Study: Middle School Alcohol Prevention Program 'Not Enough' in Chicago

Keeping middle schoolers from alcohol is a tougher task in the inner city than in rural areas, even for experts armed with the best prevention programs, a new University of Florida study shows. A three-year, three-pronged prevention program did little to keep Chicago middle schoolers from drinking or using drugs, despite its prior success in rural Minnesota, where the program reduced alcohol use 20 to 30 percent, UF and University of Minnesota researchers recently reported in the online edition of the journal Addiction.

"The intervention found to be effective in rural areas was not effective here, which really surprised us," said Kelli A. Komro, a UF associate professor of epidemiology in the UF College of Medicine and the study's lead author. "This is an important finding to realize this program was not enough. The bottom line is this: Low-income children in urban areas need more, long-term intensive efforts."

Adolescents who drink by age 15--about half of teens--are more likely to struggle in school, abuse alcohol later in life, smoke cigarettes, and use other drugs than those who don't. Even worse, exposure to alcohol at a young age may damage the developing brain, according to a 2007 U.S. Surgeon General report. "Almost any problem kids might have, alcohol increases that risk," Komro said.

By targeting middle-school-age children, the UF and University of Minnesota team hoped to reduce these risks. The researchers studied 5,812 sixth-, seventh- and eighth-graders from mostly low-income communities in Chicago, randomly dividing the neighborhoods into two groups: those who would participate in the prevention program and those who would not. But at the end of the study, surveys showed no difference in alcohol use among the teens who took part in the project and those who did not.

One particular problem surfaced during the community component of the project. The organizers struggled to rally some community members around the cause, often having to explain why they should be concerned about adolescent alcohol use. That gave researchers some insight into why the program did not work there.

"People in these areas are concerned with housing, they're concerned with gangs and other drug use," Komro said. "There was a whole upfront effort where we had to educate people about how alcohol was related to those other issues, and that it was an important issue to think about with their young people.We know from other studies in low-income, urban neighborhoods, there is a higher concentration of alcohol outlets, compared to suburban or rural areas. There were a lot of alcohol ads around these schools and a greater density of pro-alcohol messages these children are exposed to. You mix that with the poverty level and it's just a high-risk environment."

Despite the overall results, there were positive findings that researchers hope to build on, Komro said. Of all the components, the family interventions had the most significant effects. And one aspect of the community project worked well: Half of the community teams went to stores that sold alcohol and asked merchants not to sell to underage kids. In those communities, the ability of young people to buy alcohol went down 64 percent.

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