Can positive faith-based encounters influence Australian young people’s drinking behaviours?

Abstract

Purpose:

Alcohol-related accidents and injuries occur disproportionately within young people – especially when gathering at social events. This study represents a partnership between a faith-based group of volunteers specifically trained to counsel and support young people to reduce their risk of alcohol-related harm, Adelaide City Council, and the South Australian Police Force aimed at reducing risk-related alcohol consumption in a metropolitan nightclub district area. It posits that supporting young people to party safely, alongside positive community engagement, may deter unsafe consumption practices – such as pre-loading and binge-drinking.

Methods:

Retrospective online survey evaluated the impact on attitudes of young people who received the intervention.

Results:

Findings suggest volunteers were perceived as positive role models who demonstrated a genuine sense of care and ability to support. As a result, one-third of respondents identified potentially more carefully pre-plan their drinking behaviour on their next night out.

Conclusion:

This study demonstrates that young people are responsive to positive interventions and that future pre-planning may become a more natural part of their party routine – resulting in less likelihood of alcohol-related risk. The outcome measure, that young people’s intentions to moderate their drinking as a result of positive encounters, is an important one.

Keywords

Alcohol consumption Australia faith-based interventions risk young people

Introduction

Consuming alcohol at dangerous levels and exposing individuals and others at risk of physical and emotional harm have been identified as a major public health concern and, in particular, among young people in Australasian countries (Connor et al., 2013; Hutton et al., 2013). In Australia alone, nearly one in eight deaths of people aged below 25 years is related to alcohol use and one in five hospitalisations in this age group is attributed to alcohol-related harm (Australian Institute of Health and Welfare [AIHW], 2011). Alcohol-related accidents or violence occurs disproportionately more among this population – especially in contexts where groups gather in social nightlife settings and especially at weekends (Bolier et al., 2011; McKetin et al., 2014; World Health Organization [WHO], 2014).

This article reports on a project developed with Encounter Youth in partnership with the Adelaide City Council and the South Australian Police Force in a Metropolitan Adelaide City nightclub district area. The study and intervention rationale was that, through supporting young people to party safely via positive community engagement (such as positive role-modelling), this might reduce health and physical risks associated with excessive alcohol consumption (Hallett et al., 2012). Awareness-raising may deter unsafe practices such as binge-drinking and violent behaviour while out partying at social events. The project is important because alcohol consumption often occurs within the context of the young person’s physical, social and cultural environment – that is, as part of the group’s norms. Reducing alcohol-related harm among young people through developing strategies to socialise ‘safely’, with or without alcohol, is a positive step towards harm prevention in Australian and wider international society. In this study, an additional safety intervention is underpinned by the notion that using faith-based groups may be a significant positive community engagement strategy. Hackworth (2010), for instance, stresses their importance (from a neo-liberalist perspective) as providing a form of care for ‘at-risk’ and vulnerable target populations. He posits that they emphasise personal responsibility (and failure) as well as de-emphasise the structural causes of risk. Similarly, Williams et al. (2012), also from a neoliberal stance, suggest that faith-based organisations (as Third Sector organisations) can play an important public health role due to ‘the gaps left by shrinking public services and the contracting out of service delivery’ (p. 1497).

Young people, aged 18–25 years, are often encultured within an ‘emerging adulthood’, in which ‘experiencing the period of time from the late teens to through to the mid-20s as a time of exploration and instability is now the norm’ (Arnett, 2004: 2). It is commonly accepted that young people are often predisposed to participating in pleasurable peer-related behaviour and activities as part of a ‘normalising’ health journey (Whitehead, 2005). Scriven and Stevenson (1998) eloquently illustrate this:

… adolescents often experiment with behaviours and lifestyles in the process of acquiring a sense of autonomy, independence and the social skills which are a necessary pre-requisite into the adult world. (p. 91)

The pre-requisite health behaviours that dominate the literature, as part of this adolescent journey, include unsafe sex, excessive drinking of alcohol and the taking of illicit drugs – behaviours sometimes influenced by recent technological communication developments, such as the significant influence of social media (Brown, 2013; Fournier et al., 2013; Gommans et al., 2015; Miller et al., 2014).

Normalisation of young people’s alcohol use has become accepted in recent years and is often understood using a risk avoidance/safety lens, thus placing the responsibility upon the individual (Arnett, 2004). There are many factors which influence the behaviours of young people. These include peer pressure, sensation seeking, social norms and the media (Gilchrist et al., 2012; Weaver et al., 2013; Westgate et al., 2014). Previous engagement with alcohol is also strongly associated with usage when attending a social event as an extension of adolescents’ usual practices (Litt and Stock, 2011; Moreno et al., 2009). Alcohol plays a significant role in Australian culture and society – as it does widely on an international scale. Policies that focus only on strategies for developing and providing health information materials for young individuals are often ineffective (Hutton et al., 2011). Health professionals need to consider broader approaches to include a range of activities – including positive community interventions. Therefore, instead of relying just on individual levels of responsibility for safe drinking, it is important to focus on the relationship between alcohol misuse and the realities of seeking enjoyment with peers (Suffoletto et al., 2014; Wright et al., 2014). This study hypothesised that positive faith-based support interventions can influence young people to re-evaluate their alcohol-related behaviour for their current or ‘next night out’.

Methods

To understand the impact of the positive support interventions on young people who met the Encounter Youth ‘Green Team’ Volunteers (EYGTV) involved in this project, a retrospective online survey was developed. The survey included demographic questions and Likert scale questions related to the attitudes of those who received the positive intervention. Demographic measures included age, gender and number of times the person had met the Green Team. In addition, whether the Green Team members were approachable, had a genuine sense of care, were supportive and trustworthy were ranked and rated. Finally, how young people’s intention to plan for their next night out had been affected was sought.

The survey was conducted between December 2013 and March 2014. Each Saturday night, 20 young persons, aged between 18 and 25 years, were approached by the EYGTV on a busy city street in the nightclub district of Adelaide between the hours of 9:00 p.m. and 3:00 a.m. All EYGTV members had undergone training in how to identify and approach intoxicated individuals. Four EYGTV were rostered on each Saturday night. Over 4 months, a total of 240 young people were approached by the volunteers to discuss drinking in moderation. Those who provided verbal consent were given wristbands that had the online web link to the survey etched into them. A total of n = 113 (47%) retrospectively completed the survey. All young people were over 18 years which is the legal drinking age in all states in Australia, with ID, and were assessed as being sober. If potential participants appeared intoxicated, they were not included. Those who met the study inclusion criteria were also instructed that it was important that the survey was completed post-intervention at a time when the participants were not intoxicated. Formal ethical approval was gained for this project from the Flinders University Social and Behavioural Research Ethics Committee.

There were 113 participants in the study. Power was established at .8 for an alpha level of .01 and the sample size calculated at n = 96. Each of the questionnaire items was rated on a 5-point Likert scale: ‘1 strongly disagree’, ‘2 disagree’, ‘3 neither agree or disagree’, ‘4 agree’ and ‘5 strongly agree’. Initially, against 11 items, exploratory factor analyses (EFAs) were used to identify components of the ‘night out’ experience and their encounter with the EYGTV team. Data suitability was assessed using the Kaiser–Meyer–Olkin (KMO) measure of sampling adequacy and Bartlett’s Test of Sphericity to test the null hypotheses. Principal component analysis (PCA), Kaiser’s criterion (eigenvalues > 1.0), scree test and parallel analysis were used to determine the number of factors retained. Only item-factor loadings >.3 were retained.

Due to the ordinal nature of the item data, polychoric correlation estimations of the items occurred against the initial EFA. These correlations measured the continuous normal distribution underlying the ordinal data. It was also used to estimate the ordinal alpha coefficient (ordinal equivalent of Cronbach’s alpha) to determine internal consistency where values greater than .60 were acceptable. As EFA and Cronbach’s alpha use Pearson correlation by default, there was a risk that it would inaccurately assume our ordinal items to be continuous. Analyses were undertaken using STATA version 13.0 (StataCorp). Polychoric correlation and ordinal alpha were estimated using R (Version 3.1.0). A multivariate linear regression model was used to predict the night out and about EYGTV aligned to the correlated-dependent variables of interest. Three explanatory variables (gender, age and number of times the young person had encountered an EYGTV team member) were used in the model. Factor scores from EFA were used to measure the outcome. Model goodness of fit was assessed via adjusted R².

Results

Of the 113 participants who responded to the survey, the majority were females (n = 74, 65.5%), while the remaining (n = 38; 33.6%) were males (see Table 1).

Table 1.

Participants’ characteristics (n = 113).

Characteristics	n	%
Gender
Male	38	33.7
Female	74	65.4
Missing	1	0.8
Age (years)
18	24	25.3
19	33	34.7
20	16	16.8
21	9	9.5
22	4	4.2
23	3	3.2
24	3	3.2
25	3	3.2
Median (25th–75th percentile)		19 (18–21)
No. of times visited by GT
1	41	36.3
2	25	22.1
3	18	15.9
4	9	8.0
5	8	7.1
6	3	2.7
7	2	1.8
10	7	6.2
Median (25th–75th percentile)		2 (1–4)

GT: Green Team.

Overall, the EYGTV team members were highly rated as being approachable, helpful and positive role models by those who completed the survey. In addition, they were identified as being supportive and trustworthy in terms of assisting young people in planning their drinking and to arrive home safely. Least so, the EYGTV team members were reported as a useful resource to refer to other support services. Figure 1 demonstrates the percentages of responses about the EYGTV overall (top panel), how the EYGTV were viewed (middle panel) and impact and views related to their next night out (bottom panel).

Figure 1.

Participants’ responses to intervention/encounter (n = 113).

Although respondents had a positive attitude towards the EYGTV, their next night out planning intention was less significant. For example, almost 30% of participants strongly disagreed/disagreed about planning to drink less on their next night out and to speak with friends about socialising without alcohol. However, overall, 35% of participants agreed/strongly agreed that the encounter had a positive effect on intention to plan differently and discuss with peers.

Data results related to EFA, with varimax rotation and internal consistency for Factors 1 (about the EYGTV) and Factor 2 (impact on next night out) and their respective items, are reported in Table 2. In turn, Table 3 reports multiple regression model results for the EYGTV encounter characteristics and the ‘next night out’. With regard to the multiple regression outcomes, age was a significant factor. Increasing age suggested the positive attitude decreased by 18%. This has had implications for further training for the programme and highlights the importance of implementing faith-based interventions as early on as possible with young adults in this age range.

Table 2.

Exploratory factor analysis (EFA) with varimax rotation and internal consistency for factors and their respective items.

Items	Factor loadings		Ordinal alpha (α)	Variance explained (%)
Items	Factor 1 (about Green Team)	Factor 2 (next night out)	Ordinal alpha (α)	Variance explained (%)
GT01	.92		.96	58.5
GT02	.93
GT03	.90
GT04	.94
GT05	.94
GT06	.93
GT07		.68	.80	27.8
GT08		.59
GT09		.53
GT10		.77
GT11		.90

GT01: The Green Team were positive role models; GT02: I felt a genuine sense of care from the from the Green Team; GT03: I found the Green Team approachable; GT04: I found the Green Team helpful; GT05: I found the Green team to be trustworthy; GT06: The Green Team were positive role models for safer drinking and socialising; GT07: I would plan my next night out differently; GT08: I can have a good night out without getting drunk; GT09: The information the Green Team gave me was useful; GT10: I have spoken to my friends about having fun without alcohol; GT11: I plan to drink less on my next night out.

Table 3.

Multiple regression model for Green Team and Next night out.

Characteristics	About Green Team			Next night out
Characteristics	β	95% CI	p-value	β	95% CI	p-value
Age	−.18	−0.36 to −0.002	.047	−.006	−0.15 to 0.13	.93
Gender
Male	–	–	–	–	–	–
Female	.39	−1.70 to 2.48	.71	.63	−1.01 to 2.28	.45
No. of times meet GT	−.27	−0.68 to 0.14	.19	−.001	−0.32 to 0.32	.99

CI: confidence interval; GT: Green Team.

Discussion

Health messages are not always effective in changing the behaviour of young people (Whitehead, 2005). They are a notoriously difficult group to target. To reduce alcohol-related harm and risk, primary health professionals are encouraged to think more broadly beyond individualistic, paternalistic and potentially punitive interventions in order to actively engage young people in choices that positively impact their health and safety. Health messages and interventions are more likely to be effective for young people in a specific context on a specific day (Suffoletto et al., 2014; Westgate et al., 2014). This study and intervention is a good example of this. One might counter that a single intervention, such as this one, will have a limited effect. However, the majority of young people who met a Green Team volunteer felt that they had experienced a positive and motivating encounter – despite it being a single intervention. In addition, young people stated that, due to this encounter with peers, they might likely reconsider how they planned their next night out when drinking and consider strategies for safer consumption. One third of the respondents stated they would plan their next night out differently.

We know that young people do not always believe that drinking is risky and often associate the use of alcohol with having fun – especially at the weekends and at social events (Hutton et al., 2012; McKetin et al., 2014; Weaver et al., 2013). What this study demonstrates is that targeted programmes, which are designed to support young people, have greater potential when young people feel that their needs are being met (including having fun) – particularly with peer groups. Blackie et al. (1998) identify that preventive public health interventions are more likely to be undertaken if young people already believe they are susceptible to a particular threat and that their health needs are understood by like-minded peers. Young people prefer to be safe and supported and especially by others of the same age (Litt and Stock, 2011). For example, where a raft of interventions are used to support young people at popular Adelaide Schoolies (school-leavers) festivals (also held in most Australian states), such as a ‘dry zone’, visible policing (on bikes, etc.), media Apps with bus routes and emergency numbers and free buses – these are known to have positive public health outcomes (Hutton et al., 2011; Kazemi et al., 2014). This is both alongside and in addition to the positive community support of faith-based groups such as the EYGTV. Positive, supportive interventions like this have an important part to play in influencing young people’s decision-making. Hackworth (2010) states that faith-based organisations play an important public health role in supporting young people as they often emphasise personal responsibility over a focus on just risk. Livingstone (2014) among others has noted a decline in alcohol consumption, especially in Australian adolescents, where such interventions are in place. Therefore, these types of services should not be overlooked – especially as their potential to fill the gap of shrinking public health services that are constantly rationalised (Williams et al., 2012).

Limitations

Limitations of this study relate mainly to generalisability. The sample population size is relatively small and the location, mainly for reasons of safety and convenience, could be potentially unique to this metropolitan setting.

Conclusion

The rationale for this project was that, by supporting young people to party safely through positive community engagement, these activities could potentially prevent them engaging in risky and unsafe practices, such as binge-drinking and violent behaviour while on a night out. Although not all young people experience alcohol-related problems, alcohol-related accidents and injuries occur disproportionately among this population. Through providing support and encouragement, this target population is more likely to rethink the way they interact with alcohol and change or modify their behaviour on a ‘big night out’. The outcome measure that young people’s intentions to moderate their drinking as a result of positive community encounters, particularly if the encounter is with groups that already have a positive image, is an important one.

Footnotes

Funding

The author(s) received no financial support for the research, authorship and/or publication of this article.

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