Journal of alcohol and drug education最新文献

Social support and psychiatric severity are known to influence substance abuse. However, little is known about how their influences vary under different conditions. We aimed to study how different types of social support were associated with substance abuse outcomes among persons with low and moderate psychiatric severity who entered Sober Living Houses (SLHs). Two hundred forty-five individuals entering 16 SLHs were interviewed at baseline and 6, 12, and 18 months. The Brief Symptom Inventory assessed psychiatric symptoms and the Important People Instrument and a modified AA Affiliation Scale assessed social support. Social support variables predicted substance abuse outcomes for persons with low and moderate psychiatric severity. However, they were the strongest and most consistent predictors for the low severity group.

We explored potential associations between the strength of state Responsible Beverage Service (RBS) laws and self-reported binge drinking and alcohol-impaired driving in the U.S. A multilevel logistic mixed-effects model was used, adjusting for potential confounders. Analyses were conducted on the overall BRFSS sample and drinkers only. Seven percent of BRFSS respondents lived in states with the strongest RBS laws, 15% reported binge drinking and 2% reported driving after having too much to drink at least once in the past 30 days. There was no evidence of a significant association between RBS law strength and self-reported binge drinking or alcohol-impaired driving. Future studies should include additional information about RBS laws and use a prospective research design.

A community readiness survey for coalitions to address the growing epidemic of prescription opioid misuse was developed in this four-part study. A total of 70 coalition members participated. 1) We conducted 30-minute phone interviews with coalition members (n=30) and a literature review to develop an item list. 2) Coalition members rated these 60 items for three criteria: importance, confidence in own answer, confidence in others' answer. 3) Highly rated items were included in a revised survey that was tested with coalition members (n=10) using in-person cognitive interviewing to assess how coalition members were interpreting the questions. 4) Lastly, pre-testing and satisfaction testing with additional coalition members (n=30). Most (83%) of the respondents reported positive overall impressions of the survey.

Objective: The purpose of this study was to document the development and testing costs of the Enhanced Alcohol Risk Management (eARM) intervention, a web enhanced training program to prevent alcohol sales to intoxicated bar patrons and to estimate its implementation costs in a "real world", non-research setting.

Methods: Data for this study were obtained retrospectively from a randomized controlled trial of the eARM intervention, which was conducted across 15 communities in a Midwestern metropolitan area. Inputs and their costs were obtained from records maintained during the randomized controlled trial. Total development and testing costs were computed, and implementation costs were estimated with input from the research team. The average implementation cost per establishment was calculated by dividing the total estimated implementation cost by the number of establishments that participated in the study. This provides an estimate of the resources needed to support a broader dissemination of interventions such as eARM.

Results: Direct development and testing costs were $484,904. Including the University's overhead cost rate of 51 percent, total development and testing costs were $732,205. Total estimated implementation costs were $179,999 over a 12 month period. The average cost per establishment was $1,588.

Conclusions: Given the large damage liability awards faced by establishments that serve alcohol to drunk drivers, establishments or their insurance companies may be willing to pay the $1,588 estimated implementation cost in order to limit their exposure to these large damage awards. Therefore, making interventions such as eARM available could be an effective and sustainable policy for reducing alcohol-related incidents.

Background: Matching evidence-based alcohol prevention strategies with a community's readiness to support those strategies is the basis for the Tri-Ethnic Community Readiness Model (CRM). The purpose of this evaluation was to assess the association of a community's readiness to address alcohol abuse in their community with the implementation of environmental and policy-based strategies.

Methods: Twenty-one substance abuse prevention coalitions in Wisconsin participated in a pre-post intervention group-only evaluation using the CRM. As part of a Substance Abuse and Mental Health Services Administration (SAMHSA) grant, all grantees were obligated by the Wisconsin Department of Health Services to implement environmental and policy-based strategies focused on one of three priority areas: young adult binge drinking, underage drinking, and alcohol-related motor-vehicle injuries and fatalities.

Results: At baseline, all communities (n=21) scored at or below a Stage 4 (on a scale of 1-9) readiness level ("preparedness"). The mean change in community readiness over the three-year period (2009-2011) was significant, but was less than one complete CRM stage (0.77, p=<0.001; 95% CI: 0.49, 1.05).

Conclusion: These findings suggest that implementation of environmental and policy-based strategies may improve a community's progression in perceived readiness to address alcohol abuse regardless of the community's baseline level of readiness to address alcohol abuse.

Recommendation: An assessment specific for measuring community readiness for policy-related strategies should be developed. The assessment would include community-level factors (e.g. community climate) for implementing policy-related prevention strategies, and not assume a linear readiness model.

While affiliation with Greek fraternities/sororities and intercollegiate athletic teams is associated with heavier drinking (Meilman et al., 1999), few studies have compared reasons for drinking among these groups. A sample of 1,541 students, identifying as either Greeks or athletes, completed an online survey. Athletes were significantly higher than Greeks on conformity reason for drinking. Tests of independent correlations indicated the magnitude of the past behavior to intention link was considerably stronger for Greeks. Greeks experienced significantly more social problems from drinking. Several group by gender ANOVA models found significant main effects with highest drinking rates, usually among Greek males, and lowest among female athletes. Understanding these specific group differences informs recommendations for group-specific and tailored educational interventions, which are discussed.

This study explored an understudied promotive factor, a belief that alcohol use is inconsistent with personal autonomy, which may reduce adolescent intention to drink and subsequent alcohol use. Autonomy was examined as an attitudinal construct within the Theory of Reasoned Action. Longitudinal data from 2,493 seventh grade students nested in 40 schools were analyzed using a structural equation model. Autonomy was negatively correlated with intention to use alcohol and subsequent alcohol use at a later wave, and intention to use fully mediated the effect of autonomy on subsequent alcohol use. These results are consistent with the proposition that when personal autonomy is perceived as inconsistent with alcohol use among younger adolescents, students indicate a lower intention to use alcohol and use less alcohol during the following school year.

This qualitative study examined the drug resistance strategies of Hawaiian youth residing in rural communities in Hawai`i. Forty seven youth participated in 14 focus groups which focused on the social and environmental context of drug use for these youth. The findings indicated that there were 47 references to resistance strategies used in drug offer situations. These strategies fell within two different categories: (1) overt/confrontational drug resistance strategies, and (2) non-confrontational drug resistance strategies. These strategies occurred within the community context of relational networks of ascribed and biological family members, and differed in frequency of use by gender. Implications for culturally grounded drug prevention programs for rural Hawaiian youth are discussed.

This paper reports on a process in which program designers, classroom teachers, and students worked together to adapt the 7(th) grade "keepin' it REAL" prevention curriculum to a developmentally, socially, and academically appropriate curriculum for 5(th) graders. A Community-Based Participatory Research methodology (CBPR), combined with a 9-step adaptation model, emphasized a collaborative approach, both transformative and empowering. Essential adaptation elements were the Risk-to-Resiliency Continuum; the teaching of a wide range of skills including risk assessment, decision making, and resistance strategies; and, maintaining the theoretical grounding of Narrative Theory, Communication Competence, and Focus Theory of Norms. This paper describes how CBPR methodology can be conducted successfully while focusing on sustained theoretical grounding and effective research practices in a school-based setting.