Faculty of Medicine, University of the Ryukyus.
Faculty of Education, University of the Ryukyus.
J Epidemiol. 2019 Oct 5;29(10):384-390. doi: 10.2188/jea.JE20180125. Epub 2018 Sep 15.
It is unclear whether either neighborhood collective efficacy or school collective efficacy is associated with adolescent alcohol use. This study aimed to examine the relative contributions of collective efficacy, both in school and in the neighborhood contexts, to alcohol use among Japanese adolescents.
A cross-sectional study was conducted in public high schools across Okinawa and Ibaraki Prefectures in Japan in 2016. The study participants consisted of 3,291 students in grades 10 through 12 cross-nested in 51 schools and 107 neighborhoods. Alcohol use was measured as current alcohol drinking, which was defined as self-reported drinking on at least 1 day in the past 30 days. Collective efficacy was measured using scales of social cohesion and informal social control in school and the neighborhood. Contextual-level collective efficacy was measured using aggregated school-level and neighborhood-level individual responses, respectively. We used non-hierarchical multilevel models to fit the cross-nested data.
Significant variation in alcohol use was shown between schools but not between neighborhoods. After adjusting for covariates, school collective efficacy at individual- and contextual-levels was protectively associated with alcohol drinking (odds ratio [OR] for the increase of one standard deviation from the mean 0.72; 95% confidence interval [CI], 0.63-0.82 and OR 0.61; 95% CI, 0.49-0.75, respectively), whereas neighborhood collective efficacy at individual- and contextual-levels was not associated with alcohol consumption.
The school-level associations of collective efficacy with adolescent alcohol use may have the greater impact than the neighborhood-level associations. Adolescent drinking prevention efforts should include enhancing school collective efficacy.
目前尚不清楚邻里集体效能或学校集体效能是否与青少年饮酒有关。本研究旨在检验集体效能（包括学校和邻里环境中的集体效能）对日本青少年饮酒行为的相对贡献。
本研究于 2016 年在日本冲绳县和茨城县的公立高中进行了一项横断面研究。研究对象包括 3291 名 10 至 12 年级的学生，他们嵌套在 51 所学校和 107 个邻里中。饮酒行为通过当前饮酒情况来衡量，定义为过去 30 天至少有 1 天饮酒。学校和邻里的社会凝聚力和非正式社会控制量表用于测量集体效能。分别使用学校层面和邻里层面的个体反应来衡量社区层面的集体效能。我们使用非层次多水平模型来拟合交叉嵌套数据。
学校之间的饮酒行为存在显著差异，但邻里之间没有差异。在调整了协变量后，个体和社区层面的学校集体效能与饮酒行为呈保护相关（个体层面每增加一个标准差的比值比 [OR] 为 0.72；95%置信区间 [CI]，0.63-0.82；社区层面 OR 为 0.61；95% CI，0.49-0.75），而个体和社区层面的邻里集体效能与饮酒行为无关。
学校层面的集体效能与青少年饮酒行为的关联可能比邻里层面的关联更具影响力。青少年饮酒预防工作应包括增强学校集体效能。
