Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, CB # 7440, Chapel Hill, NC, 27599, USA.
Prev Sci. 2019 Aug;20(6):811-823. doi: 10.1007/s11121-018-0946-x.
Several school- and family-based preventive interventions target and effectively reduce adolescent alcohol misuse. However, whether demographic groups achieve equal success with these interventions is unclear. In particular, most interventions target younger adolescents, and program effectiveness tends to be measured with majority White samples; subgroup analyses are rarely reported. We analyze longitudinal data from a sample of N = 6189 adolescents (40% Black, 60% White; 50% female) in 6th through 12th grade to quantify the degree to which age, race, and gender moderate the associations between seven well-known risk and protective factors (RPFs) that serve as common intervention targets. The RPFs that we study are drawn from social learning theory, problem behavior theory, and social control theory, including individual factors (positive alcohol expectancies and deviant behavior), family context (perceived parental involvement, perceived parent alcohol use, and access to alcohol), and peer context (descriptive and injunctive norms). Multilevel growth models allow us to conduct the demographic subgroup moderation analysis. Results suggest that these well-studied RPFs explain alcohol involvement to varying degrees, but they explain substantially more variation in alcohol involvement by White adolescents compared with Black adolescents. We find differential patterns of significance and of leading predictors of alcohol involvement as a function of age, race, and gender and the interactions thereof. These results indicate that the prevention field needs to better understand the RPFs affecting minority and high school youth in order to provide a stronger basis for alcohol prevention efforts.
有几种基于学校和家庭的预防干预措施针对青少年酗酒问题,并有效地减少了青少年酗酒现象。然而,这些干预措施是否能使不同的人群取得同等的成功还不清楚。特别是,大多数干预措施针对的是较年轻的青少年,而项目的有效性往往是通过以白人为主的样本进行衡量的;很少有报告进行亚组分析。我们分析了来自一个 6 至 12 年级的 N = 6189 名青少年(40%为黑人,60%为白人;50%为女性)样本的纵向数据,以量化七个著名的风险和保护因素(RPF)与年龄、种族和性别之间的关联程度,这些因素是常见的干预目标。我们研究的 RPF 来自社会学习理论、问题行为理论和社会控制理论,包括个体因素(积极的酒精预期和偏差行为)、家庭环境(感知到的父母参与、感知到的父母饮酒和获得酒精的途径)和同伴环境(描述性和规范性规范)。多层次增长模型使我们能够进行人口统计学亚组调节分析。结果表明,这些经过充分研究的 RPF 在不同程度上解释了酒精摄入,但与黑人青少年相比,它们在解释白人青少年的酒精摄入方面有更大的差异。我们发现,随着年龄、种族和性别以及它们之间的相互作用的变化,酒精摄入的显著性和主要预测因素的模式也会发生变化。这些结果表明,预防领域需要更好地了解影响少数民族和高中生的 RPF,以便为酒精预防工作提供更坚实的基础。