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Nikolaus Koutakis

Reducing youth alcohol drinking through a parent-targeted intervention: the Örebro Prevention Program . Nikolaus Koutakis. enter for Developmental Research. UNIVERSITY OF ÖREBRO. SWEDEN. Heilsueflandi skólar , Reykavik, 9 th Aprill 2010.

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Nikolaus Koutakis

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  1. Reducing youth alcohol drinking through a parent-targeted intervention: the Örebro Prevention Program Nikolaus Koutakis enter for Developmental Research UNIVERSITY OF ÖREBRO SWEDEN Heilsueflandi skólar , Reykavik, 9th Aprill 2010

  2. Externalizing problem behaviors increases over the teenage years.

  3. (r= .55, p < .001) The percentage of youth who said they have been drunk and percentage of parents who had found their youth drunk %

  4. How do parents react to this?

  5. Parent’s reactions to youth’s problem behavior. • Longitudinal evidence that parents reaction to youth problematic behaviors is to resign and take a few steps back resulting in less parenting behaviors. Glatz (in press)Huh, Tristan, Wade & Stice (2006) Huver, Engels, Vermulst & de Vries (2007)Kerr, Stattin & Pakalniskiene (2008)

  6. We know more about how parenting styles is related to youth adjustment e.g.: Baumrind (1989; 1991) Collins, Maccoby Steinberg, Hetherington & Bornstein, (2000) Crouter & Head (2002 )Dishion & McMahon (1998) Gray & Steinberg (1999) Kerr & Stattin (2000)Loeber, Farrington, Stouthamer-Loeber, & van Kammen (1998) Stattin & Kerr (2000)

  7. > 10 times Parents attitudes towards 16-year olds alcohol drinking in relation to the children’s actual drinking. 40 35 30 Parents attitude 25 % 20 Restrictive Permissive 15 10 5 0 Never Drunkenness in the latest year

  8. Child perspective: Parents are legitimate authorities

  9. Percentage of youths who accept or do not accept parents limit setting for different types of prudential and personal issues

  10. Parents can and are expected to be clear authorities within their family

  11. ÖPP rests on the principle that parents have an important role in regulating their youth

  12. So, parents are important but are they motivated? Do we need to motivate parents? A common assumption is that parents of early adolescents are concerned about this issue and therefore highly susceptible and motivated to participate in prevention strategies.

  13. Are parents in general concerned? Do parents have worries that their children will get in to trouble because of alcohol drinking?

  14. Youth self report 45 Parent report Amount of youth that believes that their parents worry about their children's alcohol consumption in relation to their parents’ report about their worries. 40 35 30 25 % 20 15 10 5 0 age 13 14 15 16

  15. Parents in general do not worry to the same extent as the youths believe.

  16. We expected increasing levels of parent worries as the child grows older. • Parents are more likely to have caught their child drunk the older the child is. • This awareness ought to make parents concerned.

  17. 45 Parent caught the child drunk Parents get increasing experiences of seeing their child drunk but parent worries are not affected by their experiences of seeing the child drunk. 40 35 Parent worries 30 25 % 20 15 10 5 0 Childs age 13 14 15 16

  18. Parents in general do not seem to worry. • If parents do not worry about underage drinking they are not motivated to engage in actions aiming to reduce it.

  19. Target: Parents to 13-15 year olds. • Administration: Ordinary school meetings. • Dose: 15-20 minutes per semester (m=5; age 13-16). • Active substance: Facts and arguments. • Side effects / limits: Not a cure for al. • Administer in any community without any cost

  20. Prerequisites for preventing underage drinking when working through parents Prevention programs targeting parents in order to reduce underage drinking should work through a strategy to influence and question common ideas and parental practices.

  21. First stage: Open parents’ eyes • Initially, focus on making parents aware of the problems with underage drinking, even to the extent that negative emotions are evoked. • Purpose: to make parents more open to suggestions for change.

  22. Second stage: Change parents’ ways of thinking about underage drinking • Tear down parental misconceptions about youth drinking, such that most youths drink and it is not possible to change the situation. • Parents should become aware that their attitudes and behavior matters. Powerlessness  Empowerment

  23. Third stage: Implement specific techniques Parents should be taught clear and simple rules about how to prevent and handle their adolescent’s drinking behavior.

  24. ÖPP is a three stage rocket Empower Provide tools Concern

  25. What if we try to maintain parents restrictive attitudes toward underage drinking; Will this have an impact on their children's alcohol drinking? Koutakis, N., & Stattin, H.

  26. Content • Information on underage drinking: • Parent values matter • About letting the child drink • Consensus agreement. • Having clear and restrictivehouse rules. • Concluding letter to al Parental agreement We, the parents of class 7a have agreed to the following common rules regarding our children loremipsumloremipsum l oremimsumloremipsumloremimsumloremipsumlorem --------------- signature

  27. Means for parent-reported restrictive attitudes toward underage drinking at grades 7, 8 and 9 for parents in the intervention and control groups.

  28. Repeated measures ANOVA displaying self reported drunkenness (a) and delinquency (b) separately for youths in the intervention and control conditions.

  29. Repeated measures ANOVA for a subsample of early starters in drunkenness and delinquency displaying self reported drunkenness (a) and delinquency (b) separately for youths in the intervention and control conditions.

  30. Effect Size Number needed to treat for one to benefit =7.7 / 7.1

  31. Conclusions • Any effective prevention program must focus on important conditions that are realistic to alter. • In order to be able to mobilize parents, it is crucial to have them motivated. • Parent attitudes and parenting practices concerning underage drinking matter. • The ÖPP approach is effective in maintaining parents restrictiveness and thereby decrease underage drunkenness.

  32. Underagedrunkenness Parent restrictive attitudes Normal trajectory More Less 15 Age 13 14

  33. ÖPP results More Parent restrictive attitudes Underagedrunkenness Less 15 Age 13 14

  34. nikolaus.koutakis@oru.se Center for Developmental Research UNIVERSITY OF ÖREBRO

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