Multilevel influences of school and family on alcohol-purchasing behaviors in school-aged children.

BACKGROUND

Little has been known about children's illegal alcohol purchasing behaviors and associated contextual factors influencing commercial accessibility to alcohol. The aims are to determine multilevel effects of school- and family-characteristics on children's alcohol purchase and to probe possible drinking experience-related heterogeneity in such links.

METHODS

A representative sample of 2630 4th- and 6th-graders in an urban region of Taiwan in 2007 was drawn via multistage probability sampling. Information about family background and individual drinking experiences was collected via paper-and-pencil self-administered questionnaires; school neighborhood characteristics were assessed via commercial datasets of geographic information system.

RESULTS

Roughly one in nine 10-12-year-old children ever purchased alcoholic beverages by 6th grade. Children who did not participate in after-school programs or had observed parental drinking had 2-3-fold increased risk to buy alcoholic beverages alone. Living with one or none of parents was associated with alcohol purchase in children who never drank alcohol (Odds Ratio [OR]=3.51; 95% Confidence Interval [CI]=2.14, 5.76). School contextual characteristics have salient effects on minors' alcohol accessibility from commercial sources (e.g., the density of nearby educational institutions, OR=0.33-0.53), and certain school neighborhood effects were notably different by children's drinking experience (e.g., the density of public transportation).

CONCLUSIONS

The present study suggests the significant effects of family socioeconomics, family drinking, and school neighboring environment on children's independent alcohol purchase, which may operate differentially by one's drinking experience. Our findings may provide implications that family and school neighborhood contexts should be considered in the devising and delivery of underage drinking prevention programs.