Note: This report was funded and/or written by our predecessor organisation, the Alcohol Education Research Council (AERC).
10 September 2005
Researchers:
The work was co-sponsored by the U.K. Alcohol Education and Research Council and the Wales Office of Research and Development for Health and Social Care.
It was carried out by Professor Laurence Moore (Cardiff University), Miss Melanie Chalder (University of Bristol), Professor Mick Bloor (University of Glasgow) and Dr Meraj Hasan (Pontypridd and Rhondda NHS Trust).
Key findings
The intervention was found to be feasible and acceptable to schools and students: 199 students were invited to attend peer supporter training, of which 146 did so, equivalent to 15% of pupils in each of the target year groups. 117 of these peer supporters attended at least 2 of the 3 follow-up sessions, and 106 handed in a completed diary of conversations. Year 9 students were less likely to agree to participate in training, and less likely to complete diaries, than their Year 8 counterparts. In data collected immediately after the end of the intervention period, 42% of students in intervention schools reported that they had talked with a peer supporter, of whom 82% had thought about consequences of drinking and 53% said that they had cut down on drinking. The peer supporters themselves had higher knowledge scores and a lower frequency of drinking and drunkenness than non-peer supporters. However, in terms of knowledge and behaviour at six-month follow-up, there were no differences between intervention and control school students.
The process evaluation built into the study identified that two days training had not been sufficient to satisfactorily cover the more complex alcohol message. Whereas in ASSIST, the message regarding the risks associated with smoking was clear and the message for the peer supporters to convey in their conversations was relatively straightforward – don’t smoke – in TAP the messages were more complex. TAP did not aim to discourage drinking per se, but focussed on regular binge drinking, and the health risks associated with drunkenness. Peer supporters were not asked to promote abstinence among their friends and wider peer group, but to promote a more sensible approach to alcohol and discourage regular binge drinking and drinking to get drunk. Interviews with peer supporters suggested that they had not fully taken on board this more complex message, and that it was difficult for them to convey such a complex message in their conversations.
Implications
The identification and training of influential pupils to act as peer supporters, disseminating messages and normative behaviours through their informal social networks, has been found to be feasible and acceptable to schools and students. Whereas this approach has had some impact on adolescent smoking uptake, the greater complexity of the alcohol harm reduction message proved to be problematic in the training of the peer supporters, and in their ability to convey such a complex message in their conversations.
Evidence from the TAP project does not justify investment in a larger scale trial. Further research should investigate the possibility of more intensive training for the peer supporters in preparation for their role.
Further research is required on validated measures of alcohol consumption suitable for use in large scale trials of young adolescents. Studies of interventions to prevent problem drinking in adolescents will also require longer term follow-up.
