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Preventing alcohol misuse in young people aged 9-11 years through promoting family communication: an exploratory evaluation of the Kids, Adults Together (KAT) Programme
Heather Rothwell, Jeremy Segrott
BMC Public Health , 2011, DOI: 10.1186/1471-2458-11-810
Abstract: Documentary analysis and interviews with key personnel examined the programme's development. Classroom preparation and KAT family events in two schools were observed. Focus groups with children, and interviews with parents who attended KAT family events were held immediately after programme delivery, and again after three months. Interviews with head teachers and with teachers who delivered the classroom preparation were conducted. Follow-up interviews with programme personnel were undertaken. Questionnaires were sent to parents of all children involved in classroom preparation.KAT achieved high levels of acceptability and involvement among both children and parents. Main perceived impacts of the programme were increased pro-social communication within families (including discussions about harmful parental alcohol consumption), heightened knowledge and awareness of the effects of alcohol consumption and key legal and health issues, and changes in parental drinking behaviours.KAT demonstrated promise as a prevention intervention, primarily through its impact on knowledge and communication processes within families, and its ability to engage with large numbers of parents. A key programme mechanism was the classroom preparation's facilitation of parental involvement in the family fun evening. The programme also incorporated features identified in the literature as likely to increase effectiveness, including a focus on harm reduction, interactive delivery, and targeting primary-school-age children. Further research is needed to test and develop programme theory through implementation in different school contexts, and to examine potential longer-term impacts, and the feasibility of large scale delivery.This paper reports the findings from an exploratory evaluation of a school-based alcohol misuse prevention programme - Kids, Adults Together (KAT), which engaged with primary school children and their parents/carers. A range of health and social impacts of alcohol misuse b
Federal structures of the prevention of alcohol misuse among children and youths [F derale Strukturen der Pr vention von Alkoholmissbrauch bei Kindern und Jugendlichen]  [cached]
Korczak, Dieter
GMS Health Technology Assessment , 2012, DOI: 10.3205/hta000104
Impulsivity, Impulsive and Reflective Processes and the Development of Alcohol Use and Misuse in Adolescents and Young Adults  [PDF]
Reinout W. Wiers,Susan L. Ames,Wilhelm Hofmann,Marvin Krank,Alan W. Stacy
Frontiers in Psychology , 2010, DOI: 10.3389/fpsyg.2010.00144
Abstract: This paper contrasts dual-process and personality approaches in the prediction of addictive behaviors and related risk behaviors. In dual-process models, behavior is described as the joint outcome of qualitatively different “impulsive” (or associative) and “reflective” processes. There are important individual differences regarding both types of processes, and the relative strength of both in a specific situation is influenced by prior behavior and state variables (e.g., fatigue, alcohol use). From this perspective, a specific behavior (e.g., alcohol misuse) can be predicted by the combined indices of the behavior-related impulsive processes (e.g., associations with alcohol), and reflective processes, including the ability to refrain from a motivationally salient action. Personality approaches have reported that general traits such as impulsivity predict addictive behaviors. Here we contrast these two approaches, with supplementary analyses on four datasets. We hypothesized that trait impulsivity can predict specific risky behaviors, but that its predictive power disappears once specific behavior-related associations, indicators of executive functioning, and their interaction are entered into the equation. In all four studies the observed interaction between specific associations and executive control (EC) was robust: trait impulsivity did not diminish the prediction of alcohol use by the interaction. Trait impulsivity was not always related to alcohol use, and when it was, the predictive power disappeared after entering the interaction between behavior-specific associations and EC in one study, but not in the other. These findings are interpreted in relation to the validity of the measurements used, which leads to a more refined hypothesis.
The CAP study, evaluation of integrated universal and selective prevention strategies for youth alcohol misuse: study protocol of a cluster randomized controlled trial
Nicola C Newton, Maree Teesson, Emma L Barrett, Tim Slade, Patricia J Conrod
BMC Psychiatry , 2012, DOI: 10.1186/1471-244x-12-118
Abstract: A cluster randomized controlled trial (RCT) is being conducted with Year 8 students aged 13 to 14-years-old from 27 secondary schools in New South Wales and Victoria, Australia. Blocked randomisation was used to assign schools to one of four groups; Climate Schools only, Preventure only, CAP (Climate Schools and Preventure), or Control (alcohol, drug and health education as usual). The primary outcomes of the trial will be the uptake and harmful use of alcohol and alcohol related harms. Secondary outcomes will include alcohol and cannabis related knowledge, cannabis related harms, intentions to use, and mental health symptomatology. All participants will complete assessments on five occasions; baseline; immediately post intervention, and at 12, 24 and 36 months post baseline.This study protocol presents the design and current implementation of a cluster RCT to evaluate the efficacy of the CAP study; an integrated universal and selective approach to prevent alcohol use and related harms among adolescents. Compared to students who receive the stand-alone universal Climate Schools program or alcohol and drug education as usual (Controls), we expect the students who receive the CAP intervention to have significantly less uptake of alcohol use, a reduction in average alcohol consumption, a reduction in frequency of binge drinking, and a reduction in alcohol related harms.This trial is registered with the Australian and New Zealand Clinical Trials registry, ACTRN12612000026820.Alcohol misuse amongst young people is common and the burden of disease, social costs, and disability associated with this use is considerable [1-4]. The peak of this disability occurs in those aged 15–24 years and corresponds with the typical age of initiation to alcohol and other drug use [5]. The high prevalence of use amongst adolescents is of particular concern given that early initiation to substance use is a risk factor for the development of substance use disorders, co‐morbid mental health p
Emotional Intelligence: An Untapped Resource for Alcohol and Other Drug Related Prevention among Adolescents and Adults  [PDF]
Ken Russell Coelho
Depression Research and Treatment , 2012, DOI: 10.1155/2012/281019
Abstract: Alcohol and Other Drug abuse in adolescents and adults continues to be a major public health problem in the United States. Care in intervention programs aimed at high risk populations identified occurs after the maladaptive behavioral delinquency has occurred, and only then is an individual afforded the opportunity to join an intervention program. The focus of this paper is to illustrate and highlight the value of prevention programs which emphasize altering maladaptive behavior before the behavior becomes problematic. Emotional Intelligence is not only an indicator of alcohol and other drug abuse, but is linked to emotional competence, social and emotional learning, the development of healthy and life promoting behavior, and has been proven to reduce some of the risk factors associated with alcohol and other drug abuse in adolescents and adults. This paper seeks to recognize the significance of Emotional Intelligence as a desirable health promoting attribute and to establish the importance of its conceptual use in a prevention based model for reducing associated high risk behaviors. 1. High Risk Behavior in Adolescents and Adults Alejandro is a 12 year old adolescent who lives in the inner city of West Oakland in Northern California. He lives in an area rampant with crime, drugs, violence and prostitution. His immigrant parents were offered asylum refugee immigration status to permanently reside in the United States twelve years ago. Alejandro is the first and only child in his family to be born in the United States. He attends high school where he gets into frequent trouble with authority. His parents often get phone calls from the school complaining that he cannot control himself, and gets into fist fights with other classmates. Due to these behavioral problems in school, his parents get very angry with him and get into arguments with each other quite often, which usually leads to Alejandro’s father turning violent and either destroying furniture or physically abusing Alejandro. This might be due in-part to the fact that Alejandro’s father is an alcoholic and has a pack a day history of smoking. His parents are not used to open communication with him, instead they just address issues by declaring that he should simply stop indulging in disruptive behavior in school, without asking him as to why and what made him resort to these delinquencies. They compare him to other well-behaved children in the community to make him feel guilty about his acts of violence which causes him to alienate and distance himself from them. As a result, Alejandro does not
Frequency, course and correlates of alcohol use from adolescence to young adulthood in a Swiss community survey
Hans-Christoph Steinhausen, Susanne Eschmann, Annina Heimgartner, Christa Metzke
BMC Psychiatry , 2008, DOI: 10.1186/1471-244x-8-5
Abstract: Alcohol use was studied by a questionnaire in a cohort of N = 593 subjects who had been assessed at three times between adolescence and young adulthood within the Zurich Psychology and Psychopathology Study (ZAPPS). Other assessment included questionnaire data measuring emotional and behavioural problems, life events, coping style, self-related cognitions, perceived parenting style and school environment, and size and efficiency of the social network.The increase of alcohol use from early adolescence to young adulthood showed only a few sex-specific differences in terms of the amount of alcohol consumption and the motives to drink. In late adolescence and young adulthood, males had a higher amount of alcohol consumption and were more frequently looking for drunkenness and feeling high. Males also experienced more negative consequences of alcohol use. A subgroup of heavy or problem drinkers showed a large range of emotional and behavioural problems and further indicators of impaired psychosocial functioning both in late adolescence and young adulthood.This Swiss community survey documents that alcohol use is problematic in a sizeable proportion of youth and goes hand in hand with a large number of psychosocial problems.The international trends in substance use and its determinants among youths have been analyzed in various recent reviews [1,2]. There can be no doubt that alcohol is among the leading substances used and abused by adolescents and young adults. A European prevalence study based on data collected in 26 countries found the highest rates of drunkenness, binge drinking, and alcohol consumption among British, Danish, and Irish youths. Alcohol use and misuse was much more widely reported than illicit drugs [3].Alcohol and nicotine use contributed most strongly to the unprecedented rise in youth drug use in Britain in the mid-1990s [1]. A German prospective longitudinal study with a large representative sample of adolescents and young adults found that cumulat
Alcohol Misuse and Multiple Sexual Partners  [cached]
Shahrzad Bazargan-Hejazi, PhD,Tommi Gaines, DrPH,Mohsen Bazargan, PhD,Bobak Seddighzadeh, BS
Western Journal of Emergency Medicine : Integrating Emergency Care with Population Health , 2012,
Abstract: Introduction: We examine the association between self-reported alcohol misuse and alcohol usewithin 2 hours of having sex and the number of sexual partners among a sample of African-Americanand Latino emergency department (ED) patients.Methods: Cross-sectional data were collected prospectively from a randomized sample of all EDpatients during a 5-week period. In face-to-face interviews, subjects were asked to report their alcoholuse and number of sexual partners in the past 12 months. Data were analyzed using multiple variablenegative binomial regression models, and effect modification was assessed through inclusion ofinteraction terms.Results: The 395 study participants reported an average of 1.4 (standard error 0.11) sexual partnersin the past 12 months, 23% reported misusing alcohol, and 28% reported consuming alcohol beforesex. There was no statistically significant association between alcohol misuse and the number ofsexual partners; however, alcohol before sex was associated with a larger number of sexual partners inthe past year. Moreover, among those who misused alcohol, participants who reported alcohol beforesex were 3 times more likely to report a higher number of sexual partners (risk ratio 3.2; confidenceinterval [CI] 1.9–5.6). The association between alcohol use before sex and number of sexual partnersis dependent upon whether a person has attributes of harmful drinking over the past 12 months.Overall, alcohol use before sex increases the number of sexual partners, but the magnitude of thiseffect is significantly increased among alcohol misusers.Conclusion: Alcohol misusers and those who reported having more than 1 sexual partner were morelikely to cluster in the same group, ie, those who used alcohol before sex. Efforts to reduce the burdenof sexually transmitted diseases, including human immunodeficiency virus, and other consequences ofrisky sexual behavior in the ED population should be cognizant of the interplay of alcohol and riskysexual behaviors. EDs should strive to institute a system for regular screening, brief intervention, andreferral of at-risk patients to reduce negative consequences of alcohol misuse, including those of riskysexual behaviors.
Alcohol use and misuse: What are the contributions of occupation and work organization conditions?
Alain Marchand
BMC Public Health , 2008, DOI: 10.1186/1471-2458-8-333
Abstract: Data come from a representative sample of 10,155 workers in Quebec, Canada. Multinomial regression models corrected for sample design effect have been used to predict low-risk and high-risk drinking compared to non-drinkers. The contribution of occupation and work organization conditions (skill used, decision authority, physical and psychological demands, hours worked, irregular work schedule, harassment, unionization, job insecurity, performance pay, prestige) have been adjusted for family situation, social network outside the workplace, and individual characteristics.Compared to non-qualified blue-collars, both low-risk and high-risk drinking are associated with qualified blue-collars, semi-qualified white-collars, and middle managers; high-risk drinking is associated with upper managers. For constraints-resources related to work organization conditions, only workplace harassment is an important determinant of both low-risk and high-risk drinking, but it is modestly moderated by occupation. Family situation, social support outside work, and personal characteristics of individuals are also associated with alcohol use and misuse. Non-work factors mediated/suppressed the role of occupation and work organization conditions.Occupation and workplace harassment are important factors associated with alcohol use and misuse. The results support the theoretical model conceptualizing alcohol use and misuse as being the product of stress caused by constraints and resources brought to bear simultaneously by agent personality, structures of daily life, and macro social structures. Occupational alcohol researchers must expand their theoretical perspectives to avoid erroneous conclusions about the specific role of the workplace.Alcohol misuse afflicts a substantial part of the working population. In the USA, 6.2% of adults working full-time reported heavy drinking in 1999 [1]. In Canada, 22% to 33% of employees exceeded the Canadian low-risk alcohol guidelines, 7% to 8% were episo
Health Care Access Among U.S. Adults Who Drink Alcohol Excessively: Missed Opportunities for Prevention  [cached]
Machell Town, MS,Timothy S. Naimi, MD, MPH,Ali H. Mokdad, PhD,Robert D. Brewer, MD, MSPH
Preventing Chronic Disease , 2006,
Abstract: Introduction Excessive alcohol consumption kills approximately 75,000 people annually in the United States. Although alcohol screening among primary care patients is recommended by the U.S. Preventive Services Task Force, it is rarely performed. It is unclear whether low screening rates are due to limited access to health care, missed screening opportunities during patient visits, or both. Methods Data came from the 2002 Behavioral Risk Factor Surveillance System, a population-based telephone survey of noninstitutionalized U.S. adults. Current health insurance status and a history of a recent medical checkup (within 2 years) were assessed in relation to alcohol consumption status. Excessive drinkers included those who reported binge drinking (consuming five or more drinks on one or more occasions in the past month), heavy drinking (consuming more than 60 drinks in the past month for men or more than 30 for women), or both. Results The prevalence of excessive drinking among the general population (17%) was only slightly higher than the prevalence among those with current health insurance (15%) or a recent checkup (14%). Among excessive drinkers, 79% had current health insurance and 78% had a recent checkup. Although excessive drinkers were somewhat less likely to have health insurance or a recent checkup compared with nonexcessive drinkers and nondrinkers, these differences were less pronounced after stratifying by age. Excessive drinkers with the lowest rates of health insurance were young, Hispanic, less educated, and unemployed. However, most excessive drinkers who lacked insurance or a checkup were employed. Conclusion Most excessive drinkers were insured and had a recent medical checkup, suggesting that low screening rates among excessive drinkers are mostly due to missed screening opportunities rather than a lack of screening opportunities. Systems approaches to address these missed opportunities should be aggressively implemented.
Personalised Normative Feedback for Preventing Alcohol Misuse in University Students: Solomon Three-Group Randomised Controlled Trial  [PDF]
Maria T. Moreira, Reza Oskrochi, David R. Foxcroft
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0044120
Abstract: Background Young people tend to over-estimate peer group drinking levels. Personalised normative feedback (PNF) aims to correct this misperception by providing information about personal drinking levels and patterns compared with norms in similar aged peer groups. PNF is intended to raise motivation for behaviour change and has been highlighted for alcohol misuse prevention by the British Government Behavioural Insight Team. The objective of the trial was to assess the effectiveness of PNF with college students for the prevention of alcohol misuse. Methodology Solomon three-group randomised controlled trial. 1751 students, from 22 British Universities, allocated to a PNF group, a normal control group, or a delayed measurement control group to allow assessment of any measurement effects. PNF was provided by email. Participants completed online questionnaires at baseline, 6- and 12-months (only 12-months for the delayed measurement controls). Drinking behaviour measures were (i) alcohol disorders; (ii) frequency; (iii) typical quantity, (iv) weekly consumption; (v) alcohol-related problems; (vi) perceived drinking norms; and (vii) positive alcohol expectancies. Analyses focused on high-risk drinkers, as well as all students, because of research evidence for the prevention paradox in student drinkers. Principal Findings Follow-up rates were low, with only 50% and 40% responding at 6- and 12-months, respectively, though comparable to similar European studies. We found no evidence for any systematic attrition bias. Overall, statistical analyses with the high risk sub-sample, and for all students, showed no significant effects of the intervention, at either time-point, in a completed case analysis and a multiple imputation analysis. Conclusions We found no evidence for the effectiveness of PNF for the prevention of alcohol misuse and alcohol-related problems in a UK student population. Registration Controlled-Trials.com ISRCTN30784467
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