Alcohol and adolescents

JOURNAL OF ADOLESCENT HEALTH CARE 19889194302

PBRNEY,

@I

ANN

F

EY, P

that the majority of edge level (6-10) and attitudes toward alcohol (II15), while realizing only modest or insignificant changes in alcohol use (6-10). It appears that attitudes

about alcoholwere

more

conservative atti@des d(p<0*oolmll$te8 owledge test and had m

uses as well as the negative aspects of

KEYWORDS: Alcohol use Almhol kt~owledge

Akuhol attitudes

School-based alcohol-education programs have historically focused on providing knowledge about alcohol and the ramifications of its use. Emphasis has also been placed on changing the student’s attitudes toward alcohol use as a means of preventing or modifying drinking behavior (l-5). Research suggests

Fnotftth MedicalCollege of Geo@u (P.D.F., M.A.F.) and the University ofGm@ W.K.R.). MEB nprint raluffts to: Putt1D. Forty, M.D., Departmentof Family Medicine, Medicd Collegeof Georgia,Augusta, GA 30912. Man*

acupt4d March 23,1987.

than blacks (22,X-30); and alcohol use increases with age (16,26,30,31). The purpose of this stu knowledge, attitudes, and use of alcohol were correlated and if tions are mediated through study also examined the students’ sources of information about alcohol and whether these sources interacted with age, sex, and race to affect knowle and attitude.

Methods Three instruments were modified for use in this study, and they were designed to ascertain the s dents’ 1) knowledge level regarding the nature an effects of alcohol, 2) attitudes toward the use of alcohol, and 3) drinking behavior. Each instrument had been validated in a previous s panel of five experts in the field of alcohol use/abuse

-. Published by Elsevier

Q Societyfor Adolescent Medicine, 1988 _~ _... SciencePublishing Co., Inc., 52 Vanderbilt Ave., New York, NY 100117

May 1988

ALCOHOL AND A

ere

a

was no

was obtained as an index of internal con-

1

JOURNAL OF ADOLESCENT WEALTH CARE Vol. 9, No. 3

FORNEY ET AL.

ofa = 0.82; the second, attitude toward socially acceptable uses of alcohol (k = 4), had an estimate of reliability of a = 0.69. Acceptable uses included having a drink during family meals, on a special occasion such as a wedding or birthday, for a religious purpose, and at a social function if alcohol is not the main reason for the function. Unacceptable uses included getting drunk, solving problems, because it is “macho,” and to overcome shyness.

p
e and

instrument was obtained by scoring each item as correct or incorrect and summing the total of correct responses. Thus, the scores for the knowledge measure (k = 14) could range from 0 to 14. Obtaining a score for each attitude measure was more complex. Some of the items were worded negatively. Where necessary, items related to unacceptable uses were recoded so that a response on the low end of the Likert scale indicated a conservative attitude, while a response at the upper end of the scale showed a more liberal attitude. Conversely, for the “acceptable use” scale, a low-numbered response indicated a more liberal attitude and a highnumbered response showed a conservative attitude. Thus, the two scales were scored consistent with what we considered a desirable. Conservative attitudes for unacceptable uses an liberal attitudes for by low scores. This acceptable uses are both denot relationship is graphically depicted as follows: Score Unacceptable uses Acceptable uses

Low ConservativeLiberal-

b f-hgh Liberal Conservative

A mean score was obtained for each scale, these means could range from 1 to 5.

Results Means, SDS, and numbers for the total sample and for each category of age, sex, and race are presented in Table 1 for the knowledge scores and the two attitude scores. Table 2 provides the intercorrelations between the knowledge scores and the two attitude scores for the total sample and for each category of age, sex, and race. An examination of this table shows that, because of the large sample size, relatively small coefficients are statistically significant (e.g., r= -0.07,

alcohol. Students were consistent attitude toward unacceptable and

cohol and attitude toward act dents who scored hi nt had more liberal

categories, for whites, and for

An analysis of variance was used to pothesis that the source of information and race do not affect knowle esis was rejected for the 5, pCO.ooO1) and for

The SOI main effect and the race-by-age interaction were examined in further detail. A simple effects analysis was used for the race-by-age interaction. Figure 1 presents this interaction, depic the least squares mean knowledge scores for and for minority by age. ysis were applied to tbi Neuman-Kuel’s multiple comparison tests using harmonic means (33) was used to determine if the

At-I&de:

M-15 16-17

5.2 5.5

2.0 2.3

227

1.7

0.5

7.2 8.5 8.6

3.0 3.1 3.Q

761

I.8 1.8 1.9

0.6 0.6 0.6

1 1

8.2 6.1

3.1 2.7

1 1

1. 1.

1418

7.5

3.2 3.1

I.395

2.0

775 469

227 635 761

3.1 2.9 2.7 2.5 2.3

0.9 0.9 0.9 O-9 0.8

0.6 0.6

1669 1266

2.5 2.8

0.9 0.8

0.7 0.5

1395 1

2.6 2.7

0.9 0.9

Att 2

Att 1

Att2

-0.22b -O.Z#

-0.08

Total sample Att 1

Att2

Att 1

Att 2

Attl

Att2

Att 1

Att 2

Att 1

-o.lsb -0.39

-0.11”

BY AGE (yr) < 12

Knowledge Attl

-0.f.P

-0.24” - o.36b

-0.19

-0.08 -0.406

12-13

-0.05

-0.07 -0.3P

BY RACE w?IITE owledge

-0.07b

Attl

-0.26b -0.3bb

-0.03

- 0.24’ - 0.45b

MINORITY

-0.P

-0.P - o.2Lsb 5Y SEX

Knowledge Att P

-0.07+

-0.2bb -0.3@

MALE -0.13’ -0.24b -0.3bb

FEMALE -0.05’ --2;

14-15

- .15b

lb-17

> 17

-0.2ob -031b

198

JOURNALOF ADOLESCENTHEALTH CARE Vol. 9, No. 3

FORNEY ET AL.

Table 3. Results of Analysis of Variance for Knowledge Scores

sumsof

source Sourceof information(SO!: Sex

Race Age SO1 x sex so1 x race SO1 x age Sex x race Sex x age Racexage so1 x sex x race SO1 x sex x age SO1 x race X age Sex x race x age SO1 x sex x age x race &Km corrected total

df

squares

F

4 1 1 4 4 4 16 1 4 4 4 16 16 4 16 2449 ZG

577.26 18.86 1137.03 2604.55 10.42 17.52 119.45 0.10 6.16 333.49 25.81 57.78 67.27 41.85 111.68 15063.69 24275.89

23.46* 3.07 184.85” 105.86’ 0.042 0.71 1.21 0.02 0.25 13.55’ 1.05 0.59 0.68 1.70 1.14

effect on attitude toward unacceptable uses of alcohol (F = 13.87, p&001), but not on a ward acceptable uses of alcohol. p=O.OOi)and age (F = 3.42, p
attitudes

toward

unacceptab

“p c 0.001.

age by SO1 interaction was not statistically significant, this process appears to take place independent of the source of information about alcohol. A post hoc examination of the SOI main effect showed that students who indicagd school as their primary source of information (X=7.61) about alcohol had a higher knowledge level about alcohol th_an those students who reported that friends (X=&.67), written media (X,= 6.52), audiovisual media (X=6.48), or parents (X=6.22) were their main source of information. Students who felt that their friends were their main source scored statistically higher on the alcohol-knowledge instrument than those whose parents were their main source.

attitudes toward unacsp either written media (X= Parents as the SOI had more im wjth respect to the attitude (X= 1.80) than did friends -Students in the 12-13 (X=1.90) year age bracke liberal attitudes toward un er 12 years of age. For the impact of age on acceptable uses of alcohol, aII comparisons between the least square means were statistically significant. As students become o more liberal in their attitude as to alcohol.

e Scores A multivariate analysis of variance (MANOVA) was used to examine simultaneously the effects of SOI, sex, age, and race on the two attitude scores. The results are found in Table 4. Wilk’s Lambda was the test statistic used for the multivariate test with the alpha set at 0.01. For this omnibus test, such of the four main effects were found to have significantly impacted the vector of attitude scores (Table 4). No interaction was statistically significant at the 0.01 level. The results of the corresponding univariates for the four main effects are shown in Table 5. Source of information (SOI) had a statistically significant

Frequency data on the drinking behavior of dents revealed that 80.5% of the students had alcohol at some time, with 31.6% claiming first tried alcohol before the age of 11 years. Current drinking habits of the students were 43.4% abstainers, 38.3% light drinkers, 5.6% frequent drinkers, and 12.7% heavy drinkers. A moderate and meaningful relation found between drinking behavior and scores for the total sample (Y= 0.27,pC more liberal the students’ drinking b higher the score on lationship does not exist in a meaningful sense

re I. Age by me interaction with knowledge scores as dependent zminble. i&m is gmphcd by age categories.

It is apparent that t+e relationship behavior and knowledge scores is

The correlation between d

JOURNAL OF ADOLESCENT HEALTH CARE Vol. 9, No. 3

Figure 2. Age by race interaction with knuwledgescoresis dependent variable. Age (years1is graphed by racecategories.

Discussion The results of our study suggest that relationships exist between a student’s knowledge, attitude, and behavior regarding the use of alcohol. A student to be a drinker has more knowlalcohol or6 liberal attitudes as to are acceptable and unacceptable uses of alcois consistent with the findings of previous studies (1649).

The fastest learning rate for knowledge about alcohol appeared to begin after age 13 years and end by 17 years of age, at which time it leveled off. Apparently, efforts to teach children about the nature and effects of alcohol have their greatest impact ing the junior high and high school periods, whereas trying to teach children at a younger age about alcohol may have little or no effect on their knowledge level. Our males and females did not differ significantly

SQUrce of ~~O~a~Q~ (SOI)

0.999

0.947 0.970 0.963

Ase

SOI SOI SOI Age

x x x x

S0I x SOI x SO1 x SO1 x “p

e

age race sex

0.995 6.992 0.

race

7.13” 18.12” 38.18 45.82” 1.41 1.05 0.66 I. 0. 0.

age x race

0.

0.96

race x sex age x sex age x sex x race

0. 0. 0.

0.46

o.ooi.

use: ai-.eptable uses and unacceptable uses. he-

Table 5. Univariate Results for Main Effects for Two Attitude Scores IvIaineffect Sources

of i~~o~atio~

Unacceptableuses Acceptableuses m (Q 13.87” 77.14”

Sex

Race Age

c 0.001. “p < 0.01.

“p

1.22

2.03 0.21 59.53” 27.70”

uses 0.

c 12

12-13 I4-i5 16-19 3 17

0.

0.03 0.17” 0.19

0.25”

0. 0. 0.

-0. -4. -0.

0.4Y

=-a

0.

-0.

FORMY ET AL.

ent or heavy drinkingamong adolescentsmust focus air ptimoting responsibledrinkingbehaviors and attitudes. Alcohol is part of our society and it seems clear that most adolescentswillexpe+ment with it. Leaviirg students to find out about alcohol in their own may lead to,serious consequencks.Effectivesources of islformationshould help stud&s decide when and how alcohol use is acceptabk. Thisstudy was funded by the National Institute on Alcoholism and Alcohol Abuse, Contract No. lR23 AAO6863-01.

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