Behaviour Change

PROPAGANDA FOR CHANGE is a project created by the students of Behaviour Change (ps359) and Professor Thomas Hills @thomhills at the Psychology Department of the University of Warwick. This work was supported by funding from Warwick's Institute for Advanced Teaching and Learning.

Tuesday, March 5, 2019

NHS:New Habits society! (u1838990)

ALCOHOL ABUSE AMONG TEENAGERS – PEER PREASURE

Introduction: Why is it important?

Alcohol, tobacco, and marijuana have long been known to be drugs of first use among teenagers, even though alcohol and tobacco are known to increase long-term risk of disease and premature mortality. Alcohol use among youth is a high risk factor for morbidity and mortality due to accidents. (Hausen & Graham, 1991). Individuals who abuse alcohol face a higher risk of suffering from cancer, liver cirrhosis, lung and cardiovascular disease, mental and behavioural disorders. They are more likely to experience injuries and accidents, to engage in violent acts, antisocial behaviour and have lower productivity at work. Alcohol abuse is also partially responsible for risky sexual practices which may lead to unwanted pregnancies and sexually transmitted diseases, as well as foetal abnormalities (Huerta & Borgonovi, 2010).

Alcohol abuse is a current problem in the United Kingdom nowadays. NHS survey finds 19% of youngsters aged 11-15 in England have smoked, 24% have taken drugs and 44% have drunk alcohol. In 2016 the survey found consumption of alcohol related to the age of the children questioned; it ranged from 15% of the 11-year-olds having had a drink, to 73% of those aged 15. Girls were slightly more likely to have ever had a drink than boys, at 46% to 43%. About half of the pupils questioned had acquired their drugs from a friend on the most recent occasion, with most of those being a friend of the same age. Just over a quarter said they had bought their drugs from a dealer, a proportion that increased with age (Gayle, 2017).


Problem: Education is not based in real Behaviour Change

Most substance use prevention programs have utilized eclectic strategies, typically with multiple components that defy precise theoretical interpretation. Programs that have been successful to date have tended to include instruction about the nature of peer pressure and skills to resist peer pressure as one component. Indeed, even programs that include a number of intervention techniques often ascribe their success primarily to the impact of teaching students to resist pressure. Peer pressure resistance training programs have been consistently confounded with other programmatic strategies that have the potential to establish conservative norms through the correction of erroneous normative beliefs (Hausen & Graham, 1991).

Therefore, I am orienting this project on preventing peer preassure among teenagers about substance consuming, specially alcohol abuse which is more normalized in our society. We will go more in depth about the attitude change towards the use of healthier options when socializing in the normative group.


Target audience

The first question that came to my mind in order to target the propper audience was “Which kind of
environments promote alcohol abuse in teenagers and how can I design the propper trailored
programme for them?”. Consequently I found out that motivations for substance use may arise from
environmental factors, such as family role models, peer influences, social pressure, and a social
environment in which substance use is encouraged. There is also considerable evidence that
personality factors play an important role in predicting substance use (Zimbardo, 1999). Some studies
show that individuals from low socioeconomic backgrounds tend to consume more alcohol compared
with their better off peers (Huerta & Borgonovi, 2010).

Education may promote different patterns of alcohol consumption by fostering skill acquisition and
knowledge development, but also by influencing labour market opportunities and the social context
in which individuals operate. Social context may in fact be a key determinant of choices over whether
and how much alcohol individuals consume. More educated individuals in fact are not only more likely to have a higher level of cognitive abilities, skills and knowledge, but are also less likely to be
unemployed, face financial difficulties, lack social support, suffer from mental health problems and
have more to lose from engaging in excessive alcohol consumption than the less educated (Huerta &
Borgonovi, 2010). Reasons for the positive association of education and drinking behaviours may
include: a more intensive social life that encourages alcohol intake; a greater engagement into
traditionally male spheres of life, a greater social acceptability of alcohol use and abuse; more
exposure to alcohol use during formative years; greater postponement of childbearing and its
responsibilities among the better educated, and smaller underreporting (Huerta & Borgonovi, 2010).

Due to all this reasons it’s why I decided to design this project for high schools in lower socioeconomic areas in the UK.


Intervention

Evidence shows that 95% of primary schools and 97% of secondary schools reported that they deliver
some alcohol and drug education (Gayle, 2017). However, my intervention would convine two
different theories that contributes to attitude change towards drug usage: behaviourism (Skinner, 50s,
60s; learning and reinforcement theories), in order to condition teenagers to have a better opinion
towards a healthier lifestyle; and the theory of planned behaviour (Ajzen, 1991) as a deep change in
teenager’s attitudes and social norms.

Most of the campaings designed to prevent drug use behaviours in high schools are based on the
negative reinforcement so it shows a list of how many problems someone may have if one takes drugs.

However, it is known in educational disciplines that the positive reinforcement is the most efficient,
so it is important to focus on all the advantages one may have when choosing a better lifestyle. The
goal of this project is to make teenagers choose a healthier lifestyle because they will have a social
recognition from the peer group after having changed their attitude towards it.

My campaign proposal is to create a healthy society in high schools as a first step, so teenagers would
spend more time in those areas and less in unhealthy ones, such as the street itself. Therefore, it is
more likely to create a behaviour change. The activities in those societies would of course include
theoretical knowledge about the beneficies of doing sport regularly as well as drinking healthier
options when socializing with the peer group. Once the knowledge is shown, teenagers need to feel
that this lifestyle is “cool”, so they can have more power against peer preasure, as they will have
control over their choices like having a healthier option and still feel accepted and integrated in the
group. The “Theory of planned behaviour” talks about the combination of the attitude toward the
behaviour, so the goal of this project would be to change the attitude towards healthy lifestyles, which
is often rejected due to the influence of teenage films and tv shows, where drug abuse is often
romanticised. The theory also talks about the subjective norm, so the project goal would be to change
the perception of drinking alcohol as being the norm when joining parties, or when simply going to a
pub. This, as said, would directly affect the behavioural control perception on teenagers, since they
will be able to choose and still fit in the normative behaviour.

The main idea would be to create a society who would meet once a week in high schools and made
interactive activities with teenagers while showing healthy habits, as well as assertive methods to face
the peer preassure. Anyways, the main strategy would be to persuade the main leaders of a social
group or role models from class. Therefore it is more likely to change the attitude towards a healthy
lifestyle, as the concept of “social modeling” claims.

Persuassion techniques

For the persuasion techniques, we want students to first join the meetings every week, so we would start with the tecnique “foot in the door”. This method is about asking first for something small, so you are making the individual “committed” to helping you, and the larger request acts as a continuation of something technically already agreed upon. So, for instance we could come to each class asking for collaboration and offering some extra points to the final mark (as positive reinforcement), so we could have volunteer audience to start off.


I crearted a group called "New Habits Society", which would be the name of the society, and in order to advertise it we would require social media, as it is the best way to get to teenagers. We would offer 6 CATS (positive reinforcement) if they join the society. In the first message I invite people over the first day, so by asking a little favour and making them come the first day, we have more possibilities that they join next meeting.


The “commitment & consistency” technique has this principle: we feel we must always align our outer actions and promises with our inner choices and systems, such as our beliefs and values. Therefore, by promoting healthy habits in the society and group identity, teenagers will feel identified with the group beliefs and attitudes. 


The next tecnique, “social proof”, talks about the groupthink. This tecnhique will be used in order to
change the teens’ attitudes towards healthier habits by taking role models into the activities that
perpetuates the grouthink in this way. The goal is to make healthy lifestyle a fashion among the group.

The activities will consist on: bringing professionals in assertivity tecniques to prepare the teenagers
to reject someone’s offer to drink alcohol, teaching teenagers group dynamics so they realize one can
have fun without the use of alcohol while developing social habilities, promotion in social media,
creating events, creating a sense of identity of the group so members would have more commitement
and more people would join, creating a particular “fashion” on having a healthy lifestyle and a sense
of belonging.

Evidence

Research found supports the main ideas given in this project. As said, the main motives for alcohol
consumption given by adolescents are related to social events, which usually take place in the
company of friends, namely: drinking makes holidays more fun, it facilitates approaching others, it
helps relaxing or facilitates sharing experiences and feelings. Also, mimicking risk behaviours may be greater when consumption begins in the context of a social event. On the other hand, having friends allows to share experiences and feelings and to learn how to solve conflicts. Not having friends, on the other hand, leads to social isolation and limited social contacts, as there are fewer opportunities to develop new relations and social interactional skills. Friendship is also positively associated to psychological well-being, whilst a conflicting relation with peers is negatively associated with health.

Stronger friendships may provide adolescents with an appropriate environment to development in a
healthy way and to achieve good academic results. Adolescents with reciprocal friendships mention
high levels of feelings of belonging in school; at the same time, reciprocity and feelings of belonging
have positive effects in academic results (Gina Tomé et al, 2012).
Adolescents spend a great part of their time at school, which also makes it a privileged context for
involvement in or protection from risk behaviours. Research confirmed that adolescents who like
school were those that more often were part of a peer group without involvement in risk behaviours;
whilst those that mentioned they did not have any friends reported that they liked school less.(Gina
Tomé et al, 2012). Another factor, which has been identified as a possible factor of decreasing peer
influence is assertive refusal. Adolescents that are able to maintain an assertive refusal are less
susceptible to the group’s influence. (Gina Tomé et al, 2012)

Future pilot study

This project could be expanded in the future as a field study, a full year project with at least a 30
teenagers sample who use alcohol regularly to socialize. Their drinking habits would be measured
before and after the year project, as well as their self-esteem and self-efficacy, related to
assertiveness, as well as an interview with each of the participants asking for their experience and how this have improved or changed their habits with a guided interview. This results would be qualitative whereas their assertivity hability and their drinking habits would be measured with quantitative data.

Personal statement

This project has a special relevance to the author. I wish I have had something like this in my teens.
Nowadays I am taking responsability for my own actions and I am quite a healthy person. I learned to
say no to peer preassure but of course I could have had the feeling that I could choose a healthier
option if I had had an influence like this project.



References



https://www.theguardian.com/society/2017/nov/02/drug-use-more-likely-than-smoking-among-secondary-school-pupils
(Gayle,2017)
Hansen, W. B., & Graham, J. W. (1991). Preventing alcohol, marijuana, and cigarette use among adolescents: Peer pressure
resistance training versus establishing conservative norms. Preventive Medicine, 20(3), 414–430
Huerta, M. C., & Borgonovi, F. (2010). Education, alcohol use and abuse among young adults in Britain. Social Science &
Medicine, 71(1), 143–151.
Keough, K. A., Zimbardo, P. G., & Boyd, J. N. (1999). Who’s Smoking, Drinking, and Using Drugs? Time Perspective as a
Predictor of Substance Use. Basic and Applied Social Psychology, 21(2), 149–164.
Tomé, G., Matos, M., Simões, C., Diniz, J. A., & Camacho, I. (2012). How Can Peer Group Influence the Behavior of Adolescents:
Explanatory Model. Global Journal of Health Science, 4(2)
Núria Rovira, u1838990
University of Warwick

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