The role of biopsychosocial factors in classifying pain intensity across various chronic pain conditions.

During adolescence, most people have their first sip of alcohol. Early-onset alcohol use has been found to be an important risk factor for several health and social problems, such as academic problems, use of other substances, mental health problems and the obstruction of brain development. The life-time prevalence of alcohol use among youth in the Netherlands aged between 12 and 16 years old has decreased from 71.9% in 1999 to 47.5% in 2021. This decline is most likely due to the raised awareness of the negative consequences of alcohol use, especially for adolescents’ development. However, this decline occurred mainly until 2015, after which the decrease has come to a standstill. Furthermore, among drinkers, youth binge drinking (i.e. drink five glasses or more on the same occasion) is still high and increased from 64.1% in 2003 to 74.7% in 2021. Thus, it seems that new interventions are necessary to further decrease alcohol use among adolescents. The current study evaluates a community-based intervention called LEF (Dutch translation of ‘courage’), designed to prevent adolescent alcohol use. A previous evaluation showed that the co-creation work for LEF (combined with publicity) contributed to changes in the targeted mechanisms and outcomes. Specifically, involving stakeholders (e.g., policymakers, young people, schools) in the development of the intervention, while also disseminating media reports of the need for the intervention was associated with favorable outcomes, prior to any actual intervention being implemented. Adolescents (aged 15 and older) in the intervention condition perceived lower accessibility of alcohol in a formal setting and reported less positive rules and norms about adolescent alcohol use, compared to the control condition. However, among younger adolescents (< 15 years of age) in the intervention condition, more weekly drinking was reported compared to their peers in the control condition. This points to potential unintended effects of the LEF community-based intervention on youth drinking in younger age groups. This makes it imperative to investigate the effects of the intervention on the targeted mechanisms after the implementation of the intervention. The current report aimed to evaluate components of the LEF intervention to explore their impact on factors targeted by the intervention. The following factors within three domains (cf. socio-ecological model;) were targeted by the intervention, i.e. (a) adolescents (e.g. social norms relating to alcohol), (b) parents (e.g. rules about alcohol), (c) community (underage alcohol sales compliance, e.g. lower accessibility of alcohol). Positive alcohol attitudes can be a powerful predictor for greater alcohol consumption and earlier age of onset. Attitudes reflect associations learned through direct and indirect experiences. A longitudinal study on adolescents between 11 and 17 years old showed that positive attitudes towards alcohol were the strongest predictor of alcohol use compared to personality characteristics, drinking of peers and age. A systematic review on alcohol prevention programs showed that adolescents’ attitudes towards alcohol can effectively be targeted by interventions, making them a key target for intervention. Attitudes are determined by a person’s belief about the appeal and consequences of certain behavior (e.g. alcohol use) and they are shaped by their upbringing, socialization and their value system.