Reducing Underage Drinking A Collective Responsibility (2004) / Chapter Skim
Currently Skimming:
10. Youth-Oriented Interventions
10. Youth-Oriented Interventions
Pages 185-215
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 185... ...
In the context of alcohol problems, a selective preventive measure would target a population known to be at greater risk for experiencing alcohol-related problems. An example would be a subset of college students who are white, male, fraternity members under the age of 24 who have a tendency to socialize, characteristics that research has shown to be associated with heavy drinking.
|
From page 186... ...
The approaches outlined in this chapter, consistent with the committee's overall task of developing a strategy to reduce underage drinking across a wide range of youth populations, are by and large universal measures. We discuss the possible value of a youth-oriented media campaign aimed at changing youth drinking behaviors; school-based approaches; approaches at residential colleges and universities; and potential opportunities in other settings, including healthcare and faith-based institutions, the workplace, and the military.
|
From page 187... ...
There has been a substantial decline in the prevalence of youth smoking, with 30-day prevalence among twelfth graders declining from a high of 37 percent in 1997 to the 2002 level of 27 percent. There is credible although not definitive evidence that the mass media campaigns have been a substantial force in this decline (Siegel and Biener, 2000; Sly et al., 2001; Siegel, 2002)
|
From page 188... ...
The lack of any longer-term downward trend in drinking or heavy drinking, despite the presence of a wide variety of public efforts to address these issues, is then one concern about initiating a major campaign against youth alcohol use, though not by itself sufficient to reject such an effort. If there have been negative alcohol messages directed toward youth, they likely pale before the pro-alcohol onslaught that surrounds youth (see Chap
|
From page 189... ...
. As of this writing, the committee does not have evidence of success in reducing youth alcohol use from any evaluated campaign (excluding limited evidence on specific college campuses)
|
From page 190... ...
If the anti-tobacco efforts are a positive model and the anti-drug efforts are not encouraging, wouldn't it be possible to model a campaign against youth alcohol use on the first and avoid the mistakes of the second? This question requires a careful consideration of how the tobacco and drug campaigns were different from one another and how the behaviors they addressed are different from alcohol use.
|
From page 191... ...
However, the differences between an anti-tobacco campaign and a campaign against youth alcohol use are too substantial too ignore. Even if some of the lessons about edgy, youth-controlled message development could be borrowed from the antitobacco campaigns, other lessons could not: no campaign against youth alcohol use, much less a federally sponsored one, could successfully replicate the anti-industry tactics that have been the hallmark of the California, Florida, and Legacy Foundation campaigns, not only because moderate alcohol use is widely accepted among adults, but also because the claims about industry duplicity and misrepresentation are rooted in the tobacco industry's unique history.
|
From page 192... ...
A similar approach would need to be taken with the development of underage drinking communication interventions. Some interventions should focus on reducing heavy drinking and some on discouraging all underage drinking; some interventions should focus on perceived risk and negative consequences, while others should focus on changing perceived norms or increasing skills at resisting peer pressure to drink.
|
From page 193... ...
Positive effects are small to modest. Research has shown, however, that some school-based approaches are more effective than others at reducing youth alcohol use.
|
From page 194... ...
School-based interventions that use normative education to undermine youth beliefs that alcohol use is prevalent among their peers and that their peers universally approve of this behavior appear to have promise. Efforts to establish nonuse norms -- implemented in conjunction with a critical look at both alcohol advertising and media and other cultural messages that make alcohol use symbolic of qualities youth want to attain (e.g., maturity, independence, popularity)
|
From page 195... ...
In addition, research on communitywide alcohol prevention programming (see Chapter 11) , such as Project Northland and family-based approaches like the Michigan State University Multiple Risk Outreach Program, offer additional critical elements that can make education interventions more effective (Williams et al., 1999; Nye et al., 1995)
|
From page 196... ...
For example, the normative education element in interventions like the Adolescent Alcohol Prevention Trials significantly deterred use of alcohol, tobacco, and marijuana among middle and high school students (Hansen and Graham, 1991)
|
From page 197... ...
This kind of consistency and rigor has the potential to ensure that programs shown to reduce underage drinking can have long-lasting effects. However, schools and communities are often funded to implement these programs through temporary mechanisms and often at a level that does not allow sustained implementation.
|
From page 198... ...
Department of Health and Human Services and the U.S. Department of Education should fund only evi dence-based education interventions, with priority given both to those that incorporate elements known to be effective and those that are part of comprehensive community programs.
|
From page 199... ...
. Furthermore, 31 percent of college students meet diagnostic criteria for alcohol abuse and 6 percent meet criteria for alcohol dependence; these data suggest that individual-based strategies for screening and intervention or referral may need to be a component of a comprehensive college based approach (Knight et al., 2002)
|
From page 200... ...
. According to NIAAA's recent report on college drinking, programs that target heavy drinkers through unified education interventions that include cognitive behavioral skills, norm clarification, and motivational enhancement interventions in conjunction with environmental and policy changes is the approach most likely to be effective at addressing college student drinking (NIAAA, 2002)
|
From page 201... ...
Alcohol expectancies have been found to predict drinking behavior among college students (Christiansen et al., 1989; Stacy et al., 1990) , and research suggests that interventions that challenge the behaviors students expect to result from drinking can decrease alcohol consumption (Darkes and Goldman, 1998)
|
From page 202... ...
Few campuses have programs that link heavy drinkers -- even when they are identified through campus systems -- to such interventions. The integration of skills training, normative feedback, and motivational interviewing techniques has been applied to one-on-one and small group interventions in order to reduce drinking rates.
|
From page 203... ...
. Research on social norms campaigns has indicated some promise, although research has generally been limited to case studies of individual campuses, generally without appropriate comparison or control groups, and they often do not control for other interventions aimed at reducing drinking problems.
|
From page 204... ...
Interventions based upon motivational enhancement, skill development, and normative clarification can promote values that are consistent with the values already found within the university culture. Parental Notification The Higher Education Amendments of 1998 provide assistance to colleges and universities in their efforts to address student alcohol and other drug use.
|
From page 205... ...
Several colleges, such as the University of Delaware, have adopted parental notification within a comprehensive approach to prevention. The integration of parental notification as part of a system to increase the monitoring, enforcement, and publicity associated with the institution's alcohol and other drug polices, has resulted in fewer suspensions, a decrease in disciplinary cases, less vandalism, and reductions in high-risk drinking behavior.
|
From page 206... ...
Although such approaches have not been evaluated, alcohol-free, late-night activities are an alcohol prevention strategy with theoretical promise. Screening for High-Risk and Heavy Drinkers Research on college student subcultures has identified specific student groups that accept and promote heavy substance use among their members (Astin, 1993; Dean, 1982)
|
From page 207... ...
. There also is inadequate evaluation of approaches, such as social norms marketing, parental notification, interventions in healthcare settings, and other innovative approaches.
|
From page 208... ...
Such research might include examining what faith-based groups currently do that addresses alcohol, with the goal of understanding how involvement in faith-based institutions moderates alcohol use and developing and evaluating innovative strategies for alcohol prevention in faith-based settings. However studies of faith-based interventions must be carefully designed to account for the possibility that selection bias, rather than program effects, accounts for any positive outcomes (Miller, 1998; Hardesty and Kirby, 1995)
|
From page 209... ...
. There is a growing interest in drawing healthcare providers into alcohol and substance abuse prevention with youth, and healthcare systems and providers represent an as yet untapped resource in prevention programming.
|
From page 210... ...
Workplace social norms may facilitate drinking behavior and additional exposure to adults who are of the legal drinking age may provide a mode of access for underage drinkers to procure alcohol. There are compelling reasons to expand workplace prevention programming.
|
From page 211... ...
At that time, 50 percent of enlisted personnel tested positive; by 1984, only 5 percent tested positive. Yet many employers who instituted drug testing also initiated other prevention programs at a similar time -- this was certainly true of the navy's approach to substance abuse prevention -- and research has not been conducted to separate the relative influence of the effects of drug testing and other programming (Cook and Schlenger, 2002)
|
From page 212... ...
Although estimates of the cost-effectiveness of early treatment are speculative, research suggests that early treatment has the potential to be cost-effective, especially in comparison with incarceration or treatment for a long-term alcohol abuse problem. For instance, costbenefit research on drug and alcohol treatment generally (Office of National Drug Control Policy, 2001)
|
From page 213... ...
. In addition, family interventions need to be prepared to address familial alcoholism, which represents a significant risk factor for youth alcohol use and future dependence.
|
From page 214... ...
. Underage drinkers who require intense treatment will also require intense continuing care.
|
From page 215... ...
Department of Health and Human Services, and the U.S. Depart ment of Justice should establish policies that facilitate diagnosing and referring underage alcohol abusers and those who are alcohol depen dent for clinical treatment.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.