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Youth Perceptions of Underage Drinking in Alachua County

Permanent Link: http://ufdc.ufl.edu/UFE0042320/00001

Material Information

Title: Youth Perceptions of Underage Drinking in Alachua County
Physical Description: 1 online resource (161 p.)
Language: english
Creator: Dever, Kelly
Publisher: University of Florida
Place of Publication: Gainesville, Fla.
Publication Date: 2010

Subjects

Subjects / Keywords: coalitions, prevention, sociology, underage
Sociology -- Dissertations, Academic -- UF
Genre: Sociology thesis, Ph.D.
bibliography   ( marcgt )
theses   ( marcgt )
government publication (state, provincial, terriorial, dependent)   ( marcgt )
born-digital   ( sobekcm )
Electronic Thesis or Dissertation

Notes

Abstract: As more 'grassroots' approaches to health research are introduced to combat local social problems, simultaneously there echoes a call to examine their potential contributions to social change. This study builds on previous work, in which coalition members of a local prevention organization, Partners in Prevention of Substance Abuse (PIPSA), were interviewed regarding their conceptions of underage drinking. With an emerging emphasis on prevention efforts becoming more localized and intimate, it has become increasingly important to extend collaboration efforts to include clients? perspectives in program design. In this vein, this qualitative study broadens prior work by including focus groups with local youth in hopes of gaining insight into their conceptions of underage drinking, their awareness of local underage drinking, and potential strategies for future prevention activities. Discourse between coalition members and local youth were then compared to highlight potential program limitations in reaching their target population. Some qualitatively different themes were found between coalition members and local youth. Also, coalition members and local youth were in agreement that underage drinking is a local issue. Youth participants offered a variety of potential prevention strategies to target local youth. Additionally, they advocated for youth-designed additions to PIPSA to increase program effectiveness.
General Note: In the series University of Florida Digital Collections.
General Note: Includes vita.
Bibliography: Includes bibliographical references.
Source of Description: Description based on online resource; title from PDF title page.
Source of Description: This bibliographic record is available under the Creative Commons CC0 public domain dedication. The University of Florida Libraries, as creator of this bibliographic record, has waived all rights to it worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law.
Statement of Responsibility: by Kelly Dever.
Thesis: Thesis (Ph.D.)--University of Florida, 2010.
Local: Adviser: Zsembik, Barbara A.

Record Information

Source Institution: UFRGP
Rights Management: Applicable rights reserved.
Classification: lcc - LD1780 2010
System ID: UFE0042320:00001

Permanent Link: http://ufdc.ufl.edu/UFE0042320/00001

Material Information

Title: Youth Perceptions of Underage Drinking in Alachua County
Physical Description: 1 online resource (161 p.)
Language: english
Creator: Dever, Kelly
Publisher: University of Florida
Place of Publication: Gainesville, Fla.
Publication Date: 2010

Subjects

Subjects / Keywords: coalitions, prevention, sociology, underage
Sociology -- Dissertations, Academic -- UF
Genre: Sociology thesis, Ph.D.
bibliography   ( marcgt )
theses   ( marcgt )
government publication (state, provincial, terriorial, dependent)   ( marcgt )
born-digital   ( sobekcm )
Electronic Thesis or Dissertation

Notes

Abstract: As more 'grassroots' approaches to health research are introduced to combat local social problems, simultaneously there echoes a call to examine their potential contributions to social change. This study builds on previous work, in which coalition members of a local prevention organization, Partners in Prevention of Substance Abuse (PIPSA), were interviewed regarding their conceptions of underage drinking. With an emerging emphasis on prevention efforts becoming more localized and intimate, it has become increasingly important to extend collaboration efforts to include clients? perspectives in program design. In this vein, this qualitative study broadens prior work by including focus groups with local youth in hopes of gaining insight into their conceptions of underage drinking, their awareness of local underage drinking, and potential strategies for future prevention activities. Discourse between coalition members and local youth were then compared to highlight potential program limitations in reaching their target population. Some qualitatively different themes were found between coalition members and local youth. Also, coalition members and local youth were in agreement that underage drinking is a local issue. Youth participants offered a variety of potential prevention strategies to target local youth. Additionally, they advocated for youth-designed additions to PIPSA to increase program effectiveness.
General Note: In the series University of Florida Digital Collections.
General Note: Includes vita.
Bibliography: Includes bibliographical references.
Source of Description: Description based on online resource; title from PDF title page.
Source of Description: This bibliographic record is available under the Creative Commons CC0 public domain dedication. The University of Florida Libraries, as creator of this bibliographic record, has waived all rights to it worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law.
Statement of Responsibility: by Kelly Dever.
Thesis: Thesis (Ph.D.)--University of Florida, 2010.
Local: Adviser: Zsembik, Barbara A.

Record Information

Source Institution: UFRGP
Rights Management: Applicable rights reserved.
Classification: lcc - LD1780 2010
System ID: UFE0042320:00001


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1 YOUTH PERCEPTIONS OF UNDERAGE DRINKING IN ALACHUA COUNTY By KELLY DEVER A DISSERTATION PRESENTED TO THE GRADUATE SCHOOL OF THE UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PH ILOSOPHY UNIVERSITY OF FLORIDA 2010

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2 2010 Kelly Dever

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3 To my wonderful family members who have always modeled and encouraged open mindedness honesty, and hard work

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4 ACKNOWLEDGMENTS I would like to thank all those who have supported me t hroughout the writing process with kind words of encouragement. I could not have done this without your support. I would like to sincerely thank Gwen Love and Cindy Grant for sharing their knowledge and experience of the Partners in Prevention of Substance Abuse (PIPSA) program with me. They guided me ever so patiently through the production of this project and I would like to show my appreciation for their dedication to the social issue of substance abuse. PIPSA is a considerate approach to improving Alach ua County substance abuse problems and should be applauded for its efforts. With more support, cooperation, and resources the program is capable of providing more physically and emotionally healthy community members. Lastly, I would like to thank my superv isory committee members, Dr. Barbara Zsembik, Dr. Jodi Lane, Dr. Marian Borg, Dr. Constance Shehan, Dr. Mark Brennan, and Dr. Rosemary Barnett. Without their feedback and suggestions, this study would not have been possible. Finally, I would like to thank my partner, John, who has given me unbelievable support throughout the final stages of this project. Your consistency and confidence in all you do inspire s me daily

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5 TABLE OF CONTENTS page ACKNOWLEDGMENTS ................................ ................................ ................................ .. 4 LIST OF TABLES ................................ ................................ ................................ ............ 7 ABSTRACT ................................ ................................ ................................ ..................... 8 CHAPTER 1 INTRODUCTION ................................ ................................ ................................ .... 10 Study Purpose ................................ ................................ ................................ ........ 10 Study Background and Significance ................................ ................................ ....... 13 2 LITERATURE REVIEW ................................ ................................ .......................... 18 Summary ................................ ................................ ................................ ................ 18 Social Issue of Substance Abuse ................................ ................................ ........... 18 Alcohol as a Substance ................................ ................................ .......................... 20 Unique Life Course Stage of Adolescent ................................ ................................ 21 Individual Influences on Adolescent Risk Behavior ................................ .......... 22 Socialization Influences on Adolescent Risk Behavior ................................ ..... 24 Reasons for Drinking in Adolescence ................................ ............................... 28 Co nsequences of Underage Drinking ................................ ................................ ..... 30 Community B ased Coalitions ................................ ................................ .................. 31 Effectiveness of Community B ased Coalitions ................................ ................. 32 Strengths of Community B ased Coalitions ................................ ....................... 33 Weaknesses of Community B ased Coalitions ................................ .................. 34 Suggested Strategies Employing Community B ased Coalitions ...................... 36 ................................ ................ 42 Criminolog ical Theory ................................ ................................ ....................... 42 Life Course Perspective ................................ ................................ ................... 44 Summary of Prior Research with PIPSA ................................ .......................... 46 3 STUDY DESIGN ................................ ................................ ................................ ..... 49 Study Overview ................................ ................................ ................................ ....... 49 Focus Group Rationale ................................ ................................ ........................... 51 Sampling Design ................................ ................................ ................................ ..... 53 Local Youth Sampling ................................ ................................ ...................... 53 Local Youth Survey and Focus Group Procedure ................................ ............ 58 Overlapping Study Design ................................ ................................ ................ 59 Limitations of Study Design ................................ ................................ .............. 60 Analytical Techniques ................................ ................................ ............................. 61 Grounded Theory: Background Considerations ................................ ............... 61

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6 ................................ ..... 62 Study Design Strengths ................................ ................................ .................... 63 4 RESULTS ................................ ................................ ................................ ............... 68 Quantitative Survey Results ................................ ................................ .................... 68 Qualitative Focus Group Results ................................ ................................ ............ 73 Public School Focus Group: Elementary ................................ .......................... 74 Public Scho ol Focus Group: Middle School ................................ ...................... 86 Public School Focus Group: High School ................................ ....................... 102 5 CONCLUSION ................................ ................................ ................................ ...... 126 Summary ................................ ................................ ................................ .............. 126 Major findings between youth focus groups ................................ ................... 126 Major findings between PIPSA coalition fo cus groups and youth focus groups ................................ ................................ ................................ ......... 132 Discussion ................................ ................................ ................................ ............ 135 Study Strengths & Weaknesses ................................ ................................ ..... 137 Prevention Implications for Coalitions ................................ ............................ 139 Future Research ................................ ................................ ............................. 140 APPENDIX A STUDENT SURVEYS ................................ ................................ ........................... 142 B STUDENT FOCUS GROUP GUIDE ................................ ................................ ..... 149 REFERENCES ................................ ................................ ................................ ............ 151 BIOGRAPHICAL SKETCH ................................ ................................ .......................... 161

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7 LIST OF TABLES Table page 2 1 Coalition Member Focus Group Characteristics ................................ ................. 48 3 1 Public School Youth Focus Group Demographics ................................ .............. 66 3 2 Alternative Youth Focus Group Demographics ................................ ................... 67 4 1 Public School Youth Survey Data ( counts). ................................ ...................... 120 4 2 Characteristics of Public School Focus Group Participants (counts). ............... 122 4 3 Alternative School Youth Survey Dat a (counts). ................................ ............... 123 4 4 Characteristics of Alternative School Focus Group Participants (counts). ........ 125

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8 Abstract of Dissertation Presented to the Graduate Schoo l of the University of Florida in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy YOUTH PERCEPTIONS OF UNDERAGE DRINKING IN ALACHUA COUNTY By Kelly Dever December 2010 Chair: Barbara Zsembik Major: Sociolog y As more health research are introduced to comb at local social problems, s imultaneo usly there echoes a call to examine their potential contributions t o social change. This study b uild s on previous work in which coalition memb ers of a local prevention organization, Partners in Prevention of Su bstance Abuse (PIPSA), were interviewed regarding their conceptions of underage drinking With an emerging emphasis on prevention efforts becoming more localized and intimate, it has becom perspectives in program design. In this vein, this qualitative study broadens prior work by including focus groups with local youth in hopes of gaining insight into their concepti ons of underage drinking their awareness of l ocal underage drinking, and potential strategies for future prevention activities. Discourse between coalition members and local youth were then compared to highlight potential program limitations in reaching t heir target population. Some q ualitatively different themes were found between coalition members and local youth. Also, coalition members and local youth were in agreement that underage drinking is a local issue. Youth participants offered a

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9 variety of pot ential prevention strategi es to target local youth. Additionally, they advocated for youth design ed additions to PIPSA to increase program effectiveness

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10 CHAPTER 1 INTRODUCTION Study Purpose community coalitions being introduced to combat local social problems, simultaneously there echoes a call to examine their potential contributions to social change (National Community Anti Drug Coalition Institute 2009). Partners in Prevention of Substanc e Abuse (PIPSA), in its eleventh year serving Alachua County, Florida, aims to reduce substance use locally. Virtually unfunded in previous years, it has recently undergone many program revisions. Of particular relevance to my study, PIPSA has declared und erage drinking a primary concern to the coalit ion and has recently received non profit status, enabling it to access funding through the state. With a new national emphasis on local community based coalitions dealing with local substance problems continued funding is likely for PIPSA, considering its proposed collaborative community based approach. This funding community members. Considering its primary concern of underage drinking, Alachua Despite recent developments in medical sociology and medical anthropology, the general literature on drug treatment, which practitioners rely heavily on, is void of an exam ination of the power relations and ideologies underlying treatment approaches (Hunt and Barker 1999). These power dynamics may be even more dramatic between youth populations and practitioners. Misrecognition of power dynamics could possibly result not onl y in ineffective program implementation but inappropriate programming, ultimately leading to a reinforcement of common stereotypes of the substance user.

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11 With an emerging emphasis on prevention efforts becoming more localized and intimate, likewise it ha s become increasingly important to extend collaboration efforts to design as well. Although Partners in Prevention of Substance Abuse (PIPSA) does not directly impa ct local youth, future initiatives are expected to. A qualitative study yielding the descriptive needs and conceptions of the youth populations in relation to underage drinking would be beneficial not only to the coalition specifically but the field of pre vention in general The shortage of qualitative projects like this both nationally and in Alachua County indicates the possibility of inaccurate portrayals of underage drinking and the discourse surrounding it. The relevant social scientific literatures I will draw upon are presented in a following section. which I conducted focus groups with PIPSA coalition members (Dever 2006). The focus on underage drinking, offer a formative evaluation of the program, and provide suggestions as to the necessary steps it should take to structure the program in a way that could be evaluative in the future. This qualitative study compares the disc ourse of a local prevention coalition to local youth surrounding the issue of underage drinking. For this study, f ocus groups were conducted with local youth selected fr om public schools. Additionally a sample of students was selected from a local alterna tive school setting to serve as a comparison group. All focus group participants were administered a survey, which asked basic demographic characteristics of the participants and possible use patterns considered

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12 re levant to the study. There were three versions of the survey in an effort to ask age appropriate questions for each of the three levels of school in this study. The ways prevention organizations impact their communi ty members may depend on visibility is sues, reluctance of community members to use services becau se of distrust, or an substance use which may be ignored as irrelevant or meaningless to the recipient community (Mumby 1 997; Gramsci 1971). The former is what this study hopes to perspectives of the recipient community may be antagonistic, working in opposition to each other. Drawing on focus groups and my prior work with PIP SA coalition members (2006) I generated a grounded theory to address three research questions: 1. How is underage drinking defined by both coalition members and local youth? 2. What extent do coalitio n members and the local youth feel there is an underage drinking problem for Alachua County? 3. Regardless of whether it is a problem or not, what are possible solutions for reducing underage drinking among youth in Alachua County? Since many evaluations gene rally focus on the process and impact of the program as defined by its program planners, the valuable insight and perhaps differing conceptions of the recipient community is oftentimes neglected (Hunt and Barker 1999). Th is study aims to gather local youth perceptions drin to compare it to prior work highlighting local prevention approaches of PIPSA. Limited work has tried to bridge this gap. This qualitative study not only emphasizes in shaping the prevention programs but challenges future coalitions across the country

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13 to broaden their coalitions to include interpretations from all populations of the community, particularly the ir potent ial target population s Their treatment success may actually depend on this. Finally, this research makes contributions to the literature in the fields of sociology, health, and community development and encourages future research to critically examine hea lth care implementation in forthcoming community coalitions throughout the United States. Study Background and Significance Substance use is commonly conceptualized as solely an individu al problem. In reality it stems from larger community issues and shou ld be handled in a more comprehensive community based approach. The National Survey on Drug Use and Health, conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), states: of the 21.1 million people who needed but did not recei ve treatment in 2004, an estimated 1.2 million reported that they felt they needed treatment for their alcohol or drug use problem. Of the 1.2 million persons who felt they needed treatment, 441,000 (35.8%) reported that they made an effort but were unable to get treated (Substance Abuse and Mental Health Services Administration 2005:7). These numbers indicate a need for substance abuse programs to consistently be available and successfully create an awareness of their services, so individuals are able to seek help for problems that may affect their quality of life. It is important to note these numbers are conservative considering there are those who do not seek treatment services but might be willing to go if they were aware of the services. Awareness tho ugh is not the only reason community members may not seek treatment. Some cite the reluctance to use services on the basis of a distrust for the medical system and all the inherent bias it may project (Braithwaite and Taylor 1992; Aguirre Molina, Molina, a nd

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14 Zambrana 2001; LaVeist 2002). Others may feel the imposition of hegemonic definitions leading them to regard services as irrelevant or meaningless (Mumby 1997). Still others such as underage drinkers that illegally use repr esent a population where even more obstacles influence whether treatment is sought and used. Using a qualitative approach, this study highlights the possible disjunctur e between the designers of prevention efforts and those in need of its services, in this case underage youth. In light of prior research, this study explores the national health strategy that aims to take prevention efforts to a more local level to reduce substance abuse. This strategy has a goal of implementing a substance abuse coalition in every county tailored specifically to its community members. Community Anti Drug Coalitions of America (CADCA) defines a coalition as a formal arrangement for collaboration among groups or sectors of a community in which each group retains its identity but all agree to work together toward a common goal of building a safe, healthy, and drug free community (National Community Anti Drug Coalition Institute 2006). The Partners in Prevention of Substance Abuse (PIPSA) program is a community based coalition serving the residents of Alachua County, Florida. At the time of the study, it was the only drug coalition in Alachua County, Florida with a primary focus on ten party iversity of Florida), it arguably has a challenge fighting the normative culture of the town (The Princeton Review 2003). PIPSA is comprised of seventy coalition members, representing nine sectors in the Alachua County community: Youth Services, School Bo ard, Law Enforcement, Business and Media, Federal State and Local

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15 Agencies, Civic and Volunteer Agencies, Religious Groups, Healthcare, and Parents and Community. The members meet to discuss substance use issues specific to Alachua County and organize effo rts of prevention, volunteering services individually and from their respective agencies. PIPSA was first established in 1999 by founding partners Corner Drug Store, Inc., UF Center for Cooperative Learning and Department of Psychiatry, and the School Boa rd of Alachua County. Originally, it received funding through an Office of Juvenile Justice and Delinquency Prevention (OJJDP) Drug Free Communities Grant, which was part of a five year state project that aimed to create a coalition in every county by the year 2004 that dealt with local problems specific to that community. The grant was matched dollar for dollar by the Ounce of Prevention Fund of Florida. As a result of wide community coalitions are becoming increasingly p opular in handling social problems at the local level, for a more considerate and appropriate approach. Because of the gaining popularity of coalition based interventions, now is an ideal time to critically examine how they are organized and offer suggesti ons in hopes of bridging the ever increasing divide between academic literature and public policy (National Community Anti Drug Coalition Institute 2006). In recent years, the PIPSA coalition has declared underage drinking a primary concern for Alachua C ounty, partly due to the local prevalence and partly due to the severity of the issue. In terms of severity, research suggests that children and youth are thought to be more vulnerable to problems associated with alcohol and drug abuse than any other group in society (Hawkins, Catalano, and Miller 1992). As for prevalence of local underage drinking, research prior to this study being conducted showed that a

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16 higher percentage of youth aged 12 to 20 used alcohol (29% nationally) than used tobacco (24%) or ill icit drugs (14%); making underage drinking a leading public health problem in the United States (Department of Children and Families 2003). While initially developing this study, the most current data available was the 2004 Florida Youth Substance Abuse Su rvey (FYSAS), since Alachua County opted not to participate in the 2006 FYSAS. According to this research, the number of youth in Alachua County who are engaging in alcohol use was even higher (32.7%) than the national (29%) or state average (30.8 %) (Dep artment of Children and Families 2003). At that time, research and treatment of youth alcohol problems was not only thought to improve the quality of life on an individual level, but was aimed at improving the overall productivity and health of the Alachu a County community. More recent data has suggested these rates have declined slightly, but the alarmingly high patterns of underage drinking still persist. FYSAS data is gathered yearly, with county breakdowns available every two years. Data from the 2008 FYSAS, show alcohol as remaining the most commonly used drug among Alachua county students, with 49.8% reporting lifetime use and 27.7% reporting past 30 day use. Unlike previous years, these numbers fall slightly below the Florida average, with 53.2% rep orting lifetime use and 29.8% reporting past 30 day use (Department of Children and Families 2008). Prior gender trends persist in Alachua county, with females reporting higher rates of lifetime usage (51.0% vs. 48.6%) but similar rates of past 30 day usa ge (27.7% vs. 27.1%) than males. Also, age patterns persist, with older students (ages 15 17) reporting higher lifetime usage rates (61.9% vs. 31.8) than their younger (ages 10 14) counterparts and higher past 30 day use rates (35.4% vs. 13.1%). Although l ifetime use

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17 rates and past 30 day use rates have continued to drop slightly since 2004, these high rates of underage drinking still persist and mirror state and national averages (Department of Children and Families 2008). Alachua County includes the cit ies of Alachua, Archer, Gainesville, Hawthorne, High Springs, La Crosse, Melrose, Micanopy, Newberry, Waldo and significant non urban areas. The total estimated population in 2004 was 223,090, with 20.2% making up the under 18 population (Department of Chi ldren and Families 2003). This is of course excluding the large numbers of transitory UF students not registered as Alachua County residents but who are commonly between the ages 18 22 and unwittingly contribute to its culture. Considering the underage dri nking level is twenty target population is a slightly larger percentage than 20.2% (Department of Children and slightly more than 20 out of every one hundred Ala chua county residents in order to intervene or prevent their use of alcohol. Although insight from youth should be seen as credible and worthy as any other knowledge presented, historically, youth have been unfairly treated as lacking the mental capacity to make informed decisions (Arnett 2007; Znet 1992). If prevention efforts are to target youth, youth opinion should be given consideration. Conceptual differences may exist between adult designed prevention efforts and the local youth they hope to serve. This qualitative study ex amines the potential disjuncture between these two populations to offer program suggestions to PIPSA and to the field of prevention in general.

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18 CHAPTER 2 LITERATURE REVIEW Summary This section draws on literature not only from medical sociology but from other disciplines that contribute to understanding the complex nature of the social problem, underage drinking. This study can help inform adolescent development literature by evidencing how youth can contribute to their communit y by offering program improvement suggestions to local program efforts. It also addresses the effectiveness of community based coalitions in dealing with underage drinking and their strengths and weaknesses suggested by current studies. This is done to con sider whether the coalition, even at its most refined state, should be used in dealing with the social issue of underage drinking, and in what ways might be more effective. PIP SA is presented as an ideal local example for analyzing these literatures becaus e of its initi ative in adopting this national strategy. Finally, the theoretical framework of the PIPSA coalition is presented, as expressed by archival data and conversations with coalition members. Literature addressing this theoretical background of the PIPSA coalition is essential in understanding its approach to Alachua County youth. Social Issue of Substance Abuse Substances may be defined as any drug used to alter a person's mood or ubstances, such as alcohol, tobacco, and drugs, satisfy an inner need for experiencing other modes of consciousness. Research has shown that, initially, substance abuse is most often a sign of deeper emotional troubles or concerns within the individual. Ko rnblum (1998) lists some major reasons people use substances: to ease pain, relax tension, lose weight,

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19 and fight depression. Youth may drink for these reasons as well as others considering their unique social circumstances during this period in their life course. The following sections will present in more detail the influences youth may be experiencing. For many, this emotionally charged need to escape from reality, whether it is due to professional, familial, or social pressures, manifests itself in the use of substances. After continued use the individual may develop a physical dependence on the substance, and begin to participate in alcohol abuse, which may be defined in its most basic description as a pattern of problem drinking that results in health consequences, social problems, or both (Medical Network Incorporated 2006). Both alcohol use and abuse in underage drinking populations is the primary concern of the coalition, since youth may not fully understand the difference at these ages. With both ph ysical and emotional dependence on a substance the individual may, at the very least, lose their ability to self regulate emotions and actions. Depending on the age of initiation, substance abuse may also disrupt normal developmental processes, jeopardizin g cognitive ability and physical maturation. In addition, it is also linked to anti social behavior. Research has shown that substance abuse has strong associations with crime, illness, and interpersonal violence (Kornblum 1998). For these reasons, coalit ions of community members find it necessary to safeguard certain populations in order to prevent these life altering consequences of alcohol use and abuse, particularly youth populations who may not recognize the future implications for their actions. It is important to note, early socialization may guard against desires to alter a

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20 its members in forms of media, school, and parental guidance, with social expectations implicit ly and explicitly made to the individual. Social support guarding against substance use and abuse can be education of its dangers, encouragement and acknowledgment of participation in non substance related activities, and social service organizations helpi ng individuals to deal with issues leading to emotional problems such as family, marriage, or financial counseling. According to Vega and Murphy sensitive are supposed to be liberating. Clients are supposed t o be given a modicum of control over their lives, as a result of need to actively construct considerate prevention efforts that aim to address local issues. Vega and Murphy should not be left to chance by any society that wants to improve the productivity of all Alcohol as a Substance In the United States, the past decade has seen somewhat of an expansio n of focus regarding substance abuse, with licit drugs now being targeted as harmful to the physical body. Tobacco companies have publicly admitted the health hazards relating to nicotine and have begun to pay reparations, funding the American Legacy Found Davis, Messeri, Hersey, and Haviland 2002). Even though alcohol has had similar discoveries relating to addiction and harm to the physical body, society has not de alt with it in a reciprocal fashion. Arguably, alcohol warnings may be too soft considering the cultural backdrop of our society, which works to normalize drinking on a consistent basis. Many coalitions

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21 across America are declaring the importance of consi dering the deleterious effects of attracting underage drinkers to a lifestyle of addiction. Young people are exposed to a steady stream of images and lyrics presenting alcohol use in an attractive light. A recent study shows a strong connection between alc ohol advertising and underage drinking (Simon 2008). If messages are inconsistent across informational sources (i.e. media, peers, parents), the social support deterring alcohol use begins to become fragmented and unclear to the child. As noted previously underage drinking is a problem at the national, state and local community, evidencing a need for prevention efforts at all levels. Alcohol remains the Surgeon General called on A mericans to act on underage drinking and conduct more 2007). Research continues to look at various factors relating to underage drinking and preventative approaches that woul d be successful if implemented. Since the prevalence of local underage drinking is of major concern, this study takes a focus on trying to examine what prevention efforts might be more successful in Alachua County. Furthermore, this research can work to in form prevention efforts targeting youth in general. Unique Life Course Stage of Adolescent First and foremost, we must adolescent is bombarded with a multitude of influences during this developmental stage of their life course. In order to better understand the complexity of their decision making processes, we must first understand the influences they are presented with during this time period. The following are factors directly or indirectly involved in risk behavior in

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22 adolescents. It is important to note that the individual influences (i.e., biological/physiological & psychosocial changes; gender; race/ethnicity ) and socialization influences (i.e., family; friends; school; US culture; local environm ent ; media), presented separately are constantly overlapping with in the individual and work to inform each other. While youth are influenced by socialization agents, they make choices and respond to their environment in different ways depending on their i ndividual characteristics (Arnett 2007). Individual I nfluences on Adolescent Risk Behavior Hormonal changes lead to changes in physical functioning and to the development of pri mary and secondary sex characteristics in the adolescent (Arnett 2007). These biological and physiological changes have a dramatic impact on the adolescent. In addition to drastic physical changes that adolescents go through during puberty, they are bomb arded with a variety of psychosocial changes as well Bonnie and During adolescence, individuals are going through rapid physical, social, and cognitive changes. These enormous changes to body, friendship and thinking about the world are juxtaposed against changing expectations for behavior and increases in need and opportunities for autonomy. One of the most widely recognized psychological change s involves the transformation from conc rete to more abstract thinking during adolescence. The onset of what is called and (Gullotta and Adams 2005). During this time, adolescents are thought to develop a broader, less immediate view of life. Ad olescents are said to move from a point of

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23 dependency (on adults) to a more autonomous sense of self and their moral beliefs are said to become more abstract and complex than during pre adolescence. During this stage of their life course, gender related socialization pressures intensify and gender roles become more concrete and defined in the adolescent (Arnett 2007). Arnett (2007) argues that sel f conceptions tend to become more abstract in adolescence, which self. Also, s elf esteem tends to decline in early adolescence due to concerns of physical appearance an d peer acceptance. Studies also indicate that the hormonal changes of puberty make some contribution to increased emotionality in early adolescence (Susman and Rogol 2004). Arnett (2007) highlights some additional individual characteristics that are particularly important to consider when considering why adolescents engage in risky behaviors. These include gender, race/ethnicity, and temperament characteristics. Past alcohol research looking at gender differences has shown that males tend to report engaging in heavy drinking at a higher rate than females (SAMHSA 2010). When considering differences in body composition and alcohol metabolism, with women, on average, weighing less and processing alcohol slower, girls may feel the same effects as boys even if they are consuming less. Also, some current research shows this gender gap closing at certain age groups. In younger teen years, more girls reported drinking than boys, while during middle teen years they tended to drink at roughly the same rate a 20) where boys tended to outpace girls significantly (SAMHSA 2010). Much like the patterns of alcohol usage relating to gender, ethnic differences are diminishing in groups with historically low drinking rates

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24 who ar e moving toward the higher rates of non Hispanic white males. Among persons aged 12 to 20, one third (32.6%) of whites are current users compared with 27.2% of American Indians or Alaska Natives, 25.7% of Hispanics, 24.3% of Native Hawaiians or Other Pacif ic Islanders, 18.8% of blacks, and 17.1% of Asians (SAMHSA 2010). Research shows that adolescents, regardless of race, ethnicity, or gender, have a common interest in alcohol. Adolescents are capable of critical thinking during this life stage, but have be en found to allow psychosocial factors such as emotions of the moment influence their decisions (Arnett 2007). involved in risk behavior. Aggressiveness, sensation seeking, and low impulse contr ol have all been found to be consistently associated with adolescent risk behavior. Social ization I nfluences on Adolescent Risk Behavior During adolescence, there is typically an increase in time spent with peers and decreased time spent with parents (Arn ett 2007). This unmonitored time parents allow their children, reinforces societal beliefs suggesting that adolescence is a time to practice adult roles (Arnett 2007). Historically, alcohol use has been an important symbol of adult status. Some research shows that even telling underage drinkers that they will not have access to alcohol only increases their motivation to drink (Peele 2007). This is due in large part to the social significance of drinking in our culture and the right to drink as reserved so lely for those in adulthood. Over time, the legal drinking age has been adjusted to reflect the perceived age of an adult. Following Prohibition, the legal drinking age was twenty one. In 1971, the voting age was lowered to 18 to match the military draft a ge, encouraging some states to lower the drinking age as well. Alcohol related problems stirred a push

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25 for federal regulation to increase the drinking age. By 1988, the majority of the states had re raised the legal drinking age to twenty one, which is whe re it has stayed for over 20 years. This current law suggests that society agrees that even older teens lack judgment when it comes to the use of alcohol. More specifically, they lack judgment between substance use and abuse, and should therefore delay e xperimenting with this substance until they are mature enough to handle its consequences. Research agrees Individuals who begin drinking before the age of 15 are more likely to have substance abuse p roblems in their lifetimes, to engage in risky sexual behavior, and to suffer other negative consequences in comparison with those who begin drinking at a later age. More recent research suggests 15 remains an important age for lifetime alcohol risk (SAMHS A 2010). Statistics show that large numbers of teens are consistently choosing day prevalence rates have hovered around the 50% mark, with adolescent social pressures probably contributing greatly to the steadiness of these rates (Regents of the University of Michigan 2006). Some notable differences in patterns of usage do remain though. Nationally, youth The average age of first alcoho l use has generally decreased since 1965, indicating youth are starting to drink at a younger age. NHSDA data indicate that the average age of self reported first use of alcohol among individuals of all ages reporting any alcohol use decreased from 17.6 ye ars to 15.9 years between 1965 and 1999. Not only are youth drinking at an earlier age, but they are drinking in heavier doses than previous years. Simon (2008) notes that underage drinkers tend to drink more heavily, inconsistently, and are more vulnerab le to adverse effects of alcohol than adults.

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26 Pointing to the sociality of substance use, research during the past 30 years supports the view that delinquency, alcohol, tobacco, and other drug use, school achievement, and other important outcomes in adoles well as with characteristics of the individual (Hawkins et al. 1992). In fact, these risk and protective factors have been shown to be more important in understanding these behaviors than ethnicity, income or family structure (Blum, Beurhing, Shew, Bearing, Sieving, and Resnick 2000). There is a substantial amount of research showing that factors is associated with more drug use and delinquency (Catalano and Hawkins 1996). For example, authoritarian or disengaged parenting style s decreased monitoring, positive parental attitudes towards drinking, and a disorganized family structure have al l been found to be associated with higher rates of drinking (Arnett 2007). There is also evidence that exposure to a number of protective factors is associated with lower prevalence of these problem behaviors (Newcomb and Felix Ortiz 1992; Newcomb 1995; P ollard, Hawkins, and Arthur 1999). Environmental influence is an important source of socialization on the adolescent There are many locations in which youth may have ease of access in getting alcohol. Youth may access alcohol throughout their neighborhoo d, depending on community acceptance. Wagenaar and Wolfson (1994:39) further note: Methods used to purchase alcohol reported by underage students include using false identification, buying from stores that are known for selling to underage youth, and seeki ng young clerks. The extant literature shows that most persons under the age of 21 are able to obtain alcohol, suggesting that this law is not rigorously enforced.

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27 A recent survey conducted by SAMSHA indicates that 40% of underage alcohol drinkers obtain alcohol from adults (SAMHSA 2010). A community may be considered a A wet community environment is one in which drinking is prevalent and common, public opinion is generall y tolerant or positive, and alcohol is readily available both commercially and at private social occasions and is advertised as available. A dry community would be one in which drinking at social occasions is not the norm and is generally frowned on, and a lcohol outlets are relatively scarce. The drinking environment is important to consider when noting the prevalence of underage drinking. It suggests important issues surrounding underage drinking, such as accessibility and availability. Florida plays host to two of the top party schools in the nation, Florida State University and the University of Florida. Specifically, Alachua County is home to the University of Florida, a consistent national contender in football and basketball a school with much to c elebrate. With the density of bars and the consistent marketing and advertising of alcohol, its wet environment works to further normalize alcohol use. Therefore, Alachua County 004:81) note: with more social occasions to drink, more positive attitudes about drinking, more advertising and outlets, and more lenient regulations concerning the sale and consumption of alcohol. In short, such environments have an enabling effect on underage drinking. Environmental influences and how they relate to social and cognitive influences should therefore be addressed. Alachua County middle and high school students may be more at risk for underage drinking, as they attempt to emulate the college students and

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28 Research also shows that underage person who lived in counties in nonmetropolitan areas were slightly more likely than those who lived in counties in metropolitan areas to engage in binge drinking (20.8% vs. 18.8%) and heavy drinking (6.9% vs. 6%) (SAMHSA 2010). For this reason, research may benefit from separating out rural and urban areas to examine potentia l differences. Reasons for Drinking in Adolescence Although such as pubertal status, psychological develo pment, social relationships and developmental transitions, have yet to b (Wagner 2009: 67), any knowledge gained from studies directly examining these interactions should help in the design of more effective prevention efforts with more long term effect. Additionally, since major d evelopmental transitions can permanently being, short term and long term reasons for adolescent substance use should be further examined. This study provides an opportunity to add to these literature gaps. Some studies have shown how this unique stage in the life course may play a role in reasons for youth participating in risky behavior like underage drinking. Some of the major reasons that have been found for youth drinking include the following: experimen tal, social, medication, and addiction. As mentioned earlier, research has found that adolescence is a time to practice adult roles (i.e., experiment with alcohol) and during this stage of the life course this is the first time where adolescents are beginn ing to increase the time spent with peers. This increased desire for experimentation and increased sociality with peers offers opportunity for risky behaviors. Furthermore, Arnett (1992) explains that sensation seeking and ego

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29 centrism in adolescence are p rominent factors for reckless behavior during this life stage. Additionally, drinking may serve as a source of medication or way for youth to cope with adolescent stress unique to this life stage. Arnold (1990) highlights some physical (i.e. anatomic & phy siological changes), psychological (shift from dependency to autonomy; development of formal operational thinking broader less immediate view of life), and sociological stressors (new relationships; development of morality) experienced by the adolescent He notes youth who have not developed successful coping skills, may suffer stress related disorders such as depression, eating disorders, and substance abuse and these are often related to the societal pressures placed on the adolescent (Arnold 1990) The refore, substance use in adolescence may be an attempt for youth to manage and perhaps control their daily stresses. Alarmingly, research also indicates that these disorders may persist and follow youth into adulthood. One study found that adolescents with anxiety disorders are at an increased risk of subsequent anxiety, depression, illicit drug dependence, and educational underachievement as young adults (Woodward & Ferguson 2001). Finally, addiction may be an important reason behind youth continuing to d rink during adolescence and into adulthood More studies using life course concepts that highlight adolescent development are needed to determine how developmental stages, individual characteristics, and various contextual influences (i.e., peers, family, school, social influences, environment, and media) and the ir interactions influence alcohol use behavior and treatment outcomes/success.

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30 Consequences of Underage Drinking The deleterious effects of unde rage drinking have been partially noted previously, but should be addressed in greater detail. There are both short term and long term making capacity which could possibly result i n accident, death, injury, illness, or arrest. When judgment is impaired, the individual is less likely to guard against impulses, which could lead to vandalism, assault, risky sexual behavior, or drunk driving. Also, adolescents, with less experience behi nd the wheel, pose a higher risk when drinking and driving. The crash risk associated with driving after drinking is higher for youths than for adults at all blood alcohol content (BAC) levels (Hingson and Kenkel 2004). Poor decision making, as a result of one drinking occasion, could lead to a life altering consequence. term disability for youth, such as suicide, homicide, assault, drowning, and recreational injury, involve alco Accumulated effects of chronic drinking could lead to long term social consequences, such as a breakdown in family relationships or poor school performance (Brown and Tapert 2004). Long term health consequences from undera ge drinking could result as well. Recent research suggests that adolescent drinking can inflict permanent damage on the developing brain (Brown and Tapert 2004), foreshadowing problems with memory and reaction time. Other health problems are related to und Heavy drinking during adolescence, especially if this behavior is continued in adulthood, places a person at risk of such health problems as pancreatitis, hepatitis, liver cirrhosis, hypertension and anemia. Recent research suggests that drinking during puberty may have deleterious effects on bone density development for young women, failing to develop maximal

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31 bone density during adolescence puts them at risk later in life for osteoporosis. Addi ction may play a serious part in these long term health problems surfacing. Research finds that early initiation of alcohol use has been associated frequently with later alcohol related problems (Sartor, Lynsky, Heath, Jacob, and True 2007). Using data fro m the National Longitudinal Alcohol Epidemiological Survey (NLAES), Dawson found that 15.7% of participants who first drank before age 15 later made criteria for alcohol dependence versus only 7.2% who started at age 21 or older (Dawson 2000). Other resear ch has found similar patterns using this same data. The odds of developing alcohol dependence decreased by 5% for every year that initiation of alcohol use was delayed at baseline and by 9% per year at the 5 year follow up (Grant, Stinson, and Harford 2001 ). Community B ased Coalitions Previous national strategies for decreasing substance use in youth populations have not been exceptionally successful. For example, Gwaltney (2005:8) explains eatments, and other important advances, too many adolescents still start smoking annually and relapse is shot educational approaches like the campaign, or extended programs like the D.A.R.E. program have been suggested to be ineffective. Gardner (2003) pulled together a literature review on the D.A.R.E. program, in which they cited six long term evaluations done during the 1990 significant difference between students who received the D.A.R.E. program and those who did not. More recent research continues to find similar results in the ineffectiveness

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32 of those involved in the D.A.R.E. program still report using alcohol during and after the program. Community based approaches involving parents, communications media, and the community in promoting norms against use seem to be more effective (Hawkins et al. 1992). Wolfsberg (2007) argues that a more ecological approach needs to be taken in reducing underage drinking. Programs that teach young people skills for resisting influences to use alcohol help them develop strong norms against use (Hawkins et al. 1992). Current research suggests that changing the adolescent normative conception of alcohol usage may result in a decrease in underage drinking. Particularly, helping ef fective (Schinke, Cole, and Lin 2009). A major goal for community based efforts is sustainability. Hawkins et al. (1992:7) shot approaches, such as those that at tempt to influence behavior only after one session or educational activity, seem to be ineffective at making any long term behavior changes among adolescents. In sum, community based efforts need to involve all members of the community that contribute to p romoting social norms, need to work to change the normative conception surrounding alcohol usage, and need to be sustainable in hopes of having any long term effect. Effectiveness of Community B ased Coalitions Solutions to youth problem behaviors are to o complex to be dealt with by any one single organization (Wolfsberg 2007; Albee 1983). Therefore, community based coalitions involving varied agencies and organizations throughout the community are necessary in dealing with the issues more comprehensively Community coalitions have

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33 broad goals of changing the infrastructure to the social issue being addressed (CADCA 2010) such as reshaping the physical, social, economic, and legal environment affecting alcoholism. Also, they attempt to generate public aw areness, knowledge and concern for the issue to ensure long term efforts. Community based coalitions have been effective in dealing with substance abuse issues, more specifically, alcohol related problems (Waganaar 1999). Pentz, Dwyer, MacKinnon, Flay, Ha nsen, Wang, and Johnson (1989) further note that comprehensive community collaborations have proven to be an effective method for preventing such youth problems as alcohol and drug abuse. In more specific ways, a community based coalition can contribute to (2004:217) suggest: It can help to create the political will and organizational support for developing and implementing proven strategies for decreasing underage drinking (such as minimum age drinking laws, zero tolerance laws, and measures to reduce physical availability and outlet concentration). It can help change the normative climate surrounding the acceptability of underage drinking, and create greater awareness of, and publicity about, enforcemen t activities, such as random breath testing and sting operations. It also helps to establish the idea that alcohol and other drugs are a community problem that local people can solve, thereby increasing the likelihood that people will support and sustain e fforts they help create. Even though community based coalitions clearly have credibility in addressing substance abuse issues like underage drinking, research does suggest that certain strategies are more effective than others. The following sections highl ight these issues. Strengths of Community B ased C oalitions Community based coalitions are vehicles for creating cohesion among its members. Through open dialogue, community members are able to set acceptable standards of its people, and work to encourage the rehabilitation of those who need it

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34 most, in order to ensure the health of its citizenry. Bogenschneider (1996:132) states emerging that the most appropriate place fo r solving problems is where they occur in Some research shows that local reside nts are capable of bringing about change in areas important to them (McKnight and Kretzman 1992). A more localized approach makes the strategy more personal and allows it to take a shape that is more tailored to the problems present in the community it hop es to address (Wolfsberg 2007; Waganaar 1999). The effort needs to be community wide to make a lasting impact on it residents. short lived in the absence of community norms th (Bogenschneider 1996:133). Weaknesses of Community B ased Coalitions There are many challenges in collaborative efforts like community coalitions (Altman 1995; Anderson, Herriot, and Hodgkinson 2001; Broner, Franczak, Dye, and McAllister 2001; Jensen, Hoagwood, and Trickett 1999; Jordan 2000; Levin 1999; Mullen 2002; Myers Walls 2000; Rawson and Branch 2002; Shapiro and Rinaldi 2001; Silverman 2000; Spear and Rawson 2002; Telleen and Scott 2001). For example, there are a variet y of disciplines simultaneously used throughout PIPSA meetings and efforts. Coordinating these may present challenges. These and other power dynamics may further complicate prevention efforts. Research notes that not all populations or sectors of society are targeted for treatment, suggesting that some populations or sectors of society are unfairly targeted (Hunt &

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35 who require treatment, especially subordinate group s or groups with little political power, is dependent more on general societal attitudes towards them than on intrinsic for prevention efforts to move away from unf air targeting practices, which ultimately only work to label deviants. Some research suggests that interventions may be considered synonymous with social control (Dever and Arxer 2006). Vega and Murphy (1990:149) state: Clearly incarceration is a means of social control, but interventions, particularly those that are truly community based, do not perform this function. In fact, just the opposite is supposed to occur. Simply put, through interventions social conditions are supposed to be changed, so that persons can lead productive lives. Rather than controlling individuals, the intention should be to provide new opportunities. Since substance abuse has such strong associations with crime, it is important to realize the goal should be to rehabilitate and not force individuals to conform in order to create any long lasting, meaningful change to social conditions. According to Vega and Murphy (1990:149): Nonetheless, someone who needs help has come to be equated with a deviant or a threat to order. So even w hen rehabilitation is undertaken, as opposed to overt social control, the usual expectation is conformity in the hand, order is defied by real intervention, for providing assista nce is intended to help persons to develop, and development is often idiosyncratic and can proceed in any number of directions. In sum, unless changes are made in conceptualizing illness, and community members are integral to this process, even community based interventions may merely serve to encourage conformity in those identified as deviant members of society (Vega and Murphy 1990:152; Dever and Arxer 2006).

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36 Suggested Strategies Employing Community B ased Coalitions Research has suggested many success ful strategies in employing community based coalitions. Hingson and Howard (2002) suggest that if community coalitions are to be successful, they must employ a variety of techniques such as educational programs, community organization, environmental policy changes, use of media, and law enforcement practices that correspond to the policies in place. It is in the combination of the strategies that success is gained. As discussed, there is no one way to reduce underage drinking. Successful community based gro ups should include various techniques from a variety of sources in the community. Key leaders across various sectors within the community are important to include. Some may not be able to participate regularly, but just by their affiliation they give the c oalition credence because of their credibility and status within the community. Also, it is important for communities to collaborate with neighboring colleges and universities, such as in Gainesville where a college may affect drinking behavior. Bonnie a Effective restrictions on underage access to alcohol in a community may be severely undermined by the ease of alcohol in the campus living communities. The reverse is also true: even a substantial campus based alcohol preventi on strategy cannot succeed if it is surrounded by a community with easy access to alcohol. These college community partnerships may save time and money by developing joint grant proposals, giving further credence to the initiative by showing its overlappi ng support by both the college and community. It is for these reasons collaboration with neighboring institutions is strongly suggested. Research shows that consistency of policy between campus and community contributes to success. There has also been

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37 succ (2004:217) note: Case studies have documented how communities have organized and used the news media to support changes in alcohol availability, reductions in outdoor advertising of a lcohol, increased compliance checks on retailers The media can be a vehicle for getting important details out regarding upcoming activities. In addition, they may broadcast or re cap important efforts by community based coalitions, like town hall meetings. School based initiatives have had a long history in targeting underage drinking. Efforts within the school setting offer the benefits of reaching a wide (and captive) audience since most youth (especially elementary and middle school aged children) are enrolled in school. Also, school based initiatives allow programs to be disseminated at specific developmental intervals. Some would argue this is essential considering the life c ourse perspective (Steinberg 1991). Since youth are reporting initial drinking between the ages 12 to 14, programs need to begin reaching them prior to this age. Dryfoos (1990) suggests intervention needs to be early, and continuous for it to facilitate lo ng work in school based initiatives: Many early drug education curricula that relied on factual information about alcohol and other drugs, including information on the negative co nsequences of use, or fear arousal were based on the theory that adolescents who used alcohol and drugs had insufficient knowledge about the consequences of use and that increased information would make them more likely to decide not to use drugs. These p rograms have not been shown to affect behavior, for cognitive reasons previously mentioned for adolescents beginning to use initially. Programs that take a critical look at the cultural messages the media is sending and the targeting tactics used

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38 to capita lize, monetarily, on a wider audience may even work. Regardless of the eory offers that youth should be involved in the decision making process in order to get them invested (Lofquist 1983). Federal and state governments may also be instrumental in decreasing underage drinking. Community based coalitions may suggest they do a variety of tasks to improve the well being of the people they serve. The federal government oversees three national surveys, reporting the prevalence of underage drinking: the National Survey on Drug Use and Health (NSDUH), Youth Risk Behavior Survey (Y RBS), and Monitoring the Future (MTF). Overall, trends seem generally consistent across surveys. Unfortunately, the federal government does not report regularly on activities across the various agencies that fund targeted underage drinking activities. Nor do they provide consensus on the evaluation of those activities. Better reporting efforts from government agencies, especially discrepancies between agencies, would provide a clearer picture of what the underage drinking scene is like. With this knowledge, programs can more effectively plan strategies. Coalitions should be tailored to fit the needs of its people. Within a community coalition, a broad range of organizations may be acceptable, or a focused selection may work best together, depending on the n eeds of the community. For example, it may be counterproductive to have members who have vested interests in alcohol production or sales, since they may be given the power to veto alternative intervention strategies that might affect their business product ivity. Although it has been encouraged that it is the

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39 place alcohol prevention programs to warn against the dangers and repercussions it might have on job productivity and possibly job security, some employe based interventions may serve to reach a population of young people who are not exposed to school full or part time job provides discretiona ry money that young people may choose to community has many resources and should be considered when developing community coalitions. Attention to irresponsible sale, promotion, a nd marketing of alcohol are essential to eliminating the culture of underage drinking, in addition to controlling the alcohol availability to youth. Decreasing the number of bars may lessen market competition, resulting in fewer alcohol specials trying to attract underage drinkers to their establishment over another. Also, the use of media or marketing can help in prevention was nationally recognized by the U.S. Departmen t of Education for teaming up with the Regional Transit System (RTS) in a campaign to discourage alcohol abuse among UF students by using advertisements on the sides of buses. In a Gatorwell Health Promotion Services advertisement, the message was broadcas t that according to uy. Drinking too

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40 There appears to be a connection between outlet density and underage drinking. Research suggests that alcohol outlet density may play a role in the initiation of underage drinking during early teenage years, especially when youth have limited mobility (Meng Jinn, Grube, and Gruenewald 2010). Although, low alcohol density in a location may not decrease the risk of underage drinking, since youth who reside in areas with low alcohol outlet density may overcome geographic constraints through social networks that increase their mobility and the ability to seek alcohol and drinking opportunities beyond the local community (Meng Jinn, Grube, and Gruenewald 2010). Recent research suggests that other com munity level characteristics, such as disorganization, are important to consider while devising prevention efforts. One study communities, marked by a high degree of resident ial mobility and housing density (Reboussin, Preisser, Son, and Wolfson 2010). Although not much research has been conducted with faith based approaches, based institutions, religiosity, and spirituality have all been shown t 2004:196). Some research has found religiousness and spirituality to be protective factors for underage drinking amongst college students (Brown, Salsman, Brechting, and Carlson 2007). A lso, parents in and of themselves, have shown to be a positive source of socialization outside of faith based contexts (Catalano and Hawkins 1996). Strategies employing healthcare staff and facilities are suggested to be successful as well. Healthcare sta ff may come across to adolescents as impartial, possibly allowing them to hear the dangers of alcohol use and abuse in a more sincere manner. As noted

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41 of screening adolesc ents for alcohol use can be improved (from an average of 59 percent to 76 percent) by training physicians on knowledge, attitudes, and skills that are distrust of medical practitioners, this is another area of community based initiatives that demands more attention (Braithwaite & Taylor 2001). Research notes that prevention efforts utilizing public health impact oriented models that are longitudinal, replicable, and provid e evidence of alcohol specific outcomes are needed (Spoth, Greenberg, and Turrisi 2009). Some research related to perceived law enforcement also suggests that strict enforcement alone does not significantly reduce underage drinking. It is a combination of community influences that are most appropriate for decreasing underage drinking. A study found that the combination of individually focused prevention programs and local enforcement of underage drinking laws may have the greatest impact on underage drinki ng (Lipperman Kreda, Paschall, and Grube 2009). Furthermore, Spoth, Greenberg, and Turrisi (2009) looked at the effectiveness of prevention efforts and domains (i.e., the individual, family, school, worksite, or community/environmental) of a have the potential of offering the coalition help in reducing underage drinking in Alachua Coun ty if employed effectively. Also, since employing strategies that have been proven ineffective could lead to an exhaustion of resources and wasted time, without any real

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42 social change, scientifically based strategies are strongly recommended when implement ing alcohol prevention programs. Finally, a community based coalition that has a focus on youth should also work to consider youth perspective and collaborate with local youth. Schubert (2007) recognizes longside a young person by listening empowerment, an emerging field, typically studies socially marginalized youth and their potential for positive youth development (Russel l, Muraco, Subramaniam, and Laub people in diverse contexts, early research suggests the potential for involving them in social problems. As primary stakeholders in the prevention process, their attitudes and perspective are vital to the design and implementation of prevention efforts. Criminological Theory Within the field of criminology there are many theories and conceptions of crime. Cullen and Agnew (2003:1) suggest: Like much social behavior, crime is multifaceted and potentially shaped by a range of factors that operate inside and outside individuals, that exist on the macro and the micro level, and that have effects across various points in the life cycle. Even within learning theory, the theory employed by PIPSA, there are many theorists with varying viewpoints. However, the underlying beliefs among the theorists are similar in a few important respects. Behavior is learned through interaction with other social actors, and more importantly, crime is learned in the same way. Cullen and Agnew

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43 definitions might be generally approving of cri minal conduct or neutralizations that justify participate in crime may encourage a person to conduct criminal behavior, since their social interactions are reinforcing this beh avior. based strategy to create long term support for behavior change. Hawkins et al. (1992:19) explain: Involving the whole community fa cilitates widespread communication to achieve consistent norms about drug use and the need for prevention, as well as knowledge about risk and protective factors. A community wide approach can also promote the development of strong bonds to family, school, and the community itself among young people. Because community approaches are likely to involve a wide spectrum of individuals, groups, and organizations, they create a broad base of support for behavior change. Unhealthy behaviors like underage alcohol use are looked at as unacceptable full behavioral formula in social learning theory includes both positive and negative punishment and positive and negative reinforcement. In theory, the support from those involved in the behavior change process leads to long bec ome integrated into the regular services and activities of local organizations and specific community it hopes to address, should be emphasized. Catalano and Hawkins advocate for every community to develop their own programs and strategies that are

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44 199 2:19). As expressed by the authors, the design allows for flexibility. Life Course Perspective course is the process of personal change from infancy through to old age and death, brought about as a result of the int eraction historical processes contributing to human action at various points over the life course. Sampson ticular attention devoted to aging, cohort effects, historical context, and the social influence of age The long term view embodied by the life course focus on trajectories implies a strong conn ection between childhood events and experiences in adulthood. However, the simultaneous shorter term view also implies that transitions or turning points can modify life trajectories they can redirect paths. Although this view is not accepted by all lif e course theorists, this offers incredible hope to community current substance abusers. Programs will be most effective if they are sensitive to the developmental needs and capabiliti es of particular age populations. Life course criminologists study crime over the life span (Benson 2002). As previously mentioned, people are thought to be influenced differently by events at different stages in the life course. More importantly, what ma y be an effective intervention for someone at one point may not be at another point in their lives. Community based programs that attempt to incorporate the life course perspective should be sensitive to these considerations.

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45 Cullen and Agnew (2003) explai n how life course criminologists generally speak in terms of three stages of development: childhood, adolescence, and adulthood. The goal is to understand the stability and changes in criminal behavior through time and over different stages of development. developmental process that starts before birth and continues throughout the life course. Individual factors interact with social factors to determine the onset, length, and end of fe course proponents agree childhood is a time when criminal behavior begins, but they argue over why continuity or change in behavior varies over the life and Agnew 2003). While some researchers believe criminal behavior is predetermined, others believe it is context dependent (Benson 2002) and potentially renegotiated at unique moments or stages of development. Life course research suggests that if crime prevention is the goal, intervention should start early and focus on fostering social bonds between children and their families. Since late adolescents/early adults are more willing to seek conventional behavior, timing is crucial in knowing what strategi es to employ when targeting this group. Within each developmental stage, priority must be given to building and strengthening positive social bonds between the appropriate community members. Each developmental stage requires unique support systems that ma y be useful only during that stage. For example, adolescent substance use may function, at least in part, to accomplish age normative developmental tasks such as identity exploration and peer bonding. To the extent that substance use during adolescence mov es beyond experimental use and becomes more of a strategy of coping, long term negative

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46 consequences would be expected particularly if it is the dominant strategy of coping Summary of Prior Research with PIPSA Focus groups were completed between April and May 2006. Out of the 70 active PIPSA coalition members, nineteen individuals participated in a total of eight separate occupational sector focus groups. Table 2 1 details the composition of focus groups in whi ch coalition members were participants. Some overlapping themes emerged between sectors of coalition mem ber focus groups Coalition members seemed to agree that a potential source of alcoho l is the home. Most tended to emphasize family based prevention ef forts as being useful for future efforts. They further noted that more longitudinal prevention efforts would be beneficial (ex., an entire cohort in a 12 year program rather than a 5 year program which is currently done). Additionally, it was noted by coal ition members that prevention programs need to be more interactive for local youth, as opposed to more educational lecture type activities. They explained that educational activities alone are not effective, since there was a general sense that underage dr inkers were already knowledgeable of substances and their effects. Coalition members tended to agree that more interactive approaches like mock car crashes and beer goggle activities as being effective strategies to prevent youth from underage drinking. PI PSA coalition members tended to be in agreement that drinking was a learned behavior drawing heavily on social learning theory throughout focus group discussions by commenting on risk and protective factors in the community. They made suggestions suc

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47 more practical note, coalition members were quick to separate adults and children when discussing them. They emphasized reasons for why youth drink as opposed to why people drink, distinguishing between adults and youth. Also, coalition members tended to c ite peer pressur e as a major reason for underage drinking, thus highlighting a tension with youth making autonomous decisions. Coalition members were quick to emphasize consequences and strict enforcement (i.e., curfew, year round schooling) as strategies for decreasing local underage drinking. Additionally, coalition members were observed to speak matter of factly and in a calm fashion about underage drinking. They talked about focusing on substance use to decrease future incarceration rates and to decreas e health costs. Finally, coalition members explained how youth were extremely talkative conscious disregard for current drinking laws.

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48 Table 2 1. Coalition Member Focus Group Characteristics Focus group by sector Total Members from sector Total Members in FG Members from sector Members outside sector Organizations represented Date Length (minutes) Law Enforcement 7 4 2 2 Gainesville Police Dept. A Corner Drug Store, Inc. 04/19/06 45 Youth Services 19 4 3 1 Corner Drug Store, Inc. 04/24/06 50 Schools 11 7 2 5 Corner Drug Store, Inc. UF Student Health Care Center Parent School Board of Alachua UF College Advocacy Initiative 05/02/06 75 Family/ Community 3 4 1 3 Parent Corner Drug Store, Inc. 05/02/06 45 Religious 2 5 2 3 Act of Faith Production Mt. Pleasant United Methodist Church Meridian Behavioral Health Care Corned Drug Store, Inc. 05/03/0 6 50 Healthcare 2 4 2 2 University of Florida UF/Area Health Education Center Corner Drug Store, Inc. 05/11/06 60 Business/ Media 5 4 1 3 Gainesville Hospitality Group Corner Drug Store, Inc. 05/25/06 35 Federal/State/ Local Agency 16 2 2 0 Department of Children & Families 05/25/06 70 Civic/Volunteers 5 0 0 0 None 05/25/06 0 Totals 70 35 15 19

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49 CHAPTER 3 STUDY DESIGN Study Overview This study built on qualitative work conducted with PIPSA coalition members in April 2006 (see Table 2 1 for deta iled focus group characteristics) It combined data collection from two distinct groups: semi structured focus groups with coalition members and semi structured focus groups with local youth The purpose of combining these data collection periods wa s to e xamine discour se from PIPSA members and a sample of their potential target population local youth The goal was to highlight any d isjuncture in conceptions of underage drinking (including definitions, perceived prevalence and salience, and solutions) bet ween coalition members a nd local youth. phenomenon, Denzin (1978) argues for qualitativ e researchers to use triangulation. convergence among multiple and different sources of information to form themes or reswell and Miller 2000: 126). Triangulation was particularly beneficial to my study as I aimed to contrast hypothetical client and service provider perspectives. Therefore, relying on multiple sources of data was essential at drawing out these differences and simultaneously increasing study validity. Denzin (1978) notes that there are four basic types of triangulation: data triangulation the use of a variety of data sources in a study (interviewing people in different status positions or with different points of view); investigator tri angulation the use of several different evaluators or social scientists; theory triangulation the use of multiple perspectives to interpret a

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50 single set of data; and methodological triangulation the use of multiple methods to study a single problem or program (such as focus groups, interviews, observations, surveys, participant observations, and organizational documents). In an effort to triangulate the data in this study, I used data triangulation and drew from three sources with possible varying pers pectives: coalition members, local youth, and a comparison of group of alternatively schooled youth. Major epistemological concerns I recognize are the tensions between my research goals and assumptions of this study and those needs of PIPSA. I not only c onducted research with particular objectives (i.e., guiding focus groups, interpreting results), but I regular access to PIPSA leaders). A fundamental question was ho w I could assess power arrangements if I was once within its power structure. Central to reflexivity is being aware of this relationship and the impact of my obligation to PIPSA. I recognize that I aim to draw out perceptions of local youth (i.e., potentia lly critiquing prevention programs like PIPSA) as well as encourage the PIPSA program (i.e., to develop a youth advisory council, and provide them with local youth perspectives). I would argue this to be a major strength to my study, since I was not fully invested in only one interest (mine objectives involved in the study. From a social constructivist standpoint, it is a major Luckmann 1966; Turnbull 2002; Tulloch 1976). The purpose of qualitative research is to discover concepts and relationships in raw data that preplanned quantitative analysis might not allow for, and organize them

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51 into a th eoretical explanatory scheme that offers new insight into the area under study. It not only allows for, but stresses, the socially constructed nature of reality. Strauss and to understand the meaning or nature of experience of persons with problems such as side the minds of local youth to understand more clearly h ow they envisioned underage drinking and local prevention efforts used to counter this social problem Specifically, this study hopes to compare definitions and standpoints and coalition member s and Alach ua county youth Focus Group Rationale Youth focus groups were conducted between September, 2007 (public school focus groups) and November, 2008 (alternative school focus groups). Unique to this (Lane 1962). Lane (1962) suggests: An opinion, belief, or attitude is best understood in the context of other opinions, beliefs, and attitudes, for they illuminate its meaning, mark its boundaries, modify and qualify its force. Even more important, by grouping opinions the observer often can discover latent ideological themes; he can see the structure of thought: premise, inference, application. These focus groups o ffered respondents a chance to qualify, clarify, and build depth information (Stewart and Samdasani 1990). I aimed to explore and explain these varying patterns of beliefs found in the focu s groups, which in and of themselves were thought to be valuable. In sum, these focus groups offer ed an in depth understanding from local youth perspectives.

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52 participants are recr uited from a limited number of sources and are usually homogenous in nature (Morgan 1997; Glaser and Strauss 1967; Patton 1987). The power of purposeful sampling lies in selecting information rich cases for study in depth (Patton 1987). A theoretical sampl ing was taken of local youth. This will be discussed in more detail in the following sections. Morgan (1997) generally recommends conducting focus groups with six to ten participants per group, while Krueger (1988) suggests seven to ten participants is su to six participants, affording each of them more opportunity for sharing ideas, but this may limit the diversity of perceptions. To achieve these numbers Morgan (1997) su ggests over sampling by 20 percent. Also, the need for over sampling varies with the study design. Morgan (1997) notes that participation depends a great deal on whether participants are being paid, where the focus groups are held, and what ties the partic ipants have with one another. A comprehensive study is typically composed of Zeller 1993; Calder 1977; Glaser and Str auss 1967). In all, nine youth focus groups were con ducted for this qualitative study (7 public schools; 2 alternative schools). Combined with my previous work, this study compared discourse of 17 focus groups. As noted (Morgan 1997; Patton 1987; Krueger 1988), a guide with pre planned probes was used for all focus group discussions and all focus group interviews were audio taped. All information shared by respondents was held in strict confidence.

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53 Following the data collection period, I transcribed and analyzed all focus group data according to the propos ed strategy in the following section. Sampling Design Local Youth Sampling T heoretical categories for local youth were distinguished prior to recruitment. T hese categories were determined according to current adolescent research, so the recruitment of local youth would be more comprehensive. According to the United Nations and the World Bank, youth are between the ages 15 to 24 (The World Bank by culture. S ince this study aimed to address underage drinking, a legal construct discussed earlier, the legal context took precedent in defining the term. Although, this was not intentionally done to dismiss other equally important contexts that youth vary by. Acco rding to prevention literature, prevention programs should be in place prior to literature review, the average age American youth begin to experiment with drinking is 12.5 prevention approach, focus groups of local youth should include members younger than members older those aged 10 to 20 years old to get a wide range of experience and understand the target population PIPSA hopes to reach with its combined prevention and intervention approach. Consi dering current developmental literature proposing cognitive differences according to age, it is probable that there is a noticeable difference between a ten year

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54 old and a twenty year old youth (Arnett 2007). Therefore, separate focus groups were conducted with each conceptually different age group. It was proposed that each of the three school groups is conceptually different according to their age range and each have varying social contexts that should be considered: upper elementary (aged 10 11); middle school (12 14); and high school (15 20). To narrow the scope of my study further, I chose to exclude private and charter schools and to specifically focus on public schools for five important reasons: (1) according to the School Board of Alachua Co unty (2006) a large percentage of students in Alachua County are currently attending public schools (~28,000); (2) public schools tend to be more heterogeneous with students most likely offering a diversity of views and experiences in Alachua County; (3) public schools are most likely the site of prevention programs like PIPSA; (4) Lewis, Dodd and Tippens (1992) suggest substance abuse is uniformly and consistently higher among public school adolescents; (5), PIPSA works closely with these public schools and can facilitate access, which is crucial in being approved for studying youth populations. In addition, the University of Florida population will be excluded. This could create a limitation of risking theoretical completeness but UF students are a trans ient group of students that may be very different than the registered Alachua County youth. In all, six Alachua County public schools were selected to take part in this study. O ne urban school was selected for all three age groups: upper elementary (Lawto n Chiles), middle school (Ft. Clarke) and high school (Eastside). Also, one rural school was selected for all three age groups: upper elementary (Chester Shell), middle school

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55 (Oak View), and high school (Santa Fe). These schools were picked for their dive rsity in race and socioeconomic status and ease of access. In consultation with school guidance counselors, a sample of Alachua County public school students were recruited from these schools to participate in stage two focus groups. A major goal in selec ting students was to have the composition of each socioeconomic status). This was done to keep the focus group as representative of the school as possible. A short surve y was administered prior to focus groups to document important to note that not all of these students may be at risk for using alcohol but all contribute in some way to Therefore, it is important to speak to a range of Alachua County youth to understand the Twenty students from each age group (two g roups of ten) were recruited thus, totaling 60 possible participants. As Morgan (1997) suggests, inviting ten students (over sampling by 20 percent) should yield focus group participation of at least eight, well within the acceptable range of six to ten. Also, encouraging participation for these focus groups is the idea that students are expected to be in school and are therefore a encouraged participation and the legitima cy of th e study. In terms of study breadth, conducting six focus groups fell within the acceptable range for a comprehensive study (Morgan 1997; Zeller 1993; Calder 1977; Glaser and Strauss 1967 )

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56 In sum, six focus groups, two per age group, were held dur ing the fall semester of 2007 to investigate youth conceptions of underage drinking. Additionally, two focus groups with a local alternative school setting (Horizon Middle, Horizon High School) were conducted in December 2008, to serve as a comparison grou p of students who took a less traditional route than public schools the population of interest in this study. Table 3 1 highlights demographics of the public school youth who participated in focus groups. As previously mentioned, a concerted effort was made by the researcher and those in the schools coordinating focus group selections to have focus group phic p opulation. Overall, focus group compositions mirrored demographics for the schools selected. The Chester Shell focus group was similar to Chester Shell Elementary in terms of racial composition and reduced lunch status. The only major difference was in terms of gender. My focus group included 62.5% females and 37.5% male s and, in actuality, Chester Shell Elementary has the reverse gender trend with 62.9% males and 37.1% females. As for Lawton Chiles, the majority of my focus group participants were white and not receiving reduced lunch, similar to their school demographic s. It would have been ideal to have slightly more females (1 2) for this focus group but the gender trend remained consistent with the school demographics. The Oak View focus group status. The focus group included slightly fewer females (1) than was ideal, reversing the gender trend that was anticipated. Due to unforeseen events (i.e., student absences, and student expulsion), some of the male students that were originally selected to be part of

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57 the first Ft. Clarke focus group were unable to participate. This first focus group included racial composition and reduced lunch status, the focus group wa s redone since gender differences were not able to be examined. The second Ft. Clarke focus group was very on reduced lunch that the school average. Also, there were slightly more males (1) participating in this focus group than was ideal. At the high school level, students majority of them self identifying as Black and the majority of t hem not receiving reduced lunch. It would have been ideal to have slightly more males (1) for this focus group but the gender trend remained consistent with the school demographics. The Santa Fe all aspects, with the exception of blacks being slightly underrepresented. Although, it is important to note, that close to 20% self Table 3 2 highlights the focus group compositions of the two alternative school focus groups that were completed in December, 2009. There were 18 total alternative group participants were very similar to their Horizon Alternative School counterparts. Horizon serves gra des 6 12 and is not broken out by middle and high school demographics. Similar to school demographics, the majority of the focus group participants were black and on reduced lunch. There was a mix of gender in both focus groups, with slightly more males th an females also mirroring t

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58 Local Youth Survey and Focus Group Procedure A survey was administered to all focus group participants to better understand their demographic characteristics (i.e., school, age, gender, race, G.P.A., fa mily structure who regularly lives with them) and basic use patterns (i.e., lifetime usage, age of initiation, and past 30 day usage) prior to their focus group participation. Survey questions were adapted for each age group (See Appendix A). In addition al to youth being asked to report their demographic information and general use patterns, they were asked if they had ever been in trouble for drinking, either at home, in school, or by law enforcement. They were also asked their perception of how often al cohol was used in the home and they felt it was only for adults over age 21. Finally, youth were asked to comment on their accessibility to alcohol in their home and whether alcohol was locked away or openly available to them. The rationale for the survey was two fold. It was aimed to gain demographic information regarding the study participants that could be later matched to school demographics. Also, the survey allowed focus group participants a chance to comment on their alcohol use patterns without the scrutiny or influence of peers. This study recognizes that some youth may not feel comfortable disclosing this information amongst peers. The survey allowed for this information to be gathered from youth where this may be relevant. Focus groups were cond ucted to gather more general perception data that youth may feel more comfortable revealin g in a group setting. I drew from questions found in Appendix B to begin focus group dialogue, with more detailed probes asked to guide discussion. Overall, these que stions allowed local youth an opportunity to express their conceptions of underage drinking and how they related to Alachua County. Also, the probes used varied according to the age group being interviewed and depending on the

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59 discussion within the focus g roup. Throughout focus groups, youth were asked to comment on their conceptions of underage drinking (i.e., definition of, local prevalence, reasons behind youth drinking), perceived risk, availability, peer influence, family influence (i.e., use and accep tance at home), and community influence (i.e., community perception, local prevention efforts). Overlapping Study Design oth coalition members and local youth were asked about their concept ions of underage drinking and if they felt it was a problem in Alachua County. If they cited it as a problem, follow up questions were asked regarding possible solutions for reducing underage drinking in Alachua County. This study aimed to emphasize the im portance of in shaping prevention programs. In the hopes of including youth perceptions of underage drinking in the PIPSA coalition, these focus group questions aimed to local youth perspective. This primary recipient community, you th. The goal was to give credence to local youth perspectives and compare and contrast adult and youth perspectives on und erage drinking Drawing on prior work ( PIPSA coalition members ) and ( local youth ) I generated a grounded theory to address three research questions: 1. How is underage drinking defined by both coalition members and local youth? 2. Wh at extent do coalition members and the local youth feel there is an underage drinking problem for Alachua County? 3. Regardless of whether it is a problem or not, what are possible solutions for reducing underage drinking among youth in Alachua County?

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60 Preve ntion efforts may be challenging on many levels for the PIPSA coalition. Since coalition members are coming from many sectors of the community, they may have differing conceptions of underage drinking and therefore, differing strategies to decrease the loc al prevalence of it. Not only may collaboration be difficult between coalition members and the youth advisory committee, but between coalition members and their respective agencies as well. This study in vestigates these possible disconnects between PIPSA c oalition members and between coalition members and local youth, in an attempt to reduce future program implementation problems. Limitations of Study Design Only emergent patterns and themes, or those that were addressed in the focus groups, were discusse d. Patterns that may seem more relevant but do not appear in the data were not emphasized in this study. While Krueger (1988) maintains focus groups are generally thought to have high face validity, researchers should be cautioned as to the results having predictive validity. Readers who insist on the importance of a study having predictive validity and generalizability may have difficulty seeing the inherent value in the data gathered with this approach. Also, self report data from adolescents is oftentime s viewed as questionable concerning self reported risky behaviors. Adolescents may purposively under report or over report some health risk behaviors because they believe engaging in these behaviors is socially undesirable or desirable (Brener, Billy, and Grady 2003). This can be seen as a potential study limitation. Although, by the tone of the focus groups youth seemed to be credible and authentic in their comments.

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61 Analytical Techniques Focus group data were analyzed according to grounded theory strat egies in order for the principal investigator to generate a grounded theory to address the following three research questions: 1. How is underage drinking defined by both coalition members and local youth? 2. What extent do coalition members and local youth fee l there is an underage drinking problem for youth in Alachua County? 3. What are possible solutions for reducing the underage drinking among youth in Alachua County? Grounded Theory: Background C onsiderations Barney Glaser and Anselm Strauss (1967) originally introduced this methodology as an alternative strategy to more traditional approaches which relied heavily on hypothesis testing and more quantitative forms of analysis. Strauss and Corbin (1998) stress that theory should inform the coding process, and t he previous literature of the social phenomena should not be ignored. Since PIPSA had declared the life course perspective as its theoretical underpinnings, it seemed more appropriate and informative to primarily use theories relevant to this type of liter including the literature of the phenomena under study and referring back to it throughout the analysis process. Strauss and Corbin (1998) do not offer a rigid structure with v erification and validation of theory at the core of the research. They allow for the opportunity of relevant literature to provide for a deeper understanding of the important issues the phenomena may be related to, and offer important linkages experts in t he field have suggested exist.

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62 While this study was not a formal exercise in grounded theory, it followed the grounded theory method in some important respect (Glaser and Strauss 1967). The goal was nei ther to test logically deduced hypotheses nor to provide statistical verifica tion. This qualitative study highlighted the problem behavior of underage drinking in Alachua County, as defined by coalition members and local youth. Elements of Strauss and Corb create an explanatory scheme of their conceptions. Because this study employed a grounded theory met hod, data analyse s were conducted simultaneously with data collection, with coding foll owing individual focus groups. The constant comparative method was used for data analysis which allowed for comparing incidents and their categories (Strauss and Corbin 1998). This allowed for any changes in coding to be made throughout the data collection periods, as new information presented itself. The coding process involved three stages: open coding, axial coding and selective coding. The goal of open coding was to capture emergent categories and organize substantive themes found in the focus groups. The point at this stage was to distinguish between the possible themes considering the possible relevance to theoretical frameworks. Axial coding occurred simultaneously with open coding and helped to refine categories, revealing how they were associated w ith sub categories. The various dimensions and properties of a category were explored and detailed in this stage. The analytic tool such as the flip flop technique was used to further refine categories. In the flip flop technique, I focused on opposites an d extremes to understand connections

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63 between different ways of looking at the same topic. Selective coding was used to identify core themes regarding local youth perceptions of underage drinking. Upon completion of all focus groups and all three stages of coding, themes emerged that guided the principal investigator in developing a theoretical framework of local youth perception, based on the raw data (recorded words of local youth). This data was then compared to coalition member discussions to critique th e theoretical framework of the PIPSA coalition as described in earlier research conducted with them (Dever 2006) Study Design Strengths The method employed was a major strength to this study. Arguably the most important aspect of the nature of focus g roups is that they make it possible for the researcher to observe the interactive processes occurring within the group of participants (Morgan 1997). In addition to producing large amounts of information during a relatively short period of time (compared t o individual interviewing), focus groups produce concentrated amounts of information on the topic of interest to the researcher in highly focused groups. As discussed previously, the researcher as an outsider has the ability to appear less knowledgeable ab out the subject and is forgiven for probes intended for clarification purposes. This flexibility in the focus group allows for unanticipated topics to be explored more fully that might not have been addressed using other research techniques. Since it is un reasonable to get all local youth to meet at one locale to productively discuss these issues in such a focused manner, focus groups provided a technique that was not only efficient, but productive as well including many viewpoints in a relatively short p eriod of time. Unlike self administered surveys and telephone interviews, focus groups allowed the researcher to note the degree of irregular participation from certain participants as well as nonverbal cues, body

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64 language and patterns of turn taking, whic h provided valuable insight into the content and style of responses the participants offered. Rather than testing hypotheses, focus groups offered the participants, those closest to the issue, to tell the researcher wh at the important aspects were. It was a way to allow for marginalized perspectives to be affecting social policy i n the process. This was relevant when encouraging local youth to sp eak dology allowed for the opportunity to study youth in focus groups in an attempt to examine the social psychological processes within a social setting in which peer influence might be important. Also, this study aimed to take a client centered approach tow ard critiquing prevention efforts. Specifically, it gathered local youth conceptions of underage drinking to offer the PIPSA coalition feedback related to program improvement from a population mphasized that people, in this case local youth, can and do think about their actions rather than respond mechanically to stimuli. n focus groups done with an alternative school population. This was an addition which only further strengthened this study. Also, this study used data triangulation as a validity procedure to examine convergence among multiple and different sources (i.e., coalition members, local youth public schooled and alternatively schooled) of information to form themes. In terms of study implications, this case study emphasizes the importance in taking a step backward prior to evaluating a program. Many eval uations generally focus on the

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65 process and impact of the program as defined by its program planners. This neglects the valuable insight and perhaps differing conceptions of the recipient community. More research done in this vein can highlight more micro i nteractions that go unnoticed during typical eval uations.

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66 Table 3 1 Public School Youth Focus Group Demographics Demographics Race/Ethnicity % (count) Reduced Lunch Gender White Black Hispanic Other Yes No Male Female Alachua C ounty 49.3 36.7 5.6 8.3 44.3 55.7 51.3 48.7 School Population & Focus Group (FG) Elementary Total = 61 Chester Shell SCH 50.6 43.7 1.6 4.1 86.9 13.1 62.9 37.1 FG 50 (4) 37.5 (3) 0 (0) 12.5 (1) 87.5 (7) 12.5 (1) 37.5 (3) 62.5 (5) FG Total = 8 Lawton Chiles SCH 54.8 24.5 5.5 15.1 30.7 69.3 52.7 47.3 FG 37.5 (3) 25 (2) 12.5 (1) 25 (2) 37.5 (3) 62.5 (5) 62.5 (5) 37.5 (3) FG Total = 8 Middle School Oak View SCH 65.2 23.9 6 5 50.1 49.9 48. 8 51.2 FG 50 (5) 30 (3) 20 (2) 0 (0) 50 (5) 50 (5) 60 (6) 40 (4) FG Total =10 Ft. Clarke SCH 52.7 32.2 7.2 8 37.3 62.7 49.5 50.5 FG 1 42.9 (3) 42.9 (3) 14.2 (1) 0 (0) 42.9 (3) 57.1 (4) 0 (0) 100 (7) FG Total = 7 F G 2 57.1 (4) 28.6 (2) 14.3 ( 1) 0 (0) 28.6 (2) 71.4 (5) 57.1 (4) 42.9 (3) FG Total = 7 High School Eastside SCH 26.7 60.3 2.7 10.3 41.3 58.7 46.4 53.6 FG 18.2 (2) 72.7 (8) 0 (0) 9.1 (1) 45.5 (5) 54.5 (6) 36.4 (4) 63.6 (7) FG Total=11 Santa Fe SCH 73.9 17 .9 4.9 3.2 25.7 74.3 51 49 FG 70 (7) 0 (0) 10 (1) 20 (2) 20 (2) 80 (8) 50 (5) 50 (5) FG Total=10

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67 Table 3 2 Alternative Youth Focus Group Demographics Demographics Race/Et hnicity % (count) R educed Lunch Gender Participation White Black Hispanic Other Yes No Male Female Horizon Alternative SCH 0% 89% 0% 2% 72% 7% 65% 35% Focus Group Composition Total = 18 Middle School Horizon Middle FG 12.5 (1) 62.5 (5) 0 (0) 2 5 (2) 87.5 (7) 12.5 (1) 50 (4) 50 (4) FG Total=8 High School Horizon High FG 20 (2) 62 (6) 0 (0) 20 (2) 80 (8) 20 (2) 70 (7) 30 (3) FG Total=10 Note: Horizon Alternative School Demographics (grades 6 12)

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68 CHAPTER 4 RESULTS Quantitative Survey Results Sixty one local youth participated in the public schoo l focus groups. An additional 18 partici pated in the alternative school focus groups. Below is a breakdown of demographic characteristics of focus group participants that were gathered via surveys. As intended, demographics of the focus groups tended to mirror the school in which they were selec ted from. Guidance counselors confirmed that there was intentionally a mix of students (i.e., based on race, gender, grades, and behavior) in each focus group, with drinkers and at risk students purposely invited as well. At times, I worked with guidance c ounselors on multiple occasions via phone and e mail to select participants that would be appropriate (i.e., in terms of demographics, behavior) for the study. All focus groups were within a range of 7 10 participants with seven out of nine public school f ocus groups having between 8 10 participants. Both alternative school focus groups were between 8 10 participants as well. Table 4 1 highlights a sample of the survey data provided by focus group participants. Participants were asked to report their dem ographic information (i.e., race, gender, age, and school), their average school grades, drinking patterns (i.e., personal experience with alcohol, frequency of usage, disciplinary action due to alcohol), and general household characteristics (i.e., family composition, family alcohol usage at home accessibility, and family acceptance of underage drinking). Table 4 1 shows there were 27 males and 34 females who participated in the public school focus groups. The majority of the focus group participants were white and not currently receiving reduced lunch. About 37% of the focus group respondents were

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69 between the ages of 9 11, while 27% were between 12 14, and 34% were 15 or older (18 19). There was clear variation in average grades reported by students, particularly at the higher grade levels. This is most likely due to the increasing challenge of curriculum at the middle and high school levels. Out of the 61 focus group participants, 26 reported that they have had a drink of alcohol in their life while 3 5 reported to have never drank. Older students were more likely than younger students to report having ever drank. Out of the 26 respondents, 7 reported drinking in the past month. Of those that reported drinking, most had their drink prior to age 12. That is, 54% of my sample reported the initiation of drinking between the ages of <8 11, while 20% reported drinking between ages 12 14 and 23% reported drinking between ages 15 18. Out of the 26 who had reported having ever drank alcohol, only 5 had reported this case also, older students (3 high school) were more likely to report having been in trouble than younger respondents (1 elementary; 1 middle). In li noted. Table 4 1 shows that 43% (26 out of 61) of my sample had used alcohol at least once in their lifetime (slightly lower than the 2008 local average: 49.8%), while 11.5% had u sed it within the past 30 days (much lower than the 2008 local average of 27.7%). Since my sample included younger populations (less than 9 years old) than the national survey typically included, this finding is understandable. FYSAS typically uses grades 6 12, with students aged 10 17. A better past 30 day estimate would require a larger national survey since this seems to be ultra sensitive to having older students in the sample. The age of initiation for my sample was 11.3 years old, slightly lower than the

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70 national average at the time of the study, which was 12.5 years old (Department of Children and Families 2003). Table 4 2 showcases characteristics (i.e., demographics and household characteristics) of public school focus group participants by drinker s and non drinkers. A mix of students comprised the drinking category. There was an equal mix of students receiving free/reduced lunch and not receiving it who self reported as drinkers. Drinkers in this sample tended to be a mix of students receiving hig h grades, average grades, and low grades alike. Drinkers also came from each age category and school level. More females than males reported ever having drank alcohol. Also, females were more likely than males to report drinking in the past month (6 out of 7). In terms of race, whites were more likely to be drinkers from my sample. Furthermore, students from rural schools were more likely to report being drinkers. Students were also asked questions regarding household characteristics to examine what characteristics were associated with underage drinking. For example, do students from more disorganized households tend to report having experimented w ith alcohol? As shown in table 4 2 students whose families tend to serve alcohol at family celebrations were more likely to be drinkers. The majority of my sample perceived their family to believe alcohol was only for adults over age 21. Although, a larger portion of drinkers as compared to non drinkers felt this was not the case. In addition, students from my sample who reported drinking tended to come from homes where alcohol was not locked up. The opposite was true for non drinkers in my sample. More often than not, students coming from non nuclear families tend ed to report drinking as opposed to standard nuclear families. Non nuclear families were defined as households wi th a

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71 variety of family members present and/or a lack of mother/stepmother as well as a father/stepfather As shown in table 4 3 alternative school youth were asked the same survey qu estions. In total, 11 males and 7 females participated in the alternative school focus groups. The majority of these participants were black and were currently receiving reduced lunch. Since Horizon Alternative School only serves 6 12 th grade, the age rang e was smaller than my public school sample. Students ranged in age from 13 18. Although there were no self reported straight A students in either the middle or high school focus group, there was good variation in average grades for my sample with some rep orting average grades and others reporting below average grades. Out of the 18 focus group participants, 11 (61%) reported that they have had a drink of alcohol in their life while 7 reported to have never drank. High school students were slightly more l ikely than middle school students to report having ever drank. Out of the 11 respondents, 2 reported drinking in the past month. Alternatively schooled youth had a slightly higher average age of initiation (11.6 vs. 11.3 years) than their public school cou nterparts. The average age of initiation for my alternative middle school sample was 10.3 years, while my alternative high school sample was 13.0 years. Fifty percent (4 out of 8 students) of my alternative middle school sample reported using alcohol in th e ir lives, while 70% (7 out of 10 students) of my alternative high school sample reported ever using alcohol. Twenty five percent (2 out of 8) of my alternative middle school sample reported past 30 d ay use, while 60% (6 out of 10 ) of my alternative high s chool sample reported past 30 day use with one student reporting

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72 drinking more than 7 days in the past 30 days. While considering these findings, it is important to note the small sample of my alternative school population. Out of the 11 participants who had reported having ever drank alcohol, 6 (55%) reported. Moreover, alternative focus group participants reported getting into trouble not only at home (3), but also at school (2), and by the police (1). Table 4 4 showcases characteristics (i.e., demographics and household c haracteristics) of alternative school focus group participants by drinkers and non drinkers. A mix of alternative students comprised the drinking ca tegory. There was an equal mix of students receiving free/reduced lunch and not receiving it who self reported as drinkers. Drinkers in this sample tended to be a mix of students receiving high grades, average grades, and low grades alike. Although, overal l, alternative student grades tended to be lower than their public school counterparts in this sample. Drinkers also came from each age category and school level. More males than females reported ever having drank alcohol. Also, alternative students were m ore likely than their public school counterparts to report drinking in the past month girls and boys alike (11 out of 18 61% vs. 26 out of 61 42%). In terms of race, consistent with research, whites were more likely to report drinking (2 out of 3 66 %). As shown in table 4 4 students whose families tend to serve alcohol at family celebrations were more likely to be drinkers. The majority of my sample (drinkers and non drinkers) perceived their family to believe alcohol was only for adults over age 2 1. In addition, students from my sample who reported drinking were slightly more likely to come from homes where alcohol was not locked up. Although for a large portion (5) of

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73 drinkers, alcohol was not reported to be kept in the home and students tended to report this question to be not applicable. More often than not, students reporting dr inking came from non nuclear families (6 out of 11 54% vs. 5 out of 11 45%). Although a large portion of non drinkers came from non nuclear families as well (5 out of 7 71%). In general, my alternative school sample was slightly more experienced in most categories of drinking than their public school counterparts (i.e., higher lifetime usage; higher past 30 day usage; more experience being in trouble with police and s chool). The only exception was this sample had a higher age of initiation. O f note, focus g roup discussions and individual conceptions of drinking did not seem to vary dramatically between these two groups. Across age categories, students who reported that their families tended to serve alcohol at family celebrations were more likely to report drinking. Also, the majority of my sample perceived alcohol to be for adults only, but students reporting drinking were less likely to say it was for adults when comp ared to non drinkers in my sample. Although a large portion of students felt this question was not applicable (since alcohol was not kept in their home), students who reported drinking tended to come from homes where alcohol was not locked up. Additionally students report ing drinking came from non nuclear families whereas non drin kers tended to come from standard nuclear families Qualitative Focus Group Results The results section will be presented as follows. Public school focus groups were first com pared within grade levels. Any differences between rural and urban focus groups were noted. Additionally, they were compared and contrasted across grade levels to see if there were any major conceptual differences. This data was then compared to alternativ e focus groups and the same gender focus group to highlight

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74 major differences. Finally, all school focus groups were compared to coalition member respondent is speaking, w asking the question. Public School Focus Group: Elementary Co nceptions of drinking/underage d rinking Although some elementary focus effort to illustrate their understanding of the topic by descr ibing strategies people use to adjust the drinking age, with some wanting it lowered to 19, and some arguing for it to be raised to 25. Many students commented on the dangers of drinking too young: [Adjustment of Drinking Age] R: 16 year olds might take advantage of drinking and might drink until they die. s one reason ndle drinking they should In a resistant tone, one respondent pointed out the strength of some youth to be because like the

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75 being emotionally affected by a substance abusing relative who s/he n o longer has contact with. Highlighting his/her resiliency, s/he further noted how this has positively shaped his/her opinions on the use of substances. Overall, respondents were quick to answer and very willing to discuss, oftentimes coming up with topic s on their own: [Additional Discussion] sell it? R: (multi ple voices) R: Yeah, I know. R: Yeah, but still why would they sell beer? R: (another person chiming in) When they know it hurts us. R: I know how they make it, too. R: I know how they make it. Some guys like in the 18 ike England or Respondents appeared very supportive of each other listening to each peer as he or she spoke and responding to their ideas in a respective manner. Because of the sensitive material and the shame or embarras sment of some of the topics, students made it a point to openly discuss their trust in their peers that their information would be kept confidential:

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76 [Confidentiality] what a R: Keep it shut. Many respondents in the focus group suggested extreme disapproval of drinking at any age. They suggested it to be bad for anyone. T here were multiple mentions that specifically about underage drinking, they tended to broaden the discussion to keep it about drinking in general, bringing in personal examp les of how it affects adults as well. Perceived risk of d rinking Respondents were asked to describe the risks involved with drinking. They emphasized a range of alcohol related issues concerning physical, emotional, academic, and relational strain witne ssed in family and friends, on television, or in local news stories. Respondents even suggested there to be some gender differences in risks related to drinking. It was explained that physical harm that people could incur from drinking included being assau lted, passing out, having black eyes, feeling or getting sick, losing memory, developing cancer (in yourself or your baby), liver or vision problems, and even dying due to a car accident, heart attack or stroke. [Physical Risks] R: I think drinking is when someone could do something to you. R: Like before gato r games they were all drunk and they all passed out before the game even started (laughing)

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77 R: I watch College Hill and they just had these people from the club and o lay by the toilet. stroke or heart attack or they could die. Respondents also noted some emotional risks related to drinking that people may experience. These risks ranged from depress ion to committing suicide. [Emotional Risks] R: You could get yourself to hate yourself. really, you know, sad and mean, and you might turn into a bad criminal. R: A lot of peo ple commit suicide. Furthermore, respondents acknowledged some academic risks involved with drinking. It alternative schooling or preventing some people from getting a job into adulthood. [Academic Risks] R: You would never get to do your work at school. R: I think you would not get the regular grades you get like if you get good you drank. Some respondents commented on some relational problems related to drinking. One respondent mentioned that those drinking might do things by accident, like spill their drinks on your food. Also, it was suggested that those drinking might not be able to

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78 fights with those around them. [Relational Problems] R: If they are over the grill cooking when they drink it might spill on the food and they might eat it R: Grown no they get crazy. people. Reasons for d rinking Respondents were encou raged to explain why people drink, particularly those underage. They suggested a variety of reasons for drinking, and sometimes offered multiple reasons at once. Students were open and supportive while zed multiple reasons behind people drinking. While many reasons were offered, the most commonly cited in the focus groups was addiction, whether this was suggested to be due to someone tricking you into trying alcohol or someone not explaining the risks in volved. [Addiction] you might get into alcohol and become addicted to it wanting more and then you k eep on getting more and then you get drunk. The second most addressed issue was peer pressure. [Peer Pressure] R: I think the reason why t hey do it is because maybe they want to be in they do it

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79 When asked if peer pressure was the only reason k ids drink, one respondent mentioned recognition that there are various factors at play when considering why people drink. Respondents also suggested kids drink because they s ee drinking modeled for them, so they do this either to mimic this behavior because it is familiar to them or to feel older. (Modeling Up) front of them because that might be a bad influence. R: They just do it because they see someone in their family or someone out on the street or on t.v., a lot of kids learn stuff from t.v., like drinking they learn. Respondents listed a few other reasons why people drink. They include family problems, depression, good taste, and genetics. (Family Prob lems) I: Like what? out on themselves. (Depression) (Genetic Predisposition toward Drinking) all our family S ince all reasons for drinking offered by respondents seemed to paint alcohol in a as celebratory nor did they suggest it was a good thing for any reason. One even

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80 com mented on what makes him/her not drink is witnessing his/her father drink excessively. sitting in the office. I: How does this affect you? R: It makes me not drink. It makes m Some words or phrases used to describe the appearance of a typical underage When asked to describe those not drinking, respondents offered up the following: e to the contrary, noting Focus group respondents were challenged to name logos from popular drinking paraphernalia that they may see often. Although some cited smoking companies and name brands, many were quite capable of naming companies that market to teens and young adults. More importantly, they suggested that it is common to see teens displaying this merchandise. Also, respondents pointed out that boys drink more often and consume more than girls, and are more addicted to it.

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81 [Frequency] and they just can boys doing it. [Consumption] R: I think the reason why boys probably drink more than girls is because probably or a bottle, [Addiction] R: Boys are more addicted to it than girls. Some respondents emphasized particular reasons why th ere may be a gender difference related to drinking. Availability of a lcohol Although some explained that t hey would not get alcohol at all, the majority of respondents noted the availability of alcohol to underage drinkers and the ease of access through family, friends, or strangers. Many respondents described getting it in the home as the easiest way to get a home: [Home Access] R: Your parents could keep it in like a cabinet or a refrigerator or something. friends and d enough to like, you th grade and his par ents,

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82 and I know where they hide the alcohol and stuff and he was just in 4 th grade. parents they have like mini bars at their house with wine setting out and like little wine glasses and beer. parents are sleeping you could just easily sneak in and get one and they would never know. Some of the stories even seemed unlikely to be hypothetical examples: [Accessibility Stories] R: Maybe you have a cousin th road. I and my brother we were walking across 301 and we were uhm over by down there selling beer. A few respondents talked about unr ealistic situations, most likely because they did not have any experience in obtaining alcohol for themselves. One even talked about a situation s/he had seen on television. [Accessibility Stories] was 25 and there was this girl that was 16 and they had a kid and she hated having a was so young and she put uhm beer in his bottle. alcohol or something and like walk out. R: Because all these like drug dealers are around these like basketball vodka or something. they were supposed friend gets really drunk and sick.

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83 Very few noted problems with getting alcohol. One sugg ested the expense of it, while a handful described scenarios of having to deal with campus police or cameras in liquor stores to prevent stealing or underage purchases. Community as risk and protective f actor When asked if there was a local problem with underage drinking, many responded yes. Only one student suggested Some were aware of local news and cited this to make the case for a drinking problem in Alachua. Although respondents were encouraged to keep their comments to underage drinking, they often included cases of adult drinking. [Local News] R: This guy killed a police officer because he was drinking. R: There are lots of really bad car crashes lately and stuff like that. Others talked in detail about personal family stories to highlight the drinking problem in Alachua County. [Family Stories] R: When one of my friends made a play date, uhm, I went over to her house like that. She got brandy and like she started drinking it and I told her to stop and like she got really sick and she died a couple years ago from drinki ng like that stuff. R: My step R: My daddy was drinking one time and driving and lost his license for life. Some respondents linked the drinking problem to other counties as well, citing stories of [Widespread Issue of Alcohol] R: Uhm my friend (from Flagler county) called me la st night and she told

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84 daddy was drinking and her daddy was drinking and her daddy blamed it on Potential prevention s trategies Respondents were the n asked to brainstorm possible solutions to this local problem. Many expressed interest in holding groups very much like the focus group in which they could come together and talk regularly. [Prevention Suggestions] R: I would really love if we had, even though this might not work and everybody might not come, but if we had a big place where it could be be a party of no drinking or something like that. That would Others mentioned more drastic measures to curtail local drinking, like writing the he drugs away and beer [Prevention Suggestions] R: I think they should make ABC uhm alcohol into like that...a toy store or something instead of alcohol. R: Have a M B W momma butt whooping program! kids. R: Yeah, but they will lie. is how the police have like alm license...people that have like kids in their families, I think the people o has children.

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85 Respondents emphasized the power of youth in helping out with decreasing underage drinking in Alachua County, based on their knowledge, experience, and ability to relate to their peers. [Power of Youth] R: I think it can just be us trying grown ups. And maybe like some grown different people to them becaus this pro blem, as illustrated by the following comment. [Power of Youth] R: Yes. R: We do not need to wait. Respondents were then asked who in the community they would refer a friend to if they needed help with a drinking problem. Doctors and police were among the last people who they would refer their friends to seek help from. Many suggested family and friends were best to help them deal with this issue. Some even mentioned examples in advis ing their friend to go to a hypnotist in order for them to deal with their addiction. Although optimistic in earlier comments throughout the focus group, respondents seemed pessimistic when asked what prevention programs might work with youth.

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86 [Youth P revention Suggestions] R: We know a lot of people that go through it, so we understand. In making reference to over these conversations and thinking of each other as having similar opinions and experiences. One suggestion respondents did make in improving prevention programs was to have them as early as p re kindergarten or kindergarten. It was suggested that they do not get to participate in these programs early enough for them to have an impact. Finally, respondents suggested what is currently being done at their schools, having middle schoolers pair up w ith younger students, works well to get kids talking. Or, having students teach people who are their own age might be more successful. Public School Focus Group: Middle School Conceptions of drinking/underage d rinking Most middle school respondents d Furthermore, one student pointed out the distinction between the legal drinking age in the U.S. as compared to other countries. limit and people under that is drinking. Middle school respondents were more open to drinking than their elementary counterparts. For them, it depended on the occasion and circumstances. For example, with parent approval underage drinking was acceptable to some respondents. [Parent Approval] R: Well, it depends on what happens. Like my mom would give my sister alcohol because she likes it. She wants her to know that it t astes bad so she

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87 a young age. So, and like she gave it to me what age they feel comfortable to uhm consume different amounts of alco then uhm people that are underage should really be drinking it because just better if the person in charg consuming it at all underage. For others, acceptability of it depended on the reason behind underage drinking. Reasons such as using alcohol as a stress reliever, to celebrate, as a health benefit, or on occasion we re generally more accepted. Using alcohol too frequently, at school, or acting out because of drinking were cited to be inappropriate uses for respondents. [Stress Relief] ot because someone else is and like have a real reason for doing it.You can gularly or be in control. [Celebration] beer. [Frequency] [Behavior] R: ng at school, I R: Like something religious...

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88 R: In some countries they actually have like a kid, like in some ceremonies they actuall 10 or 11. [Health Benefits] es and stuff. Only one respondent fully disapproved of underage drinking, citing health risks associated with drinking at a young age. [Health Risks] you have to be over 21 to dr ink it is because uhm your liver is not fully developed and if you drink alcohol it messes with your liver. Perceived risk of d rinking Respondents talked about a variety of risks as a consequence of drinking. They tended to focus on the physical or health related problems related to drinking. While some respondents mentioned extremes like death, many focused on more short [Physical Risks] on in life they can get sick from it and die. you have to be over 21 to drink it is because uhm your liver is not fully developed and if you drink alcohol it messes with your liver he energy to, you know, go play football or run. A few respondents even talked about some health benefits of drinking.

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89 [Health Benefits] R: Well, I think that if someone does dri nk, it depends on their health. Because like some people think that wine is actually good for your arteries and stuff. Furthermore, respondents pointed out some academic and social risks related to underage drinking. They felt that it would be difficult to drink while still maintaining good grades and extracurricular involvements. Additionally, respondents thought that drinkers typically exhibited a negative attitude or a bad mood while drinking. [Academic Risks] probably go down or something. want to do it. or focus in school. [Social Risks] every five seconds (lots of laughter) and starts cursing you out for no As evidenced by the following comments, these academic risks were challenged by others in the focus groups. [Academic Risks Challenged] just, he can then it will kind of wear off by the next day. Reasons for Drinking The top three reasons middle school respondents lis ted for underage drinking included seeing role models drink, peer pressure, and stress.

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90 Many respondents commented on the stress in their lives as being a major reason behind underage drinking. Of the respondents who talked about stress as the reason for d rinking, many indicated this was due to family problems in the home. One respondent talked about how s/he felt stress because of her/his race and more importantly, the compounding historical discrimination her/his race has experienced. Drinking was even li among adolescents. [Stress] they are s tressed s omething. out. ng it. [Stress at Home} making mistakes while playing sports and dealing with peer ridicule or disappointment]. uhm, after like str a relief for me just like for emotion kids like how they cut themselves, I sed out a lot, and they just need a way to get stuff off their chest

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91 tty good A handful of respondents talked about how they see alcohol commonly used by adults r, particularly on television. [Role Models] ups fault R: Yeah, like surroundings, or being on television or he way people do it is because they be showing it in videos and stuff Within focus group discussions, there were mixed opinions regarding peer pressure. The few that did suggest it was a relevant reason for underage drinking, suggested that the way peer pressure is presented in the media is not accurate. One respondent went a step further to note that when peer pressure is not noticeably present in the interaction, this may make it even more entici ng to drink. [Peer Pressure] them, like their surroundings. to do it even more.

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92 Respondents suggested a few other reasons for underage drinking, which included rebellion, curiosity and celebration. One respondent suggested underage drinkers first try it out of curiosity and then continue to try it until they learn to like it, possibly to meet certain social expectations of young adulthoo d. [Rebellion] R: I think because people make it to be like you cannot do that, kids want to go and they do it anyways. It gives them more motive in a way. [Curiosity] like we [Celebration] m Unique to middle school focus groups, one respondent expressed doubt in alcohol addiction. S/he felt certain that people had the power to stop drinking if they wished, unlike the addiction of nicotine in cigarettes which s/he further explained as being harder to stop. Additionally, one middle schooler bragged about drinking, in an effort to denote status among peers. After being challenged by a peer about drinking at su ch a young age s/he backtracked slightly. [Addiction] You can stop if you want to. [Drinking as Status] R: I started when I was like 5. R: You still drink?

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93 In addition to providing reasons for underage drinking, middle school respondents were asked to describe the typical youth who drinks. They commented on a range of topics including behavior, demographics, and physi cal characteristics of how they conceptualized the typical drinker. Most respondents suggested that race was not a factor in underage drinking, with the exception of one respondent from the rural focus commented on the age of initiation for underage drinking. It seemed to be a consensus that although some start earlier, underage drinking is more likely to start in middle school. Although some youth reported drinking at earlier ages on their surveys, youth confirmed that, on average, they tend to start drinking around 11 years old (public school youth 11.3; alternative school youth 11.6). Middle school respondents also explained that people most likely to be drinking are thos th grader drinking alcohol. The majority of comments respondents made revolved around the physical appearance of the underage drinker. During the urban focus group, students even offered to draw a picture of the underage dr inker on the dry erase board that depicted the comments of described the drinker a s being less than hygienic, with a worn appearance.

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94 face? shower and stuff. Their description conc luded by commenting on the gender of the typical underage drinker. Boys and girls seemed to disagree about whether boys and girls have similar levels of stress in their lives. Boys seemed to think they had more stress while girls were quick to point out th at they have stress too. Also, boys and girls commented that girls cope with this stress differently, by drinking not as often as boys, but to the point of often when th more physiological reasons. R: I actually uhm saw this in the newspaper that boys are more likely to go crazy when they drink. R: Girls get stressed. nd girls get really girls drink so much when they do drink. Availability of a lcohol The majority of students noted the availability of alcohol and the ease of access from a variety of sources. Some even commented on the taste

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95 of alcohol, suggesting their experience with obtaining it. In both the rural and urban middle school focus groups, there was debate on whether it was easier to get alcohol tended to emphasize the ease of access in more urban areas, while urban students tended to emphasize the ease of access in more rural areas. But, when these two groups talked specifically about wher e alcohol was available to them, they cited similar sources, like home, friends and local stores. Many respondents suggested that the greatest opportunity to get alcohol would be from home, whether it came by stealing, being offered it by parents, or be ing provided it by other relatives (i.e., brothers, cousins, uncles, parents). Also, they would [Home Access] R: You can go steal it from your house. R: As soon as I get home. of p arents R: Some kid your parents are it depends sometimes on how easy it is for you to get my parents they have a cabinet designated for it and w hen like my sister and I would babysit for some people and when they come they put a lock you know? So, it just depends on what they think about it. R: If their parents have al cohol in the house or something. Also, some respondents commented on having access to older friends who would make alcohol readily available.

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96 R: It depends on who your friends are. It could be easy or it can be hard, get a lcohol from his friends who are 21 maybe then that might be pretty easy. R: And some fifth graders like they have like mature friends like in 6 th and 7 th they tend to get it from them. Other respondents talked about alcohol even being available to them through liquor stores or strangers at liquor stores, either through fake identification cards or because they would sell to underage people. Judging by the inaccuracies in the details of some stories, it was likely that some students were not speaking from personal experience but [Liquor Store Access] R: Li ke there are stores in Gainesville that sell underage to people. $1.50, like 6 packs, I mean like 8 packs for $1.50. them like a 12 Although the majority of students commented on obtaining and drinking alcohol outside of school, a handful noted how this had been done also at school. [Alcohol Usage at School] R: I think it might have happened once before like a couple years ago. There were these kids who had uhm water bottles with no labels or anything a kind of clear sometimes they had that and it looked like water and they were just drinking it. R: Yeah, that happened at my old school. A kid brought like one of those bike water bottles and and so she took it from him and showed like the police officer and he knew

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97 and rum, they were just drinking that during lunch, i n the lunch room. deputies, so sometimes it just depends on how discrete you are about it. Overall, few, if any, argued that alcohol was not readily available to them. From a youth perspective, alcohol was easily accessible in Alachua County. Community as risk and protective f actor Respondents seemed to agree that there was a drinking problem in Alachua C ounty, as well as other problems (i.e., marijuana). One respondent noted that most people are quiet about their drinking, so many more than those who are visibly drinking are actually doing so. [Hidden Drinking] R: I think a lot more people, young people drink than we notice they just keep it on a down not extremely proud of it. Others cited specific reasons to back up their opinion about the drinking problem in Alachua County. [Evidence of Local Drinking] R: Well, for people who are driving, like 16 year olds and 18 year olds uhm that are driving, the y might be underage drinking like that and then uhm getting in accidents because there have been a lot of accidents going on. lot of car wrecks that involve deaths like in terms of drinki his car was like totaled. so she goes to high school parties and one of the ones she went to the y had alcohol and people were drinking and stuff. Although many respondents recognized there is a local problem with drinking, some felt that there was constant policing of local youth. These respondents spoke of feeling

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98 threatened by cops living nearby, fearful they were being watched even in their Middle school respondents had plenty to say regarding prevention programs, particularly those that are not successful and the possible reasons for this. They were in consensus that s care tactics did not seem to have a long lasting affect on them. R: (scare tactics laughing at it. R: I still t here...challenge day had a really great affect on people for like a couple Additionally, if prevention programs are supposed to be taken seriously teachers need to lead by example. This excerpt includes a comment where a student seemed frustrated that they were expected to participate in something that adults were not willing to take seriously. [Adult Examples] R: They need to work on their drug awareness program because right now they stink. R: Middle school respondents were initially pessimistic when asked what prevention programs might work for youth their age. They suggested that only through personal experience would you th truly understand the dangers of drinking. [Personal Experience of Drinking Dangers] R: I think you could have 100 people tell you like drinking is bad for you, or take it seriously.

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99 have had it like in their family, you know. Like someone sees her get in an accident or, you know, die yo u know or stuff like that. They seem to take it more seriously because they know the severe consequences you know. Potential prevention strategies. When probed more about the possibility of successful prevention programs, respondents offered a variety o f suggestions. For example, showcasing role models (either local or national) who have quit drinking might bring better awareness to youth. [Role Models] drinking] and like where they are now. More importantly, they suggested having youth designed programs and activities to prevention activities in realistic ways and the scenarios could benefit by h aving youth design them in more updated ways. [Argument for Youth Designed Activities] think adults thi nk that youth have pretty much the same opinion about really they have very different opinions. R: Very, very different. R: The youth could do it [design the programs] like certain adults that make some drinkers, non drug abusers. So, they just make up like really random stuff and then on the Mendez program R: No one does that.

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100 lly Another suggestion included offering alternatives to drinking as a stress reliever, since many respondents cite str ess as a major reason why youth drink. [Alternative Stress Relieving Activities] So, I think like if you would want to uh make the underage drinking population go down uhm it wou ld be like having classes of giving them Finally, a less welcomed prevention strategy was to decrease the legal drinking age. [Lower Drinking Age] R: This is going to sound really weird, but I bet you the underage drinking if they uhm got rid of the law that you had to be older than 21 to drink I bet you it would rise for like the first few months and then it would drop significantly. Many respondents argued that this would not do what was intended and that there would be even more drinking and drinking related problems. Seek Help. Respondents were slow to respond wh en asked whom they would seek help if they themselves had a drinking problem or if they needed to refer a friend. A handful cited peers as the best to speak with. The majority explained why they enforcement, or counselors to seek help. [Doctors/Nurses] R: They would tell parents. [Adults] [Law Enforcement]

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101 cops they like give you uhm examples where to go to like when they give you a card that says services, they might just give you a warning. [Counselors] R: They are required to report you. There were mixed reactions about going to faith based members for help. Som e respondents were more trusting than others to seek out their help if having a drinking problem. [Trust of Faith based Members] R: People from the church would be great. [Distrust of Faith based Members] ike I think it would hurt the way they look at you. since we do church is trying to make stuff better and help out everything but we still got Middl e school respondents were very talkative and interested in the discussion of the focus group. In addition to the topics we were scheduled to discuss, respondents offered some insight into other questions or concerns people their age were considering. It wa s quite apparent that participants enjoyed the opportunity to discuss and even offered up additional topics to discuss amongst their peers. The following are Influence

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102 [Additional Topics] you have a beer can or like a bottle of beer in a little cup holder? Would that be like, just be cause you have that would you get arrested or is it if either. R: So, why do they sell it in stores?.Why do they sell it in Publix, why do they sell it in Walgreens, why do they sell it in like gas stations? R: The people who sell beer and stuff they already know where to sell it at. a Public School Focus Group: High School Conceptions of drinking/u n derage d rinking Although most high school responde nts said underage drinking relates to those under the age of 21, some noted that it was anyone under the age of 18 and cited reasons for this response. [Under 21] [Under 18] R: I think 18 and under because if you can go into the army and kill people There were others who recognized the legal drinking age was 21, but argue d for it to be for drinking

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103 [Maturity] are not grown. e told me. Still, others suggested that people are going to drink regardless of legal drinking age and many respondents noted how they knew many people who were drinking underage. Although one high school respondent noted that no one should drink because on drinking. Rural and urban high school respondents were in agreement that some people can handle their alcohol and others cannot. They offered acceptance to those who di [Acceptance: Aware of Drinking Limit] R: Ok if you know your limit. people that can handle their liquor if they like there are some adults that can handle their liquor and there are some three, four, five, well, then you know [Accept ance: Controlled Behavior] dri Perceived risk of d rinking High school respondents were less descriptive than elementary and middle school respondents regarding the perceived risk of drinking. They suggested that it may affect some p eople, but not all. They emphasized physical, mental, and emotional risks associated with drinking. The most extreme of these were physical risks drinkers could incur by consuming alcohol resulting in a range of

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104 situations including: liver damage, yellow s kin, beer belly, physical assault, and even death. [Physical Assault] R: It was this lady talking to my mom and she like she went to a club, she went to The Venue or something, and she said, she was so drunk or something, and she said some man put her in the car and he was feeling on R: I remember we were, well I was in 9 th grade, we had a friend where she had come back from those college parti th grade with all of us and she pondent made a disapproving face]. I: Do you think she was kind of bragging or she was embarrassed? mind say that know what happened to you or who did, if anything, to you. [Death] R: I knew someone that died from drinking. [Liver Damage] As for mental or emotional risks associated with drin king, they noted that people may emotional states could also affect the academic life of the drinker. There was debate on whether these students who were regularly drinking were coming to school consistently. It was later suggested that overachievers were regular drinkers as well. [Academic Risks of Drinking] R: It could affect their grades because instead of doing their homework and

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105 R: They come to school to eat (laughs). R: They come to school drunk though. R: Other risks that respondents addressed as being associated with drinking were a build up of tolerance to alcohol and the cost to maintain a drinking habit. Reasons for d rinking High school respondents listed a vari ety of reasons why people drink, particularly those underage. There reasons ranged from less serious ones Some participants even cited positive reasons for socially drink ing, such as having fun Participants also made more serious observations regarding the reasons behind why people drink. On the more negative side, the four maj or reasons respondents cited are individual stress, peer pressure, self doubt, and addiction. Respondents noted individuals going through a lot of stress, from too much pressure on themselves, a need to escape their current reality and feel different, or f eeling that they have no future. Drinking was suggested to be a way these individuals cope with their stress related feelings. [Stress] R: [t o feel different] to get drunk. away.

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106 Ot her respondents commented on the self doubt individuals sometimes feel that may lead them to drink. They are suggested to do this because they may be shy, unable to fit in with others (i.e., dance), and also because they will then later have an excuse for anything they did while they had been drinking. [Self Doubt] others heads nods). They f eel like they are a diffe rent person. without being drunk or high or something. Many participants offer ed a comment regarding peer pressure. Some suggested that this was a major reason why people drink. [Peer Pressure as Main Influence for Drinking] R: Sometimes they see their friends doing it and so they want to do it too. like 5 years ago. R: [they drink] because they want to be cool. Many were quick to point out that although peer pressure may exist on some level, it does not exist in the way it is commonly portrayed. It was suggested that there are also other factors at play simultaneously influencing people to drink. [Peer Pressure as one Reason for Drinking]

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107 asp Also, there were some who even challenged peer pressure as something that exists at all. One respondent noted that it was an individual choice of people and they drink because they want to, without regard to outside p ressures. [Peer Pressure ] R: People do it because they want to do it. know ? Respondents also commented on how underage people could be addicted. They mentioned some early signs of this addiction may include drinking on a regular basis and not caring about getting into trouble. [Addiction] I: (probe) Are people your age addicte d? R: Yes (multiple voices). R: They want to do it entirely too much, like on a regular basis. Finally rebellion was another reason why people drink, particularly those underage. It was noted that young people may be drawn to illegal activities. Additionally, children may rebel against overly strict parents by drinking. [Rebellion]

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108 In addition to being asked reasons behind drinking, respondents were asked to give a description of the typical drinker. The majority of respondents seemed to agree that they knew a lot of people who drink and there is no one description of the typical drinker. The following are just a few examples of this type of comment. One student did note that drin [Typical Drinker] R: I know a lot of people that do it all the tim situation. After the discussion continued for some time, a few respondents made observations of those who may drink more often. M [Rich Kids] R: Rich kids are drinking. they people drinking than it is the so R: Yeah, a lot of rich white kids drink. two weeks and then they

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109 party we went to. A few high school respondents noted how other populations of students may be drinking more than others. It was noted that International Baccalaureate (I.B.) students are regularly d typically have fun like other students. Additionally, there was debate whether drinking was more prevalent in rural or urban schools. Those from rural areas noted some reasons why they ma y be more associated with drinking. [I.B. Students] someone would be smart, but the majority of people in the I.B. program get drunk so often that you would think that they are so educa ted in all this stuff, they know so much information about every effect of alcohol and yet [Rural vs. Urban] space There was a strong Students Against Drunk Driving (SADD) chapter at one of the high schools where focus groups were conducted. At this particular school, students em phasized that SADD members would be a group who is especially not likely to drink. will not drink. Respondents mentioned that there are approximately 20 officers and 300 other students on campus affiliated with the organization. It was also noted that Availability of a lcohol High school r espondents mentioned a variety of sources from which they could get alcohol. The most common sources included older friends

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110 and family. In the rural focus group, participants were particularly excited when talking to laugh and speak out abr uptly when this topic arose to provide me with details on this activity. [Older Friends] R: Friends over 21. R: At a party. R: A lot of us go to mud bogs. big mud thing that we drive trucks in and we go in circles and play around in mud. Respondents elaborated on why it may be acceptable to drink at home. Their comments ranged from parents having complete acceptance of their child drinking to parents allowi ng them to drink at home in an attempt to control where and when they drink. [Parents Complete Acceptance] [Parents [Parents Controlling the Situation] doing it somewhere they might get drunk. drinking and try to get back home and get in a wreck.

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111 Other respondents noted that they will avoid dealing with their children drinking because the [Parents Denial] stop you. Finally, one respondent noted how easy is was to steal alcohol from the home without their parents ever k nowing. [Home Stealing] R: Stealing from older people, stealing from parents, anything. Less common sources to get alcohol from inc luded strangers. One respondent alcohol for you if you ask them. This comment was challenged by another who [Strangers] to get it. s true. R: Well, it depends on who in the store works there. Co mmunity as risk and protective f actor Although high school respondents commented on drinking being a national problem, they also cited signs they have seen locally to suggest it is prevalent had a lot to do with the culture of drinking expanding outward to the local underage population. One student pointed out a mixed message s/he was receiving at school. allowed to wear anything with alcohol logos,

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112 them advertising to college students. Respondents highlighted the images they have of UF students out partying downtown or tailgating. Some noted seeing these images on the news, while others noted they had first hand experience in seeing UF students drinking/drunk downtown. Some confessed to sneaking into clubs themselves and attending college parties. One respondent noted h ow s/he regretted this decision later. [College Student Images] they just celebrating with everybody else and get drunk, and they drink they iple laughs) walking backwards (multiple laughs). [Clubs/Parties] R: A lot of students sneak into clubs. I: (probe) Are kids your age going to college parties? R: Yes. R: UF and Santa Fe [Community College]. R: All types of parties college party. Respondents emphasized the lack of e nforcement contributing to the underage drinking problem. [Lack of Law Enforcement] enforcing it but they have no idea.

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113 Respondents also emphasized other locations that drinking was occurring. The rural and urban focus groups highlighted different drinking spots. The rural focus group University area. Interestingly, when probed, both groups of students started to elaborate on their conceptions of drinking in rural versus urban areas. Rural students seemed to emphasize it being more common in more urban areas, while urban students talked about how easy it was to do in more rural areas. [Urban High School Focus Group] R: You know you can easily turn som ething as simple as cranberry juice into an alcoholic drink. R: If you let it sit in the sun long enough it becomes alcohol. R: Like in Fort Wide, Lake City, they have stills and stuff, you know how some people bootleg and stuff. [Rural High School Focus Group] going on in Gainesville. opposed to the larger cities; like if there was a problem we could see a newspape r ad or whatever. We probably hear it, I think once in a while like a teen gets drunk at the bar or in Gainesville. emphasis on marijuana. Many respondents commented on the prevalence of this substance in both the rural and urban focus groups. Particularly in the focus group, respondents mentioned that it was a bigger problem than underage drinking. [Prevalence of Marijuana]

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114 R: Reefer. R: Mari ju ana (la ughs). R: Mary jane. I: (probe) Have there been a lot of incidents? R: Everyday. R: People smoke it during lunch. R: Before school, at lunch, after school. R: I know this girl she smokes every day before she comes to school. R: I had two girls smoking ou tside my art class the other day when I was smoking during school. R: They smoke in the bathrooms; they have the dogs that come and sniff R: They honestly be in the wrong classrooms too. Potential prevention strategies. High school f ocus group participants were somewhat pessimistic when asked to brainstorm successful prevention programs. Some even went so far as to say that something ne eded to happen to them personally before underage drinkers would stop. [Need Personal Experience] need to stop. stuff

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115 R: It has to be a personal experience. everything [i.e., PowerPoint presentations, candy, programs linking elementary and even recommen ded just varying the programs up from year to year to break the monotony might work better. challenged, respondents offered up some interesting suggestions for prevention program improvements. They noted how a good role model might influence someone not to drink. Respondents explained how a recent death at their high school impacted students. [Influential Role Model] R: I think it affected some people last year when Dante died. R: He helped a lot of people. He went through school talking about it. Yeah, he threw a party, he had threw a party and he had a yeah, he stopped the party or whatever and he gave us a talk about 20 minutes, yeah about do that no more. re behind the wheel, Also, participants debated the usefulness of elaborate scare tactics. They noted how mock car crashes, and visual images might influence underage drinkers to stop. They

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116 fu anyway. [Scare Tactics] R: I think they should have people come to the school and show you like dead bodies and stuff. R: I think people around here need prime examples. R take your driver test and they showed you like all these side effects of drunk driving and stuff and it like scared me so much. I think that would just scare people. And I think th R: Like if somebody sees it, and you get like a first person perspective from it it would be di voice). R: But some people never learn. same ones that are drinking. look like if you like start drinking at a younger age, like high school level, if you keep drinking throughout your life what it could do to your looks and R: Yeah, you could make a website of th is. Respondents explained how discussion groups, much like the focus groups, could also benefit underage drinkers. They emphasized that these need to be lead by former drinkers to be realistic, and the presence of non drinkers is critical to openness and t rust within the focus group. [Discussion Groups] group thing in every grade.

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117 R: I would feel that they were judging me [if including non drinkers in discussion]. t hrough about, y Other suggestions from respondents included decreasing the alcohol content in alcohol, giving economic details of the cost of drinking, and mocking the act of drinking through commercials like those used to educate abo ut the dangers of smoking. [Decrease Alcohol Content] R: You could do like different things like how maybe cigarettes or whatever, how they have like less nicotine and stuff like that but also like the drink instead of putting a certain percent of alcoh ol, just lower the percentage of alcohol. [Provide Economic Details of Drinking] R: If someone smokes like 3 packs a week or something they wind up spending over a thousand dollars. Seek help. Finally, high school respondents were asked who they would seek help from if they or their friend were dealing with a drinking problem. The majority of respondents said family or close friends. Only one respondent commented that the ut some even suggested seeking help from their parents. [Seek Help From Family] R: Sometimes you have people telling you things you already know, like somebody else that you know cares about you in that kind of way then it might make you change your mind. Many noted the reservations in going to seek help from other adul ts who most likely will make things more difficult for them. It was noted that parents will judge you and treat you differently instead of trying to help you through a drinking problem.

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118 [Reservations with Parents] to bring it up. Respondents felt that church members might not be accepting of someone having a drinking problem eith er. [Reservations with Church Members] Some respondents commented on the potential for doctors, guidance counselors, and police to report your drinking problem to your parents, if you had sought them out for help. Additionally, some thought police might specifically target them for future citations if they knew they had a drinking problem. [Reservations with Doctors/Nurses] not going to tell your mom anything. I promise and then like on the ride said. I was like, great! [Reservations with Guidance Counselors] R: Guidance counselor. il legal. Like if you said, and you were just sitting there and you said you had might not want to say. [Reservations with Police] R: They actually like go to your house and like talk.

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119

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120 Table 4 1 Public School Youth Survey Data (counts). Elementary Middle High Che ster Shell Lawton Chiles Oak View Ft. Clarke 1 Ft. Clarke 2 East side Santa Fe TTL GENDER Male 3 5 6 4 4 5 27 Female 5 3 4 7 3 7 5 34 RACE White 4 3 5 3 4 2 7 28 Black 3 2 3 3 2 8 21 Hispanic 1 2 1 1 1 6 Other 1 2 1 2 6 REDUCE D LUNCH Yes 7 3 5 3 2 5 2 27 No 1 5 5 4 5 6 8 34 AGE 1 2 1 4 10 3 5 3 11 11 4 1 1 2 8 12 4 2 1 7 13 1 5 6 14 4 4 15 5 5 10 16 3 1 4 17 2 2 4 1 2 3 AVG. GRADES Elementary School Satisfactory 7 7 Unsatisfactory Both Satis factory & Unsatis factory 1 1 Middle School A's 1 1 1 A's & B's 3 2 3 B's B's & C' s 6 2 3 C's C's & D's 2 D's D's & F's F's High School 3.5 4.0 3 1 3.0 3.49 4 1 2.5 2.99 2 6 2.0 2.49 2 2 <2.0 EVER DRANK Yes 2 5 2 2 7 8 26 Never 6 8 5 5 5 4 2 35 Past mth 1 1 2 3 7

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121 Table 4 1. Continued Elementary Middle High Chester Shell Lawton Chiles Oak View Ft. Clarke 1 Ft. Clarke 2 East side Santa Fe TTL AGE OF 1ST DRINK 2 1 1 1 5 9 1 1 10 1 1 1 2 5 11 1 1 1 3 12 1 1 13 1 2 3 14 1 1 15 1 1 16 2 2 4 17 1 1 0 No A nswer 1 1 TROUBLE Total 1 1 3 5 at home 1 1 3 5 at school by police

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122 Table 4 2 Characteristics of Public School Focus Group Participants (counts). DEMOGRAPHICS DRINKERS (26 total) NON DRINKERS (35 total) Gender Male 10 17 Female 16 18 Race White 15 13 Black 8 13 Hispa nic 2 4 Other 1 5 Rural vs. Urban Rural 15 13 Urban 11 22 HOUSEHOLD CHARACTERISTICS Alcohol Home Always 4 2 Sometimes 13 4 Rarely 5 6 Never 4 20 NA 3 Adults Only Yes 18 31 No 8 3 NA 1 Locked Locked 3 13 Unlocked 18 11 NA 5 11 FAMILY STRUCTURE Nuclear 12 21 Non nuclear 14 14

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123 Table 4 3 Alternative School Youth Survey Data (counts). Middle School High School Horizon Middle Horizon High Total GENDER Male 4 7 11 Female 4 3 7 RACE White 1 2 3 Black 5 6 1 1 Hispanic 0 0 0 Other 2 2 4 REDUCED LUNCH Yes 7 8 15 No 1 2 3 AGE 10 11 12 13 2 2 14 6 6 15 4 4 16 2 2 17 3 3 1 1 AVG. GRADES Middle School A's A's & B's 2 2 B's B's & C's 2 2 C's C's & D's 4 4 D's D's & F's F's High School 3.5 4.0 3.0 3.49 2 2 2.5 2.99 4 4 2.0 2.49 3 3 <2.0 1 1

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124 Table 4 3. Continued Middle School High School Horizon Middle Horizon High Total EVER DRANK Yes 4 7 11 Never 4 3 7 Past mth? 2 6 8 AGE OF 1 ST DRINK 2 1 3 9 10 1 1 11 12 1 1 2 13 1 1 14 1 1 15 2 2 16 17 1 1 No answer TROUBLE Total 2 4 6 at home 1 2 3 at school 1 1 2 by police 1 1

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125 Table 4 4. Characteristics of Alternative School Focus Group Participants (counts). DEMOGRAPHICS DRINKERS (11) NON DRINKERS (7) Gender Male 7 4 Female 4 3 Race White 2 1 Black 6 5 Hispanic 0 0 Other 3 1 HOUSEHOLD CHARACTERISTICS Alcohol Home Always 3 0 Sometimes 3 2 Rarely 2 1 Never 3 4 NA 0 0 Adults Only Yes 8 4 No 2 3 NA 1 0 Locked Locked 3 3 Unlocked 3 1 NA 5 3 FAMILY STRUCTURE Nuclear 5 2 Non nuclear 6 5

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126 CHAPTER 5 CONCLUSION Summary Major f indings between youth focus g roups Overall, self reported underage d rinkers came from each age category, school level, lunch status, race and gender. In general, my alternative school sample was slightly more experienced in all categories of drinking than their public school counterparts (i.e., higher lifetime usage; highe r past 30 day us age; & more experience being in trouble wi th police and school). Although of note focus group discussions and individual conceptions of drinking did not seem to vary dramatically between these two gr oups. Across age categories, youth who re ported that their families tended to serve alcohol at family celebrations were more likely to report drinking. Also, the majority of my sample perceived alcohol to be for adults only, but youth reporting drinking were less likely to say it was for adults w hen compared to non drinkers in my sample. Alth ough a large portion of youth felt this question was not applicable (since alcohol was n ot kept in their home), youth who reported drinking tended to come from homes where alcohol was not locked up. Additional ly, students reporting drinking came from homes with non nuclear families whereas non drinkers t ended to come from homes with standard nuclear families In element ary focus groups, urban youth tended to speak more of recent news about alcohol related in cidents (i.e., car crashes). Rural focus group participants tended to talk more about their families and alcohol problems, clearly experiencing stresses from t his at home. Elementary youth were noted to make longer comments that were substantially unique i n topic from each other. They tended to be more descriptive than

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127 participants from older age groups, oftentimes commenting on the rationale behi nd why people are drinking. They cited reasons such as peer pressure, addiction and family and individual stress leading youth to drink. Elementary youth were extremely supportive of each other throughout the focus group discussion and seemed to bond over being against drinking at any age. Ele mentary youth were less forgiving of those drinking, most often commenting on alcohol abuse of adults they know well. This aversion to drinkers was noted by the researcher, and it was apparent that they were not describing themselves as those drinking. Middle school participants were more approving of drinking than elementar y participants, but less approving than there high school counterparts. They suggested knowledgeable of brand names than elementary participants, but less knowledgeable when com pared to high schoolers. They also highlighted peer pressure and stress as major reasons behind youth drinking. At this age level, drinking was likened to the relief mode ls drink as a reason why youth drink. High school participants used shorter, less descriptive comments. They were more concise in their comments and less willing to challenge their peers by stating a completely different stance than another. This may su ggest peer influence is more at play during this age group. It appeared that high school focus group participants were less willing to elaborate on their opinions, perhaps because of their uneasiness in sharing with their peers or perhaps they are still tr ying to understand their feelings related to these topics. More joking occurred in high school focus groups when talking

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128 about drinking. This may be evidence of uneasiness with the topic or just the opposite, comfort with the topic because of its prevalenc e in their age group. More research is needed to tease this concept out. In high school focus groups, drinking was not as serious a topic as it was in younger age groups. Also, high schoolers were quicker to point out certain social types drinking more tha n others (i.e., urban focus group said rich, white kids were drinkers; rural focus group said rural populations tend to drink more). Although there was little consensus when it came to narrowing down one population that drinks, with students broadening the conversation again to the varied demographics of underage drinkers. High school youth noted medical (stress) social (peer pressure; self doubt) and addiction related reasons for youth drinking. They explained tha t alcohol is used as a stress relieve r to There were noted similarities across grade levels. All focus group participants were extremely supportive of their peers in both verbal agreement and obser ved facial responses. Another major finding that was echoed across grade levels was an extreme distrust of adults, particularly involving disclosure of underage drinking. This distrust of adults did not vary across adult roles. For example, when probed if they trusted nurses more than teachers or police more than their pastor, youth consistently reported that they were not comfortable disclosing drinking behavior to any adult unless they wanted to be helped. Most focus group participants tended to conceptu alize adult drinking and underage drinking as very similar, even citing similar reasons for drinking between populations. Focus group participants of each school level commented on the inadequacies of current prevention programs. For example, many highligh ted the

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129 strength of group discussion formats like the focus group that could be helpful in fostering dialogue about these social issues. It was clear that focus group participants did not approve of current prevention efforts and each grade level suggested they would be willing and, more importantly, more capable of designing efforts themselves or at the very least, in consultation with prevention designers. Focus group participants across grade levels were fully capable of communicating their thoughts on drinking and were observed to appear happy that someone offered them the opportunity to speak about a topic oftentimes thought of as taboo. One thing that came up in many of the focus groups that was unanticipated was the possibility of youth recently re locating to Alachua County. Some focus group participants had varying conceptions of neighborhood or community, since they had moved from another town. This actually allowed them to make comparisons between their old town and their new town. Also, across g rade levels there was a high level of youth advisory council. Youth were appreciative of the opportunity to discuss topics like underage drinking. Some said Theories within Sociology may lend themselves well to prevention programs. Local youth may benefit from understanding how people are individually choosing to drink and therefore have individual agency, but they are also being socialized to drink or not drink in ways they may not recognize depending on t heir protective (i.e., family and school

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130 to. In sum, there appeared to be some age graded similarities and differences in the public school youth focus groups Ele mentary youth provided more descriptive and unique comments when compared to middle and high school youth. Conformity in expression tended to converge more at the middle and then high school levels respectively. While all focus group participants were outw ardly supportive of each other, high school youth tended to give cues that they did not completely agree with one another (i.e., head shaking, eye rolls) Although when probed high school youth usually did not provide a counterpoint, this level of disagree ment was not found to a large extent in elementary and middle school focus groups. Elementary youth presented themselves as less experienced than both their middle and high school counterparts, while high school youth tended to appear more knowledgeable th an middle school youth when referencing alcohol name brands, use patterns, and access to alcohol. Levels of a pp roval in underage drinking tended to increase with each level of education, with high school youth tending to be the most approving of alcohol us age in underage populations. High school youth joked more regarding the topic than their elementary and middle school peers. Overall, there were more similarities than differences between the age graded focus groups. Youth from each of the age levels seeme d to highlight similar reasons for underage drinking, which were also found in the literature. They tended to emphasize experimental, social (peer pressure) medical (stress) and addiction related reasons for drinking during this life stage. Youth also of fered similar

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131 suggestions on potential prevention efforts (i.e., interactive, youth designed, family based efforts) that might be more successful. Alternative school focus group discussions were not extremely different than their public school count erparts. Much like their peers, they knew examples of students who drank and students who did not drink. They were not overly supportive of underage or adult drinking, and some even suggested banning it all together although this was quickly met with dis seem any more likely than their public school peers to confess their usage (as if to brag about their behavior) nor were they less open regarding their behavior. Additionally, they were just as hopeful as their public school peers in decreasing underage drinking, highlighting their willingness to help to improve prevention efforts if given the chance. Like their public school peers, they were not trusting of adults like nurses, doctors, or pa rents. Unique from their public school peers, they noted how adults in the past have taken their comments related to drinking very seriously and have acted on them (i.e., placed them in counseling). Some notable differences in alternative focus group dis cussions was an emphasis on personal experience in being counseled. While these participants had years of experience getting counseling for substance use issues, they spoke of the negative experiences in substance abuse counseling and prevention efforts th ey had to go through in very much the same way as their public school peers. For example, both populations noted issues related to counseling and prevention efforts, even though public school peers may not have even had this personal experience to comment from.

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132 peers, than we could assume this was due to their experiences with counseling, but since their comments were very similar this assumption cannot be made. Additi onally, their suggestions for improvement centered around peer counseling and an aversion to current educational programs, similar to public school participants. Behaviorally speaking, alternative school participants tended to have more side conversations, laughed more about the topic, and were observed to make more outbursts in reaction to The same gender (female) middle school focus group did not differ from the other middle school focus groups, with the exception of study partici pants in same gender focus groups citing only females in their examples. Interestingly, all situations the focus group participants described involved females. Since this research did not intend to be gender specific, this focus group is limiting in scope for the purposes of this study. Although, this would be interesting to explore in more detail for future studies with both boy and girl same gender focus groups. Participants in this focus group talked about similar topics and offered similar prevention su ggestions than their mixed gender middle school counterparts. Additionally, participants in the same gender focus group were equally supportive of each other as compared to the other mixed gender focus groups. Major findings between PIPSA co alition fo cus groups and youth focus g roups There were some notable similarities and differences found between PIPSA coalition member focus groups and local public school focus groups. These will be discu ssed in the following section A major similarity between coal ition member discussions and student discussions was an agreement that underage drinking is an issue in Alachua County. Also, both populations seemed to agree that a potential source of alcohol is the home. Coalition members suggested this to be the case and

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133 youth confirmed this was commonly occurring. In this vein, family based prevention efforts were noted to be valuable by coalition members and local youth. Different than coalition members, local youth emphasized drinking problems of family members as a n additional reason to incorporate them into the prevention/intervention of drinking in the home. Coalition members neglected this connection while discussing family based efforts. Youth also suggested that prevention efforts need to start earlier than is currently being done and they would be willing to participate in lengthy prevention activities if varied up year to year. PIPSA coalition members echoed this and suggested that more longitudinal prevention efforts would be beneficial (ex., an entire cohort in a 12 year program rather than a 5 year program which is currently done). Additionally, it was noted by coalition members that prevention programs need to be more interactive for local youth, as opposed to more educational lecture type activities. They further explained that educational activities alone are not effective, since there was a general sense that underage drinkers were already knowledgeable of substances and their effects. This was a major point of agreement within youth focus groups, with on e members cited more interactive approaches like mock car crashes and beer goggle activities as being more effective, local youth commented that although they liked these ac Just as there were similarities between coalition member focus groups and local youth focus groups, there were some notable theoretical and practical differences between the two populatio ns. On a theoretical note, PIPSA coalition members tended to be in agreement that drinking was a learned behavior drawing heavily on social

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134 learning theory throughout focus group discussions, while many local public school students talked about people dr many youth did not recognize social learning theory or the principles behind it. This could work to the advantage of PIPSA if they were to highlight the varied social influences youth manage as they ar e progressing through this developmental stage. Since it is generally understood that both conforming AND deviant substance use are explained sociologically as products of the general social structure and culture and the more immediate groups and social si tuations with which individuals are confronted (Akers 1992). This perception could work to empower youth. If students are thinking of their behavior as so individualistic, they may fail to recognize the reasons behind their behavior, and thus, feel less in control of their own social circumstances. Perhaps more individualistic thinking is characteristic of this developmental stage, and prevention efforts could use this knowledge to strategize how to work within or even against this mindset. On a more pr actical level, coalition members talked differently than local youth in a few important respects. These are important to highlight if PIPSA designed prevention efforts are to recognize local youth perspective. Coalition members were quick to separate adult s and children when discussing them. They emphasized reasons for why youth drink as opposed to why people drink, citing peer pressure as a major reason, neglecting youth agency. This was done in an attempt to better target them. Unlike coalition members, y outh tended to collapse them in during their discussions and emphasized that they drank for many o f the same reasons as adults including individual and family stress.

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135 Another difference between these populations was in how underage drinkers should be dealt with. Coalition members tended to emphasize consequences and strict enforcement more than local youth (i.e., curfew, year round schooling). Local youth did not think extreme measures like this would be effective in getting youth to abstain from drin king. Additionally, coalition members were observed to appear less emotional when talking about drinking when compared to local youth and spoke in a calmer fashion as compared to youth. Youth appeared more animated and passionate about their comments (i.e. some youth raised their voices at times to make their points). Coalition members talked about focusing on substance use to decrease future incarceration rates and to decrease health costs, while local youth sometimes told emotional stories about family m embers and their substance abuse issues. PIPSA could perhaps better incorporate youth emotion into their prevention efforts, having them speak of personal experiences. Finally, coalition members explained how youth were extremely talkative about drinking a In focus groups, local youth were observed to be very different than how coalition members described them. Youth talked about drinking in very negative ways at times. Also, when disclo sing personal drinking patterns, youth were not observed to be particularly boastful, but were observed to speak very matter of factly. Additionally, there is local research to back up this finding. Data from the 2008 FYSAS suggest that relatively few stud drank alcohol regularly (12.4%). Discussion This qualitative study examined local youth perceptions of underage drinking It compared the discourse of PIPSA coalition members (the pro gram designers) and local

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136 youth (potential program recipients). Additionally, it took a closer look at the conceptions of local youth regarding the issue of underage drinking a sensitive topic combined with a somewhat rare population to qualitatively stu dy. Although there were similarities between PIPSA coalition members, there were some notable differences found as well. These are important to address if PIPSA designed prevention efforts are to recognize local youth perspective in their program design. C oalition members and local youth were in agreement about the prevalence of underage drinking, but offered different prevention strategies. It would be beneficial to the PIPSA coalition and prevention efforts, in general, to address these specific considera tions offered by local youth. Youth were observed to be particularly excited to share their conceptions on underage drinking. Including them regularly in PIPSA discussions in the form of a youth advisory council would also be beneficial to the coalition. A dditionally, PIPSA should brainstorm ways for adult professionals (i.e., doctors, police, guidance counselors) could be more approachable to foster a more community wide approach, since these are typically found to be more effective at reinforcing efforts. Finally, prevention efforts that include perception that drinking plays a complex role in managing emerging adulthood, identity work and stress management in adolescenc e During adolescence substance use may function, at least in part, to accomplish age normative developmental tasks identity exploration and peer bonding. If this is the dominant coping strategy for an adolescent stress, additional coping strategies ne ed to be presented and fostered to them in order for them to successfully negotiate future development al transitions and for alcohol dependence to be limited to adolescence.

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137 Study Strengths & Weaknesses A major strength of this study is the theoretical p erspective it employs. This study assumes that society, reality, and the self are constructed through interaction (relying on language and communication). This study aimed to uncover the ways in which youth and coalition members actively participate in the creation of their perceived social reality. Their interactions (or lack thereof) were thought to be inherently dynamic and interpretive and the focus was on how participants created, enacted, and changed meanings and actions throughout focus groups (Charm az 2006). This study emphasizes that people, in this case local youth, can and do think about their actions rather than respond mechanically to stimuli. Furthermore, there was evidence that their conceptions were less static as originally presumed by coali tion members and their behavior was suggested to vary depending on the context (i.e., being in a family with a substance abuser may lead to more negative perceptions of drinking) they were suggested to be in. This research not only recognizes the unique pe rspectives underage drinkers use in structuring their behavior, but it stresses the complexity of the world of underage drinkers and the many social influe nces they manage daily. Another strength to this study was the opportunity to study youth in focus gr oups in an attempt to examine the social psychological processes within a social setting in which peer influence might be important. Focus groups allowed youth to explain the negotiations that are at play when they are considering drinking. Furthermore, it gave them the opportunity to reflect on the variability in human behavior and hear how others think groups done with an alternative school population. Finally, this study used data triangulation as a validity

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138 procedure to examine convergence among multiple and very different sources (i.e., coalition members, local youth public schooled and alternativel y schooled) of information to form themes. A limitation of this study was the small sample of students that were included. It was necessary to limit the scope of this study in order to examine local youth conceptions. Another limitation is that thi s study only takes a snapshot view, whereas more longitudinal research that follows students over time to see how their conceptions change from year to year might be better suited in examining the social processes that take place as youth come in contact w ith various social phenomena (i.e., people, prevention programs) throughout their adolescence. Additionally, since this study built on previous work conducted in 2005, questions asked of coalition members were drafted much earlier than student questions. T hese questions may have been better aligned if this research was conducted simultaneously. Another limitation of this study is how local youth were selected. There may have been some selection bias, in which guidance counselors selected students who would be most cooperative within the focus group. This could have been a limiting effect in terms of the type of student that I was able to include in this study. It is recognized that other students not included in my sample may have dramatically different pers pectives on underage drinking. Additionally, other research may find that public school students differ dramatically from those no longer in the school system or those in more alternative settings. Therefore, this study is not generalizable to all local yo uth or even all public school youth. Finally, self report data from adolescents is oftentimes viewed as questionable concerning self reported risky behaviors. Adolescents may purposively under report or over report some health

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139 risk behaviors because they b elieve engaging in these behaviors is socially undesirable or desirable (Brener, Billy, and Grady 2003). This can be seen as a potential study limitation. Although, by the tone of the focus groups youth seemed to be credible and authentic in their comments Prevention Implications for Coalitions This qualitative study provides some important prevention implications for coalitions involved in prevention efforts generally and PIPSA specifically. These relate to the social distance between adults and youth, the impact of adolescent stress and the value of youth perspective. The social distance between adults and you th was expressed to be significant Prevention programs, in and of themselves, may have unintended consequences of creating distance between adu lts and yout h. In this case, youth might be willing to use Prevention progra ms may be improved if they utilize college students or younger mentors to facilitate program ming to youth. Furthermore college students or you nger mentors who have had experience may even be seen as more credible by youth. Any strategies to combat the distance of adults and youth would be beneficial to prevention efforts. Secondly youth tend t o view substance use as a stress reliever. If alternatives to drinking were available from prevention programs youth may be less likely to engage in drinking Prevention efforts might benefit from proactively showcasing alternatives of stress relief to you th. Thirdly, youth are knowledgeable of the major tenets behind social learning theory. Although social learning terms were not technically used, it was evident in many of the youth comments that they understood how social contexts can influence

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140 a person t o drink or not drink. Many youth spoke of their family backgrounds leading them to make choices. Some spoke of having the option to drink (i.e., availability in the home), while others commented on what encouraged them not to drink (i.e., witnessing an alc oholic family member). Prevention efforts could utilize this conceptual model to more clearly illustrate to youth all the factors that go into an individual choosing to drink. Finally, a major study implication of this research is the value of youth perspe ctive (or client perspective) in prevention programs. It was evident in these focus groups that Insight from youth (clients) can lead to program improvements that might better r each the intended target population. Future Research In terms of study implications, this case study emphasizes the importance in taking a step backward prior to evaluating a program. Many evaluations generally focus on the process and impact of t he program as defined by its program planners. This neglects the valuable insight and perhaps differing conceptions of the recipient community. More research done in this vein can highlight more micro interactions that go unnoticed during typical evaluatio ns. Theoretically, Sociologists could study and critique best practices of incorporating social learning theory into prevention efforts to highlight what methods youth are more willing to respond to. Methodologically speaking, it may be important to expl ore some same gender focus groups since there is evidence that girls provide examples of girls when asked in isolation from boys. In much the same way, race specific focus groups might hone in on more nuances of how students are conceptualizing underage dr inking and how it may relate to race. Additionally, future research may benefit from mixing

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141 grade levels to see if there are any differences in how students talk about underage drinking when they are around their older and younger peers. Future work should encourage students to draft prevention programs and to brainstorm best practices in curtailing underage drinking and examine how these efforts may be more or less effective than adult designed prevention efforts.

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142 APPENDIX A STUDENT SURVEYS Pre Survey Elementary Version 1. Fictitious name _______________ 2. [SCHOOL] What school do you attend? 3. [AGE] Which category below best represents your age? 4. [GENDER] Which category best represents your gender? 5. [RACE] Choose the category tha t best describes you? 6. [AVERAGE GRADE] What grades do you usually get? 7. [PARENTAL INVOLVEMENT] Who do you live with most of the time? Directions: Please check the box next to your answers to the following questions Directions: Choose a fictitious name that you will identify yourself by in the upcoming focus gr oup. Please do not pick a name that is associated in any way with your own name Record this fictitious name in the space below.

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143 Other _______________ 8. [PERSONAL EXPERIENCE] Have you ever drank a lcohol? 8a. At what age did you have your first drink? 8b.Please approximate how often you normally drink alcoholic beverages. 3 times a week 8c. How many times have you drank alcohol during the past 30 days? 8d. Have you ever been disciplined at home for using alcohol? 12 months 8e. Have you ever been disciplined at school for using alcohol? 8f. Have you ever been disciplined by police for usin g alcohol? Directions: If you answered YES to the previ ous question, please answer 8a 8f. If you answered NO, please skip to question 9

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144 9. [YOUTH ADVISORY COMMITTEE] Would you be interested in participating in a youth advisory committee for a local drug prevention program, Partners in Prevention of Substance Abuse (PIPSA)? Pre Survey Middle School Version 1. Fictitious name _______________ 2. [School] What school do you attend? 3. [Age] Which category below best represents your age? 4. [GENDER] Which category best represents your gender? 5. [RACE] Choose the category that best describes you? l/Multiracial 6. [AVERAGE GRADE] What grades do you usually get? Directions: Please check the box next to your answers to the following questions Directions: Choose a fictitious name that you will identify yourself by in the upcoming focus group. Please do not pick a name that is associated in any way with your own nam e Record this fictitious name in the space below.

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145 7. [PARENTAL INVOLVEMENT] Who do you live with most of the time? her and father Other _______________ 8. [PERSONAL EXPERIENCE] Have you ever drank alcohol? 8a. At what age did you have your first drink? 8a. At what age di d you have your first drink? 8b.Please approximate how often you normally drink alcoholic beverages. 3 times a week 8c.How m any times have you drank alcohol during the past 30 days? 8d. Have you ever been disciplined at home for using alcohol? nths 8e. Have you ever been disciplined at school for using alcohol? Directions: If you answered YES to the previous question, please answer 8a 8f. If you answered NO, please skip to question 9

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146 8f. Have you ever been disciplined by police for using alc ohol? 9. [YOUTH ADVISORY COMMITTEE] Would you be interested in participating in a youth advisory committee for a local drug prevention program, Partners in Prevention of Substance Abuse (PIPSA)? Pre Survey High School Version 1. [FICTITIOUS NAME] _______________ 2. [SCHOOL] What school do you attend? 3. [AGE] What category best represents your age? ounger 4. [GENDER] Which category best represents your gender? 5. [RACE] Choose the category that best describes you? al Directions: Please check t he box next to your answers to the following questions Directions: Choose a fictitious name that you will identify yourself by in the upcoming focus group. Please do not pick a name that is associated in any way with your own name Record this fictitious name in the space below.

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147 6. [GRADE POINT AVERAGE] What is your grade point average? 4.0 3.49 2.99 2.49 7. [PARENTAL INVOLVEMENT] Who do you live with most of the time? Other _______________ 8. [PERSONAL EXPERIENCE] Have you ever drank alcohol? 8a. At what age did you have your first drink? 8a. At what a ge did you have your first drink? 8b.Please approximate how often you normally drink alcoholic beverages. 3 time s a week 8c.How many times have you drank alcohol during the past 30 days? 8d. Have you ever been disciplined at home for using alcohol? No, never Directions: If you answered YES to the previous question, please answer 8a 8f. If you answered NO, please skip to question 9

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148 8e. Have you ever been disciplined at school for using alcohol? 8f. Have you ever been disciplined by police for using alcohol? 9. [YOUTH ADVISORY COMMITTEE] Would you be interested in participating in a youth advisory committee for a local drug preventio n program, Partners in Prevention of Substance Abuse (PIPSA)?

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149 APPENDIX B STUDENT FOCUS GROUP GUIDE Introduction Sociology at the Un iversity of Florida. I would like to speak with you about your general thoughts and concerns regarding the community coalition Partners in Prevention of Substance Abuse (PIPSA). You have the right to not answer any question and to end the interview at any time.] I. CONCEPTIONS OF UNDERAGE DRINKING 1. What is underage drinking? When is underage drinking a problem? o Is any underage drinking ok? o Can you think of a friend who drinks and it is a problem for them? bad appearance, etc)? o Can you think of a friend who drinks alcohol but it is not a problem for them? How does this not affect them (good grades, plays sports, looks good)? 2. Is there an underage drinking problem in Alachua County? If so, what are possi ble solutions for reducing underage drinking in Alachua County? 3. Why do youth drink? Is it because of stress, to act older, fear, anxiety, to look cool, peer/friend pressure? II. PERCEIVED RISK 4. Do you think youth risk harming themselves if they us e alcohol? If so, what type of harm is this (physical, emotional, academic, relational)? III. DISAPPROVAL 5. Do you disapprove of your peers drinking alcohol? Why or why not? IV. AVAILABILITY 6. How difficult do you think it would be for you to get alcoh ol, if you wanted some? Where could you easily get alcohol? 7. Where is alcohol kept in your home?

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150 Is it in a locked refrigerator/cabinet or closet? Is it in an unlocked refrigerator/cabinet or close? Is it in an open bar or serving table? V. PEER INFLUENCE 8. Do you feel your peers influence you or your friends to use alcohol? 9. Do your friends wear clothes or possess toys that have logos, emblems or advertisements for alcohol products or companies that sell alcoholic beverag es? If so, what brands? 10. Out of your peers, what type of youth is more likely to drink? Who is less likely to drink? VI. FAMILY INFLUENCE 11. Overall, how is the use of alcohol treated at your house? Do they sometimes serve alcohol at family celebrat ions? Is alcohol only for adults over age 21? Is alcohol for everyone to enjoy? VII. COMMUNITY INFLUENCE Is the community accepting of it? o Why do you feel that way? 13. Who in the communi ty should be involved in educating youth about alcohol use (schools, family, law enforcement police or judges, health care professionals like nurses or doctors, faith based organizations like chur ches)? 14. If you had an alcohol problem, where would you most likely go for help (school, family, faith based organization, public health department, substance use treatment center, take care of it yourself, police)? 15. What sort of programs would work best with youth populations (educational, peer counseling, college mentoring)?

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151 REFERENCES Aguirre Molina, Marilyn, Carlos W. Molina, and Ruth Enid Zambrana. 2001. Health Issues in the Latin o Community. San Francisco, CA: Jossey Bass Inc. The Journal of Criminal Law and Criminology 81 (3): 653 676. Akers, Ronald L. 1992. Drugs Alcohol, and Society: Social Structure, Process, and Policy Belmont, CA: Wadsworth Publishing. Rutter ed. Stress, Coping, and Development in Children. New York: McGraw Hill. Health Psychology 14: 526 536. researcher divide in industrial, work and organizational (IWO) psychology: Where are we Journal of Occupational and Organizational Psychology 74: 391 411. p Developmental Review 12 (4): 339 373. Arnett, Jeffrey Jensen. 2007. Adolescence and Emerging Adulthood: A Cultural Approach. 3 rd ed. Upper Saddle River, New Jersey: Pearson Education. Arnold, Eugene L. 1990. Childhood Stress New York: Wiley Bellah, R. N., R. Madsen, W. M. Sullivan, A. Swindler, and S. M. Tipton. 1985. Habits of the Heart: Individualism and Commitment in American Life. Berkeley, CA: University of California Press. Benson, Michael L. 2002. Crime and the Life Course Los A ngeles, CA: Roxbury Publishing Company. Berger, Peter L., and Thomas Luckmann. 1966. The Social Construction of Reality: A Treatise in the Sociology of Knowledge. Garden City, New York: Anchor Books. Blum, R. W., T. Beurhing, M.L. Shew, L.H. Bearing, R. E. Sieving, and M.D. Resnick. American Journal of Public Health 90 (12).

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161 BIOGRAPHICAL SKETCH Kelly Ann Dever is a 6 th year graduate student in the department of Sociology and Criminology & Law at the Univer sity of Florida Her work focuses on program development and evaluation research that address public health and community based approaches to the prevention of health problems, particularly substance abuse issues. Prior to graduate school, she worked at a social science research company, Westat, as an interviewer. Her research there included studies contracted by the Centers for Disease Control, the National Institutes of Health, the Centers for Medicare and Medicaid Services, the Roswell Park Cancer Instit ute, the United States Environmental Protection Agency, the United States Department of Education, and the Treasury Department. She received her Bachelor of Arts degree at Stetson University in 2002 from the department of Sociology and Anthropology. During her studies there, she interviews for various research projects. While working on her dissertation, Kelly worked as a research analyst for the Center for Research and Evaluati on (CRE) at the Charlotte Mecklenburg public school district. She completed two large scale program evaluations of local education programs. These included a qualitative and quantitative analysis of the Bill and Melinda Gates Small Schools Initiative as im plemented by Charlotte Mecklenburg Schools (CMS), as well as a qualitative evaluation of Teach for Ameri ca program within CMS. Kelly had also gained valuable teaching experience throughout her graduate career and hopes to pursue teaching in the University setting.