Despite the high rate of alcohol related problems among adolescents, only a limited number of interventions have been demonstrated to have efficacy for youth. While there are notable exceptions, a major problem involves the enlisting and engaging of youth, particularly minority youth, in intervention efforts. The present project builds on our adolescent alcohol intervention research designed to facilitate self-change efforts adolescents normally make to resolve their alcohol problems. Specifically, we will test the effectiveness of a package of 3 secondary intervention options (Project Options), which is based on developmental social information processing theory of adolescent alcohol involvement and grounded in both social and developmental psychology theory. The self-change options (i.e., Brief Website Intervention, Individual Guided Self-Change, and Peer Motivational Group Discussion) were selected based on: 1) types of self change efforts adolescents prefer and perceive as helpful, 2) types of self-change efforts adolescents engage in who successfully (for at least a one year) cease drinking or reduce their alcohol involvement to non-problematic levels, and 3) demonstrated ability to engage students with these treatment formats. In the initial study of these interventions in high schools we demonstrated feasibility of designing and successfully implementing a voluntary alcohol intervention, and preliminary evidence of utility. These low threshold strategies are thus developmentally sensitive, acceptable to youth, and offer an opportunity to evaluate the effectiveness of this new self-selection intervention paradigm to successfully engage youth in reducing alcohol problems. In the current 5-year application we propose to compare compliance and short-term outcomes of Self-Selection into this secondary intervention to Randomized Assignment into the intervention in 4 high schools (9,500 students). The Self-Selection Condition also examines service preferences (Website, Individual, and Group), retention, and short-term outcomes (1 and 3 month) when advertisement and availability are comparable for all forms of the self-selected interventions. Randomized Condition is a randomized trial of the three forms of the intervention, which compares outcomes when adolescent choice of initial service is not available. A random sample of students at each school and service-seeking students who receive assessment only will be surveyed to determine behavior change (reduction and cessation of alcohol and related problems) without intervention. Primary outcomes include quit attempts, and reductions in hazardous drinking and alcohol related problems. Three hypothesized mediators of youth change efforts will be evaluated (motivation, perceived norms, cessation expectancies), and gender, age, and ethnic differences in service preferences, retention and short-term outcomes will be determined.
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