and two follow-ups (fall of first and second years). Students were randomized to one of four conditions (pre-college matriculation [PCM], pre-college matriculation plus boosters [PCM+B], after college matriculation [ACM], and control conditions). Seven indicators of drinking (drink in past month, been drunk in past month, weekday [Sunday to Wednesday] drinking, Thursday drinking, weekend [Friday, Saturday] drinking, heavy episodic drinking in past 2 weeks, and peak blood alcohol concentration <.08) were used in a latent transition analysis (LTA) to examine a stage-sequential model of drinking. LTA models with dummy-coded intervention variables were used to examine the effects of the intervention conditions on changes in drinking patterns.
Results:
Results indicated that four patterns of drinking were present at all waves: (a) nondrinkers, (b) weekend light drinkers, (c) weekend heavy episodic drinkers, and (d) heavy drinkers. Results indicated that the PCM condition was most effective at influencing baseline heavy drinkers' transition out of this pattern to lower risk patterns at first follow-up, whereas the ACM condition was not effective at preventing drinking escalation for baseline nondrinkers at first follow-up. No decay of effects was observed at long-term follow-up for the PCM condition. Finally, the results also indicated that increased dosage of the parental intervention was not significantly associated with either reduction or escalation of use.
Conclusions:
The results underscore the value of pre-college parental interventions and targeted efforts to reduce high-risk drinking among college students.
A debate remains regarding whether parents should teach their children harm-reduction tips for using alcohol while in college or whether they should maintain a zero-tolerance policy. Which type of alcohol-related communication parents should endorse is not empirically clear. The current study made use of a longitudinal measurement-burst design to examine this issue.
The sample consisted of 585 second-year students from a large university in the northeastern United States. Participants completed a baseline survey and 14 daily web-based surveys. Students were assessed for perceptions of parental alcohol-related messages and their own alcohol use. Multilevel models were estimated using HLM 6.04.
The data indicate that zero-tolerance messages appeared most protective against alcohol use and consequences. Harm-reduction messages were most risky, even when compared with mixed messages or the absence of a message.
Findings indicate that a zero-tolerance approach was associated with safer outcomes than other messages, even if students were already using alcohol.
This study used Latent Transition Analysis (LTA) to examine a stage-sequential model of alcohol use among a sample of high-risk matriculating college students (N = 1,275). Measures of alcohol use were collected via web-administered surveys during the summer before entering college and followed-up during the fall semester of college. Seven indicators of alcohol use were used in the LTA models, including temporal measures of typical drinking throughout the week. The results indicated that four latent statuses characterized patterns of drinking at both times, though the proportion of students in each status changed during the transition to college: (a) nondrinkers; (b) weekend nonbingers; (c) weekend bingers; and (d) heavy drinkers. Heavy drinkers were distinguished by heavy episodic drinking (HED), and increased likelihood of drinking throughout the week, especially on Thursdays. Covariates were added to the LTA model to examine the main and interaction effects of parent- and peer-based intervention components. Results indicated that participants in the parent and peer conditions were least likely to transition to the heavy drinkers status. Results also indicated that the parent condition was most effective at preventing baseline nondrinkers from transitioning to heavy drinkers whereas the peer condition was most effective at preventing escalation of use among weekend nonbingers. The results underscore the value of considering multiple dimensions of alcohol use within a person-centered approach. Differential treatment effects were found across baseline drinking class, suggesting the benefit for tailored intervention programs to reduce high-risk drinking among college students. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
Matriculation from high school to college is typified by an increase in alcohol use and related harm for many students. Therefore, this transition period is an ideal time for preventive interventions to target alcohol use and related problems.
The purpose of this report is to describe the design and methods used in the Transitions Project, a randomized controlled trial of two interventions designed to prevent and reduce heavy episodic drinking and alcohol-related negative consequences among incoming college students.
This study used a 2 × 2 factorial design to investigate the effects of a two-session brief motivational intervention delivered to students and a handbook-based parent intervention. Interventions were administered to students and parents. Follow-up assessment took place at 10- and 22-months post-baseline.
The Transitions Project successfully recruited and retained participants across a major transition period (i.e., entering college), administered and compared two distinct but complementary interventions, and collected and analyzed highly skewed data. The application of a factorial design and two-part latent growth curve modeling allowed us to examine main and interactive intervention effects in terms of both initiation and growth in heavy drinking and alcohol-related problems.
While we conducted successful tests of our primary and secondary study hypotheses over a lengthy follow-up period, our study design did not permit full interpretation of null findings. We suggest that researchers carefully consider assessment timing, tests of assessment reactivity, and ensure objective tests of intervention efficacy when conducting clinical trials of motivational interventions.
The lessons we learned while conducting this trial have the potential to assist other researchers designing and conducting future preventive interventions targeting parents and college students. The data analytic procedures presented can also help guide trials that plan to analyze zero-inflated non-normal outcome data.
Using a randomized factorial design, we examined the efficacy of a brief motivational intervention (BMI) and a parent-based intervention (PBI) as universal preventive interventions to reduce alcohol use among incoming college students.
Participants (N = 1,014) were assessed prior to matriculation and at 10 months and 22 months postbaseline. Two-part latent growth modeling was used to simultaneously examine initiation and growth in heavy episodic drinking and alcohol-related consequences.
This study retained 90.8% (n = 921) of randomized students at the 10-month follow-up and 84.0% (n = 852) of randomized students at the 22-month follow-up. BMI participants were significantly less likely than non-BMI participants to initiate heavy episodic drinking and to begin experiencing alcohol-related consequences. Effect sizes were minimal at 10 months (Cohen's h ranged from 0.02 to 0.07) and were small at 22 months (hs ranged from 0.15 to 0.22). A significant BMI x PBI interaction revealed that students receiving both the BMI and the PBI were significantly less likely to report the onset of consequences beyond the sum of the individual intervention effects (h = 0.08 at 10 months, and h = 0.21 at 22 months). Hypothesized direct BMI effects for reductions in heavy episodic drinking and consequences were not observed. Significant mediated effects via changes in descriptive norms were present for both growth and initiation of heavy episodic drinking and consequences.
To our knowledge, the current study is the first to provide support for BMI as a universal preventive intervention for incoming college students. Although hypothesized PBI main effects were not found, mediation analyses suggest future refinements could enhance PBI effectiveness.
A randomized controlled trial, using parent-based intervention (PBI) was designed to reduce the incidence of alcohol-involved sexual victimization among first-year college students. The PBI, adapted from Turrisi et al. (2001), was designed to increase alcohol-specific and general communication between mother and daughter. Female graduating high school seniors and their mothers were recruited from the community and randomly assigned to one of four conditions: Alcohol PBI (n = 305), Enhanced Alcohol + Sex PBI (n = 218), Control (n = 288) or Unmeasured Control (n = 167). Mothers in the intervention conditions were provided an informational handbook and encouraged to discuss its contents with their daughters prior to college matriculation. Consistent with hypotheses, PBI, either standard or enhanced, was associated with lower incidence of incapacitated rape in the first year of college relative to controls. Path analysis revealed support for a hypothesized indirect effects model, by which intervention increased mother-daughter communication, which predicted lower frequency of first semester heavy episodic drinking, resulting in lower rates of alcohol-involved sexual victimization in the first year of college.
The current study is a multisite randomized alcohol prevention trial to evaluate the efficacy of both a parenting handbook intervention and the Brief Alcohol Screening and Intervention for College Students (BASICS) intervention, alone and in combination, in reducing alcohol use and consequences among a high-risk population of matriculating college students (i.e., former high school athletes).
Students (n = 1,275) completed a series of Web-administered measures at baseline (in the summer before starting college) and follow-up (after 10 months). Students were randomized to one of four conditions: parent intervention only, BASICS only, combined (parent and BASICS), and assessment-only control. Intervention efficacy was tested on a number of outcome measures, including peak blood alcohol concentration, weekly and weekend drinking, and negative consequences. Hypothesized mediators and moderators of intervention effect were tested.
The overall results revealed that the combined-intervention group had significantly lower alcohol consumption, high-risk drinking, and consequences at 10-month follow-up, compared with the control group, with changes in descriptive and injunctive peer norms mediating intervention effects.
The findings of the present study suggest that the parent intervention delivered to students before they begin college serves to enhance the efficacy of the BASICS intervention, potentially priming students to respond to the subsequent BASICS session.
To study characteristics of importance for participation in a diet and physical exercise prevention programme.
Primary Health Care, Sollentuna, and the Karolinska Hospital, Stockholm, Sweden.
A sample of 187 men, aged 35-60, with increased risk factors for CHD, were invited to a 6-month prevention programme. Participants (n = 158) were randomized into a diet group, a physical exercise group, a diet and physical exercise group, and a control group. Twenty-seven men, who declined participation, formed the group of nonparticipants.
Participants and nonparticipants were compared with respect to health beliefs, health knowledge, CHD risk factors, demographic and personality factors.
Characteristics of men participating and not participating in the intervention trial.
Nonparticipants, compared with participants, believed less in the benefits of dietary change and perceived the health threat of stroke and myocardial infarction as less serious. Nonparticipants had a better knowledge of a number of risk factors for cardiovascular disease.
Belief in treatment efficacy and perceived health threat, rather than health knowledge, predicted initial participation in a non-pharmacological intervention trial.
The research evaluated the efficacy of an intervention to reduce the onset and extent of binge drinking during the 1st year of college. The approach was on influencing the students before they start college, through their parents, during the critical time between high school graduation and the beginning of college. Specifically, parents were educated about binge drinking and how to convey information to their teens, and then encouraged to talk with their teens just before their teens embarked on their college education. Teens whose parents implemented the intervention materials were compared with a control sample during their 1st semester on drinking outcomes, perceptions about drinking activities, perceived parental and peer approval of drinking, and drinking-related consequences. As anticipated, teens in the treatment condition were significantly different (p < .05) on nearly all outcomes in the predicted directions (e.g., lower drinking tendencies, drinking consequences). The benefits of a parent-based intervention to prevent college drinking are discussed.
This study investigated the influences of peer and parent variables on alcohol use and problems in a sample of late adolescents in the summer immediately prior to entry into college. Participants (N = 556) completed a mail survey assessing peer influences (alcohol offers, social modeling, perceived norms), parental behaviors (nurturance, monitoring), and attitudes and values (disapproval for heavy drinking, permissiveness for drinking), and alcohol use and alcohol-related consequences. Hierarchical regression analyses indicated significant associations between both peer and parental influences and alcohol involvement, and showed that parental influences moderated peer-influence-drinking behavior, such that higher levels of perceived parental involvement were associated with weaker relations between peer influences and alcohol use and problems. These findings suggest that parents continue to exert an influential role in late adolescent drinking behavior.
Parent-based interventions (PBIs) and living at home with one’s parents both have been shown to mitigate alcohol risk associated with the first year of college. The current study extends these findings by examining the independent and interactive effects of these two constructs on first-year drinking. The sample included 82 parent-student dyads. Parents were randomized to receive an online PBI that either did (intervention; n=44) or did not (n=38) include alcohol-related content in December 2020. Students completed online surveys assessing college residence and drinking (typical weekly and peak) in August 2020 (T1) and February 2021 (T2). Hierarchical zero-inflated Poisson models assessed the main and interaction effects of having a parent in the intervention group (vs. control) and living with parents (vs. without) on drinking outcomes, controlling for T1 alcohol use. Results revealed that living with parents predicted decreases in typical weekly drinking and having a parent in the intervention predicted decreases in the number of drinks consumed on one’s peak drinking occasion at T2. Treatment*residence was also significantly associated with typical weekly drinking in the inflated model. These results suggest that moving out was associated with a greater likelihood of not drinking during a typical week if students had a parent in the intervention and a lower likelihood of not drinking during a typical week if they had parent in the control application. Together, findings support continued exploration of this online PBI as it appears to reduce peak drinking during the first year of college and reduces the odds of students drinking during a typical week when they move out of their parents’ home.
Past research has explored the content and frequency of alcohol-specific communication between parents and their emerging adult children. The current study aimed to address a gap in the research by examining parents' motivation for discussing alcohol. To accomplish this, we developed a multidimensional Parent Motives for Alcohol Communication Scale (PMACS). A total of 633 parents completed the PMACS along with measures assessing communication frequency, communication content, attitudes toward drinking, relationship quality, and perceptions of child alcohol use. An Exploratory Factor Analysis yielded five core communication motives. Parents were commonly motivated by desires to prevent their child’s alcohol use, to respond to their child’s heavy drinking, to teach their child how to drink safely, to meet relationship needs or expectations, and by a family history of alcohol problems. After controlling for demographic factors, communication motives predicted frequency of alcohol-specific communication. The patterns of relationship among motives and conceptually related constructs provided preliminary support for the construct validity of the PMACS.
http://deepblue.lib.umich.edu/bitstream/null/1/FINAL.pdf
Past cross-sectional research suggests that zero-tolerance messaging by parents of college students may be more effective than harm-reduction communication at reducing student alcohol risk. The current study employs longitudinal data to examine whether communication type interacts with student alcohol use to predict subsequent drinking outcomes. U.S. college students reported on their own exposure to zero-tolerance and harm-reduction maternal communication. Approximately seven months later, students completed measures of maternal alcohol approval and their own alcohol behaviors. The relationship between communication and subsequent alcohol behaviors depended on students’ baseline drinking. For heavy drinkers, harm-reduction communication was associated with less alcohol use and consequences. For those who drank less than two drinks a week, zero-tolerance communication was associated with fewer negative consequences. Zero-tolerance communication was associated with perceiving mothers as less approving, while harm reduction communication was associated with perceiving mothers as more approving. There were indirect effects of communication on drinking through perceived maternal approval. While overall harm-reduction communication may lead students to perceive mothers as more approving of alcohol use, there may be contexts in which this type of communication is beneficial.
The current study aims to examine discrepancies in parents' and college students' perceptions of alcohol risk and the role of perceived risk in predicting parents' intentions to discuss alcohol with their child.
In total, 246 college student-parent dyads (56.1% female students, 77.2% mothers) were recruited from a mid-size university. Participants completed measures of absolute likelihood, comparative likelihood, and severity of alcohol consequences.
In comparison to students, parents perceived the risks of alcohol poisoning (p<.001), academic impairment (p<.05), and problems with others (p<.05) to be more likely. In addition, parents rated the majority of alcohol consequences (e.g., passing out, regrettable sexual situation, throwing up) as more severe than students (all ps<.001). However, parents tended to be more optimistic than their child about the comparative likelihood of alcohol consequences. After controlling for demographics and past alcohol communication, greater absolute likelihood (β=.20, p=.016) and less confidence in knowledge of student behavior (β=.20, p=.013) predicted greater intentions to discuss alcohol.
Providing parents of college students with information about college drinking norms and the likelihood of alcohol consequences may help prompt alcohol-related communication.
Copyright © 2014 Elsevier Ltd. All rights reserved.
The study examined parent profiles among high school athletes transitioning to college and their association with high-risk drinking in a multi-site, randomized trial. Students (n = 587) were randomized to a control or combined parent-based and brief motivational intervention condition and completed measures at baseline and at 5- and 10-month follow-ups. Four parent profiles (authoritative, authoritarian, permissive, indifferent) were observed among participants. Findings indicated control participants with authoritarian parenting were at the greatest risk for heavy drinking. Alternately, students exposed to permissive or authoritarian parenting reported lower peak drinking when administered the combined intervention, compared to controls. Findings suggest the combined intervention was efficacious in reducing peak alcohol consumption among high-risk students based on athlete status and parenting profiles.
Multi-component parent-based interventions (PBIs) provide a promising avenue for targeting alcohol use and related consequences in college students. Parents of college-aged children can have a significant influence on their children's alcohol use decisions. However, parents tend to underestimate their own child's alcohol use and overestimate other similar parents' approval of student drinking. These misperceptions could have important implications for parents' own attitudes and alcohol-related communication with their student. Targeting these misperceptions through normative feedback could help promote greater and more in-depth alcohol-related communication. The present study examines the potential efficacy of web-based alcohol-related normative feedback for parents of college students.
A sample of 144 parents of college students received web-based normative feedback about students' alcohol use and approval, as well as other same-college parents' alcohol approval. Parents completed measures of perceived student alcohol use, student alcohol approval, other-parent alcohol approval, and intentions to discuss alcohol use both pre- and post-normative feedback.
Post-feedback, parents reported stronger intentions to talk to their student about alcohol, were less confident in their knowledge of their students' alcohol use, and believed that their student drank in greater quantity and more frequently than pre-feedback. Parents also perceived other parents to be less approving of alcohol use after viewing normative feedback.
These findings provide preliminary support for the use of web-based normative feedback for parents of college students. Given these promising results, further research developing and testing this approach merits attention.
The authors examined differences between students with and without written parental consent to take part in a sensitive health survey. The data were collected using a consent procedure combining "active" and "passive" response options. Two thousand seven hundred five 9th and 12th graders whose parents provided written consent completed a full survey. An identical survey, without sex-related questions, was completed by 3,533 students whose parents gave "passive" consent to this less sensitive version. Students with written consent were more likely to be White, to live in two-parent households, to have a grade point average of B or above, and to be involved in extracurricular activities. They were also more likely to have been exposed to health promotion interventions. Irregular seat belt use was lower in the written-consent group at both grade levels. Among 9th graders, cigarette smoking was less prevalent in the written-consent group. There were no significant differences in alcohol or illicit drug use.
Research on parent-based interventions (PBIs) to reduce college student drinking has explored the optimal timing of delivery and dosage. The present study extended this work by examining the effectiveness of three different PBI conditions on student drinking outcomes as a function of parenting types and students' pre-college drinking patterns. Four hypotheses were evaluated (early intervention, increased dosage, invariant, and treatment matching risk). A random sample of 1,900 college students and their parents was randomized to four conditions: (1) pre-college matriculation, (2) pre-college matriculation plus booster, (3) post-college matriculation, or (4) control, and was assessed at baseline (summer prior to college) and 5-month follow-up. Baseline parent type was assessed using latent profile analysis (positive, pro-alcohol, positive, anti-alcohol, negative mother, and negative father). Student drinking patterns were classified at baseline and follow-up and included: non-drinker, weekend light drinker, weekend heavy episodic drinker, and heavy drinker. Consistent with the treatment matching risk hypothesis, results indicated parent type moderated the effects of intervention condition such that receiving the intervention prior to college was associated with lower likelihood of being in a higher-risk drinking pattern at follow-up for students with positive, anti-alcohol, or negative father parent types. The findings are discussed with respect to optimal delivery and dosage of parent-based interventions for college student drinking.
This study evaluated the effectiveness of a parent based intervention (PBI) in reducing drinking among first year college students (N=443). Students were assigned to one of three conditions: PBI, PBI plus booster brochures (PBI-B), and an assessment only control group (CNT). At a 4-month post-intervention follow-up, results indicated students in the PBI-B group reported significantly less drinking to intoxication and peak drinking relative to the PBI group and CNT group. No significant differences were found between the PBI group and CNT group. Results provide further support for PBIs to reduce college student drinking and suggest that a booster brochure increases the effectiveness of PBIs.
Alcohol consumption among college students remains a major public health concern. Universal, Web-based interventions to reduce risks associated with student alcohol consumption have been found to be effective in changing their alcohol-related behavior. Recent studies also indicate that parent-based interventions, delivered in booklet form, are effective. A parent-based intervention that is also Web-based may be well suited to a dispersed parent population; however, no such tool is currently available. The purpose of this study was to test the efficacy of an online parent-based intervention designed to (1) increase communication between parents and students about alcohol and (2) reduce risks associated with alcohol use to students. A total of 558 participants, comprising 279 parent-teen dyads, were enrolled in the study. The findings suggested that parents who participated in the online intervention were more likely to discuss protective behavioral strategies, particularly those related to manner of drinking and stopping/limiting drinking, with their teens, as compared with parents in an e-newsletter control group. Moreover, students whose parents received the intervention were more likely to use a range of protective behavioral strategies, particularly those related to manner of drinking and stopping/limiting drinking, as compared with students whose parents did not receive the intervention. A universal, online, parent-based intervention to reduce risks associated with student alcohol consumption may be an efficient and effective component of a college's overall prevention strategy.
Despite research suggesting that parental involvement can affect alcohol involvement among adolescents, few studies have focused on parent-based alcohol prevention strategies among college undergraduates. We report the results of a randomized trial of a parent-based intervention (PBI) in a sample of college freshmen.
Across two cohorts, 724 incoming freshman-parent dyads completed baseline assessments and were randomly assigned to PBI or intervention as usual (an alcohol fact sheet for parents). Student follow-up assessments were completed at 4 and 8 months.
Two-part latent growth curve modeling was used to test hypothesized intervention effects. Outcome variables were drinks per week (past month), heavy episodic drinking (past 2 weeks), and alcohol-related problems (past 3 months). Over the 8-month follow-up period, PBI had a significant effect on drinks per week but not heavy episodic drinking or alcohol-related problems. Specifically, compared with students in the intervention-as-usual condition, students receiving the PBI were significantly less likely to transition from nondrinker to drinker status and showed less growth in drinking over the freshman year. However, the direct PBI effect on growth was qualified by a PBI x Gender interaction, with probes indicating that the effect applied to women but not men in the PBI condition.
This study extends previous research by demonstrating the potential utility for PBIs to decrease the likelihood of transitioning into drinker status and, at least for women, for slowing growth in drinking over the freshman year.
As part of a parent intervention to reduce heavy-drinking, college freshmen were assessed for their attitudes toward drinking and reasonable alternatives to drinking on the weekends, as well as cognitive variables underlying attitudinal variables. Intervention parents received a handbook the summer prior to college entrance with information about college drinking and best practices for parent-teen communication. Results revealed that the association between intervention condition and drinking outcomes was mediated by attitudes favorable to drinking and reasonable alternatives to drinking, as well as beliefs about alcohol related behavior. This parent program was shown to be efficacious for changing high-risk drinking in college. Findings are discussed regarding the further development of college drinking prevention programs involving parents.
This study explored secondary effects of a multisite randomized alcohol prevention trial on tobacco, marijuana, and other illicit drug use among a sample of incoming college students who participated in high school athletics. Students (n = 1,275) completed a series of Web-administered measures at baseline during the summer before starting college and 10 months later. Students were randomized to one of four conditions: a parent-delivered intervention, a brief motivation enhancement intervention (Brief Alcohol Screening and Intervention for College Students [BASICS]), a condition combining the parent intervention and BASICS, and assessment-only control. A series of analyses of variance evaluating drug use outcomes at the 10-month follow-up assessment revealed significant reductions in marijuana use among students who received the combined intervention compared to the BASICS-only and control groups. No other significant differences between treatment conditions were found for tobacco or other illicit drug use. Our findings suggest the potential utility of targeting both alcohol and marijuana use when developing peer- and parent-based interventions for students transitioning to college. Clinical implications and future research directions are considered.
The current study examined whether permitting young women to drink alcohol at home during senior year of high school reduces the risk of heavy drinking in college. Participants were 449 college-bound female high school seniors, recruited at the end of their senior year. Participants were classified into one of three permissibility categories according to their baseline reports of whether their parents allowed them to drink at home: (a) not permitted to drink at all; (b) allowed to drink with family meals; (c) allowed to drink at home with friends. Repeated measures analysis of variance was used to compare the drinking behaviors of the three groups at the time of high school graduation and again after the first semester of college. Students who were allowed to drink at home during high school whether at meals or with friends, reported more frequent heavy episodic drinking (HED) in the first semester of college than those who reported not being allowed to drink at all. Those who were permitted to drink at home with friends reported the heaviest drinking at both time points. Path analysis revealed that the relationship between alcohol permissiveness and college HED was mediated via perceptions of parental alcohol approval.
The current study tested age of onset as a moderator of intervention efficacy on drinking and consequence outcomes among a high-risk population of college students (i.e., former high school athletes).
Students were randomized to one of four conditions: assessment only control, combined parent-based intervention (PBI) and brief motivational intervention (BMI), PBI alone, and BMI alone. Participants (n = 1,275) completed web-administered measures at baseline (summer before starting college) and 10-month follow-up.
Overall, the combined intervention demonstrated the strongest and most consistent reductions across all outcomes, particularly with the youngest initiators. Participants who initiated drinking at the youngest ages had significantly lower peak drinking, typical weekly drinking, and reported consequences at follow-up when they received the combined intervention when compared to the control group. The BMI and PBI groups, when examined independently, demonstrated significant effects across outcomes but were inconsistent across the different age groups.
Results suggest the combination of a PBI and a peer-delivered BMI is an appropriate and efficacious way to reduce drinking and related consequences among individuals who initiated drinking earlier in adolescence and are at an increased risk of experiencing alcohol problems.
Suboptimal childhood vaccination uptake results in disease outbreaks, and in developed countries is largely attributable to parental choice. To inform evidence-based interventions, we conducted a systematic review of factors underlying parental vaccination decisions. Thirty-one studies were reviewed. Outcomes and methods are disparate, which limits synthesis; however parents are consistently shown to act in line with their attitudes to combination childhood vaccinations. Vaccine-declining parents believe that vaccines are unsafe and ineffective and that the diseases they are given to prevent are mild and uncommon; they mistrust their health professionals, Government and officially-endorsed vaccine research but trust media and non-official information sources and resent perceived pressure to risk their own child's safety for public health benefit. Interventions should focus on detailed decision mechanisms including disease-related anticipated regret and perception of anecdotal information as statistically representative. Self-reported vaccine uptake, retrospective attitude assessment and unrepresentative samples limit the reliability of reviewed data - methodological improvements are required in this area.
This study examined the impact of parental modeled behavior and permissibility of alcohol use in late high school on the alcohol use and experienced negative drinking consequences of college students. Two-hundred ninety college freshmen at a large university were assessed for perceptions of their parents' permissibility of alcohol use, parents' alcohol-related behavior, and own experienced negative consequences associated with alcohol use. Results indicate that parental permissibility of alcohol use is a consistent predictor of teen drinking behaviors, which was strongly associated with experienced negative consequences. Parental modeled use of alcohol was also found to be a risk factor, with significant differences being seen across the gender of the parents and teens. Discussion focuses on risk factors and avenues for prevention research.
To determine demographic, functional, and health-related factors that may have influenced the selection of older adults for a randomized trial of balance enhancement.
Comparison of participants with nonparticipants at various stages of the recruiting process.
Northeastern suburban community.
Registered voters aged 75 and older (n = 7191).
Demographic, health-related, functional, balance, gait, and falling characteristics.
The overall participation rate in the randomized trial was 1.5%. Compared with nonparticipants, participants were significantly more likely to be male, married, living with others, living in a house, highly educated, healthy, and physically active.
Recruiting older subjects by mail to studies of rigorous interventions can produce significant selection biases that may limit the population to which results can be generalized.
The authors compared parents' perceptions of their college student children's health and health risk behaviors with the college students' own reports. One hundred sixty-four parent-college student child dyads completed questionnaires regarding the students' health, illness status, and health risk behaviors. Parents tended to be overoptimistic about their children's health and health risk behaviors, underestimating the frequency of their children's alcohol, smoking, marijuana, and sex-related behaviors, and overestimating the students' self-reports of general health. Such misperceptions may inhibit parent-student conversations about health and risky health behavior, ultimately putting the student at greater health risk.
(1) To explore the social and cultural influences, and health beliefs associated with low uptake of MMR (measles, mumps and rubella vaccine). (2) To describe and explore the prevalence of health beliefs associated with non-compliance with MMR, with a view to improving the personal relevance and impact of information for parents, in the context of persisting low uptake following public controversy.
We undertook a survey of mothers' experiences of and attitudes to the MMR, developed through ethnographic study, which was linked to maternal and child information on the Child Health Database in Brighton, England.
Mothers interpret MMR risk through concepts of child health embedded in family health history, with a majority both of compliers and non-compliers holding that each child's immune system is unique. Cultural 'risk factors' for non-compliance relate strongly to the use of complementary healthcare, such as homeopathy, with evidence that rejection of vitamin K is associated with MMR non-compliance. Forty per cent, both of compliers and non-compliers, did not consider the possible benefits to other children of MMR.
These findings have paradoxical and challenging consequences for the promotion of immunization in the policy context of increasing emphasis on healthy choices. They demonstrate the need for immunization information that acknowledges and addresses lay concepts of immunity.
To investigate parents' views regarding potential new vaccines. We examined attitudes towards severity of specific infections, acceptability of potential vaccines and preferences for the number of injections they would want their child to receive on any one occasion.
Cross sectional survey.
Parents of children aged 18-24 months in three Primary Care Trusts in England were asked to complete a questionnaire.
Of the 859 parents who responded (38%), over 90% believed that the vaccines currently on offer prevent disease always or almost always. Of those who rated meningitis as serious or very serious, 84% would accept a vaccine against meningococcal group B infection and 69% against pneumococcal infection. Only 34% of those who said their child would make a full recovery from chicken pox would accept a vaccine. Over half the respondents preferred new vaccines to be given separately. Fifty seven percent of parents would not want their child to have more than two injections per clinic visit.
Parents' views on the severity of illness influence their acceptance of a new vaccine. Their preference for as few injections as possible at a single clinic visit needs to be reconciled with their concerns over the use of combination vaccines.