Effect of Health Messages on Alcohol Attitudes and Intentions in a Sample of 16-17-Year-Old Underage Drinkers

Messages focused on the effect of alcohol on the immune system boosted intention to adhere to alcohol intake guidelines during Covid-19 lockdown

Objective: Research shows that personal relevance may affect the impact of alcohol-related health information. This study explored alcohol consumption during the UK Covid-19 lockdown, and whether a message emphasising the effect of alcohol on the immune system was more effective in altering intentions to follow low-risk drinking guidelines than other messages about the effects of alcohol on health.

Methods & Measures: From April to June 2020, 953 drinkers completed an online questionnaire, and were randomly allocated to exposure to a control condition or one of three messages emphasising the impact of alcohol on: the immune system; mental health; or physical health. Outcome variables were: concern about alcohol intake, and intention to adhere to low-risk drinking guidelines.

Results: Pre-post ANCOVAs revealed that participants in the immunity message group had significantly stronger intention to adhere to low-risk guidelines than the control group (after controlling for initial intention). Concern for the effect of alcohol on health was not significantly affected.

Conclusion: During Covid-19 lockdown, a message emphasising the impact of alcohol on the immune-system had a greater effect on intention to observe low-risk drinking guidelines than other messages. Contextually relevant messages could be used for alcohol health campaigns and for improving alcohol labelling.

Alcohol Health Warning Labels: A Rapid Review with Action Recommendations

A rapid review of research on health warning labels located on alcohol containers (AWLs) was conducted. Using five search engines (Embase, Medline, Pubmed, Scopus, Psyinfo), 2975 non-duplicate citations were identified between the inception date of the search engine and April 2021. Of those, 382 articles were examined and retrieved. We selected 122 research papers for analysis and narrative information extraction, focusing on population foci, study design, and main outcomes. Research included public opinion studies, surveys of post-AWL implementation, on-line and in-person experiments and real-world quasi-experiments. Many studies focused on the effects of the 1989 United States Alcoholic Beverage Labeling Act on perceptions, intentions and behavior. Others focused on Australia, Canada, the United Kingdom, England or Scotland, Italy and France. There was substantial variation in the design of the studies, ranging from small-scale focus groups to on-line surveys with large samples. Over time, evidence has been emerging on label design components, such as large size, combination of text and image, and specific health messaging, that is likely to have some desired impact on knowledge, awareness of risk and even the drinking behavior of those who see the AWLs. This body of evidence provides guidance to policy-makers, and national and regional authorities, and recommendations are offered for discussion and consideration.

Intervention impact on alcohol use, alcohol harms, and a combination of both: A latent class, secondary analysis of results from a randomized controlled trial

BACKGROUND

Alcohol use and alcohol-related harm (ARH) among adolescents places a substantial burden on health, and public services more generally. To date, attempts to intervene at a universal level have yielded results varying from iatrogenic to null, although some skill-enhancing universal interventions have successfully impacted drinking behaviors. One such intervention is SHAHRP. The present study is a secondary analysis of data from the STAMPP Trial, providing new, and more nuanced findings.

METHODS

A total of 13,914 adolescents (41.7% female) participated in this cRCT where schools were randomly assigned to a control or intervention group. Growth mixture modelling was used to identify trajectory classes from baseline through third follow-up (+33 months) of adolescents on heavy episodic drinking (HED) and ARH. Extracted classes were related to school intervention participation using multinomial logistic regression.

RESULTS

Five trajectory classes of the HED and ARH composite were identified: Low (62%), Late Onset (16%), Early Onset (13%), Delayed Onset (7%), and Unstable (3%). The intervention was most strongly related to Late Onset (OR = 0.50, 95%CI [0.25, 1.01]) and Delayed Onset (OR = 0.55, 95%CI [0.26, 1.16]), although not statistically significant. With classes constructed with ARH only, the Delayed Onset class was significantly related to the intervention (OR = 0.60, 95%CI [0.43, 0.84]).

CONCLUSIONS

These results support those previously reported on the STAMPP Trial and provide a more nuanced insight into the effects of the intervention.

Tackling student drinking within the drinking subculture of a university sports competition: a culture change approach

Purpose

This paper explores the impact of a suite of alcohol culture change interventions implemented by Deakin University in Melbourne, Australia. The interventions were designed to change the alcohol culture at a bi-annual nation-wide university multi-sport competition known as Uni Nationals. This study aims to understand the critical success factors of the alcohol culture change initiatives that were developed by the university and implemented as part of a broader set of institutional practices.

Design/methodology/approach

A qualitative research design utilised in-depth, semi-structured interviews with nine Uni Nationals student team leaders. In total, two group interviews and four individual interviews were conducted with student team leaders who participated in the Uni Nationals. The interview transcripts were coded and themed. The themes were further refined and interpreted into a narrative. A total of two transcripts were independently coded by the first two authors. Discordant coding was flagged and discussed until a consensus was achieved. The remaining interviews were coded by the first author and discussed with the second author to ensure consistency. A socio-ecological framework was used to understand perceived changes to alcohol culture.

Findings

Student leaders were aware of and felt supported by the university-wide approach to changing the culture of Uni Nationals. Overall, the qualitative study indicated that students were positive about the alcohol culture change interventions. The leadership training that engaged team leaders in interactive activities had the greatest impact. Student leaders found the targeted messages, mocktail events and Chef de Mission (CdM) less effective cultural change strategies. However, they helped to establish expectations of students in this setting where a heightened focus on sport was associated with higher alcohol consumption.

Originality/value

While there has been growing academic interest in exploring “drinking cultures”, there has been relatively little focus on alcohol culture of university students at sporting events. The paper contributes to addressing this gap by shedding light on the impact of a group of interventions on the drinking culture of the Uni Nationals subculture.

A Scoping Review of "Responsible Drinking" Interventions

Public health groups, researchers, the beverage alcohol industry, and other stakeholders have promoted and applied the concept of "responsible drinking" for the past 50 years. However, little is known about the state of the existing responsible drinking evaluation research and its application to policy and practice. This project provides a scoping review of studies evaluating responsible drinking interventions. Two primary research questions guided this investigation: (1) To what extent have authors attempted to define the concept of responsible drinking while evaluating responsible drinking interventions? and (2) What is the state of the responsible drinking intervention evaluation literature? We retrieved 49 peer-reviewed articles that evaluated interventions designed to promote "responsible drinking." Four articles provided, or attempted to provide, an explicit definition of responsible drinking; these four definitions lacked consensus. The existing responsible drinking interventions varied considerably in terms of the messages they attempted to convey (e.g., avoid binge drinking, use protective behavioral strategies, stick to relatively safe drinking limits), again suggesting lack of consensus. We observed greater consensus concerning the approach to evaluating responsible drinking interventions: studies typically recruited college students to complete brief, well-controlled experiments and measured potential predictors of drinking behavior (e.g., attitudes, expectancies, intentions) rather than actual drinking behavior. We discuss limitations of this methodological approach and the need for greater consensus regarding the concept of responsible drinking.