Elsevier

Addictive Behaviors

Volume 107, August 2020, 106398
Addictive Behaviors

Examining the associations between alcohol-related parental communication, alcohol use, and protective behavioral strategy use among young adults

https://doi.org/10.1016/j.addbeh.2020.106398Get rights and content

Highlights

  • Parent communication is not longitudinally associated with young adult drinking.

  • Parent communication is longitudinally associated with drinking strategies.

  • Research is needed to disentangle parental communication and alcohol use.

Abstract

Underage alcohol use is a public health concern as it remains prevalent and problematic. Protective behavioral strategies (PBS) may prevent or reduce alcohol-related consequences, yet daily-level findings show they instead might be associated with increased drinking and consequences. While parents are a possible source of influence to their child’s decision making, it is unclear whether parental communication about alcohol affects drinking outcomes, with mixed findings noted in the literature. Furthermore, little research focuses on understanding how parental communication may impact the use of PBS. This study assessed whether alcohol specific parental communication would be associated with reduced drinking and increased use of PBS. Data from baseline and 3-month follow up were evaluated from a control group of a larger randomized controlled trial on 18- to 20-year-olds in the U.S. (N = 269). Outcomes included drinks per week, peak drinks per occasion, negative consequences and use of PBS. Using negative binomial regression modeling, controlling for age, sex, and whether participants lived with parents, findings revealed that parental communication was not associated with drinks per week, peak drinks per occasion, or negative consequences reported 3 months later. However, it was positively associated with limiting/stopping drinking PBS, manner of drinking PBS, and serious harm reduction PBS reported 3 months later. Results suggest that parental communication about alcohol may be more effective in increasing the use of protective behavioral strategies rather than reduction of drinking. Research is needed to determine why parental communication may influence the use of PBS and how we can strengthen the quality or focus of communication to ultimately increase the impact on risk behaviors.

Introduction

The prevalence of young adult alcohol use continues to be a public health concern with 79.7% of 18–25 year olds reporting having used alcohol in their lifetime, 55.1% using alcohol in the last month, and 38.4% reporting past month heavy episodic drinking (HED; Substance Abuse and Mental Health Services Administration [SAMHSA], 2019). However, young adults are not homogenous in their drinking, with differences observed between those who are underage drinkers (i.e., younger than 21) versus those who can legally drink in the United States. Specifically, research indicates that underage individuals who engage in alcohol use have more frequent heavy drinking occasions than older individuals, but older individuals have more total drinks consumed per heavy drinking occasion (Esser et al., 2017, Kanny et al., 2018). Although trends indicate that there is a decline in underage alcohol use (National Institute on Drug Abuse, 2017), it still remains the most commonly used substance by adolescents and young adults (SAMHSA, 2019) and is associated with an array of negative harms (Centers for Disease Control and Prevention (CDC), 2014, Substance Abuse and Mental Health Services Administration, 2019).

Additionally, excessive alcohol use is the third leading cause of preventable death with 88,000 total deaths and 4,300 deaths among underage youth each year (Centers for Disease Control and Prevention [CDC], 2014). Not only does excessive drinking contribute to preventable deaths, but it also has societal costs. In 2010, the United States incurred $249 billion in economic costs associated with alcohol; $24 billion dollars were related to underage drinking and $191 billion related to heavy episodic drinking (CDC, 2014; Sacks, Gonzales, Bouchery, Tomedi, & Brewer, 2015). Accordingly, identifying protective factors that may ameliorate drinking-related consequences may help inform the development and refinement of effective alcohol prevention programs.

Section snippets

Parental communication

Although parental influences on alcohol use are strong for those individuals who are younger (i.e. children and adolescents; Miller-Day, 2002, Miller-Day and Kam, 2010), there is a robust body of literature that indicates that parental influence still plays an important role in young adults. Specifically, parents are considered to be a salient influence on decision making in their children’s lives into young adulthood and the college years (e.g., Boyle and Boekeloo, 2009, Donaldson et al., 2016

Protective behavioral strategies (PBS)

One way to prevent or reduce alcohol-related negative consequences is to promote the use of protective behavioral strategies (PBS). PBS are behaviors that individuals can engage in either before, during, or after drinking in order to limit negative alcohol-related consequences and/or reduce alcohol use (Pearson, 2013). Three types of PBS have been examined, including strategies for limiting or stopping drinking (e.g., drink water while drinking alcohol, stop drinking at a predetermined time),

PBS and parental communication

Related to parental communication, we are aware of only one study that has explicitly looked at whether parental communication about alcohol impacts engagement in PBS use; the one study we are aware of primarily focused on PBS as part of larger parent-based interventions where parents received training on how to discuss PBS with their children. Specifically, Donovan, Wood, Frayjo, Black, and Surette (2012) delivered an online intervention over 4 weeks to both parents and their college-enrolled

Participants and procedures

Participants for the present study included 269 young adults aged 18–20 who were assigned to a control group in a randomized controlled trial evaluating an intervention for alcohol-related risky sexual behavior. In the current study, we utilize data from the baseline and 3-month assessments, as a first step in this line of inquiry is to determine and document proximal associations between study variables. Data were collected between March 2015 and March 2018. Control participants at baseline

Correlations and descriptive information

Means, standard deviations (SDs), and correlations are presented in Table 1. On average, participants reported they had discussed a little fewer than half (M = 11.42, SD = 8.08) of the alcohol-related topics with their parents at baseline. The mean for total drinks per week at the 3-month follow-up was 12.21 (SD = 15.26), and the mean for peak drinks consumed on one occasion in the past month at 3-month follow-up was 8.01 (SD = 5.16) drinks. Participants also reported experiencing 7.24 (SD =

Discussion

As hypothesized, this study identified significant relationships between parental communication about alcohol and all three subtypes of PBS (manner of drinking, limiting/stopping, serious harm reduction) at 3-month follow-up. However, contrary to hypotheses, for the models predicting drinks per week, peak number of drinks, and negative consequences, parental communication was not related to drinking outcomes. Conversely, the models for each of the three PBS subgroups (manner of drinking,

Future directions

In light of the current findings, future research should seek to further investigate the complexity of parental communication to determine which aspects of communication may contribute to the influence on PBS. Additionally, a deeper look into the mechanisms of parent and child relationships may provide insight into how exactly parental communications predicts use of PBS. Furthermore, researchers should seek to understand how parental communication strategies may influence PBS across adolescents

Role of funding source

Data collection and manuscript preparation were supported by a grant from the National Institute on Alcohol Abuse and Alcoholism (R01AA021379) awarded to Dr. Melissa A. Lewis. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Alcohol Abuse and Alcoholism or the National Institutes of Health.

Contributors

Dana Litt was a Co-Investigator from which the study data was drawn and was in charge of study conceptualization, data analyses, paper writing, and coordination of authors. Tracey Garcia, Ashley Lowery, Cassidy LoParco, and Annalynn Galvin assisted with manuscript preparation. Mary Larimer assisted the first author with developing the clinical implications portion of the manuscript. Melissa Lewis was the PI of the grant from which the study data was drawn and assisted the first author with

Conflict of interest

No conflict declared.

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