Alcohol prevention strategies effective for American Indian teens, study shows

A study published in The American Journal of Public Health provides recommendations for community-based and individual-level prevention strategies to prevent alcohol use among American Indian and white teens living in multicultural rural communities.

American Indian teens and other rural youth show higher rates of starting to drink at young ages and higher rates of alcohol-related problems than other groups. Kelli A. Komro, PhD, professor in the Department of Behavioral Sciences and Health Education at Emory University's Rollins School of Public Health, led a team of researchers in a research trial that followed students in the Cherokee Nation, located in northeastern Oklahoma. The study evaluated the effects of two strategies that previous research indicated may be beneficial:

• Communities Mobilizing for Change on Alcohol (CMCA) – a citizen-led community-organizing effort that holds local officials responsible for taking action to reduce alcohol access, use, and consequences among underage youth.
• CONNECT – an individually-delivered brief intervention in which a trained social worker meets briefly with each student once per semester to motivate healthy behaviors.

Six communities were randomly assigned to treatment or control conditions. Students in two communities received both intervention strategies while students in two other communities received neither intervention strategy. In addition, another community received only CMCA, and another received only CONNECT.

Results show that alcohol use in the past 30 days, including any use and heavy drinking episodes, were significantly reduced among students receiving either of the interventions.

"Drinking among high school students remains a serious problem leading to injuries, poor school performance, increased risk of addiction and other long-term health problems. Without effective prevention strategies, American Indian and rural youth are especially vulnerable to early alcohol use and its many damaging consequences," explains Komro. "We found that community and school support and engagement in prevention is critical to shaping a more healthful environment for teens. Strategies such as ones conducted in this study should be further investigated with a focus on sustainability."

Alex Wagenaar, PhD, a research professor at Emory and a senior co-investigator on the study noted that "successful prevention efforts must focus on strategies that well-designed scientific trials show are effective, rather than simply doing what feels good or what schools and communities think might help." In the long run, there is nothing more practical than good science, he argued.