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This group-randomized trial assessed the effects of a universal prevention training curriculum for school administrators and teachers that focused on effective strategies to prevent adolescent substance use and related problems. Twenty-eight schools in three regions of Peru were randomly assigned to either an intervention or control condition (14 schools per condition). Repeated cross-sectional samples of 11 to 19-year-old students participated in four surveys from May 2018 to November 2019 (N = 24,529). School administrators and teachers at intervention schools participated in a universal prevention training curriculum focusing on the development of a positive school climate as well as effective policies related to school substance use. All intervention and control schools were offered Unplugged, a classroom-based substance use prevention curriculum. Outcome measures included: lifetime drug use; past-year and past-month tobacco, alcohol, marijuana, and other drug use; awareness of school tobacco and alcohol use policies; perceived enforcement of school policies; school bonding; perceived friends' use of tobacco, alcohol, marijuana and other drugs; and personal problems in general and problems related to substance use. Multi-level analyses indicated significant reductions in past-year and past-month smoking, friends' substance use, and problems related to substance use and in general at intervention relative to control schools. Significant increases were found in intervention vs. control schools related to students' awareness of school substance use policies, perceived likelihood of getting caught for smoking, and school bonding. These findings suggest that the universal prevention training curriculum and the school policy and climate changes it promoted reduced substance use and related problems in the study population of Peruvian adolescents.

Background and Objectives: We examined associations between sources of social influence (i.e. close friends, other underage people present) within specific settings with the number of drinks underage youth consumed. Methods: Data were collected through a cross-sectional survey with 422 underage youth in California (14 to 19 years old) who reported past-6-month alcohol use. Participants were asked to think about the last time they drank alcohol in the past 6 months at: restaurants, bars/nightclubs, own home, another's home, outdoors, and fraternities/sororities. Outcomes were the number of whole drinks participants drank the last time in each setting. Independent measures were social characteristics of these drinking events including number of people <21 years old present, number of close friends present, number of <21 years old who consumed alcohol, and number of close friends who consumed alcohol. We also assessed socio-demographics and accounted for the overall exposure to each setting in the past 6 months. Results: Using negative binomial regression models, the number of close friends was positively associated with number of drinks consumed at restaurants, another's home, and outdoors. The number of close friends drinking was positively associated with the number of drinks at restaurants, own home, another's home, and outdoors. Number of people <21 years old was positively associated with number of drinks at own home, and number of people <21 years old who consumed alcohol was positivity associated with number of drinks consumed at restaurants, own home, another's home, and outdoors. Conclusions: Results suggest that social influence from close friends and from other underage youth are context-specific. [ABSTRACT FROM AUTHOR]

Previous research suggests that the context in which drinking occurs contribute to specific alcohol-related problems. In the current study we assessed how often adolescents attended different contexts in which they could drink, how often they drank in those contexts, and whether drinking patterns and parental monitoring were related to alcohol use in those contexts. We collected survey data from 1,217 adolescents 15-18 years of age in 24 midsized California cities. Measures included past-year frequencies of attending and drinking in restaurants, bars/nightclubs, and outdoor places, typical hours spent at home (i.e., own home or someone else's home), perceptions of parental control and disclosure to parents about free time activities, and demographics. Multilevel zero-inflated negative binomial models were used to assess associations between drinking patterns, parental control, and disclosure and frequency of attending and drinking in specific contexts. There were large variations in attending contexts in which drinking could take place. More frequent drinking was related to less time spent at home, while heavier drinking was associated with more time spent at home. Parental control was related to less frequent attendance at bars/nightclubs, and disclosure to less frequent involvement in outdoor activities and spending more time at home. Among drinkers, frequencies of attendance were strongly related to frequencies of drinking in all contexts except the home. Parental control and disclosure were related to more frequent drinking at restaurants and exposure to bars/nightclubs and drinking at outdoor activities. Parental monitoring may reduce exposure to risks by shifting adolescent contexts for alcohol use.

Alcohol remains readily available to youth in most countries. We examined the associations between both the on- and off-premises commercial availability of alcohol to youth and their alcohol use, heavy episodic drinking, and alcohol-related harms. We conducted the study using data from a survey of a sample of 594 students in central Mexico between 12 and 17 years of age in 2016. Both the perceived availability of alcohol and the purchasing of alcohol at an off-premises establishment were positively related to past-30-day alcohol use and heavy episodic drinking, as well as to alcohol-related harms in the past year. Consumption at on-premises establishments was also positively associated with alcohol-related harms. Preventive efforts to reduce the availability of alcohol at off- and on-premises establishments, by such strategies as mystery shopper and responsible beverage service programs, are imperative.

We report the results of a quasi-experimental evaluation of a mystery shopper intervention in Zacatecas and Guadalupe, Mexico. Underage youth attempted to purchase beer at 50 Modelorama stores and 32 Oxxo stores (intervention groups), and at 19 comparison convenience stores in March, July, and August 2018. After each attempt, intervention store operators were informed if a sale was made. Modelorama operators also received training and were warned that repeated sales to minors could jeopardize their franchise. Average sales rates to minors were 63.8% at Modeloramas, 86.5% at Oxxo stores, and 98.2% at comparison stores. The findings suggest that mystery shopper interventions with training, feedback to store operators, and sanctions after repeated sales to underage youth may reduce sales to minors in low- and middle-income countries.

Objective: The objective of this study was to compare drink driving and related road safety issues in 2 urban areas of 6 countries and develop an equation for estimating the rate of crash underreporting to the police in urban areas of countries that lack this information. Methods: This study is a secondary analysis of 1 to 2 waves of surveys in pairs of matched medium-sized cities in Belgium, Brazil, China, Mexico, South Africa, and Ohio, United States; the surveys supported evaluation of local alcohol harm reduction efforts. Data were from 2017 to 2019 except 2023 for Mexico. Mailed surveys in Ohio and household interviews elsewhere of quota samples matched to census data yielded 23,240 completed interviews. Relevant questions covered drinking, driving under the influence of alcohol (DUI), DUI enforcement, and, except in South Africa, road crashes. GLM regression provided an equation for estimating police reporting rates of urban injury and no-injury crashes from a country's purchasing-power parity–adjusted gross domestic product (GDP) per capita. Results: The percentage of drivers driving unlicensed was 30% in Mexico and South Africa, 15% in Brazil, 8% in China, and <1% elsewhere. Among adults who both drove and drank, self-reported urban DUI rates ranged from 12% in China to 53% in South Africa, with 4 countries between 18% and 26%. Among those reporting DUI, the percentage stopped by police for doing so was 14% in Belgium, 15% in Brazil, 25% in China, 31% in Mexico, 45% in South Africa, and only 3% in Ohio. The surveys yielded data on 380 urban crashes. Past-year crash involvement was 2% to 3% in Belgium and China and 5% to 6% elsewhere. The 10% injury rate in Ohio crashes was significantly below the 24% to 35% rates elsewhere. Injury crashes were almost universally reported except in Brazil (60% reported). Only 49% to 56% of non-injury crashes were reported, except in Ohio (73%). Perceived alcohol-involved crash rates of 18% to 19% in Belgium and Ohio were significantly lower than the 32% reported in Brazil, 41% in China, and 57% in Mexico. In the regression, GDP per capita and injury involvement were positively associated with police crash reporting. Conclusions: Our equation more closely approximates urban police crash reporting rates than prior studies that assumed that they matched U.S. data. DUI enforcement is weak/ineffective in urban Ohio. With suggested adjustments, our survey questions should be usable in other international road safety and DUI studies. [ABSTRACT FROM AUTHOR]

This study examined the usefulness of a survey on underage drinking in a rural American Indian community health clinic. One hundred ninety-seven youth (90 male, 107 female; age range 8-20 years) were recruited from clinic waiting rooms and through community outreach. The study revealed that the usefulness of the survey was twofold: Survey results could be used by clinic staff to screen for underage drinking and associated problems in youth served by the clinic, and the process of organizing, evaluating, and implementing the survey results accomplished several important goals of community-based participatory research. (Contains 4 tables.)

Despite efforts to limit underage access to alcohol, alcohol availability remains a challenge for youth drinking prevention. This article fills a gap in our understanding of alcohol consumption among youths by systematically investigating how and under what circumstances they obtain alcohol and the context within which they consume it. Qualitative interviews (n = 47) were conducted with teens to collect information about where and how they obtain alcohol and the contexts within which they drink. Respondents were knowledgeable about commercial and social sources and used this knowledge in their decision making regarding where to obtain alcohol. Teens used their social relationships to circumvent existing policies designed to limit underage access to alcohol. Findings indicate that the majority of teens' drinking occasions occur in their own or someone else's home.

Qualitative interviews were conducted with parents of teens to explore how parents store and monitor prescription drugs in the home. Most parents had prescription drugs in the house, but took few precautions against teens accessing these drugs. Strategies for monitoring included moving the drugs to different locations, remembering how many pills were left, and how medication containers were positioned. Reasons given for not securing drugs were that parents did not think that their teens would be interested in their prescription drugs and did not believe that they could be used to get high. This study highlights the need for parents to be educated about securing prescription drugs, the dangers of non-medical prescription drug use by teens, and which drugs might be used for non-medical purposes.

Results from a qualitative study with parents about underage drinking are presented. Semistructured interviews (n = 44) were conducted with parents of teens to investigate whether and why parents permit underage drinking. Parents had three primary reasons for allowing underage drinking: deliberate, spontaneous, and harm reduction. Deliberate reasons included passing on knowledge about drinking responsibly and appreciating alcohol. Parents also spontaneously decided to let their teen drink. Some of these spontaneous situations involved feeling pressure from other adults to let their teen drink. Another reason was a desire to reduce potential harm. Parents feared that forbidding underage drinking would harm their relationship with their teen and potentially lead to drunk driving. Prevention efforts aimed at parents should take into account parents' motivations to let teens drink.

This article reports on the development and psychometric properties of the Adolescent Sexual Expectancies Scale (ASEXS). Data were obtained from three annual longitudinal surveys of youth aged 10-17 at the first administration (N = 932 at Wave 3). Confirmatory factor analyses indicated that 4 correlated factors corresponding to Social Risk, Social Benefit, Health Risk, and Pleasure adequately represented the expectancy items. High alpha coefficients and stability across survey waves indicated good internal and test-retest reliability for these factors. Latent variable autoregressive analyses indicated that Social Risk expectancies predicted changes in sexual behavior over the course of the study. Multigroup analyses established that the measurement and predictive models were equivalent for males and females and across age groups. The ASEXS provides researchers with a useful measure for examining adolescents' expectancy beliefs about the consequences of sexual behavior.

The neighborhood context can interfere with parents' abilities to effectively monitor their children, but may be related to specific monitoring strategies in different ways. The present study examines the importance of mothers' perceptions of neighborhood disorganization for the specific monitoring strategies they use and how each of these strategies are related to youths' alcohol use and delinquency. The sample consists of 415 mother-child dyads recruited from urban and suburban communities in Western New York state. Youths were between 10 and 16 years of age (56% female), and were mostly Non-Hispanic White and African American (45.3 and 36.5%, respectively). Structural equation modeling shows that mothers who perceive greater neighborhood problems use more rule-setting strategies, but report lower levels of knowledge of their children's whereabouts. Knowledge of whereabouts is related to less youth alcohol use and delinquency through its association with lowered peer substance use, whereas rule-setting is unrelated to these outcomes. Thus, mothers who perceive greater problems in their neighborhoods use less effective monitoring strategies. Prevention programs could address parental monitoring needs based upon neighborhood differences, tailoring programs for different neighborhoods. Further, parents could be apprised of the limitations of rule-setting, particularly in the absence of monitoring their child's whereabouts.