A new study at University of Florida (UF) has cited that it is more difficult to keep middle schoolers away from alcohol in urban areas than in rural areas, even though the experts with the best prevention programs are in the city.
The three-year, three-pronged prevention program led by Kelli A. Komro, a UF associate professor of epidemiology in the UF College of Medicine, did not do much for keeping Chicago middle schoolers from drinking or using drugs, despite its prior success in rural Minnesota, where the program reduced alcohol use 20 to 30 percent.
"The intervention found to be effective in rural areas was not effective here, which really surprised us. This is an important finding to realize this program was not enough. The bottom line is this: Low-income children in urban areas need more, long-term intensive efforts," said Komro.
The study also pointed out that adolescents who drink by age 15 (about half of teens) are more likely to struggle in school, abuse alcohol later in life, smoke cigarettes and use other drugs than those who don't. In fact, according to a 2007 U.S. Surgeon General report, exposure to alcohol at a young age may even damage the developing brain.
"Almost any problem kids might have, alcohol increases that risk," said Komro.
The researchers targeted middle-school-age children, in the hope to reduce these risks and studied 5,812 sixth-, seventh- and eighth-graders from mostly low-income communities in Chicago, randomly dividing the neighbourhoods into two groups: those who would participate in the prevention program and those who would not.
The program included three preventive approaches to communicate the message that drinking is not acceptable in school, at home and in the community.
In participating schools, an alcohol prevention curriculum was used in the classroom. Komro said that students led these sessions because the prevention messages are more accepted when they come from peers instead of teachers. The family component included homework assignments that parents and children could complete together, organized events for families, and educational postcards with helpful hints that were sent to parents. For the community aspect of the program, researchers hired organizers to work with community volunteers to change the risks and problems with teen drinking in their neighbourhoods.
However, when the study ended, year-end surveys displayed no difference in alcohol use among the teens who took part in the project and those who did not. It was found that at least 70 pct of the schools in the neighbourhoods that did not use the program had some form of drug and alcohol prevention program in the schools. Komro said that it's unlikely that these programs skewed the results of the study though.
One particular problem surfaced during the community component of the project. The organizers had a difficult time in bringing together some community members around the cause, often having to explain why they should be concerned about adolescent alcohol use. This led the researchers to know why the program did not work there.
"People in these areas are concerned with housing, they're concerned with gangs and other drug use. There was a whole upfront effort where we had to educate people about how alcohol was related to those other issues, and that it was an important issue to think about with their young people. We know from other studies in low-income, urban neighborhoods, there is a higher concentration of alcohol outlets, compared to suburban or rural areas. There were a lot of alcohol ads around these schools and a greater density of pro-alcohol messages these children are exposed to. You mix that with the poverty level and it's just a high-risk environment," said Komro.
Komro said that despite the overall results, there were positive findings that researchers hope to build on.
Of all the components, the family interventions had the most significant effects. And one aspect of the community project worked well: Half of the community teams went to stores that sold alcohol and asked merchants not to sell to underage kids. In those communities, the ability of young people to buy alcohol went down 64 percent.
The study was reported in the online edition of the journal Addiction.