Disentangling the temporal relationship between alcohol‐related attitudes and heavy episodic drinking in adolescents within a randomized controlled trial

Andrew Percy; R. Noah Padgett; Michael T. McKay; Jon C. Cole; Gregor Burkhart; Chloe Brennan; Harry R. Sumnall

doi:10.1111/add.16721

Disentangling the temporal relationship between alcohol‐related attitudes and heavy episodic drinking in adolescents within a randomized controlled trial

Andrew Percy
, R. Noah Padgett
, Michael T. McKay
, Jon C. Cole
, Gregor Burkhart
, Chloe Brennan
, Harry R. Sumnall

Research output: Contribution to journal › Article › peer-review

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Abstract

Background and aims
Within many alcohol prevention interventions, changes in alcohol-related attitudes (ARA) are often proposed as precursors to changes in drinking behaviour. This study aimed to measure the longitudinal relationship between ARA and behaviour during the implementation of a large-scale prevention trial.
Design and setting
This study was a two-arm school-based clustered randomized controlled trial. A total of 105 schools in Northern Ireland and Scotland participated in the Steps Towards Alcohol Misuse Prevention Programme (STAMPP) Trial.
Participants
A sample of 12 738 pupils (50% female; mean age = 12.5 years at baseline) self-completed questionnaires on four occasions (T1–T4). The final data sweep (T4) was 33 months post baseline.
Measurements
Individual assessments of ARA and heavy episodic drinking (HED) were made at each time-point. Additional covariates included location, school type, school socio-economic status and intervention arm. Estimated models examined the within-individual autoregressive and cross-lagged effects between ARA and HED across the four time-points (Bayes estimator).
Findings
All autoregressive effects were statistically significant for both ARA and HED across all time-points. Past ARA predicted future ARA [e.g. ARAT1 → ARAT2 = 0.071, credibility interval (CI) = 0.043–0.099, P < 0.001, one-tailed]. Similarly, past HED predicated future HED (e.g. HEDT1 → HEDT2 = 0.303, CI = 0.222–0.382, P < 0.001, one-tailed). Autoregressive effects for HED were larger than those for ARA at all time-points. In the cross-lagged effects, past HED statistically significantly predicted more positive ARA in the future (e.g. HEDT2 → ARAT3 = 0.125, CI = 0.078–0.173, P < 0.001, one tailed) except for the initial T1–T2 path. In contrast, past ARA did not predict future HED across any time-points.
Conclusions
Changes in alcohol-related attitudes were not a precursor to changes in heavy episodic drinking within the Steps Towards Alcohol Misuse Prevention Programme (STAMPP) Trial in Scotland and Northern Ireland. Rather, alcohol-related attitudes were more likely to reflect prior drinking status than predict future status. Heavy episodic drinking status appears to have a greater impact on future alcohol attitudes than attitudes do on future heavy episodic drinking.

Original language	English
Pages (from-to)	645-654
Number of pages	10
Journal	Addiction
Volume	120
Issue number	4
Early online date	10 Dec 2024
DOIs	https://doi.org/10.1111/add.16721
Publication status	Published online - 10 Dec 2024

Bibliographical note

Data Availability Statement

The data that support the findings of this study are openly availablein the Queen’s University Belfast data repository, https://doi.org/10.17034/498b761c-0051-45c0-a92b-4398f8fa501c. Full details of theMplus code used in the analysis can be found at https://osf.io/bmhak/?view_only=67d2dc1013af46a880662a2c8067635a.

Funding

This data collection was funded by the National Institute of Health and Care Research (NIHR) Public Health Research (PHR) programme (project number 10/3002/09) https://www.nihr.ac.uk/ (H.S., J.C., A.P.). Analysis and preparation of the manuscript were supported by the authors\u2019 institutions. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. We wish to acknowledge the role played by participating schools, parents and school children, as well as the support provided by key staff in the relevant Education Authorities. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the NIHR\u2010PHR, NIHR, NHS or the Department of Health. The sponsor university (LJMU) for the original STAMPP trial received and administered a payment from the alcohol industry for printing of student workbooks in the Glasgow trial site only. A.P. reports that he has previously received funding from the European Foundation of Alcohol Research (ERAB) in relation to the development of statistical models for longitudinal data (2008\u201310). H.S. reports that his department has previously received funding from the alcohol industry (indirectly via the industry funded Drinkaware charity) for unrelated primary research.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Adolescents
alcohol
attitudes
Autoregressive
cross-lagged
drinking
random intercept
prevention
STAMPP
RCT
RI-CLPM
autoregressive
random intercept, prevention, STAMPP, RCT

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10.1111/add.16721Licence: CC BY

Final published versionFinal published version, 758 KBLicence: CC BY

Cite this

@article{e4a5aa4e0ab04545aeb7e59f51c8a7e1,

title = "Disentangling the temporal relationship between alcohol‐related attitudes and heavy episodic drinking in adolescents within a randomized controlled trial",

abstract = "Background and aims Within many alcohol prevention interventions, changes in alcohol-related attitudes (ARA) are often proposed as precursors to changes in drinking behaviour. This study aimed to measure the longitudinal relationship between ARA and behaviour during the implementation of a large-scale prevention trial. Design and setting This study was a two-arm school-based clustered randomized controlled trial. A total of 105 schools in Northern Ireland and Scotland participated in the Steps Towards Alcohol Misuse Prevention Programme (STAMPP) Trial. Participants A sample of 12 738 pupils (50\% female; mean age = 12.5 years at baseline) self-completed questionnaires on four occasions (T1–T4). The final data sweep (T4) was 33 months post baseline. Measurements Individual assessments of ARA and heavy episodic drinking (HED) were made at each time-point. Additional covariates included location, school type, school socio-economic status and intervention arm. Estimated models examined the within-individual autoregressive and cross-lagged effects between ARA and HED across the four time-points (Bayes estimator). Findings All autoregressive effects were statistically significant for both ARA and HED across all time-points. Past ARA predicted future ARA [e.g. ARAT1 → ARAT2 = 0.071, credibility interval (CI) = 0.043–0.099, P < 0.001, one-tailed]. Similarly, past HED predicated future HED (e.g. HEDT1 → HEDT2 = 0.303, CI = 0.222–0.382, P < 0.001, one-tailed). Autoregressive effects for HED were larger than those for ARA at all time-points. In the cross-lagged effects, past HED statistically significantly predicted more positive ARA in the future (e.g. HEDT2 → ARAT3 = 0.125, CI = 0.078–0.173, P < 0.001, one tailed) except for the initial T1–T2 path. In contrast, past ARA did not predict future HED across any time-points. Conclusions Changes in alcohol-related attitudes were not a precursor to changes in heavy episodic drinking within the Steps Towards Alcohol Misuse Prevention Programme (STAMPP) Trial in Scotland and Northern Ireland. Rather, alcohol-related attitudes were more likely to reflect prior drinking status than predict future status. Heavy episodic drinking status appears to have a greater impact on future alcohol attitudes than attitudes do on future heavy episodic drinking.",

keywords = "Adolescents, alcohol, attitudes, Autoregressive, cross-lagged, drinking, random intercept, prevention, STAMPP, RCT, RI-CLPM, autoregressive, random intercept, prevention, STAMPP, RCT",

author = "Andrew Percy and Padgett, \{R. Noah\} and McKay, \{Michael T.\} and Cole, \{Jon C.\} and Gregor Burkhart and Chloe Brennan and Sumnall, \{Harry R.\}",

note = "{\textcopyright} 2024 The Author(s). Addiction published by John Wiley \& Sons Ltd on behalf of Society for the Study of Addiction.",

year = "2024",

month = dec,

day = "10",

doi = "10.1111/add.16721",

language = "English",

volume = "120",

pages = "645--654",

journal = "Addiction",

issn = "0965-2140",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "4",

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TY - JOUR

T1 - Disentangling the temporal relationship between alcohol‐related attitudes and heavy episodic drinking in adolescents within a randomized controlled trial

AU - Percy, Andrew

AU - Padgett, R. Noah

AU - McKay, Michael T.

AU - Cole, Jon C.

AU - Burkhart, Gregor

AU - Brennan, Chloe

AU - Sumnall, Harry R.

PY - 2024/12/10

Y1 - 2024/12/10

N2 - Background and aims Within many alcohol prevention interventions, changes in alcohol-related attitudes (ARA) are often proposed as precursors to changes in drinking behaviour. This study aimed to measure the longitudinal relationship between ARA and behaviour during the implementation of a large-scale prevention trial. Design and setting This study was a two-arm school-based clustered randomized controlled trial. A total of 105 schools in Northern Ireland and Scotland participated in the Steps Towards Alcohol Misuse Prevention Programme (STAMPP) Trial. Participants A sample of 12 738 pupils (50% female; mean age = 12.5 years at baseline) self-completed questionnaires on four occasions (T1–T4). The final data sweep (T4) was 33 months post baseline. Measurements Individual assessments of ARA and heavy episodic drinking (HED) were made at each time-point. Additional covariates included location, school type, school socio-economic status and intervention arm. Estimated models examined the within-individual autoregressive and cross-lagged effects between ARA and HED across the four time-points (Bayes estimator). Findings All autoregressive effects were statistically significant for both ARA and HED across all time-points. Past ARA predicted future ARA [e.g. ARAT1 → ARAT2 = 0.071, credibility interval (CI) = 0.043–0.099, P < 0.001, one-tailed]. Similarly, past HED predicated future HED (e.g. HEDT1 → HEDT2 = 0.303, CI = 0.222–0.382, P < 0.001, one-tailed). Autoregressive effects for HED were larger than those for ARA at all time-points. In the cross-lagged effects, past HED statistically significantly predicted more positive ARA in the future (e.g. HEDT2 → ARAT3 = 0.125, CI = 0.078–0.173, P < 0.001, one tailed) except for the initial T1–T2 path. In contrast, past ARA did not predict future HED across any time-points. Conclusions Changes in alcohol-related attitudes were not a precursor to changes in heavy episodic drinking within the Steps Towards Alcohol Misuse Prevention Programme (STAMPP) Trial in Scotland and Northern Ireland. Rather, alcohol-related attitudes were more likely to reflect prior drinking status than predict future status. Heavy episodic drinking status appears to have a greater impact on future alcohol attitudes than attitudes do on future heavy episodic drinking.

AB - Background and aims Within many alcohol prevention interventions, changes in alcohol-related attitudes (ARA) are often proposed as precursors to changes in drinking behaviour. This study aimed to measure the longitudinal relationship between ARA and behaviour during the implementation of a large-scale prevention trial. Design and setting This study was a two-arm school-based clustered randomized controlled trial. A total of 105 schools in Northern Ireland and Scotland participated in the Steps Towards Alcohol Misuse Prevention Programme (STAMPP) Trial. Participants A sample of 12 738 pupils (50% female; mean age = 12.5 years at baseline) self-completed questionnaires on four occasions (T1–T4). The final data sweep (T4) was 33 months post baseline. Measurements Individual assessments of ARA and heavy episodic drinking (HED) were made at each time-point. Additional covariates included location, school type, school socio-economic status and intervention arm. Estimated models examined the within-individual autoregressive and cross-lagged effects between ARA and HED across the four time-points (Bayes estimator). Findings All autoregressive effects were statistically significant for both ARA and HED across all time-points. Past ARA predicted future ARA [e.g. ARAT1 → ARAT2 = 0.071, credibility interval (CI) = 0.043–0.099, P < 0.001, one-tailed]. Similarly, past HED predicated future HED (e.g. HEDT1 → HEDT2 = 0.303, CI = 0.222–0.382, P < 0.001, one-tailed). Autoregressive effects for HED were larger than those for ARA at all time-points. In the cross-lagged effects, past HED statistically significantly predicted more positive ARA in the future (e.g. HEDT2 → ARAT3 = 0.125, CI = 0.078–0.173, P < 0.001, one tailed) except for the initial T1–T2 path. In contrast, past ARA did not predict future HED across any time-points. Conclusions Changes in alcohol-related attitudes were not a precursor to changes in heavy episodic drinking within the Steps Towards Alcohol Misuse Prevention Programme (STAMPP) Trial in Scotland and Northern Ireland. Rather, alcohol-related attitudes were more likely to reflect prior drinking status than predict future status. Heavy episodic drinking status appears to have a greater impact on future alcohol attitudes than attitudes do on future heavy episodic drinking.

KW - Adolescents

KW - alcohol

KW - attitudes

KW - Autoregressive

KW - cross-lagged

KW - drinking

KW - random intercept

KW - prevention

KW - STAMPP

KW - RCT

KW - RI-CLPM

KW - autoregressive

KW - random intercept, prevention, STAMPP, RCT

UR - https://www.scopus.com/pages/publications/85211445592

U2 - 10.1111/add.16721

DO - 10.1111/add.16721

M3 - Article

C2 - 39657732

SN - 0965-2140

VL - 120

SP - 645

EP - 654

JO - Addiction

JF - Addiction

IS - 4

ER -

Disentangling the temporal relationship between alcohol‐related attitudes and heavy episodic drinking in adolescents within a randomized controlled trial

Abstract

Bibliographical note

Data Availability Statement

Funding

UN SDGs

Keywords

Access to Document

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