Adolescents’ reflections on school-based alcohol education in the United Kingdom: education as usual compared with a structured harm reduction intervention

Abstract

Alcohol consumption by adolescents in the United Kingdom (UK) remains high. Schoolbased interventions are expected to play a key role in preventing adolescent alcohol consumption. A series of focus groups were conducted with pupils who received alcohol education as usual and pupils who received a Northern Ireland adaptation of the School Health and Alcohol Harm Reduction Project (SHAHRP), a universal alcohol education programme designed to reduce the harms experienced by young drinkers. This study sought to compare and contrast the participants' engagement with, and enjoyment of the different alcohol education that they had received. Focus groups were completed with 129 pupils in 16 schools in Northern Ireland and Scotland. Alcohol education as usual was viewed negatively and was regarded as unstructured, boring, repetitive and unrealistic. In contrast, the adaptation of SHAHRP was viewed positively and was regarded as enjoyable and worthwhile, engaging and relevant to the participants' experiences of alcohol use. These findings suggest that one reason why alcohol education as usual may not be successful in preventing adolescent drinking and protecting adolescents from negative outcomes may be due to its failure to engage participants. Higher acceptability by pupils means that the adaptation of SHAHRP may be one viable alternative.

Developing harm reduction in the context of youth substance use: insights from a multi-site qualitative analysis of young people’s harm minimization strategies

“…The development and implementation of substance use programming that is informed by evidence from harm reduction approaches is needed in order to resonate with young people. Further, for harm reduction programing to be effective, it must also be informed by youth experiences [ 21 ] and, as youth called for in this study, honesty. Multi-site analysis of findings across research sites in this study has illustrated the differences in the ways in which substance use is taken up by youth based on a range of individual and community factors.…”

“…Bok & Morales [ 20 ] argue that in social contexts in which drug use is positively reinforced by peers, and in which youth endorse positive effects of drug use, abstinence and prevention approaches to drug education are “a form of denial, by adults, about the actual behaviors of teenagers and young adults” (p. 94). Further, prevention programming frequently presents alcohol and drug information in a manner that may not resonate with the intended youth audience, for example highlighting potential negative consequences as a deterrent strategy or “scare tactic”, rather than acknowledging and addressing social contexts of use [ 21 , 22 ]. Prevention approaches also fail to acknowledge that youth frequently use substances for pleasure and enjoyment of intoxication, instead framing substance use as a sign of distress or lack of common sense [ 23 , 24 ].…”

“…Outside of programming specifically directed to vulnerable youth and youth using injection drugs (e.g., [ 34 ]), youth perspectives on harm reduction are frequently absent from the conversation informing these approaches [ 21 , 30 ]. With limited research centering youth experiences of and perspectives on drugs and alcohol, educational strategies for addressing the harms of youth substance use risk continuing with a top-down approach that is not informed by or relevant to youth context [ 22 ].…”

Perceptions of school-based alcohol education by educational and health stakeholders: “Education as usual” compared to a randomised controlled trial

“…Finally, we investigated what conditions would need to be satisfied in order to support the future implementation of STAMPP. We have reported programme recipient (school pupils) responses to STAMPP elsewhere (Harvey, McKay, & Sumnall, 2016), whilst the trial outcomes are currently under review.…”

“You can’t chain a dog to a porch”: a multisite qualitative analysis of youth narratives of parental approaches to substance use

“…To date, much of this work has been in the area of drug use prevention, which has largely reflected abstinence-based, zero-tolerance ideologies [7]. However, such approaches have been critiqued as unresponsive to many youth contexts, and ineffective in reducing harms associated with substance use, in part because they deter youth from seeking help in instances of unsafe use, such as intoxicated driving or over-consumption [7–10]. Youth voices have been absent from the development and implementation of these approaches, which has contributed to the lack of resonance of parental strategies with the actual context of youths’ lives, and has limited opportunities for parental responses to youth substance use that effectively minimize harm [10].…”