title: Reasons for non-participation in a parental program concerning underage drinking: a mixed-method study.
abstract: BACKGROUND
  Alcohol consumption among adolescents is a serious public health concern. Research has shown that prevention programs targeting parents can help prevent underage drinking. The problem is that parental participation in these kinds of interventions is generally low. Therefore, the aim of the present study is to examine non-participation in a parental support program aiming to prevent underage alcohol drinking. The Health Belief Model has been used as a tool for the analysis.
  
  
  METHODS
  To understand non-participation in a parental program a quasi-experimental mixed-method design was used. The participants in the study were invited to participate in a parental program targeting parents with children in school years 7-9. A questionnaire was sent home to the parents before the program started. Two follow-up surveys were also carried out. The inclusion criteria for the study were that the parents had answered the questionnaire in school year 7 and either of the questionnaires in the two subsequent school years (n = 455). Multinomial logistic regression analysis was used to examine reasons for non-participation. The final follow-up questionnaire included an opened-ended question about reasons for non-participation. A qualitative content analysis was carried out and the two largest categories were included in the third model of the multinomial logistic regression analysis.
  
  
  RESULTS
  Educational level was the most important socio-demographic factor for predicting non-participation. Parents with a lower level of education were less likely to participate than those who were more educated. Factors associated with adolescents and alcohol did not seem to be of significant importance. Instead, program-related factors predicted non-participation, e.g. parents who did not perceive any need for the intervention and who did not attend the information meeting were more likely to be non-participants. Practical issues, like time demands, also seemed to be important.
  
  
  CONCLUSIONS
  To design a parental program that attracts parents independently of educational level seems to be an important challenge for the future as well as program marketing. This is something that must be considered when implementing prevention programs.
authors.affiliation: School of Health and Medical Sciences, Orebro University, S-701 82 Orebro, Sweden. camilla.pettersson@oru.se
authors.forename: Camilla
authors.initials: C
authors.lastname: Pettersson
authors.forename: Margareta
authors.initials: M
authors.lastname: Lindén-Boström
authors.forename: Charli
authors.initials: C
authors.lastname: Eriksson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000517:prevention & control*; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D016487:Parenting; D010290:Parents / Q000523:psychology*; D015397:Program Evaluation; D045808:Refusal to Participate / Q000523:psychology* / Q000706:statistics & numerical data; D012574:Schools; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013548:Sweden