Evaluation of a family-based substance abuse prevention program targeted for the middle school years

A family-based substance abuse prevention program was evaluated which emphasizes family cohesion, school and peer attachment, self-esteem, and attitudes about adolescent use of alcohol and tobacco. The program was implemented in rural communities and targeted families with students entering middle or junior high school. Baseline surveys were conducted with students and parents in four schools and were readministered one year later. Because the program was voluntary, a quasi-experimental design was used to compare participants (29 students and 28 parents) and nonparticipants (268 students and 134 parents). Analyses of covariance indicated that student participants, as compared to nonparticipants, had higher family cohesion, less family fighting, greater school attachment, higher self-esteem, and believed that alcohol should be consumed at an older age at the one year follow-up. There were fewer significant results for parent participants. Strategies for involving parents in prevention programs are discussed.     

What “likes” have got to do with it: Exposure to peers' alcohol-related posts and perceptions of injunctive drinking norms

Objective: Examine 1) whether observed social reinforcements (i.e., “likes”) received by peers' alcohol-related social media posts are related to first-year college students' perceptions of peer approval for risky drinking behaviors; and 2) whether associations are moderated by students' alcohol use status. Participants: First-year university students (N = 296) completed an online survey in September, 2014. Method: Participants reported their own alcohol use, friends' alcohol use, perceptions of the typical student's approval for risky drinking, and ranked 10 types of social media posts in terms of the relative numbers of “likes” received when posted by peers. Results: Observed social reinforcement (i.e., “likes”) for peers' alcohol-related posts predicted perceptions of peer approval for risky drinking behaviors among non-drinking students, but not drinking students. Conclusions: For first-year college students who have not yet initiated drinking, observing peers' alcohol-related posts to receive abundant “likes” may increase perceptions of peer approval for risky drinking.     

Project success' effects on substance use-related attitudes and behaviors: a randomized controlled trial in alternative high schools

Using a randomized controlled effectiveness trial, we examined the effects of Project SUCCESS on a range of secondary outcomes, including the program's mediating variables. Project SUCCESS, which is based both on the Theory of Reasoned Action and on Cognitive Behavior Theory, is a school-based substance use prevention program that targets high-risk students. We recruited two groups of alternative high schools in successive academic years, and randomly assigned schools in each group to either receive the intervention (n = 7) or serve as a control (n = 7). Students completed surveys prior to and following the administration of the program, and again 1 year later. Although participation in Project SUCCESS significantly increased students' perceptions of harm resulting from alcohol and marijuana use, students in the control group reported greater increases in peer support. We also found conflicting evidence in two opposing trends related to students' perceptions of the prevalence and acceptability of substance use. Therefore, the effects of Project SUCCESS on substance use-related beliefs and behaviors must be considered mixed.     

Heavy episodic drinking and college entrance

The college environment appears to encourage heavy drinking. Consequently, correlates of student drinking were assessed at college entrance. First-semester freshmen (N = 520, 54 percent women) completed self-report measures of social affiliation and self/peer drinking for high school and college. Analyses indicated that: 1) increased drinking at college entrance mirrored perceived increases by peers, 2) perceptions of peer drinking were robustly overestimated with women displaying the larger overestimation bias; and 3) social affiliation was associated with men's drinking and moderated its relation to perceived peer drinking at college entrance. These results advance understanding of the manner in which heavy drinking patterns emerge as men and women enter college, and campus programs that consider these factors may better promote health and reduce the harms associated with heavy drinking among college students.     

Attitudinal and normative predictors of alcohol use by older adolescents and young adults

A model of alcohol use based on the theory of planned behavior, expectancy theory, and the developmental literature on the influence of parents and peers was examined with 87 eleventh grade students, 105 college freshmen, and 107 college juniors. Specifically, the influence of attitudes about the positive and negative consequences of drinking, perceived parental and peer norms about alcohol consumption, and perceived control over drinking predicted self-reported alcohol use. The results suggest that, during adolescence, decisions to consume alcohol are rational, based on the consideration of the positive consequences of alcohol use and perceptions of control over drinking; however, the negative consequences of alcohol use are discounted. While perceived peer norms predicted alcohol consumption in all three age groups, the influence of perceived parental norms varied such that they predicted alcohol use only among the college juniors. Implications and avenues for future research are discussed.     

How Academic Achievement,Attitudes, and Behaviors Relate to the Course of Substance Use During Adolescence: A 6‐Year,Multiwave National Longitudinal Study

Self‐report data regarding alcohol, cigarette, and marijuana use were collected biennially from ages 14 to 20 in a nationally representative panel sample of adolescents (N=1,897) from the Monitoring the Future study. Growth curve analyses were performed using hierarchical linear modeling to consider psychosocial background, motivation and school attitudes, and parental and peer influences at age 14 as predictors of concurrent substance use and change in substance use. Results indicated that school misbehavior and peer encouragement of misbehavior were positively associated with substance use at age 14 and with increased use over time; school bonding, school interest, school effort, academic achievement, and parental help with school were negatively associated. The protective effects of positive school attitudes and perceptions of high status connected to academics were stronger for low‐achieving compared with high‐achieving youth. Implications for a developmental perspective on substance use etiology and prevention are discussed.     

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.     

Voluntary After‐School Alcohol and Drug Programs for Middle School Youth: If You Build it Right,They Will Come

Few after‐school programs target alcohol and other drug (AOD) use because it is difficult to encourage a diverse group of youth to voluntarily attend. The current study describes CHOICE, a voluntary after‐school program which targeted AOD use among middle school students. Over 4,000 students across eight schools completed surveys and 15% participated in CHOICE. Analyses indicated that there were some differences between CHOICE participants and nonparticipants. For example, African American and multiethnic students were more likely to attend. Past month alcohol users were more likely to initially attend, and marijuana users were more likely to continue attendance. Thus, CHOICE reached students of different racial and ethnic groups and attracted higher risk youth who may not typically obtain prevention services.     

Efficacy of a web-based, tailored, alcohol prevention/intervention program for college students: 3-month follow-up

This study presents the results of an efficacy evaluation of a web-based brief motivational alcohol prevention/intervention program called Michigan Prevention and Alcohol Safety for Students (M-PASS). Four on-line sessions providing individually-tailored feedback were delivered to first-year college students over 9 weeks. Non- and low-risk drinking participants received risk prevention, while high-risk drinking participants received a risk-reduction intervention. Both intervention and control groups were surveyed at baseline and at a 3-month follow-up. Analysis showed positive effects for both men and women on stage of change, drinking behavior, drinking motivation and attitudes, and use of risk-reduction strategies. These results provided evidence of efficacy and found that M-PASS had both intervention and prevention effects, making it unique among currently developed brief alcohol interventions for college students.     

A covariance structure model test of antecedents of adolescent alcohol misuse and a prevention effort

As part of an alcohol misuse prevention evaluation, questionnaires were administered to 4,157 junior high school students to determine levels of alcohol misuse, exposure to peer use and misuse of alcohol, susceptibility to peer pressure, internal health locus of control, and self-esteem. A conceptual model of the antecedents of adolescent alcohol misuse and the effectiveness of a prevention effort was tested using covariance structure modeling techniques. The factor loadings for the model were all moderate to high, indicating that the observed variables served well as measurement instruments for the latent variables. The hypothesized structural relationships among the latent variables of alcohol misuse, exposure to peer use and misuse of alcohol, susceptibility to peer pressure, internal health locus of control, and self-esteem were supported by the data. The full model explained 45 percent of the variance in alcohol misuse in the analysis based on the total sample. The direct effect of the intervention on alcohol misuse was small but significant in the hypothesized direction. The direct effects of the intervention on susceptibility to peer pressure and internal health locus of control were not significant. The model was tested separately for groups of students who had high versus low scores on susceptibility to peer pressure in order to test the interaction between susceptibility to peer pressure and exposure to peer use and misuse of alcohol. The percentage of variance accounted for in alcohol misuse did not increase upon testing the model separately for students who had high versus low scores on susceptibility to peer pressure. Observed differences in the significance of the parameter estimates between the high and low susceptibility to peer pressure groups suggest that different approaches to the design and evaluation of substance abuse prevention programs may be necessary for different subgroups of students.     

An Exploratory Study of a Computer-Assisted Alcohol Education Program

In many alcohol prevention and treatment programs, education is one of the components employed to change attitudes towards alcohol and drinking behavior. This exploratory research sought to determine whether brief exposure to a computer-based alcohol education program can improve attitudes toward alcohol and self-awareness of alcohol's effects. Seventy-one students were randomly assigned to (a) alcohol education via computer-assisted instruction (CAI), (b) alcohol education via traditional written materials, or (c) placebo/control. Results indicated that the CAI and written materials were about equally effective in improving subjects' attitudes toward alcohol although the computer program was rated most interesting.     

Oral Cancer Risk Behaviors Among Indiana College Students: A Formative Research Study

Objectives: In fall 2004, the authors used a survey to assess the knowledge, attitudes, motivations, and behaviors of college students relative to oral cancer prevention to inform development of targeted prevention programming. Participants: A convenience sample of 1,003 undergraduate students at one public university in Indiana participated. Methods: Discriminant function analysis was employed to analyze participants' motivations; perceived risks; individuals who influence participants' alcohol, tobacco, and marijuana use; and factors that facilitate and discourage use. The study sample was divided into users and nonusers to differentiate between groups and predictor (discriminating) variables. Multiple regression analysis was used to determine the extent to which participants' knowledge, attitudes, peer perceptions, sex, age, and ethnicity contributed to participants' combined alcohol, tobacco, and marijuana use behaviors. Results: With 2 exceptions, discriminant function analysis (p < .01) correctly categorized user status (ie, nonusers vs combined users of alcohol and cigarettes; nonusers vs combined users of alcohol, cigarettes, and marijuana) by the predictor variables. Multiple regression analysis to determine whether independent variables predicted combined drug use generated significant (p < .01) results across all combined use behaviors. Conclusions: Multiple oral cancer prevention program options along with additional formative research efforts were suggested by study results.     

Interactive multimedia preventive alcohol education: a technology application in higher education

This article summarizes the process of implementation and short-term impact on knowledge and attitudes of an interactive multimedia software program on preventive alcohol education for young adults. The three factors related to behavioral change addressed in the software are self-efficacy in maintaining personal control and safety while using alcohol, attitudes and related expectations regarding the physiological and behavioral consequences of alcohol consumption, and peer norms regarding alcohol consumption. As compared to alternative alcohol education and a no-alcohol education groups, students using the interactive computer lesson reported learning more about dose-response and ways to intervene with friends in peril. The article concludes with consideration of the import of this technology for informing students about the consequences of alcohol use, and the utility to higher education institutions of using this technology in an era when pressures increase for due diligence around student safety but with few additional institutional resources.     

Peer,social media,and alcohol marketing influences on college student drinking

Objective: To investigate how alcohol marketing and peers may promote college students' alcohol use through social media. Participants: College students (N = 682) aged 18 to 22 years from a large Southern university completed paper surveys in April 2014. Methods: Structural equation modeling was used to investigate relationships among variables as well as moderation by gender and race. Results: Drinking behavior was directly related to perceived norms and attitudes toward alcohol that develop, in part, from direct and indirect interactions with their online and offline peers, as well as engagement with alcohol-related content on social media. Gender and ethnicity moderated some effects. Conclusions: College student drinking is influenced by friends' alcohol-related content posted on social networking sites and by greater engagement with traditional and online alcohol marketing. College campus alcohol misuse interventions should include components to counter peer influences and alcohol marketing on social media.     

Safer Sex and the Health Belief Model

Abstract

The goal of the present study was to build on the Health Belief Model (HBM) by adding predictors of late adolescent safer sex behavior: perceptions of peer norms for sexual behavior, and sexual attitudes that emerge from socialization. Sexually active, late adolescent college students (N = 154, 62.3% female; mean age 20.8 years, 76% European American) participated in the study. Predictors from the original HBM included perceived vulnerability, condom use self-efficacy, and attitudes about condoms. In addition, peer norms for condom use and sexual behavior, general sexual attitudes, and endorsement of the sexual double standard were included as predictors of safer sex behavior. Attitudes about condoms, perceived vulnerability, condom use self-efficacy, and the sexual double standard emerged as significant correlates of condom use. General sexual attitudes and the sexual double standard were significantly correlated with alcohol use before or during sex. With the addition of these variables, the regression models accounted for 28% of the variance in condom use, and 14% of the variance in alcohol use before or during sex.     

Perceived norms and alcohol consumption: differences between college students from rural and urban high schools

OBJECTIVE: The authors examined perceived norms and drinking among college students who attended high schools in rural and urban communities. PARTICIPANTS AND METHODS: Undergraduates (99 men and 85 women) who attended high schools in communities with populations ranging from less than 100 to more than 400,000 completed surveys assessing perceived norms and alcohol consumption. RESULTS: Analyses revealed that students from smaller towns and in smaller high school graduating classes reported heavier drinking and that perceived norms were positively associated with drinking. Perceived norms were unrelated to population variables, and the relationship between perceived norms and drinking did not vary as a function of population variables. Results suggest that differences in drinking as a function of coming from more rural areas contribute to drinking behavior in college independently of perceived norms. CONCLUSIONS: College students may adjust to campus drinking norms relatively quickly, and longitudinal research would be useful in understanding this transition.     

Role rehearsal and efficacy: two 15-month evaluations of a ninth-grade alcohol education program.

A ninth-grade alcohol education program aimed at reducing drinking, drinking and driving, and riding with a drinking driver was developed on the basis of problem behavior theory, social cognitive theory and role theory. In Year 1 the program was taught by Social Studies teachers to half of the eighty-four ninth-grade classes in all nine junior high schools in a single school system; the other half served as controls. In Year 2 the program was taught to the ninth-grade students of the same school system by English teachers. Students' knowledge, skills and practices were measured before and four-six weeks and one year after the program. Results indicated significant increases in knowledge and perceived ability to resist pressures to drink among experimental students. No significant differences were noted for the drinking or the drinking and driving practices of either group. One year after the program, significantly fewer students in the experimental classes reported riding with a driver who had been drinking. Results suggested that English teachers were more effective than Social Studies teachers in teaching this program.     

Evaluating the effect of a campus-wide social norms marketing intervention on alcohol-use perceptions,consumption, and blackouts

Objective: To evaluate the effect of a campus-wide social norms marketing intervention on alcohol-use perceptions, consumption, and blackouts at a large, urban, public university. Participants: 4,172 college students (1,208 freshmen, 1,159 sophomores, 953 juniors, and 852 seniors) who completed surveys in Spring 2015 for the Spit for Science Study, a longitudinal study of students' substance use and emotional health. Methods: Participants were e-mailed an online survey that queried campaign readership, perception of peer alcohol use, alcohol consumption, frequency of consumption, and frequency of blackouts. Associations between variables were evaluated using path analysis. Results: We found that campaign readership was associated with more accurate perceptions of peer alcohol use, which, in turn, was associated with self-reported lower number of drinks per sitting and experiencing fewer blackouts. Conclusions: This evaluation supports the use of social norms marketing as a population-level intervention to correct alcohol-use misperceptions and reduce blackouts.