Alcohol Prevention Programs Research Articles

Predictors of beverage-specific, alcohol consumption trajectories: A Swedish population-based cohort study.

Aim: The aim of the study was to examine whether changes in alcohol consumption over time differ according to beverage types, and to what extent socioeconomic, lifestyle and health-related factors predict beverage-specific trajectories in Sweden. Study design: We included participants from the Stockholm Public Health Cohort who were surveyed repeatedly in 2002, 2010 and 2014. Alcohol consumption trajectories were constructed for 13,152 individuals with valid information on amount and frequency of drinking. Preferred beverage types (i.e., beer, wine or spirits) were defined based on the most consumed beverages. Multinomial logistic regression was used to quantify individual predictors of different trajectories, overall and by beverage type. Results: Overall 56.9% of respondents were women, the mean age was 49.2 years, SD (13.1). Wine was cited as the preferred beverage for 72.4% of participants, and stable moderate drinking was the most common trajectory regardless of beverage type (68.2%, 54.9% and 54.2% in individuals with wine, beer and spirits as preferred beverages, respectively). Associations between drinking trajectories and baseline lifestyle factors did not differ by beverage type. Lower socioeconomic position (SEP) was associated with unstable moderate wine drinking (for unskilled manual SEP: adjusted odds ratio [aOR] 1.54, 95% confidence interval [CI] 1.23, 1.93), unstable heavy beer drinking (for skilled manual SEP: aOR 1.99, 95% CI 1.14, 3.52; and unskilled manual SEP: aOR 1.72, 95% CI 1.05, 2.82), and former beer drinking trajectory (for skilled manual SEP: aOR 1.81; 95% CI 1.21, 2.72; and unskilled manual SEP: aOR 1.66; 95% CI 1.17, 2.37). Conclusion: Lower SEP was associated with unstable heavy drinking of beer, former beer drinking, and unstable moderate wine drinking trajectories indicating that targeted alcohol prevention programmes need to focus on these groups.

Updated systematic review of Australian school-based prevention programmes for alcohol and other drugs: a review protocol

IntroductionAdolescent onset substance use is associated with neurodevelopmental, social and psychological harms. Thus, alcohol and other drug prevention programmes are essential to promote health and well-being during this period. Schools...

Evaluation of a workplace alcohol prevention program targeted on managers' inclination to initiate early alcohol intervention.

Alcohol interventions targeting the adult population are often conducted in healthcare settings, while preventive interventions often target adolescents or young adults. The general working population is often overlooked. A workplace-based intervention, consisting of development and implementation of an organizational alcohol policy, and skills development training for managers (APMaT) was carried out in order to prevent and reduce alcohol-related harms by identifying hazardous consumers at an early stage. This study aims to evaluate APMaT by focusing on managers' inclination to initiate early alcohol intervention. In a cluster randomized design, data were obtained from 187 managers (control: n = 70; intervention: n = 117). Inclination to initiate early alcohol intervention was measured using three items on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Changes in managers' inclination to intervene were analyzed by applying multilevel ordered logistic regression. Predictors included in the model were group (control vs. intervention), time (baseline vs. 12-month follow-up), and the multiplicative interaction term (group×time). Significant increase in inclination to intervene against hazardous alcohol consumption among managers in the intervention group compared to managers in the control group was observed. Specifically, a 50% increase of confidence to initiate an intervention was observed among managers in the intervention group. APMaT seems effective to increase managers' inclination to intervene early against hazardous consumption in the workplace. The effectiveness of APMaT at the employee level should be explored in prospective studies.

Alcohol Consumption Literacy, Alcohol Confrontation Efficacy, and the Educational and Training Needs of Coaches to Manage Student-Athlete Alcohol Misuse

The rate of alcohol consumption among student-athletes places them at risk for engaging in unsafe behaviors. Although coaches play a key role in regulating alcohol use among athletes, many lack the knowledge and self-confidence to be effective. This study aimed to examine the relationship between alcohol consumption literacy and alcohol confrontation efficacy among National Collegiate Athletic Association head coaches and attempted to identify types of training and education wanted to better manage student-athlete alcohol use. A total of 518 National Collegiate Athletic Association head coaches completed alcohol consumption literacy and alcohol confrontation efficacy measures and two open-ended questions about what kind of alcohol training, information, and skills were needed. When accounting for previous education/training and gender of team coached, alcohol consumption literacy predicted all confrontation efficacy subscales. Content analysis showed coaches wanted training related to alcohol literacy, effective communication, and prevention planning. Findings have implications for designing alcohol prevention and intervention programs aimed at National Collegiate Athletic Association coaches.

Perceived barriers in the dissemination of an organisational alcohol policy as part of implementing an alcohol prevention programme among managers

PurposeAn alcohol prevention programme, consisting of the implementation of an organisational alcohol policy and skills development training for managers, was delivered in Swedish workplaces. Previous findings revealed challenges in policy implementation because of the lack of dissemination amongst managers. This study aims to describe perceived dissemination barriers of the organisational alcohol policy by managers.Design/methodology/approachA cross-sectional survey (n = 193 managers) was performed to identify common dissemination barriers in the workplace and complementary case illustrations derived from semi-structured interviews (n = 18 managers) were used to understand the dissemination barriers of the organisational alcohol policy. Frequency distributions were presented to describe common perceived barriers.FindingsSixty-five per cent of managers reported that their workplace had not changed their approach to addressing alcohol-related issues compared to their usual practice before programme delivery. Various organisational factors, such as deprioritisation of programme dissemination, lack of communication and inadequate strategies were some of the common barriers perceived by managers. Moreover, managers reported uncertainties regarding any changes concerning the workplace’s approach for addressing alcohol-related issues. Increased efforts in disseminating the organisational alcohol policy can reduce uncertainties among managers.Practical implicationsA thorough process evaluation to understand processes in programme delivery and implementation is necessary to ensure the uptake of the intervention.Originality/valueThis study highlighted the complexity of disseminating an alcohol policy in a dynamic setting, such as the workplace, and provided the importance of addressing organisational obstacles.

Development of a Dynamically Tailored mHealth Intervention (What Do You Drink) to Reduce Excessive Drinking Among Dutch Lower-Educated Students: User-Centered Design Approach.

BackgroundThe high prevalence and adverse consequences of excessive drinking among lower-educated adolescents and young adults are public concerns in the Netherlands. Evidence-based alcohol prevention programs targeting adolescents and young adults with a low educational background are sparse.ObjectiveThis study aimed to describe the planned process for the theory- and evidence-based development, implementation, and evaluation of a dynamically tailored mobile alcohol intervention, entitled What Do You Drink (WDYD), aimed at lower-educated students from secondary vocational education and training (Middelbaar Beroepsonderwijs in Dutch).MethodsWe used intervention mapping as the framework for the systematic development of WDYD. It consists of the following six steps: assessing needs (step 1), formulating intervention objectives (step 2), translating theoretical methods into practical applications (step 3), integrating these into a coherent program (step 4), anticipating future implementation and adoption (step 5), and developing an evaluation plan (step 6).ResultsReducing excessive drinking among Dutch lower-educated students aged 16 to 24 years was defined as the desired behavioral outcome and subdivided into the following five program objectives: make the decision to reduce drinking, set realistic drinking goals, use effective strategies to achieve drinking goals, monitor own drinking behavior, and evaluate own drinking behavior and adjust goals. Risk awareness, motivation, social norms, and self-efficacy were identified as the most important and changeable individual determinants related to excessive drinking and, therefore, were incorporated into WDYD. Dynamic tailoring was selected as the basic intervention method for changing these determinants. A user-centered design strategy was used to enhance the fit of the intervention to the needs of students. The intervention was developed in 4 iterations, and the prototypes were subsequently tested with the students and refined. This resulted in a completely automated, standalone native app in which students received dynamically tailored feedback regarding their alcohol use and goal achievement via multiple sessions within 17 weeks based on diary data assessing their alcohol consumption, motivation, confidence, and mood. A randomized controlled trial with ecological momentary assessments will be used to examine the effects, use, and acceptability of the intervention.ConclusionsThe use of intervention mapping led to the development of an innovative, evidence-based intervention to reduce excessive alcohol consumption among lower-educated Dutch adolescents and young adults. Developing an intervention based on theory and empirical evidence enables researchers and program planners to identify and retain effective intervention elements and to translate the intervention to new populations and settings. This is important, as black boxes, or poorly described interventions, have long been a criticism of the eHealth field, and effective intervention elements across mobile health alcohol interventions are still largely unknown.Trial RegistrationNetherlands Trial Registry NTR6619; https://trialsearch.who.int/Trial2.aspx?TrialID=NTR6619

Web-Based Alcohol and Sexual Assault Prevention Program With Tailored Content Based on Gender and Sexual Orientation: Preliminary Outcomes and Usability Study of Positive Change (+Change).

BackgroundAlcohol use and sexual assault are common on college campuses in the United States, and the rates of occurrence differ based on gender identity and sexual orientation.ObjectiveWe aimed to provide an assessment of the usability and preliminary outcomes of Positive Change (+Change), a program that provides integrated personalized feedback to target alcohol use, sexual assault victimization, sexual assault perpetration, and bystander intervention among cisgender heterosexual men, cisgender heterosexual women, and sexual minority men and women.MethodsParticipants included 24 undergraduate students from a large university in the Southwestern United States aged between 18 and 25 years who engaged in heavy episodic drinking in the past month. All procedures were conducted on the web, and participants completed a baseline survey, +Change, and a follow-up survey immediately after completing +Change.ResultsOur findings indicated that +Change was acceptable and usable among all participants, despite gender identity or sexual orientation. Furthermore, there were preliminary outcomes indicating the benefit for efficacy testing of +Change.ConclusionsImportantly, +Change is the first program to target alcohol use, sexual assault victimization, sexual assault perpetration, and bystander intervention within the same program and to provide personalized content based on gender identity and sexual orientation.Trial RegistrationClinicalTrials.gov NCT04089137; https://clinicaltrials.gov/ct2/show/NCT04089137

Reasons for alcohol use and non-use by underage U.S. autistic youth: A qualitative study.

What is already known about the topic? Hazardous alcohol use is when a person's drinking puts them at increased risk for negative events (e.g. health problems or car crashes). Some studies show that autistic people may be at greater risk for hazardous alcohol use than non-autistic people, while other studies have found that hazardous alcohol use is less common among autistic people than non-autistic people. We need to learn why autistic underage youth choose to drink alcohol or not. The goal of this study was to learn from US autistic youth about their attitudes and behavior related to alcohol. Forty autistic youth aged 16-20 years old were interviewed.What this article adds? Youth described several reasons why they choose to drink alcohol, including feeling like non-autistic people are more accepting when drinking, that it puts them in a less irritable or bored mood, helps them cope with problems, and helps them fit in. Reasons for not drinking alcohol include worries about becoming addicted, medication interactions, not liking the taste, fear of experiencing hangover and other health problems, and concern about acting foolish when drunk.Implications for practice, research, or policy Results reveal that hazardous alcohol use in autistic adults could have its roots in underage experiences that give autistic youth temporary relief from social anxiety, feeling lonely, and challenges with sensory processing. Right now, there are no evidence-based alcohol prevention programs in the United States for autistic people. One or more such programs may be needed. The results from this study could be used to adapt existing programs for non-autistic youth to the unique needs and risk factors of autistic youth.

Prevention of Alcohol Consumption Programs for Children and Youth: A Narrative and Critical Review of Recent Publications.

BackgroundYouth substance use is a public health problem globally, where alcohol is one of the drugs most consumed by children, and youth prevention is the best intervention for drug abuse.ObjectiveReview the latest evidence of alcohol use prevention programs in empirical research, oriented to all fields of action among children and youth.MethodsA narrative and critical review was carried out within international databases (PsychInfo, Pubmed, Web of Science, and Scopus) in August 2021 and was limited to empirical studies that appeared in the last five years (2017–2021). A flow diagram was used according to the PRISMA statements. Empirical research articles in English with RCTs and quasi-experimental design that included alcohol, children, and young people up to 19 years of age (universal, selective, or indicated programs) were included. The authors examined the results and conceptual frameworks of the Prevention programs by fields of action.ResultsTwenty-two articles were found from four fields of action: school (16), family (2), community (2), and web-based (2), representing 16 alcohol prevention programs. School-based alcohol prevention programs are clinically relevant [Theory of Planned Behavior, Refuse, Remove, Reasons, Preventure, The GOOD Life, Mantente REAL, Motivational Interviewing (BIMI), Primavera, Fresh Start, Bridges/Puentes], they are effective in increasing attitudes and intentions toward alcohol prevention behavior, while decreasing social norms and acceptance of alcohol, reducing intoxication, and increasing perceptions with regards to the negative consequences of drinking.DiscussionThis narrative and critical review provides an updated synthesis of the evidence for prevention programs in the school, family, community, and web-based fields of action, where a more significant number of programs exist that are applied within schools and for which would have greater clinical relevance. However, the prevention programs utilized in the other fields of action require further investigation.

Acceptability and feasibility of Strong& Deadly Futures, a culturally-inclusive alcohol and drug prevention program for Aboriginal and/or Torres Strait Islander secondary students

Although there are effective alcohol and drug prevention programs available for Australian secondary schools, no effective culturally-inclusive programs exist for Aboriginal and/or Torres Strait Islander students. To address this gap, we developed the Strong & Deadly Futures program for young people aged 12–14 years. The web-based program was developed with Aboriginal, Torres Strait Islander and non-Indigenous staff and students at four secondary schools (2 urban, 2 rural). This mixed-methods study reports on qualitative and quantitative feedback from students (n ​= ​235) and school staff (n ​= ​8) in a pilot trial to assess acceptability and feasibility of this curriculum-aligned program. Feedback indicated that students were highly engaged and motivated to learn as a result of the story-based mode of delivery, and teachers reported the ease of program implementation and adaptation. Implications for future school-based health program development are discussed. Overall, Strong & Deadly Futures appears to be an acceptable and feasible culturally-inclusive alcohol and drug prevention program. Further research will test the program's efficacy in a randomised controlled trial.

Know Your Safe Drinking Skills: Adaptation Strategies for the College Effect

Objective: The current study investigates the effects of an alcohol-prevention program delivered to college students in a formal classroom setting. Participants: The sample comprised 231 first-year college students who enrolled in a multisection “First Year Experience” course at a large northeastern university in the United States. Method: A naturalistic experiment was conducted, with a baseline evaluation at the beginning of the semester and a post-experiment evaluation near the end of the semester. Results: Social drinking attitudes, proximal drinking norm and the college effect are significant predictors of pre- and post-intervention episodic drinking frequency. The intervention reduced episodic drinking frequency as well as perceived distal and proximal drinking norms. It also increased drinking attitudes and did not change perceived efficacy or drinking-outcome expectancies. Conclusions: Practitioners could consider implementing a similar intervention to allow students to learn and practice safe drinking skills in the first year of their college life.

A Web-Based Alcohol and Other Drug Prevention Program (Strong & Deadly Futures) for Aboriginal and Torres Strait Islander School Students: Protocol for a Cluster Randomized Controlled Trial.

BackgroundThere are no available school-based alcohol and drug prevention programs with evidence of effectiveness among Aboriginal and Torres Strait Islander youth. To address this, we codeveloped the Strong & Deadly Futures well-being and alcohol and drug prevention program in partnership with an Indigenous creative design agency and 4 Australian schools.ObjectiveThis paper presents the protocol to evaluate the effectiveness of Strong & Deadly Futures in reducing alcohol and other drug use and improving well-being among Aboriginal and Torres Strait Islander youth.MethodsThe target sample will be 960 year 7 and 8 students from 24 secondary schools in Australia, of which approximately 40% (384/960) will identify as Aboriginal or Torres Strait Islander. The study design is a 2-group, parallel cluster randomized controlled trial with allocation concealment. Recruited schools will be block randomized (ratio 1:1), stratified by geographical remoteness, by an independent statistician. Schools will be randomized to receive Strong & Deadly Futures, a web-based alcohol and drug prevention and social and emotional well-being program that delivers curriculum-aligned content over 6 lessons via an illustrated story, or health education as usual (control). Control schools will be supported to implement Strong & Deadly Futures following trial completion. Surveys will be administered at baseline, 6 weeks, 12 months, and 24 months (primary end point) post baseline. Primary outcomes are alcohol use (adapted from the National Drug Strategy Household Survey), tobacco use (Standard High School Youth Risk Behavior Survey), and psychological distress (Kessler-5 Psychological Distress Scale). Secondary outcomes are alcohol and drug knowledge and intentions, alcohol-related harms, binge drinking, cannabis use, well-being, empowerment, appreciation of cultural diversity, and truancy.ResultsThe trial was funded by the National Health and Medical Research Council in January 2019, approved by the Human Research Ethics Committee of the University of Sydney (2020/039, April 2020), the Aboriginal Health and Medical Research Council of New South Wales (1620/19, February 2020), the Western Australian Aboriginal Health Ethics Committee (998, October 2021), and the ethics committees of each participating school, including the New South Wales Department of Education (2020170, June 2020), Catholic Education Western Australia (RP2020/39, November 2020), and the Queensland Department of Education (550/27/2390, August 2021). Projected dates of data collection are 2022-2024, and we expect to publish the results in 2025. A total of 24 schools have been recruited as of submission of the manuscript.ConclusionsThis will be the first cluster randomized controlled trial of a culturally inclusive, school-based alcohol and drug prevention program for Aboriginal and Torres Strait Islander youth; therefore, it has significant potential to address alcohol and other drug harms among Aboriginal and Torres Strait Islander youth.Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12620001038987; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380038&isReview=trueInternational Registered Report Identifier (IRRID)PRR1-10.2196/34530

Do Alcohol Prevention Programs Influence Adolescents' Drinking Behaviors? A Systematic Review and Meta-Analysis.

This study analyzed the effects of various alcohol prevention programs on the drinking behavior of adolescents. There were seven electronic databases used for the literature search. A systematic review and meta-analysis are employed for works published in Korean and English from January 2010 to April 2021, with strict inclusion criteria yielding 12 papers in the review. The type of alcohol prevention interventions included educational and motivational interventions. Six studies had more than 500 participants each, and five studies had more than 10 participating schools. The programs did not effectively reduce the frequency of drinking or binge drinking of adolescents but significantly reduced the amount of alcohol consumed. Based on the results of this study, when planning alcohol prevention programs for adolescents, it is necessary to adopt a multi-level approach, including the engagement of parents and the community.

Individual differences in the associations between risk factors for alcohol use disorder and alcohol use-related outcomes.

Family history of alcohol use disorder; AUD (FH +) and impulsivity-related traits are known risk factors for problem drinking that have been investigated in predominately White samples. This cross-sectional study examined whether these risk factors vary by sex in the overall, majority White sample and in a Black subsample. A model building regression procedure was used to investigate the combined effect of FH + and impulsivity-related traits on alcohol quantity, frequency, and problems by sex (overall sample: N = 757, 50% female, 73% White, agemean = 33.74, SD = 11.60; Black subsample: n = 138, 47% female, agemean = 33.60, SD = 9.87). Overall Sample. No sex differences were found in the compounding effects of FH + and impulsivity-related traits on alcohol outcomes. Males reported more physical, social, and overall alcohol-related problems than females. FH + was positively associated with all alcohol-related consequences. Poor self-regulation was the only trait associated with all alcohol outcomes. Black Subsample: A three-way interaction suggested a negative association between inhibition and frequency of alcohol use among FH + males only. A two-way interaction also suggested impulse control was associated with more interpersonal alcohol-related problems among males only. Main effects were also found in the expected direction such that higher impulsivity and FH + were associated with poorer alcohol outcomes. These findings suggest no sex differences in the overall sample in the interactive effects of established risk factors for AUD on alcohol outcomes, and that poor self-regulation may be key for personality-targeted alcohol prevention and intervention programs. Preliminary findings of sex differences in the Black subsample should be replicated. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Persistent attention-deficit/hyperactivity disorder predicts socially oriented, but not physical/physiologically oriented, alcohol problems in early adulthood.

Although individuals with histories of childhood attention-deficit/hyperactivity disorder (ADHD) report more alcohol-related problems in adulthood than those without ADHD, it is unknown whether there are group differences in certain types of alcohol problems. We tested whether the nature of alcohol problems differed for individuals with and without childhood ADHD, as well as adulthood-persistent ADHD, to facilitate a personalized medicine approach for alcohol problems in this high-risk group. Data were drawn from a prospective, observational study. Children diagnosed with ADHD and demographically similar individuals without childhood ADHD were followed prospectively through young adulthood (N=453; 87.6% male). ADHD symptom persistence was assessed using self-reports and parent reports. Alcohol problems and heavy drinking were assessed repeatedly from 18-30years old to construct lifetime measures. Full-sample confirmatory factor analyses identified 5 alcohol problem "types:" interpersonal problems/risky behaviors, occupational/academic impairment, impaired control/treatment seeking, tolerance/withdrawal, and drinking to blackout. Latent class analyses of items within each type yielded the best fit for 3-class solutions for all sets of items except blackout drinking, for which 2classes emerged. Children with ADHD were more likely than those without ADHD to belong to high-risk latent classes for interpersonal problems/risky behaviors, occupational/academic problems, and impaired control (the high-risk class that indexed treatment-seeking behavior). These effects were driven by individuals whose ADHD symptoms persisted into adulthood. Few group differences emerged for tolerance/withdrawal and blackout drinking, except that individuals with only childhood ADHD (no persistence) were more likely to belong to the low-risk groups than those with adulthood-persistent ADHD and without ADHD. Individuals with ADHD histories whose symptoms persist into adulthood may be more likely to experience socially oriented alcohol problems and impaired control/treatment seeking than individuals without an ADHD history and those with childhood ADHD only. Tailored alcohol prevention and treatment programs may benefit this high-risk population.

C.A.R.E.S: A mobile health program for alcohol risk reduction in community college students

BackgroundCompared to students at four-year residential colleges, Community College Students (CCS) are at greater risk for binge drinking and alcohol related risks, however few interventions have been developed specifically for the needs of CCS. Methods and designThis study design tests the efficacy of a smartphone app (CARES) compared to an existing online alcohol education (AE) program. CCS (n = 250) will be recruited using a nationwide social media campaign and randomly assigned to either arm, stratified by sex and age (over/under 21). Eligibility screening, consent and assessments are conducted online and both interventions are accessible by smartphone. Assessments will be conducted at baseline, 4- and 8- weeks, end of treatment (12-weeks) and at 6-month follow-up. The primary outcomes are heavy episodic drinking (past 2 weeks), and alcohol related problems Confidence in refusing alcohol, use of protective behavioral strategies and expectations regarding alcohol use. Demographics including age, sex, race/ethnicity, marital and parental status and employment will be analyzed as potential covariates. DiscussionCommunity colleges serve approximately half of all US college students but frequently lack the resources to implement full-service alcohol prevention and education programs. The specific needs of CCS also differ from those of residential college students for whom most alcohol prevention programs have been developed. If proven efficacious, the CARES intervention may offer a scalable, easily disseminable program designed for the needs of community colleges and their students.ClinicalTrials.gov Registration: NCT03927482.

How Risk Signaling Influences Binge Drinking Impression Formation: An Evolutionary Experimental Approach.

Background. Evolutionary theory-driven alcohol prevention programs for adolescents are lacking. This study introduced a binge drinking impression formation paradigm to test whether emphasizing sexual dysfunction induced by alcohol abuse lowers positive attitudes and expectancies related to binge drinking when compared with cognitive or long-term health consequences. Method. In a between-subjects experiment, 269 French high school students (age, M = 15.94, SD = 0.93, 63.20% women) watched professional-quality videos emphasizing sexual impotence (n = 60), cognitive impairment (n = 72), or long-term effects (cancer, cardiovascular disease, n = 68) induced by alcohol and then had to evaluate a drinking scene. We predicted that the video on impotence would be the most impactful when compared with the other videos. Results. Results showed that women evaluated the target as less attractive after viewing the cognitive video compared with the video on impotence. Men were more willing to play sports against the target after viewing the cognitive video, compared with the video on impotence. Conclusions. These results showed that evolutionary meaning might shape impressions formed by participants depending on the context. This study calls for further replications using the same design and materials.

"Klar bleiben" (keep aclear head)-acompetition for school classes to reduce alcohol consumption

In Germany, alcohol is the most popular drug among adolescents. So far, school-based alcohol prevention programs have focused on elementary school children and pupils in early adolescence. The school program "Klar bleiben" ("Keep aClear Head") was especially designed for young people in late adolescence (10thgraders) with the aim of establishing non-binge drinking as asocial norm.Students in the participating classes commit themselves to abstain from binge drinking for six weeks (contract management). The class gives feedback after each week. After at least five positive feedbacks, the class is rated as successful and enters aprize draw. Elaborated teaching impulses and information resources for teachers and parents are further components of the prevention program.The evaluation of the class competition by 92teachers can be regarded as consistently positive. The results of acluster-randomized study showed arelative risk reduction of 10.4% in binge drinking in the last month for those adolescents who had already consumed alcohol before and belong to the intervention group. After the end of the intervention, this group of adolescents consumed an average of 0.19 fewer alcoholic beverages per drinking occasion compared to adolescents from the control group. The findings presented here are encouraging, keeping in mind that the intervention is relatively inexpensive.

Preventing Alcohol Use Among Adolescents by Targeting Parents: A Qualitative Study of the Views of Facilitators, Parents, and Teachers on a Universal Prevention Program “Effekt”

The purpose of this study was to better understand facilitators', parents', and teachers' experiences, attitudes, and perceived impact of the international alcohol prevention program "Effekt" and its delivery to help explain its ineffectiveness in Estonia. One focus group with program facilitators (n = 8, 7 women) and individual interviews with seventh grade teachers (n = 12, 11 women) and parents (n = 24, all women) were carried out. The semi-structured interview schedules sought to explore participants' attitudes toward the program, delivery process, impact, participation barriers, and facilitators and long-term implementation. Interviews were transcribed, and data analysis was guided by the thematic analysis method. Participants identified both positive and negative elements regarding program delivery that are broken down into three main themes: perceived value of the program, perception of low participation rates, and long-term perspective. Perceived value of the program: Participants perceived the program to be effective from the parents' perspective, but they considered its effect on children questionable. Perception of low participation rates: The perception of low participation rates was considered as the main factor reducing the program's impact. This was potentially influenced by factors such as a weak engagement process, lack of perceived relevance, infrequent meetings, and parents not attending school meetings. Long-term perspective: Most participants supported the idea of implementing the program with some adjustments, such as involving children, tailoring the content, and increasing the engagement of teachers. Limited engagement, low perceived relevance, practical issues, and impractical format were perceived as major contributors to the ineffectiveness of the program. Taking these and other identified factors into account may help inform future prevention programs targeting parents.

College students' perspectives on an alcohol prevention programme and student drinking - A focus group study.

Aim: While there is considerable research on the efficacy of interventions designed to reduce alcohol consumption and related harms among college students, there is limited research on students’ own perspectives on such interventions. This qualitative study aimed to address this gap by examining college students’ perspectives in the context of an alcohol prevention programme for college students in Ireland. Methods: Focus groups were used as the means of data collection, and participants were selected using purposive sampling based on two criteria – type/location of college and category of student. A total of eight focus groups were conducted at two institutions taking part in the programme. Participants comprised four categories of student: undergraduates, mature students, international students and students who were members of clubs or societies. Results were analysed through the lens of a social-ecological framework. Results: The study findings indicated that students perceived alcohol as being endemic to college life and wider society. As a result, many of the students were sceptical or ambivalent regarding the potential efficacy of alcohol prevention programmes. Despite the perceived pervasiveness of alcohol, the study pointed to heterogeneity in drinking practices among the participants. Moreover, the study participants expressed divergent views when asked whose responsibility it was to control student alcohol consumption. Conclusions: Viewing the findings through a social-ecological lens, students seemed to collectively acknowledge the different layers of influence on student drinking, acknowledging the complex nature of this issue. Providing a greater variety of leisure spaces, including alcohol-free environments, was viewed particularly favourably by the student participants in terms of solutions proposed.