Alcohol Use Prevention Research Articles

Alcohol consumption and alcohol policy

Alcohol is a unique addictive substance used by many people for different reasons. Alcohol use affects not only the users but also the family and the whole society in a negative way. Alcohol is one of the most commonly used substances for entertainment purposes in the world and 1 in 3 people is a current drinker. 2348 billion people (43% of the population) aged 15 and over are current drinkers and males drink about 2 times more frequently than females (53.6%/32.3%). According to the Global Alcohol and Health Report published by the World Health Organization (WHO) (2018), total alcohol per capita consumption (APC) worldwide aged 15 and over increased from 5.7 liters in 2000 to 6.4 liters in 2016. Harmful alcohol consumption is a major public health problem and it is known to be associated with more than 200 diseases and injuries. Policies and measures to prevent alcohol use are not implemented adequately and the burden of alcohol-related illnesses continues to increase tremendously. In order to prevent and reduce the harmful effects of alcohol, alcohol policies should be formulated based on the best evidence from a public health perspective.

Parental alcohol-specific rules effectively reduce adolescents’ tobacco and cannabis use: A longitudinal study

AimsThe current study aimed to longitudinally examine the direct and indirect effects (via alcohol use) of parental alcohol-specific rule-setting on adolescent tobacco and cannabis use. Based on the gateway hypothesis, we expected parental alcohol-specific rules to affect adolescent tobacco and cannabis use through adolescent alcohol use. Design and participantsA longitudinal design including three waves and 906 Dutch adolescents (Mage = 13.51 years, SD = 0.60) was used to apply zero-inflated Poisson models (ZIP). MeasurementsSelf-report questionnaires measured adolescents’ perceived rules about alcohol at T1, cigarette use at T1 and T3 (frequency of life-time and current smoking), cannabis use at T1/T3 (frequency of yearly and monthly use) and frequency of monthly alcohol use at T1/T2. FindingsStricter alcohol-specific rules at T1 predicted lower incidence and prevalence rates of cigarette (life-time: β = −0.20, p < .00; current: β = −0.21, p = .04) and cannabis use (monthly: β = −0.43, p = .02; yearly: β = −0.28, p = .19) two years later (T3). This direct effect was no longer significant when alcohol use at T1 was controlled for. Moreover, a significant indirect effect of alcohol-specific rules at T1 on tobacco and cannabis use T3 via monthly alcohol use T2 was found. ConclusionsThe current study demonstrated that strict rules regarding alcohol may not only reduce alcohol but subsequently also other substance use such as tobacco and cannabis. Thus, interventions targeting the prevention of alcohol use, which appears to serve as a gateway, also affects the involvement in other substances.

The long-term effectiveness of universal, selective and combined prevention for alcohol use during adolescence: 36-month outcomes from a cluster randomized controlled trial.

To compare the long-term universal outcomes of the Climate Schools programme, the selective preventure programme and their combined implementation to standard substance use education in reducing the uptake of alcohol use, engagement in binge drinking and alcohol-related harms over a 3-year period. A cluster-randomized controlled trial. Substance use prevention programmes delivered in Australian secondary schools. Students from 26 Australian secondary schools (n=2190), mean age at baseline 13.3 years (standard deviation=0.48), 57.4% male. Schools were recruited between September 2011 and February 2012. Schools were block-randomized to one of four groups: universal prevention (climate; 12×40-minute lessons); selective prevention (preventure; 2×90-minute sessions); combined prevention (climate and preventure; CAP); or health education as usual (control). The climate intervention delivered 12×40-minute lessons aimed at reducing alcohol and cannabis use and related harms. The preventure intervention delivered 2×90-minute group sessions to high-risk students. The CAP group implemented the climate programme to the entire year group and the preventure programme to the high-risk students. Participants were all consenting 8th grade students (in 2012) assessed at baseline, post-intervention (6-9months post-baseline) and at 12, 24 and 36months post-baseline on measures of alcohol use, knowledge and related harms. Primary outcomes were alcohol use, binge drinking (five or more standard drinks) and alcohol-related harms, obtained from all students regardless of whether or not they received intervention. Intervention effects at 36months post-baseline were estimated from generalized multi-level mixed models using data from all time-points and accounting for school-level clustering. Exploratory analyses examined intervention effects among low- and high-risk adolescents. Compared with students in the control condition, students in the climate, preventure and CAP groups demonstrated significantly slower increases in their likelihood to drink any alcohol [odds ratio (OR)=0.64, 95% confidence interval (CI)=0.50-0.82 for climate; OR=0.55, 95% CI=0.43-0.71 for preventure and OR=0.67, 95% CI=0.53-0.84 for CAP] to engage in binge drinking (OR=0.60, 95% CI=0.44-0.82 for climate; OR=0.59, 95% CI=0.44-0.80 for preventure and OR=0.68, 95% CI=0.51-0.92 for CAP) and to experience alcohol harms (OR=0.63, 95% CI=0.49-0.82 for climate; OR=0.55, 95% CI=0.43-0.71 for preventure and OR=0.64, 95% CI=0.50-0.81 for CAP). There was no strong evidence that the combined approach showed advantages over universal prevention. The direction and magnitude of effects were consistent in low- and high-risk adolescents. The universal Climate Schools programme and the selective preventure programme were effective in reducing alcohol consumption and alcohol problems compared with standard Australian health education, when trialled individually and together over a 3-year period.

Pilot Study of the Adaptation of an Alcohol, Tobacco, and Illicit Drug Use Intervention for Vulnerable Urban Young Adults.

Objectives: There is limited information about the applicability and effectiveness of tobacco and illicit drug use interventions in urban and racial/ethnic minority youth, a population with great need for prevention of alcohol and drug use. We pilot-tested the feasibility of a behavioral intervention to reduce alcohol, tobacco, and illicit drug use among urban young adults in New Orleans, Louisiana.Study Design: The 12-week intervention pilot project was developed to be implemented at a community-based social service organization that provides educational, juvenile justice-related case management, and mentoring services to youth with substance use and incarceration histories.Methods: One-hour intervention sessions included interactive discussions and lesson reviews guided by a health educator and peer facilitators. Recruitment was done by case managers. Thirty African American young adults aged 16–21 years participated between January 2016 and July 2017.Results: We were able to adapt the 14-session intervention to a 12-session, weekly curriculum that was well-received by the target population. Average rating for each session was 9.5 ± 0.3 (scale 0–10). Youth were willing to engage in the program, but retention was low. Rates of alcohol and drug use were significantly higher within our pilot population than national estimates. We found no significant decreases in self-reported alcohol, tobacco, or illicit drug use after participation in the intervention.Conclusion: Results emphasize the need to devote additional educational resources to intervention and retention factors for vulnerable youth. Individuals often experiment with drugs during adolescence; thus, this period represents a prime opportunity for education and intervention.

Systematic review of universal family prevention programs: Analysis in terms of efficacy, retention and adherence.

Adherence is an important aspect of the effectiveness of family interventions for universal drug prevention. Some approaches suggest adherence assessments should be improved because they are partial and do not take into account all dimensions. The objective of the study is to analyze adherence and retention measures used in family intervention programs for the prevention of substance use in young people aged 10-14 years. To this end, the literature was reviewed on universal programs which have obtained good preventive results. The information sources consulted are: PubMed, PsycINFO (EBSCO), PsycArticles (EBSCO), Social Work abstracts (EBSCO), CINAHL (EBSCO) SocIndex (EBSCO), Scopus, Academic Search Premier (EBSCO), SCIC-ISOC, Cochrane Database of Systematic Reviews, ERIC, ScienceDirect, Web of Science, Project Cork, Researchgate, and consultation with experts. The search results show 21 studies belonging to 6 family programs: Strengthening Families Program 10-14, Parents Who Care, Family Check-Up, Linking Lives Health, Prevention of Alcohol use in Students, and Örebro Prevention Program. The studies analyzed provide little information on the different elements involved in adherence. Retention and differential attribution are the data that appear most frequently, while other aspects such as active participation do not appear in the studies. The results are discussed and recommendations are made to improve the evaluation of adherence and retention in family prevention programs.

Marijuana Legalization and Youth Marijuana, Alcohol, and Cigarette Use and Norms

Rates of adolescent substance use have decreased in recent years. Knowing whether nonmedical marijuana legalization for adults is linked to increases or slows desirable decreases in marijuana and other drug use or pro-marijuana attitudes among teens is of critical interest to inform policy and promote public health. This study tests whether nonmedical marijuana legalization predicts a higher likelihood of teen marijuana, alcohol, or cigarette use or lower perceived harm from marijuana use in a longitudinal sample of youth aged 10-20 years. Data were drawn from the Seattle Social Development Project-The Intergenerational Project, an accelerated longitudinal study of youth followed both before (2002-2011) and after nonmedical marijuana legalization (2015-2018). Analyses included 281 youth surveyed up to 10 times and living in a state with nonmedical marijuana legalization between 2015 and 2018 (51% female; 33% white, 17% African American, 10% Asian/Pacific Islander, and 40% mixed race or other). Multilevel modeling in 2019 showed that nonmedical marijuana legalization predicted a higher likelihood of self-reported past-year marijuana (AOR=6.85, p=0.001) and alcohol use (AOR 3.38, p=0.034) among youth when controlling birth cohort, sex, race, and parent education. Nonmedical marijuana legalization was not significantly related to past-year cigarette use (AOR=2.43, p=0.279) or low perceived harm from marijuana use (AOR=1.50, p=0.236) across youth aged 10-20 years. It is important to consider recent broad declines in youth substance use when evaluating the impact of nonmedical marijuana legalization. States that legalize nonmedical marijuana for adults should increase resources for the prevention of underage marijuana and alcohol use.

Intention to drink and alcohol use before 18 years among Australian adolescents: An extended Theory of Planned Behavior

IntroductionPreventing adolescent alcohol use is an international public health priority. To further understand adolescent alcohol use, this study tested a model of adolescent intention to consume alcohol that incorporated multiple social systems influences. MethodsParticipants included 2529 Australian secondary school students (Mage = 14.20; 53.7% female). Participants completed a survey about risk and protective factors for alcohol use at individual, family, school and community levels. Structural Equation Modeling (path analysis) was used to evaluate an extended Theory of Planned Behavior (TPB) that incorporated social system determinants of intention to consume alcohol. ResultsThe final model explained 60% of the variance in adolescent alcohol use intention. All TPB constructs correlated with intention and experience of lifetime alcohol use. More exposure to information about alcohol use had a weak but significant influence on adolescents’ stronger perceived behavioral control. Having less friends who use alcohol, stricter parental rules for adolescent alcohol use, and unfavorable parent attitudes towards alcohol use, were associated with stronger adolescent anti-alcohol attitudes and subjective norms. Community level pro-abstinence attitudes predicted unfavorable adolescent attitudes to alcohol and intention to consume alcohol. Parental rules showed significantly stronger influences on alcohol use intention amongst younger adolescents. ConclusionsKey social systems around adolescents significantly predicted intention to consume alcohol, and the extended TPB model explained the major variance in adolescent alcohol use. The findings emphasize the importance of multi-level approaches to the prevention of alcohol use. Situation-based factors that could trigger impulsive emotional response may be a future intervention focus.

Governing Noncommunicable Diseases Through Political Rationality and Technologies of Government: A Discourse Analysis.

In the last two decades, global action to address noncommunicable diseases (NCDs) has accelerated, but policy adoption and implementation at the national level has been inadequate. This analysis examines the role of rationalities of governing, or governmentality, in national-level adoption of global recommendations. Critical discourse analysis was conducted using 49 formal institutional and organizational documents obtained through snowball sampling methodology. Text were coded using a framework of five forms of governmentality and analyzed to describe the order of discourse which has emerged within the global NCD policy domain. The dominant political rationality used to frame NCDs is rooted in risk governmentality. Recommendations for tobacco control and prevention of harmful alcohol use rely on a governmentality of police mixed with discipline. The promotion of physical activity relies heavily on disciplinary governmentality, and the prevention of unhealthy diet mixed disciplinary measures, discipline, and neoliberal governmentalities. To translate global NCD prevention and control strategies to national action, acceptability for the political rationalities embodied in policy options must be nurtured as new norms, procedures, and institutions appropriate to the political rationalities of specific interventions are developed.

Social, economic and family factors associated with binge drinking in Spanish adolescents

BackgroundThe main aim of this study was to determine the socioeconomic and family factors associated with binge drinking (BD) in Spanish adolescents who participated in a web-based computer intervention for the prevention of binge drinking known as Alerta Alcohol.MethodsLongitudinal analyses were carried out in a sample of Andalusian adolescents aged 15 to 19 enrolled in public schools, which was part of a two-arm cluster randomized controlled trial with an intervention group (IG) who received the Alerta Alcohol programme and a control group (CG) who did not receive any active intervention. Panel count data and the following econometric procedures were used: negative binomial, a two-part model and a finite mixture model. The endogenous variable in all models was the number of BD occasions in the last 30 days. A total of 1247 subjects in the pre-intervention period, with an average age of 16.8 years, plus 612 adolescents in the follow-up period (4 months later), were included in the analysis.ResultsIn relation to findings, being older (≥ 17 years old), having more pocket money and higher family alcohol consumption were associated with greater BD. By contrast, subjects who completed the questionnaire on Wednesday, Thursday or Friday, further from the previous weekend, indicated a lower number of BD occasions.ConclusionsOur results suggest the need to include families, especially parents and siblings, in interventions aimed at preventing alcohol use among adolescents, given the association shown between BD and both family alcohol consumption and weekly pocket money or availability of money to adolescents. Given the findings with regard to age, future research aimed at intervening in early adolescence to prevent BD would be justified.Trial registration(ClinicalTrials.gov): NCT03288896. Registration date: September 20, 2017. “Retrospectively registered”.

Regulator of G protein signaling 6 (RGS6) is a critical modulator of reward behavior and dopamine signaling in the mesolimbic circuit

Alcohol (EtOH) is the most commonly abused drug worldwide and chronic EtOH consumption often leads to development of dependence and abuse. EtOH dependence is a progressive, neurological disorder characterized by an accumulation of neuroadaptations resulting from chronic EtOH exposure. The neurobiological mechanisms underlying EtOH‐seeking behavior and dependence are not fully understood. As a result, there are limited therapeutics designed to reduce alcohol cravings or withdrawal symptomology, and abstinence remains the only effective way to prevent alcohol use disorders (AUDs). Previously, we showed that RGS6 deficiency in mice leads to reduced EtOH seeking and reward behaviors. Reduced EtOH seeking in RGS6−/− mice was partially reversed by GABAB and D2 autoreceptor (D2R) antagonism and completely reversed by singular inhibition of DAT. These findings, together with the observed reduction in striatal DA content in RGS6−/− mice, led us to hypothesize that RGS6 functions to promote mesolimbic DA transmission by suppressing GPCR‐Gαi/o‐mediated upregulation of DAT. To investigate this possibility, we examined the effects of RGS6 loss on DAT expression in VTA cell bodies and synaptic terminals in the nucleus accumbens (NAcc). In addition, we examined the effects of RGS6 loss on mesolimbic DA transmission using optogenetic stimulated release of DA and c‐Fos staining in the NAcc. We observed robust expression of RGS6 in VTA cell bodies and terminals where its loss led to upregulated expression of DAT. These findings suggest that RGS6 functions to promote EtOH seeking and reward behavior by promoting DA neurotransmission in the mesolimbic circuit by suppressing GPCR‐Gαi/o‐DAT upregulation.Support or Funding InformationNational Institutes of Health [AA025919]; the Michael J. Fox Foundation [1151]; and University of Iowa Pharmacological Sciences Training Grant [T32GM067795].

College alcohol belief and alcohol use: Testing moderations by cultural orientations and ethnicity.

Alcohol is considered an integral part of the college life; students who hold stronger college alcohol beliefs typically consume more alcohol and experience more negative drinking consequences. Asian Americans are increasingly at risk for hazardous alcohol use, yet little research has focused on whether college alcohol beliefs are conceptualized similarly in this group and whether individuals' cultural orientations moderate the relations between college alcohol beliefs and alcohol involvement. Asian American (N = 439; Mage = 22.77, 42.6% women) and Euro American (N = 161; Mage = 21.04; 41.6% women) undergraduate students were recruited to test measurement invariance of the College Life Alcohol Salience Scale and the Stephenson Multigroup Acculturation Scale. We examined the relations between college alcohol beliefs and alcohol involvement, and the degree to which cultural orientations and ethnicity moderated these relations. Scores from a 14-item College Life Alcohol Salience Scale and a 26-item Stephenson Multigroup Acculturation Scale demonstrated scalar invariance across Asian and Euro American groups. Bivariate correlations showed robust associations between college alcohol beliefs and alcohol involvement. Among Asian and Euro Americans who were not immersed in their ethnic heritage society, students were at greater odds of being a drinker when they endorsed stronger college alcohol beliefs, and drinkers consumed more alcohol when they endorsed lower college alcohol beliefs. Interventions aimed to prevent alcohol use and misuse can assess and target students' college alcohol beliefs and promote greater connectedness to their ethnic heritage cultures. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Qualitative exploration of the intersection between social influences and cultural norms in relation to the development of alcohol use behaviour during adolescence

ObjectivesFew contemporary studies have examined peer and social drivers of alcohol use during mid-adolescence. We sought to explore young people’s perspectives on socio-cultural influences relating to alcohol use behaviour during...

Alcohol use and risk of suicide: a systematic review and Meta-analysis

Objectives: Alcohol use has several consequences and is one of the variables that increase risk of suicide. This meta-analysis was performed using cohort studies to clarify the association of alcohol use and suicide.Method: Scientific sources were reviewed regarding the keywords. After screening, thirty cohort studies were identified for the meta-analysis. The analysis was performed based on the random effects and subsequent analysis of the subgroups, based on various variables.Result: Analysis of the results showed that there is a relationship between alcohol use and suicide. Risk Ratio (RR) between alcohol use and suicide was 1.65. In men, pooled RR was 1.56 with 95% CI = 1.20–2.03, and in women, the pooled RR was equal to 1.40 with 95% CI = 1.11–1.77.Conclusion: Overall, the findings indicate that alcohol use is a risk factor for suicide. Therefore, it seems that prevention and control of alcohol use can be effective in promoting mental health.

The Influence of Personality and Drinking Motives on College Student Binge Drinking in the US and Portugal

Abstract. The present study examined whether personality traits and drinking motives interact to predict binge drinking and alcohol-related problems in a cross-cultural sample of college students. Participants were undergraduate drinkers ( N = 904; 66% female) from universities in Portugal ( N = 391) and the US ( N = 513). Participants completed measures assessing neuroticism, extraversion, conscientiousness, drinking motives, frequency of binge drinking, and the number of alcohol-related problems. A significant Country × Neuroticism × Conformity interaction was explained by differences between US and Portuguese samples. The effect of this interaction on alcohol- related problems was mediated by binge drinking. Findings suggest similarities and differences across cultures in the manner in which personality and drinking motives are associated with alcohol outcomes. Across cultures, neuroticism, extraversion, conscientiousness, and drinking motives are key factors to consider in the assessment, prevention, and treatment of alcohol use among college students.

A randomized trial of brief web-based prevention of unhealthy alcohol use: Participant self-selection compared to a male young adult source population

BackgroundHow much a randomized controlled trial (RCT) sample is representative of or differs from its source population is a challenging question, with major implications for generalizability of results. It is particularly crucial for freely-available web-based interventions tested in RCTs since they are designed to reach broad populations and could increase health disparities if they fail to reach the more vulnerable individuals. We assessed the representativeness of a sample of participants in a primary/secondary prevention web-based brief intervention RCT in relation to its source population. Then we compared those recruited to those not recruited in the RCT. MethodsThere is a mandatory army recruitment process in Switzerland at age 19 for men. Between August 2010 and July 2011, 12,564 men (source population) attended two recruitment centers and were asked to answer a screening questionnaire on alcohol use. Among 11,819 (94.1%) who completed it, 7027 (59.5%) agreed to participate in a longitudinal cohort study with regular assessments. In 2012, these participants were invited to a web-based brief intervention RCT. Participation was not dependent on the presence or quantity of alcohol use. We assessed the representativeness of the RCT sample in relation to the source population and compared participants recruited/not recruited in the RCT with respect to education level and alcohol use. ResultsThe RCT sample differed from the source population: individuals 20 and over were significantly less represented (34.3% vs 37.9%, p = 0.006), as were those with lower education level (58.6% vs 63.0%, p = 0.0009). The prevalence of any alcohol use was higher in the RCT population (92.3% vs 90.6%, p = 0.03) but unhealthy alcohol use was less represented (37.1% vs 43.2%, p < 0.0001). Differences on alcohol use measures and education were similarly found when those recruited in the RCT were compared to those who were not, including in a multivariable model, showing independent associations between less unhealthy alcohol use and higher education and recruitment in the RCT. ConclusionsRCT participants differed from other members of the source population, with those participating in the RCT having higher prevalence of any alcohol use but lower levels of consumption and lower prevalence of indicators of unhealthy alcohol use. Individuals with higher education were overrepresented in the RCT sample. Selection bias may exist at both ends of the drinking spectrum and individuals with some indicators of greater vulnerability were less likely to participate. Results of web-based studies may not adequately generalize to the general population.Trial registration: The trial was registered at current controlled trials: ISRCTN55991918.

O uso de bebida alcoólica entre gestantes adolescentes

Objetivo: identificar o consumo de bebida alcoólica entre as adolescentes gestantes. Método: estudo de abordagem quantitativa, descritiva e de corte transversal. Os participantes foram 27 adolescentes gestantes adscritas nas Estratégia de Saúde da Família. Resultados: constatou-se que 54% referiram fazer uso de bebida alcoólica nos últimos 12 meses e 7,4% apresentavam chance de ter diagnóstico de dependência alcoólica. Das 5 participantes que relataram ser a segunda gestação, 80% afirmaram ter utilizado álcool na gravidez anterior. Identificou-se que em relação de risco sobre o padrão de consumo de álcool 81,4% se enquadram na zona I, 14,8% na zona II e 7,4% na zona IV. Conclusão: reafirma-se a necessidade de ações de prevenção do uso de álcool na gestação e a relevância do papel do enfermeiro no acompanhamento integral durante o pré-natal.

Drug use among Teenagers and Young Adults in Bhutan.

Background:Use, possession, and illegal transactions of controlled substances have increased in recent years in Bhutan. This study aimed to determine the national prevalence of ever drug use and identify its associated factors amongst teenagers and young adults.Methods:This study was conducted using data from the National Health Survey 2012 of Bhutan. The outcome variable of interest was ever drug use in teenagers and young adults. The questionnaire was developed following the WHO STEPwise approach to surveillance of non-communicable diseases (STEP). Univariate and multivariate logistic regression were performed to identify correlates of ever drug use.Results:The prevalence of ever drug use among teenagers and young adults was 3.2% (n = 672). The factors associated with ever drug use were: being men; being single; being in age group of 18-24 years; having a primary school, high school, monastic, university, or diploma education; being technicians or salespersons; feeling always lonely; having ever consumed alcohol, and having ever smoked.Conclusion:Compared to the other countries in the WHO South-east Asia region, the prevalence of ever drug use in Bhutan is low. Use of other substances, including smoking and alcohol use, was associated with ever drug use. For greater effect, drug use prevention strategies should include prevention of smoking and alcohol use.

Differences in alcohol use between younger and older people: Results from a general population study

BackgroundPrevention of problematic alcohol use is mainly focused on younger adults, while heavy drinking in middle-aged and older adults might be more frequent with more impact on functioning and health care use. Therefore, alcohol use and alcohol disorder in both age groups was compared. To facilitate age-specific prevention, it was examined whether risk factors of heavy drinking and impact on functioning and health care use differs across the life-span. MethodsData of people (23–70 years) were used from the Netherlands Mental Health Survey and Incidence Study-2 (N = 4618), a general population-based cohort. Heavy alcohol use was defined as >14 drinks/week for women and >21 drinks/week for men. Alcohol disorder was defined as DSM-IV disorder of alcohol abuse and/or alcohol dependence. (Multinomial) logistic regression analyses were used to study risk factors of alcohol use and associations between alcohol use and health care use and functioning. ResultsThe past-year prevalence of heavy alcohol was higher in older (55–70 years) compared to younger people (6.7% versus 3.8%), whereas alcohol disorder was less prevalent (1.3% versus 3.9%). Heavy alcohol use was associated with higher level of education in older adults compared to younger adults. Other characteristics of problematic alcohol use and its impact on functioning and health care use did not differ between age groups. ConclusionsHeavy drinking is more prevalent among middle-aged and older people. Contrary to younger adults, prevention of heavy alcohol use in those aged 55–70 should focus on higher educated people.

Impact of a primary care training program on the prevention and management of unhealthy alcohol use: A quasi-experimental study

ObjectiveTo assess the impact of a training program targeted to Primary Care (PC) professionalson the acquisition of communication skills, attitudes, and knowledge about the prevention and management of unhealthy alcohol use. MethodsA quasi-experimental, pre- and post-intervention study was performed in PC centers of Cordoba (Spain). Family doctors, residents and nurses participated in the study. The intervention was based on a motivational interviewing training program, which consisted in a workshop on learning skills, attitudes and knowledge about the alcohol management. PC providers were videotaped with a standardized patient in order to check the clinical and communication competencies acquired. A descriptive, bivariate and multivariate analysis was carried out (p < 0.05). ResultsPC providers’ communication skills and attitudes showed significant improvements in the variables studied (p < 0.001), as well as in the clinical interview evaluation parameters. ConclusionThe present study reveals the impact of a training program targeted to PC professionals on communication skills, attitudes, and knowledge about the prevention and management of patients with unhealthy alcohol use. Practice implicationsTraining activities targeted to PC providers represent a valuable strategy to improve communication skills, attitudes and knowledge of these professionals in their clinical practice.

Exploring the Trajectory and Prevention of Alcohol Use Among Young People From the Perspective of Professional Youth Workers.

Excessive alcohol use is a significant health issue. Underage drinking is one expression of excessive alcohol use. Researchers have identified a trajectory of alcohol involvement. Gaps exist in understanding the influences that delay and promote the trajectory of alcohol use among young people. The purpose of this study was to explore the contexts and influences that limited and contributed to the trajectory of alcohol use among young people. A qualitative descriptive design was used. Eight youth workers from a city in Northern England participated in individual audio-recorded semistructured interviews. Transcriptions were coded. Data were analyzed within, and across, codes to identify themes. The theme "Alcohol is an Expected Part of Life" characterized a hypothetical trajectory of alcohol involvement. "Fostering Community in Youth Centers" characterized how participants' perceptions informed their work. The results increase understanding of how contexts may influence initiation, promotion, and prevention of alcohol use among young people.