Gender disparities in attitudes, norms, and perceived control related to intentional condomless sexual intercourse: A psychosocial theory-driven comparison among cisgender heterosexual male and female college varsity athletes in Taiwan

Background

While condom use has been extensively studied as a protective behavior, research directly focusing on condomless sexual intercourse (CSI) as a distinct and intentional risk behavior, particularly regarding gender differences, remains scarce.

Methods

Building upon the Theory of Planned Behavior (TPB), this study addresses this gap by comparing TPB factors and individual TPB items regarding intentional CSI among cisgender heterosexual college varsity athletes in Taiwan (N = 1348).

Results

High CSI intention was more prevalent among men (53.6 %) than women (31.7 %). Our expanded TPB framework identified five distinct TPB factors pertaining to attitudes, norms, and perceived control. Multivariate logistic regression analysis demonstrated that all five TPB factors were significantly associated with CSI intention among men, but only three among women. Notably, our factor analysis differentiated attitudes toward positive/negative outcomes of CSI and perceived control under facilitating/constraining conditions, revealing attitudes toward positive outcomes of CSI as the strongest driver of CSI intention among both men (AOR = 2.51-4.09) and women (AOR = 3.79-5.71). Further analysis of TPB items disclosed that men prioritized psychological pleasure (AOR = 2.18), whereas women exhibited a "partner-centered" tendency, emphasizing trust by sex partners (AOR = 3.43).

Conclusions

Overall, men exhibited more favorable views toward CSI than women, with gender differences evident in the differential associations of varying TPB factors and items with CSI intention. Future research could explore the development of these differential attitudes, norms, and perceived control concerning CSI. Given the modifiable nature of TPB variables, our study's insights can inform actionable strategies and targeted interventions tailored for young men and women.

Social influences on alcohol outcome expectancy development from childhood to young adulthood: A narrative review

Purpose of Review

Alcohol outcome expectancies emerge in early childhood, develop throughout adolescence, and predict alcohol outcomes well into adulthood. Social factors shape how expectancies are learned in myriad ways, yet such social learning influences seldom are examined in the context of developmental factors. This review summarized literature on the social origins of alcohol expectancies through vicarious (observational) and experiential (direct) alcohol-related learning from childhood to young adulthood within a social learning framework.

Recent Findings

Young children primarily endorse negative expectancies, which decline rapidly with age amidst escalations in positive expectancies across adolescence. Parents and peers can contribute to vicarious learning about alcohol and facilitate experiential learning in different ways and to varying degrees across development. Media and social media, which children are increasingly exposed to as they mature, often depict alcohol-outcome relations that may further contribute to expectancy development in later adolescence and young adulthood.

Summary

Social influences on alcohol expectancy learning are complex and change over time, although this dynamic complexity typically is not depicted in extant literature. Developmentally-informed research capturing co-occurring shifts in social influences and alcohol expectancies is needed.

A randomized iterative approach to optimizing an online substance use intervention for collegiate athletes

BACKGROUND

Rates of drug use among collegiate athletes are high, yet there are few evidence-based interventions for this population. myPlaybook, an online intervention for collegiate athletes, targets multiple predictors of drug use (i.e., norms, positive and negative expectancies about use, and harm prevention intentions).

PURPOSE

We aimed to optimize modules from myPlaybook.

METHOD

We evaluated modules through three sequential randomized factorial trials, using the Multiphase Optimization Strategy framework. We recruited and randomized 54 (Trial 1), 47 (Trial 2), and 42 (Trial 3) schools and invited all first-year and transfer collegiate athletes to participate. Athletes completed a baseline survey, their randomly assigned modules, and immediate posttest and 30-day follow-up surveys. Across trials, 3,244 (48.8% female), 2,837 (51.9% female), and 2,193 (51.4% female) athletes participated. In Trial 1, we evaluated and revised less effective modules (defined as d < 0.3-0.4 for targeted outcomes). In Trial 2, we re-evaluated and revised less effective modules. In Trial 3, we re-evaluated the revised modules.

RESULTS

Trial 1: All effects were d < 0.15, so we revised modules to target proximal outcomes (i.e., the hypothesized mediating variables in our conceptual model), rather than specific drug use behaviors. Trial 2: Most effects were d < 0.3, so we revised all modules. Trial 3: The norms module improved descriptive and injunctive norms (all d >0.35). The expectancies module improved alcohol positive expectancies (d = 0.3). The other modules were not effective.

CONCLUSIONS

After three trials, two myPlaybook modules substantially improved proximal outcomes, increasing the likelihood that the combined intervention will have a meaningful clinical impact on collegiate athletes' drug use.

Tackling student drinking within the drinking subculture of a university sports competition: a culture change approach

Purpose

This paper explores the impact of a suite of alcohol culture change interventions implemented by Deakin University in Melbourne, Australia. The interventions were designed to change the alcohol culture at a bi-annual nation-wide university multi-sport competition known as Uni Nationals. This study aims to understand the critical success factors of the alcohol culture change initiatives that were developed by the university and implemented as part of a broader set of institutional practices.

Design/methodology/approach

A qualitative research design utilised in-depth, semi-structured interviews with nine Uni Nationals student team leaders. In total, two group interviews and four individual interviews were conducted with student team leaders who participated in the Uni Nationals. The interview transcripts were coded and themed. The themes were further refined and interpreted into a narrative. A total of two transcripts were independently coded by the first two authors. Discordant coding was flagged and discussed until a consensus was achieved. The remaining interviews were coded by the first author and discussed with the second author to ensure consistency. A socio-ecological framework was used to understand perceived changes to alcohol culture.

Findings

Student leaders were aware of and felt supported by the university-wide approach to changing the culture of Uni Nationals. Overall, the qualitative study indicated that students were positive about the alcohol culture change interventions. The leadership training that engaged team leaders in interactive activities had the greatest impact. Student leaders found the targeted messages, mocktail events and Chef de Mission (CdM) less effective cultural change strategies. However, they helped to establish expectations of students in this setting where a heightened focus on sport was associated with higher alcohol consumption.

Originality/value

While there has been growing academic interest in exploring “drinking cultures”, there has been relatively little focus on alcohol culture of university students at sporting events. The paper contributes to addressing this gap by shedding light on the impact of a group of interventions on the drinking culture of the Uni Nationals subculture.

Alcohol and Athletics: A Study of Canadian Student-Athlete Risk

American student-athletes (SAs) are at heightened risk for hazardous alcohol consumption compared with their nonathlete peers. However, little is known about this risk or the influence of psychosocial predictors on drinking behavior among Canadian SAs. This study compared rates of alcohol use across Canadian SAs and nonathletes and investigated whether the use of athlete-specific psychosocial predictors can improve the prediction of alcohol use outcomes in SAs. Participants (179 varsity athletes and 366 nonathletes) completed anonymous self-report questionnaires. Results suggest that Canadian athletes are at a heightened risk for experiencing alcohol-related problems compared with nonathletes, with general psychosocial predictors explaining the majority of variance in SA alcohol use. However, and quite notably, athlete-specific positive reinforcement motives predicted SA binge drinking. This research provides some of the first evidence of drinking-related problems among Canadian SAs and supports the potential use of preventative efforts to help SAs develop safe strategies for alcohol use.

Relevance of Athlete-Specific Psychosocial Factors in High School Student-Athlete Alcohol Consumption

Background: Research suggests that adolescent student-athletes are at heightened risk for alcohol consumption. The identification of unique, modifiable risk factors for alcohol use in this population is needed. Purpose/Objectives: Building on previous work highlighting the importance of each of athlete-specific drinking motives and alcohol expectancies, this study investigated whether athlete-specific psychosocial predictors optimize our ability to predict adolescent athlete alcohol consumption after accounting for general psychosocial predictors. Methods: Participants were 352 current high school student-athletes who completed a self-report questionnaire about their alcohol use attitudes, behaviors, and cognitions. Results: Hierarchical regression revealed that among the total sample, gender, class year, liquid courage/sociability, sexuality, and negative alcohol expectancies, and negative athletic-functioning alcohol expectancies predicted alcohol consumption. Among lifetime drinkers, gender, class year, enhancement motives, conformity motives (negative), negative athlete-functioning alcohol expectancies, and sport-related coping motives predicted alcohol consumption. Conclusions/Importance: Negative athletic-functioning alcohol expectancies and sport-related coping motives emerged as important, athlete-specific predictors of adolescent athlete alcohol use. These factors provide important opportunities for targeted prevention efforts.

Everyone Else Is Doing It: The Association Between Social Identity and Susceptibility to Peer Influence in NCAA Athletes

The authors examined athletes' conformity to teammates' risky behaviors through a performance-based manipulation paradigm. They hypothesized that athletes who strongly identified with their team would be at increased risk of conforming to teammates' behaviors. Athletes (N = 379) from 23 intact National Collegiate Athletic Association (NCAA) teams completed surveys (e.g., social identity) and reported the extent to which they would engage in risky behavior scenarios (e.g., drinking and driving). Then, researchers displayed ostensible responses that were manipulated to appear as though teammates reported high engagement in the risky behaviors. Finally, athletes again responded to the hypothetical scenarios and a conformity index was created. Results indicated that social identity, at both individual and group levels, positively predicted conformity-indicating that athletes with stronger social identities are more susceptible to peer influence. Although these findings highlight a pernicious aspect of social identity, they also provide insight into how group-level processes could be leveraged to prevent risky behaviors in student-athletes.

Revision of AUDIT Consumption Items to Improve the Screening of Youth Binge Drinking

This study analyzes the appropriateness of an improved version of one of the most frequently used instruments for the screening of high-risk alcohol consumption. This adaptation was created in accordance with certain limitations recognized by other researchers and in an attempt to adjust the content and scales of some items to a more consensual definition of binge drinking. After revising items 2 and 3, the areas under the ROC curves of the AUDIT and of different abbreviated versions were calculated. A total of 906 minors (468 females) between the ages of 15 and 17 were evaluated. Stratified sampling was conducted on a population of high school students in the city of Valencia (Spain). One school was randomly chosen from each of the city’s 16 school districts. Information was collected on sociodemographic aspects, consumption patterns and the AUDIT containing the improved items. The percentage of underage BD reached 36%, regardless of gender or age. BD groups have been differentiated by different intensity levels, both in males and females. Upon comparing the effectiveness of the distinct versions of the AUDIT, it is recommended that researchers and clinics use the combination of the revised items 2 and 3 to ensure a more precise identification of underage BD. A cut-off point of 5 for this test would permit identification of 94% of the underage BD and would notably reduce false positives.

Perceived norms and alcohol use among first-year college student-athletes' different types of friends

OBJECTIVE

To describe first-year college student-athletes' friendship contexts and test whether their perceptions of alcohol use and approval by different types of friends are associated with their own alcohol use.

PARTICIPANTS

First-year student-athletes (N = 2,622) from 47 colleges and universities participating in National Collegiate Athletic Association (NCAA) sports during February-March 2013.

METHODS

Student-athletes completed online surveys during the baseline assessment of an alcohol and other drug prevention program evaluation. Analyses tested whether perceptions of friends' alcohol use (descriptive norms) and perceptions of friends' approval of alcohol use (injunctive norms) predicted their alcohol use.

RESULTS

Both use and approval perceptions by upperclassmen, same-team, and most influential friends significantly predicted alcohol use. By contrast, only perceived use by first-year, nonteam, and less influential friends significantly predicted alcohol use.

CONCLUSIONS

Athletics departments' alcohol policies and prevention programming for first-year student-athletes should address the potential influence of different types of friends on alcohol use.

Experiences and attitudes of collegiate athletic trainers regarding alcohol-related unintentional injury in athletes

CONTEXT

Alcohol-related unintentional injury (ARUI) has been an unexamined consequence of alcohol consumption by collegiate athletes. It has a potentially devastating effect on their athletic performances and careers. Awareness of this problem in athletes could have a huge effect on what athletic trainers (ATs) do to recognize, treat, and prevent it in a collegiate athlete population.

OBJECTIVE

To examine the experiences and attitudes among collegiate and university ATs about ARUI in the athletes in their care.

DESIGN

Cross-sectional study.

SETTING

Web-based survey.

PATIENTS OR OTHER PARTICIPANTS

A total of 1767 e-mail addresses for collegiate and university ATs within National Athletic Trainers' Association Districts 1, 2, 3, and 9.

MAIN OUTCOME MEASURE(S)

We calculated frequencies, percentages, and attitudes of ATs regarding ARUI in collegiate athletes during the 2010-2011 academic year.

RESULTS

The resulting sample size for the analysis was 459 (26.0%) participants of the initial total sample. More than 56% (n = 260) of the ATs reported that they had evaluated, treated, or referred if needed at least 1 ARUI in a collegiate athlete. On average, these ATs had evaluated, treated, or referred if needed 3 alcohol-related unintentional injuries within the 2010-2011 academic year. About 73% (n = 331) of ATs agreed that ARUI is a serious problem. Nearly 80% (n = 358) indicated they believe ATs should receive more training to identify student-athletes with alcohol-related problems.

CONCLUSIONS

Alcohol-related unintentional injury is a common and serious consequence of alcohol use among collegiate athletes. Many ATs also view it as a serious problem yet would like more training in how to address it. Alcohol-related unintentional injury may have important negative effects on the careers and athletic performances of athletes. Researchers need to determine how prevalent ARUI is in the collegiate athlete population and what ATs can do to address it.

Sport-related achievement motivation and alcohol outcomes: an athlete-specific risk factor among intercollegiate athletes

Intercollegiate athletes report greater alcohol consumption and more alcohol-related problems than their non-athlete peers. Although college athletes share many of the same problems faced by non-athletes, there are some consequences that are unique to athletes. Studies have demonstrated that alcohol negatively affects athletic performance including increased dehydration, impeded muscle recovery, and increased risk for injury. Beyond risk factors for alcohol misuse that may affect college students in general, research has begun to examine risk factors that are unique to collegiate athletes. For example, research has found that off-season status, the leadership role, and athlete-specific drinking motives are associated with increased alcohol use. Given these findings, it is possible that other athlete-specific variables influence alcohol misuse. One such variable may be sport achievement orientation. The purpose of the current study was to examine the relationship between sport achievement orientation and alcohol outcomes. Given previous research regarding seasonal status and gender, these variables were examined as moderators. Varsity athletes (n=263) completed the Sport Orientation Questionnaire, which assesses sport-related achievement orientation on three scales (Competitiveness, Win Orientation, and Goal Orientation). In addition, participants completed measures of alcohol use and alcohol-related problems. Results indicated that Competitiveness, Win Orientation, and Goal Orientation were all significantly associated with alcohol use, but not alcohol-related problems. Moreover, these relationships were moderated by seasonal status and gender. These interactions, clinical implications, and limitations are discussed.