Reducing Harms from Adolescents' Drinking: The Effects of an Alcohol Intervention Curriculum Designed for Chinese Youth

Young people in China's urban areas have increasing exposure to Western influences and are drinking alcohol beyond the traditional times. To understand this behavior we developed a series of scales: Chinese Alcohol Expectancy Questionnaire, Chinese Alcohol Self-Regulation Self-Efficacy Questionnaire, and Chinese Cultural Orientation Questionnaire.

Based on findings from these scales, a high school alcohol education program was designed to increase alcohol knowledge, reinforce positive alcohol expectancies, modify negative alcohol expectancies, improve self-efficacy to refuse a drink and reduce risky drinking behavior.

The program was taught by trained teachers to 306 students in 10th and 11th grades in three schools. Another 332 students in matched schools served as the control group. Three waves of questionnaire surveys, pretest, posttest and 6 month follow-up, were conducted in both intervention and control schools. A series of path analysis models were adopted to evaluate the effects on knowledge, expectancies, self efficacy, and drinking behavior. Effects on frequency of drinking, mediated by knowledge, expectancies and self-efficacy were assessed with parallel path analysis models.

The curriculum increased Chinese high school students' knowledge, alcohol self-regulation self-efficacy and reduced positive alcohol expectancies and frequency of drinking at immediate posttest. However, at 6 month follow-up, without booster sessions, few effects were identified. The effect on drinking behavior was mediated by positive alcohol expectancy and self-regulation self efficacy.

This paper highlights the value of developing curricula based on data and theory, the challenges of introducing alcohol education in new environments, and the importance of booster sessions in the intervention practices.