The purpose of this research is to develop and pilot test the effectiveness of alcohol abuse prevention strategies targeting high-risk youth in a primary health care setting. These prevention strategies will be based upon an innovative Multi-Component Motivational Stages (McMOS) theoretical model. Specifically, we propose to develop and evaluate the efficacy of a three-phase prevention intervention involving; 10 a media-related materials prevention strategy i the form of youth Self-Instructional Modules; 2) an interpersonal prevention strategy in the form of Medical Consultations provided by physicians and nurses; and 3) an environmental strategy in the form of Follow-Up Telephone Contacts administered by a health care provider. Each of the prevention strategies will be developed to match the participating youth's stage of behavioral development in the alcohol change process. This study will employ an experimental design to pilot test the effects of the intervention and compare the effects of physician versus nurse administered health consultations. Participating youth will be randomly assigned to one of four experimental conditions: 1) Self-Instructional Models Only, 2) Self-Instructional Models plus Medical Consultations, 3) Self-Instructional Models plus Modules plus Medical Consultations plus Follow-Up Telephone Contacts, or 4) a Control. The primary outcome measures to be examined include alcohol consumption patterns and the stages of behavioral change associated with alcohol consumption. Secondary outcome measures will include the use of behavioral strategies to avoid alcohol consumption, motivation to avoid drinking, intentions to drink in the future, alcohol-related beliefs, and self-efficacy related to avoiding drinking. One and three month outcomes will be determined for the prevention strategies.
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