A motivational interviewing approach to universal
school-based prevention: eliciting adolescent
behaviour change regarding alcohol consumption
Joanna Bragg, Penny A Cook
Margaret Coffey and Linda Dubrow-Marshall
Alcohol Research UK
Post Graduate and Early Career Symposium
4 April 2017
Context
• Increasing trends in alcohol consumption and significant health
implications, a global concern
• 3.3 million deaths worldwide due to harmful alcohol consumption (WHO,
2014)
• Impacts on over 200 diseases and types of injuries (Sassi, 2015)
• UK adolescents amongst the highest consumers of alcohol worldwide
• Despite reported decline in consumption, pockets of ‘binge’ drinking
remain cause for concern
• Associated risks - physical and mental health, wider societal and
financial
• UK 15-24 year olds main causes of death not linked to disease
Socio-Economic Deprivation
• Alcohol-related mortality data (UK) show people are dying younger
(Shipton et al, 2013), in particular those in locations of significant
socio-economic deprivation
• More disadvantaged social groups tend to experience
disproportionately higher levels of alcohol attributable harm (EU,
2006; WHO, 2010; Erskine, 2013)
• Adolescents with low SES more likely to: (O’Neill et al, 2015)
• Engage in risky behaviours
• Disengage with school
• Have poor academic outcomes (eg NEET)
“confront the bunker between health and education”
Sir Al Aynsley-Green
AYPH Conference, 2016
Holistic approach
• Social determinants
• Address factors associated with low SES (low self-esteem, poor
parenting skills, lack of positive role models) to:
• Improve self-esteem and wellbeing
• Influence intrinsic motivation to change
• Improve engagement with school
• Ultimately reduce adolescent alcohol consumption
Intervention components
• Limited evidence for effectiveness of universal school-based interventions
to address alcohol misuse
• Effective components: eg pupil focus, role play, information provision,
resistance strategies
• Motivational interviewing – therapeutic technique developed to elicit
behaviour change in relation to substance abuse (Miller and Rollnick, 1991)
• The spirit of MI – collaboration, evocation and autonomy
• Principles of MI – expressing empathy, developing discrepancy, rolling with resistance
and supporting self-efficacy
• Encouraging intrinsic motivation towards behaviour
Emergent Findings
• Positive response from schools
• Implementation
• Pupil engagement
• Impact
Contact
Email: [email protected]