Alcohol Screening and Brief Intervention as Standard Practice: Working with the American Indian/Native Alaskan Populations

Alcohol use and the resulting problems associated with high-risk drinking in the American Indian/Native Alaskan (AI/NA) population are well-documented, as alcohol misuse has taken an incredible toll on many AI/NA communities. Presently, both overall health issues and alcohol use occur disproportionately within this population. This article provides an updated overview of the impact of alcohol use in the United States and within AI/NA communities specifically. It also provides recommendations for an alcohol-related screening and brief intervention instrument that social workers can begin using in their practice and can be utilized within the AI/NA community.     

A review of environmental-based community interventions

Alcohol use and related problems can be influenced by a wide variety of prevention interventions, including efforts that focus on changing the community alcohol environment-for example, by reducing underage access to alcohol, decreasing alcohol availability among adults, and increasing awareness of alcohol-related issues. Examples of environmental-based community interventions that focus on reducing alcohol use and related problems are Communities Mobilizing for Change on Alcohol, the Community Prevention Trial, the Sacramento Neighborhood Alcohol Prevention Project, Saving Lives, Operation Safe Crossing, and Fighting Back. Evaluations of these programs found that programs that change the community environment can reduce alcohol use and related problems among both youth and adults, even in communities with relatively low readiness to address alcohol issues. Research also has identified particular settings and situations where alcohol environmental changes are particularly needed as well as factors influencing the effectiveness of certain strategies. Despite the progress made, additional questions still need to be addressed in future research to maximize the benefits associated with environmental-based community interventions.     

Impact of Disability and Other Physical Health Issues on Academic Outcomes Among American Indian and Alaskan Native College Students: An Exploratory Analysis

This study investigated whether self-identified disabilities among American Indian and Alaskan Native college students impact academic performance and persistence to graduation and explored the differences in health and academic grades between American Indian and Alaskan Native students and students of other racial and ethnic identities using the National College Health Assessment. Findings indicate that American Indian or Alaskan Native students have significantly lower grades than White and Asian students, and American Indian and Alaskan Native women report the highest incidence of health problems of any demographic group. Exploratory results point to future research to determine the full impact of disabilities and poor health on academic success.     

Use of computer-assisted instruction in the prevention of alcohol abuse

Recent critiques of and research with traditional alcohol prevention programs have revealed serious problems. Prevention programs typically increase knowledge and appropriate attitudes about alcohol while having little effect on drinking behavior. In this article several concepts are introduced in support of a technology which has the potential to revitalize alcohol education efforts. First, Bandura's self-efficacy theory offers a direction for re-conceptualizing the design of prevention programs as well as the measurement of their effects. Second, computer-assisted instruction (CAI) programs may provide a means for capturing attention, effectively educating about alcohol, and supplementing traditional approaches. One current CAI program is described in detail. Implications for research and practice and obstacles to effective CAI use are also discussed.     

Regulating availability: how access to alcohol affects drinking and problems in youth and adults

Regulations on the availability of alcohol have been used to moderate alcohol problems in communities throughout the world for thousands of years. In the latter half of the 20th century, quantitative studies of the effects of these regulations on drinking and related problems began in earnest as public health practitioners began to recognize the full extent of the harmful consequences related to drinking. This article briefly outlines the history of this work over four areas, focusing on the minimum legal drinking age, the privatization of alcohol control systems, outlet densities, and hours and days of sale. Some historical background is provided to emphasize the theoretical and empirical roots of this work and to highlight the substantial progress that has been made in each area. In general, this assessment suggests that higher minimum legal drinking ages, greater monopoly controls over alcohol sales, lower outlet numbers and reduced outlet densities, and limited hours and days of sale can effectively reduce alcohol sales, use, and problems. There are, however, substantial gaps in the research literature and a near absence of the quantitative theoretical work needed to direct alcohol-control efforts. Local community responses to alcohol policies are complex and heterogeneous, sometimes reinforcing and sometimes mitigating the effects of availability regulations. Quantitative models of policy effects are essential to accelerate progress toward the formulation and testing of optimal control strategies for the reduction of alcohol problems.     

Alcohol Use Among Black and White Adolescents Exploring the Influence of Interracial Friendship,the Racial Composition of Peer Groups,and Communities

Black adolescents use less alcohol, on average, than white adolescents. Prior research has struggled to explain the disparity in alcohol use between blacks and whites but not for a lack of potential mediating mechanisms. The current study draws on differential association theory and two waves of panel data (n = 1,016) to examine the influence of interracial friendship, the racial composition of peer groups, and communities on black–white differences in alcohol use. Findings indicate that (1) the racial composition of peer groups and communities influence changes in alcohol use, and (2) racial segregation contributes to racial disparities in alcohol use while interracial friendship reduces these disparities. Results suggest that the socially conservative values of the African‐American community are a strong deterrent to adolescent drinking, affecting even those adolescents who are themselves white but associate with black youth.     

新常态下推进"撤村建居"的探索与思考

"撤村建居"是一个庞大的系统工程,与国家、集体和个人利益息息相关,稍有不慎就会造成社会的不稳定因素.要以有利于经济社会全面发展、有利于加强社会事务管理、有利于提高人民生活水平为要求,统一规划,合理布局,加快农村社区建设,推进新型城镇化步伐.在实施过程中应注意妥善解决好以下问题:"撤村建居"过程中原村集体资产的处置,"撤村建居"后的换届,"撤村建居"后的公益事业及工作经费,"撤村建居"后的社区划分和管理,失地农民的社会保障,建设资金的来源等.     

Drinking places: Young people and cultures of alcohol consumption in rural environments

This paper focuses on the contemporary British moral panic about young people and the consumption of alcohol in public space. Most of this public debate has focused on binge drinking in urban areas as a social problem. Here, we consider instead the role of alcohol in rural communities, and in particular alcohol consumption in domestic and informal spaces, as well as the formal drinking landscape of pubs and bars. Drawing on empirical work (including a survey, interviews and participant observation) in rural Cumbria, UK we explore the specific socio-spatial nature of local attitudes to alcohol consumption and its regulation. In doing so, we reflect on the nature of rural lifestyles, community spaces and intergenerational relations. The paper concludes by highlighting some of the implications for health promotion professionals of the generally positive attitude towards young people's drinking in the rural area where the research was conducted. It also draws attention to the need for academics to pay closer attention to the ways that moral panics about binge drinking are implicitly producing a monolithic image of alcohol consumption in urban areas that fails to acknowledge the socio-spatially differentiated nature of practices of alcohol consumption and regulation.     

Alcohol abuse on a college campus: A needs assessment

This paper reports the results of a needs assessment study conducted by a university-based alcohol abuse prevention project. Data are presented on the drinking patterns and drinking problems of a random sample of 462 students. Results suggest that students are experiencing numerous difficulties in the physical, educational, legal and psychosocial areas due to their use of alcoholic beverages. Implications for prevention and intervention programming are discussed and the need for planning programs from a data-based perspective rather than a rational and intuitive approach is stressed.     

Problem Drinking among transnational mexican migrants: Exploring migrant Status and Situational Factors

We present research finding son problem drinking among transnational Mexican migrants employed in the mushroom industry of southeastern Pennsylvania. Our research explored the relationship between situational factors-living arrangements, social isolation, and peer pressure to drink-and problem drinking. Individual characteristics of the migrants, such as age, education level, migration history, and work experience in the mushroom industry are also considered. The premise of our study is that the migrants' judicial status in the country-as foreign solo men and, at times, undocumented or illegal migrants-places them at a high risk to binge drink. The men mainly live without their families in relatively isolated, grower-provided housing or overcrowded apartment units for months, if not years, away from traditional community and kin deterrents to heavy drinking. We employed the ethnographic method in two complementary field studies: a community ethnography, designed to identify the community context of problem drinking, and a series of case studies of migrant drinkers, designed to identify the relationships between situational factors and problem drinking. Focus groups were used to explore and verify the findings being generated in the two studies. Our findings reveal that there is an alcohol abuse problem among the migrants as a consequence of situational and other factors, such as festive occasions, bad news from home, and a long workweek. Their binge drinking does not always result in negative behavior because the migrants follow drinking norms, and violators of these norms are dealt with accordingly. Nonetheless, binge drinking does place them at a high risk for negative behavior, which results in problems in their housing units and in local communities.     

Self-reported drinking-game participation of incoming college students

Drinking games are associated with excess alcohol use and alcohol-related problems, yet it is unclear whether they are unique to the college environment or whether students come to college familiar with such games. The authors queried 1,252 students attending voluntary summer orientation programs about their experiences with drinking games. A majority (63%) indicated they had played drinking games and viewed them as a means to get drunk quickly and to socialize, control others, or get someone else drunk. Logistic regression analyses revealed that familiarity with drinking situations was associated with a greater likelihood of playing drinking games. Students who reported drinking more frequently and consuming greater quantities of alcohol than others, having lifetime marijuana use, and initiating alcohol consumption between the ages of 14 and 16 years were significantly more likely to have participated in drinking games. These findings demonstrate the importance of considering students' participation in drinking games when campus officials address alcohol use.     

Acquaintance rape and alcohol consumption on college campuses: how are they linked?

This article explores the links between acquaintance rape and alcohol consumption among college students. Both heavy drinking and acquaintance rape are serious problems on college campuses, and they frequently co-occur. Seven explanations for the relationship between alcohol consumption and acquaintance rape are provided: three of these explanations focus on alcohol consumption by the perpetrator and four focus on alcohol consumption by the victim. The need to conduct studies and develop prevention programs that address these issues is discussed.     

UPSTREAM! Together evaluation results from community efforts to prevent mental,emotional, and behavioral health problems

Mental, emotional, and behavioral (MEB) health problems are prevalent globally. Despite effective programs that can prevent MEB problems and promote mental health, there has not been widespread adoption. UPSTREAM! Together was a planning project in three Colorado communities. Communities partnered with academic and policy entities to 1) translate evidence about MEB problem prevention into locally-relevant messages and materials and 2) develop long-term plans for broad implementation of interventions to prevent high-priority MEB problems. Community members recognized the need to talk about MEB problems to prevent them. The UPSTREAM! communities localized messages designed to start conversations and sustain attention on preventing MEB problems. The communities understood that prevention takes sustained community attention and advocacy, knowing that important outcomes may be years away. Long-term implementation plans aimed to strengthen families and enhance social connections among youth. Despite community readiness and capacity to implement evidence-based programs, there were few funding opportunities, delaying program implementation and revealing gaps between funding policies and community readiness. This community-engaged experience suggests an achievable approach, acceptable to communities, and worthy of further development and testing. Policies that cultivate and support local expertise may help to increase wider community adoption of evidence-based programs that promote mental health among youth.     

The reliability of environmental measures of the college alcohol environment

Much of what we know about students' drinking patterns and problems related to alcohol use is based on survey research. Although local and national survey data are important to alcohol-prevention projects, they do not sufficiently capture the complexity of the alcohol environment. Environmental prevention approaches to alcohol-related problems have been shown to be effective in community settings and researchers have begun to study and adapt such approaches for use on college campuses. Many environmental approaches require systematic scanning of the campus alcohol environment. This study assessed the inter-rater reliability of two environmental scanning tools (a newspaper content analysis form and a bulletin analysis form) designed to identify alcohol-related advertisements targeting college students. Inter-rater reliability for these forms varied across different rating categories and ranged from poor to excellent. Suggestions for future research are addressed.     

A review of social host policies focused on underage drinking parties: suggestions for future research

Underage drinking continues to be a public health concern, partially due to the ease in which adolescents obtain alcohol and consume it in private locations. States and municipalities have implemented strategies to counteract this, including adopting public policies called social host policies, despite limited evidence of effectiveness. Traditionally, these laws have held adults accountable for furnishing alcohol to underage drinkers. However, states and communities are using another policy, also called social host, to deter underage drinking parties where easy access to alcohol and high-risk use occurs. These innovative laws hold individuals who control the property accountable for underage drinking that occurs there, regardless of alcohol source. We conducted a critical analysis of social host policies focused on hosting underage drinking parties and constructed a conceptual model to understand their targeted factors. Future research recommendations are discussed.     

How aware of child sexual abuse (CSA) are ethnic minority communities? A literature review and suggestions for raising awareness in Australia

A systematic literature review was conducted to help address the gap in national and international knowledge about child sexual abuse (CSA) and ethnic minority communities. This paper reports the findings of that review in relation to the theme of community awareness. The results suggest that awareness of CSA may be low in ethnic minority communities due to misperceptions that it is ‘a Western problem’. This in turn may be associated with norms in the country of origin which are asserted to transfer after migration, such as CSA being seen as a private family matter that does not invite systematic intervention from the state, low media and research attention, widespread acceptance of myths about CSA, and prohibitive norms on discussing matters to do with sex including abuse. Such trends are seen to be the result of, but also then further protect and preserve, collectivist and patriarchal structures. They also make it challenging for raising community awareness. Nevertheless, genuine community engagement through outreach/educational/preventative programs that empower minorities through co-delivery, are high on cultural competency, tailored to specific groups, and use a feminist framework where appropriate, are seen as necessary; they represent investment in minority communities and child safety of children from minority communities. Overall, realistic goals about the effectiveness of outreach educational programs, combined with value for culturally meaningful constructions of child safety, are seen as key toward the success of awareness-raising programs.     

Fear,Shame, and Health Promotion

Abstract

Drinking games are associated with excess alcohol use and alcohol-related problems, yet it is unclear whether they are unique to the college environment or whether students come to college familiar with such games. The authors queried 1,252 students attending voluntary summer orientation programs about their experiences with drinking games. A majority (63%) indicated they had played drinking games and viewed them as a means to get drunk quickly and to socialize, control others, or get someone else drunk. Logistic regression analyses revealed that familiarity with drinking situations was associated with a greater likelihood of playing drinking games. Students who reported drinking more frequently and consuming greater quantities of alcohol than others, having lifetime marijuana use, and initiating alcohol consumption between the ages of 14 and 16 years were significantly more likely to have participated in drinking games. These findings demonstrate the importance of considering students' participation in drinking games when campus officials address alcohol use.     

Factors predicting placement of urban American Indian/Alaskan Natives into out-of-home care

American Indian/Alaskan Native children have disproportionately been placed into out-of-home care compared to White children in the child welfare system. What were the factors that child protective services (CPS) workers considered when deciding to remove a child from the home? Utilizing data from the National Survey of Child and Adolescent Well-Being, this study examined out-of-home care factors for 2215 urban American Indian/Alaskan Native (AI/AN) and White children. In the urban sample, children from White families were younger and were more likely to be investigated for lack of supervision, while AI/AN families were investigated for physical neglect. In the placement regression models, urban AI/AN children came from homes where caregivers had greater alcohol, drug and mental health problems. Decisions by CPS workers to place AI/AN children may have been influenced by racial bias. A CPS system that acknowledges culture and race may reduce overrepresentation in placement. Efforts to work with AI/AN families prior to a child's removal may prove to be beneficial and less expensive.     

Perceptions of drinking among Hispanic college students: how qualitative research can inform the development of collegiate alcohol abuse prevention programs

Alcohol abuse on college campuses continues to be a significant public health issue and health promotion strategies are being directed at changing the culture of collegiate drinking. From a qualitative research perspective such efforts remain uniformed since this area of research is currently dominated by large-scale surveys that illuminate little regarding undergraduate perceptions of alcohol use. This study describes results conducted on perceptions of drinking among college students, and discusses the implications these results may have for developing collegiate alcohol abuse prevention programs.     

Perception of Substance Use Problems in Asian American Communities by Chinese,Indian, and Vietnamese American Youth

SUMMARY

The study was a cross-sectional survey using a convenience sample of 87 Asian American youth respondents to examine their perceptions of substance use problems in the Asian American community. The authors examined respondents' perceptions of the severity of substance use problems in the Asian American community, perceived characteristics of persons with problems of substance use, perceived etiology of substance use problems, beliefs about treatment, perceived help-seeking preferences and helpful services. The youth demonstrated an increased awareness of the severity of substance use problems in the community, although such awareness was more prominent for drinking problems than drug use problems. Respondents showed a positive attitude toward treatment, although such an attitudinal change was not yet accompanied by a change in their behavioral preferences. Findings suggested a tendency for Asian American youth respondents to utilize personal resources rather than professional help or formal treatment programs in response to substance use problems. In addition, respondents shared similar “myths” of Asian problem drinkers and drug users. Implications for developing culturally relevant interventions for prevention and treatment as well as future research are discussed.