Truancy, alcohol use and alcohol-related problems in secondary school pupils in Norway.

This study focuses on a vulnerable group of pupils often missed by mainstream school surveys. It explores alcohol use and alcohol-related problems for a sample of truants of secondary school age, comparing behaviours with a school-based sample from the same geographical area. Analyses are based on a survey among truants (n = 107) and a school survey (n = 3702) undertaken in Bergen, Norway. When compared with mainstream pupils, the truants reported an earlier alcohol debut and a higher frequency of drinking. They reported significantly higher levels of binge drinking (6+ units). Truants were four times more likely to report regular drunkenness and twice as likely to report problems associated with their alcohol consumption. In the truancy sample, boys were more likely to engage in regular and excessive drinking, while girls reported higher levels of problems linked to their drinking. Results suggest that higher levels of truancy were related to more frequent drinking, drunkenness and alcohol-related problems. There are strong indications for early intervention activities directed at truants, and registration of truancy in itself could be a simple and effective way of identifying pupils at risk of a wide range of social and health problems, including high levels of alcohol use.

The relationship among self-efficacy expectancies, severity of alcohol abuse, and psychological benefits from drinking.

The aim of the study is to examine the relationship among self-efficacy expectancies and two important clinical aspects of alcohol abuse, namely the severity of abuse and strength of the perceived psychological benefits from drinking. The self-efficacy expectancies were measured by the Situational Confidence Questionnaire (Annis, 1984) in a group of alcoholic men (N = 203). A systematic and significant relationship was identified between the subjects' confidence in coping with high-risk factors for heavy drinking and their severity of abuse. The subjects' level of confidence decreased proportionally with an increase in their abuse. Furthermore, the subjects' perceived psychological benefits from drinking covaried with their self-efficacy. A significant association was found between lower self-efficacy scores and experiencing great psychological benefits from drinking such as improved social skills, less depression and tension, and improved cognition. A combination of the two variables, severity of abuse and strength of perceived benefits, shows a systematic and differentiated picture among the subgroups. Clinical implications based on the results are presented.

Association between gender and marital status and confidence in remaining abstinent among alcohol abusers in treatment.

AIMS: To assess the importance of gender and marital status on self-efficacy expectancies of alcohol abusers in treatment. DESIGN, PARTICIPANTS AND SETTING: Cross-sectional study with a group of alcohol abusers in treatment (n = 259, 56 women) at the Bergen Clinics Foundation, Norway. MEASUREMENTS: The Situational Confidence Questionnaire was applied for the self-efficacy assessment. FINDINGS: Self-reports of significant life problems were associated with low self-efficacy expectancies. Controlling for this, female abusers scored significantly higher than their male counterparts on risk of relapse in "positive emotional state" and "pleasant emotional states with others". CONCLUSIONS: Situations perceived as being at high risk for relapse were associated with gender and significant life problems. The findings have implications for a more differentiated approach in the relapse prevention treatment programmes.

Sexual debut and predictors of condom use among secondary school students in Arusha, Tanzania.

A cross-sectional survey was conducted using interviews among 852 students attending seven secondary schools in the Arusha region, Northern Tanzania, to predict determinants of sexual debut and recent condom use among students. Schools were sampled according to location, school size and ownership criteria. Subjects were randomly sampled within grade-level and gender through use of class registers. Altogether, 528 students were sexually active. Males were more likely than females to report their sexual debut status (82.0% versus 33.3%; OR = 8.78; 95% CI: 6.17-12.49). Among males, incidence of sexual debut increased with grade-level, but decreased according to religious affiliation. None of the socio-demographic predictor variables used in this study had a significant association with sexual debut among females when age was controlled for. Of the sexually active students, 26.8% reported having ever used a condom and 21.5% reported use of condoms during their most recent sexual encounter. Late sexual debut, prolonged duration of dating before intercourse and having only one sex partner were significantly associated with increased condom use during the most recent occasion. Condom use increased with levels of education, but gender was not significantly linked to increased condom use. Condom use was particularly infrequent among casual sex partners. We observed a marked gender difference among students with respect to their sexual debut status, but no such difference was found in relation to condom use.

PIP: A cross-sectional survey conducted among 528 sexually active secondary school students in Northern Tanzania identified marked gender differences in terms of predictors of sexual debut status but not in relation to condom use. A sexual behavior survey was conducted in seven secondary schools (two urban, three semi-urban, and two rural) in Arusha in 1993. At least 20% of students at each school were randomly selected (after stratification by gender and grade level) for participation, resulting in a sample of 849 students (501 males and 348 females); 411 of these males and 115 females reported they were sexually active. Sexual debut status among male students was positively associated with increasing age, school forms three and four, and Roman Catholic religious affiliation; among female students, age was the only significant predictor. 141 (26.8%) of sexually active students had ever used condoms, and 111 (21.5%) had used them at last intercourse. No gender differences were observed in condom use. Condom use at most recent intercourse was significantly associated with higher level of education, delayed sexual debut, prolonged duration of dating before intercourse, and having only one sexual partner.

Relationship between sexual experience and non-sexual behaviours among secondary school students in Arusha, Tanzania.

A sexual behaviour study was conducted among 655 secondary school students to assess the association between sexual experience and non-sexual behaviours. Among students aged 15-19 years, the prevalence of nonvirginity increased with age, from 58.8% to 85.6% for males, and from 21.9% to 44.9% for females. Sexual experience correlated positively with measures of problem behaviours (r = .31) and negatively with a measure of church or mosque attendance (r = -.09). Overall, the relationship between sexual experience and non-sexual behaviours demonstrated the conventionality-unconventionality polarity suggested by problem behavior theory. The observed relationships were relatively stronger at young ages and declined with increasing age, suggesting the developmental functions of these behaviours. Hence, the relations between sexual experience and non-sexual behaviours provided empirical support of the potential utility of the theory of problem behaviour in HIV/AIDS prevention and control among students in Arusha, Tanzania.

[Alcohol problems in the health services--secondary preventive strategies]. / Alkoholproblemer i helsevesenet--sekundoerforebyggende strategier.

An effective secondary preventive programme to deal with alcohol problems presupposes adequate knowledge of the population's drinking habits, the problems accompanying alcohol abuse, the manner in which the health services encounter the problem drinker, professional expertise in secondary prevention, and the methods shown by research to be effective. The knowledge does exist, and it only remains to implement a unified programme for secondary preventive measures within the health services at a local or national level.

Treatment and prevention of alcohol and drug abuse: coordination of professional services.

A need assessment evaluation among primary health and social professionals in two municipalities in Norway revealed that treatment services for alcohol and drug abuse were not satisfactorily coordinated. Conferences, work shops and consultation on a regular basis over a three year period increased the level of competence of the local health and social professionals and the coordination of treatment service in the two municipalities. Re-hospitalization of clients was significantly reduced and more clients received treatment and follow-up by local agencies. Impediments to an even better coordination of services wer conflicting ideologies concerning abuse and dependency, lack of simple and standardized assessment methods and the lack of time in the primary health and social system.