Normative feedback for parents of college students: piloting a parent based intervention to correct misperceptions of students' alcohol use and other parents' approval of drinking

Effects of the FITSTART + PBI on drinking and negative alcohol-related consequences during the first year of college

Objective: This study evaluated FITSTART+, a parent-based intervention (PBI), for preventing risky drinking among first-year college students. Participants: Participants were traditional first-year students aged between 17 and 20. Method: In total, 391 eligible students completed a baseline survey and their parents were then invited to use the FITSTART+ PBI or Control web-applications. 266 students had a parent who created a profile in the app (FITSTART+ PBI, n = 134; FITSTART+ Control, n = 132). Additionally, 58 parents randomized to the FITSTART+ PBI did not complete the personalized normative feedback (PNF) component of the intervention. Results: No significant effect on drinking or related consequences was detected between Intervention and Control groups. However, exploratory analyses revealed that completing PNF in the FITSTART+ PBI condition was associated with a greater likelihood of remaining zero on consequences at follow-ups. Conclusion: The PNF component of the FITSTART+ PBI showed potential in preventing risky drinking, warranting further research.

"Letting Go and Staying Connected": Substance Use Outcomes from a Developmentally Targeted Intervention for Parents of College Students

We present results of a randomized, controlled, efficacy trial of a handbook intervention for parents of first-year college students. The aim of the interactive intervention was to decrease risk behaviors by increasing family protective factors. The handbook, based in self-determination theory and the social development model, provided evidence-based and developmentally targeted suggestions for parents to engage with their students in activities designed to support successful adjustment to college. We recruited 919 parent-student dyads from incoming students enrolled at a university in the U.S. Pacific Northwest and randomly assigned them to control and intervention conditions. We sent handbooks to intervention parents in June before students' August matriculation. Research assistants trained in motivational interviewing contacted parents to encourage use of the handbook. Control parents and students received treatment as usual. Participants completed baseline surveys during their final semester in high school (time 1) and their first semester at college (time 2). Self-reported frequency of alcohol, cannabis, and simultaneous use increased across both handbook and control students. In intent-to-treat analyses, odds of increased use were consistently lower and of similar magnitude for students in the intervention condition than in the control condition, and odds of first-time use were also lower in the intervention condition. Contact from research assistants predicted parents' engagement, and parent and student report of active engagement with handbook predicted lower substance use among intervention than control students across the transition to college. We developed a low-cost, theory-based handbook to help parents support their young adult children as they transition to independent college life. Students whose parents used the handbook were less likely to initiate or increase substance use than students in the control condition during their first semester in college.ClinicalTrials.gov Identifier: NCT03227809.

"Let's Not Talk About It": Parents' Reasons for Not Discussing Alcohol Use With Emerging Adult Children

PURPOSE

It is unclear why parents avoid discussing alcohol use with their emerging adult (EA) children. Understanding parents' reasons for not communicating could inform parent-based interventions (PBIs) aimed at encouraging constructive discussions. The current study adds to the literature by examining common reasons parents avoid discussing alcohol use with their EA children.

METHODS

Parents of EAs completed a web-based survey that included items assessing reasons for not communicating about alcohol, as well as measures of alcohol communication intentions, parenting self-efficacy, relationship quality, and interest in participating in an alcohol PBI.

RESULTS

Results from the Exploratory Factor Analysis revealed five core reasons why parents do not communicate about alcohol: (1) they lack the skills or resources to communicate; (2) they believe their child is a nondrinker; (3) they believe their child is an independent, trustworthy decision maker; (4) they can teach their child how to drink through modeling; (5) they believe communication is futile. Believing that an EA could and should make their own alcohol decisions was the most common reason for not communicating. In multivariate analyses, this reason for not communicating was associated with greater levels of parental self-efficacy and perceiving a child to drink less alcohol. Further, this reason for not communicating was associated with lower intentions to communicate about drinking and less interest in taking part in a PBI.

DISCUSSION

Most parents reported barriers to communication. Understanding why parents are reluctant to discuss alcohol use could inform PBI efforts.

35-Year-Old Parents Do Not Approve of 17-Year-Olds' Cigarette, Marijuana, or Alcohol Use: U.S. National Data 1993-2018

PURPOSE

Parents' attitudes about adolescent substance use likely guide their parenting behaviors. This study documents prevalence of parents' disapproval of adolescent substance use and characteristics associated with disapproval.

METHODS

Survey data from national samples of 35-year-old parents from the U.S. Monitoring the Future study were collected 1993-2018. Multivariable logistic regression examined predictors of disapproving attitudes about substance use by a hypothetical 17-year-old child, including occasional marijuana use or drunkenness, and regular cigarette, marijuana, or alcohol use.

RESULTS

Across all cohorts, rates of disapproving attitudes ranged from 93.7% disapproving of getting drunk occasionally to 97.2% disapproving of regular cigarette use, with some erosion in disapproval for some substances across cohorts. Parents' own recent abstinence from substance use predicted greater odds of disapproval.

CONCLUSIONS

The overwhelming majority of 35-year-old parents disapprove of adolescent substance use. Prevention and public health messaging can support parenting by sharing this important information.

Evaluating Non-response Bias in a Parent-Based College Alcohol Intervention

Background: The purpose of this study was to address a dearth in the literature on non-response bias in parent-based interventions (PBIs) by investigating parenting constructs that might be associated with whether a parent volunteers to participate in a no-incentive college drinking PBI. Method: Incoming first-year students (N = 386) completed an online questionnaire that included items assessing plausible predictors of participation in a PBI (students' drinking, perceptions of parents' harm-reduction and zero-tolerance alcohol communication, whether parents allowed alcohol, and changes in parents' alcohol rules). Four months later, all parents of first-year students at the study university were invited to join the PBI, which was described as a resource guide to teach them how to help their student navigate the college transition and prepare them for life at their university. Results: Parents who signed up for the intervention used greater harm-reduction communication than those who did not sign up, were more likely to have allowed alcohol use, and signing up was significantly associated with student reports that fathers became less strict toward drinking after high school. Students' drinking and zero-tolerance communication did not significantly differ between the groups. Conclusion: Results indicate that non-response bias can be an issue when utilizing a real-world, non-RCT recruitment approach to invite parents into a PBI (i.e., non-incentivized, inviting all parents). Findings suggest that more comprehensive recruitment strategies may be required to increase parent diversity in PBIs.

Parental Concerns About Students' Transition Into College: Substance Use and Sexual Assault

Parents play an important role in the development of their college-bound children, including engagement in risk behaviors and associated consequences. Still, few studies have investigated parental concerns about their children's transition into college. The aim of this study was to describe parental concerns about substance use and sexual assault and to test differences between parents of sons and parents of daughters in their levels of concern and communication. Data are from 450 parents of incoming students to a large, midwestern university. Parents responded to questions regarding their concerns about substance use and sexual assault. Results found that parents of sons are more concerned about substance use while parents of daughters are more concerned about sexual assault. Parents of daughters also communicate more about sexual assault than parents of sons. Finally, there was a positive relationship between relationship quality and communication about sexual assault. Implications for future research and the development of parent-based prevention are explored.

Normative feedback and intentions to help friends with bulimic symptoms

The current study examined accuracy in estimating campus norms for eating disorder (ED) pathology and the impact of normative feedback on intentions to help friends. Participants: The sample included 130 undergraduate women. Method: Participants estimated prevalence of ED pathology and were randomly assigned to normative feedback or a control condition. Vignettes were presented describing bulimic and sleep disorder symptoms. After presentation of each vignette, participants reported sympathy for and intentions to help friends with similar symptoms. Results: Nine ED pathology estimates were significantly higher than comparison values documented in a larger survey of women attending their university in the previous year. Those who received normative feedback reported lower intentions to help and lower sympathy for a student with bulimic symptoms compared to sleep disorder symptoms. Conclusion: Results raise the possibility that normative feedback could reduce support for friends with bulimic symptoms.

'Mama Don't Preach': Young Adults' Perceptions of Maternal Messages about Underage Drinking

College students commonly report that their parents provide advice about how to drink safely; however, there is very little research exploring the content of parent-child harm-reduction conversations. The present study explores the types of advice mothers provide underage college students about drinking. A random sample of college students (ages 18 to 20) completed an online survey about their alcohol use and conversations they had with their mother about alcohol. Students' perceptions of mother-child harm-reduction conversations include the themes of: specific protective behavioral strategies, ambiguous behavioral advice, decision making advice, value-based advice, warning-based advice, and advice conveying approval. Discussion of specific protective behavioral strategies was most common for female students and students who reported binge drinking. Mothers did not typically address how to implement harm-reduction strategies effectively. The findings have implications for the assessment of harm-reduction communication between parents and emerging adult children.

Underage drinking as a natural part of growing up: a UK study of parental beliefs

Purpose

Parental beliefs about underage drinking are known to influence the drinking behaviours of their children. The purpose of this paper is to explore parental beliefs about their own child drinking alcohol and young people in general, in order to ascertain whether there is a need to target such beliefs in the design of public health interventions.

Design/methodology/approach

Parents of 11–18 year olds attending one of nine schools in the Midlands of England, UK were invited to take part. Participants completed a newly designed 40-item questionnaire measuring parental beliefs about the impact and causes of underage drinking; talking to their child about alcohol; and how much and how often they thought their child consumed alcohol.

Findings

In total, 185 parents took part in the study, reporting on their eldest child aged 18 or under. The majority of parents agreed that underage drinking is detrimental to child health and wellbeing. However, over 60 per cent believed that alcohol consumption is a “natural part of growing up”, and stronger agreement with this belief was associated with higher parental reports of alcohol consumption in their children.

Social implications

The majority of parents recognised the risks and negative effects of alcohol; however, many also believe it is a natural part of growing up. Parents may hold conflicting beliefs about underage drinking, which could impact on the drinking beliefs and behaviours of their children.

Originality/value

Public health interventions may need to counter the common parental belief that underage drinking is a normal part of growing up and therefore to be expected. Clear messages about the impact parent beliefs and behaviour have on young people drinking, to ensure parents recognise that messages are aimed at themselves, and not just “other parents” are imperative.

Drinking Game Participation Among High School and Incoming College Students: A Narrative Review

The transition from high school to college has been characterized as a potentially vulnerable period because of decreased parental supervision and increased autonomy. This transition can increase risk for participation in high-risk behaviors such as drinking games (DGs), which are a social drinking activity that encourages intoxication and are associated with negative alcohol-related consequences. To date, there has not been a narrative review of DG research that examines this activity among high schoolers and incoming college students specifically, and thus, the current review bridges this gap. Findings indicate that DG participation is consistently linked to negative consequences (e.g., passing out, becoming sick) and other high-risk behaviors, such as prepartying (drinking before going to a social event). In addition, DG participation is linked to demographic (e.g., age, gender), psychological (e.g., personality, alcohol cognitions), and contextual/cultural factors (e.g., the college drinking culture). These findings have implications for current prevention and intervention efforts and suggest promising directions for future research.

An Examination of the Relationship Between Consequence-Specific Normative Belief Patterns and Alcohol-Related Consequences Among College Students

BACKGROUND

Research has previously identified a high-risk subgroup of college students who experience high levels of multiple and repeated alcohol-related consequences (MRC group). The purpose of this study was to examine the association between consequence-specific normative influences and experiencing multiple and repeated drinking-related consequences using a person-centered approach. Normative subgroups were identified using latent profile analysis (LPA), which were then used to predict MRC group status at 6-month follow-up.

METHODS

First-year college student drinkers (N = 2,024) at a large northeastern university completed online surveys during the fall and spring semesters of their freshman year. Retention was high with 92% of invited participants completing T2, of which the MRC group accounted for 27%.

RESULTS

Three student profiles were identified from LPA on T1 data: Nonpermissive Parents (77%), Positive Peer and Parent Norms (21%), and Permissive Parents (3%). Logistic regression revealed that both the Positive Peer and Parent Norms and Permissive Parents profiles had significantly higher odds of MRC group membership at follow-up (1.81 and 2.78 times greater, respectively).

CONCLUSIONS

The results suggest value in prevention efforts that include normative beliefs about alcohol-related consequences. Further, parental norms in particular have the potential to enhance interventions, especially through direct communication of disapproval for experiencing consequences.

Online personalized normative alcohol feedback for parents of first-year college students

This study examined the efficacy of a personalized normative feedback (PNF) alcohol intervention for parents of students transitioning into college. A sample of 399 parent-student dyads were recruited to take part in the intervention during the summer prior to matriculation. Parents were randomly assigned to receive either normative feedback regarding student drinking and other college parents' alcohol-related communication or general college health norm information. Students completed measures of alcohol use, alcohol consequences, and parent-child alcohol-specific communication both 1 and 6 months after matriculation. The results indicated that in comparison with the control condition parents who received PNF reported immediate changes in their perceptions of other parents' behaviors; however, these changes in parent perceived norms did not translate into long-term changes in student drinking behaviors or parent-child communication. Findings highlight the need to consider content beyond normative feedback for parent based alcohol intervention. (PsycINFO Database Record

A parent-based intervention reduces heavy episodic drinking among first-year college students

A randomized controlled trial tested an interactive normative feedback-based intervention-codenamed "FITSTART"-delivered to groups of 50-100 parents of matriculating college students. The 60-min session motivated parents to alter their alcohol-related communication by correcting normative misperceptions (e.g., about how approving other parents are of student drinking) with live-generated data. Then, tips were provided on discussing drinking effectively. Incoming students (N = 331; 62.2% female) completed baseline measures prior to new-student orientation. Next, at parent orientation in June, these students' parents were assigned to either FITSTART or a control session. Finally, 4 months later, students completed a follow-up survey. Results revealed that students whose parents received FITSTART during the summer consumed less alcohol and were less likely to engage in heavy episodic drinking (HED) during the first month of college. These effects were mediated by FITSTART students' lower perceptions of their parents' approval of alcohol consumption. Further, FITSTART students who were not drinkers in high school were less likely to initiate drinking and to start experiencing negative consequences during the first month of college, where FITSTART students who had been drinkers in high school experienced fewer consequences overall and were significantly more likely to report that they did not experience any consequences whatsoever during the first month of college. Importantly, FITSTART is the first parent-based intervention to impact HED, one of the most well-studied indicators of risky drinking. Thus, interactive group normative feedback with parents is a promising approach for reducing college alcohol risk. (PsycINFO Database Record

The Upside of Helicopter Parenting: Engaging Parents to Reduce First-Year Student Drinking

University personnel tend to view "helicopter" parents as problematic. This paper presents an alternative view in which these highly engaged parents can instead be utilized productively. We describe and assess the fidelity of a novel program in which involved parents were effectively leveraged to mitigate student alcohol-related risk. The feasibility of utilizing similar programs at other schools is discussed as are implications for alcohol risk prevention.

Drinking Games Participation Among High School and Incoming College Students: A Narrative Review

The transition from high school to college has been characterized as a potentially vulnerable period because of decreased parental supervision and increased autonomy. This transition can increase risk for participation in high-risk behaviors such as drinking games (DGs), which are a social drinking activity that encourages intoxication and are associated with negative alcohol-related consequences. To date, there has not been a narrative review of DG research that examines this activity among high schoolers and incoming college students specifically, and thus, the current review bridges this gap. Findings indicate that DG participation is consistently linked to negative consequences (e.g., passing out, becoming sick) and other high-risk behaviors, such as prepartying (drinking before going to a social event). In addition, DG participation is linked to demographic (e.g., age, gender), psychological (e.g., personality, alcohol cognitions), and contextual/cultural factors (e.g., the college drinking culture). These findings have implications for current prevention and intervention efforts and suggest promising directions for future research.

High-risk alcohol use and anxiety and depression symptoms in adolescents and adults with type 1 diabetes mellitus: a cross-sectional study

BACKGROUND

The medical literature shows that alcohol consumption is common among diabetic individuals and is associated with poor adherence to treatment, resulting in increased morbidity and mortality. However, no study has assessed the association between high-risk alcohol consumption and the presence of anxiety and depression in individuals with type 1 diabetes mellitus (1DM).

METHODS

The present cross-sectional study was conducted in Uberlândia, Brazil, and it assessed 209 outpatients in relation to alcohol consumption and the presence of anxiety and depression symptoms, using the Alcohol Use Disorders Identification Test (AUDIT), the Hospital Anxiety and Depression (HAD) scale, and glycemic control, according to the levels of glycated hemoglobin (HbA1c). The chi-square test and logistic regression analysis were used to investigate the association between the investigated variables.

RESULTS

The prevalence of high-risk alcohol consumption (AUDIT ≥ 8) among individuals with 1DM was high, specifically 24.9% among the entire group of subjects, 12.9% among the adolescents, 14.7% among the females, and 34.6% among the males. In comparisons based on gender and age, the odds of high-risk drinking were higher among males and participants aged 30 to 40 years (33.9%). The frequency of high-risk alcohol consumption did not differ as a function of gender among adolescents (females: 9.0%, males: 16.2%; p = 0.374). There was a linear trend in proportions related to the scores of anxiety and depression symptoms with high-risk alcohol consumption scores, indicating the association of these variables (p = 0.0229 and p = 0.0262, respectively). Moreover, the odds of female subjects exhibiting anxiety and depression symptoms were higher (odds ratio - OR: 4.4 and OR: 7.4, respectively). Glycemic control did not exhibit an association between high-risk alcohol consumption and the presence of anxiety and depression symptoms.

CONCLUSIONS

The frequency of high-risk drinking increased along with age and was greater among males; however, this frequency did not exhibit differences in terms of gender among adolescents. There was a positive association between high risk alcohol consumption and anxiety and depression symptoms, although glycemic control was inadequate in most of the sample independent of alcohol consumption and the presence of anxiety and depression symptoms.