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Working in partnership with:South East Coast Strategic Health Authority,Kent and Medway Primary Care Trusts,Kent and Medway NHS and Social Care Partnership Trust.
AN I
NTERNATIONAL CONFERENCE ON ALCOHOL AND YOUNG PEOPLE
rebro PreventionProgramme
Nikolaus KoutakisLecturer and Researcher, Centre for DevelopmentalResearch,
rebro University, Sweden
UNIVERSITY OF
REBRO
Center forDevelopmental
Research
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Whats the problem?
Among adults: rapid increasein the latest decade.
Consequences for publichealth, violence in public andprivate settings, traffic relatedincidents
Authorities are concerned.
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Drunkenness at least once in thelast semester
0
10
20
30
40
50
60
70
80
90
100
P
ercentageofsubjects
10 11 12 13 14 15 16 17 18
Boys
Girls
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Been drunk >10 times in latestsemester
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strategies in Europeanschools:
Lessons on:
Biological / PharmacologicalconsequencesDrug orientation
Illustrative example
Provideinfor
mationabout
harm
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Imp c t assumpt on a outthe cause of underage use(?)Youth use alcohol and drugs because they
lack knowledge about the risk of using.As rational consumers of information youth
will stay away from alcohol and drugs wheninformed about the risks of using.
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Parents attitudes towards 16-year oldalcohol drinking in relation to thechildrens actual drinking.
0
5
10
15
20
25
30
35
40
Never > 10 times
Restrictive
Permissive
Parents attitude
Drunkenness in the latest year
%
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PARENTALATTITUDESDEPENDSONSEVERALTHINGS
Buttheyaretypicallysubjecttochange
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0
10
20
30
40
5060
70
80
90
100
13 14 15 16
A child of my son or daughters age is way too young to
concern him- or herself with alcohol. We think it is obvious that
adolescents under 18 years should not concern themselves with
alcohol.
Childs age
%
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Parents are important but arethey motivated?
A common assumption is thatparents of early adolescents are
concerned about this issue andtherefore highly susceptible andmotivated to participate in
prevention strategies.
Do we need to motivateparents?
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Are parents in generalconcerned?
Do parents have worries thattheir children will get in totrouble because of alcoholdrinking?
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their parents worry about theirchildren's alcohol consumption inrelation to their parents report
about their worries.%
age
0
5
10
15
20
25
30
35
40
45
13 14 15 16
Youth self report
Parent report
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Parents in general do not
worry to the same extent asthe youths believe.
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worries are not affected by theirexperiences of seeing the childdrunk.
%
Childs age0
5
10
15
20
25
30
35
40
45
13 14 15 16
Parent caught
the child drunk
Parent worries
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Parents in general do not seem toworry.
If parents do not worry about
underage drinking they are notmotivated to engage in actionsaiming to reduce it.
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Prevention programs targetingparents in order to reduceunderage drinking should work
through a strategy to influenceand question common ideasand parental practices.
Prerequisites for preventing
underage drinking whenworking through parents
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First stage: Openparents eyes
Initially, focus on making parentsaware of the problems with underage
drinking, even to the extent thatnegative emotions are evoked.
Purpose: to make parents more open
to suggestions for change.
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econ s age: angeparents ways of thinkingabout underage drinking
Tear down parental misconceptionsabout youth drinking, such that most
youths drink and it is not possible tochange the situation.
Parents should become aware that
their attitudes and behavior matters.
Powerlessness
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Third stage: Implementspecific techniques
Parents should be taught clear
and simple rules about how toprevent and handle theiradolescents drinking behavior.
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PP is a three stage rocket
ConcernEmpower
Provide tools
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What if we try to maintainparents restrictive attitudestoward underage drinking;
Will this have an impact ontheir children's alcoholdrinking?
outakis, N., & Stattin, H.
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Target: Parents to 13-15 year olds.
Administration: Ordinary school meetings.
Dose: 15-20 minutes per semester (m=5; age 13-16).
Active substance: Facts and arguments.
Side effects / limits: Not a cure for al.
Administer in any community without any cost
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Content Information on underage drinking: Parent values matterAbout letting the child drink
Consensus agreement. Having clear and restrictive
house rules. Concluding letter to al
Parentalagreement
We,theparentsof
class7ahaveag
reedto
the
followingcommon
rulesregardingour
children----------------------------
----------------------------
----------------
------------
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Figure 1. Means for parent-reported restrictiveattitudes toward underage drinking at grades 7, 8 and9 for parents in the intervention and control groups.
3,4
3,5
3,6
3,7
3,8
3,9
4
grade 7 grade 8 grade 9
Parents'restrictiveattitudes
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1.1
1.15
1.2
1.25
1.3
1.35
grade 7 grade 8 grade 9
Mean
delinquency
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
grade 7 grade 8 grade 9
Meand
runkenness
Figure 2. Repeated measures ANOVA displaying selfreported drunkenness (a) and delinquency (b)separately for youths in the intervention and controlconditions.
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1.3
1.35
1.4
1.451.5
1.55
1.6
1.65
1.7
1.75
grade 7 grade 8 grade 9
Meand
elinquency
0
0,2
0,4
0,6
0,8
1
1,2
1,4
1,6
1,8
2
grade 7 grade 8 grade 9
eanrunenness
Figure 3. Repeated measures ANOVA for a subsampleof early starters in drunkenness and delinquencydisplaying self reported drunkenness (a) anddelinquency (b) separately for youths in the
intervention and control conditions.
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Over all ES Early starters ESRepeatedmeasures,control for pretest
Post testcontrol for preest
Repeatedmeasures,control for pretest
Post test,control for pretest
Drunkenness .48 .35 .72 .52
ntisocial
behavior
.42 .38 .46 .32
Effect Size
Number needed to treat for one to benefit =7.7 / 7.1
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Conclusions
Any effective prevention program must focuson important conditions that are realistic toalter.
In order to be able to mobilize parents, it iscrucial to have them motivated.
Parent attitudes and parenting practicesconcerning underage drinking matter.
The PP approach is effective in maintainingparents restrictiveness and thereby decreaseunderage drunkenness.
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Requirements forimplementing PP locally2 day training: Intro. Prevention sciencePPTheoretical explanation Professional communicationCommon arguments
Practical simulations
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Normal trajectory
Age 13 14 15
Underage
drunkenness
Parent restrictiveattitudes
Less
More
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PP results
Age 13 14 15
Underage
drunkenness
Parent restrictive
attitudes
Less
More
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UNIVERSITY OF REBRO
Center for Developmental Research