Early Intervention to Engage Parents in Socializing Children Against Alcohol Use

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DESCRIPTION (provided by applicant): Nearly 40% of young people in the United States first consume alcohol by age 12. Initiation of alcohol use during childhood increases significantly the likelihood of habitual alcohol use, high risk alcohol use, and alcohol-related health risk behaviors during adolescence. Aim I: Develop a parent-child intervention designed to increase the likelihood of an alcohol-free childhood. The intervention will engage parents and children in activities that instill and reinforce attitudinal and behavioral norms against any underage consumption of alcohol. Within the context of normal parenting practices (e.g., communication, modeling, rule setting, monitoring), the intervention will, for example, enable parents to communicate norms that prohibit ever sipping another's drink with alcohol and ever having a drink of one's own; eliminate child access to alcohol products at home; eliminate any child involvement in adult alcohol use (e.g., fetching drinks); communicate family norms regarding child sipping, access, serving, etc. to relatives and other parents; teach children how to respond to peers or adults who might offer alcohol; counter pro-drinking images and messages from television and other media; and reinforce children for staying alcohol-free. This comprehensive program of protective alcohol use socialization will be modeled after a successful anti-smoking socialization intervention. Aim II: Conduct a two-group, randomized controlled trial to test the effect of the intervention on initiation of alcohol use by children. Recruit 1,406 mothers, stepmothers, or other female guardians who have an eldest 8-year old child who has never consumed alcohol for a nonreligious purpose. Randomize eligible participants who complete baseline telephone interviews to a treatment (intervention plus two annual boosters) or alternative control (fact sheet) condition. Evaluate implementation following delivery of each intervention unit. Measure intervention effects by interviewing children and mothers 1, 2, 3, and 4 years post-baseline. Test primary hypothesis: Children exposed to the intervention will be significantly less likely than controls to initiate alcohol use by age 12. Test secondary hypothesis: Among children who remain abstinent to age 12, those exposed to the intervention will have significantly lower susceptibility to initiating alcohol use than controls. Conduct analyses to identify mediators and moderators of intervention effects. PUBLIC HEALTH RELEVANCE: Early initiation of alcohol use increases significantly the likelihood of alcohol use, high risk alcohol use (e.g., binge drinking), alcohol-related problems (e.g., diminished school performance), and other health risk outcomes (e.g., motor vehicle injury or death; pregnancy) during adolescence. A primary prevention program is needed that begins during childhood, engages parents, and successfully promotes an alcohol- free childhood. This research project will design and evaluate a home-based alcohol use prevention program for parents and their elementary-school-aged children.