Background
Methods
Field of expertise | First round | Second round | Third round |
---|---|---|---|
Interventions and studies about binge drinking adolescents targeting adolescents | 28% | 45% | 41% |
Interventions and studies about binge drinking adolescents targeting parents | 5% | 3% | 3% |
Both | 67% | 52% | 56% |
First round
Second round
Third round
Ethics approval
Results
Strategy | Second round | Third round | ||
---|---|---|---|---|
N = 64 | N = 39 | |||
Mdn | IQD | Mdn | IQD | |
1. Advise parents not to provide adolescent child with alcohol | 6 | 2 | 6 | 2 |
2. Provide normative information (e.g., actual figures) to parents about adolescent drinking | 5 | 1.5 | 5 | 1 |
3. *Advise parents to have clear and consistent rules
|
7
|
1
| - | - |
4. Give parents the opportunity to communicate with other parents to have the same kind of rules | 5 | 2 | 5 | 2 |
5. Present different parenting styles and its relation with drinking and other variables that relate to positive youth development | 5 | 1.25 | 5 | 2 |
6. *Provide approaches to communication (particularly conflict resolution)
|
6
|
1
| - | - |
7. *Demonstrate an authoritative parenting style as opposed to authoritarian and permissive parenting styles
| 6 | 2 |
6
|
1
|
8. Present evidence regarding the efficacy of the authoritative approach in a way that is palatable for parents | 5 | 2 | 5 | 2 |
9. Describe ways of using authoritative parenting styles | 6 | 2 | 6 | 1.50 |
10. Encourage parents to spent time with their adolescents | 6 | 2 | 6 | 1.50 |
11. Advise parents to talk to their adolescent children regularly about things that interest the adolescent | 6 | 1.75 | 6 | 2 |
12. *Provide parents with evidence that delaying introduction to alcohol consumption helps protect their adolescent children from alcohol-related harms
| 6 | 2 |
6
|
1
|
13. *Give immediate and tailored feedback to the parents
| 6 | 1.25 |
6
|
1
|
14. *Demonstrate more or less effective communication styles
|
6
|
1
| - | - |
15. Build communities on special topics (celebration of 16th birthday) | 5 | 2 | 4 | 2 |
16. Educate parents about negative consequences for the development of the brains until age 24 | 5 | 2 | 5 | 2 |
17. Emphasize short term negative effects of alcohol on adolescents | 5 | 2 | 5 | 2 |
18. *Advise parents to get to know the whereabouts of the adolescent
| 6 | 2 |
6
|
1
|
19. *Advise parents to get to know the friends of the adolescent
| 6 | 2 |
6
|
1
|
20. Advise parents to conduct family bounding activities (e.g., having evening meal together) | 6 | 2 | 6 | 2 |
21. Make clear to parents that their own youth habits differ from the current youth habits | 5 | 1.75 | 5 | 2 |
22. Advise parents to have clear expectations towards the adolescent not to drink alcohol | 6 | 2 | 6 | 1.25 |
23. Advise parents to communicate about expectations not to drink alcohol towards the adolescent | 6 | 2 | 6 | 1.25 |
24. Emphasize that communication between parent and child has to be firm | 5 | 2 | 5 | 2 |
25. *Emphasize that communication between parent and child has to be consistent
|
7
|
1
| - | - |
26. *Emphasize that communication between parent and child has to be kind
|
6
|
1
| - | - |
27. *Emphasize that communication between parent and child has to be open
|
6
|
1
| - | - |
28. Emphasize that communication between parent and child has to be healthy | 6 | 2 | 6 | 2 |
29. *Emphasize that communication between parent and child has to be from positive quality
| 6 | 2 |
6
|
1
|
30. Advise parents to come to agreements with their adolescent child regarding alcohol consumption | 5 | 2 | 5 | 1.50 |
31. Advise parents to be a good role model (do not drink (much) in presence of the adolescent) | 6 | 2 | 6 | 1.25 |
32. Advise parents to monitor the alcohol consumption of their adolescent child | 5 | 1 | - | - |
33. Advise parents not to serve alcohol at home | 4 | 3 | 4 | 2 |
34. *Emphasize the importance of responsive parenting (parents who expect a lot from their adolescent child and provide them with a sense of self-efficacy)
|
6
|
1
| - | - |
35. *Consistent adolescent management practices (balancing the two dimensions of ‘care’ and ‘control’) regarding alcohol consumption
| 6 | 2 |
6
|
0.75
|
36. *Advise parents to have active interest in the adolescents life
| 6 | 2 |
6
|
1
|
37. Advise parents to conduct activities that the adolescent enjoys | 5 | 1.75 | 5 | 1 |
38. *Advise parents to instruct older siblings not to provide their younger siblings with alcohol
|
6
|
1
| - | - |
39. *Emphasize that family can continue to be a moderating influence throughout adolescence and even young adulthood because parents usually affect long term goals and values
| 6 | 2 |
6
|
1
|
40. *Strengthen parents self-efficacy towards making agreements and setting rules
| 6 | 2 |
6
|
1
|
Strategies targeting parents
Strategies targeting adolescents
Strategy | Second round | Third round | ||
---|---|---|---|---|
N = 61 | N = 35 | |||
Mdn | IQD | Mdn | IQD | |
1. Present dramatic portrayals that adolescents can identify with | 4 | 2.75 | 4 | 1.50 |
2. Provide normative data regarding peer drinking | 5 | 2 | 5 | 2 |
3. Lessen the “coolness” factor of drinking: use role models that are cool without alcohol | 5 | 2 | 5 | 2 |
4. Place an emphasis on how adolescents make meaning of their own drinking and how that relates to their own drinking (e.g., “this happens to others but not to me”) | 5 | 2 | 5 | 1 |
5. Adolescents should be reminded that the choice to drink is theirs and theirs alone | 5 | 2 | 5 | 1.25 |
6. Explain why choosing not to drink is a good choice | 5 | 1.75 | 5 | 1 |
7. Add or remove alcohol cues in a pictorial scenario to demonstrate how social environmental cues can manipulate alcohol consumption | 5 | 2 | 5 | 1 |
8. Use prevalence overestimates reduction (present their own use, their perception of peer use and actual peer use of every 100 peers) | 5 | 2 | 5 | 2 |
9. Role playing games creating your own avatar | 4.50 | 3 | 4 | 2 |
10. Present social situations and ask them how they would react and present the different (positive and negative) consequences | 5 | 1 | - | - |
11. *Provide the opportunity to try out different reactions and their consequences in social situations
|
6
|
1
| - | - |
12. Show a movie with victims that have been significantly affected by drinking (for example road accidents) | 3 | 2 | 2 | 1 |
13. Improving skills in dealing with general life issues | 6 | 3 | 6 | 2 |
14. Encouraging adolescents’ interests in other activities that do not involve alcohol consumption | 5 | 2 | 5 | 1 |
15. Increase knowledge about detrimental effects of alcohol before the age of 24 years | 4 | 2.75 | 5 | 1.25 |
16. *Increasing refusal skills (ability to say “no”)
|
6
|
1
| - | - |
17. *Increase self-efficacy over their ability to refuse to engage in binge drinking
| 6 | 2 |
6
|
0
|
18. *Increase their levels of perceived control whether or not they could refuse to engage in binge drinking
| 6 | 1.25 |
6
|
0
|
19. *Train self-control (the ability to set limits for oneself)
| 6 | 2 |
6
|
0.50
|
20. Provide knowledge about the harm of binge drinking / negative consequences of alcohol | 5 | 2 | 5 | 1 |
21. Increasing the sense of risk through emphasizing the short term consequences | 5 | 1.50 | 5 | 1 |
22. Provide accurate information about alcohol expectancies | 5 | 2 | 5 | 1 |
23. *Provide ways to cope with negative mood states other than drinking
|
6
|
1
| - | - |
24. Stress that there are alternatives to alcohol and binge drinking | 5 | 2 | 5 | 1 |
25. Focus on how adolescents make meaning of their own drinking (arguments that adolescents use to defend their alcohol consumption) | 5 | 2 | 5 | 1 |
26. Show good graphic vomit shots | 1 | 2 | 1 | 0 |
27. Show them embarrassing behavior due to binge drinking | 2 | 3.75 | 2 | 2 |
28. Develop planning and communication skills | 5 | 2 | 5 | 1 |
29. *Develop decision making skills
| 5 | 1.25 |
6
|
1
|
30. Giving advice to others on the topic | 4 | 2.50 | 3.50 | 1 |
31. Emphasize the benefits of positive choices | 5 | 2 | 5 | 1.25 |
32. Check out their personality and tailor the intervention on this personality: fearful personality | 4 | 3 | 4 | 2 |
33. Check out their personality and tailor the intervention on this personality: having negative thinking patterns | 5 | 3 | 4.50 | 1.75 |
34. Check out their personality and tailor the intervention on this personality: sensation seeking personality | 6 | 2 | 6 | 2 |
35. Check out their personality and tailor the intervention on this personality: impulsive personality | 6 | 2 | 5.50 | 2 |
36. Discriminate motives to drink and tailor intervention on these: drinking to deal with negative emotions (coping motives) | 6 | 2 | 5 | 2 |
37. Discriminate motives to drink and tailor intervention on these: drinking to enhance positive emotions (enhancement motives) | 6 | 2 | 5.50 | 2 |
38. Discriminate motives to drink and tailor intervention on these: drinking to be social (social motives) | 6 | 2 | 5.50 | 2 |
39. Discriminate motives to drink and tailor intervention on these: drinking to conform to the group (conformity motive) | 6 | 2 | 5 | 2 |
40. Changing adolescents’ positive attitude towards binge drinking | 5 | 2 | 5 | 1 |
41. Creating awareness of ambivalence (balance between positive and negative consequences of drinking) | 5 | 2 | 5 | 2 |
42. Strengthening those aspects that are already seen by the adolescent as positive consequences of not drinking | 5 | 1 | - | - |
43. Strengthening those aspects that are already seen by the adolescent as negative consequences of drinking | 5 | 1 | - | - |
44. Emphasize the possibility of getting high status by acting healthy | 5 | 3 | 5 | 1.25 |
45. Stimulate action planning skills on preventing binge drinking | 5 | 2 | 5 | 1 |
46. Stimulate to plan moderate drinking beforehand (e.g., special events or holiday) | 5 | 2 | 5 | 1 |
47. Encouraging the adolescents’ sense of autonomy and self esteem | 5 | 2 | 5 | 1 |
Strategies to reduce drop-out of adolescents
Strategy | Second round | Third round | ||
---|---|---|---|---|
N = 56 | N = 34 | |||
Mdn | IQD | Mdn | IQD | |
1. *Monetary incentives
| 6 | 2.25 |
6
|
0.50
|
2. *Non-monetary incentives (e.g., movie tickets)
|
6
|
1
| - | - |
3. *Reminder per e-mail
| 6 | 2.75 |
6
|
0.25
|
4. *Reminder per sms (text message)
| 6 | 2 |
6
|
0.25
|
5. *Engaging graphics
| 6 | 3 |
6
|
1
|
6. *Self-assessment with personalized feedback
| 6 | 2 |
6
|
1
|
7. *Use of highly relevant material
| 6 | 2 |
6
|
0
|
8. *Attractive design
| 6 | 2 |
6
|
0.25
|
9. *Inspiring topics
| 6 | 2 |
6
|
0.25
|
10. *Using language that relates to the adolescents
| 6 | 2 |
6
|
1
|
11. *Use as little text as you can get away with
| 6 | 2 |
6
|
0.50
|
12. *Use as much interaction as possible
| 6 | 2 |
6
|
0.50
|
13. Use of humor | 5 | 3 | 5 | 1.50 |
14. *Engrossing website
| 6 | 1.75 |
6
|
0
|
15. The use of the website should be addictive itself | 4 | 3 | 4 | 1.75 |
16. Give points to earn (e.g., game component) | 5 | 2 | 5 | 2 |
17. Set little goals to achieve during the intervention | 5 | 1 | - | - |
Strategies to reduce drop-out of parents
Strategy | Second round | Third round | ||
---|---|---|---|---|
N = 56 | N = 34 | |||
Mdn | IQD | Mdn | IQD | |
1. Monetary incentives | 5 | 3 | 5 | 1.75 |
2. Non-monetary incentives (e.g., movie tickets) | 5 | 2 | 5 | 1 |
3. *Reminders per e-mail
| 6 | 2 |
6
|
1
|
4. *Reminders per sms (text message)
| 6 | 2.50 |
6
|
0.75
|
5. *Use of highly relevant material
| 6 | 2 |
6
|
0.50
|
6. *Interesting topics
| 6 | 2 |
6
|
0
|
7. *Ensuring that they realize that doing this will make a difference
|
6.5
|
1
| - | - |
8. *Use of language that does not sound pompous or may be interpreted as condescending
| 6 | 2 |
6
|
1
|
9. *Make clear that it is understood that parents are the best experts when it comes to their children and that parents want what’s best for their children and that being a parent can be extremely difficult
| 6 | 2 |
6
|
0
|
10. *Recommendations need to be realistic and feasible
|
6.5
|
1
| - | - |
11. Engrossing website | 5 | 2 | 5 | 0.25 |
12. The use of the website should be addictive itself | 3 | 3.50 | 3 | 2 |
13. Compelling set of lessons | 5 | 2 | 5 | 1 |
14. *Make the need for the intervention salient to parents
| 6 | 2 |
6
|
0
|
15. Attractive design | 5 | 1 | - | - |
16. *Usability
|
7
|
1
| - | - |
17. *Tailored
|
6
|
1
| - | - |
18. Tips / reaction from an expert | 5 | 2 | 5 | 1 |
19. Parents should have the possibility to communicate with each other (e.g., forum) | 5 | 2 | 5 | 1.50 |