Multiple comorbidities of 21 psychological disorders and relationships with psychosocial variables: A study of the online assessment and diagnostic system within a web-based population
- Al-Asadi, Ali, Klein, Britt, Meyer, Denny
- Authors: Al-Asadi, Ali , Klein, Britt , Meyer, Denny
- Date: 2015
- Type: Text , Journal article
- Relation: Journal of Medical Internet Research Vol. 17, no. 2 (2015), p. 355
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- Description: Background: While research in the area of e-mental health has received considerable attention over the last decade, there are still many areas that have not been addressed. One such area is the comorbidity of psychological disorders in a Web-based sample using online assessment and diagnostic tools, and the relationships between comorbidities and psychosocial variables. Objective: We aimed to identify comorbidities of psychological disorders of an online sample using an online diagnostic tool. Based on diagnoses made by an automated online assessment and diagnostic system administered to a large group of online participants, multiple comorbidities (co-occurrences) of 21 psychological disorders for males and females were identified. We examined the relationships between dyadic comorbidities of anxiety and depressive disorders and the psychosocial variables sex, age, suicidal ideation, social support, and quality of life. Methods: An online complex algorithm based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision, was used to assign primary and secondary diagnoses of 21 psychological disorders to 12,665 online participants. The frequency of co-occurrences of psychological disorders for males and females were calculated for all disorders. A series of hierarchical loglinear analyses were performed to examine the relationships between the dyadic comorbidities of depression and various anxiety disorders and the variables suicidal ideation, social support, quality of life, sex, and age. Results: A 21-by-21 frequency of co-occurrences of psychological disorders matrix revealed the presence of multiple significant dyadic comorbidities for males and females. Also, for those with some of the dyadic depression and the anxiety disorders, the odds for having suicidal ideation, reporting inadequate social support, and poorer quality of life increased for those with two-disorder comorbidity than for those with only one of the same two disorders. Conclusions: Comorbidities of several psychological disorders using an online assessment tool within a Web-based population were similar to those found in face-to-face clinics using traditional assessment tools. Results provided support for the transdiagnostic approaches and confirmed the positive relationship between comorbidity and suicidal ideation, the negative relationship between comorbidity and social support, and the negative relationship comorbidity and quality of life. © 2015, Journal of Medical Internet Research. All rights reserved.
- Authors: Al-Asadi, Ali , Klein, Britt , Meyer, Denny
- Date: 2015
- Type: Text , Journal article
- Relation: Journal of Medical Internet Research Vol. 17, no. 2 (2015), p. 355
- Full Text:
- Reviewed:
- Description: Background: While research in the area of e-mental health has received considerable attention over the last decade, there are still many areas that have not been addressed. One such area is the comorbidity of psychological disorders in a Web-based sample using online assessment and diagnostic tools, and the relationships between comorbidities and psychosocial variables. Objective: We aimed to identify comorbidities of psychological disorders of an online sample using an online diagnostic tool. Based on diagnoses made by an automated online assessment and diagnostic system administered to a large group of online participants, multiple comorbidities (co-occurrences) of 21 psychological disorders for males and females were identified. We examined the relationships between dyadic comorbidities of anxiety and depressive disorders and the psychosocial variables sex, age, suicidal ideation, social support, and quality of life. Methods: An online complex algorithm based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision, was used to assign primary and secondary diagnoses of 21 psychological disorders to 12,665 online participants. The frequency of co-occurrences of psychological disorders for males and females were calculated for all disorders. A series of hierarchical loglinear analyses were performed to examine the relationships between the dyadic comorbidities of depression and various anxiety disorders and the variables suicidal ideation, social support, quality of life, sex, and age. Results: A 21-by-21 frequency of co-occurrences of psychological disorders matrix revealed the presence of multiple significant dyadic comorbidities for males and females. Also, for those with some of the dyadic depression and the anxiety disorders, the odds for having suicidal ideation, reporting inadequate social support, and poorer quality of life increased for those with two-disorder comorbidity than for those with only one of the same two disorders. Conclusions: Comorbidities of several psychological disorders using an online assessment tool within a Web-based population were similar to those found in face-to-face clinics using traditional assessment tools. Results provided support for the transdiagnostic approaches and confirmed the positive relationship between comorbidity and suicidal ideation, the negative relationship between comorbidity and social support, and the negative relationship comorbidity and quality of life. © 2015, Journal of Medical Internet Research. All rights reserved.
Child and adolescent exposure to alcohol advertising in Australia's major televised sports
- Carr, Sherilene, O'Brien, Kerry, Ferris, Jason, Room, Robin, Livingston, Michael, Vandenberg, Brian, Donovan, Robert, Lynott, Dermot
- Authors: Carr, Sherilene , O'Brien, Kerry , Ferris, Jason , Room, Robin , Livingston, Michael , Vandenberg, Brian , Donovan, Robert , Lynott, Dermot
- Date: 2016
- Type: Text , Journal article
- Relation: Drug and Alcohol Review Vol. 35, no. 4 (2016), p. 406-411
- Full Text: false
- Reviewed:
- Description: INTRODUCTION AND AIMS: Exposure to alcohol advertising is associated with greater alcohol consumption in children and adolescents, and alcohol advertising is common in Australian sport. We examine child, adolescent and young adult exposure to alcohol advertising during three televised sports in Australia: Australian Football League (AFL), cricket and the National Rugby League (NRL). METHODS: Alcohol advertising and audience viewing data were purchased for all AFL, cricket and NRL TV programs in Australia for 2012. We estimated children and adolescents (0-17 years) and young adults (18-29 years) exposure to alcohol advertising during AFL, cricket and NRL programs in the daytime (06:00-20:29 h), and night-time (20:30-23:59 h). RESULTS: There were 3544 alcohol advertisements in AFL (1942), cricket (941) and NRL programs (661), representing 60% of all alcohol advertising in sport TV, and 15% of all alcohol advertisements on Australian TV. These programs had a cumulative audience of 26.9 million children and adolescents, and 32 million young adults. Children and adolescents received 51 million exposures to alcohol advertising, with 47% of this exposure occurring during the daytime. Children and adolescents exposure to alcohol advertising was similar to young adults and peaked after 8.30pm. DISCUSSION AND CONCLUSIONS: Child and adolescent and young adult's exposure to alcohol advertising is high when viewing sport TV in Australia in the daytime and night-time. Current alcohol advertising regulations are not protecting children and adolescents from exposure, particularly in prominent televised sports. The regulations should be changed to reduce children and adolescent excessive exposure to alcohol advertising when watching sport. [Carr S, O'Brien KS, Ferris J, Room R, Livingston M, Vandenberg B, Donovan RJ, Lynott D. Child and adolescent exposure to alcohol advertising in Australia's major televised sports. Drug Alcohol Rev 2016;35:406-411].
Content and functionality of alcohol and other drug websites: Results of an online survey
- Klein, Britt, White, Angela, Kavanagh, David, Shandley, Kerrie, Kay-Lambkin, Frances, Proudfoot, Judith, Drennan, Judy, Connor, Jason, Baker, Amanda, Young, Ross
- Authors: Klein, Britt , White, Angela , Kavanagh, David , Shandley, Kerrie , Kay-Lambkin, Frances , Proudfoot, Judith , Drennan, Judy , Connor, Jason , Baker, Amanda , Young, Ross
- Date: 2010
- Type: Text , Journal article
- Relation: Journal of Medical Internet Research Vol. 12, no. 5 (2010), p.
- Full Text:
- Reviewed:
- Description: Background: There is a growing trend for individuals to seek health information from online sources. Alcohol and other drug (AOD) use is a significant health problem worldwide, but access and use of AOD websites is poorly understood. Objective: To investigate content and functionality preferences for AOD and other health websites. Methods: An anonymous online survey examined general Internet and AOD-specific usage and search behaviors, valued features of AOD and health-related websites (general and interactive website features), indicators of website trustworthiness, valued AOD website tools or functions, and treatment modality preferences. Results: Surveys were obtained from 1214 drug (n = 766) and alcohol website users (n = 448) (mean age 26.2 years, range 16-70). There were no significant differences between alcohol and drug groups on demographic variables, Internet usage, indicators of website trustworthiness, or on preferences for AOD website functionality. A robust website design/navigation, open access, and validated content provision were highly valued by both groups. While attractiveness and pictures or graphics were also valued, high-cost features (videos, animations, games) were minority preferences. Almost half of respondents in both groups were unable to readily access the information they sought. Alcohol website users placed greater importance on several AOD website tools and functions than did those accessing other drug websites: online screening tools (
- Authors: Klein, Britt , White, Angela , Kavanagh, David , Shandley, Kerrie , Kay-Lambkin, Frances , Proudfoot, Judith , Drennan, Judy , Connor, Jason , Baker, Amanda , Young, Ross
- Date: 2010
- Type: Text , Journal article
- Relation: Journal of Medical Internet Research Vol. 12, no. 5 (2010), p.
- Full Text:
- Reviewed:
- Description: Background: There is a growing trend for individuals to seek health information from online sources. Alcohol and other drug (AOD) use is a significant health problem worldwide, but access and use of AOD websites is poorly understood. Objective: To investigate content and functionality preferences for AOD and other health websites. Methods: An anonymous online survey examined general Internet and AOD-specific usage and search behaviors, valued features of AOD and health-related websites (general and interactive website features), indicators of website trustworthiness, valued AOD website tools or functions, and treatment modality preferences. Results: Surveys were obtained from 1214 drug (n = 766) and alcohol website users (n = 448) (mean age 26.2 years, range 16-70). There were no significant differences between alcohol and drug groups on demographic variables, Internet usage, indicators of website trustworthiness, or on preferences for AOD website functionality. A robust website design/navigation, open access, and validated content provision were highly valued by both groups. While attractiveness and pictures or graphics were also valued, high-cost features (videos, animations, games) were minority preferences. Almost half of respondents in both groups were unable to readily access the information they sought. Alcohol website users placed greater importance on several AOD website tools and functions than did those accessing other drug websites: online screening tools (
Online alcohol interventions: A systematic review
- White, Angela, Kavanagh, David, Stallman, Helen, Klein, Britt, Kay-Lambkin, Frances, Proudfoot, Judith, Drennan, Judy, Connor, Jason, Baker, Amanda, Hines, Emily, Young, Ross
- Authors: White, Angela , Kavanagh, David , Stallman, Helen , Klein, Britt , Kay-Lambkin, Frances , Proudfoot, Judith , Drennan, Judy , Connor, Jason , Baker, Amanda , Hines, Emily , Young, Ross
- Date: 2010
- Type: Text , Journal article , Review
- Relation: Journal of Medical Internet Research Vol. 12, no. 5 (2010), p. e62p.1-e62p.12
- Full Text:
- Reviewed:
- Description: Background: There has been a significant increase in the availability of online programs for alcohol problems. A systematic review of the research evidence underpinning these programs is timely. Objectives: Our objective was to review the efficacy of online interventions for alcohol misuse. Systematic searches of Medline, PsycINFO, Web of Science, and Scopus were conducted for English abstracts (excluding dissertations) published from 1998 onward. Search terms were: (1) Internet, Web*; (2) online, computer *; (3) alcohol*; and (4) Eeffect *, trial*, random* (where * denotes a wildcard). Forward and backward searches from identified papers were also conducted. Articles were included if (1) the primary intervention was delivered and accessed via the Internet, (2) the intervention focused on moderating or stopping alcohol consumption, and (3) the study was a randomized controlled trial of an alcohol-related screen, assessment, or intervention. Results: The literature search initially yielded 31 randomized controlled trials (RCTs), 17 of which met inclusion criteria. Of these 17 studies, 12 (70.6%) were conducted with university students, and 11 (64.7%) specifically focused on at-risk, heavy, or binge drinkers. Sample sizes ranged from 40 to 3216 (median 261), with 12 (70.6%) studies predominantly involving brief personalized feedback interventions. Using published data, effect sizes could be extracted from 8 of the 17 studies. In relation to alcohol units per week or month and based on 5 RCTs where a measure of alcohol units per week or month could be extracted, differential effect sizes to posttreatment ranged from 0.02 to 0.81 (mean 0.42, median 0.54). Pre-post effect sizes for brief personalized feedback interventions ranged from 0.02 to 0.81, and in 2 multi-session modularized interventions, a pre-post effect size of 0.56 was obtained in both. Pre-post differential effect sizes for peak blood alcohol concentrations (BAC) ranged from 0.22 to 0.88, with a mean effect size of 0.66. Conclusions: The available evidence suggests that users can benefit from online alcohol interventions and that this approach could be particularly useful for groups less likely to access traditional alcohol-related services, such as women, young people, and at-risk users. However, caution should be exercised given the limited number of studies allowing extraction of effect sizes, the heterogeneity of outcome measures and follow-up periods, and the large proportion of student-based studies. More extensive RCTs in community samples are required to better understand the efficacy of specific online alcohol approaches, program dosage, the additive effect of telephone or face-to-face interventions, and effective strategies for their dissemination and marketing.
- Description: Background: There has been a significant increase in the availability of online programs for alcohol problems. A systematic review of the research evidence underpinning these programs is timely. Objectives: Our objective was to review the efficacy of online interventions for alcohol misuse. Systematic searches of Medline, PsycINFO, Web of Science, and Scopus were conducted for English abstracts (excluding dissertations) published from 1998 onward. Search terms were: (1) Internet, Web*; (2) online, computer *; (3) alcohol*; and (4) E\effect *, trial*, random* (where * denotes a wildcard). Forward and backward searches from identified papers were also conducted. Articles were included if (1) the primary intervention was delivered and accessed via the Internet, (2) the intervention focused on moderating or stopping alcohol consumption, and (3) the study was a randomized controlled trial of an alcohol-related screen, assessment, or intervention. Results: The literature search initially yielded 31 randomized controlled trials (RCTs), 17 of which met inclusion criteria. Of these 17 studies, 12 (70.6%) were conducted with university students, and 11 (64.7%) specifically focused on at-risk, heavy, or binge drinkers. Sample sizes ranged from 40 to 3216 (median 261), with 12 (70.6%) studies predominantly involving brief personalized feedback interventions. Using published data, effect sizes could be extracted from 8 of the 17 studies. In relation to alcohol units per week or month and based on 5 RCTs where a measure of alcohol units per week or month could be extracted, differential effect sizes to posttreatment ranged from 0.02 to 0.81 (mean 0.42, median 0.54). Pre-post effect sizes for brief personalized feedback interventions ranged from 0.02 to 0.81, and in 2 multi-session modularized interventions, a pre-post effect size of 0.56 was obtained in both. Pre-post differential effect sizes for peak blood alcohol concentrations (BAC) ranged from 0.22 to 0.88, with a mean effect size of 0.66. Conclusions: The available evidence suggests that users can benefit from online alcohol interventions and that this approach could be particularly useful for groups less likely to access traditional alcohol-related services, such as women, young people, and at-risk users. However, caution should be exercised given the limited number of studies allowing extraction of effect sizes, the heterogeneity of outcome measures and follow-up periods, and the large proportion of student-based studies. More extensive RCTs in community samples are required to better understand the efficacy of specific online alcohol approaches, program dosage, the additive effect of telephone or face-to-face interventions, and effective strategies for their dissemination and marketing.
- Authors: White, Angela , Kavanagh, David , Stallman, Helen , Klein, Britt , Kay-Lambkin, Frances , Proudfoot, Judith , Drennan, Judy , Connor, Jason , Baker, Amanda , Hines, Emily , Young, Ross
- Date: 2010
- Type: Text , Journal article , Review
- Relation: Journal of Medical Internet Research Vol. 12, no. 5 (2010), p. e62p.1-e62p.12
- Full Text:
- Reviewed:
- Description: Background: There has been a significant increase in the availability of online programs for alcohol problems. A systematic review of the research evidence underpinning these programs is timely. Objectives: Our objective was to review the efficacy of online interventions for alcohol misuse. Systematic searches of Medline, PsycINFO, Web of Science, and Scopus were conducted for English abstracts (excluding dissertations) published from 1998 onward. Search terms were: (1) Internet, Web*; (2) online, computer *; (3) alcohol*; and (4) Eeffect *, trial*, random* (where * denotes a wildcard). Forward and backward searches from identified papers were also conducted. Articles were included if (1) the primary intervention was delivered and accessed via the Internet, (2) the intervention focused on moderating or stopping alcohol consumption, and (3) the study was a randomized controlled trial of an alcohol-related screen, assessment, or intervention. Results: The literature search initially yielded 31 randomized controlled trials (RCTs), 17 of which met inclusion criteria. Of these 17 studies, 12 (70.6%) were conducted with university students, and 11 (64.7%) specifically focused on at-risk, heavy, or binge drinkers. Sample sizes ranged from 40 to 3216 (median 261), with 12 (70.6%) studies predominantly involving brief personalized feedback interventions. Using published data, effect sizes could be extracted from 8 of the 17 studies. In relation to alcohol units per week or month and based on 5 RCTs where a measure of alcohol units per week or month could be extracted, differential effect sizes to posttreatment ranged from 0.02 to 0.81 (mean 0.42, median 0.54). Pre-post effect sizes for brief personalized feedback interventions ranged from 0.02 to 0.81, and in 2 multi-session modularized interventions, a pre-post effect size of 0.56 was obtained in both. Pre-post differential effect sizes for peak blood alcohol concentrations (BAC) ranged from 0.22 to 0.88, with a mean effect size of 0.66. Conclusions: The available evidence suggests that users can benefit from online alcohol interventions and that this approach could be particularly useful for groups less likely to access traditional alcohol-related services, such as women, young people, and at-risk users. However, caution should be exercised given the limited number of studies allowing extraction of effect sizes, the heterogeneity of outcome measures and follow-up periods, and the large proportion of student-based studies. More extensive RCTs in community samples are required to better understand the efficacy of specific online alcohol approaches, program dosage, the additive effect of telephone or face-to-face interventions, and effective strategies for their dissemination and marketing.
- Description: Background: There has been a significant increase in the availability of online programs for alcohol problems. A systematic review of the research evidence underpinning these programs is timely. Objectives: Our objective was to review the efficacy of online interventions for alcohol misuse. Systematic searches of Medline, PsycINFO, Web of Science, and Scopus were conducted for English abstracts (excluding dissertations) published from 1998 onward. Search terms were: (1) Internet, Web*; (2) online, computer *; (3) alcohol*; and (4) E\effect *, trial*, random* (where * denotes a wildcard). Forward and backward searches from identified papers were also conducted. Articles were included if (1) the primary intervention was delivered and accessed via the Internet, (2) the intervention focused on moderating or stopping alcohol consumption, and (3) the study was a randomized controlled trial of an alcohol-related screen, assessment, or intervention. Results: The literature search initially yielded 31 randomized controlled trials (RCTs), 17 of which met inclusion criteria. Of these 17 studies, 12 (70.6%) were conducted with university students, and 11 (64.7%) specifically focused on at-risk, heavy, or binge drinkers. Sample sizes ranged from 40 to 3216 (median 261), with 12 (70.6%) studies predominantly involving brief personalized feedback interventions. Using published data, effect sizes could be extracted from 8 of the 17 studies. In relation to alcohol units per week or month and based on 5 RCTs where a measure of alcohol units per week or month could be extracted, differential effect sizes to posttreatment ranged from 0.02 to 0.81 (mean 0.42, median 0.54). Pre-post effect sizes for brief personalized feedback interventions ranged from 0.02 to 0.81, and in 2 multi-session modularized interventions, a pre-post effect size of 0.56 was obtained in both. Pre-post differential effect sizes for peak blood alcohol concentrations (BAC) ranged from 0.22 to 0.88, with a mean effect size of 0.66. Conclusions: The available evidence suggests that users can benefit from online alcohol interventions and that this approach could be particularly useful for groups less likely to access traditional alcohol-related services, such as women, young people, and at-risk users. However, caution should be exercised given the limited number of studies allowing extraction of effect sizes, the heterogeneity of outcome measures and follow-up periods, and the large proportion of student-based studies. More extensive RCTs in community samples are required to better understand the efficacy of specific online alcohol approaches, program dosage, the additive effect of telephone or face-to-face interventions, and effective strategies for their dissemination and marketing.
UPPS-P facets of impulsivity and alcohol use patterns in college and noncollege emerging adults
- Tran, Joanna, Teese, Robert, Gill, Peter
- Authors: Tran, Joanna , Teese, Robert , Gill, Peter
- Date: 2018
- Type: Text , Journal article
- Relation: American Journal of Drug and Alcohol Abuse Vol. 44, no. 6 (2018), p. 695-704
- Full Text:
- Reviewed:
- Description: Background: Alcohol use and related problems reach a peak in emerging adulthood. Impulsivity is a multifaceted construct known to be involved in emerging adult alcohol use. Few studies have examined impulsivity and alcohol use across both college attending and noncollege attending emerging adults. Objectives: To clarify the multifaceted nature of impulsivity and its links to emerging adult alcohol use, this study investigated whether the five distinct facets of the UPPS-P model of impulsivity were predictive of three different behavioral outcomes: alcohol intake, alcohol related problems and binge drinking. In addition, the moderating effects of college attendance were tested. Methods: A community sample comprising 273 Australian college and noncollege attendees (58.6% women; 41.4% men) aged between 18 and 30 years (Mage = 23.71, SD = 2.81). Results: Multiple regression analyses demonstrated that lack of premeditation predicted alcohol intake and binge drinking behavior, whilst positive and negative urgency predicted alcohol related problems. Moderation analyses revealed that the effects of impulsivity on alcohol patterns were consistent for college and noncollege attending emerging adults. Conclusion: These findings highlight the importance of impulsive urgency (both positive and negative) in emerging adult problematic alcohol use, and support the generalizability of college samples to broader emerging adult populations. Emerging adults may use alcohol to avoid negative mood states and further enhance positive mood states. Improved emotional regulation may help both college and non-college emerging adults reduce their alcohol use.
- Authors: Tran, Joanna , Teese, Robert , Gill, Peter
- Date: 2018
- Type: Text , Journal article
- Relation: American Journal of Drug and Alcohol Abuse Vol. 44, no. 6 (2018), p. 695-704
- Full Text:
- Reviewed:
- Description: Background: Alcohol use and related problems reach a peak in emerging adulthood. Impulsivity is a multifaceted construct known to be involved in emerging adult alcohol use. Few studies have examined impulsivity and alcohol use across both college attending and noncollege attending emerging adults. Objectives: To clarify the multifaceted nature of impulsivity and its links to emerging adult alcohol use, this study investigated whether the five distinct facets of the UPPS-P model of impulsivity were predictive of three different behavioral outcomes: alcohol intake, alcohol related problems and binge drinking. In addition, the moderating effects of college attendance were tested. Methods: A community sample comprising 273 Australian college and noncollege attendees (58.6% women; 41.4% men) aged between 18 and 30 years (Mage = 23.71, SD = 2.81). Results: Multiple regression analyses demonstrated that lack of premeditation predicted alcohol intake and binge drinking behavior, whilst positive and negative urgency predicted alcohol related problems. Moderation analyses revealed that the effects of impulsivity on alcohol patterns were consistent for college and noncollege attending emerging adults. Conclusion: These findings highlight the importance of impulsive urgency (both positive and negative) in emerging adult problematic alcohol use, and support the generalizability of college samples to broader emerging adult populations. Emerging adults may use alcohol to avoid negative mood states and further enhance positive mood states. Improved emotional regulation may help both college and non-college emerging adults reduce their alcohol use.
High-intensity drinking in adult Australian twins
- Dash, Genevieve, Davis, Christal, Martin, Nicholas, Statham, Dixie, Lynskey, Michael, Slutske, Wendy
- Authors: Dash, Genevieve , Davis, Christal , Martin, Nicholas , Statham, Dixie , Lynskey, Michael , Slutske, Wendy
- Date: 2020
- Type: Text , Journal article
- Relation: Alcoholism: clinical and experimental research Vol. 44, no. 2 (2020), p. 522-531
- Full Text:
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- Description: Background: Many adult drinkers consume far beyond the binge threshold. This “high-intensity drinking” (HID), defined as 2 (HID-2) and 3 (HID-3) times the binge threshold, is of public health interest due to its role in acute alcohol-related harms. Research on HID has mostly been limited to college-aged young adults, focused on contextual factors, and neglected the potential role of genetic influences on the propensity to engage in HID. Methods: Structured diagnostic interviews assessing past-year alcohol involvement were conducted with 3,785 individuals (1,365 men, 2,420 women; Mage = 32, range = 21 to 46), including 3,314 twins and 471 nontwin siblings from the Australian Twin Registry. Multinomial logistic regression analyses were conducted to compare HID-2 and HID-3 to binge drinking on demographic correlates, drinking characteristics, and drinking-related consequences. Biometric modeling was conducted to estimate the role of genetic, common, and individual-specific environmental factors in HID propensity. Results: Among past-year drinkers, the prevalence of HID-2 and HID-3 was both 22%, with men disproportionally represented. The frequencies of drinking, intoxication, and binge drinking significantly increased across the heavier drinking categories, which also evidenced higher average consumption quantities and higher rates of alcohol-related consequences. The propensity to engage in HID was significantly heritable (A = 37% [95% CI: 28 to 46%]), with individual-specific environmental influences accounting for the remainder of the variance. Conclusions: This study convincingly demonstrates that HID is not restricted to college-aged young adults, but also can be highly prevalent among those of working age, and that the propensity to engage in HID is partially explained by genetic influences. © 2020 by the Research Society on Alcoholism
- Authors: Dash, Genevieve , Davis, Christal , Martin, Nicholas , Statham, Dixie , Lynskey, Michael , Slutske, Wendy
- Date: 2020
- Type: Text , Journal article
- Relation: Alcoholism: clinical and experimental research Vol. 44, no. 2 (2020), p. 522-531
- Full Text:
- Reviewed:
- Description: Background: Many adult drinkers consume far beyond the binge threshold. This “high-intensity drinking” (HID), defined as 2 (HID-2) and 3 (HID-3) times the binge threshold, is of public health interest due to its role in acute alcohol-related harms. Research on HID has mostly been limited to college-aged young adults, focused on contextual factors, and neglected the potential role of genetic influences on the propensity to engage in HID. Methods: Structured diagnostic interviews assessing past-year alcohol involvement were conducted with 3,785 individuals (1,365 men, 2,420 women; Mage = 32, range = 21 to 46), including 3,314 twins and 471 nontwin siblings from the Australian Twin Registry. Multinomial logistic regression analyses were conducted to compare HID-2 and HID-3 to binge drinking on demographic correlates, drinking characteristics, and drinking-related consequences. Biometric modeling was conducted to estimate the role of genetic, common, and individual-specific environmental factors in HID propensity. Results: Among past-year drinkers, the prevalence of HID-2 and HID-3 was both 22%, with men disproportionally represented. The frequencies of drinking, intoxication, and binge drinking significantly increased across the heavier drinking categories, which also evidenced higher average consumption quantities and higher rates of alcohol-related consequences. The propensity to engage in HID was significantly heritable (A = 37% [95% CI: 28 to 46%]), with individual-specific environmental influences accounting for the remainder of the variance. Conclusions: This study convincingly demonstrates that HID is not restricted to college-aged young adults, but also can be highly prevalent among those of working age, and that the propensity to engage in HID is partially explained by genetic influences. © 2020 by the Research Society on Alcoholism
Under the influence : identifying determinants of young adults' involvement in alcohol-influenced aquatic activity to improve drowning prevention efforts
- Authors: Calverley, Hannah
- Date: 2020
- Type: Text , Thesis , PhD
- Full Text:
- Description: BACKGROUND: Young adults are an at-risk group for experiencing an alcohol-related drowning incident. Investigations and drowning prevention efforts have aimed to address young adults’ prevalence in alcohol-related drownings and contribute to understanding their level of risk. Some explanations have concluded young adults’ need for autonomy and independence coincides with their exposure to alcohol and social norm pressures. However, gaps in knowledge remain, specifically young adults’: behaviours, knowledge and attitudes towards alcohol-influenced aquatic activity and the associated risks; and, their awareness and perceptions of alcohol-themed drowning prevention campaigns. METHODS: This PhD, completed with publications, aimed to address these gaps through four interlinked projects: (i) a systematic review of alcohol education programs to determine evidence-based quality criteria necessary for inclusion in programs to successfully change young adults’ alcohol-related behaviours, knowledge and attitudes; (ii) a program audit of alcohol-themed drowning prevention campaigns to establish current prevention efforts in high-income countries and areas for improvement; (iii) a survey among young adults from Australia and the United Kingdom to establish their knowledge, attitudes and predictors of intentions and involvement in alcohol-influenced aquatic activities; and, (iv) interviews to deepen understanding of young adults’ knowledge, attitudes and behaviours relating to alcohol-influenced aquatic activity, their awareness of alcohol-themed drowning prevention campaigns and their suggestions for improvement. Six publications resulted from this research. RESULTS: Friends influenced frequency of young adults’ involvement in alcohol-influenced aquatic activity, but involvement was dependent on the characteristics of the peer group, self-confidence and risk disassociation. Attitudes were neutral towards alcohol-influenced aquatic activity, but when participants perceived personal control over the risks it was deemed more acceptable. Alcohol-related safety strategies from other contexts (e.g., driving) were applied to aquatic settings, but specific water safety knowledge/education was low. Stronger swimmers, Australian young adults and those who had received alcohol-specific water safety education displayed more knowledge of alcohol and its effects in aquatic contexts. Participants lacked awareness of alcohol-themed drowning prevention campaigns, and used campaign logos and names to interpret key messages. Little information was available on the alcohol-themed drowning prevention campaigns identified in the program audit and only two had evidence of evaluation, limiting progress of future prevention efforts. Ten quality criteria identified from evidence-based literature were considered to be necessary for inclusion in alcohol education programs. Programs included in the systematic review which incorporated these criteria were more likely to report success in influencing behaviour changes among the participants. CONCLUSIONS: To decrease the incidence of alcohol-related drowning among young adults, the findings of the projects included within this thesis result in the following recommendations. For enhanced likelihood of successful outcomes, alcohol-themed drowning prevention campaigns should align campaign design, implementation and evaluation with best-practice literature. The identified influencers on young adults’ involvement in alcohol-influenced aquatic activity, such as their peers, should be incorporated into prevention efforts and appropriate information provided to encourage informed decision making. Alcohol education programs (e.g., drink driving education) should include information about alcohol use in aquatic settings to clarify the risks associated with transferring safety strategies between drinking contexts, and appropriate information should be provided about alcohol consumption in aquatic settings.
- Description: Doctor of Philosophy
- Authors: Calverley, Hannah
- Date: 2020
- Type: Text , Thesis , PhD
- Full Text:
- Description: BACKGROUND: Young adults are an at-risk group for experiencing an alcohol-related drowning incident. Investigations and drowning prevention efforts have aimed to address young adults’ prevalence in alcohol-related drownings and contribute to understanding their level of risk. Some explanations have concluded young adults’ need for autonomy and independence coincides with their exposure to alcohol and social norm pressures. However, gaps in knowledge remain, specifically young adults’: behaviours, knowledge and attitudes towards alcohol-influenced aquatic activity and the associated risks; and, their awareness and perceptions of alcohol-themed drowning prevention campaigns. METHODS: This PhD, completed with publications, aimed to address these gaps through four interlinked projects: (i) a systematic review of alcohol education programs to determine evidence-based quality criteria necessary for inclusion in programs to successfully change young adults’ alcohol-related behaviours, knowledge and attitudes; (ii) a program audit of alcohol-themed drowning prevention campaigns to establish current prevention efforts in high-income countries and areas for improvement; (iii) a survey among young adults from Australia and the United Kingdom to establish their knowledge, attitudes and predictors of intentions and involvement in alcohol-influenced aquatic activities; and, (iv) interviews to deepen understanding of young adults’ knowledge, attitudes and behaviours relating to alcohol-influenced aquatic activity, their awareness of alcohol-themed drowning prevention campaigns and their suggestions for improvement. Six publications resulted from this research. RESULTS: Friends influenced frequency of young adults’ involvement in alcohol-influenced aquatic activity, but involvement was dependent on the characteristics of the peer group, self-confidence and risk disassociation. Attitudes were neutral towards alcohol-influenced aquatic activity, but when participants perceived personal control over the risks it was deemed more acceptable. Alcohol-related safety strategies from other contexts (e.g., driving) were applied to aquatic settings, but specific water safety knowledge/education was low. Stronger swimmers, Australian young adults and those who had received alcohol-specific water safety education displayed more knowledge of alcohol and its effects in aquatic contexts. Participants lacked awareness of alcohol-themed drowning prevention campaigns, and used campaign logos and names to interpret key messages. Little information was available on the alcohol-themed drowning prevention campaigns identified in the program audit and only two had evidence of evaluation, limiting progress of future prevention efforts. Ten quality criteria identified from evidence-based literature were considered to be necessary for inclusion in alcohol education programs. Programs included in the systematic review which incorporated these criteria were more likely to report success in influencing behaviour changes among the participants. CONCLUSIONS: To decrease the incidence of alcohol-related drowning among young adults, the findings of the projects included within this thesis result in the following recommendations. For enhanced likelihood of successful outcomes, alcohol-themed drowning prevention campaigns should align campaign design, implementation and evaluation with best-practice literature. The identified influencers on young adults’ involvement in alcohol-influenced aquatic activity, such as their peers, should be incorporated into prevention efforts and appropriate information provided to encourage informed decision making. Alcohol education programs (e.g., drink driving education) should include information about alcohol use in aquatic settings to clarify the risks associated with transferring safety strategies between drinking contexts, and appropriate information should be provided about alcohol consumption in aquatic settings.
- Description: Doctor of Philosophy
- Calverley, Hannah, Petrass, Lauren, Blitvich, Jennifer
- Authors: Calverley, Hannah , Petrass, Lauren , Blitvich, Jennifer
- Date: 2021
- Type: Text , Journal article
- Relation: Health Promotion Journal of Australia Vol. 32, no. S2 (2021), p. 229-237
- Full Text: false
- Reviewed:
- Description: Issue addressed: Young adults are over-represented in alcohol-related drownings in high-income countries; however, little research has investigated their behaviours and decision-making to inform prevention efforts. Methods: Semi-structured interviews were conducted with 23 young Australian adults (aged 18-24 years). Questions, informed by previous research, inquired about behavioural practices in aquatic contexts and influences on involvement in alcohol-influenced aquatic activity. Interviews were transcribed verbatim. Thematic and interpretative phenomenological analysis followed. Results: Two main themes: personal and contextual awareness, and the impact of other people affected perceptions and involvement in alcohol-influenced aquatic activity. Perceived control of situations and self-confidence affected how these influences impacted individuals’ involvement. Participants acknowledged some young adults likely overestimate their aquatic abilities. This awareness was not discussed in relation to their own capabilities. Conclusion: Drowning prevention efforts should inform young adults of the dangers of combining alcohol and aquatic activities, and make risks appear more immediate and applicable. Consideration should be given to measuring both perceived and actual aquatic abilities within various aquatic environments, to determine whether self-reported perceived competence is an accurate proxy measure for actual aquatic ability. The influence of alcohol should also be highlighted. Steps are required for a positive shift in Australian norms of alcohol use in aquatic settings and the social and cultural attitudes towards this. So what?: This study provides new insight into young adults’ perceptions and involvement in alcohol-influenced aquatic activity. It enhances the evidence base for drowning prevention and health promotion practitioners and should inform more focused campaigns to prevent alcohol-related drownings among young Australian adults. © 2021 Australian Health Promotion Association
Alcohol_focused drowning prevention campaigns : what do we know and what should we do now?
- Calverley, Hannah, Petrass, Lauren, Blitvich, Jennifer
- Authors: Calverley, Hannah , Petrass, Lauren , Blitvich, Jennifer
- Date: 2020
- Type: Text , Journal article
- Relation: International Journal of Aquatic Research and Education Vol. 12, no. 2 (2020), p.
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- Reviewed:
- Description: Alcohol and drugs have been identified as key risk factors for youth (aged 15-24 years) and adult drownings in high-income countries (HIC). Whilst alcohol specific drowning prevention education programs have been developed and implemented, youth continue to be over-represented in drowning statistics, including those linked with alcohol. Therefore, this project aimed to: (i) review and assess all alcohol themed drowning prevention campaigns within HICs; (ii) determine whether the campaign had undergone evaluation for effectiveness; and (iii) provide recommendations to improve the effectiveness of future interventions. For each of the eighty-one HICs identified for the 2019 fiscal year, searches of peer-reviewed literature (through academic databases) and grey literature (through webpages and emails to organisations) were conducted. Twelve alcohol focused campaigns were identified, with only two providing limited information about program evaluation. For most campaigns identified, there was a dearth of information available and therefore assessment of campaign quality was unfeasible. This brief report highlights a lack of alcohol themed drowning prevention campaigns in HIC, and an absence of evaluations on their effectiveness. Implications associated with a lack of program evaluation are discussed and adoption of the recommendations from this brief report should enhance the quality of future research in this area. © 2020 Human Kinetics Publishers Inc.. All rights reserved.
- Authors: Calverley, Hannah , Petrass, Lauren , Blitvich, Jennifer
- Date: 2020
- Type: Text , Journal article
- Relation: International Journal of Aquatic Research and Education Vol. 12, no. 2 (2020), p.
- Full Text:
- Reviewed:
- Description: Alcohol and drugs have been identified as key risk factors for youth (aged 15-24 years) and adult drownings in high-income countries (HIC). Whilst alcohol specific drowning prevention education programs have been developed and implemented, youth continue to be over-represented in drowning statistics, including those linked with alcohol. Therefore, this project aimed to: (i) review and assess all alcohol themed drowning prevention campaigns within HICs; (ii) determine whether the campaign had undergone evaluation for effectiveness; and (iii) provide recommendations to improve the effectiveness of future interventions. For each of the eighty-one HICs identified for the 2019 fiscal year, searches of peer-reviewed literature (through academic databases) and grey literature (through webpages and emails to organisations) were conducted. Twelve alcohol focused campaigns were identified, with only two providing limited information about program evaluation. For most campaigns identified, there was a dearth of information available and therefore assessment of campaign quality was unfeasible. This brief report highlights a lack of alcohol themed drowning prevention campaigns in HIC, and an absence of evaluations on their effectiveness. Implications associated with a lack of program evaluation are discussed and adoption of the recommendations from this brief report should enhance the quality of future research in this area. © 2020 Human Kinetics Publishers Inc.. All rights reserved.
Predicting young adults’ intentions and involvement in alcohol-influenced aquatic activity
- Calverley, Hannah, Petrass, Lauren, Blitvich, Jennifer
- Authors: Calverley, Hannah , Petrass, Lauren , Blitvich, Jennifer
- Date: 2021
- Type: Text , Journal article
- Relation: International Journal of Aquatic Research and Education Vol. 13, no. 3 (2021), p.
- Full Text:
- Reviewed:
- Description: Globally, alcohol consumption is a public health issue and a risk factor for drownings among young adults. While studies have identified a prominence of alcohol in youth drownings, little is known about the factors that influence young adults’ involvement in alcohol-influenced aquatic activity. The current study aimed to identify the predictors of young adults’ intention to participate, and past participation, in alcohol-influenced aquatic activity. A reliable and valid survey, informed by the Theory of Planned Behavior, was distributed to young adults (aged 18-24 years) educated in the UK and Australia. Cumulative odds ordinal logistic regressions with proportional odds were conducted to establish predictors. Overall, 182 participants completed the survey. Subjective norms (Wald
- Authors: Calverley, Hannah , Petrass, Lauren , Blitvich, Jennifer
- Date: 2021
- Type: Text , Journal article
- Relation: International Journal of Aquatic Research and Education Vol. 13, no. 3 (2021), p.
- Full Text:
- Reviewed:
- Description: Globally, alcohol consumption is a public health issue and a risk factor for drownings among young adults. While studies have identified a prominence of alcohol in youth drownings, little is known about the factors that influence young adults’ involvement in alcohol-influenced aquatic activity. The current study aimed to identify the predictors of young adults’ intention to participate, and past participation, in alcohol-influenced aquatic activity. A reliable and valid survey, informed by the Theory of Planned Behavior, was distributed to young adults (aged 18-24 years) educated in the UK and Australia. Cumulative odds ordinal logistic regressions with proportional odds were conducted to establish predictors. Overall, 182 participants completed the survey. Subjective norms (Wald
Exploring adolescent-parent interaction strategies for accessing alcohol at home
- Dresler, Emma, Whitehead, Dean, Weaver, Kelly
- Authors: Dresler, Emma , Whitehead, Dean , Weaver, Kelly
- Date: 2017
- Type: Text , Journal article
- Relation: Health Education Vol. 117, no. 6 (2017), p. 566-580
- Full Text:
- Reviewed:
- Description: Purpose: The purpose of this paper is to determine the extent to which youth have ready access to alcohol and the extent to which immediate family influence affects consumption. Design/methodology/approach: This qualitative descriptive exploratory study undertook semi-structured peer-group interviews with 20 participants from four New Zealand high schools. The interviews centred on exploring the “general” experiences of youth related to alcohol access – but with a focus on alcohol access “at home” and the parental role. Findings: The study confirmed that the home unit was the main source of alcohol for most youth and parents were the most common source of provision. Parents provided financial access to alcohol by giving their child money to purchase it themselves through older family members or friends. It was also found that youth used negotiation strategies with their parents to influence their consumer purchases of alcohol. Research limitations/implications: Youth frequently used strategies such as pressure tactics, exchange tactics, ingratiating tactics and consultation tactics to influence their family’s decision-making process and to pressure their parents into supplying them with alcohol. Practical implications: It is important to recognise the role that family play as “gatekeepers” for readily allowing access and supplying youth with alcohol – and the reasons for doing so. Social implications: Alcohol plays an important part in many societies. It is important to understand how young people consume and access alcohol – particularly when the family plays a major role in access and consumption. Originality/value: Many studies have been conducted in relation to youth and alcohol consumption. Very few, as far as we can tell, explore the role of the family from the young consumers’ perspective and especially from a qualitative narrative perspective. © 2017, © Emerald Publishing Limited.
- Authors: Dresler, Emma , Whitehead, Dean , Weaver, Kelly
- Date: 2017
- Type: Text , Journal article
- Relation: Health Education Vol. 117, no. 6 (2017), p. 566-580
- Full Text:
- Reviewed:
- Description: Purpose: The purpose of this paper is to determine the extent to which youth have ready access to alcohol and the extent to which immediate family influence affects consumption. Design/methodology/approach: This qualitative descriptive exploratory study undertook semi-structured peer-group interviews with 20 participants from four New Zealand high schools. The interviews centred on exploring the “general” experiences of youth related to alcohol access – but with a focus on alcohol access “at home” and the parental role. Findings: The study confirmed that the home unit was the main source of alcohol for most youth and parents were the most common source of provision. Parents provided financial access to alcohol by giving their child money to purchase it themselves through older family members or friends. It was also found that youth used negotiation strategies with their parents to influence their consumer purchases of alcohol. Research limitations/implications: Youth frequently used strategies such as pressure tactics, exchange tactics, ingratiating tactics and consultation tactics to influence their family’s decision-making process and to pressure their parents into supplying them with alcohol. Practical implications: It is important to recognise the role that family play as “gatekeepers” for readily allowing access and supplying youth with alcohol – and the reasons for doing so. Social implications: Alcohol plays an important part in many societies. It is important to understand how young people consume and access alcohol – particularly when the family plays a major role in access and consumption. Originality/value: Many studies have been conducted in relation to youth and alcohol consumption. Very few, as far as we can tell, explore the role of the family from the young consumers’ perspective and especially from a qualitative narrative perspective. © 2017, © Emerald Publishing Limited.
- Davis, Christal, Gizer, Ian, Colodro-Conde, Lucia, Statham, Dixie, Martin, Nicholas, Slutske, Wendy
- Authors: Davis, Christal , Gizer, Ian , Colodro-Conde, Lucia , Statham, Dixie , Martin, Nicholas , Slutske, Wendy
- Date: 2022
- Type: Text , Journal article
- Relation: Twin Research and Human Genetics Vol. 25, no. 4-5 (2022), p. 187-195
- Full Text: false
- Reviewed:
- Description: Genes associated with educational attainment may be related to or interact with adolescent alcohol, tobacco and cannabis use. Potential gene-environment interplay between educational attainment polygenic scores (EA-PGS) and adolescent alcohol, tobacco, and cannabis use was evaluated with a series of regression models fitted to data from a sample of 1871 adult Australian twins. All models controlled for age, age2, cohort, sex and genetic ancestry as fixed effects, and a genetic relatedness matrix was included as a random effect. Although there was no evidence that adolescent alcohol, tobacco or cannabis use interacted with EA-PGS to influence educational attainment, there was a significant, positive gene-environment correlation with adolescent alcohol use at all PGS thresholds (ps <.02). Higher EA-PGS were associated with an increased likelihood of using alcohol as an adolescent (
mHealth interventions to reduce alcohol use in young people : a systematic review of the literature
- Hutton, Alison, Prichard, Ivanka, Whitehead, Dean, Thomas, Susan, Rubin, Mark, Sloand, Elizabeth, Powell, Terrinieka, Frisch, Keri, Newman, Peter, Goodwin Veenema, Tener
- Authors: Hutton, Alison , Prichard, Ivanka , Whitehead, Dean , Thomas, Susan , Rubin, Mark , Sloand, Elizabeth , Powell, Terrinieka , Frisch, Keri , Newman, Peter , Goodwin Veenema, Tener
- Date: 2020
- Type: Text , Journal article , Review
- Relation: Comprehensive Child and Adolescent Nursing Vol. 43, no. 3 (2020), p. 171-202
- Full Text:
- Reviewed:
- Description: Harmful use of alcohol has serious effects on public health and is considered a significant risk factor for poor health. mHealth technology promotes health behavior change and enhances health through increased social opportunities for encouragement and support. It remains unknown whether these types of applications directly influence the health status of young people in reducing harmful levels of alcohol consumption. The purpose of this systematic review is to examine current evidence on the effectiveness of mHealth technology use in positively influencing alcohol-related behaviors of young people without known alcohol addiction. Relevant articles published from 2005 to January 2017 were identified through electronic searches of eight databases. Studies with interventions delivered by mHealth (social networking sites, SMS and mobile phone applications) to young people aged 12–26 years were included. Outcome measures were alcohol use, reduction in alcohol consumption or behavior change. Eighteen studies met the inclusion criteria. Interventions varied in design, participant characteristics, settings, length and outcome measures. Ten studies reported some effectiveness related to interventions with nine reporting a reduction in alcohol consumption. Use of mHealth, particularly text messaging (documented as SMS), was found to be an acceptable, affordable and effective way to deliver messages about reducing alcohol consumption to young people. Further research using adequately powered sample sizes in varied settings, with adequate periods of intervention and follow-up, underpinned by theoretical perspectives incorporating behavior change in young people’s use of alcohol, is needed. © 2019 Taylor & Francis.
- Authors: Hutton, Alison , Prichard, Ivanka , Whitehead, Dean , Thomas, Susan , Rubin, Mark , Sloand, Elizabeth , Powell, Terrinieka , Frisch, Keri , Newman, Peter , Goodwin Veenema, Tener
- Date: 2020
- Type: Text , Journal article , Review
- Relation: Comprehensive Child and Adolescent Nursing Vol. 43, no. 3 (2020), p. 171-202
- Full Text:
- Reviewed:
- Description: Harmful use of alcohol has serious effects on public health and is considered a significant risk factor for poor health. mHealth technology promotes health behavior change and enhances health through increased social opportunities for encouragement and support. It remains unknown whether these types of applications directly influence the health status of young people in reducing harmful levels of alcohol consumption. The purpose of this systematic review is to examine current evidence on the effectiveness of mHealth technology use in positively influencing alcohol-related behaviors of young people without known alcohol addiction. Relevant articles published from 2005 to January 2017 were identified through electronic searches of eight databases. Studies with interventions delivered by mHealth (social networking sites, SMS and mobile phone applications) to young people aged 12–26 years were included. Outcome measures were alcohol use, reduction in alcohol consumption or behavior change. Eighteen studies met the inclusion criteria. Interventions varied in design, participant characteristics, settings, length and outcome measures. Ten studies reported some effectiveness related to interventions with nine reporting a reduction in alcohol consumption. Use of mHealth, particularly text messaging (documented as SMS), was found to be an acceptable, affordable and effective way to deliver messages about reducing alcohol consumption to young people. Further research using adequately powered sample sizes in varied settings, with adequate periods of intervention and follow-up, underpinned by theoretical perspectives incorporating behavior change in young people’s use of alcohol, is needed. © 2019 Taylor & Francis.
- Calverley, Hannah, Petrass, Lauren, Blitvich, Jennifer
- Authors: Calverley, Hannah , Petrass, Lauren , Blitvich, Jennifer
- Date: 2021
- Type: Text , Journal article
- Relation: Drugs: Education, Prevention and Policy Vol. 28, no. 6 (2021), p. 595-605
- Full Text: false
- Reviewed:
- Description: Retrospective studies have identified alcohol as a significant risk factor in drownings involving young adults. Few studies have explored this issue, therefore the current contextual understanding of alcohol consumption in aquatic settings is limited. This study used a survey (n = 182) and one-to-one and small group interviews (n = 23) to investigate knowledge and attitudes of United Kingdom and Australian young adults (aged 18–24 years) towards involvement in aquatic activity after consuming alcohol. Findings illustrated a poor level of general and aquatic-specific alcohol knowledge. Australian educated participants, and those self-reporting: stronger swimming competence; and/or completion of alcohol and water safety education; and/or participation in aquatic activity following alcohol consumption, achieved significantly higher knowledge scores. Most reported a neutral attitude, and those with previous experience of alcohol consumption in aquatic settings had more accepting attitudes of this behavior (p < 0.001). The aquatic activity, context and amount of alcohol consumed influenced attitudes. Participants reported a lack of alcohol-focused drowning prevention or water safety education for their age group, and many referred to their upbringing and parents’ behaviors as reference for what was safe. Drowning prevention practitioners should consider these results to ensure young adults understand the risks of consuming alcohol in all aquatic contexts. © 2020 Informa UK Limited, trading as Taylor & Francis Group.
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