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 (e.g., multi systemic intervention and family-based therapy), a major problem involves the enlisting and engaging youth, particularly minority youth, in intervention efforts. The present project seeks to capitalize on the naturally occurring self-change efforts that adolescents normally make to resolve their alcohol problems in order to refine and test a set of change options for adolescents in the high school context. Specifically, in four high schools (approximately 9,000 students), we will test the effectiveness of a package of self-change options based on cognitive social learning theory formulations of alcohol involvement and grounded in both social and developmental psychology theory. The package of self-change options (i.e., Brief Intervention, Guided Self-Change, and Peer Group Counseling) have been selected based on our pilot studies of: 1) prevalence of self-change efforts for alcohol problems among high school students (approximately 25%); 2) types and characteristics of self-change efforts adolescents perceive as helpful; and 3) types of self-change efforts engaged in by adolescents who successfully (for at least a one year period) reduce their alcohol involvement to non-problematic levels or cease drinking (Wagner, Brown, et al., in press). These low cost, 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. The proposed five-year study will be conducted in two phases: 1) manualize/systematize the change facilitation options and gather baseline data at all schools and 2) sequentially implement the intervention options package across sites with up to two year follow-up for outcome evaluation. In addition to specific alcohol use and problem outcomes, we will evaluate the generalizability of the intervention for other related or problem behaviors (e.g., cigarette and other drug use, affective distress). Finally, using a three-tiered analytic approach, we will analyze data to determine: 1) effectiveness of the intervention package, 2) preference and effectiveness of various intervention options, 3) utilization rates across genders, age, and ethnic groups and in relation to both types of alcohol problems experienced and risk factors exhibited by adolescents.
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