Good choices, great future: An applied theatre prevention program to reduce alcohol-related risky behaviours during Schoolies

Lived Experience Performance to Reduce Stigma, Enhance Understanding of Gambling Harm and Change Attitudes and Behaviours of Professionals and Community Members

Gamblers and their family members or friends (affected others) can experience stigma and shame due to gambling which can result in a reluctance to seek timely support. However, gamblers and affected others access intersecting health services and talk to friends or family, thereby providing opportunities for early intervention. Three sides of the coin is a group of storytellers with lived experience of gambling harm who use dramatic performance to share personal stories to enhance the understanding of gambling-related harm in allied professions and the broader community. They do this to encourage attitude and behaviour change so that gamblers and affected others receive empathy and support during encounters with these groups. A mixed-methods study was used to explore whether these performances were successful in increasing understanding and changing attitudes and behaviour of allied professionals and the community in the short and longer-term. Data collected immediately post-performance revealed that performances increased understanding of gambling, and improved attitudes and behavioural intent of audience members in relation to gamblers and affected others. Professionals also reported an increased willingness and confidence to discuss gambling harm with clients. Follow-up data demonstrated potential longer-term impact, with respondents continuing to report more positive attitudes towards those affected by gambling harm and professionals being confident to explore gambling issues in their clients and provide appropriate referrals. These finding demonstrate that performance based on lived experience can be a powerful education tool, encouraging deep connection to the issue, resulting in a nuanced understanding and sustained attitudinal and behavioural change.

Psychosocial interventions and strategies to support young people at mass gathering events: a scoping review

OBJECTIVES

To improve health and safety outcomes at mass gathering events (MGEs) for young attendees, it is essential to understand the psychosocial factors that may influence behaviour so that the implementation of support strategies before, during and after MGEs can be developed to enhance outcomes. This review identifies the psychosocial outcomes that may occur at MGEs, including social connection, substance use, risky behaviours and psychological distress and examines what interventions have been implemented to target these outcomes.

STUDY DESIGN

Scoping review.

METHODS

This study examined MGE psychosocial interventions with predominantly youth attendees was conducted using the Preferred Reporting Items of Systematic reviews and Meta-Analysis extension for Scoping Reviews guidelines. Papers were collected from the databases CINAHL, MEDLINE, Embase and PsycINFO. Titles and abstracts were scanned for relevance, followed by a full-text screening. Information relevant to the research question was extracted from papers meeting the inclusion criteria.

RESULTS

Twenty-six papers met the inclusion criteria. The psychosocial factors that were most studied included social influence, social interactions and psychological stressors, which lead to behaviours such as excessive alcohol consumption, drug taking, risky casual sex and risk taking amongst psychological factors of young attendees. Effective interventions implemented before or during MGEs, such as alcohol-free zones, antidrinking campaigns, psychoeducation and disapproval from parents with regard to drinking alcohol, showed promise in reducing harms.

CONCLUSION

Psychosocial interventions have the potential to reduce harms and enhance well-being for young people attending MGEs. This review has identified gaps and opportunities in the current literature with regard to psychosocial interventions and strategies to support young people at MGEs and makes recommendations to support the development and refinement of evidence-based interventions aimed at young MGE attendees.

Exploring arts-based interventions for youth substance use prevention: a scoping review of literature

INTRODUCTION

There is a rise in problematic substance use among Canadian youth, which is precipitating a public health crisis. Interventions are needed to empower youth to mitigate substance use risks. Active youth involvement in substance use prevention is urgently needed to increase uptake and ownership of the process and outcome of the intervention. Arts-based interventions are ideal participatory action approaches that can empower young people to be active agents in substance use prevention. These approaches can help promote health, reduce harm, and change behaviours. Scoping reviews are a vital tool that can help the research team identify relevant interventions that can be adapted to a community.

METHODS

This scoping review explores various arts-based substance use prevention interventions for youth. The scoping review used the iterative stages of Arksey and O'Malley to search Portal ERIC, Ovid MEDLINE, C.I.N.A.H.L., E.M.B.A.S.E., Web of Science, and A.P.A. PsycInfo and grey literature from Canadian Centre on Substance Use and Addiction and websites suggested by the Canadian Agency for Drugs and Technologies in Health. Inclusion criteria are a) articles utilizing arts-based intervention on substance use prevention; b) studies with a clearly defined intervention; c) intervention targeting the youth (age 12-17) and d) publications written in English. Thematic analysis was used to identify the main themes from the included articles.

RESULTS AND DISCUSSION

Themes identified in a thematic synthesis of these studies included a) the intent of the intervention; b) intervention characteristics; and c) the perceived effectiveness of interventions. Art-based interventions increased knowledge and changed attitudes and practices on substance use among youth. Making the interventions aesthetically appealing and engaging, active youth involvement in the development of the intervention and developing youth-centred interventions which attended to the realities they faced were central to the success of these interventions.

Complexities in interdisciplinary community engagement projects: some reflections and lessons from an applied drama and theatre project in diabetes care

There is a growing interest in using drama techniques and theatrical performance to disseminate health information to lay audiences as part of community engagement projects. This process can be challenging for a number of reasons, however. In this paper, we describe the process and pitfalls of an interdisciplinary project involving the development and performance of a play about diabetes mellitus. The play formed part of a long-term, three-way community engagement project between social science, applied drama and a diabetes clinic in South Africa. Building on a framework derived from a number of applied drama methods, we elicited narratives from key 'storytellers' that were developed and embodied by actors in a new performance called Blood Sugars Creating this play provided insight into working in an interdisciplinary space and highlighted the importance of establishing shared goals and joint ownership of the project right from the outset. This was without doubt a challenging project and the complexities of finding common ground across three disciplines are not to be underestimated. In this paper, we explore the collaboration and its challenges, drawing on the framework of complexity theory. In particular, we examine the layers of complexity that emerged as a result of the interdisciplinary nature of the project and the demands of balancing the authenticity of the stories with the perceived requirements of health messaging. We consider the methodological, conceptual and ethical challenges of this type of research, and discuss some recommendations for teams taking on similar complex multidisciplinary research and intervention projects.

"Can't Wait to Blackout Tonight": An Analysis of the Motives to Drink to Blackout Expressed on Twitter

BACKGROUND

Alcohol-related blackouts are associated with a range of negative consequences and are common among social drinkers. Discussing alcohol use on social networking platforms (e.g., Twitter) is common and related to higher alcohol consumption levels. Due to the widespread nature of alcohol-related social networking posts and alcohol-related blackouts, we examined the content of alcohol-related blackouts posts/"Tweets" on Twitter, with a focus on intentions to blackout and specific motivations for blacking out.

METHODS

A set of Tweets containing "blackout," "blackout," "blacking out," "blacked out," or "blacks out" were collected from April 26, 2018, and April 29, 2018. Using NVivo software, we coded all preblackout Tweets (i.e., before the blackout experience) for intentions and motives to blackout.

RESULTS

Most Tweets that we collected expressed an intention to blackout and these intentions ranged in strength (i.e., will blackout vs. might blackout). With respect to specific motives for blacking out, celebration motives were identified. For example, Tweets addressed blacking out to celebrate one's birthday, someone else's birthday, a school or work accomplishment, a sports win, during a vacation, or a holiday. Another endorsed motive for blacking out was loss or coping motives. For example, the Tweets commented on blacking out to deal with stress or a bad day.

CONCLUSION

Our findings suggest that Twitter users express intentions to blackout due to celebration or coping reasons. Given the consequences associated with blackout drinking, future research should consider the link between blackout intentions, blackout motives, and alcohol-related harm.

Impact of a brief psychoeducational intervention for reducing alcohol use and related harm in school leavers

INTRODUCTION AND AIMS

Many young people engage in risky partying behaviours and excessive alcohol use in the transition period following high school graduation. Despite this, there is limited longitudinal research on adolescents before and after school graduation; and limited evaluation of interventions targeting these high-risk periods. The present study aims to address this gap in the literature by examining the impact of brief psychoeducation interventions on substance use, psychological distress and well-being during this important life transition.

DESIGN AND METHODS

Participants were 334 high school leavers (53% female, M_age  = 17.14) from Queensland, Australia. They received either: (i) a psychoeducation intervention on safe partying behaviours; (ii) a reconstructed version of the psychoeducation intervention; or (iii) a standard health curriculum control. Surveys were conducted at baseline; 2 weeks, immediately following post-graduation celebratory event 'Schoolies'; and 4 months, immediately following university orientation 'O-week'.

RESULTS

Significant time by group effects were found for problem drinking, F(2, 227) = 3.07, P < 0.05, and well-being, F(4, 439) = 3.54, P < 0.01. There was stability in problem drinking from baseline to follow-up for the psychoeducation groups but small increases in problem drinking for the control (d = 0.12). Both psychoeducation groups had improvements in well-being scores from baseline to post-Schoolies (d = 0.40; 0.20), which were maintained across time. In contrast, the control condition showed a decrease in well-being scores from baseline to the post O-week follow-up (d = 0.15).

DISCUSSION AND CONCLUSIONS

Brief school-based psychoeducational interventions may result in small improvements in well-being, and possibly stabilise the trajectory of problematic drinking in high-risk environments.

Anticipating and addressing event-specific alcohol consumption among adolescents

Background

Various specific events and celebrations are associated with excessive alcohol consumption and related harms. End-of-school celebrations such as Schoolies in Australia are of particular concern given high levels of documented harm among underage and young drinkers. The present study investigated high school students’ expectations of their Schoolies celebrations to inform future interventions to reduce adverse outcomes among members of this vulnerable group and other young people involved in similar rites of passage.

Methods

A link to an online survey was distributed via high schools and Schoolies-related websites. The survey included qualitative questions that invited respondents to discuss (i) aspects of Schoolies they were looking forward to most and least and (ii) their perceptions of the likely consequences if they refrained from consuming alcohol during the event. In total, 435 students provided responses.

Results

Respondents discussed the role of Schoolies in marking their transition to adulthood. Their comments revealed a cross-temporal focus indicating that Schoolies is simultaneously symbolic of the past, present, and future. Through its ability to enhance social interaction, alcohol was perceived to have a vital role in realising the potential of this event to signify and facilitate this temporal progression.

Conclusions

Results suggest interventions that treat Schoolies as an isolated event that occurs in specific locations may fail to appreciate the extent to which these events transcend time for those involved. Instead, harm reduction is likely to involve a reconceptualisation of the event among both participants and authority figures to facilitate the provision of alternative pastimes to drinking during Schoolies that yield similar social benefits.

Effects of an Interactive School-Based Program for Preventing Adolescent Sexual Harassment: A Cluster-Randomized Controlled Evaluation Study

Many adolescents experience sexual harassment and victims of sexual harassment have higher risks regarding well-being and health behaviors such as higher risks of suicidal thoughts, suicidal ideation and feeling unsafe at school. A peer-performed play and school lessons on preventing sexual harassment behavior were presented to secondary school students. We evaluated its effectiveness, using a cluster-randomized controlled design to assign schools to an experimental condition [n = 14 schools; 431 students (51 % female)] and a control condition [n = 11 schools; 384 students (51 % female)]. To measure the effects of the intervention at first post-test and 6-month follow-up, our multilevel analyses used a two-level random intercept model. Outcome measures were sexual harassment behaviors, behavioral determinants and distal factors influencing these behaviors. At post-test, students in the experimental group reported a reduced intention to commit sexual harassment behavior and higher self-efficacy in rejecting it. At post-test and follow-up there was a significant positive effect on social norms for rejecting sexual harassment behavior. At follow-up, sexual self-esteem was higher in students in the experimental group than in the control group. Effects on these determinants will benefit adolescents' future sexual behaviors. In combination, the play and lessons, possibly together with continued sexual health education and skills programs on social-emotional learning in subsequent school years, have potential for preventing sexual harassment behavior.

What are school leavers’ priorities for festival preparation?

This paper reports on the findings from a qualitative research study that explored how young people prepared to minimise and/or avoid alcohol-related harm while attending a Schoolies Festival (SF). SFs are mass gatherings at which young people (schoolies) celebrate their graduation from high school. The attendance of schoolies, in various Australian communities, ranges between 10000 and 30000 individuals during the event. The literature suggests that schoolies are at higher than normal risk of harm at SF from misuse of alcohol, unsafe sex, aggressive behaviour, and other risk-taking factors. As a result of these concerns, SF organisers developed an infrastructure that treats alcohol-related harm, and provides on-site care (first aid stations) by St John Ambulance staff. This study used focus groups to identify strategies used by schoolies to avoid alcohol-related harm during SFs. Data revealed that schoolies did not actively seek health information before attending the event and did not display an interest in doing so. It is important to note that schoolies planned to use alcohol to celebrate and have a good time. Therefore a harm minimisation approach with a focus on providing the necessary infrastructure at SFs to minimise the dangers associated with excess alcohol use is important. Schoolies indicated that they had no desire for information about the hazards of alcohol ingestion. If any health messages were to be used by health authorities, it would be far more appropriate to promote the message of ‘take care of your mate’, to contribute to building a supportive environment at the event. This may be of more benefit to minimise harm at SFs than funding other health messages.

High rates of alcohol consumption and related harm at schoolies week: a portal study

OBJECTIVE

To investigate alcohol consumption, substance use and risky and harmful behaviour among young people attending 'schoolies' week in Victoria.

METHODS

Breathalyser tests and brief surveys (n=558) measuring alcohol, energy drink and illicit drug use, and experience of aggressive incidents, alcohol-related injury and unprotected sex, were undertaken with young people attending schoolies week in Lorne and Torquay.

RESULTS

Schoolies reported consuming a mean of 8.8 drinks in the current session, with a mean blood alcohol count (BAC) of 0.05; 18.3% recorded a BAC of greater than 0.08. One in six participants had consumed alcohol with energy drinks; 7.7% reported using illicit substances. Participants who co-consumed alcohol and energy drinks recorded a higher BAC than alcohol-only users. One in five participants had experienced alcohol-related harm at schoolies week, including aggressive incidents, alcohol-related injury and engagement in unprotected sex. Each alcoholic drink consumed increased the potential for involvement in aggressive incidents by 8% and alcohol-related accidents/injuries by 5%; illicit drug use was associated with six times the likelihood of engaging in unprotected sex with a non-partner.

CONCLUSIONS AND IMPLICATIONS

Excessive alcohol consumption and experience of related harms are common among young people attending schoolies week. Harm reduction initiatives targeting schoolies week should focus on the consequences of excessive alcohol consumption, illicit drugs and the co-consumption of alcohol and energy drinks.