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1.  Relationships Between Alcohol-Related informal Social Control, Parental Monitoring and Adolescent Problem Behaviors Among Racially Diverse Urban Youth 
Journal of community health  2008;33(6):425-433.
The purpose of the present study is to investigate the relationships between alcohol-related informal social control and parental monitoring on alcohol use, behavior and intentions; violent behavior; and delinquent behavior in a racially diverse population of young urban adolescents. Baseline surveys were administered to 6th grade male and female students in 61 urban Chicago schools as part of Project Northland Chicago, a group randomized trial for the prevention/reduction of substance use. A subset of their parents (n=3034) was also surveyed regarding alcohol use, violence, and delinquency and related issues. Structural equation modeling was used to assess relationships between alcohol-related informal social control (as measured by parental perceptions of neighborhood action regarding youth drinking) and parental monitoring (as reported by parents), and three adolescent outcomes (alcohol use, behaviors and intentions; violent behavior; and delinquent behavior; as reported by teens). Associations between alcohol-related informal social control and parental monitoring were positive and significant (p<.001). Direct paths from parental monitoring to all three adolescent outcomes were negative and statistically significant (alcohol use, behaviors and intentions, p<.001; violent behavior, p<.001; and delinquent behavior, p<.001). Alcohol-related informal social control was not significantly associated with adolescent outcomes. Efforts to engage parents to be more active in monitoring adolescents’ activities may be related to lower levels of underage drinking, violence and delinquency among both female and male urban youth. Neighborhood norms and action against teenage drinking may be too distal to adolescent outcomes to be directly associated.
doi:10.1007/s10900-008-9117-5
PMCID: PMC2603288  PMID: 18607698
Parental monitoring; Alcohol-related informal social control; Adolescent behaviors; Alcohol; Delinquency; Violence
2.  Do High Risk Urban Youth also have Older Friends? 
Purpose
The purpose of this study was to explore how behavioral, intra-personal and socio-environmental factors were associated with the likelihood of having at least one older friend.
Methods
Participants included 3709 ethnically-diverse 8th grade students in the Project Northland Chicago intervention trial. Socio-demographic characteristics included gender, family composition, language spoken at home, race/ethnicity, and age. Behavioral factors included cigarette, alcohol, and marijuana use, depressed feelings, willingness to wear alcohol-branded merchandise, and violent and delinquent behavior. Intrapersonal factors included low refusal self efficacy and outcome expectations and expectancies. Socio-environmental factors included alcohol offers and access, normative estimates and expectations, and peer alcohol use. Having an older friend was defined as having at least one friend aged 16 or older (students’ mean age=14.2). Logistic mixed-effects regression models were used and controlled for gender, race/ethnicity, treatment status, and age.
Results
Females and older eighth graders were significantly more likely to have at least one older friend. Students who scored higher on all of the behavioral, intra-personal and socio-environmental risk factors were significantly more likely to have at least one older friend. Significant gender interactions were found for several of the relationships.
Conclusion
Overall this study found multiple risk-related factors are associated with having older friends in eighth grade. Particularly important factors appear to be cigarette, marijuana and alcohol use, having friends who use alcohol, having increased alcohol offers, and being willing to wear or use alcohol-branded merchandise.
doi:10.1016/j.jadohealth.2010.08.002
PMCID: PMC3079854  PMID: 21501805
Peers; Friends; Risk Behaviors; Risk Factors; Adolescence
3.  Early Adolescent Exposure to Alcohol Advertising and Its Relationship to Underage Drinking 
Purpose
To determine whether early adolescents who are exposed to alcohol marketing are subsequently more likely to drink. Recent studies suggest that exposure to alcohol ads has a limited influence on drinking in mid-adolescence. Early adolescents may be more vulnerable to alcohol advertising effects.
Methods
Two in-school surveys of 1,786 South Dakota youth measured exposure to television beer advertisements, alcohol ads in magazines, in-store beer displays and beer concessions, radio-listening time, and ownership of beer promotional items during sixth grade, and drinking intentions and behavior at seventh grade. Multivariate regression equations predicted the two drinking outcomes using the advertising exposure variables and controlling for psychosocial factors and prior drinking.
Results
After adjusting for covariates, the joint effect of exposure to advertising from all six sources at Grade 6 was strongly predictive of Grade 7 drinking and Grade 7 intentions to drink. Youth in the 75th percentile of alcohol marketing exposure had a predicted probability of drinking that was 50% greater than that of youth in the 25th percentile.
Conclusions
Although causal effects are uncertain, policy makers should consider limiting a variety of marketing practices that could contribute to drinking in early adolescence.
doi:10.1016/j.jadohealth.2007.01.002
PMCID: PMC2845532  PMID: 17531759
advertising; alcohol marketing; children; drinking; television
4.  Co-use of Alcohol and Tobacco Among Ninth-Graders in Louisiana 
Preventing Chronic Disease  2009;6(3):A85.
Introduction
The co-use of alcohol and tobacco by adolescents is a public health problem that continues well into adulthood and results in negative behavioral, social, and health consequences. The purpose of this study was to examine the co-use of alcohol and tobacco among ninth-graders in south-central Louisiana.
Methods
We created a health habits survey to collect data from 4,750 ninth-grade students, mean age 15.4 years. Cross-sectional analysis used χ 2, 1-way analysis of variance, and logistic regression methods.
Results
Almost 20% of students were co-users. Students who were white, performed poorly in school, did not expect to graduate high school, and had more discretionary money to spend were more likely to be co-users. Co-users had friends who got drunk weekly and were more likely to approve of alcohol use among friends than among adults. Significant differences in attitudes toward drinking and smoking were observed between co-users and nonusers. For adolescent drinkers, including girls, hard liquor was the preferred beverage.
Conclusion
These data for high school students are applicable for prevention strategies at a critical age when harmful health behaviors can mark the start of lifelong habits. Intervention efforts will be successful only if they account for multiple levels of influence.
PMCID: PMC2722390  PMID: 19527586
5.  The Longitudinal Impact of HIV+ Parents' Drug Use on their Adolescent Children 
The impact of parental substance use on the emotional and behavioral adjustment of their adolescent children was examined over five years. A representative sample of 220 parents with HIV (PWH) and 330 adolescent children in New York City were repeatedly assessed. Some parents never used marijuana or hard drugs over the 5 years (nonusers). Among those who were users, substance use varied over time. PWH who used substances during a specific 3-month period were classified as active users and those who abstained from substance use were classified as inactive users. Longitudinal regression analyses were used to analyze the impact of variations in patterns of substance use over time on their adolescent children's emotional adjustment and behavioral problems. PWH relapse exacerbated adolescent substance use, trouble with peers, and adolescent emotional distress. Even time-limited reductions in parents' substance abuse can have a significant positive impact on their adolescent children's emotional and behavioral adjustment. Interventions which address parental substance use among PWH should be developed to ameliorate the impact of substance use relapse on their adolescents.
doi:10.1037/a0015427
PMCID: PMC2843584  PMID: 19290725
Addiction; HIV; problem behavior; adolescent development; relapse
6.  Trajectories of Physical Aggression Among Hispanic Urban Adolescents and Young Adults: An Application of Latent Trajectory Modeling from Ages 12 to 18 
This study sought to identify trajectories of physical aggression among urban Hispanic youth, and to examine the effects of risk and protective factors at age 11 on trajectories of physical aggression over time (ages 12–18). Relying on data from 731 urban Hispanic adolescents from Project Northland Chicago (PNC), latent trajectory modeling was used to determine the number of trajectories, and multinomial logistic regression was used to identify the predictors associated with trajectory membership. The results suggested five trajectories of physical aggression (non-aggressive, low stable, escalators, early-rapid desistors, and high aggression/moderate desistors). After adjusting for several risk and protective factors, language preference (e.g. speaking Spanish at home) was identified as a protective factor, while indirect exposure to alcohol, sadness/depression, fewer negative alcohol-related attitudes, and threatening to fight were associated with increased risk for physical aggression. Study implications indicate that early, multilevel prevention efforts are necessary to deter the initiation and promote the desistance of physical aggression over time among urban Hispanic adolescents.
doi:10.1007/s12103-010-9074-2
PMCID: PMC2995259  PMID: 21132116
Physical aggression; Hispanics; Longitudinal; Urban; Adolescents; Alcohol; Trajectories
7.  Personal values and involvement in problem behaviors among Bahamian early adolescents: a cross-sectional study 
BMC Public Health  2007;7:135.
Background
Few studies, particularly in developing countries, have explored the relationship between adolescents and parental values with adolescent problem behaviors. The objectives of the study are to (1) describe adolescents' personal values, their problem behaviors, and the relationships thereof according to gender and (2) examine the relationship between parental values, adolescent values, and adolescents' problem behaviors among sixth-grade students and one of their parents.
Methods
The data used in these analyses were from the baseline assessment of a school-based HIV risk reduction intervention being conducted and evaluated among sixth grade students and one of their parents across 9 elementary schools in The Bahamas. Personal values were measured by the Portrait Values Questionnaire (PVQ). Seven reported problem behaviors were queried from the students, which included physical fight with a friend, drank alcohol, beer, or wine, smoked a cigarette, pushed or carried any drugs, carried a gun, knife, screwdriver or cutlass to use as a weapon, had sex and used marijuana or other illicit drugs over the past 6 months. Multilevel modeling for binary data was performed to estimate the associations between adolescent and parental values and adolescent problem behaviors.
Results
Among 785 students, 47% of the students reported at least one problem behavior. More boys (54%) reported having one or more problem behaviors than girls (41%, p < 0.01). Boys compared to girls expressed a higher level of self-enhancement (means score: 36.5 vs. 35.1; p = 0.03), while girls expressed a higher level of self-transcendence (42.3 vs. 40.7; p = 0.03). The results of multilevel modeling indicates that boys with a higher level of self-enhancement and girls with a higher level of openness to change and a lower level of conservation were more likely to report engagement in problem behaviors. Only two parental values (self-transcendence and conservation) were low or modestly correlated with youth' values (openness to change and self-enhancement). Parental-reported values documented limited association on adolescents' reported values and behaviors.
Conclusion
In designing interventions for reducing adolescents' problem behaviors, it may be important to understand the values associated with specific problem behaviors. Further exploration regarding lack of association between adolescent and parental values and problem behaviors is needed.
doi:10.1186/1471-2458-7-135
PMCID: PMC1924852  PMID: 17605792
8.  Parents’ and children’s self report of parenting factors 
Health education journal  2010;69(1):31-42.
Objective
The purpose of this study was to determine if parents’ and children’s reports of parenting practices were correlated, if the reports were differentially associated with alcohol use, and which report had the strongest association with alcohol use.
Design
Cross-sectional and longitudinal.
Setting
Public schools, Chicago, Illinois.
Method
Participants included 1373 ethnically-diverse students and parents involved in an alcohol use prevention intervention. Surveys were conducted in sixth grade and eighth grade. Mixed-effects regression analyses were used to model relationships cross-sectionally and longitudinally.
Results
Parents’ and children’s perceptions of parenting practices, while significantly correlated, were not strongly associated. Analyses within each parenting domain found parents’ report of parental monitoring and children’s reports of alcohol-specific communication, general communication, and relationship satisfaction were associated with alcohol use behaviors and intentions. After adjusting for all other parenting practices, parents’ report of parental monitoring and children’s report of alcohol-specific communication were most strongly related to alcohol use behaviors and intentions both cross-sectionally and longitudinally.
Conclusions
When comparing results across studies, it is important to identify whose report was used, parent or child, as the results may differ based on reporter. Studies with limited resources may consider using parents’ reports about parental monitoring and using children’s reports for alcohol-specific communication, general communication, and relationship satisfaction.
doi:10.1177/0017896910363325
PMCID: PMC2885720  PMID: 20563227
Parenting; parent-child relationships; alcohol use; early adolescence
9.  Receptivity to alcohol marketing predicts initiation of alcohol use 
Purpose
This longitudinal study examined the influence of alcohol advertising and promotions on the initiation of alcohol use. A measure of receptivity to alcohol marketing was developed from research about tobacco marketing. Recall and recognition of alcohol brand names were also examined.
Methods
Data were obtained from in-class surveys of 6th, 7th, and 8th graders at baseline and 12-month follow-up. Participants who were classified as never drinkers at baseline (n=1,080) comprised the analysis sample. Logistic regression models examined the association of advertising receptivity at baseline with any alcohol use and current drinking at follow-up, adjusting for multiple risk factors, including peer alcohol use, school performance, risk taking, and demographics.
Results
At baseline, 29% of never drinkers either owned or wanted to use an alcohol branded promotional item (high receptivity), 12% students named the brand of their favorite alcohol ad (moderate receptivity) and 59% were not receptive to alcohol marketing. Approximately 29% of adolescents reported any alcohol use at follow-up; 13% reported drinking at least 1 or 2 days in the past month. Never drinkers who reported high receptivity to alcohol marketing at baseline were 77% more likely to initiate drinking by follow-up than those were not receptive. Smaller increases in the odds of alcohol use at follow-up were associated with better recall and recognition of alcohol brand names at baseline.
Conclusions
Alcohol advertising and promotions are associated with the uptake of drinking. Prevention programs may reduce adolescents’ receptivity to alcohol marketing by limiting their exposure to alcohol ads and promotions and by increasing their skepticism about the sponsors’ marketing tactics.
doi:10.1016/j.jadohealth.2007.07.005
PMCID: PMC2175037  PMID: 18155027
10.  Childhood and adolescent predictors of heavy drinking and alcohol use disorders in early adulthood: a longitudinal developmental analysis 
Addiction (Abingdon, England)  2008;103(Suppl 1):23.
Aims
To identify childhood and adolescent factors differentiating heavy alcohol users in early adulthood from more moderate users or abstainers.
Design
Low-income participants followed from birth to age 28 years.
Participants
A total of 178 adults (95 males) who were first-born children of low-income mothers recruited in Minneapolis, Minnesota, during their third trimester of pregnancy.
Measurements
Maternal hostility (24/42 months), externalizing and internalizing behavior problems (9 years), peer acceptance and academic achievement (12 years), maternal alcohol use and participants’ drinking behavior (16 years), quantity of alcohol use per occasion (19, 23 and 26 years), alcohol use disorders (28 years).
Findings
For men: (i) higher amounts of alcohol consumption at age 16 increased the odds of being a heavy drinker compared to an abstainer (age 19) and a moderate drinker (ages 23 and 26); (ii) lower achievement scores at age 12 and having a mother who drank more when the participant was age 16 increased the odds of being a heavy drinker compared to moderate drinker (age 26). Higher levels of externalizing behavior problems at age 9 and drinking more when the participants were age 16 increased the odds that men would have a current alcohol use disorder at age 28. For women: (i) drinking more at age 16 increased the odds of being a heavy drinker compared to being either an abstainer or a moderate drinker (age 26); (ii) having higher levels of achievement at age 12 increased the odds of being a heavy drinker compared to an abstainer at age 23. Adolescent alcohol use mediated the relation between externalizing behavior at age 9 and alcohol use at age 26 for women.
Conclusions
Problem drinking may be the result of a long-term developmental process wherein childhood externalizing behavior problems sets a pathway leading to heavy drinking during and after adolescence.
doi:10.1111/j.1360-0443.2008.02174.x
PMCID: PMC2822999  PMID: 18426538
Adolescence; alcohol; childhood; problem behavior
11.  Effects of Alcohol on Trajectories of Physical Aggression Among Urban Youth: An Application of Latent Trajectory Modeling 
Journal of youth and adolescence  2009;39(9):1012-1026.
Several studies have investigated factors associated with physical aggression during adolescence. Yet, little is known about the longitudinal relationship between drug use, particularly alcohol use, and physical aggression among minority youth. The present study examined the effects of alcohol and substance use at age 11 on trajectories of physical aggression over time (ages 12–14) among urban adolescents from Chicago, IL. Data from the Project Northland Chicago (n = 3038, 49.4% female) was used. The current study sample included 1,160 Black, 1,015 Hispanic and 863 White/other adolescents for a total of 3,038 adolescents. Four trajectories of physical aggression were identified: Non-aggressive (16%), Desistors (9%), Escalators (20%) and Chronic Aggressive (55%). After adjusting for physical aggression behaviors, delinquent friends, lack of supervised time, demographic variables, smoking and marijuana use, past year alcohol users at age 11 were 2.1 times more likely to be “Escalators” and 1.9 times more likely to be in the “Chronic Aggressive” group. Gender and ethnic differences were also observed in the trajectories of physical aggression. Black youth were 2.5 times more likely to be in the “Chronic Aggressive” group. Findings highlight the importance of targeting alcohol prevention to reduce physical aggression among urban young adolescents.
doi:10.1007/s10964-009-9484-y
PMCID: PMC2890031  PMID: 20012555
Physical aggression; Group-based; Longitudinal; Urban; Adolescents; Alcohol
12.  Developmental Pathways to Alcohol Abuse and Dependence in Young Adulthood* 
Journal of studies on alcohol  2000;61(6):799-808.
Objective
To determine if people who were diagnosed with alcohol abuse or dependence (AAD) at age 21 had different developmental patterns of alcohol use in adolescence than non-AAD individuals.
Method
An ethnically diverse urban sample of 808 children was surveyed at age 10 in 1985 and followed prospectively to age 21 in 1996. AAD at age 21 was assessed following USM-IV criteria. Latent Transition Analysis (LTA) was used to identify four statuses of alcohol use (nonuse, initiation only, current use only, heavy episodic drinking), as well as transition probabilities between these four statuses from elementary school to middle school and from middle school to high school among the AAD and non-AAD group.
Results
The prevalence of alcohol use statuses during elementary school was similar in the two groups. Differences in alcohol use emerged in middle school and became more pronounced in high school. In middle school, AAD individuals were more likely to have initiated or been current drinkers than non-AAD individuals. However, the two groups did not differ in the prevalence of heavy episodic drinking in middle school. In high school, most AAD individuals were in the heavy episodic drinking status (54%), while most non-AAD individuals were in the initiation only (33%) or current use only (34%) statuses.
Conclusions
These findings suggest preventive intervention targets for different developmental periods. Alcohol abuse and dependence at age 21 may be prevented by delaying alcohol initiation, by reducing current use in middle school and by reducing heavy episodic drinking in high school.
PMCID: PMC1975961  PMID: 11188485
13.  Expectancy Change and Adolescents’ Intentions to Use Marijuana 
Drug prevention campaigns commonly seek to change outcome expectancies associated with substance use, but the effects of violating such expectancies are rarely considered. This study details an application of the expectancy violation framework in a real world context by investigating whether changes in marijuana expectations are associated with subsequent future marijuana intentions. A cohort of adolescents (N = 1,344; age range = 12-18 years) from the National Survey of Parents and Youth was analyzed via secondary analysis. Nonusers at baseline were assessed 1 year later. Changes in expectancies were significantly associated with changes in intentions (p < .001). Moreover, in most cases, changes in expectancies and intentions had the strongest relationship among those who became users. The final model accounted for 31% of the variance (p < .001). Consistent with laboratory studies, changes in marijuana expectancies were predictive of changes in marijuana intentions. These results counsel caution when describing negative outcomes of marijuana initiation. If adolescents conclude that the harms of marijuana use are not as grave as they had been led to expect, intentions to use might intensify.
doi:10.1037/a0013020
PMCID: PMC2628596  PMID: 19071982
adolescence; marijuana use; expectancy violations; outcome expectancies; drug prevention
14.  Alcohol Use Among Rural Middle School Students: Adolescents, Parents, Teachers, and Community Leaders’ Perceptions* 
The Journal of school health  2009;79(2):58-92.
BACKGROUND
Although rural adolescents use of alcohol is at some of the highest rates nationally, rural adolescent alcohol use has not been studied extensively. This study examines how community attitudes and behaviors are related to adolescent drinking in rural environments.
METHODS
Data were gathered in 22 rural communities in the Upper Midwest (North Dakota, South Dakota, Wisconsin, and Wyoming). Surveys were collected from 1424 rural sixth- to eighth-grade adolescents and 790 adults, including parents, teachers, and community leaders. Census data were also collected.
RESULTS
Drinkers differed from nondrinkers by the following factors: higher perceptions of peer, parental, and overall community drinking, as well as lower levels of parental closeness and religiosity. Factors distinguishing binge and nonbinge drinkers were increased drinking to reduce stress, drinking to fit in, perceptions of peer drinking, and perceived lack of alternatives to drinking. Parents were significantly less likely to perceive adolescent alcohol use as a problem than other community adults; school officials were most likely to perceive it as a problem. Parental perceptions were also the least correlated to actual adolescent use, while adolescent perceptions were the most highly correlated.
CONCLUSIONS
Community factors such as overall prevalence of drinking, community support, and controls against drinking are important predictors of reported use in early adolescence. School officials were more likely to view adolescent alcohol use as a problem than were parents. School officials’ perceptions of adolescent use were also more related to actual adolescent use than were parental perceptions of adolescent use.
doi:10.1111/j.1746-1561.2008.00377.x
PMCID: PMC2930515  PMID: 19187084
adolescent alcohol use; school effects; rural adolescents
15.  The Role of Parental Alcohol Consumption on Driving Under the Influence of Alcohol: Results from a Longitudinal, Nationally Representative Sample 
Accident; analysis and prevention  2011;43(6):2182-2187.
Purpose
Many studies have examined the role of peer and parental alcohol use on drinking behaviors among adolescents. Few studies, however, have examined parental influences on driving under the influence (DUI) of alcohol. The current study uses data from a longitudinal study to examine the role of parental alcohol use during adolescence on the risk for DUI among young adult men and women.
Methods
Data were derived from 9,559 adolescents and young adults who participated in the National Longitudinal Study of Adolescent Health (Add Health) Waves I and III. Survey logistic regression was used to examine the relationship between multilevel risk and protective factors and self-reported DUI. Analyses were stratified by gender and frequency of parental alcohol consumption to understand the role of parental alcohol use on risk for DUI among their youth.
Results
Risk and protective factors for DUI were very similar among men and women. Parental alcohol use significantly predicted DUI among women (OR = 1.39, p<0.01) and men (OR = 1.33, p<0.05). When parents did not report alcohol use, peer alcohol use significantly increased risk for DUI for both women (OR=1.26, p<0.05) and men (OR=1.31, p<0.001). When parents reported alcohol use, however, peer alcohol use was not a significant independent predictor.
Conclusions
Findings suggest remarkable similarities in risk and protective factors for DUI across gender groups. For men and women, parental alcohol consumption was a risk factor for DUI. Peers’ alcohol use predicted DUI only when parents did not use alcohol.
doi:10.1016/j.aap.2011.06.012
PMCID: PMC3154683  PMID: 21819850
ALCOHOL; GENDER; DRUNK DRIVING; DUI; PARENT
16.  The Motivational Context for Mandated Alcohol Interventions for College Students by Gender and Family History 
Addictive behaviors  2009;35(3):218.
Objective
Alcohol interventions to reduce drinking for college students sanctioned for alcohol use reduce drinking and/or problems. However, intrinsic motivation to change cannot be assumed if students are mandated to receive interventions. The purpose of this study was to explore the influence of both gender and family history on motivational variables prior to a mandated intervention.
Method
Participants were 677 students (63% male) who violated residence hall alcohol policy and were mandated to participate in an alcohol abuse prevention intervention. During a baseline assessment, students described their drinking patterns and completed an assessment of biological risk for alcohol problems; they also reported attitudes regarding the sanction event, perceived peer norms regarding sanctions, resistance to influences on their alcohol use, motivation to change alcohol use, and decisional balance regarding current alcohol use.
Results
Many gender differences emerged on the motivational variables suggestive of more motivation to change among female students; family history was related only to drinking patterns and decisional balance.
Conclusions
If motivational factors influence receptivity and response to mandated interventions, then these finding suggest that greater attention to enhancing motivation to change in male students is warranted.
doi:10.1016/j.addbeh.2009.10.011
PMCID: PMC2815154  PMID: 19914002
brief intervention; college drinking; alcohol abuse prevention; mandated students; gender; family history
17.  “I’ll Never Drink Like That Again”: Characteristics of Alcohol-Related Incidents and Predictors of Motivation to Change in College Students* 
Journal of studies on alcohol  2006;67(5):754-763.
Objective
Alcohol use and its associated behaviors are among the most common reasons for medical treatment and disciplinary infractions among college students. The purpose of this study was to describe the characteristics of students who had recent serious alcohol-related incidents and to identify predictors of motivation to change alcohol use and heavy drinking in particular, with specific attention to gender.
Method
Students (N = 227; 52% female) who had been mandated to attend a session of alcohol education following alcohol-related medical treatment and/or a disciplinary infraction were assessed on their alcohol use, alcohol problems, characteristics of their alcohol-related incident, reactions to the incident, attributions about the incident, and motivation to change drinking and heavy drinking. Path and regression analyses were used to identify the individual and incident-related characteristics that were related to motivation to change.
Results
Perceived aversiveness of the incident was directly and positively related to motivation to change drinking and heavy drinking. Alcohol consumption in the month before the incident and past-year alcohol problems were negatively related to motivation to change heavy drinking, and women were more motivated to change heavy drinking than men. The more students consumed in the incident, the more likely they were to feel responsible for it, and the more responsible they felt about the incident, the greater its aversiveness.
Conclusions
Individual and incident-related characteristics are both directly and indirectly associated with motivation to change following an alcohol-related incident, and therefore have implications for interventions with college drinkers who have experienced an alcohol-related incident.
PMCID: PMC3139334  PMID: 16847545
18.  Genetic and Environmental Influences on the Rate of Progression to Alcohol Dependence in Young Women 
Background
The development of alcohol dependence (AD) involves transitions through multiple stages of drinking behaviors and is shaped by both heritable and environmental influences. We attempted to capture this dynamic process by characterizing genetic and environmental contributions to the rate at which women progressed through 3 significant transitions along the pathway to AD: nonuse to initiation, initiation to onset of first alcohol-related problem, and first problem to onset of AD.
Methods
The sample consisted of 3,546 female twins from the Missouri Adolescent Female Twin Study. Participants ranged in age from 18 to 29 years. Retrospective reports of alcohol use histories were collected by telephone diagnostic interview and transition times between drinking milestones were coded ordinally. Standard genetic analyses were conducted in Mx to derive a trivariate model that provided estimates of genetic and environmental influences that were common as well as specific to the 3 transition times.
Results
Heritable influences were found for rate of progression across all 3 transitions, accounting for 30 to 47% of the variance in transition times. Shared environmental contributions were evident only in rate of progression from nonuse to initiation (i.e., age at first drink). Heritable contributions to the rate of movement through successive drinking milestones were attributable to a common factor, whereas environmental influences were transition-specific.
Conclusions
The current study is unique in its use of a genetically informative design to document the rate of movement between drinking milestones in a female sample and to examine genetic contributions to multiple transition times over the course of AD development. Results indicate that an earlier report of heritability for males in rate of progression from regular drinking to AD generalizes to women and to other alcohol stage transitions. Findings also suggest the need to consider stage-specific environmental contributions to alcohol outcomes in developing interventions.
doi:10.1111/j.1530-0277.2008.00621.x
PMCID: PMC3593341  PMID: 18331380
Alcohol Dependence; Genetics; Women; Transition; Course
19.  Association of parents' alcohol use and family interaction with the initiation of alcohol use by sixth graders: A preliminary study in Taiwan 
BMC Public Health  2009;9:172.
Background
The family is the main environment where children are socialized and learn individual behavior. Although previous studies have examined predictors of preadolescent first alcohol use, few studies have analyzed factors associated with alcohol use in children in a country with low alcohol consumption. The aim of this study was to investigate the initiation of alcohol use by sixth graders and determine family factors associated with first alcohol use.
Methods
Data used in this study was collected as part of the Child and Adolescent Behaviors in Long-term Evolution (CABLE) project in 2002 (when study participants were in grade 5 and aged 10–11 years) and 2003 (when study participants were in grade 6 and aged 11–12 years). Data from a total of 1,183 participants was analyzed. Main study variables included children's alcohol use: (1) never user (never user in 2002 and 2003), or (2) first-time user (never user in 2002 but ever user in 2003); parents' alcohol use: (1) both parents ever users, (2) mother ever user and father never user, (3) father ever user and mother never user, (4) both parents never users; parental support; and family conflict. Correlates of first alcohol use were identified using logistic regression.
Results
There were 183 students (15.5%) who became first-time users of alcohol in the sixth grade. Having parents who both used alcohol, less parental support, and more family conflict were significant predictors of sixth graders' first alcohol use. Family interaction and parents' drinking were equally important predictors of preteen's first use of alcohol.
Conclusion
Family factors influence children's initiation of alcohol use. It is important to educate parents about the effects of alcohol on children and to emphasize the importance of prevention.
doi:10.1186/1471-2458-9-172
PMCID: PMC2702380  PMID: 19497107
20.  Alcohol and Risky Sexual Behavior among Heavy Drinking College Students 
AIDS and behavior  2008;14(4):845-853.
Multiple event-level methodology was used to examine the relation between risky sexual behavior and alcohol use among sexually active, heavy drinking college students (N = 221). Using a structured timeline followback interview, participants reported their sexual, alcohol, and drug use behaviors over a 3-month period. Over 2,700 vaginal or anal sexual events were reported from 177 participants. Overall, condom use was not associated with heavy or non-heavy alcohol consumption among those reporting both sexual events concurrent with heavy drinking and when no alcohol was consumed. Results from multilevel regression analyses revealed a more complex pattern. Among women, but not men, less condom use was associated with steady vs. casual sexual partners, but partner type interacted with alcohol consumption such that less condom use occurred when heavy drinking preceded sex with steady partners. At the event-level, alcohol consumption among heavy drinking college students leads to risky sexual behavior but the relation differs by gender and partner type.
doi:10.1007/s10461-008-9426-9
PMCID: PMC2982799  PMID: 18648928
condom use; alcohol use; HIV risk behavior; sexual behavior; event-level analysis
21.  Peer selection and influence effects on adolescent alcohol use: a stochastic actor-based model 
BMC Pediatrics  2012;12:115.
Background
Early adolescent alcohol use is a major public health challenge. Without clear guidance on the causal pathways between peers and alcohol use, adolescent alcohol interventions may be incomplete. The objective of this study is to disentangle selection and influence effects associated with the dynamic interplay of adolescent friendships and alcohol use.
Methods
The study analyzes data from Add Health, a longitudinal survey of seventh through eleventh grade U.S. students enrolled between 1995 and 1996. A stochastic actor-based model is used to model the co-evolution of alcohol use and friendship connections.
Results
Selection effects play a significant role in the creation of peer clusters with similar alcohol use. Friendship nominations between two students who shared the same alcohol use frequency were 3.60 (95% CI: 2.01-9.62) times more likely than between otherwise identical students with differing alcohol use frequency. The model controlled for alternative pathways to friendship nomination including reciprocity, transitivity, and similarities in age, gender, and race/ethnicity. The simulation model did not support a significant friends’ influence effect on alcohol behavior.
Conclusions
The findings suggest that peer selection plays a major role in alcohol use behavior among adolescent friends. Our simulation results would lend themselves to adolescent alcohol abuse interventions that leverage adolescent social network characteristics.
doi:10.1186/1471-2431-12-115
PMCID: PMC3469361  PMID: 22867027
22.  Differential Impact of a Dutch Alcohol Prevention Program Targeting Adolescents and Parents Separately and Simultaneously: Low Self-Control and Lenient Parenting at Baseline Predict Effectiveness 
Prevention Science  2012;13(3):278-287.
To test whether baseline levels of the factors accountable for the impact of the Prevention of Alcohol use in Students (PAS) intervention (self-control, perceived rules about alcohol and parental attitudes about alcohol), moderate the effect of the intervention. A cluster randomized trial including 3,490 Dutch early adolescents (M age = 12.66, SD = 0.49) and their parents randomized over four conditions: 1) parent intervention, 2) student intervention, 3) combined intervention and 4) control group. Moderators at baseline were used to examine the differential effects of the interventions on onset of (heavy) weekly drinking at 34-month follow-up. The combined intervention was only effective in preventing weekly drinking among those adolescents who reported to have lower self-control and more lenient parents at baseline. No differential effect was found for the onset of heavy weekly drinking. No moderating roles of self-control and lenient parenting were found for the separate student and parent interventions regarding the onset of drinking. The combined intervention is more effective among adolescents with low-self control and lenient parents at baseline, both factors that were a specific target of the intervention. The relevance of targeting self-control in adolescents and restrictive parenting is underlined.
doi:10.1007/s11121-011-0267-9
PMCID: PMC3353106  PMID: 22298017
Early adolescents; Alcohol use; Intervention; Randomized trial; Moderation
23.  Correlates of Early Alcohol and Drug Use in Hispanic Adolescents: Examining the Role of ADHD with Comorbid Conduct Disorder, Family, School, and Peers 
This study examined correlates of early adolescent alcohol and drug use in a community sample of 217 eighth-grade adolescents with behavior problems and from Hispanic/ Latino immigrant families. Structural equation modeling was used to examine relationships of multiple contexts (e.g., family, school, and peers) to alcohol and drug use. Results suggest that conduct disorder in youth with high levels of hyperactivity symptoms, poor school functioning, and peer alcohol and drug use was directly related to early adolescent alcohol and drug use. Attention deficit/hyperactivity disorder with comorbid conduct disorder and family functioning was indirectly related to early alcohol and drug use through poor school functioning and through peer alcohol and drug use. Results are discussed in terms of possible targets for interventions to prevent alcohol and drug use in Hispanic adolescents.
doi:10.1080/15374410802359676
PMCID: PMC2916647  PMID: 18991132
24.  Rationale, design and methods of the HEALTHY study behavior intervention component 
International journal of obesity (2005)  2009;33(Suppl 4):S44-S51.
HEALTHY was a multi-center primary prevention trial designed to reduce risk factors for type 2 diabetes in adolescents. Seven centers each recruited six middle schools that were randomized to either intervention or control. The HEALTHY intervention integrated multiple components in nutrition, physical education, behavior change and communications and promotion. The conceptual rationale as well as the design and development of the behavior intervention component are described. Pilot study data informed the development of the behavior intervention component. Principles of social learning and health-related behavior change were incorporated. One element of the behavior intervention component was a sequence of peer-led, teacher-facilitated learning activities known as FLASH (Fun Learning Activities for Student Health). Five FLASH modules were implemented over five semesters of the HEALTHY study, with the first module delivered in the second semester of the sixth grade and the last module in the second semester of the eighth grade. Each module contained sessions that were designed to be delivered on a weekly basis to foster self-awareness, knowledge, decision-making skills and peer involvement for health behavior change. FLASH behavioral practice incorporated individual and group self-monitoring challenges for eating and activity. Another element of the behavior intervention component was the family outreach strategy for extending changes in physical activity and healthy eating beyond the school day and for supporting the student's lifestyle change choices. Family outreach strategies included the delivery of newsletters and supplemental packages with materials to promote healthy behavior in the home environment during school summer and winter holiday breaks. In conclusion, the HEALTHY behavior intervention component, when integrated with total school food and physical education environmental changes enhanced by communications and promotional campaigns, is a feasible and acceptable mechanism for delivering age-appropriate social learning for healthy eating and physical activity among an ethnically diverse group of middle school students across the United States.
doi:10.1038/ijo.2009.116
PMCID: PMC2747742  PMID: 19623189
middle schools; type 2 diabetes; prevention; peer influence; behavior modification
25.  Who Needs Liquor Stores When Parents Will Do? The importance of social sources of alcohol among young urban teens 
Preventive medicine  2007;44(6):471-476.
Objectives
Examine sources of alcohol over time in a large, ethnically-diverse adolescent population from a poor, urban environment.
Methods
Surveys were administered at four time points (6th–8th grades) assessing demographic characteristics, past year alcohol use, and sources of alcohol to youth in Chicago, Illinois 2003–2005. Growth curve analysis was used to examine alcohol access trends among all alcohol using youth and consistent alcohol users. Interactions by race and gender were tested.
Results
Social sources of alcohol were the most prevalent source over time. Parents were the primary source of alcohol, but their prominence significantly decreased over time. Taking alcohol from home, and getting alcohol from other adults, individuals under age 21, and commercial sources significantly increased as sources of alcohol over time. Males were significantly more likely than females to get alcohol from commercial sources and friends’ parents.
Conclusions
Greater attention for reducing social access to alcohol, particularly among parents, is needed for alcohol prevention efforts prior to and during middle school.
doi:10.1016/j.ypmed.2007.02.018
PMCID: PMC1987716  PMID: 17428525
adolescents; urban; diverse; race/ethnicity; alcohol; prevention; intervention; group randomized trial; Project Northland Chicago; commercial; alcohol sources; social access; growth curve modeling

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