Theories and models supporting prevention approaches to alcohol problems among youth.

The Alcohol, Drug Abuse, and Mental Health Administration's Office for Substance Abuse Prevention (OSAP) was established to initiate programs to provide prevention and early intervention services for young people, especially high-risk youth. OSAP's starting point was the theories and models that provide the background body of knowledge. The models summarized here guide new prevention efforts and provide a framework for analyzing diverse experiences in the field. The goal has been to develop strategies based on theories and models of prevention that can reverse or prevent adolescent alcohol use. Among the psychosocial models, research in social learning theory is the theoretical basis for prevention efforts using the team approach among individuals, small groups, families, and communities. A prevention technique based on cognitive dissonance theory proposes verbal inoculations to establish or strengthen beliefs and attitudes, helping a young person to resist drinking, which may be in conflict with another, more desirable goal. In the developmental concept adolescence is a period of role confusion out of which the person's identity should emerge. Prevention efforts built on this view seek to help adolescents to form positive identities by achievement as students, athletes, and in community roles. Behavioral intention theory provides a framework for understanding the role of perceived social norms in directing behaviors. In the social development model, prevention programs should create positive peer groups and ensure that the social environment does not give mixed messages. Health behavior theory is the basis for prevention strategies directed toward a person's entire behavior instead of one aspect. The stages of the drug involvement model form the basis for prevention programs providing early intervention directed at the so-called gateway drugs.Among the communications models, the health promotion concept advocates a comprehensive approach in developing health campaigns and attention to the five major elements of the communications process. Mass media campaigns based on the communication-behavior change concept address the steps required to move a target population from initial awareness of interest in a problem to the adoption and maintenance of advocated attitudes or behaviors.Among public policy models, researchers have concluded that higher real prices on alcohol and restricted availability have the effect of lowering alcoholic beverage consumption among young people and the incidence of heavy and frequent drinking.Raising the minimum age for purchase has been found to reduce the rate of automobile accidents involving young persons. Essential components of prevention strategies and approaches are presented.