The DRAM, Vol. 19(5) – An online program to prevent underaged drinking among Korean students

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Underage drinking increases the risk of developing alcohol use disorder later in life and is a prominent phenomenon worldwide. Past research has shown that people tend to have negative attitudes toward alcohol during childhood but develop more positive attitudes during their teenage years. This shift in perspective could be due to experiencing greater social pressures to consume alcohol. Consequently, it is important to influence attitudes related to alcohol consumption before people start drinking. Online and school-based interventions represent promising approaches to counter the development of positive alcohol expectancies, as these programs could reach students before they initiate drinking behaviors. This week, The DRAM reviews a study by Younkyoung Kim and colleagues that discusses the development and assessment of a novel online, school-based intervention designed to influence Korean school childrens’ perspectives on alcohol consumption.

What was the research question?
Will participating in an online, school-based intervention influence school childrens’ perspectives on alcohol?

What did the researchers do?
The researchers developed a novel online alcohol consumption-prevention intervention, grounded in the Theory of Planned Behavior, designed for young school children. The intervention consisted of five sessions, each with a different focus or activity. These were: (1) information related to adverse effects of alcohol consumption, (2) an alcohol impairment simulation, (3) strategies for being a healthy person, (4) drinking alternatives, and (5) practice refusing alcohol. Each session was divided into a set of school- and home-based activities that were related to each session’s theme. The researchers looked for changes in outcomes measured before and after participants completed the program.

What did they find?
Participants enrolled in the intervention had significantly improved attitudes, perceived behavioral control, and intentions related to alcohol consumption after completing the program. Enrollment in the program did not influence participants’ perceived norms (e.g., drinking more alcohol because you believe the people around you are heavier drinkers) related to alcohol consumption. Participants in the study also reported a high level of satisfaction with the educational content that was presented in the intervention’s five sessions.


Figure. This Figure depicts (A) the stages that the researchers used to develop the online intervention and (B) the effects of intervention participation on the study’s outcomes. Statistically significant differences between pre-test and post-test assessments are marked with an asterisk. Adapted from Younkyoung Kim and colleagues. Click image to enlarge.

Why do these findings matter?
The results of this study indicated that online programs can significantly influence school childrens’ perceptions related to alcohol consumption. This finding is important because online programs have a number of advantages compared to face-to-face programs. First, online programs have the advantage of being standardized. This means that the content will always be the same for every person who participates in an online program. For face-to-face programs, the fact that administrators could deliver content in different ways (e.g., their public speaking abilities may differ, some speakers may supplement information with anecdotal examples) could influence the outcomes of the intervention. Because online programs have a higher degree of standardization, they have a higher likelihood of working as they are intended. Second, online interventions can be accessed at any time or place, so long as participants have access to and the ability to use a computer. This allows for online programs to have a much further reach compared to face-to-face programs. However, it is worth noting that online programs lack facilitators, which means that there would not be someone present to correct participants if they misunderstood or misinterpreted information.

Every study has limitations. What are the limitations in this study?
The study was conducted among elementary school students. While this was an appropriate age to intervene with, the study’s results cannot be generalized to older students. Similarly, the intervention was conducted in South Korea. Due to cultural differences, the results of the study are not generalizable to populations in other countries.

For more information:
The National Institute on Alcohol Abuse and Alcoholism has tips and resources for people struggling with problem drinking. For additional drinking self-help tools, please visit our Addiction Resources page.

— Seth McCullock, PhD

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