Program Profile: Örebro Prevention Program

This is a prevention program designed to decrease adolescents’ underage drinking and delinquency by increasing parents’ restrictive and prohibitory attitudes toward these behaviors. The program is rated Promising. Adolescents whose parents participated in the program had a statistically significant lower likelihood of having been drunk in the past month, lower alcohol use overall, and lower delinquency levels, compared with adolescents whose parents did not participate in the program.

A Promising rating implies that implementing the program may result in the intended outcome(s).

A Promising rating implies that implementing the program may result in the intended outcome(s).

Program Goals

The Örebro Prevention Program’s (OPP’s) goal is to increase and maintain parents’ restrictive and prohibitory attitudes toward underage drinking starting when their children are in their teens. This is accomplished through structured presentations at the parent meetings at their child’s school.

Target Population/Eligibility

OPP targets all parents of youths ages 13–16 and indirectly the youths themselves. The prevention program is aimed at increasing and maintaining strict attitudes and decreasing permissiveness toward underage drinking.

Program Activities

Following an initial 30-minute presentation that describes OPP, the program is delivered to the parents through structured 20-minute presentations during parent meetings in school—once each semester. Each presentation has the goal of increasing and maintaining parents’ restrictive attitudes toward underage drinking. Participating parents are encouraged to adopt a zero-tolerance policy toward youth drinking and to communicate this message clearly to their children. Program staff present parents with information on how common underage drinking is during ages 10–18 and the potential short- and long-term consequences of it—such as violence, drug use, and unprotected sex.

After OPP staff present parents with information and earlier research, they tell the parents that they are still very influential in their children’s attitudes and behaviors. Their views and attitudes toward drinking will shape their children’s attitudes and behavior.

Next, OPP staff provide parents with concrete methods to set rules about underage drinking and to communicate their attitudes. Parents are encouraged to consider setting some rules concerning their children’s conduct in regard to alcohol and even to create a contract that both parents and child sign outlining those alcohol-specific rules. Parents are also encouraged to get their children involved in organized activities, giving them a prosocial activity to do instead of drinking with their peers.

After each parent meeting, all parents are mailed a brief summary of the meeting, reinforcing what was discussed. In addition, throughout the school year brochures describing community events and organized activities are mailed to parents.

Program Theory

OPP was developed on the assumption that interventions that target the family are effective at reducing underage drinking. Strict parental attitudes and disapproval of underage drinking are thought to have an impact on youths' drinking behavior. Permissive attitudes toward drinking are actually more important than the drinking behavior of parents themselves. Another key factor is involving youths with organized activities. OPP operates on the belief that parental attitudes can affect their children's behavior and that occupying children's time with organized activities will lower rates of underage drinking.

Study

Koutakis, Stattin, and Kerr (2008) used a quasi-experimental pre–post intent-to-treat design with matched comparison groups to assess the effectiveness of the Örebro Prevention Program (OPP) on youth drunkenness and delinquency. Schools were selected based on information from a survey about alcohol use conducted of all 3,094 ninth graders in Örebro County. To discern whether type of community played a role in the program implementation and effects, schools were chosen from rural, suburban, and urban areas. In each area there was one treatment school and one matched comparison school. Schools were matched based on size of school, type of community, and alcohol use and delinquency (gathered from the countywide survey). The treatment group consisted of 339 parents and 393 youths. Parents received the OPP informational sessions throughout the school year. The comparison group consisted of 312 parents and 418 youths. These parents received no instruction or encouragement to set strict rules with their children regarding drinking. Parents and youths who refused to participate were evenly distributed across school and conditions, so as not to bias any of the outcomes. The main reason youths did not participate was absence from school because of illness.

Baseline assessment occurred at the beginning of the seventh grade. Follow-ups were completed near the end of the school year in eighth and ninth grades. The total follow-up period was roughly 2½ years. Adolescents completed questionnaires in their classrooms. Parents received questionnaires in the mail about 2 weeks after their child’s assessment. Students and parents were reminded at each assessment that participation was completely voluntary. No incentives were given to parents or youths to participate.

The measurements collected from parents in the study included self-reported attitudes toward drinking, education level, and ethnicity. Measurements collected from adolescents in the study were self-reported involvement in organized activities, drunkenness, and delinquency. Parental attitudes toward drinking were measured by having parents choose a statement that best reflected their attitudes. Statements ranged from lenient (“We trust our son/daughter drinks in a responsible way”) to very strict (“A child our son or daughter’s age is way too young to drink alcohol”). Adolescent measures were reported numbers of organized activities they were involved in, number of times they had been drunk in the past 4 weeks, and number of delinquent acts committed in the past year.

Baseline equivalence between treatment and comparison groups was determined using t–test for independent groups. To detect changes in alcohol use, drunkenness, and delinquency over time, general linear models were used. When multivariate effects were found to be significant, analysis of covariance (ANCOVA) was used to control for baseline differences. ANCOVAs and logistic regression were used to determine the influence of differential attrition on the final outcomes. Chi-square analyses were used to test for group differences in alcohol use and frequent drunkenness. The study authors conducted subgroup analyses on gender and location of program delivery (i.e., rural, suburban, or urban setting).

Subgroup Analysis

Koutakis, Stattin, and Kerr (2008) conducted subgroup analyses on gender and location of program delivery (i.e., rural, suburban, or urban setting). With regard to gender, they found no statistically significant differences between boys and girls who participated in the Örebro Prevention Program (OPP) on any measure. There were also no statistically significant differences in community type, suggesting that the effect of OPP did not vary by the geographical location in which it was delivered.

These sources were used in the development of the program profile: