Section associated with drinking and driving, the perceived barriers

Section 3


The first article
I studied was a systematic review and meta-analysis on the effects of brief
alcohol interventions on drinking and driving among youth. This study evaluated
whether brief alcohol interventions (BAIs) were effective in reducing the
number of adolescents that drive after drinking. “Brief interventions refer to
a broad family of interventions that can vary in length, structure, delivery
personnel, underpinning theory, and philosophy” (Steinka-Fry, et al., 2015,
para. 9). The significant feature of this style of intervention is the short
duration, and this study focused on interventions within 5 hours or less. A few
therapeutic components of a BAI highlighted in this article included one or
more of the following: “assessment and feedback related to alcohol consumption;
comparison of drinking habits with relevant norms (e.g., same gender, same age
peers); goal-setting and contracting exercises; decisional balance exercises
highlighting the pros and cons of drinking; discussion of drinking moderation
strategies; and provision of information” (Steinka-Fry, et al., 2015, para. 9).

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In my opinion, these interventions align with the key constructs of the Social
Cognitive Theory (SCT) in the aspect of goal-setting, self-monitoring and
behavior limitations. I also feel it encompasses the Health Behavior Model
(HBM) in relations to the perceived severity and susceptibility of the risks
associated with drinking and driving, the perceived barriers and variables
associated with alcohol use, and the perceived benefit of the value of
drinking. The findings were evident in showing that BAIs were effective in
reducing the number of adolescents consuming alcohol, and had a significant
impact in reducing the number of DWI outcomes.

The second article
I reviewed focused on strategies to prevent underage drinking. This research
provided an overview into multiple effective intervention programs to prevent
alcohol use among adolescents, including: school based curriculum, extracurricular
activities, group family education, and policy restrictions reducing youth
access to alcohol. One behavioral intervention highlighted in the article that
has major influence in youth alcohol consumption was strict regulation of commercial
access to alcohol. “Lawmakers implemented several policy strategies targeting
these influences to reduce the availability of alcohol to youth. These
strategies include: raising the minimum legal drinking age (MLDA), curtailing
commercial access, limiting social access, and reducing economic availability”
(NIH, n.d., para. 25). This type of regulation is monitored through compliance
checks, in which local law enforcement use members of the youth population to “test”
whether a commercial facility will sell alcohol to the minors. A violation of
this law could result in fees, penalties, loss of permit to sale alcohol, up to
criminal charges of endangerment. Because this study focused on multiple
intervention aspects at all stages of a behavior change related to alcohol use,
I believe the evaluated interventions align with a combination of the Transtheoretical
Model of Change, Social Cognitive Theory, and the Health Belief Model. The
intervention programs outlined really encompass all variables that influence a
positive behavior change in alcohol use within the youth population.  

This article defined
the combination of the three aligned theories listed above as the application
of the Theory of Triadic Influence (TTI). Although this theory was not
discussed in class, I agree that it is applicable to my objective and behavior
change because it encompasses personal, social and environmental factors that
are associated with alcohol use, specifically in adolescents. This theory is
often referred to as “the “mega-theory” of health behavior, because all
behaviors have roots in three domains: the person’s personal characteristics,
current social situation, and cultural environment” (NIH, n.d., para. 4). “The
TTI categorizes independent variables that predict behavior into three levels
of influence: ultimate, distal, and proximal. People have little control over ultimate
causes due to their effects being the most persuasive and meditated (ex:
influenced by media, politics, religions)” (Flay & Snyder, 2012, para. 5). “Distal
level influences are variables affecting behavior that individuals are likely
to wield some control over (ex: self-control, bond with parent or role model). Lastly,
proximal level influences are more behavior specific-based and are ultimately
under the control of the individual” (PEOPLE, XX, para. 6-7).

I particularly
like this theory because it takes into consideration the effects of exposure, choices,
objectives and experiences that influence an adolescent’s decision to drink. This
combination of all behavioral theories goes beyond intrapersonal and interpersonal
theories and includes more environmental factors that influences alcohol
related behaviors. That is why I believe the Theory of Triadic Influence best
aligns with my objective to reduce the number of adolescents that drink and
drive under the influence.  



















Section 4


The meta-analysis on
the effects of brief alcohol interventions on drinking and driving among youth synthesized
data from a series of studies in a systematic review of the effectiveness of
BAIs in adolescents. The systematic review identified experimental evaluations
that measured the consequences of driving while intoxicated. The studies were
then coded “on a range of variables related to study methods, intervention
details, participant characteristics, statistical findings, and general study
characteristics. Data extraction followed a standardized coding protocol, with
data entered directly into a FileMaker Pro database” (Steinka-Fry, et al., 2015,
para. 15). 

random-effects meta-analyses using a structural equation modeling approach were
used to summarize the effects of the interventions” (Steinka-Fry, et al., para.

2). The research concluded that the participants involved in a brief alcohol intervention
reported a reduction in drinking and driving. “Supplemental analyses indicated
that reductions in driving while intoxicated were positively associated with
the reduced post-intervention heavy use of alcohol” (Steinka-Fry, et al., para.


In order to
collect data and evaluate outcomes related to an intervention for my objective,
I would take a qualitative research approach. I would collect data through
direct interaction with adolescents on a one-on-one basis (as I did throughout
the semester), or in a group setting with direct interaction. I would then have
a follow up interview/interaction in order to evaluate a progress of outcome in
the desired behavior change. A questionnaire or survey from the adolescent and
their parents (or caregiver) would also provide a way of evaluating progress
and effectiveness of promoting and educating positive alcohol related

Community Based
Participatory Research (CBPR) is very relatable to my objective in reducing
alcohol use amongst adolescents, as it recognizes inequalities that exist
between the community and adolescents. CBPR takes an approach on empowerment
through education, decision-making control, and increased promotion of positive
behaviors for all parties involved. Two behavioral interventions mentioned in article
two that adheres to CBPR principles are: school based interventions and family
based interventions. Implementing an alcohol awareness program within a school
district is an example of an intervention that would align with CBPR
principles. This intervention not only integrates knowledge and action for
mutual benefit, but also facilitates a partnership approach and addresses
health related risks. School based interventions aid in the development of
personal, social, and intellectual skills to cope with peer pressure related to
alcohol use. These efforts are most effective when combined with family,
community, and social involvement. Parental involvement, having a strong open
relationship, enforcing supervision and positive reinforcement all contribute
to the success of family based interventions. By incorporating interventions within
a family setting, it enables co-learning and empowerment and integrates
knowledge and action for mutual benefit. It is important for parents to be a
positive role model in drinking and/or drinking and driving habits. “Parents
play a critical role in their children’s introduction to alcohol” (Gilligan &
Kypri, 2012, para 1). The majority of a child’s perception of alcohol stems
from values, attitudes and behaviors established within their home. Implementing
a combined methodology to include both school and home interventions builds on
strengths and opens the potential to facilitate collaborative partnerships
within all phases of an intervention. Although an individual intervention may
be successful in reducing the use of alcohol and drinking and driving, a combinational
approach targeting all influences of behavior is key in order to effectively
reduce the number of adolescents that engage in negative alcohol related