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Examination of Brief Parent-Based Interventions to Reduce Drinking Outcomes on a Nationally Representative Sample of Teenagers
... Namoos et al. (2024 further indicated that parents who actively discuss alcoholrelated risks with their teens and model responsible behaviors, such as avoiding drinking and driving, have an important impact on their teens' attitudes toward impaired driving, fostering a more negative perception of that behavior (Namoos et al., 2024). Similarly, Glenn et al. (2024) highlighted that parental interventions emphasizing communication and accountability significantly decrease the likelihood of teens riding with impaired drivers (Glenn et al., 2024). Other aspects of parental monitoring, such as structured agreements on limiting high-risk conditions like night driving (which are also mandated by Graduate Driving License (GDL) laws in most states; Williams et al., 2006), supervised practice driving and hazard recognition training (Curry et al., 2015), and innovative tools like event-triggered video feedback paired with parental reviews (McGehee et al., 2007), have also been found effective. ...
... Namoos et al. (2024 further indicated that parents who actively discuss alcoholrelated risks with their teens and model responsible behaviors, such as avoiding drinking and driving, have an important impact on their teens' attitudes toward impaired driving, fostering a more negative perception of that behavior (Namoos et al., 2024). Similarly, Glenn et al. (2024) highlighted that parental interventions emphasizing communication and accountability significantly decrease the likelihood of teens riding with impaired drivers (Glenn et al., 2024). Other aspects of parental monitoring, such as structured agreements on limiting high-risk conditions like night driving (which are also mandated by Graduate Driving License (GDL) laws in most states; Williams et al., 2006), supervised practice driving and hazard recognition training (Curry et al., 2015), and innovative tools like event-triggered video feedback paired with parental reviews (McGehee et al., 2007), have also been found effective. ...
Introduction: Risky road behaviors (RRBs), including driving-related (e.g., texting while driving, driving under the influence) and passenger-related (e.g., not wearing seat belts, riding with a drunk driver) behaviors, contribute significantly to injury and death among adolescents. This study aims to analyze how perceived parental monitoring by teens impacts their passenger-and driver-related risky road behaviors. Methods: Data from the 2021 National Youth Risk Behavior Survey (NYRBS) were analyzed to examine the association between teens' perception of parental monitoring and engagement in driving-related and passenger-related risky road behaviors. Logistic regression models were used to estimate adjusted odds ratios (AOR). Results: A strong perception of parental monitoring consistently demonstrated a protective effect against driving-related risky behaviors (AOR = 0.63, 95% CI: 0.53-0.74) and passenger-related risky behaviors (AOR = 0.62, 95% CI: 0.53-0.72) when compared to those with lower perceptions. Teens sleeping in public places had notably higher odds of driving-related risky behaviors (AOR = 2.99, 95% CI: 2.01-4.46) compared to those sleeping at home. Males were less likely to engage in passenger-related risky behaviors (AOR = 0.91, 95% CI: 0.86-0.97) but more likely to engage in driving-related risky behaviors (AOR = 1.28, 95% CI: 1.12-1.47). Conclusions: Perceived parental monitoring was associated with reduced engagement in both passenger-and driving-related risky road behaviors among teen drivers and passengers. Safety interventions aimed at reducing risky road behaviors among teens should include strategies for strengthening parental involvement, emphasizing supervision and communication. Practical Applications: Our findings suggest that parental monitoring could play a significant role in reducing teens' engagement in risky road behaviors. Safety programs should empower parents in the use of effective parental monitoring strategies, such as active supervision and better communication.
... Other frequently used strategies included avoiding driving after drinking or riding in a car with drinking drivers (i.e., using a designated driver; refusing to ride in a car with someone who has been drinking). Consistent messaging by parents (Glenn et al. 2024) and media campaigns (Johnson 2016) related to driving while intoxicated and riding with drivers who have been drinking may contribute to the frequency of using these PBS. ...
Sensation seeking is a significant predictor of alcohol‐related consequences among high school students. High school seniors report the highest prevalence rates of alcohol use and binge drinking among students in high school. Among high sensation‐seeking students, higher rates of Protective Behavioral Strategies (PBS) use are associated with fewer alcohol‐related consequences. To date, however, there is no research investigating which specific PBS are related to lower levels of alcohol‐related consequences in this high‐risk group of students. The current study examined the frequency of use and effectiveness of 20 PBS measured by the PBS Scale‐20 among high sensation‐seeking high school seniors (N = 77). “Go‐zone” methodology was used to classify PBS items into one of four zones (i.e., used frequently, high effectiveness; used infrequently, high effectiveness; used frequently, low effectiveness; used infrequently; low effectiveness). Four PBS were identified as “go‐zone” strategies (e.g., used frequently; high effectiveness) and five strategies were identified as used infrequently but highly effective. Findings from the current study extend the literature on PBS use as a buffer against alcohol‐related consequences among high sensation‐seeking high school students. Implications for school mental health professionals are discussed.
Trial Registration: ClinicalTrials.gov identifier: NCT03613818
Digital mental health interventions (DMHIs) present a promising way to address gaps in mental health service provision. However, the relationship between user engagement and outcomes in the context of these interventions has not been established. This study addressed the current state of evidence on the relationship between engagement with DMHIs and mental health outcomes. MEDLINE, PsycINFO, and EmBASE databases were searched from inception to August 1, 2021. Original or secondary analyses of randomized controlled trials (RCTs) were included if they examined the relationship between DMHI engagement and post-intervention outcome(s). Thirty-five studies were eligible for inclusion in the narrative review and 25 studies had sufficient data for meta-analysis. Random-effects meta-analyses indicated that greater engagement was significantly associated with post-intervention mental health improvements, regardless of whether this relationship was explored using correlational [r = 0.24, 95% CI (0.17, 0.32), Z = 6.29, p < 0.001] or between-groups designs [Hedges' g = 0.40, 95% CI (0.097, 0.705), p = 0.010]. This association was also consistent regardless of intervention type (unguided/guided), diagnostic status, or mental health condition targeted. This is the first review providing empirical evidence that engagement with DMHIs is associated with therapeutic gains. Implications and future directions are discussed.
Systematic Review Registration: PROSPERO, identifier: CRD 42020184706.
Prevention curricula rely on audience engagement to effectively communicate their messages. However, to date, measurement of engagement has primarily focused on self-report that is often an indicator of liking or satisfaction. Emerging technologies for intervention delivery hold promise not only for additional engagement indicators but also for dissemination outside of traditional vehicles such as classroom delivery. The present study, grounded in the theory of active involvement (Greene 2013), explores the role of engagement (as measured by self-report, program analytics, and observation) with short-term substance use prevention outcomes such as self-efficacy to counter-argue and descriptive and injunctive norms. The study tracks 4-H youth (N = 310) engaged with a media literacy focused e-learning substance prevention curriculum, REAL media. Results indicate that self-reports of engagement predicted self-efficacy to counter-argue, but a program-analytic indicator of dosage predicted lower injunctive and descriptive norms, all at 3 months. The observational indicator was correlated with self-efficacy to counter-argue but not significant in the predictive models. The implications and directions for future research regarding how engagement is measured in prevention and included in studying program effects are discussed. Clinical trial: NCT03157700, May 2017.
Evidence-based interventions to reduce substance misuse among adolescents are resource and time intensive. We conducted a pilot randomized controlled trial to evaluate a novel, adaptable, and resource-efficient substance misuse preventive intervention for parents/guardians, focusing on talking with children about substance use and eating family meals. We randomized 70 parents of children in third-through-sixth grades within a large, urban public school system in New England to the intervention or control condition. Over a 6-month follow-up period, we assessed feasibility and acceptability of the intervention and examined frequency of parent–child conversations about alcohol, marijuana, and other drugs, and frequency and duration of family meals. A total of 29 parents were assigned to the intervention and 35 to the control condition. The intervention was found to be feasible and acceptable to participants as evidenced by high recruitment and retention rates and positive feedback from qualitative exit interviews. At 3-month and 6-month follow up, 64.3 % and 44.5 % of parents in the intervention condition were talking “a lot” to their children about alcohol, compared to 8.7 % and 8.7 % of the parents in the control condition, respectively (p < 0.01 and p = 0.03). Patterns in frequency and duration of family meals between the two conditions were not significantly different over time. In conclusion, a higher percentage of parents randomized to the intervention condition spoke with their children about alcohol, marijuana, and other drugs, but the frequency and duration of meals was not impacted. Further testing of the brief intervention with a larger sample to assess efficacy is warranted.
In the light of continuing debate over the applications of significance testing in psychology journals and following the publication of J. Cohen's (1994) article, the Board of Scientific Affairs (BSA) of the American Psychological Association (APA) convened a committee called the Task Force on Statistical Interference (TFSI) whose charge was "to elucidate some of the controversial issues surrounding applications of statistics including significance testing and its alternatives; alternative underlying models and data transformation; and newer methods made possible by powerful computers" (BSA, personal communication, February 28, 1996). After extensive discussion, the BSA recommended that publishing an article in American Psychologist, as a way to initiate discussion in the field about changes in current practices of data analysis and reporting may be appropriate. This report follows that request. Following each guideline are comments, explanations, or elaborations assembled by L. Wilkinson for the task force and under its review. The report is concerned with the use of statistical methods only and is not meant as an assessment of research methods in general. The title and format of the report are adapted from an article by J. C. Bailar and F. Mosteller (1988). (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Because u nderage drinking is a serious public health concern and associated with numerous detrimental consequences, many interventions to prevent underage drinking have been developed. However, the effectiveness of all these interventions has not been proven. A recent review of the relevant literature that used stringent criteria for the types of studies and interventions included, as well as for the evaluation and classification of the studies, found that out of more than 400 studies screened, only 127 could be evaluated for efficacy and only 41 showed some evidence of effects. In addition, several areas were identified in which intervention research could be strengthened. For example, increased coverage is needed for understudied areas of intervention (e.g., specific types of interventions or interventions in specific populations). Other aspects of the knowledge base in this area that can benefit from further improvement include, among others, the availability of longitudinal studies, availability of information on alcoholspecific outcomes, or availability of replication studies. The standards for determining and reporting evidence of effectiveness in different studies also need to be clarified. Finally, prevention research needs to adopt public health impact-oriented models to accurately determine the potential of existing interventions to prevent underage drinking and its consequences.
Descriptive norms are consistently found to predict adolescent alcohol use but less is known about the factors that predict descriptive norms. The objective of this study is to test if drinking with peers predicts later alcohol consumption and if this relationship is mediated by a change in the descriptive norms of peer alcohol use. Data are from a nationally representative cohort of high school students surveyed in the 10th and 11th grade (N = 2,162). Structural equation modeling was used to test a mediation model of the relationship between drinking with peers (T1) on later alcohol use (T2) and mediation of the relationship by descriptive norms (T2). Descriptive norms significantly mediated the relationship between drinking with peers and alcohol use for both males and females with a somewhat larger effect for males compared to females. These results support a continued focus on the development and evaluation of interventions to alter descriptive norms of alcohol use.
Previous studies on general parenting have demonstrated the relevance of strict parenting within a supportive social context for a variety of adolescent behaviors, such as alcohol use. Yet, alcohol-specific parenting practices are generally examined as separate predictors of adolescents' drinking behavior. The present study examined different developmental profiles of alcohol-specific parenting (rule-setting, quality and frequency of communication about alcohol use) and how these patterns relate to the initiation and growth of adolescents' drinking. A longitudinal sample of 883 adolescents (47 % female) including four measurements (between ages 12 and 16) was used. Latent class growth analysis revealed that five classes of parenting could be distinguished. Communication about alcohol appeared to be fairly stable over time in all parenting classes, whereas the level of rule-setting declined in all subgroups of parents as adolescents grow older. Strict rule-setting in combination with a high quality and frequency of communication was associated with the lowest amount of drinking; parents scoring low on all these behaviors show to be related to the highest amount of drinking. This study showed that alcohol-specific rule-setting is most effective when it coincides with a good quality and frequency of communication about alcohol use. This indicates that alcohol-specific parenting behaviors should be taken into account as an alcohol-specific parenting context, rather than single parenting practices. Therefore, parent-based alcohol interventions should not only encourage strict rule setting, the way parents communicate with their child about alcohol is also of major importance.
The Timeline Followback (TLFB) interview has been used extensively in the assessment of alcohol and other substance use. While this methodology has been validated in multiple formats for multiple behaviors, to date no systematic comparisons have been conducted between the traditional interview format and online versions. The present research employed a randomized within-subjects design to compare interview versus online-based TLFB assessments of alcohol and marijuana use among 102 college students. Participants were randomly assigned to receive either the online version first or the in-person interview format first. Participants subsequently completed the second format within 3 days. While we expected few overall differences between formats, we hypothesized that differences might emerge to the extent that participants are more comfortable and willing to answer honestly in an online format, which provides a degree of anonymity. Results were consistent with expectations in suggesting relatively few differences between the online version and the in-person version. Participants did report feeling more comfortable in completing the online version. Moreover, greater discomfort during the in-person assessment was associated with reporting more past-month marijuana use on the online assessment, but reported discomfort did not moderate differences between formats in reported alcohol consumption. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
Peer pressure is consistently implicated in the excessive drinking of college students. However, both theory and empirical findings suggest that peer pressure is a combination of three distinct influences: overt offers of alcohol, modeling, and social norms. Overt offers of alcohol can range from polite gestures to intense goading or commands to drink. Modeling occurs when the student's behavior corresponds to another student's concurrent drinking behavior. Perceived social norms can serve to make excessive alcohol use appear common and acceptable to the student. This review critically examines the literature on each form of peer influence and provides suggestions for future research.
The short-term results of a randomized trial testing a brief feedback and motivational intervention for substance use among homeless adolescents are presented. Homeless adolescents ages 14-19 (N = 285) recruited from drop-in centers at agencies and from street intercept were randomly assigned to either a brief motivational enhancement (ME) group or 1 of 2 control groups. The 1-session motivational intervention presented personal feedback about patterns of risks related to alcohol or substance use in a style consistent with motivational interviewing. Follow-up interviews were conducted at 1 and 3 months postintervention. Youths who received the motivational intervention reported reduced illicit drug use other than marijuana at 1-month follow-up compared with youths in the control groups. Treatment effects were not found with respect to alcohol or marijuana. Post hoc analyses within the ME group suggested that those who were rated as more engaged and more likely to benefit showed greater drug use reduction than did those rated as less engaged. Limitations of the study are discussed as are implications for development of future substance use interventions for this high-risk group.
This study is a formative assessment of REAL Parenting (RP): a brief, digital intervention for parents of high school students that encourages parent-teen communication about alcohol and, in turn, aims to prevent teen alcohol use. The aims of this study were to describe engagement with, and acceptability and usability of RP; and to explore the relationship of these measures with each other and with short-term outcomes. Participants were 160 parents randomly assigned to the treatment group who received RP as part of a randomized pilot trial (Mage = 45.43[SD = 7.26], 59.3% female, 56% White, 19% Hispanic). App-based program analytics captured real-time engagement with RP. Parents completed self-report measures of acceptability, usability, perceived communication effectiveness, perceived self-efficacy to communicate, and frequency of communication post-intervention. Descriptive statistics were calculated to describe engagement, acceptability and usability, and zero-order correlations were calculated to examine associations between these and self-report variables. About 75% (n = 118) of parents accessed the intervention and two-thirds (n = 110) accessed at least one module. Self-report ratings of acceptability and usability were neutral to positive, and mothers liked RP more than fathers. Self-report, but not program analytic indicators were associated with short-term outcomes. Findings suggest that, with little incentive, most parents will access an app focused on parent-teen communication about alcohol. While parent feedback was positive, it also highlighted areas for improvement with app content and design. Correlations suggest that analytic metrics of engagement are useful to discern who is and is not using interventions, and self-report measures are important for understanding pathways by which interventions are associated with short-term outcomes.
Objective:
Excessive alcohol consumption leads to a range of public health problems and social and financial burdens. Traffic crashes resulting from alcohol-involved driving are a major contributor to the overall health consequences of alcohol. Various laws and enforcement strategies aim to prevent alcohol-involved driving. The extent to which law enforcement agencies prioritize enforcement of alcohol-impaired driving laws can help to reduce alcohol-impaired driving. Among law enforcement agencies in the US, we examined prioritization of alcohol-impaired driving enforcement and how it is associated with use of specific enforcement strategies, as well as agency and community characteristics.
Methods:
We conducted a survey of a national sample of 1,024 US police and sheriff agencies in 2019. We assessed prioritization of alcohol-impaired driving enforcement, use of specific enforcement strategies (saturation patrols, sobriety checkpoints, open container law enforcement, training field officers to identify driving impairment), and agency and jurisdiction characteristics. We assessed how priority of enforcement (high vs. low) was associated with use of specific strategies, and agency and jurisdiction characteristics using regression models that accounted for agencies nesting within states.
Results:
A majority of agencies (68%) placed a high priority on alcohol-impaired driving enforcement. Almost all agencies (93%) reported performing at least one alcohol-impaired driving enforcement strategy and the most common strategy used was saturation patrols. Agencies that prioritized alcohol-impaired driving enforcement were more likely to use sobriety checkpoints and saturation patrols, conduct enforcement of open container laws and train field officers in identifying driving impairment (p < 0.05). They were also more likely to have an officer assigned primarily to alcohol enforcement, have an alcohol division, and serve jurisdictions that had fewer Black residents (p < 0.05).
Conclusions:
Many law enforcement agencies utilize strategies to address alcohol-impaired driving, however, some strategies are underutilized and an opportunity exists for agencies to incorporate additional strategies to help prevent alcohol-impaired driving. Agencies that made alcohol-impaired driving enforcement a priority were more likely to conduct related enforcement strategies. Encouraging police and sheriff agencies to prioritize alcohol-impaired driving enforcement may be an effective approach for preventing alcohol-related harms.
Background
Riding with a drinking driver (RWDD) is a serious concern that leads to numerous preventable deaths every year. There is a significant gap in research on empirically tested predictors of RWDD that could be implemented in prevention efforts. College students are in need of such prevention efforts, as they have some of the highest rates of alcohol‐related crash fatalities and may RWDD more than their non‐college peers. The current study utilized behavioral decision‐making approach to examine predictors of RWDD and declining a ride from a drinking driver (Decline) in older college students.
Methods
Students (n=791) in their 3rd year of college were enrolled from 3 large and diverse universities. Psychosocial (e.g., expectancies, norms) and decision‐making variables (willingness to RWDD and intentions to use alternatives) were assessed in the fall of their 3rd year. One year later, RWDD and Decline behaviors were assessed. Zero‐inflated Poisson (ZIP) analyses were used to assess how decision‐making variables predicted RWDD and Decline behavior. Associations between psychosocial and decision‐making variables were also assessed.
Results
Thirteen percent of students reported RWDD and ~28% reported Decline behavior. Willingness to RWDD and typical weekly drinking were both associated with increases in RWDD (OR = 1.58 and 1.40, respectively), whereas intentions to use alternatives, sex, and ethnicity were not associated with RWDD. Only weekly drinking was associated with Decline, with an increase of drinking associated with increased Decline (OR= 1.48). All psychosocial variables were significantly associated with the decision‐making variables except positive expectancies.
Conclusions
Results provide evidence that willingness to RWDD is a predictor of future RWDD, even if students intend to use safe alternatives. Future research is needed to better understand decision‐making factors that influence Decline. Results also suggest prevention and interventions efforts, such as brief motivational interviewing, Parent‐Based Interventions, and normative feedback interventions could be adapted to reduce RWDD.
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Purpose
The purpose of this study is to examine driving-related consequences associated with levels of drinking intensity among a national sample of young adult drinkers.
Methods
Data come from a nationally representative sample of 12th graders sampled annually in 2005–2014 with subsamples surveyed at age 19/20 years. Multivariable logistic regressions examined associations of 12th-grade drinking intensity (0–4, 5–9, 10–14, and 15+ drinks in a row) with driving consequences at age 19/20 years.
Results
Twelfth-grade binge drinkers (compared with nonbinge drinkers) were more likely to experience negative driving consequences at age 19/20 years. Among binge drinkers, 15+ drinkers (compared with 5–9 drinkers) in 12th grade had increased the risk of negative drinking consequences at age 19/20 years.
Conclusions
These results suggest that while underage binge drinkers are at an increased risk for having driving consequences, those who engage in higher intensity drinking are at even greater risk for these consequences. High-intensity drinkers may require additional screening or intervention to reduce future driving-related consequences.
Background:
Research measuring levels of enforcement has investigated whether increases in police activities (e.g., checkpoints, driving-while-intoxicated [DWI] special patrols) above some baseline level are associated with reduced crashes and fatalities. Little research, however, has attempted to quantitatively measure enforcement efforts and relate different enforcement levels to specific levels of the prevalence of alcohol-impaired driving.
Objective:
The objective of this study was to investigate the effects of law-enforcement intensity in a sample of communities on the rate of crashes involving a drinking driver. We analyzed the influence of different enforcement strategies and measures: (1) specific deterrence - annual number of driving-under-the-influence (DUI) arrests per capita; (2) general deterrence - frequency of sobriety checkpoint operations; (3) highly visible traffic enforcement - annual number of traffic stops per capita; (4) enforcement presence - number of sworn officers per capita; and (5) overall traffic enforcement - the number of other traffic enforcement citations per capita (i.e., seat belt citations, speeding tickets, and other moving violations and warnings) in each community.
Methods:
We took advantage of nationwide data on the local prevalence of impaired driving from the 2007 National Roadside Survey (NRS), measures of DUI enforcement activity provided by the police departments that participated in the 2007 NRS, and crashes from the General Estimates System (GES) in the same locations as the 2007 NRS. We analyzed the relationship between the intensity of enforcement and the prevalence of impaired driving crashes in 22-26 communities with complete data. Log-linear regressions were used throughout the study.
Results:
A higher number of DUI arrests per 10,000 driving-aged population was associated with a lower ratio of drinking-driver crashes to non-drinking-driver crashes (p=0.035) when controlling for the percentage of legally intoxicated drivers on the roads surveyed in the community from the 2007 NRS. Results indicate that a 10% increase in the DUI arrest rate is associated with a 1% reduction in the drinking driver crash rate. Similar results were obtained for an increase in the number of sworn officers per 10,000 driving-age population.
Discussion:
While a higher DUI arrest rate was associated with a lower drinking-driver crash rate, sobriety checkpoints did not have a significant relationship to drinking-driver crashes. This appeared to be due to the fact that only 3% of the on-the-road drivers were exposed to frequent sobriety checkpoints (only 1 of 36 police agencies where we received enforcement data conducted checkpoints weekly). This low-use strategy is symptomatic of the general decline in checkpoint use in the U.S. since the 1980s and 1990s when the greatest declines in alcohol-impaired-driving fatal crashes occurred. The overall findings in this study may help law enforcement agencies around the country adjust their traffic enforcement intensity in order to reduce impaired driving in their community.
In a national field experiment, the same questionnaires were administered simultaneously by RDD telephone interviewing, by the Internet with a probability sample, and by the Internet with a nonprobability sample of people who volunteered to do surveys for money. The probability samples were more representative of the nation than the nonprobability sample in terms of demographics and electoral participation, even after weighting. The nonprobability sample was biased toward being highly engaged in and knowledgeable about the survey's topic (politics). The telephone data manifested more random measurement error, more survey satisficing, and more social desirability response bias than did the Internet data, and the probability Internet sample manifested more random error and satisficing than did the volunteer Internet sample. Practice at completing surveys increased reporting accuracy among the probability Internet sample, and deciding only to do surveys on topics of personal interest enhanced reporting accuracy in the nonprobability Internet sample. Thus, the nonprobability Internet method yielded the most accurate self-reports from the most biased sample, while the probability Internet sample manifested the optimal combination of sample composition accuracy and self-report accuracy. These results suggest that Internet data collection from a probability sample yields more accurate results than do telephone interviewing and Internet data collection from nonprobability samples.
This present study examined agreement between retrospective accounts of substance use and earlier re ported substance use in a high school age sample. Three issues were addressed: (1) extent of overall agreement; (2) evidence for the presence of a response-shift bias; and (3) extent to which current use biases recall of substance use. Subjects were 415 high school students who took part in a smoking prevention program. At the last measurement, which took place 2½ years after the pretest, the students were asked to recall pretest use of tobacco, alcohol, and marijuana, and use one year earlier. Results showed an overall tendency for students to recall less use of uncontrolled substances than had been previously reported. For the one controlled substance included in the questionnaire, marijuana, current nonusers tended to recall less use than they had reported at the time, whereas current users tended to recall more use than had been re ported. The present study found no evidence for a response-shift bias. It is suggested that the explicitly worded anchors on the response scales helped prevent such a bias. Finally, the results suggest that current use biases recall of past use to a substantial extent, and that this bias affects recall of alcohol use most se verely.
Social norm-based interventions in college drinking are common but show mixed efficacy. Although such interventions assume a passive social-influence process, past research relied heavily on retrospective measures, leaving open the possibility that heuristic biases during recall may alternatively account for or inflate estimates of social influence from prospective norm-drinking associations. The present study examined this possibility, using retrospective and daily aggregated measures of self and perceived peer drinking behavior.
For each of 3 years, students (N = 574; 288 men) reported on their drinking levels and perceptions of descriptive drinking norms, using conventional retrospective reports over a month period and daily diary reports for 30 days. Using structural equation modeling, we tested cross-lag longitudinal models for evidence of social-influence/alternative processes and compared cross-lag effects across retrospective and daily aggregate models to determine the extent to which heuristic recall biases contribute to the norm-behavior association.
Perceptions of social norms had a small but reliable effect on changing drinking behavior across years, as indicated by model comparisons. Past drinking behavior also consistently shaped changing perceptions of drinking norms. These effects were not attributable to, nor inflated by, heuristic biases during retrospective reporting of personal and peer behavior.
These results suggest that social influence and not heuristic biases contribute to the long-term norm-drinking association but that alternative processes, whereby past drinking behavior shapes norm perceptions, contribute more to the norm-drinking association. Implications for interventions designed to reduce college drinking are discussed.
Alcohol-impaired driving (AID) continues to be a major public health problem in the U.S. The objective of this study was to estimate the number of annual driver- and passenger-reported episodes of AID and explore the effect of sociodemographic characteristics and drinking patterns on both behaviors.
Data from a nationally representative random-digit-dial telephone survey of U.S. adults were analyzed in 2007.
From July 23, 2001, to February 7, 2003, an estimated 7 million drivers reported 190 million annual episodes of AID, and an estimated 10.5 million passengers reported 290 million annual episodes of AID. A comparison of estimates from this survey to those from a similar survey conducted in 1994 shows that episodes of both driver- and passenger-reported AID have increased by slightly more than 50%. Multivariable analysis revealed several gender differences in risk factors for both driver- and passenger-reported AID. For example, being of Hispanic ethnicity and not always wearing a seat belt were both associated with an increased risk of AID episodes for men but not women. A strong association between binge drinking and both driver- and passenger-reported AID was found for both genders.
Episodes of driver- and passenger-reported AID increased substantially between the middle 1990s and the early 2000s. The passenger estimates suggest that drivers may under-report AID by about 50%. Public health interventions to reduce AID should give equal consideration to impaired drivers and their passengers.
Alcohol-related motor vehicle crashes are a major public health problem, resulting in 15,786 deaths and more than 300,000 injuries in 1999. This report presents the results of systematic reviews of the effectiveness and economic efficiency of selected population-based interventions to reduce alcohol-impaired driving.
The Guide to Community Preventive Services's methods for systematic reviews were used to evaluate the effectiveness of five interventions to decrease alcohol-impaired driving, using changes in alcohol-related crashes as the primary outcome measure.
Strong evidence was found for the effectiveness of .08 blood alcohol concentration laws, minimum legal drinking age laws, and sobriety checkpoints. Sufficient evidence was found for the effectiveness of lower blood alcohol concentration laws for young and inexperienced drivers and of intervention training programs for servers of alcoholic beverages. Additional information is provided about the applicability, other effects, and barriers to implementation of these interventions.
These reviews form the basis of the recommendations by the Task Force on Community Preventive Services presented elsewhere in this supplement. They can help decision makers identify and implement effective interventions that fit within an overall strategy to prevent impaired driving.
Effectiveness of strategies to counter injurious risk-taking in adolescents depends on the degree to which behaviors are modifiable or intrinsic to a sensation-seeking personality. Alcohol consumption is often targeted because it is seen as a modifiable determinant. This study sought to clarify the relative importance of engagement in heavy episodic drinking (HED) independently of sensation-seeking tendency (SS), as a predictor of potentially harmful (and protective) behaviors.
A written survey was administered to students aged 15-17 years in 40 high schools in New South Wales (NSW), Australia to measure HED, SS, and harmful and protective behaviors associated with drug and alcohol use, driving, and celebrating.
Of 2705 respondents, 60% reported HED, 36% failed to wear a seatbelt, 23% rode with an alcohol-impaired driver, 23% rode with a drug-impaired driver and 9% had been alcohol impaired while driving. Two-thirds (65%) had engaged in harmful behaviors and 99% had engaged in protective behaviors while celebrating. SS, gender, income, and age were significant predictors of HED. HED and SS were significant, independent predictors of every harmful or protective behavior. HED had the greatest effect on harmful celebrating behaviors, riding with an alcohol-impaired acquaintance, and riding with a drug-impaired driver. HED had a stronger effect than SS, for alcohol-impaired driving, riding with an alcohol-impaired acquaintance, riding with a drug-impaired driver, and harmful celebrating behaviors.
The vast majority of adolescents who are low to average sensation seekers may benefit from population-based prevention strategies emphasizing that decisions leading to harmful outcomes are more likely if they engage in HED.
This study identifies social mechanisms that might help prevent youth from being involved in driving under the influence of alcohol (DUI) and riding with drinking drivers (RWDD). Data collected through telephone surveys with 1534 adolescents and young adults aged 15-20 years (mean=17.6, S.D.=1.6) in California, USA, were analyzed. Structural equation modeling analyses showed that DUI and RWDD were strongly related to drinking in unstructured situations, modeling of DUI by peers and parents, and perceived peer approval or disapproval of DUI. DUI outcome expectancies were indirectly related to DUI and RWDD through situational drinking. Parental monitoring and DUI law enforcement were also indirectly related to DUI and RWDD through DUI expectancies and other mechanisms. The findings, overall, suggest that parental influence remains important even through late adolescence. Parental monitoring, in particular, might help to reduce unstructured socializing with peers, drinking, and affiliation with peers who engage in DUI. Parental monitoring may also foster beliefs about the risks of DUI. Conversely, parents' own DUI behavior may normalize drinking and DUI behaviors, thus countering monitoring efforts.
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.
Examining the associations between engagement, acceptability, usability, and short-term outcomes of REAL parenting: A digital parent-based intervention to prevent alcohol use among high school teens
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