Adolescents' Alcohol use and Misuse: The socializing influence of perceived family life

'They're like little police': Australian parents' perceptions of their children's awareness of drinking during COVID-19

INTRODUCTION

As a result of COVID-19 and associated lockdown restrictions, children may have been exposed to more home-based alcohol consumption and parents' drinking practices. This paper explores Australian parents' perceptions of their children's awareness of drinking and their reflections on the impact of COVID-19 on children's exposure and acquisition of alcohol-related knowledge.

METHODS

In-depth interviews were undertaken with 30 parents and carers of children aged four to 12 years from across Australia. Participants described their family lives, the role of alcohol, any changes in alcohol and family dynamics experienced because of COVID-19 and their children's exposure and knowledge of alcohol before and during their experience of COVID-19. Using social learning theory as a guiding framework, transcripts were analysed to identify relevant themes.

RESULTS

Pre-COVID-19 children were commonly thought to be aware of behavioural changes owing to alcohol consumption, made associations between people, beverages and activities and recognised boundaries around consumption. COVID-19 was suggested to have impacted the environments in which children were exposed and the types of modelling and practices they were exposed to. It was more common for participants to describe COVID-19 affecting other children's learning and knowledge of alcohol, rather than their own.

DISCUSSION AND CONCLUSIONS

Participants were mindful of children's knowledge and the role they played in modelling consumption practices prior to and during the COVID-19 lockdowns. There may be scope to use the insights provided here to support parents in modelling approaches and engaging with children about alcohol in ways that challenge or disrupt its prominence or acceptability.

Parent participation in alcohol prevention: Evaluation of an alcohol prevention programme

Aim:

The main purpose of this study was to evaluate the effectiveness of the parental part of the Norwegian Unge & Rus (Youth and Alcohol) programme. The intervention was aimed at changing parents’ rules and attitudes towards adolescent alcohol use, and their ability to talk with their adolescents about alcohol, as well as improving parents’ relationships with and knowledge about their adolescents. These topics were addressed during parent meetings at school.

Method:

The effectiveness of the parent programme was tested using a longitudinal quasi-experimental control group design. Parents completed four online questionnaires N = 1166 at T1 in 2011 and N = 591 at T4 in 2013. Mixed models with observations nested in individuals were used to test the difference in rates of change between the groups.

Results:

Parents in both groups reported strict rules and attitudes towards alcohol use. There were no significant differences in the changes between the two parent groups in terms of rules and attitudes at the three follow-up time points. The parents in the intervention did not change significantly compared to the parents in the comparison group on other alcohol-related questions.

Conclusions:

Parents are important facilitators for the transmission of alcohol-related attitudes and rules. However, our study did not show significant differences between changes experienced by the intervention group and those of the comparison group for the main outcome variables, such as rules, attitudes and talking about alcohol with their adolescents.

Drinking with parents: Different measures, different associations with underage heavy drinking?

Aims:

Is drinking with parents (DWP) likely to curb or to encourage adolescent heavy drinking? The scant number of studies addressing this issue have arrived at contradictory conclusions, which may reflect that different measures of DWP have been used. We pursued the assumption, taking potential confounding related to parental alcohol-specific rule-setting and parenting style into account.

Method:

Data stem from the Norwegian 2015 ESPAD survey of 15–16 year olds. Drinking with parents at the last drinking event and the frequency of DWP in the past year were assessed among those who had consumed alcohol (n = 1374). Severe drunkenness and binge drinking in the past month were the outcomes. Parental covariates were accounted for in Poisson regression models.

Results:

One in five (21%) had been drinking with their parents the last time they consumed alcohol, and this DWP measure was strongly and inversely related to both drunkenness and binge drinking. Adolescents who reported no DWP episodes in the past year (61%) and those who reported 1–2 such episodes (30%) barely differed with respect to the two outcomes. More frequent DWP (9%) was significantly associated with an increased risk of heavy episodic drinking, but the statistical impact on severe drunkenness was no longer significant when adjusting for parental covariates.

Conclusions:

Different measures of DWP were related differently to adolescent heavy drinking, indicating that studies based on DWP at the last drinking event are biased in favour of the view that adolescents may “learn” sensible drinking by consuming alcohol with their parents.

Preventing substance misuse: study protocol for a randomised controlled trial of the Strengthening Families Programme 10-14 UK (SFP 10-14 UK)

BACKGROUND

Prevention of alcohol, drug and tobacco misuse by young people is a key public health priority. There is a need to develop the evidence base through rigorous evaluations of innovative approaches to substance misuse prevention. The Strengthening Families Programme 10-14 is a universal family-based alcohol, drugs and tobacco prevention programme, which has achieved promising results in US trials, and which now requires cross-cultural assessment. This paper therefore describes the protocol for a randomised controlled trial of the UK version of the Strengthening Families Programme 10-14 (SFP 10-14 UK).

METHODS/DESIGN

The trial comprises a pragmatic cluster randomised controlled effectiveness trial with families as the unit of randomisation, with embedded process and economic evaluations. Participating families will be randomised to one of two treatment groups - usual care with full access to existing services (control group), or usual care plus SFP 10-14 UK (intervention group). The trial has two primary outcomes - the number of occasions that young people report having drunk alcohol in the last 30 days, and drunkenness during the last 30 days, both dichotomised as 'never' and '1-2 times or more'. The main follow-up is at 2 years past baseline, and short-term and intermediate outcomes are also measured at 9 and 15 months.

DISCUSSION

The results from this trial will provide evidence on the effectiveness and cost-effectiveness of an innovative universal family-based substance misuse prevention programme in a UK context.

TRIAL REGISTRATION

Current Controlled Trials ISRCTN63550893.

Alcohol use among rural middle school students: adolescents, parents, teachers, and community leaders' perceptions

BACKGROUND

Although rural adolescents use of alcohol is at some of the highest rates nationally, rural adolescent alcohol use has not been studied extensively. This study examines how community attitudes and behaviors are related to adolescent drinking in rural environments.

METHODS

Data were gathered in 22 rural communities in the Upper Midwest (North Dakota, South Dakota, Wisconsin, and Wyoming). Surveys were collected from 1424 rural sixth- to eighth-grade adolescents and 790 adults, including parents, teachers, and community leaders. Census data were also collected.

RESULTS

Drinkers differed from nondrinkers by the following factors: higher perceptions of peer, parental, and overall community drinking, as well as lower levels of parental closeness and religiosity. Factors distinguishing binge and nonbinge drinkers were increased drinking to reduce stress, drinking to fit in, perceptions of peer drinking, and perceived lack of alternatives to drinking. Parents were significantly less likely to perceive adolescent alcohol use as a problem than other community adults; school officials were most likely to perceive it as a problem. Parental perceptions were also the least correlated to actual adolescent use, while adolescent perceptions were the most highly correlated.

CONCLUSIONS

Community fac tors such as overall prevalence of drinking, community support, and controls against drinking are important predictors of reported use in early adolescence. School officials were more likely to view adolescent alcohol use as a problem than were parents. School officials' perceptions of adolescent use were also more related to actual adolescent use than were parental perceptions of adolescent use.

Alkoholkonsum in der Adoleszenz - soziale und individuelle Einflussfaktoren

Zusammenfassung: Fragestellung: Der Einfluss verschiedener sozialer und individueller Faktoren auf den Alkoholkonsum Jugendlicher wurde geprüft. Methodik: Mit Hilfe einer ursprünglich 384 Probanden umfassenden, prospektiven Längsschnittstudie wurde die psychische Entwicklung von der Geburt bis zum Jugendalter untersucht. Als Variablen im Jugendalter wurden erfasst: 1) der Alkoholkonsum mit 16 Jahren, 2) die Sensitivität gegenüber der Wirkung von Alkohol, 3) Temperament, 4) der Kontakt zu Gleichaltrigen, 5) das elterliche Erziehungsverhalten und 6) psychische Auffälligkeiten. Ergebnisse: Die Mehrheit der Jugendlichen (97%) konsumierte Alkohol, 24% mindestens einmal wöchentlich. Soziale Faktoren (wie der negative Einfluss der Peers, elterliches Erziehungsverhalten) und individuelle Faktoren (wie die Sensitivität gegenüber der Wirkung von Alkohol, Temperamentsmerkmale und psychische Auffälligkeiten) sagten die Menge des monatlich konsumierten Alkohols im Alter von 16 Jahren voraus. Schlussfolgerungen: Gefährdete Jugendliche sollten frühzeitig identifiziert werden. Zur Prävention eignen sich Maßnahmen zur Stärkung der Eltern, Verringerung des Kontakts zu sozial auffälligen Jugendlichen und ein Training zur Verbesserung der Körperwahrnehmung und Alkoholsensitivität.

Early unsupervised drinking--reducing the risks. The School Health and Alcohol Harm Reduction Project

The School Health and Alcohol Harm Reduction Project (SHAHRP) aimed to reduce alcohol-related harm by enhancing students' abilities to identify and deal with high-risk drinking situations and issues. The SHAHRP study involved a quasi-experimental research design, incorporating intervention and control groups and measuring change over a 32-month period. The study occurred in metropolitan, government secondary schools (13 - 17-year-olds) in Perth, Western Australia. The 14 intervention and control schools involved in the SHAHRP study represent approximately 23% of government secondary schools in the Perth metropolitan area. The sample was selected using cluster sampling, with stratification by socio-economic area, and involved over 2,300 intervention and control students from junior secondary schools. The retention rate of the study was 75.9% over 32 months. The intervention incorporated evidence-based approaches to enhance potential for behaviour change in the target population. The intervention was a classroom-based programme, with an explicit harm minimization goal, and was conducted in two phases over a 2-year period. The results were analysed by baseline context of alcohol use to assess the impact of the programme on students with varying experience with alcohol. Knowledge and attitudes were modified simultaneously after the first phase of the intervention in all baseline context of use groups. The programme had little behavioural impact on baseline supervised drinkers; however, baseline non-drinkers and unsupervised drinkers were less likely to consume alcohol in a risky manner, compared to their corresponding control groups. In line with programme goals, early unsupervised drinkers from the intervention group were also significantly less likely to experience harm associated with their own use of alcohol compared to the corresponding control group. Unsupervised drinkers experienced 18.4% less alcohol-related harm after participating in both phases of the programme and this difference was maintained (19.4% difference) 17 months after the completion of the programme. This study indicates that a school drug education programme needs to be offered in several phases, that programme components may need to be included to cater for the differing baseline context of use groups, and that early unsupervised drinkers experience less alcohol-related harm after participating in a harm reduction programme.

Reaching adolescents who drink harmfully: Fitting intervention to developmental reality

Alcohol use usually starts in early adolescence. While the greater proportion of young people develop adaptive patterns of drinking, many drink at harmful levels and may be at risk for future alcohol-related problems. Findings from the empirical literature suggest that universal prevention programs may delay onset of drinking among low-risk baseline abstainers; however, there is little evidence supporting their utility for at-risk adolescents. Further research is needed on how risk and protective factors interact to determine substance use trajectory, and intervention outcomes that take substance use trajectories into account may capture change more effectively than the use of absolute measures of substance use. Indicated prevention programs may benefit from modulations that account for adolescent individuation and identity formation. It is argued that motivational interviewing within a harm reduction framework is well suited to adolescents.

Adolescent and adult alcohol attitudes in a high alcohol consumption community

The study examines alcohol-related attitudes among adolescents and adults in a high consumption community, exploring whether adolescents and adults hold similar or different views regarding adolescent drinking. Data were gathered from adults in a Midwestern city via random telephone survey of 487 adults (30% with children under the age of 21). Students in grades 6-12 (n = 558) also completed a youth version of the survey in classrooms. Results indicated that becoming a parent was associated with more restrictive attitudes about adolescent alcohol use, regardless of the age of their children. Adolescents aged 14 to 17 had the least restrictive attitudes. Adults aged 18 to 24 (who were not parents) reported values similar to older adolescents. Younger adolescents, while similar to older adolescents in perception of community alcohol problems, were more like parents and older adults in attitudes about adolescent drinking. Both adolescents and adults greatly overestimated actual amounts of community adolescent binge drinking.

What harms do young Australians experience in alcohol-use situations?

OBJECTIVE

An insight into the alcohol-related experiences of young students in Perth, Western Australia, with particular emphasis to alcohol-related harm.

METHOD

The sample of 2,329 students (female: n = 1,089, male: n = 1,240) is a school-based group selected using cluster sampling, with stratification by socio-economic area and represents 11 to 12 year olds' experiences with alcohol and alcohol-related harm. The SHAHRP survey instrument was developed and pre-tested to measure students' knowledge, attitudes, patterns and context of use, harms associated with the students' own alcohol consumption and harms associated with other people's use of alcohol and incorporates the students' perceptions of alcohol-related harm.

RESULTS

Nearly two-thirds of all young people consumed alcohol under adult supervision; nearly 40% of all young males and 34% of all young females drink alcohol in unsupervised situations; and a fifth of young males consumed alcohol alone. Young males start drinking younger and consumed alcohol more regularly than young females, and consumed more alcohol per occasion. In the past 12 months, young males experienced more than five and young females more than three alcohol-related harms associated with their own alcohol consumption. They experienced a similar number of harms associated with other people's use of alcohol. Unsupervised drinkers were nearly seven times more likely to experience alcohol-related harm than supervised drinkers and nearly 13 times more likely to experience alcohol-related harm than non-drinkers.

CONCLUSION AND IMPLICATIONS

The results can help inform the development of alcohol education programs for young people.