Influencing inhalant intentions by changing socio-personal expectations

Parent-child drug communication: pathway from parents' ad exposure to youth's marijuana use intention

The authors combined the 2-step flow of communication model and the theory of planned behavior to create a framework to evaluate the effectiveness of a set of advertisements from the National Youth Anti-Drug Media Campaign promoting parent-child drug communication. The sample consisted of 1,349 pairs of parents and children who responded to the first and second annual rounds of the National Survey of Parents and Youth, and 1,276 pairs from Rounds 3 and 4. Parents' exposure to the campaign reported at Round 1 was indirectly associated with youth's lowered intentions to use marijuana at Round 2. Ad exposure was associated with positive changes in parental attitudes toward drug communication and perceived social approval of antidrug communications. These two beliefs, along with perceived behavioral control, predicted parents' intentions to discuss drugs with their children. Parental intentions to discuss drugs reported at Round 1 were associated with youth's report of actual drug communication with their parents at Round 2. Frequency and breadth of the topics in parent-child drug communication were associated with less positive attitudes toward marijuana use among youth who spoke with their parents. Together, the child's attitudes toward marijuana use and perceived ability to refuse marijuana use predicted youth's intentions to use marijuana. The proposed model fit well with the data and was replicated in a parallel analysis of the data from Rounds 3 and 4. Implications for future antidrug media campaign efforts are discussed.

Media campaigns for the prevention of illicit drug use in young people

BACKGROUND

Substance-specific mass media campaigns which address young people are widely used to prevent illicit drug use. They aim to reduce use and raise awareness of the problem.

OBJECTIVES

To assess the effectiveness of mass media campaigns in preventing or reducing the use of or intention to use illicit drugs amongst young people.

SEARCH METHODS

We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2013, Issue 1), including the Cochrane Drugs and Alcohol Group's Specialised Register; MEDLINE through PubMed (from 1966 to 29 January 2013); EMBASE (from 1974 to 30 January 2013) and ProQuest Dissertations & Theses A&I (from 1861 to 3 February 2013).

SELECTION CRITERIA

Cluster-randomised controlled trials, prospective and retrospective cohort studies, interrupted time series and controlled before and after studies evaluating the effectiveness of mass media campaigns in influencing drug use, intention to use or the attitude of young people under the age of 26 towards illicit drugs.

DATA COLLECTION AND ANALYSIS

We used the standard methodological procedures of The Cochrane Collaboration.

MAIN RESULTS

We included 23 studies involving 188,934 young people, conducted in the USA, Canada and Australia between 1991 and 2012. Twelve studies were randomised controlled trials (RCT), two were prospective cohort studies (PCS), one study was both a RCT and a PCS, six were interrupted time series and two were controlled before and after (CBA) studies. The RCTs had an overall low risk of bias, along with the ITS (apart from the dimension 'formal test of trend'), and the PCS had overall good quality, apart from the description of loss to follow-up by exposure.Self reported or biomarker-assessed illicit drug use was measured with an array of published and unpublished scales making comparisons difficult. Pooled results of five RCTs (N = 5470) show no effect of media campaign intervention (standardised mean difference (SMD) -0.02; 95% confidence interval (CI) -0.15 to 0.12).We also pooled five ITS studies (N = 26,405) focusing specifically on methamphetamine use. Out of four pooled estimates (two endpoints measured in two age groups), there was evidence of a reduction only in past-year prevalence of methamphetamine use among 12 to 17 years old.A further five studies (designs = one RCT with PCS, two PCS, two ITS, one CBA, N = 151,508), which could not be included in meta-analyses, reported a drug use outcome with varied results including a clear iatrogenic effect in one case and reduction of use in another.

AUTHORS' CONCLUSIONS

Overall the available evidence does not allow conclusions about the effect of media campaigns on illicit drug use among young people. We conclude that further studies are needed.

Factors mediating the association of the recency of parent's marijuana use and their adolescent children's subsequent initiation

This study was designed to determine whether the relation between parents' recency of (lifetime) marijuana use (RMU) and their adolescent children's subsequent marijuana initiation was mediated by the adolescents' expectancies regarding the consequences of usage, their anticipated severity of punishment for use, and their evaluative attitudes toward marijuana. Parents and their initially marijuana-abstinent adolescent children drawn from the National Survey of Parents and Youth were studied (N = 1,399). A bootstrapped multiple mediation analysis tested whether adolescents' expectations, anticipated punishment, and attitudes toward marijuana collected in the first year of the longitudinal study mediated the relationship between parents' RMU and their adolescent children's marijuana initiation 1 year later. Analysis revealed a statistically significant association between the parental measure and youths' subsequent initiation (p < .001). The three mediators were related significantly to parents' RMU and adolescents' usage. Individually, each variable mediated the association of the parental measure and that of their initially abstinent adolescents when usage was assessed 1 year later. The results offer insight into the positive association of parents' RMU with their child's marijuana use and provide insights that may be useful in future prevention efforts.

Increasing social support for depressed individuals: a cross-cultural assessment of an affect-expectancy approach

Depression is a mental illness affecting 121 million people. The Substance Abuse and Mental Health Services Administration recently launched a national, bilingual (English and Spanish) campaign to motivate young adults to support friends with mental illness. This article highlights and assesses the usefulness of two theoretically derived variables for increasing the social support received by all depressed individuals: (a) affect and (b) social support outcome expectations. In accord with the Substance Abuse and Mental Health Services Administration's bilingual campaign, the authors conducted two studies using intercepts at 2 swap meets in the U.S. Southwest. One study sample consisted of Spanish-dominant Hispanics, the other non-Hispanics. For both samples, results indicate that affect, social support outcome expectations, and their interaction accounted for more than 50% of the variance of social support intentions (67% in the Hispanic sample when familism was considered). Affect is commonplace in the helping behavior literature; results indicate social support outcome expectations deserve equal consideration. Moreover, an unexpected finding emerged: Perceiving a lack of willpower, need for attention, and lack of moral character to be the cause of depression resulted in increased sympathy among the Hispanic sample but increased anger among non-Hispanics.

Volatile substance misuse among youth in Israel: results of a national school survey

Volatile substance misuse (VSM) among Israeli youth has been identified as widespread and growing. Using data from the 2009 National School Survey of 12-18 year olds (N = 7,166), this study describes VSM prevalence among Jews and Arabs, examining relationships between past-month VSM and sociodemographic, behavioral, psychological, and interpersonal characteristics. Past-month VSM, reported by 7.5% of respondents, was significantly associated with other risky behaviors including past-month illicit drug use (Adjusted odds ratios (AOR) = 5.41, 95% CI: 3.5-8.1), Internet gambling (AOR = 2.12, 95% CI: 1.5-3.1), smoking, binge drinking, and truancy. National drug policy must address VSM and develop strategies to reduce demand and supply. Potential study limitations are noted.

The Amyl Nitrite Expectancy Questionnaire for Men who have Sex with Men (AEQ-MSM): a measure of substance-related beliefs

A measure of perceived reinforcement associated with amyl nitrite was developed and evaluated among gay and bisexual men. This is the first known expectancy measure to date for this drug class. The Amyl Nitrite Expectancy Questionnaire for Men who have Sex with Men (AEQ-MSM) was completed online by 102 gay and bisexual men, between 2006 and 2008 in Queensland, Australia. The AEQ-MSM demonstrated good psychometric properties and was associated with consumption patterns. Factor analysis revealed three distinct reinforcement domains: "Enhanced sexual desire and pleasure," "Disorientation," and "Sexual negotiation." Limitations include sampling via self-selection, recruitment through health centers and self-report data. Implications for sexual activity and risk-taking, including reducing associated harm (e.g., HIV transmission), and future directions are discussed.

Pathways from parental knowledge and warmth to adolescent marijuana use: an extension to the theory of planned behavior

Despite research indicating that effective parenting plays an important protective role in adolescent risk behaviors, few studies have applied theory to examine this link with marijuana use, especially with national data. In the current study (N = 2,141), we hypothesized that parental knowledge (of adolescent activities and whereabouts) and parental warmth are antecedents of adolescents' marijuana beliefs-attitudes, subjective norms, and perceived behavioral control-as posited by the Theory of Planned Behavior (TPB; Ajzen 1991). These three types of beliefs were hypothesized to predict marijuana intention, which in turn was hypothesized to predict marijuana consumption. Results of confirmatory factor analyses corroborated the psychometric properties of the two-factor parenting structure as well as the five-factor structure of the TPB. Further, the proposed integrative predictive framework, estimated with a latent structural equation model, was largely supported. Parental knowledge inversely predicted pro-marijuana attitudes, subjective norms, and perceived behavioral control; parental warmth inversely predicted pro-marijuana attitudes and subjective norms, ps < .001. Marijuana intention (p < .001), but not perceived behavioral control, predicted marijuana use 1 year later. In households with high parental knowledge, parental warmth also was perceived to be high (r = .54, p < .001). Owing to the analysis of nationally representative data, results are generalizable to the United States population of adolescents 12-18 years of age.