The competitive renewal seeks four years of funding to conduct a multi-site clinical trial of a promising and innovative secondary intervention to facilitate youth efforts to stop hazardous drinking. Recent studies demonstrate the critical role o progression to heavy episodic drinking in the developmental process of alcohol use disorders, and important associations between certain cognitive factors and recent and planned alcohol change attempts for teens. This voluntary, school-based brief intervention (BI), which targets such hazardous drinking, will be tested in three cities (Miami, Florida;Minneapolis, Minnesota;and Portland, Oregon) at 6 socioculturally and ethnically diverse schools (approximately 1440 students). We will test a conceptual model of purposeful drinking change efforts of youth and determine the 4 and 12 week effectiveness of the BI to increase quit efforts and reduce progression of alcohol involvement (frequency of binge drinking, maximum drinks per occasion, and alcohol-related problems) compared to an Education (ED) comparison condition. The proposed block randomized clinical trial will serve the critical step of replicating initial intervention effectiveness findings in diverse communities and test important treatment factors in facilitating behavior change of adolescents. The intervention design, methods and analyses are specifically linked to the conceptual model of purposeful alcohol change efforts of youth. Based on prior research by our group, we hypothesize that three cognitive factors (e.g. use and non-use expectancies, motivation, perceived peer norms) partially mediate purposeful alcohol self-change efforts of adolescents. The intervention targets these potentially malleable cognitions using Motivational Interviewing in an adolescent-friendly group format. The proposed study also examines the therapy process measure of therapeutic alliance and a new Motivational Interviewing specific construct of group level change talk, hypothesized to influence adolescent efforts to reduce hazardous drinking and alcohol related problems. Using longitudinal modeling procedures we will test impact of the intervention and proposed cognitive and therapeutic process mediators on quit attempts and severity of alcohol involvement at 1 month and 3 months following initiation of treatment. Should results of this model prove fruitful, t would open a new direction to interventions for hazardous drinking among adolescents, and lead to greater understanding of mechanisms of behavior change for youth and processes of therapy effective in promoting self-regulation of drinking behavior at this stage of life.
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