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Citation |
Obradors-Rial N, Ariza C, Continente X, Muntaner C. Alcohol 2019; ePub(ePub): ePub. |
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Affiliation |
Bloomberg Faculty of Nursing and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; K-21 program Mind-Society interaction, Korea University, Suite 606B, Jeongui Building, San 1, Jeongreung-3dong, Seongbuk-gu, Seoul, Seoul 136-853, Republic of Korea. |
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Copyright |
(Copyright © 2019, Elsevier Publishing) |
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DOI |
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PMID |
31082505 |
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Abstract |
Risky alcohol consumption among adolescents has health and social consequences. Evidence identifying the school context that determines alcohol consumption among rural and urban adolescents is lacking. This study aimed to describe the contextual school and town factors determining risky alcohol consumption among rural and urban 10th-grade adolescents (15-17 years old) from Catalonia (north-eastern Spain). The study had a cross-sectional design. Cluster sampling with the class as the sampling unit was used, and a total of 1,268 10th-grade adolescents from Catalonia nested in 26 high schools participated in the study. A computerized and self-administrated questionnaire was used to collect individual variables. Contextual variables were collected from the Catalan police registers, geocoded sources, and governmental internet databases and by aggregation of answers from the self-administrated questionnaire. The prevalence of risky alcohol consumption was calculated, and a multilevel Poisson regression analysis with robust variance was conducted with data from adolescents nested within high schools. The results show that risky alcohol consumption is higher among rural adolescents (59.3%) than among urban youth (51.1%) (p<0.005). Positive expectancies; drunkenness of siblings and friends; and most of the variables indicating accessibility are associated to risky alcohol consumption at the individual level. At the contextual level, the sports' centre rate and the high school's percentage of risky student alcohol consumption are strongly associated to individual risky alcohol consumption. The town environment (rural or urban), the unemployment rate, and the number of pubs and nightclubs lost their significance after adjustment by the individual and mediating variables. In conclusion, individual factors as the influence of drinking patterns of siblings and friends, and more alcohol access opportunities are associated with adolescents' risky alcohol consumption. The associated contextual factors are the sports centre rate and the percentage of risky classmate alcohol consumers. Interventions targeting adolescents should focus at community and high school levels, trying to reduce adolescents' accessibility to alcohol. Language: en |
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Keywords |
adolescent; alcohol drinking; multilevel analysis; risk factors; rural population; urban population |