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Background: There is growing optimism regarding the use of screening and brief intervention (SBI) to identify and reduce risk behaviors during adolescence. However, understanding successful SBI implementation remains unclear. We previously reported the effects of CONNECT, a school-based SBI, on reducing the primary outcome, the rate of monthly alcohol use among primarily American Indian (AI) and White high school students in the Cherokee Nation. In this paper, we describe the design and implementation process for CONNECT. Method: CONNECT was designed to reduce alcohol use with 2 key strategies: (1) SBI with motivational interviewing (MI), implemented by a school-based CONNECT coach, and (2) a media campaign. Results: Implementation results indicate that during each semester of the 2-1/2 years, between 73% and 100% of eligible students had at least one 15-minute meeting with a CONNECT coach. Postcards and posters with positive communication tips for parents were displayed in CONNECT communities. No statistically significant differences occurred between the CONNECT and control groups on the hypothesized intermediate outcomes. Conclusions: We describe implementation of a universal, school-based, culturally adapted SBI that was effective in reducing alcohol use among youth living in the Cherokee Nation. Schools provide an important context for universal delivery of SBI interventions, such as CONNECT, for diverse adolescent populations, including AI youth.

This study reports efforts to locate and survey participants in Project Northland Chicago (PNC), a longitudinal, group-randomized trial of an alcohol preventive intervention for racial/ethnic minority, urban, early-adolescents, 3-4 years following the end of the intervention. Data were collected annually among students from 6th-8th grade and then at age 17-18. Tracking procedures were used to maintain contact with participants and data collection consisted of three phases: (1) Internet- and mail-based surveys; (2) in-school survey administration; and (3) courier service delivery. Contact was lost with 11% of this urban cohort from the end of the PNC intervention activities through these longterm follow-up efforts, as indicated by returned locating postcards. Fifty-three percent of the cohort responded to the survey, the majority completing in Phase 1 of our data collection. Additional school-based and courier-delivery efforts increased our response rate by 11.5%. Costs per completed survey were $118 in Phase 1, $166 in Phase 2, and $440 in Phase 3. This study illustrates that it is possible to track and follow-up a high-risk cohort as they progress through adolescence, even with minimal efforts in intervening years. Lessons learned from this study may inform future efforts to track and collect longitudinal data among high-risk populations. (Contains 3 figures and 2 tables.)

Alcoholic beverage consumption among high school students has shifted from beer to liquor. The current longitudinal study examined the effects of beverage-specific alcohol use on drinking behaviors among urban youth. Data included 731 adolescents who participated in Project Northland Chicago and reported consuming alcohol in 7th grade. Logistic regression tested the effects of beverage-specific use on consequences (e.g., alcohol use in the past month, week, heavy drinking, and ever drunkenness). Compared to wine users, adolescents who reported drinking hard liquor during their last drinking occasion had increased odds of alcohol use during the past month (OR = 1.44; 95% CI = 1.01-2.05), past week (OR = 3.37; 95% CI = 1.39-8.18), and ever drunkenness (OR = 1.56; 95% CI = 1.07-2.29). Use of hard liquor was associated with increased risk of alcohol-related consequences. Early selection of certain alcoholic beverages (e.g., hard liquor) may result in negative health outcomes and problematic alcohol use over time. (Contains 2 tables and 1 figure.)

Objectives. We systematically reviewed the effects of alcohol taxes and prices on alcohol-related morbidity and mortality to assess their public health impact. Methods. We searched 12 databases, along with articles' reference lists, for studies providing estimates of the relationship between alcohol taxes and prices and measures of risky behavior or morbidity and mortality, then coded for effect sizes and numerous population and study characteristics. We combined independent estimates in random-effects models to obtain aggregate effect estimates. Results. We identified 50 articles, containing 340 estimates. Meta-estimates were r=-0.347 for alcohol-related disease and injury outcomes, -0.022 for violence, -0.048 for suicide, -0.112 for traffic crash outcomes, -0.055 for sexually transmitted diseases, -0.022 for other drug use, and -0.014 for crime and other misbehavior measures. All except suicide were statistically significant. Conclusions. Public policies affecting the price of alcoholic beverages have significant effects on alcohol-related disease and injury rates. Our results suggest that doubling the alcohol tax would reduce alcohol-related mortality by an average of 35%, traffic crash deaths by 11%, sexually transmitted disease by 6%, violence by 2%, and crime by 1.4%. (Am J Public Health. 2010;100: 2270-2278. doi:10.2105/AJPH.2009.186007)