Talk to the hand, cause the face ain’t listening

If the evidence for youth focused mass media anti-drug adverts isn’t great what about focusing on parents?

I can’t say that I know whether there’s any more evidence for this approach, but it is certainly a tactic that those with budgets in this area have and are trying.

Today I came across the ‘Talk, they Hear You’ campaign that the Substance Abuse and Mental Health Services Administration in the US have put together to try to persuade parents that their influence on the risks their children take with alcohol can start earlier and go on longer than they might imagine.

As you can see the message is quite positive, and will be reinforced with online tools for practising the ‘awkward’ conversations and tricky issues that might be thrown up by an issue like alcohol.

It reminded me of the Why Let Drink Decide approach that briefly ran at the end of the last government where the message was a little darker, with pre-teens reminding us just how soon their innocence could be lost.

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Brighton and Hove considering parent contracts to reduce youth drinking

Photo by Flickr User jk5854The BBC are reporting that Brighton and Hove Council are considering whether to ask parents to sign contracts pledging not to give their children alcohol.

I’ve had a look at the paper that will be discussed by councillors this evening and what’s clear is that this proposal is only a part of a much wider discussion that is taking place which will include: promoting alcohol free events to young people, looking at reducing the availability of alcohol during high-profile events, a cumulative impact zone, work to reduce illegal alcohol sales, supporting the introduction of Minimum Unit Pricing, and a range of other strategies and tactics.

But I do want to focus on what they’re proposing to do with parents. Continue reading

#LDNprev conference

“Inspiring, interesting and informative”, the three words most used to describe Mentor’s youth advisors #LDNprev conference to discuss helping young Londoners to be safer when it comes to drugs and alcohol.

LYIP feedback

The conference included sessions on school drug and alcohol education, the skills that parents need to discuss these issues with their children, and on community safety.  These were based on research that our youth advisors had carried out with over 1,000 young people, experts, and policy makers and have been written up into three short papers published on our website.

Continue reading

Ethics of asking

The Daily Express have a story about a survey carried out with school children in Perth and Kinross.  The report focuses on the concerns expressed by one parent who is quoted as saying:

“Asking children for information about potential illegal activities when you, in fact, have a duty to report them to the relevant authority, leaves us stunned. ”

The council in their reply point out that parents were given the chance to ask for their children not to be included and that the children did not have to answer any questions they felt uncomfortable about.

(If our recent experience of working with local authorities is anything to by then this research may have needed approval by an ethics committee.)

I’m not sure how widely this view of the responsibilities of the council will be held by other parents; who after all would appreciate it if having given permission for the questions to be asked then found the police visiting their home to caution their children?

But the reaction does suggest to me that those of us interested in asking these sorts of questions need to take care when planning, communicating and carrying out our projects.

The drug prevention standards published by the EMCDDA have some useful guidance on the ethics of drug prevention.  The

principles of ethical drug prevention in the

standards are:

  • adhering to legal requirements;

  • respecting participants’ rights and autonomy (e.g. as defined in international frameworks on

    human rights and the rights of children );

  • providing real benefits for participants (i.e. ensuring that the programme is relevant and useful for

    participants)

  • causing no harm or substantial disadvantages for participants (e.g. iatrogenic effects, illness or

    injury, exclusion, stigma);

  • providing transparent, truthful and comprehensive information

    ;

  • obtaining participants’ consent before participation;

  • ensuring that participation is voluntary;

  • treating participant data confidentially;

  • tailoring the intervention to participants’ needs

    ;

  • involving participants as partners in the development, implementation, and evaluation of the

    programme; and

  • protecting participants’ and staff members’ health and safety.

Family Meal Time

We know that family functioning is critical to the health and wellbeing of young people and one of the proxies that people try to measure that by is the number of times we eat together as a family.

I’ve seen this reiterated in a report from Child Trends which looks at a range of issues for families and creates a global map which tries to allow us to see how things are going against other nations and regions.

They say:

In the United States, eating together as a family has been associated with myriad positive outcomes, ranging from reduced levels of substance and alcohol use to lower levels of depression, even after accounting for other family factors. Eating meals together is also associated with favorable educational outcomes, such as showing a commitment to learning, seeking and earning higher grades, spending more time on homework, and reading for pleasure. After including controls for background characteristics, one study found that eating meals as a family was the most important predictor of adolescent flourishing.

The report does note that the impact of eating together seems to diminish as young people enter early adulthood, and that it seems to have bigger effects in families that are already functioning well, and less well on families that are marked by conflict in the relationships.

And while these things need to be considered with some care what is notable from what the report finds is that just 65 percent of 15-year-olds in the United Kingdom frequently shared meals with their families, compared to over 80% in the majority of Western European countries that are reported.

Child Trends - meals

Demos – Feeling the effects

Demos have been thinking about the impact that parenting can have on young people’s drinking and have published a report, Feeling the Effects, which argues for what they call ‘tough love’.

The report makes the argument that:

good parenting in general may be the best and most effective approach to minimise hazardous drinking levels in society in the long term.

Demos suggest:

Many parents think their drinking has little or no impact on their families, convincing themselves that if they feed and clean their children and make sure they attend school, they have fulfilled their most important parenting duties.

This follows a similar line of argument put forward by the 4 Children report that parents’ drinking is doing more harm than they may acknowledge.

The research that Demos have carried out includes a quantitative analysis of the British Cohort Study which follows a large group of people who were born in 1970, and qualitative work with 50 families that are or have sought support from specialist services as a result of parental drinking.

The report has tried to categorise parents into four different types of parenting style:

  • disengaged: low discipline and low affection
  • laissez-faire: low discipline and high affection
  • authoritarian: high discipline and low affection
  • ‘tough love’: high discipline and high love

If you swap ‘tough love’ for authoritative parenting, then the characterisation will be familiar to many academic studies of  parenting and unsurprisingly it is that style of parenting which is the ideal.

Demos describe their main findings as:

  • Parents who drink ‘always’ are significantly less likely to be ‘tough love’ parents
  • Mothers who drink ‘always’ are more likely to have children who drink at hazardous levels in adulthood

This and the qualitative research leads them to make a number of policy recommendations.  Included in these are some that we will want to be aware of, in particular what they say about information campaigns.

the majority of adverts and information awareness campaigns focus on units consumed and the harms to the drinkers themselves rather than providing advice to those responsible for children. With the exception of the charity Drinkaware, very few appear to offer direct advice to parents, not only about their children’s alcohol consumption, but also about the impact of their own drinking and parenting style.

They argue that the alcohol industry should be providing some of this advice and that the Public Health Responsibility Deal may be the way forward on this.  They also call for the advertising agencies that have worked on behaviour change campaigns – including Drinkaware – should be working with the government’s Behaviour Change Unit.

Drinkaware PostersThis causes me some concern.

A recent piece of research that I came across, and which will be published in a peer reviewed journal shortly, showed that one of Drinkaware’s recent campaign’s is likely to increase drinking rather than reduce it (right).  This is unfortunately not the first time that a ‘boomerang’ effect has been seen from public health campaigning.

What the poster makes clear is that there are ways of testing the effects of media campaigns at relatively low cost, but I’ve yet to come across an advertising agency that does the sort of testing that Tony Moss and his colleagues carried out.

Talking about early intervention they say that their research suggests:

if parents showed affection and warmth to their children in early years those children were less likely to grow up to drink at ‘hazardous’ levels as teenagers and adults.

They also call for better family interventions for those families where alcohol is an issue.  Neither of these recommendations are controversial, but perhaps because of the focus of the report what seems missing to me is a wider preventative strategy that recognises that there are other settings in which a life-course approach could be effective.

So no mention of the support that children can get from schools or youth clubs, no mention of the role of the wider family – kinship care isn’t mentioned and the only mention of grandparents is in the context of their alcohol problems.  This despite them finding:

The drinking behaviour of the teen’s girlfriend or boyfriend has the strongest impact on the teen’s likelihood of being a binge drinker.

There is more to be got from the report but it’s limitations are, I hope, clear.

The other thing to note is that the research was paid for by SAB Miller, and while Demos are clear this did not influence the report in any way it leaves Demos open to attack, particularly as they seem to be ambivalent about environmental interventions such as Minimum Unit Pricing.

Parents, children and alcohol

Interesting survey results about the link between parental drinking and that of their children from Drinkaware. Including:

Children whose parents drink above recommended daily guidelines are more likely to:

  • Report having ever been drunk, compared to those children with parents who drink within the guidelines or not at all 19% to 11%
  • Drink at least monthly compared to those with parents who drink within the guidelines or not at all 21% to 12%.

via Drinkaware

LYIP Focus Group Findings on Parents and Prevention

Merton 3The Youth Advisors have been working hard over the last few weeks on focus group research. They devised a  set of questions to try and capture information from other young Londoners about the role of parents in prevention. The next step was to meet with their peers across the capital and discover their views. To date, over 70 young people have taken part.

We have had fantastic responses which have allowed the LYIP develop some recommendations. What’s been especially fascinating is the level of consistency in responses. An overview of what we’ve discovered so far will give you a sense of how well the group has been doing.

There was an overwhelming belief amongst young Londoners we spoke to that parents do have a role in educating their children about drugs and alcohol.

Their children have the right to know that their parents are […] looking out for it. […] The fact that they do say something about it sort of shows that they do take responsibility.

Young people believe that parents’ responsibility for drug education should be seen as one aspect of a well-rounded approach which includes school and the wider community, “from schools to government to extra-curricular activities to parents”.

There are, however, a number of ‘buts’.  Many young people report not talking to their parents about drugs and alcohol and they offered a number of suggestions as to why this is the case.

Lack of knowledge:

My parents don’t know about drugs and alcohol.

They don’t want to say anything just in case they say something wrong and mess it up.

Cultural barriers:

[Parents from some cultures], shy away from it or don’t mention it at all, ‘cause you’re taught it’s wrong. Full stop.

You just know – culture-wise […] I’ve never had that conversation, but it’s just one of those things you don’t.

An unwillingness to acknowledge drugs and alcohol may ever be an issue for their children:

Maybe they know, but they just don’t wanna believe it, ‘No, my child’s not taking drugs’ sort of thing. They just don’t want to talk about it because they do think it’s an awkward situation.

The uncomfortable nature of holding a conversation about drugs and alcohol:

Not a lot of parents feel comfortable to actually talk about it

It depends on what kind of parents people have. Some people are comfortable talking to their parents and some people are not

Parental knowledge around drugs and alcohol was discussed in depth. There was not an expectation amongst young people we spoke to that parents should have a comprehensive knowledge of drugs and alcohol. However, the majority of young people did believe that they should have at least a basic knowledge and were clear that simply saying ‘no’ was not enough. Young people want to know why.

Being youth, you’re more intrigued to know about everything.

If they’re actually educated enough that they know all the risks and all the perks as well, then they’ll be able to weigh it up themselves.

They can say, ‘Oh yeah, it’s not good,’ but then kids will probably go on and think, ‘Oh, that’s all they know, they haven’t really told me enough information so obviously they don’t know enough and nor do I’.

Some young people spoke of a contradiction between a non-negotiable ‘no’ message coupled with scare tactics from parents and the experiences they saw for themselves at parties or with friends. Without a more rounded discussion, this may make children more likely overlook a parent’s message given the wide gulf between what they hear from them and what they have actually seen.

Young people were also concerned that without enough knowledge, parents may give them wrong information:

I […] do not believe that parents always have the right advice because they might not always be, like, fluent in the sort of stuff.

It could go the wrong way […] if parents don’t know how to handle it.

Basic knowledge, together with clear messages about decision-making, were considered important by many of the young people we spoke to.

Young people were also clear that talking about drugs and alcohol to your children should start early. The majority of participants suggested that conversations should begin before children become teenagers, either at the end of primary school or the beginning of secondary school. Young people clarified that conversations often only occur too late or “after the event” and believed parents have a role in pre-empting this.

I think sometimes, the younger age, people tend not to think about it […] but by the time they do decide that they’re going to talk about it, there’s been a lot of outside influences.

Overwhelmingly, focus group participants said that conversations should be open, relaxed and recurrent. ‘Sit down’ talks were considered awkward.

It should just be an open dialogue. It shouldn’t be a sit down conversation that’s going to be really awkward. It should just be […] brought up casually and not really made a big deal ‘cause otherwise it will just […] feel really weird afterwards.

There was a sense that this would be much easier for some parents than for others. Those who had open relationships with their children anyway should carry that openness into conversations around drugs and alcohol. Young people also spoke at using stimuli in order to begin conversations, in particular responding to news stories, documentaries or other television programmes.

Parents who adopted an authoritative as opposed to authoritarian parenting style were thought by many young people to be in a good position to help prevent young people from using drugs and alcohol. Young people were not opposed to boundaries being put in place by their parents, but they did want them to be reasonable and to be open to discussion.

I understand why they give you a curfew and at this point I don’t really mind.

We live in London – they’re looking out for me [by setting a curfew].

If you don’t set boundaries then you have no boundaries.

Parents need to be understanding of their children. They can’t just expect them to be perfect all the time […] work with them.

There was a strong theme of overly-strict parenting leading to rebellion.

They’re more sneaky if their parents are more strict.

They’re more likely to rebound due to those boundaries because they feel […] suppressed.

They [children] might find it bullying sometimes maybe and intimidating, that they’re saying, like, they don’t trust their children that much and they [the children] just, like, want to revenge or something.

Recommendations

The group met on Saturday 1st December to look through their research findings and have developed a set of draft recommendations.

  • Parents must play a part in educating their children about drugs and alcohol.
  • Parents should have opportunities to improve their knowledge about drugs and alcohol. This could be in a school setting and should offer the opportunity for parents to work together on determining their roles and responsibilities.
  • Parents should ensure that conversations about drugs are recurrent, relaxed and open.
  • Conversations about drugs and alcohol should begin before children become teenagers.
  • Children are less likely to rebel and more likely to talk to their parents if they adopt an authoritative as opposed to authoritarian style of parenting.

Parental Influence on Substance Use in Adolescent Social Networks

 

We’ve written before about the impact that parents can make on the risks that their children face and their health decisions.

This new research from the US suggests that parents, and mothers in particular, can play an important part beyond the protection they give their own children.

The researchers suggest that authoritative mothers can not only affect their children, but also have a protective effect on the friends of their children.

They report:

If an adolescent had a friend whose mother was authoritative, that adolescent was 40% (95% CI, 12%-58%) less likely to drink to the point of drunkenness, 38% (95% CI, 5%-59%) less likely to binge drink, 39% (95% CI, 12%-58%) less likely to smoke cigarettes, and 43% (95% CI, 1%-67%) less likely to use marijuana than an adolescent whose friend’s mother was neglectful, controlling for the parenting style of the adolescent’s own mother, school-level fixed effects, and demographics. These results were only partially mediated by peer substance use.

via Archives of Pediatrics & Adolescent Medicine.

The characteristics that are associated with authoritative parenting are that they:

  • Listen to their children
  • Encourage independence
  • Place limits, consequences and expectations on their children’s behaviour and administer fair and consistent discipline
  • Are nurturing and express warmth to, and about, their children
  • Encourage their children to express their opinions
  • Encourage their children to discuss options in their lives

What strikes me about this research is that it fits with other studies that show that the close relationships between adolescents – whether that is through parents, friends or romantic partners – all play a strong part in determining the norms of their friendship groups when it comes to drug and alcohol use.