Research Article Recent Alcohol Use and Episodic Heavy Drinking among Hispanic youth Keith A. King and Rebecca A. Vidourek ABSTRACT Background: A sizeable percentage of Hispanic youth are affected by alcohol use. Research is needed to identify specific factors placing Hispanic youth at elevated risk. Purpose: This study examined whether recent alcohol use (past 30 days) and frequent episodic heavy drinking among 7th - 12th grade Hispanic students (N = 946) in Greater Cincin- nati schools differed based on perceived harm of use, ease of access and parent/peer disapproval of use. Methods: The PRIDE national survey for grades 6-12 was administered to youth in their school classrooms. Results: One-in-four (24.5%) recently used alcohol and one-in-seven (15.2%) frequently (often/a lot) engaged in episodic heavy drinking. Students at highest risk for recent alcohol use and frequent episodic heavy drinking were those who felt use was not harmful/somewhat harmful, felt alcohol access was fairly easy/very easy and had parents/peers who did not disapprove of use. Discussion: These results should be considered when developing and implementing alcohol prevention efforts for Hispanic youth. Ongoing parent-child communication, rule-setting and rule enforcement should be encouraged. Translation to Health Education Practice: Findings can assist health educators to more thoroughly understand how perceived harm, ease of access and parent/peer disapproval affect recent alcohol use and episodic heavy drinking among Hispanic youth. King KA, Vidourek RA. Recent alcohol use and episodic heavy drinking among Hispanic youth. Am J Health Educ. 2010;41(4):231-243. This paper was submitted to the Journal on November 10, 2009, revised and accepted for publication on February 4, 2010. BACKGROUND Early age of first use is associated with in- harm of alcohol use and how such perceived Despite numerous prevention efforts, a creased risk of suicide, violence, delinquency harm may impact recent use and episodic sizeable percentage of Hispanic youth con- and alcohol abuse.4-7 Those who drink before heavy drinking. tinue to be affected by alcohol use.1 Nearly age 14 are four times more likely to develop Similarly, whereas ease of access to half (47.6%) of Hispanic high school stu- alcohol abuse and dependence than those dents have used alcohol in the past 30 days, who begin drinking at age 21.8 compared to 47.3% of white and 34.5% of Perceived harm of alcohol use affects Keith A. King is a professor in the Health Promo- African American youth.2 One-in-four His- individuals’ intention to use alcohol.9 tion & Education Program, College of Educa- panic males (28.3%) and females (25.3%) However, the majority of students do not tion, Criminal Justice and Human Services, report engaging in current episodic heavy perceive alcohol use as harmful. Data from University of Cincinnati, ML 0068, 526 TC, drinking, defined as drinking five or more the most recent Monitoring the Future Study Cincinnati, OH 45221-0068; E-mail: keith. alcoholic beverages within a few hours. revealed that 14.9% of 8th graders, 11.6% [email protected]. Rebecca A. Vidourek is an assistant Hispanic youth begin drinking at an ear- of 10th graders and 8.3% of 12th graders professor in the Health Promotion & Education lier age than white youth3 with 29.0% of His- drinking alcohol was harmful.1 Despite this Program, College of Education, Criminal Justice panic youth drinking alcohol before the age research, little is specifically known regard- and Human Services, University of Cincinnati, of 13, compared to 21.5% of white youth.2 ing Hispanic youth’s perceptions regarding Cincinnati, OH 45221-0068. American Journal of Health Education — July/August 2010, Volume 41, No. 4 231 Keith A. King and Rebecca A. Vidourek alcohol has been shown to positively cor- the most common locations and times in Greater Cincinnati. School and student relate with youth alcohol consumption,10 a which Hispanic youth use alcohol. Much of participation was voluntary. If parents did paucity of studies has specifically examined the research on Hispanic youth involvement not wish to have their child participate, Hispanic youth perceived ease in obtaining in alcohol use has focused on the impact of then the child was excluded from the survey. alcohol. Research indicates that youth who culture and acculturation.28-31 All responses were anonymous and confi- are able to obtain alcohol tend to drink dential. Students self-identified themselves more frequently than their counterparts11,12 PURPOSE as Hispanic. and tend to have higher levels of alcohol- The present study was conducted to Procedures related problems.13,14 However, studies are address these gaps and assist in providing Surveys were administered to students needed to investigate the potential effect of health professionals with information that of all ethnic groups in participating schools perceived accessibility of alcohol on His- can be used when developing prevention in their homerooms during regular school panic youth involvement in recent alcohol efforts for Hispanic youth. The purpose hours. Prior to survey administration, use and episodic heavy drinking. of this study was to examine the relation- students were informed of the study pur- General population studies have found ships among recent alcohol use, frequency pose, voluntary nature of the survey and that youth are at elevated risk for alcohol use of involvement in episodic heavy drinking confidentiality of responses. Students were if there are low levels of parental monitoring and perceived harm, ease of alcohol access instructed to refrain from answering items and parental involvement15 and high levels of and parent/peer disapproval for substance that they did not wish to answer. Once sur- parental alcohol use.16 Parental disapproval use among 7th -12th grade Hispanic youth. veys were completed, students placed them of youth alcohol use tends to serve as a In addition, the most common locations in an envelope that was subsequently given protective factor against underage drink- and daily times Hispanic youth use alcohol to the office staff and then sent out for data ing.17 Among Hispanic youth, high levels of were identified. The following research ques- analysis. Students who self-identified as His- parental supervision and parental support tions were investigated: (1) What percent of panic were included in the analysis for this have been shown to be strong correlates to Hispanic youth engage in recent alcohol use study. Approval for this study was granted decreased alcohol use.18-20 Family closeness and frequent episodic heavy drinking?; (2) by the Institutional Review board. is an especially important component within What are the most common locations and Instrument the Hispanic community.21 Among Hispanic daily times that Hispanic youth use alcohol?; The following sections/items of the (3) What percent of Hispanic youth perceive youth, parental respect plays an important PRIDE Survey for Grades 6-12 were used in alcohol and other drug use as harmful?; (4) role in reducing alcohol initiation.22 Ad- this study: (1) Personal/family information; What percent of Hispanic youth perceive ditional research is needed to determine (2) Perceived harm of alcohol and other drug alcohol and other drugs as easy to access?; the effect of parental disapproval of alcohol use; (3) Perceived ease in accessing alcohol (5) Does perceived harm and ease of access use specifically on recent alcohol consump- and other drug use; (4) Perceived parent/ differ based on parental communication, tion and binge drinking frequency among peer disapproval of substance use; (5) Par- rule-setting and rule enforcement regarding Hispanic youth. ent communication/rules/enforcement; and substance use?; (6) What percent of Hispanic Associating with peers who use alcohol (6) Frequency of alcohol use. The Perceived youth feel their parents and peers disapprove tends to increase youth alcohol use,23 where- Harm subscale consisted of eight items and of youth alcohol and other drug use?; (7) Do as perceiving few peers as alcohol users and required students to rate how harmful they perceived harm, ease of access and parent/ having peers who disapprove of alcohol use felt that using alcohol and other drugs was peer disapproval differ based on sex?; and tends to reduce use.18,24,25 Similar to the re- to their health via a four-point scale (1 = (8) Do recent alcohol use and frequency of search involving parental disapproval, stud- not harmful; 2 = somewhat harmful; 3 = episodic heavy drinking among Hispanic ies are needed that investigate the impact of harmful; 4 = very harmful). The Perceived youth differ based on perceived harm, ease peer disapproval on recent alcohol use and Ease of Access subscale consisted of four of access and parent/peer disapproval of binge drinking among Hispanic youth. items and required students to rate how alcohol and other drug use? Whereas risk and protective factors for easy it was for them to get alcohol and other alcohol have been well established among drugs via a five-point scale (1 = very easy; METHODS general youth populations,26 gaps in the 2 = fairly difficult; 3 = fairly difficult; 4 = research currently exist regarding Hispanic Participants very difficult; 5 = cannot get). The Perceived youth. Despite Hispanic youth being at el- Participants of this study were Hispanic Parent/Peer Disapproval subscale consisted evated risk for early alcohol initiation, little students in 7th through 12th grades (N = of eight items and required students to rate is actually known regarding specific risk 946) in public and private schools within how wrong their parents or friends feel it and resiliency factors among this popula- the Greater Cincinnati area. Schools were would be for them to use alcohol and other tion.27 More information also is needed on recruited by the Coalition for a Drug Free drugs (1 = not wrong at all; 2 = a little wrong; 232 American Journal of Health Education — July/August 2010, Volume 41, No. 4 Keith A. King and Rebecca A. Vidourek 3 = wrong; 4 = very wrong). Three items Perceived Harm, Ease of Access and Parent/ school districts that completed the survey. were used to assess parent communication, Peer Disapproval indices. Of this total sample, 946 students self- rule-setting and rule enforcement regarding identified as Hispanic. The sample was Data Analysis alcohol and other drug use. Students used a equally distributed across grades 7 through The SPSS statistical software package was five-point scale (1 = never; 2 = seldom; 3 = used to analyze all data. Frequency distribu- 12 with 17.0% in 7th grade, 16.7% in 8th sometimes; 4 = often; 5 = a lot) to rate how tions (ranges, means, standard deviations) grade, 18.1% in 9th grade, 18.0% in 10th often their parents talked to them about the were performed to determine student grade, 15.1% in 11th grade, and 15.1% in dangers of alcohol and other drug use, set demographics, frequency of involvement 12th grade. Regarding sex, 51.5% were male clear rules about using alcohol and other in recent alcohol use and episodic heavy and 48.5% were female. The majority lived drugs and punished them when they broke drinking, most common locations and times with the mother and father (58.8%), whereas alcohol use rules. of use as well as perceived harm of use, ease 15.4% lived with their mother only, 2.7% This survey is written in English and has of accessing substances and perceived par- lived with their father only, 12.0% lived been previously tested for validity and reli- ent/peer disapproval of use. According to with their mother and stepfather, 2.4% lived ability and used throughout the U.S. Stability distributions, responses on each criterion with their father and stepmother, and 8.7% reliability was established by distributing the variable were categorized according to the lived with another individual. One in four survey to a sample of students (N = 631) median split (high, low). Odds ratios were (24.5%) reported that they had used alco- on two occasions one week apart, resulting computed to determine whether recent al- hol in the past month, and 15.2% reported in Pearson correlation coefficients ranging cohol and episodic heavy drinking differed that they frequently (often/a lot) drank five from .814 to .851.32 The survey has also been based on perceived harm, ease of access and or more alcoholic beverages within a few shown to be valid and reliable with percent parent/peer disapproval. The alpha level of hours (episodic heavy drinking). Results agreements of greater than 80% on most significance was set at 0.05. indicated that 7.7% of junior high school variables. 33 Results of this survey tend to be students reported using alcohol in the past similar to those found by the Monitoring the RESUlTS month compared to 31.7% of high school Future survey.34 Table 1 displays the alpha A response rate of 77.4% was achieved students. Similarly, 5.1% of junior high coefficients and survey items for each of the for all students in the Greater Cincinnati school students reported frequent episodic Table 1. internal Consistency of Perceived Harm, Ease of Access and Parent/Peer Disapproval of Use Variable Number Variable α Survey Items of Items Perceived Harm in 8 .928 How harmful do you feel the following are to your health: drinking beer; Using Substances drinking coolers, breezers, or hard lemonade; drinking liquor; smoking cigarettes; smoking cigars; using smokeless tobacco; smoking marijuana, using other illicit drugs? Perceived Ease 4 .893 How easy is it to get: beer wine, liquor or other alcohol products; ciga- in Accessing Sub- rettes, smokeless tobacco, cigars; marijuana; other illicit drugs? stances Perceived Parent 4 .874 How wrong would your parents feel it would be for you to: use alcohol; Disapproval of use tobacco; use marijuana; use other illicit drugs? (not wrong at all, a Substance Use little wrong, wrong, very wrong) Perceived Peer 4 .905 How wrong would your friends feel it would be for you to: use alcohol; Disapproval of use tobacco; use marijuana; use other illicit drugs? (not wrong at all, a Substance Use little wrong, wrong, very wrong) American Journal of Health Education — July/August 2010, Volume 41, No. 4 233 Keith A. King and Rebecca A. Vidourek heavy drinking compared to 19.5% of high least common drinking times for beer, wine likely to feel that alcohol use was harmful/ school students. Concerning sex, 26.9% of and liquor were before school (3.1%, 2.9%, very harmful. males and 21.2% of females reported using 3.2%, respectively), during school (3.8%, Perceived Ease of Access to Alcohol and alcohol in the past month, whereas 16.6% 3.7%, 3.6%, respectively) and after school Other Drugs of males and 12.9% of females reported (4.8%, 3.9%, 3.9%, respectively). Slightly less than half (45.3%) felt that frequent episodic heavy drinking. Perceived Harm of Alcohol Use it was easy/very easy to access to alcohol or Most Common Locations and Times of Results indicated that 67.7% of students tobacco products (41.1%), while one-third Alcohol Use among Hispanic Students felt it was harmful/very harmful to their felt it was easy/very easy to access marijuana Students who reported drinking alcohol health to drink any type of alcohol. Regard- (32.4%) and one-fourth felt it was easy/very were asked to report where they usually ing specific alcoholic beverages, about half easy to access other illicit drugs (22.9%). drank. Results showed that students most felt it was harmful/very harmful to drink Ease of access to substances did not differ frequently drank beer, wine coolers, and beer (51.8%) and wine coolers, breezers, based on sex but did differ based on grade, liquor at a friends’ house (19.5%, 16.0%, hard lemonade, etc. (50.8%), whereas nearly with high school students reporting easier 15.8%, respectively) or at home (11.4%, two-thirds felt it was harmful/very harmful access (Table 2). Students with parents 9.9%, 9.5%, respectively), whereas they least to drink liquor (62.8%). Females and junior who talked to them often/a lot about the frequently drank in a car (4.1%, 3.2%, 3.5%, high school students were significantly more dangers of substance use (P < 0.001) and respectively) or at school (4.8%, 3.5%, 4.2%, likely than males and high school students to who set clear substance use rules often/a lot (P < 0.001) were significantly less likely to respectively). Students were also requested feel that overall substance use was harmful to feel that alcohol was fairly easy/very easy to report the time of the day in which they their health (Table 2). Students with parents to access. usually drank alcohol. Results indicated that who talked to them often/a lot about the students most commonly drank beer, wine dangers of substance use (P < 0.001), who set Perceived Parent/Peer Disapproval of coolers and liquor on the weekends (24.2%, clear rules about substance use (P < 0.001), Alcohol and Other Drugs 19.5%, 20.9%, respectively) and on week- and who punished them when they broke Most students reported that their par- nights (6.6%, 5.2%, 5.5%, respectively). The substance use rules (P = 0.010), were more ents felt it was wrong/very wrong for them Table 2. Perceived Harm, Ease of Access and Parent/Peer Disapproval of Substance Use by Sex and Grade Sex Grade Variable Male Female Junior High High School Perceived Harm N (%) N (%) N (%) N (%) Low 231 (54.5) 172 (43.0) 113 (37.9) 324 (54.5) High 193 (45.5) 228 (57.0)*** 185 (62.1) 270 (45.5)*** Perceived Ease in Accessing Substances Low 204 (49.5) 203 (51.7) 201 (70.0) 245 (42.0) High 208 (50.5) 190 (48.3) 86 (30.0) 338 (58.0)*** Perceived Parent Disapproval of Use Low 191 (47.0) 147 (37.9) 88 (31.3) 193 (68.7) High 215 (53.0) 241 (62.1)* 277 (48.1) 299 (51.9)*** Perceived Peer Disapproval of Use Low 202 (51.0) 143 (37.6) 77 (28.6) 192 (71.4) High 194 (49.0) 237 (62.4)*** 299 (52.5) 271 (47.5)*** Chi-square analyses were conducted. *** P < 0.001; * P < 0.05 N = 946; Percents refer to valid percents; Missing values excluded. 234 American Journal of Health Education — July/August 2010, Volume 41, No. 4 Keith A. King and Rebecca A. Vidourek to use alcohol (78.0%), tobacco, (85.1%), grades reported using alcohol in the past 30 found that increased perceived harm of marijuana (86.9%), or illicit drugs (88.0%). days and 15.2% reported frequently (often/a alcohol use as well as that of all other drug Females and high school students were more lot) engaging in episodic heavy drinking. use was associated with decreased odds for likely than males and junior high school Such rates are alarming especially since both recent use and frequent involvement students to feel that their parents disap- early alcohol initiation is associated with in episodic heavy drinking. This was true proved of substance use (Table 2). Less than increased risk for future substance abuse and regardless of sex or grade. Previous research half reported that their friends felt it was dependence.8,35 Hispanic students continue among general youth populations has simi- wrong/very wrong to use alcohol (47.4%), to be affected by alcohol use.1 Regarding the larly revealed a strong correlation between while greater than half reported that their most common locations and times students perceived risk and youth substance use. 41-44 friends felt it was wrong/very wrong to use use alcohol, students reported that they most Continued educational and awareness cam- tobacco (58.5%), marijuana (61.5%), or il- frequently drank alcohol at a friends’ house paigns are needed to increase the percentage licit drug use (70.8%). Females and junior or at home on the weekends and weeknights. of youth who understand the dangers associ- high school students were significantly more The least common drinking locations were ated with underage drinking. likely than males and high school students in a car or at school and the least common Parental communication, rule-setting to report that their friends feel it is wrong drinking times were before, during and after and enforcement of rules regarding sub- to use substances. school. Such information should be used stance use were found to be significantly Recent Alcohol Use and Episodic Heavy when planning alcohol prevention and in- associated with perceived harm of use. Drinking by Perceived Harm of Use, Ease tervention efforts with Hispanic youth. Students most likely to perceive substance of Access and Parental/Peer Disapproval Contrary to general population studies use as harmful were those with parents of Use which show that most youth do not perceive who frequently talked to them about the Logistic regression was used to calculate alcohol use to be harmful,1 the present study dangers of substance use, set clear rules odds ratios and determine whether recent found that two-thirds (67.7%) of Hispanic about use and who punished them when alcohol use and frequent episodic heavy students felt using any type of alcohol was they broke alcohol use rules. General stud- drinking differed significantly based on harmful/very harmful to their health. This ies have shown that youth with parents who perceived harm, ease of access and pa- finding is important since perceived harm do not consistently set and enforce clear rental/peer disapproval of substance use. of alcohol use is associated with individuals’ rules regarding substance use tend to feel Results indicated that students who felt intention to use alcohol.9 In this study most that occasional alcohol use is not harmful substance use was harmful, who felt access Hispanic youth were aware of the dangers and cannot lead to dependence or abuse.45 was difficult, and who had parents/peers of alcohol and other drug use. Similar to The present study adds to the literature in who disapproved of substance use were at other ethnic groups, Hispanic females were showing the association between parental decreased odds for recent alcohol use and significantly more likely than Hispanic males communication on harm of use and youth frequent episodic heavy drinking (Table 3). to feel that drinking alcohol was harmful. alcohol use as well as supporting the key ele- Such findings held true for both males and Perhaps this difference in perceived harm ments of authoritative parenting.46 However, females (Tables 4-5) and junior high school can help to explain why Hispanic male caution should be exercised in attempting to and high school students (Tables 6-7) with youth report higher levels of recent alcohol generalize the findings of this study since it one exception--parent disapproval of sub- use than Hispanic female youth.36 because involves a cross-sectional design and there- stance use was not a significant predictor of alcohol use is a way that masculinity is com- fore is unable to determine cause-and-effect frequent episodic heavy drinking for junior monly expressed among males in the His- relationships. Nevertheless, most youth state high school students. panic community,37-39 perhaps males offset they would value increased parent-child dis- the potential harm of use with the potential cussion regarding substance use.47 Open and DiSCUSSiON acquisition of enhanced machismo. Stud- ongoing communication between parents Results from this study can be used to ies have shown that many Hispanic youth and children is an effective method to assist assist health educators and prevention spe- feel it is culturally appropriate for males to youth in developing a sensible relationship cialists in more thoroughly understanding drink alcohol while females are expected with alcohol48,49 and has been recommended the psychosocial factors associated with His- to abstain.27 Other studies have also noted by several researchers.50 Setting clear rules panic youth involvement in recent alcohol gender socialization differences perceived by and enforcing such rules are correlated with use and episodic heavy drinking. In turn, the Hispanic youth.40 decreased youth alcohol consumption.51-53 findings can aid professionals in developing Nevertheless, much concern should be Among the Hispanic population, re- effective prevention programs and efforts for raised in lieu of the fact that a sizeable per- search has established the critical nature this population. The present study found centage of Hispanic youth did not perceive of the family as a protective factor against that 24.5% of Hispanic students in 7th -12th alcohol use as harmful. The present study youth involvement in risky behaviors.21,54,55 American Journal of Health Education — July/August 2010, Volume 41, No. 4 235 Keith A. King and Rebecca A. Vidourek 1 1 1 1 P 0 0 0 0 0 0 0 0 <. <. <. <. 2 1 7 7 2 3 0 3 2 χ 0.7 9.4 0.7 7.8 6 9 3 9 e (95% CI) (.114, .289) (7.105, 24.353) (.213, .487) (.056, .165) s U g f n o 4 rinki oval OR 1.0 .182 1.0 13.15 1.0 .322 1.0 .096 D r p y p dic Heav eer Disa Fre-quent Episodic Heavy Drinking N (%) 98 (25.5) 25 (5.8) 12 (2.9) 108 (20.3) 75 (23.0) 40 (8.8) 98 (29.6) 17 (3.9) o P s t/ Use and Epi eived Paren Infre-quent Episodic Heavy Drinking N (%) 287 (74.5) 403 (94.2) 399 (97.1) 273 (71.7) 251 (77.1) 416 (91.2) 233 (70.4) 420 (96.1) ohol Perc P <.001 <.001 <.001 <.001 c d Al an Recent Access, 2 χ 101.933 154.405 74.265 151.162 r o of Ratios f m, Ease (95% CI) (.123, .251) (7.046, 16.394) (.175, .340) (.071, .156) s d r d a O H 7 Table 3. by Perceived Did Not Use in Used Past in Past MonthMonth ItemN (%)N (%)OR Perceived Harm 268 176 a Low1.0(60.4)(39.6) 408 47 High.175(89.7)(10.3) Perceived Ease of Access 399 12 a Low1.0(97.1)(2.9) 273 108 High10.74(71.7)(28.3) Perceived Parent Disapproval of Use 226 144 a Low1.0(61.1)(38.9) 425 66 High.244(86.6)(13.4) Perceived Peer Disapproval of Use 212 170 a Low1.0(55.5)(44.5) 427 36 High.105(92.2)(7.8) a Indicates Referent b All categories do not total 946 due to missing data 236 American Journal of Health Education — July/August 2010, Volume 41, No. 4 Keith A. King and Rebecca A. Vidourek P 01 01 01 01 P 01 01 01 01 0 0 0 0 0 0 0 0 <. <. <. <. <. <. <. <. 2 1 7 7 5 2 8 5 2 χ 0.72 9.43 0.70 7.83 2 χ 0.20 2.83 3.54 4.99 6 9 3 9 5 7 3 7 e (95% CI) (.114, .289) (7.105, 24.353) (.213, .487) (.056, .165) e (95% CI) (.089, .270) (7.271, 33.621) (.134, .383) (.050, .169) Drinking proval of Us OR 1.0 .182 1.0 13.154 1.0 .322 1.0 .096 Females proval of Us OR 1.0 .155 1.0 15.635 1.0 .226 1.0 .092 Alcohol Use and Episodic Heavy and Perceived Parent/Peer Disap Infre-Fre-quent quent Episodic Episodic Heavy Heavy DrinkingDrinking PN (%)N (%) 287 98 (25.5)(74.5) 403 <.00125 (5.8)(94.2) 399 12 (2.9)(97.1) 273 108 <.001(71.7)(20.3) 251 75 (23.0)(77.1) 416 <.00140 (8.8)(91.2) 233 98 (29.6)(70.4) 420 <.00117 (3.9)(96.1) t Alcohol Use among Males and and Perceived Parent/Peer Disap Did Not Used Use in in Past Past MonthMonth PN (%)N (%) 104 65 (38.5)(61.5) 206 <.00120 (8.8)(91.2) 191 8 (4.0)(96.0) 113 <.00174 (39.6)(60.4) 92 (63.9)52 (36.1) 211 <.00127 (11.3)(88.7) 79 (55.6)63 (44.4) 218 .00116 (6.8)(93.2) Ratios for Recent m, Ease of Access, (95% 2 CI) χ (.123, 101.933.251) (7.046, 154.40516.394) (.175, 74.265.340) (.071, 151.162.156) ds Ratios for Recen m, Ease of Access, (95% 2 CI) χ (.142, 35.673.384) (4.473, 63.29413.385) (.185, 27.151.473) (.070, 61.435.219) Table 3. Odds by Perceived Har Did Not Use in Used Past in Past MonthMonth ItemN (%)N (%)OR Perceived Harm 268 176 a Low1.0(60.4)(39.6) 408 47 High.175(89.7)(10.3) Perceived Ease of Access 399 12 a Low1.0(97.1)(2.9) 273 108 High10.747(71.7)(28.3) Perceived Parent Disapproval of Use 226 144 a1.0 Low(61.1)(38.9) 425 66 High.244(86.6)(13.4) Perceived Peer Disapproval of Use 212 170 a Low1.0(55.5)(44.5) 427 36 High.105(92.2)(7.8) a Indicates Referent b All categories do not total 946 due to missing data Table 4. Od by Perceived Har Did Not Use in Used Past in Past MonthMonth ItemN (%)N (%)OR Perceived Harm 138 89 a Low1.0(60.8)(39.2) 408 25 High.234(89.7)(13.1) Perceived Ease of Access 185 19 a Low1.0(90.7)(9.3) 112 89 High7.737(55.7)(44.3) Perceived Parent Disapproval of Use 113 73 a Low1.0(60.8)(39.2) 178 34 High. 296(84.0)(16.0) Perceived Peer Disapproval of Use 110 86 a Low1.0(56.1)(43.9) 176 17 High.124(91.2)(8.8) a Indicates Referent b All categories do not total 946 due to missing data American Journal of Health Education — July/August 2010, Volume 41, No. 4 237 Keith A. King and Rebecca A. Vidourek P <.001 <.001 .002 <.001 9 5 3 4 6 6 0 2 χ 2.9 2.0 9.7 7.6 3 4 4 e es (95% CI) (.069, .300) (5.474, 44.839) (.191, .699) (.040, .199) es Us mal Femaloval of Fe OR 1.0 .144 1.0 15.667 1.0 .365 1.0 .089 d pr np Males aeer Disa Fre-quent Episodic Heavy Drinking N (%) 37 (25.2) 10 (4.6) 4 (2.1) 41 (25.0) 25 (19.2) 18 (8.0) 36 (29.3) 8 (3.6) gP n/ king amoed Parent Infre-quent Episodic Heavy Drinking N (%) 110 (74.8) 207 (95.4) 188 (97.9) 123 (75.0) 105 (80.8) 207 (92.0) 87 (70.7) 217 (96.4) nv riei Dc 1 1 1 1 y er P 00 00 00 00 avd P <. <. <. <. e Hn a odic ess, 2 χ 2.151 3.117 2.066 5.676 sc 2 4 1 3 piAc E Ratios for m, Ease of es (95% CI) (.113, .432) (4.610, 23.780) (.197, .649) (.056, .266) Odds d Har Mal OR 1.0 .221 1.0 10.470 1.0 .357 1.0 .122 e 5.v Table by Percei Frequent Episodic Heavy Drinking N (%) 49 (24.7) 12 (6.8) 7 (3.8) 53 (29.3) Use 38 (23.3) 19 (9.8) e 48 (27.9) 8 (4.5) missing data Infre-quent Episodic Heavy Drinking N (%)Item Perceived Harm 149 a Low(75.3) 165 High(93.2) Perceived Ease of Access a Low177 (96.2) High128 (70.7) Perceived Parent Disapproval of 125 a Low(76.7) 175 High(90.2) Perceived Peer Disapproval of Us 124 a Low(72.1) 170 High(95.5) a Indicates Referent b All categories do not total 946 due to 238 American Journal of Health Education — July/August 2010, Volume 41, No. 4 Keith A. King and Rebecca A. Vidourek 1 1 1 1 P 0 0 0 0 0 0 0 0 <. <. <. <. 2 χ 70.303 98.768 42.668 100.922 e) d a udents se h – 12th Gr (95% CI) (.127, .286) (5.809, 15.681) (.202, .428) (.077, .189) h School Stproval of U gh School (9t OR 1.0 .190 1.0 9.544 1.0 .294 1.0 .121 and Higer Disap Hi Used in Past Month N (%) 150 (46.6) 38 (14.2) 21 (8.6) 158 (47.4) 121 (44.2) 56 (18.9) 148 (50.2) 29 (10.8) e hP g/ unior Hid Parent Did Not Use in Past Month N (%) 172 (53.4) 229 (85.8) 222 (91.4) 175 (52.6) 153 (55.8) 241 (81.1) 147 (49.8) 239 (89.2) Je g v amonPercei P .003 <.001 .001 <.001 e d sn ohol Ucess, a de) 2 χ 8.693 19.495 11.018 12.255 cc a AlA Gr atios for Recent d Harm, Ease of h School (7th – 8th (95% ORCI) 1.0 (.114, .279.682) 1.0 (2.593, 6.58016.699) 1.0 (.101, .245.592)) 1.0 (.076, .201.532) Re g e 6. Odds by Perceiv Junior Hi Used in Past Month N (%) 15 (14.0) 8 (4.3) 7 (3.6) 16 (19.5) Use 14 (16.9) 9 (4.7) e 12 (16.0) 7 (3.7) missing data Tabl Did Not Use in Past Month N (%) 92 (86.0) 176 (95.7) ccess 190 (96.4) 66 (80.5) sapproval of 69 (83.1) 181 (95.3) pproval of Us 63 (84.0) 183 (96.3) otal 946 due to Item Perceived Harm a Low High Perceived Ease of A a Low High Perceived Parent Di a Low High Perceived Peer Disa a Low High a Indicates Referent b All categories do not t American Journal of Health Education — July/August 2010, Volume 41, No. 4 239 Keith A. King and Rebecca A. Vidourek 1 1 1 1 P 0 0 0 0 0 0 0 0 <. <. <. <. 9 5 7 4 0 4 4 9 2 χ 0.8 2.4 9.0 0.4 4 6 1 6 e) d ol Students Use 9th – 12th Gra (95% CI) (.120, .341) (5.794, 25.827) (.228, .578) (0.66, .220) gh Schoroval of h School ( OR 1.0 .202 1.0 12.233 1.0 .363 1.0 .121 gh and Hieer Disapp Hig Fre-quent Episodic Heavy Drinking N (%) 83 (29.7) 20 (7.9) 8 (3.6) 92 (31.1) 64 (26.6) 32 (11.6) 84 (32.6) 14 (5.5) HiP g Junior d Parent/ Infre-quent Episodic Heavy Drinking N (%) 196 (70.3) 234 (92.1) 217 (96.4) 204 (68.9) 177 (73.4) 244 (88.4) 174 (67.4) 240 (94.5) ne ov g amPercei P .005 <.001 .061 <.001 n kind n vy Dricess, a de) 2 χ 7.869 12.882 3.504 12.431 ac a eA Gr pisodic H Ease of 7th – 8th (95% CI) (.064, .688) (2.087, 22.716) (.115, 1.094) (.031, .476) os for Ed Harm, h School ( OR 1.0 .210 1.0 6.885 1.0 .355 1.0 .122 Table 7. Odds Ratiby Perceive Junior Hig Infre-Frequent quent Episodic Episodic Heavy Heavy DrinkingDrinking N (%)N (%)Item Perceived Harm a Low87 (89.7)10 (10.3) 166 High4 (2.4)(97.6) Perceived Ease of Access 179 a Low4 (2.2)(97.8) High65 (86.7)10 (13.3) Perceived Parent Disapproval of Use a Low70 (90.9)7 (9.1) 169 High6 (3.4)(96.6) Perceived Peer Disapproval of Use a Low57 (87.7)8 (12.3) 175 High3 (1.7)(98.3) a Indicates Referent b All categories do not total 946 due to missing data 240 American Journal of Health Education — July/August 2010, Volume 41, No. 4