Translating Family-Focused Prevention Science into Public Health Impact: Illustrations from Partnership-Based Research

By Spoth, Richard L.; Schainker, Lisa M. et al. | Alcohol Research, Fall 2011 | Go to article overview

Translating Family-Focused Prevention Science into Public Health Impact: Illustrations from Partnership-Based Research


Spoth, Richard L., Schainker, Lisa M., Hiller-Sturmhoefel, Susanne, Alcohol Research


Underage drinking is a serious public health concern that places an enormous burden on affected youth, families, communities, and society as a whole. The pervasiveness of the problem is illustrated by findings from the Monitoring the Future Survey (Johnston et al. 2010), showing that even among 8th graders, about 15 percent had consumed alcohol in the month preceding the survey; this increased to almost 45 percent among 12th graders (see table 1). Furthermore, a significant proportion of the youth surveyed reported that they had been drunk in the month preceding the survey.

In addition to being illegal, underage drinking is especially worrisome because it can have a long-term or, in some cases, lifelong impact on an adolescent's physical and intellectual development. For example, alcohol consumption might adversely affect the still-developing brain, causing potentially lasting changes in brain structure and function that are likely to negatively influence the individual into adulthood (Tapert and Schweinsburg 2006; Tapert et al. 2008). Also, adolescents who indulge in heavy drinking are likely to engage in risky behaviors, such as drinking and driving; traffic accidents pose the single greatest mortality risk associated with underage drinking (Grunbaum et al. 2002; Hingson and Kenkel 2004; Hingson et al. 2005). Likewise, alcohol-related risky sexual behavior (e.g., unprotected sexual activity) can lead to consequences such as sexually transmitted diseases and pregnancy (Grunbaum et al. 2002; Hingson et al. 2004; National Institute on Alcohol Abuse and Alcoholism [NIAAA] 1993). Moreover, adolescents who drink alcohol are at increased risk for behavioral problems, such as delinquency, violence, and poor academic performance (Hingson et al. 2002; Substance Abuse and Mental Health Services Administration [SAMHSA] 2008) and mental health problems, such as depression and suicidality (NIAAA 1997; Swahn et al. 2008; Windle and Windle 2001). Finally, underage drinking increases the risk for using other drugs during late adolescence and into adulthood (Ellickson et al. 2003) as well as for developing alcohol use disorders (AUDs)--that is, alcohol abuse and dependence--during adulthood (Dawson et al. 2008; Grant and Dawson 1997). In addition, these consequences of underage drinking result in substantial economic costs, which have been estimated to be approximately $62 billion per year (Foster et al. 2003; Levy et al. 1999).

Studies on the etiology of adolescent problem behaviors such as underage drinking indicate that such problems are influenced to a large extent by family factors. These influences can both increase the risk of problem behaviors and protect against the development of such behaviors. Thus, a family history of AUDs or certain parenting behaviors (e.g., inconsistent or harsh discipline) can increase a child's risk of early alcohol use and later development of AUDs (Hussong et al. 2008; Latendresse et al. 2008). At the same time, family factors can reduce the likelihood that an adolescent will experience alcohol-related problems. Most importantly, an effective, positive parent-child relationship--characterized by child monitoring, parental involvement in the child's day-to-day activities, and parent-child bonding or affective quality--provides a scaffold that helps children and adolescents develop the adaptive skills (e.g., self-regulation, emotion, and behavior) needed to protect themselves from underage alcohol and other drug (AOD) use (Elias et al. 1997; Masten and Coatsworth 1998; Mrazek and Haggerty 1994).

Because family influences are so pivotal in shaping adolescent problem behaviors, much research has centered on family-focused prevention approaches to reduce problem behaviors. For example, many well-designed studies have demonstrated that family-focused interventions (e.g., programs that focus on parenting practices, such as parent-child communication, parent-child bonding, and effective family management) can reduce problem behaviors in children and adolescents. …

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