Influence of sports' programs and club activities on alcohol use intentions and behaviors among adolescent males.ABSTRACT In the United States United States, officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area. , more than 70 percent of all deaths among youth and young adults each year are related to four causes: motor vehicle crashes, other unintentional injuries unintentional injury Accidental injury Public health Any injury caused by an accident. See Injury. , homicide homicide (hŏm`əsīd), in law, the taking of human life. Homicides that are neither justifiable nor excusable are considered crimes. A criminal homicide committed with malice is known as murder, otherwise it is called manslaughter. , and suicide. Alcohol misuse and abuse contribute to each of these behaviors. Alcohol is the most frequently consumed mind-altering substance among adolescents. In addition to its independent negative health effects and contributions to unintentional injury, alcohol abuse is identified as a correlate of chronic disease. There is a need to understand factors that may influence adolescents 'decisions to engage in, or adopt, risky behaviors and to assess differences in these influencing factors. The purpose of this study was to assess the influence of organized activity participation on adolescent males' use of alcohol and intentions to use alcohol. This study revealed protective effects of involvement in recreational activities on alcohol abuse and intentions but no effect of engagement in sports activities. Studies that can successfully address these relationships can enhance the development of multi-dimensional interventions for reducing and preventing risk behaviors in youth. INTRODUCTION In the United States, more than 70 percent of all deaths among youth and young adults each year are related to four causes: motor vehicle crashes, other unintentional injuries, homicide, and suicide (Eaton, et al., 2006). Alcohol misuse and abuse contributes to each of these behaviors (Grunbaum, et al., 2002). In addition to its independent negative health effects and contributions to unintentional injuries, alcohol is also identified as a correlate of chronic disease risk (Emberson, Shaper, Wannamethee, Morris & Whincup, 2005; Thun, et al., 2006). Adolescence adolescence, time of life from onset of puberty to full adulthood. The exact period of adolescence, which varies from person to person, falls approximately between the ages 12 and 20 and encompasses both physiological and psychological changes. is described as the peak period for initiation to alcohol use (D'Amico & McCarthy, 2006) and alcohol is the most frequently consumed mind-altering substance among adolescents (MacKay, Fingerhut & Duran, 2000). Binge drinking binge drinking An early phase of chronic alcoholism, characterized by episodic 'flirtation' with the bottle by binges of drinking to the point of stupor, followed by periods of abstinence; BD is accompanied by alcoholic ketoacidosis–accelerated lipolysis and behavior occurs frequently among youth and it is associated with multiple health risks (Harnett, Thorn thorn, in botany thorn, sharp-pointed projection on some plants, usually protective in function. Botanically, thorns are distinguished as modified stems (as in the honey locust and hawthorn) from spines, which are modified leaves (as in the barberry), and , Herring herring, common name for members of the large, widely distributed family Clupeidae, comprising many species of marine and fresh-water food fishes, including the sardine (Sardinia), the menhaden (Brevoortia), and the shad (Alosa). , Kelly, 2000). Approximately 75% of the alcohol consumed is in the form of binge binge (binj) 1. a period of uncontrolled or excessive self-indulgent activity, particularly of eating or drinking. 2. to indulge in such activity. drinks (Office of Juvenile Justice and Delinquency Prevention The Office of Juvenile Justice and Delinquency Prevention (or OJJDP) is an office of the United States Department of Justice and a component of the Office of Justice Programs. , 2001). Alcohol is described as a gateway drug that sometimes leads to experimentation with marijuana marijuana or marihuana, drug obtained from the flowering tops, stems, and leaves of the hemp plant, Cannabis sativa (see hemp) or C. indica; the latter species can withstand colder climates. and marijuana use often functions as a gateway to use of other illicit Not permitted or allowed; prohibited; unlawful; as an illicit trade; illicit intercourse. ILLICIT. What is unlawful what is forbidden by the law. Vide Unlawful. 2. substances (Wagner & Anthony, 2002). In addition, heavy use of alcohol has been hypothesized to lead to the abuse of multiple substances in adulthood (Gossop, Marsden & Stewart, 2002). Because of its strong association with injury and disease, the federal government has called for initiatives to address alcohol-related health-compromising behaviors (U.S. Department of Health and Human Services Noun 1. Department of Health and Human Services - the United States federal department that administers all federal programs dealing with health and welfare; created in 1979 Health and Human Services, HHS , 2000). These initiatives delineate risk-reduction objectives which target the use of alcohol by adolescents and young adults. Specific alcohol-related objectives target a reduction in the use of alcohol and a decrease in the proportion of binge-drinking episodes. To date, progress has been made in some areas, yet alcohol abuse behaviors remain common among adolescents. Health behavior theories Behavior theory can refer to:
There is an ever-increasing need to understand factors that may influence adolescents' decisions to engage in, or adopt, risky behaviors and to assess differences in these influencing factors. Studies that can successfully address these relationships could serve to enhance the development of multi-dimensional interventions for reducing and preventing risk behaviors in youth. Adolescent males have high rates of use and abuse of alcohol (Harnett, Thom, Herrin & Kelly, 2000; Lorente, Peretti-Watel, Griffet & Frelot, 2003). While many variables are believed to influence alcohol behavior, the purpose of our study was to assess the influence of organized activity participation on adolescent males' use of alcohol, and intentions to use alcohol. Specifically, we examined differences in alcohol use behaviors and behavior intentions of adolescent males who participated in school-based sports, community-based sports, and school- or community-based clubs and organizations versus those who did not participate. METHODS This study investigated alcohol use and adoption intentions of a sample of 1690 adolescent males who were enrolled in grades 10 through 12 in four public school systems across the state of Alabama. Institutional Review Board approval was granted by The University of Alabama The University of Alabama (also known as Alabama, UA or colloquially as 'Bama) is a public coeducational university located in Tuscaloosa, Alabama, USA. Founded in 1831, UA is the flagship campus of the University of Alabama System. . We obtained parental consent Parental consent laws (also known as parental involvement or parental notification laws) in some countries require that one or more parents consent to or be notified before their minor child can legally engage in certain activities. and active subject assent An intentional approval of known facts that are offered by another for acceptance; agreement; consent. Express assent is manifest confirmation of a position for approval. prior to participation. Instrumentation Data were collected utilizing the Adolescent Health Survey. The Adolescent Health Survey is comprised of 69 items addressing demographic characteristics; extracurricular participation; salient others; participants' substance use attitudes, patterns, and intentions; perceptions of referent ref·er·ent n. A person or thing to which a linguistic expression refers. Noun 1. referent - something referred to; the object of a reference others' substance use attitudes; and substance use patterns by these salient others. Items for this instrument were drawn from the Alabama Adolescent Survey (Nagy, Hunt & Adcock, 1990) and the Youth Risk Behavior Survey The Youth Risk Behavior Survey (YRBS) is a biannual survey of adolescent health risk and health protective behaviors such as smoking, drinking, drug use, diet, and physical activity conducted by the Centers for Disease Control and Prevention. (Eaton, et al., 2006). Sampling We randomly selected fifteen public school systems from those whose superintendents participated in the Superintendents' Advisory Council at The University of Alabama. A letter, with supporting documentation, was sent to the superintendents of each of these systems inviting their participation. We made follow up telephone contact with superintendents in order to describe the project, answer questions, and encourage participation. Each school system was offered an individual summary report and access to the survey instrument as incentives to participate. Four school systems which included 12 schools agreed to participate. Data Collection We collected data on site at the participating schools. In most cases, data were collected in individual classrooms during regularly scheduled class periods. Participants completed a consent form prior to data collection. Those whose parents did not give consent, and those who chose not to complete the survey, remained in the classroom and were assigned alternative tasks by the teacher. Some students were absent on the day of the survey and few chose not to participate resulting in a response rate of 95%. Participants responded to survey items by completing a 10-item NCS (Network Call Signaling) CableLabs version of MGCP. See MGCP/MEGACO. NCS - Network Computing System: Apollo's RPC system used by DEC and Hewlett-Packard.The protocol has been adopted by OSF. SCANTRON form. Upon completion of surveys, participants placed their questionnaires and answer forms in a separate collection envelope which was sealed by the Principal Investigator Noun 1. principal investigator - the scientist in charge of an experiment or research project PI scientist - a person with advanced knowledge of one or more sciences . Students and officials from individual schools and school districts were not allowed to view completed forms. Data Analyses Preliminary analyses were conducted through crosstabulation tables utilizing the chi-square statistic statistic, n a value or number that describes a series of quantitative observations or measures; a value calculated from a sample. statistic a numerical value calculated from a number of observations in order to summarize them. . We tested statistically significant variables from the preliminary analyses for each outcome variable: use of alcohol, binge drinking, intention to use alcohol, and intention to binge drink. The Statistical Package for the Social Sciences (statistics, tool) Statistical Package for the Social Sciences - (SPSS) The flagship program of SPSS, Inc., written in the late 1960s. ["SPSS X User's Guide", SPSS, Inc. 1986]. (SPSS A statistical package from SPSS, Inc., Chicago (www.spss.com) that runs on PCs, most mainframes and minis and is used extensively in marketing research. It provides over 50 statistical processes, including regression analysis, correlation and analysis of variance. ) was used to conduct all analyses. Goodness-of-fit measures contained within the SPSS hierarchical loglinear analysis and logistic regression In statistics, logistic regression is a regression model for binomially distributed response/dependent variables. It is useful for modeling the probability of an event occurring as a function of other factors. procedures automatically assessed the fit of each model and the linearity of the relationship between the group odds and predictor variables Noun 1. predictor variable - a variable that can be used to predict the value of another variable (as in statistical regression) variable quantity, variable - a quantity that can assume any of a set of values , respectively. RESULTS Participants One thousand six hundred ninety (n=1690) adolescent males, enrolled in grades 10 through 12 in four public school systems across Alabama served as participants. One thousand three hundred seventy-two (81.2%) participants were White and 250 (14.8%) were African American African American Multiculture A person having origins in any of the black racial groups of Africa. See Race. . Frequencies for other ethic eth·ic n. 1. a. A set of principles of right conduct. b. A theory or a system of moral values: "An ethic of service is at war with a craving for gain" groups were: Hispanic (.9%), Asian/Pacific Islander (1.2%), Native American (1.0%), and other (.7%). Participants ranged in age from 14 (8.6%) to 17+ (37.5%) years. Four hundred thirteen participants (24.4%) were age 15 and the remaining 499 (29.5%) were 16 years old. Forty-one percent of participants were 10th graders, 31% were in the 11th grade, and 28% were seniors. Over seventy percent (70.3%) of the sample lived in a traditional family setting with both a mother and father; 15.4% lived with mother only; 3.8% lived with father only; 3.9% lived with mother and family; 1.4% lived with father and family; 2.5% lived with grandparents grandparents npl → abuelos mpl grandparents grand npl → grands-parents mpl grandparents grand npl and 2.7% lived in another setting. Assessment of participation status revealed that 868 participants (51.3%) had participated in at least one school-based sport during the past year, and 817 participants (48.3%) reported no participation. We categorized cat·e·go·rize tr.v. cat·e·go·rized, cat·e·go·riz·ing, cat·e·go·riz·es To put into a category or categories; classify. cat these participants as school athletes and non-school athletes, respectively. Similarly, 901 participants (53.4%) had participated in community-based sports during the past 2 weeks and were classified as recreational athletes. Seven hundred eighty-four participants (46.4%) had not participated in sports or athletic activities in the community during the previous 2 weeks. We classified these participants as non-recreational athletes. School and/or community-based club participation during the previous 2 weeks was reported by 53% of the sample (n=896), while the remaining participants reported 0 hours of participation in these activities. Club member and non-club member were the respective classifications for these participants. Multiple extracurricular group membership by the same participants was observed. Five hundred (56.0%) of the participants classified as club members also participated in school-based sports, and 550 (61.5%) club members were recreational athletes as well. Six hundred (66.8%) of the recreational athletes also participated on school-based athletic teams. Forty-eight percent (n=814) of the participants reported no alcohol consumption during the previous month and were classified as non-drinkers. The remaining 872 participants (51.5%) had consumed alcohol at least once during the preceding month and were classified as drinkers. Five hundred eighty-two (34.4%) participants were classified as binge drinkers and 1103 (65.3%) were non-bingers. Binge drinkers were students who had consumed five or more drinks in a row on at least one occasion during the past 2 weeks (Centers for Disease Control, 2007). Significant differences were observed for alcohol use between participants and non-participants in school- and community-based clubs/organizations. Club members were significantly less likely than non club members to drink alcohol ([chi square chi square (kī), n a nonparametric statistic used with discrete data in the form of frequency count (nominal data) or percentages or proportions that can be reduced to frequencies. ] = 30.17, df = 2, n = 1683, p < .001) or binge drink ([chi square] = 28.86, df = 2, n = 1684, p < .001) than non-club members. Table 1 summarizes the results of the alcohol use by extracurricular participation group. Intentions to drink alcohol ([chi square] = 24.15, df = 2, n = 1674, p < .001) or binge drink ([chi square] = 24.17, df= 2, n = 1680, p < .001) in the next 6 months were significantly lower for club members than non-club members. Summaries of these analyses are presented in Table 2. DISCUSSION The purpose of our study was to assess the influence of organized activity participation on adolescent males' use of alcohol, and intentions to use alcohol. Specifically, we examined differences in alcohol use behaviors and behavior intentions of adolescent males who participated in school-based sports, community-based sports, and school- or community-based clubs and organizations versus those who did not participate. Our results generally support Jessor's Problem Behavior Theory (1982) in that participants who were involved in positive extracurricular activities were less likely to use or intend to use alcohol. These findings complement the basic tenets of Social Learning Theory (Bandura ban`dur´a n. 1. A traditional Ukrainian stringed musical instrument shaped like a lute, having many strings. 1977) and the Theory of Planned Behavior (Ajzen, 1988, 1991) and are consistent with results from Hellandsjo Bu and colleagues (2002). Our results indicated no differences in alcohol use between participants and non-participants in sports activities. This finding is inconsistent with some studies that found substantially less alcohol use among youth who participated in organized sports (Ferron, Narring, Cauderay & Michaud, 1999; Hellandsjo Bu, Watten, Foxcroft, Ingebrigtsen & Relling, 2002). A study by Lorente and colleagues (2003) reported that student athletes drank less often but had more episodes of intoxication intoxication, condition of body tissue affected by a poisonous substance. Poisonous materials, or toxins, are to be found in heavy metals such as lead and mercury, in drugs, in chemicals such as alcohol and carbon tetrachloride, in gases such as carbon monoxide, and than non-athletes. Results of our current study were also inconsistent with work by Kueffler, Lim & Choi (2005) that reported that athletes had significantly higher rates of alcohol use than non-athletes. Some studies compared alcohol intake of adolescent athletes by level of activity. Moderate and high activity adolescent athletes were significantly more likely than non-athletes to have consumed alcohol in the past month (Carr, Kennedy & Dimick, 1996; Pate, Trost, Levin lev·in n. Archaic Lightning. [Middle English levene, levin; see leuk- in Indo-European roots.] & Dowda 2000; Rainey, McKeown, Sargent & Valois, 1996). In addition, the literature indicates that high activity athletes have been significantly more likely to report binge-drinking in the past month. With the large numbers of deaths from binge drinking, this behavior has become a growing concern (Wechsler & Kuo, 2002). Results of the current study are consistent with other studies; for example, Miller and colleagues (2003) reported increased levels of alcohol use and binge drinking among male athletes when compared with nonathletes. Researchers stated that this was related to the "jock 1. jock - A programmer who is characterised by large and somewhat brute-force programs. 2. jock - When modified by another noun, describes a specialist in some particular computing area. " image or mentality and the problem drinking prevailed even after controlling for age, race, socioeconomic status socioeconomic status, n the position of an individual on a socio-economic scale that measures such factors as education, income, type of occupation, place of residence, and in some populations, ethnicity and religion. , physical maturity, social maturity and frequency of athletic activity. Hoffman (2006) stated that male athletes had more alcohol use than non athletes and males who were most likely to consume alcohol attended high-socioeconomic-status schools. In the present study, significant differences were observed regarding alcohol use between participants and non-participants in clubs and organizations. In the present study, only club participation consistently appeared to be protective. This is consistent with work by Anderson-Butcher, Newsome & Ferrari (2003) that identified protective outcomes for youth of participation in the Boys and Girls boys and girls mercurialisannua. Club of America activities. These protective outcomes included reduce(t alcohol use in addition to improved academic achievement (Anderson-Butcher, Newson & Ferrari (2003). Harrison and Narayan (2003) echo these results in their work. Additionally, being involved in recreational activities was selected by youth as one of the five most frequently stated strategies for reducing alcohol consumption (Metrik, Frissell, McCarthy, D'Amico & Brown, 2003). With respect to alcohol use intention, the similarity of drinking intentions between participants and non-participants in sports may reflect the lack of differences for alcohol consumption observed in these participants. Similarly, the lack of binge drinking differences between interscholastic in·ter·scho·las·tic adj. Existing or conducted between or among schools. in  ter·scho·las or recreational athletes and their
non-participant peers provides the most sensible explanation for the
similarity of their binge drinking intentions.
Club members were significantly less likely to be drinkers or binge drinkers than were non-members. Because they drank less than non club members, the expectation for these same participants would be lower alcohol-related behavioral intentions. Therefore we were not surprised that club members were significantly less likely than non club members to intend to consume alcohol or binge drink. Implications for Practitioners and Researchers There is an ever-increasing need to understand factors that may influence adolescents' decisions to engage in alcohol abuse behaviors and to assess differences in these influencing factors. This study revealed protective effects of recreational activities on alcohol abuse and intentions among a group of male adolescents but showed no effect of sports activities on alcohol use. Since promoting physical activity is desirable, planning ways to encourage activity while reducing alcohol use risk is desired (Nelson & Gordon-Larsen, 2006). Physical activity and club activities may be valuable in promoting drug-free lifestyles. Program planners may consider providing brief sport-based screening and consultation tailored to adolescents' health habits to potentially reduce alcohol use (Werch, Moore, Diclemente, Owen & Bledsoe, 2003). More research regarding the role of club activity in alcohol and other drug abuse behavior is needed (Foxcroft, Ireland, Lister-Sharp, Lowe & Breen, 2003). In addition, more research is needed regarding the influences of types of sports on alcohol behaviors among males (Peretti-Watel, Beck & Legleye, 2002). Moore and Werch (2005) reported that males in club swimming were at a lowered risk for alcohol abuse but males in school-sponsored football, swimming, and wrestling were at higher risk. This study was primarily comprised of White males in a Southern state which was one of its limitations. Future studies are needed that are nationally representative and address ethnic and cultural differences in alcohol consumption behaviors and intentions to abuse alcohol. In addition, since some research has indicated that female alcohol abusers display gender-specific problems, studies that address male and female differences are suggested (Miller, Melnick, Barnes, Farrell & Sabo, 2005; Moore & Werch, 2005). Another limitation was that the current study did not examine the role of other factors in alcohol use and intention to use. Protective factors including self efficacy (Watkins, Howard-Barr, Moore & Werch, 2006) achievement-focused values, positive peer role models, close ties to caring adults, nurturing family interaction, peer support and school environment appear to be influential factors (Oman, Vesely, Aspy, McLeroy, Rodine & Marshall, 2004). Detailed findings regarding ethnic, cultural and gender differences regarding alcohol abuse are needed. The types of activities that can be applied to designing effective multi-dimensional drug abuse prevention interventions should be explored. Efficacious ef·fi·ca·cious adj. Producing or capable of producing a desired effect. See Synonyms at effective. [From Latin effic programs can play a major role in reducing the major health and social problems related to alcohol abuse. Send any correspondence concerning this agile to: Lori Turner, Ph.D., RD, Professor, Box 870311, The University of Alabama, Tuscaloosa, AL 35487-0311, Telephone: (205) 248-1292, Fax: (205) 248-7568, Email: lwturner@ches.ua.edu. REFERENCES Ajzen, I. (1988). From intentions to actions. In I. Ajzen (Ed.), Attitudes, personality, and behavior (pp. 112-145). Chicago: Dorsey Press. Ajzen, I. (1991). The Theory of Planned Behavior. Organization and Behavior in Human Decision Processes, 50, 179-211. Anderson-Butcher, D., Newsome, W. S., Ferrari, T. M. (2003). 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Deidre Leaver-Dunn, PhD, ATC ATC Air Traffic Control ATC Average Total Cost ATC Certified Athletic Trainer ATC At the Center (Hartford, Maine retreat center) ATC Applied Technology Council ATC All Things Considered Lori Turner, PhD, RD and Brian M. Newman, MS, ATC University of Alabama
TABLE 1
Alcohol Use Behaviors and Activity Participation (n=1690)
Alcohol Use Behavior by School-Based Sports Participation
School Athlete
Behavior No (%) Yes (%) [chi square]
Drinking Alcohol 46.8 53.2 1.68
Binge Drinking 47.8 52.2 0.16
Alcohol Use Behavior by Community-Based Sports Participation
Recreational Athlete
Behavior No (%) Yes (%) [chi square]
Drinking Alcohol 46.2 53.8 0.14
Binge Drinking 47.8 52.2 0.57
Alcohol Use Behavior by Community- and School-Based
Club/Organization Participation
Club Member
Behavior No (%) Yes (%) [chi square]
Drinking Alcohol 53.3 46.7 30.17
Binge Drinking 55.8 44.2 28.86 *
* p <.001
TABLE 2
Alcohol Use Intention and Activity Participation (n=1690)
Alcohol Use Intention by School-Based Sports Participation
School Athlete
Behavior No (%) Yes (%) [chi square]
Drinking Alcohol 47.8 52.2 0.27
Binge Drinking 46.0 54.0 1.62
* p <.001
Alcohol Use Intention by Community-Based Sports Participation
Recreational Athlete
Behavior No (%) Yes (%) [chi square]
Drinking Alcohol 46.8 53.2 0.02
Binge Drinking 48.8 51.2 1.28
* p <.001
Alcohol Use Intention by School- and Community- Based
Club/Organization Participation
Club Member
Behavior No (%) Yes (%) [chi square]
Drinking Alcohol 54.7 45.3 24.15 *
Binge Drinking 56.3 43.7 24.17 *
* p <.001
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