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Official websites use. Share sensitive information only on official, secure websites. This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author s and the source are credited. Excessive alcohol consumption increases the years of life lost to premature death and disability worldwide. Religion is a mitigating factor in alcohol consumption. The results suggested that it may be useful to conceive of church-attending youth as a subset of the adolescent social network when planning primary alcohol prevention programs for young people. Alcohol affects health in various ways: direct pathophysiological effects, lessening of agility and coordination, changes in moods and emotions, and mitigation of mental and reasoning abilities Jernigan ; Monteiro ; Rehm and Monteiro Thirty-nine codes of the International Classification of Diseases are entirely attributable to alcohol Rehm and Monteiro Alcohol is a contributing cause for a number of additional chronic and infectious conditions as well as many categories of intentional and unintentional injuries Jernigan ; Rehm and Monteiro The most effective measures to decrease alcohol-related health consequences impact alcohol consumption at the population level; these measures include taxation, control of alcohol sales including minimum-age limits , and drinking-driving prohibitions Brand et al. Stakeholders from local vendors to transnational corporations and international trade agreements may not place public health interests as the highest priority and can complicate effective policy implementation Jernigan ; Monteiro Individual behavior change models, particularly primary prevention strategies with young people, have generally not shown good long-term results Foxcraft et al. However, a few strategies have shown promise Marlatt and Witkiewitz Harm reduction strategies are at least as effective as abstinence programs, and all interventions could be improved with better definition of the relevant factors related to adolescent development and behavior Foxcraft et al. Religion is a common element of civic life in the Dominican Republic. The influence of Christianity is apparent in civic life in the names of many small businesses and in the use of Biblical quotes on bulletin boards in public schools and in government-sponsored national safe driving campaigns. However, the degree to which this represents personal beliefs or an administrative assumption is uncertain. The extent to which participation in religious services relates to age at first drink, quantity of alcohol consumed, episodes of inebriation, episodic heavy drinking, and alcohol-related problems among adolescents in the Dominican Republic is uncertain. Religion could be a relevant factor in planning primary prevention activities for youth in Latin America and elsewhere. This study examines some elements of alcohol use in the Dominican Republic and self-reported church attendance of youth in grades 7 through Modifications included language changes to reflect common local usage and addition of several original items and items from other sources WHO b. Other than age, all items were multiple choice. The questionnaire was limited to 16 items to minimize respondent burden and fatigue Smith et al. The questionnaire collected data on basic demographics age, gender, grade level ; indication of spiritual life church attendance of students and their families ; the family environment related to alcohol alcohol in the home, if household members drink and how often ; age at alcohol initiation i. This study used the definitions from the original survey source WHO a. The questionnaire was evaluated for face, content, and construct validity Browne a. A standard to check criterion validity was not available. Face validity was evaluated through review by the authors and professional educators. Content validity was evaluated by piloting the questionnaire with students from seventh through twelfth grade, and two follow-up focus groups in which each item was reviewed. Construct validity was evaluated by examining patterns for known groups more alcohol consumption reported with increasing grade level, for example , as well as convergence and discriminatory characteristics. Test—retest reproducibility was evaluated through the focus groups in which students indicated that they would maintain their original responses. The questionnaire was administered to a convenience sample of students from seventh through twelfth grades in nine schools: three public and six private three secular and three church-related from 17 February through April 14, Questionnaires consisted of three sheets of paper printed on both sides with introductory information on page one and questions on pages two through six see ' Appendix '. All questionnaires were administered by one of five trained personnel who were all first-language Spanish speakers. Questionnaires were distributed to all students in each class who placed them into individual envelopes when they finished. Students deposited the envelopes into a collection bag for each class. During data entry, grade level and school were systematically entered for each student. Multiple responses by a student to an item were coded as missing answers. Statistics were both descriptive and analytical. Continuous data were evaluated by t test for two groups and one-way analysis of variance for multiple groups. Paired ordinal data were evaluated with the Wilcoxon signed rank test. Ordinal data were compared for two groups by Wilcoxon rank sum test and for multiple groups by the Kruskal—Wallis test. Overall Type I error was controlled to a level of 0. Kaplan-Meier survival analysis and proportional hazards regression were used for censored data such as age at first alcoholic drink. P values less than 0. The survey was administered to 3, students. Two surveys were excluded from the analysis as not interpretable, leaving a sample size of 3, surveys. The final sample included three public schools 2, students , three secular private schools students , and three church-related schools students. To obtain this sample, eleven schools were approached; the administrations of two secular private schools declined participation and replacement schools were surveyed. Eleven students 0. Overall, 2, students Mean response rate for items was The median number of items answered was 15 for all school types and for male and female students. Gender was indicated by 3, students Age was provided by 3, students Reported ages in the sample were used to calculate age at first alcoholic drink and percentage of current underage drinkers; otherwise grade level was utilized as a surrogate for age. Responses indicated that alcohol is never stored in the homes of 1, students One or more members of the household were reported to drink alcohol by 2, students Frequency of alcohol consumption by household members was Never Several items were associated in predictable ways. While this supports the internal validity of the questionnaire, it also suggests possible confounding of those factors. Students were most likely to have their first alcoholic drink between ages 11 and 15 years Fig. Age at first alcoholic drink was delayed related to female gender relative risk 0. About one-third Even with the delay in first alcoholic drink for female students, the proportion of current drinkers was not different by gender male Current drinkers varied by grade level: seventh, Within the sample population, The average daily consumption among the current drinkers on days that they did consume alcohol was less than one drink, Students reported episodes of inebriation: None, Of the students who report buying their alcohol, Only a small proportion of students 7. Multiple episodes three or more were reported by 1. Of the students reporting alcohol-related problems, 9. There are multiple determinants of adolescent alcohol consumption, including health beliefs, self-identity formation, advertising and media exposure, public policy, and social networks Anderson et al. Adolescent religiosity is protective against health risk behavior and alcohol misuse for youth in North America, South America, and Eastern Europe Jernigan ; Piko and Fitzpatrick ; Sanchez et al. However, a review of the literature on adolescent religiosity, spirituality, health attitudes, and health behaviors found inconsistent theoretical bases and a lack of standard operational definitions of religiosity Rew and Wong An attempt to separate religiosity into a public domain frequency of attendance at religious services and participation in youth group activities and a private domain frequency of prayer and importance of religion found that both domains were protective against youth risk behaviors Nonnemaker et al. Pertinent adolescent social networks affecting alcohol consumption include family and peers Kristjansson et al. This study suggested that church participation represented a subset of the peer social network related to adolescent alcohol use. Within the area of family networks, family-focused interventions for young people can result in delayed alcohol initiation and decreased alcohol consumption Foxcraft and Tsertsvadze ; however, in general, family-based programs have not shown effects for young people 16 years and older Spoth et al. A review of critical incidents of adolescent alcohol drinking in the Netherlands suggests that parents have a minor influence on curtailing problematic drinking behavior, frequently being unaware of alcohol-related incidents Van Hoff et al. These findings suggest a waning influence of the family on older adolescent behavior. Alcohol use by peers and friends, as well as gaining their respect or approval, is a factor in adolescent alcohol consumption Kristjansson et al. Young adolescents are particularly susceptible to exposure to a peer drinking network Kelly et al. The perceived status or popularity of the influential peer or friend is also a factor Bot et al. Paradoxically, popularity increases for adolescents who drink with their peers Balsa et al. Adolescent social networks influence initiation of alcohol consumption and drinking behavior Ali and Dwyer ; Mundt Peer education strategies employ various theories including social learning, diffusion of innovations, and social role and expectations Strange The choice of peer educators may depend to some extent on the theoretical bases of the preventive health intervention Strange Demographic similarity of the educator to the target population is important; however, knowledge of the topic, effective communication skills, and personality may be more important Strange Adolescents with more frequent church attendance represent a potential pool of peer educators who may be predisposed and motivated to offer anti-drinking and risk reduction messages to other students. Rather than the non-drinking students, those frequent church attending students who have some alcohol consumption experience might be more knowledgeable peer educators. However, public health alliances with these movements have been problematic Jernigan As recently observed about faith-based HIV programs, the presence of judgmental attitudes in religious programs can impede their successful integration into public health programs Derose et al. Disagreements and tensions over institutional values between religious and health leaders limit their ability to work collaboratively Derose et al. Given the inverse association between church attendance and alcohol consumption, another possible explanation for a loss of program efficacy could be that the social networks associated with the religious environment are more receptive to the anti-alcohol messages than the general public. The levels of adolescent alcohol consumption in this study were comparable to other published reports. The levels were similar or less than in other low- and middle-income countries Assanangkornchai et al. A recent study of Dominican eighth, tenth, and twelfth graders found that The proportions of current drinkers in the present study were equal for the young men and women, even though the women had fewer episodes of inebriation and less average consumption than the male students. Young women may have a risk equal to that of their male counterparts for complications of heavy episodic drinking such as accidents and unintentional injuries, a principal health risk for young men that drink Ye and Cherpitel Age limits on drinking are wide-spread, but less widely enforced Jernigan ; Monteiro Enforcement of the minimal age for alcohol purchase might decrease underage drinking Johnson et al. In addition, increased exposure of juveniles to alcohol occurs in tourist areas Guilamo-Ramos et al. Analysis of alcohol promotion shows that young drinkers and women are a focus of alcohol advertising Yoast et al. There are possible sources of bias in this study Browne a , b ; Smith et al. The sample population includes only those students attending school. Mandatory education in the Dominican Republic stops after the eighth grade. Accordingly, those young people not electing to continue in school are not represented in this study. Recall bias could have occurred, though young respondents are reasonably accurate in their self-reported drinking Northcote and Livingston There were relatively few non-responders, but a bias arising from those who chose not to answer-specific items cannot be excluded. Two secular private schools declined participation. One of these schools had the highest tuition of any of the non-public schools, being more than twice the value at the second most expensive school. The other school that declined participation had the third highest tuition costs. The decision by these two schools not to participate may have produced a socio-economic bias in the data. Higher material affluence is associated with more experimental alcohol use among adolescents in Ghana Doku et al. The high proportion of under-age current drinkers in this study supported the use of regulatory policy approaches. The equal representation of male and female students among current drinkers and heavy episodic drinkers suggested that changing social norms may be placing young women at increasing risk of alcohol-related problems. The challenge is in translating the various observations from this and other studies into effective primary prevention programs to decrease alcohol risks for youth. This study suggests that a better understanding of the interactions between drinking and non-drinking adolescent peer networks—as well as the determinants of individual status and popularity within those networks—will be useful. Church-attending youth may represent a source of peers willing and motivated to participate in primary prevention activities. Additional qualitative studies such as focus groups, analyzing adolescent narratives, and anthropological thick descriptions could enhance the understanding of the important factors and their meanings within adolescent social networks. Entonces, no escriba tu nombre en esta encuesta. Contesta a las preguntas basado en lo que realmente sabes o haces. No hay respuestas correctas ni incorrectas. La encuesta demanda menos de 20 minutos para llenarla. Cuando termines con la encuesta, favor ponerla en el sobre y devolverla. El consumo de alcohol no incluye beber unos pocos sorbos de vino en actividades religiosas. Si eres una chica, vaya a la pregunta para hembras. Si eres un chico, vaya a la pregunta para varones. Tambalearse cuando uno camina, no ser capaz de hablar correctamente y vomitar son algunos signos de tener una borrachera. As a library, NLM provides access to scientific literature. J Relig Health. Find articles by Michael N Dohn. Find articles by Maximinia Nolasco Pozo. Find articles by Elizabet Altagracia Cabrera. Find articles by Anita L Dohn. Issue date Open in a new tab. Tu curso: 1. Asistes tu a una iglesia: Nunca. Algunos miembros de tu familia asisten a una iglesia: Nunca. Nunca he bebido alcohol aparte de unos pocos sorbos. No tome alcohol. Ninguna — 0 veces. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel.

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