Using qualitative methods within a mixed-methods approach to developing and evaluating interventions to address harmful alcohol use among young people.

OBJECTIVE: This article illustrates how qualitative methods can be used in the development and evaluation of behavior change interventions. Although many campaigns advise young people to drink responsibly, few clarify how to convert this general advice into specific behavioral strategies. Resilience-based approaches argue that treating young non-drinkers and moderate drinkers as "experts" in responsible alcohol use may facilitate co-creation of acceptable interventions that focus on how to change behavior. METHOD: Four distinct phases of intervention development were linked to past research and future developments. RESULTS: First, analysis of correlates of alcohol use using data from a survey of 1,412 people aged 16-21 indicated that alcohol harm-reduction interventions should help young people to develop skills and strategies to resist alcohol. Second, interpretative phenomenological analysis of 25 interviews with people purposively selected from among the survey sample identified general strategies and specific tactics used by young people to manage opportunities to drink. Third, insights from the first 2 phases and past qualitative research guided development of video resources to be use in school-based alcohol education to illustrate strategies and tactics for moderate or non-use of alcohol. Fourth, 18 focus groups with students and teachers were used to evaluate the video: structured thematic analysis indicated that after revision the video would be a valuable addition to school-based alcohol education. CONCLUSIONS: Findings from the 4 phases highlight the value of using different qualitative and quantitative methods as part of a program of work designed to inform the development, refinement, and evaluation of health psychology interventions.

How alike are young non-drinkers, former-drinkers, low-risk drinkers, and hazardous drinkers?

The aim of this study was to examine whether - in terms of personality characteristics and beliefs--former-drinkers and people who have never consumed alcohol exist on a continuum that includes low-risk drinkers and hazardous drinkers, or are distinct groups. An online questionnaire hosted on a secure server was completed by 1418 young people (642 men and 776 women) aged 16-21 living in South-East England. Participants' scores on the Alcohol Use Disorders Identification Test (AUDIT) were used to classify them as non-drinkers, former-drinkers, low-risk drinkers or hazardous drinkers. Multinomial logistic regression identified eight significant multivariate correlates that explained 39% of the variance in men's AUDIT category membership (χ(2)(24) = 263.32, p < .01), and seven significant multivariate correlates that explained 41% of the variance in women's AUDIT category membership (χ(2)(21) = 332.91, p < .01). The results suggest that non-drinkers and former-drinkers are more similar to each other than they are to both low risk and hazardous drinkers. We should not, therefore, treat these groups of young people as representing a drinking continuum. In particular, interventions for high risk young drinkers may be more effective if distinguished from general campaigns intended for all young people.

Which alcohol control strategies do young people think are effective?

INTRODUCTION AND AIMS: The aims of this study were to examine young people's belief in the effectiveness of various alcohol control strategies and to identify demographic, attitudinal and behavioural correlates of perceived effectiveness. DESIGN AND METHODS: An online questionnaire hosted on a secure server was completed by 1418 men and women aged 16-21 years living in South-East England. It assessed the perceived effectiveness of various alcohol control strategies. Key correlates included sensation seeking, impulsivity, conscientiousness, alcohol outcome expectancies, drink refusal self-efficacy, perceived peer alcohol use and Alcohol Use Disorders Identification Test scores. RESULTS: The most effective strategies were perceived to be enforcing responsible service legislation, strictly monitoring late-night licensed premises and teaching alcohol refusal skills. Greater belief in the effectiveness of alcohol control strategies was expressed by older participants, those who consumed less alcohol and those who expected more negative outcomes from alcohol consumption. DISCUSSION AND CONCLUSIONS: The data suggest that in order to increase the perceived effectiveness of alcohol control strategies, we may need to address young people's beliefs about the negative outcomes of alcohol use. Strategies that young people believe are effective may be easier to implement, but this does not imply that unpopular but effective strategies should not be tried.