Design of an instrument to measure alcohol-related psychosocial influences in the development of norms among 13-year-old to 17-year-old adolescents

A Study on the Effect of Alcoholism on the Family Members of Alcoholic Patients

Introduction Alcohol use disorder is commonly known as “alcoholism” but is also known as a family disorder, not because it runs in families but because it tends to impact the family members more than just the individual. Alcoholism is one of the leading causes of marital problems, divorce, domestic violence, child abuse and neglect, and strained relationships between the partners and also between the parent and child. The per capita alcohol consumption has increased from 2.2 L (2005) to 2.7 L (2016) and is expected to increase by another 2.2 L by 2025. According to the World Health Organization, 55% of domestic violence is related to alcohol abuse by the partner. This study aims to identify the impact of alcoholism on the individual’s health as well as the family members depending on the level of alcohol dependence.

Materials and Methods A cross-sectional study was conducted among patients admitted in the ward with a history of alcohol intake. AUDIT-C (Alcohol Use Disorders Identification Test–C) questionnaire was used to detect dependence and also a structured questionnaire was used to gather information regarding the financial and psychological well-being of the family from the family member accompanying the person. Other parameters of the patient were also considered such as liver function test, abdomen ultrasonography, and upper gastrointestinal endoscopy, wherever available.

Results A total of 100 patients were included in the study; 59 patients were admitted due to various reasons secondary to alcohol intake. A score of >4 was suggestive of alcohol dependence: 73% (73) of the participants had a score of >4; 65% of the participants’ family members gave a positive history of impaired interpersonal relationships; 45% gave a positive history of battering; and 69% had mental health issues such as depression, lack of confidence, inferiority complex, and decreased sleep. Also, 51% (51) gave a positive history of financial contribution by the participant toward the family expenses.

Conclusion The study shows that the problems of alcohol abuse have been associated with increased suffering to the family members, which contributes to a high level of interpersonal conflict, domestic violence, financial difficulties, and psychological disturbances, along with increasing the risk of developing comorbidities associated with alcohol abuse by the individual, which further adds to burden of the family.

Development and testing of the Youth Alcohol Norms Survey (YANS) instrument to measure youth alcohol norms and psychosocial influences

OBJECTIVES

This study aimed to develop and validate an online instrument to: (1) identify common alcohol-related social influences, norms and beliefs among adolescents; (2) clarify the process and pathways through which proalcohol norms are transmitted to adolescents; (3) describe the characteristics of social connections that contribute to the transmission of alcohol norms; and (4) identify the influence of alcohol marketing on adolescent norm development.

SETTING

The online Youth Alcohol Norms Survey (YANS) was administered in secondary schools in Western Australia PARTICIPANTS: Using a 2-week test-retest format, the YANS was administered to secondary school students (n=481, age=13-17 years, female 309, 64.2%).

PRIMARY AND SECONDARY OUTCOME MEASURES

The development of the YANS was guided by social cognitive theory and comprised a systematic multistage process including evaluation of content and face validity. A 2-week test-retest format was employed. Exploratory factor analysis was conducted to determine the underlying factor structure of the instrument. Test-retest reliability was examined using intraclass correlation coefficient (ICC) and Cohen's kappa.

RESULTS

A five-factor structure with meaningful components and robust factorial loads was identified, and the five factors were labelled as 'individual attitudes and beliefs', 'peer and community identity', 'sibling influences', 'school and community connectedness' and 'injunctive norms', respectively. The instrument demonstrated stability across the test-retest procedure (ICC=0.68-0.88, Cohen's kappa coefficient=0.69) for most variables.

CONCLUSIONS

The results support the reliability and factorial validity of this instrument. The YANS presents a promising tool, which enables comprehensive assessment of reciprocal individual, behavioural and environmental factors that influence alcohol-related norms among adolescents.

Potential and Challenges in Collecting Social and Behavioral Data on Adolescent Alcohol Norms: Comparing Respondent-Driven Sampling and Web-Based Respondent-Driven Sampling

Background

Respondent-driven sampling (RDS) is a method successfully used to research hard-to-access populations. Few studies have explored the use of the Internet and social media with RDS, known as Web-based RDS (WebRDS). This study explored the use of combining both “traditional” RDS and WebRDS to examine the influences on adolescent alcohol use.

Objective

This paper reports on the recruitment processes and the challenges and enablers of both RDS and WebRDS. It details comparative recruitment data and provides a summary of the utility of both methods for recruiting adolescents to participate in an online survey investigating youth alcohol norms.

Methods

Process evaluation data collected from research staff throughout the study were used to assess the challenges and solutions of RDS and WebRDS. Pearson chi-square test (Fisher’s exact test if applicable) was used to compare the differences in sociodemographics and drinking behavior between data collected by RDS and WebRDS.

Results

Of the total sample (N=1012), 232 adolescents were recruited by RDS and 780 by WebRDS. A significantly larger proportion of Aboriginal or Torres Strait Islander (P<.001) participants who spoke English as their main language at home (P=.03), and of middle and lower socioeconomic status (P<.001) was found in the RDS sample. The RDS sample was also found to have a higher occurrence of past 7-day drinking (P<.001) and past 7-day risky drinking (P=.004). No significant differences in gender, age, past month alcohol use, and lifetime alcohol use were observed between the RDS and WebRDS samples. This study revealed RDS and WebRDS used similar lengths of chains for recruiting participants; however, WebRDS conducted a faster rate of recruitment at a lower average cost per participant compared to RDS.

Conclusions

Using WebRDS resulted in significant improvements in the recruitment rate and was a more effective and efficient use of resources than the traditional RDS method. However, WebRDS resulted in partially different sample characteristics to traditional RDS. This potential effect should be considered when selecting the most appropriate data collection method.

Investigation of alcohol-related social norms among youth aged 14-17 years in Perth, Western Australia: protocol for a respondent-driven sampling study

INTRODUCTION

Alcohol use among young people is a major public health concern in Australia and internationally. Research elucidating social norms influencing alcohol use supports the desire to conform to peers. However, there is a lack of evidence on how social norms are transmitted from the community to young people and between family members and peers, as previous studies are limited to mainly school and university environments. This article describes the proposed process to investigate common alcohol-related norms held by 14-year-olds to 17-year-olds in Perth, Western Australia, and to clarify the process and pathways through which proalcohol norms are transmitted to adolescents.

METHODS AND ANALYSIS

This cross-sectional quantitative study will use respondent-driven sampling (RDS) to recruit a sample of 672 adolescents from sporting groups, youth programmes and the community in Perth. Data will be collected with a previously developed and validated multidimensional online survey instrument. A variety of strategies will be explored to aid participation including face-to-face recruitment and survey administration, web-based RDS and a 'mature minor' consent assessment protocol. Data analysis will include descriptive statistics of demographic characteristics, as well as social network and dyadic analyses, to explore the connections between shared understanding of norms and behaviours among individuals and how these translate into reported practices.

ETHICS AND DISSEMINATION

This research is expected to extend our understanding of normative development pathways to inform future interventions, and will be widely disseminated through conference presentations, peer-reviewed papers, media channels and community seminars. A study reference group of key health industry stakeholders will be established to encourage integration of study findings into policy and practice, and results will guide the development of community interventions. The Curtin University Human Research Ethics Committee has granted approval for this research.