Historical interpretations of alcohol use and misuse. implications for nursing curricula

Since the 1950's, nursing schools have been encouraged to include some formal content on alcoholism in their curricula. Yet there remains on immerse disparity between the prevalence of drug and alcohol problems in our society and the required number of hour on these topics in our nursing curricula. The International Nurses Society on Addictions calls on the nursing profession to promote healthy lifestyles for "at-risk" individuals. In a historical context, this article critiques the ambivalence related to alcohol use and misuse in the United States. Within that background, pedagogy to help nursing faculty and students meet current societal and professional demands and standards regarding intervention for alcohol-related problems will be explored. The constructivist educational and caring-educative models are highlighted.     

Assessment of drug abuse prevention curricula developed at the local level

Public schools are a critical site for drug abuse prevention and education. Although in recent years prevention curriculum developers have been able to identify successful strategies, it is not clear how well these findings have been transferred to local schools. This article reports on a study of schools that have developed their own drug abuse prevention curriculum. The process that these schools used is compared to a model of curriculum development. In general, the process that local schools use is characterized by high levels of involvement by a variety of personnel, low levels of training, little use of resources outside the school corporation, poor training of teachers who will be implementing the curriculum, and little evaluation. Availability of external funds for development from federal or state sources were powerful motivators for curriculum development. Recommendations for changes in professional development and curriculum materials availability are made.     

The impact of a culturally enhanced drug prevention program on drug and alcohol refusal efficacy among urban African American girls

This study examined the utility of the Specific Event Drug and Alcohol Refusal Efficacy scale (SEDARE) as an outcome of a culturally enhanced drug abuse prevention program for urban African-American girls in early adolescence. The SEDARE captures the perceived likelihood that youth will use drugs and alcohol in specific situations. Ninety-two girls participated in the program. Girls in the intervention group had higher drug refusal efficacy as measured by the SEDARE than girls in the comparison group. Girls varied in situations they perceived they could refuse drugs and alcohol. Findings are discussed with implications for drug abuse prevention programs for urban African-American girls.     

The prevalence of evidence-based substance use prevention curricula in the nation's elementary schools

Current guidelines for school-based substance use prevention suggest that prevention efforts should begin in elementary grades, before students begin using substances. Previous research suggests, however, that the use of evidence-based curricula in these grades may be low. Using a 2005 survey of public school districts in the United States that include elementary grades (n = 1563), we assessed the prevalence of elementary curricula use, particularly those designated as evidence-based. We found that although 72% of districts administer a substance use prevention curriculum to their elementary students, only about 35% are using one that is evidence-based and only about 14% are using an evidence-based curriculum more so than any other prevention curriculum. We present prevalence estimates for specific evidence-based curricula and conclude by discussing possible reasons for and implications of our findings.     

Disclosing sexual abuse: the impact of developmental variables

Despite increasing evidence that even a young child can be a competent witness in a court of law, there is one factor that is often used to impeach the credibility of a child in a sexual abuse case, and that is the nature and timing of the child's disclosure of the sexual victimization. This paper examines the impact of developmental variables on that disclosure and suggests that when those variables are recognized, the credibility of the young child as a witness increases.     

Effects on high school students of teaching a cross-age alcohol prevention program

This study examined the impact on high school students who taught elementary students MADD's Protecting You/Protecting Me (PY/PM), an alcohol use prevention and vehicle safety program. High school students (N = 188) enrolled in a peer helping course completed surveys before and after teaching PY/PM, and a comparison group of peer helper students (N = 141) from matched schools completed surveys at the same times. Results indicated that, relative to the comparison group, those exposed to PY/PM gained knowledge of alcohol's effects, increased their perceptions of the risks of high levels of alcohol use, gained teaching skills, and showed less frequent episodes of binge drinking. No effects were found for attitudes toward future drinking, perceptions of the risk of low levels of alcohol use, alcohol use, or vehicle safety. This cross-age prevention program may be successful in changing high school students' knowledge, attitudes, and behaviors regarding high levels, but not low levels, of alcohol use.     

Neighborhood influences on adolescent cigarette and alcohol use: mediating effects through parent and peer behaviors

The influence of neighborhoods on adolescent behaviors has received increasing research attention. In the present study, we use structural equation models to specify pathways from neighborhoods to adolescent cigarette and alcohol use through parental closeness, parental monitoring, parent substance use, and peer substance use. We use a national sample with 959 adolescents 12 to 14 years of age whose residential addresses were matched with 1990 Census tracts to provide neighborhood characteristics. We found that for adolescent cigarette use low socioeconomic status (SES) neighborhoods were associated with increased parental monitoring, which was further associated with decreased adolescent cigarette use. For adolescent alcohol use, high SES neighborhoods were associated with increased parent drinking, which was further associated with increased adolescent alcohol use. Low SES neighborhoods were associated with increased parental monitoring and increased peer drinking, which were in turn associated with decreased and increased adolescent alcohol use, respectively.     

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.     

Alcohol prevention strategies on college campuses and student alcohol abuse and related problems

This study examined the relationship between colleges' alcohol abuse prevention strategies and students' alcohol abuse and related problems. Alcohol prevention coordinators and first year students in 22 colleges reported whether their schools were implementing 48 strategies in six domains, and students (N = 2041) completed another survey concerning their use of alcohol and related consequences. Colleges were most likely to prevent alcohol use in public places on campus and the delivery and use of kegs. Four alcohol prevention domains were inversely associated with at least one of five outcomes related to student alcohol abuse or related consequences, and the alcohol policy and enforcement domain was inversely associated with all outcomes. Colleges should pay particular attention to strategies related to policy and enforcement.     

Correction of normative misperceptions: an alcohol abuse prevention program.

Normative misperception refers to the tendency of college students to misperceive campus drinking norms to be more liberal than they actually are. Initial investigations have demonstrated the effectiveness of normative education on reduction of alcohol use in primary and secondary education settings. This study examined the utility of a group program designed to challenge seventy-one male college students' misperceptions of college drinking norms. Participants were enrolled into either a normative education group or a control group representing traditional alcohol education efforts. Participants in the normative education groups demonstrated more accurate perceptions of campus drinking norms and a significant reduction in consequences of alcohol use while those in the control group did not. Changes in normative perceptions were among the strongest contributors to a function discriminating between those who decreased their drinking and those who did not. Results suggest that normative education may be an effective approach to modifying drinking behaviors.     

The disparate impact of alcohol,methamphetamine, and other drugs on family reunification

Parental substance abuse is one of the most prominent reasons that children enter foster care. The relative role of substance type in delaying reunification has remained elusive. This study sought to understand the impact of parental use of alcohol, methamphetamine, other drugs, and poly-substances on reunification rates for children in foster care. The authors used administrative foster care data from a Midwestern state between years 2007 and 2012 to evaluate the unique contribution of each substance use domain. Results suggest that parental methamphetamine use has the most significant impact on the likelihood of reunification, followed by other drugs, and poly-substances. These findings further indicate that children removed due to any parental drug use stay in foster care for an average of 49–156 days longer than their peers. Implications for research and practice are addressed.     

Boards of trustees must assume responsibility for making alcohol prevention on campus a top priority

ABSTRACT

Few colleges have made the prevention of alcohol-related injuries and deaths an institutional priority, and even fewer have implemented prevention strategies with a solid evidentiary base. We look to presidents to provide leadership on this issue, but those who do are atypical. Boards of trustees should step in by asserting that student wellness be a primary focus in the institution's strategic plan, with specific, measurable goals; holding the president accountable for progress in reducing high-risk drinking and its consequences; and mandating a line item in the annual budget, with adequate staffing and revenues to put evidence-based practices in place. Boards will be more likely to respond when led to focus on the cost implications of the campus alcohol problem; the link between high-risk drinking and mission-critical institutional objectives such as academic performance, student engagement, and retention; and the institution's potential liability if evidence-based prevention strategies are not in place.     

Effects of alcohol on the nonverbal communication of anxiety: The impact of beliefs on nonverbal behavior

Three male and three female raters were shown videotapes of 29 male subjects who were speaking to a silent female confederate. Raters were asked to make 10 judgments about the subjects' behavior. The subjects had been assigned to one of two expectancy conditions in which they were led to believe the drink they consumed prior to meeting the confederate contained alcohol and tonic or tonic only. Actually, half of the subjects in each expectancy condition received alcohol and half received tonic only. Judgments of the female raters viewing the videotapes were congruent with physiological measures of the subjects' anxiety. Those subjects who believed they received alcohol were perceived by female raters as more relaxed, less anxious, less inhibited, and more dominant than subjects who believed they received tonic. The actual content of the drink had no significant effects on the raters' judgements of the subjects' behavior. Male raters were unable to discriminate among the experimental conditions. Implications for possible gender of rater effects in behavioral assessment procedures as well as for the impact of beliefs on nonverbal communication are discussed.     

Estimating the cost impact of three dual diagnosis treatment programs

Specialized intervention programs for people with concurrent severe mental illness and substance abuse reduce the total costs of care. Compared to baseline, cost savings of over 40% were achieved by 18 months, primarily due to significant reductions in the use of acute and subacute mental health services and despite an increase in outpatient mental health services. There also was an observable impact on cost reductions in medical and criminal justice services without an increase in family costs over the same time period.