Do risky friends change the efficacy of a primary care brief intervention for adolescent alcohol use?
OBJECTIVE
To determine if peer risk (having friends who drink or approve of drinking) modifies the effects of a computer-facilitated screening and provider brief advice (cSBA) intervention on adolescent alcohol use.


METHODS
We assessed the intervention effect using logistic regression modeling with generalized estimating equations on a sample of 2,092 adolescents. Effect modification by peer risk was analyzed separately for alcohol initiation (drinking at follow-up in baseline nondrinkers) and cessation (no drinking at follow-up in baseline drinkers) by testing an interaction term (treatment condition by peer risk). Interpretation of the interaction effect was further clarified by subsequent stratification by peer risk.


RESULTS
The intervention effect on alcohol cessation was significantly greater among those with peer risk (adjusted relative risk ratios; risk 1.44, 1.18-1.76 vs. no risk .98, .41-2.36) at 3 months' follow-up. There was no such finding for alcohol initiation.


CONCLUSIONS
Alcohol screening and brief provider counseling may differentially benefit adolescent drinkers with drinking friends.
Craig Dalsimer Division of Adolescent Medicine, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Jennifer
J
Louis-Jacques
Harvard Medical School, Boston, Massachusetts; Center for Adolescent Substance Abuse Research, Division of Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts.
John R
JR
Knight
Harvard Medical School, Boston, Massachusetts; Center for Adolescent Substance Abuse Research, Division of Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts.
Lon
L
Sherritt
Harvard Medical School, Boston, Massachusetts; Center for Adolescent Substance Abuse Research, Division of Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts.
Shari
S
Van Hook
Harvard Medical School, Boston, Massachusetts; Center for Adolescent Substance Abuse Research, Division of Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts; Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts. Electronic address: sion.harris@childrens.harvard.edu.
Sion K
SK
Harris
D000293:Adolescent; D000294:Adolescent Behavior; D000428:Alcohol Drinking / Q000517:prevention & control*; D003376:Counseling; D005260:Female; D033062:Friends; D006801:Humans; D008297:Male; D010379:Peer Group; D011320:Primary Health Care; D012309:Risk-Taking
Adolescent; Alcohol use; Peer risk; Prevention