Social Factors and Prevention Interventions: Research Annual Report 2003

Section Head: Dr. Kathryn Graham

In the Social Factors and Prevention interventions Section, our research identifies environmental factors (e.g., social, physical, cultural) and individual factors (e.g., personality, predisposition, risk, protection) that are associated with mental health and substance use problems. We then use this knowledge to develop and evaluate research-driven interventions to reduce the occurrence and severity of such problems.

Current programs of research in this section focus on gender and alcohol, preventing barroom aggression, alcohol-related aggression among students and other young adults, school-based and workplace-based prevention programs, healthy psychosocial development and childhood risk and preventive factors, parenting and school culture, and preventing and treating problem gambling.

A National Survey on Alcohol and Gender: the GENACIS Project

The Canadian Institutes of Health Research have funded Dr. Kathryn Graham's national survey on gender and alcohol. This survey, co-led by Dr. Andrée Demers from the University of Montreal and involving collaboration with researchers from across Canada, is part of a multinational collaboration known as the GENACIS (Gender, Alcohol and Culture, an International Study) Project, involving about 30 countries from around the world.

In this study, we will examine the relationship between gender and drinking patterns, as well as the interaction of gender and alcohol consumption related to issues such as social and health consequences of drinking, partner violence, depression and social roles, both at the national level and as part of cross-national comparisons.

Families Working Together

Led by Dr. David DeWit (camh) and Drs. Thomas Nochjaski and Andrew Safyer (University at Buffalo), the Families Working Together Project, funded by the U.S. National Institute on Alcohol Abuse and Alcoholism (NIAAA), has completed its third year.

The goal of the project is to evaluate the effectiveness of the Strengthening Families Program, a program designed to build resiliency among families struggling with alcohol problems. We have recruited families from 10 alcohol and drug treatment agencies (five in Ontario and five in New York); 277 of our target of 360 Ontario families are already enrolled. Preliminary results -- of the impact of the program on children's social and coping skills -- were presented at an international conference this past June.

Reducing Aggression and Injury in Bars

Dr. Kathryn Graham heads an international team of investigators conducting a randomized control study, funded by the NIAAA, to evaluate the effectiveness of the Safer Bars program on reducing aggression and injury related to drinking in licensed premises.

The impact of the Safer Bars program was assessed by teams of trained observers, who conducted over 1,300 nights of observation in study bars and clubs before and after the intervention.

The study found that bars and clubs that participated in the Safer Bars program showed a significant decrease in physical aggression, especially more severe aggression such as punching and kicking, when compared with bars and clubs in the control group.These results have generated international interest leading to a number of invited presentations around the world.

Promoting Healthy Childhood and Adolescence

Dr. DeWit and collaborators from CAMH, and from universities and programs across Canada, have been funded by the Hospital for Sick Children Foundation (Innovative Grants Competition) to study the feasibility of conducting a national evaluation of the Big Brothers/Big Sisters adult mentoring program.

In 2002, Dr. DeWit and his colleagues published a report summarizing the results of the School Culture Project. This project included a survey of over 2,400 students at 22 high schools in Ontario to study the impact of school culture on academic achievement, behavioural functioning and mental health of high-school students.

Findings revealed that a positive social environment at school contributes to feelings of belonging and acceptance among students, and these feelings, in turn, are associated with strong academic performance, positive mental health and minimal behavioural problems.

Fairness and the Human Spirit at Work

Dr. Martin Shain and Ms Helen Suurvali have completed the development and preliminary evaluation of the Neighbour at Work Project. As part of this project, employees volunteer to participate in exercises that help them revisit the fundamental promises of their employment relationships.

The test site for this project was the federal department of Human Resources (HRDC) in Prince Edward Island. Our preliminary evaluation shows that the concept and practice of the Neighbour at Work idea have great appeal for all levels of staff and that the surveys and workshops can successfully raise and resolve issues about the quality of the employment relationship. This idea needs the full support of senior management and unions if it is to have credibility and power.

The project is now entering a quasi-experimental phase, in which staff in several worksites will be trained to conduct surveys and workshops themselves. We will then be able to compare the effectiveness of their interventions with worksites that do not adopt the program. Outcome measures will include indicators of improved mental health.

In this area, we have also prepared an extensive review of the scientific literature on mental health in the workplace for Bill Wilkerson's Global Business and Economic Roundtable on Addictions and Mental Health.

Understanding and Preventing Problem Gambling

Over the past several years, Dr. Nigel Turner has led a program of research into the development of gambling problems and applying this knowledge to prevention and treatment.

Two completed studies (Winners and Pathways) have shown that problem gambling results from a combination of impulsivity, pre-existing unhappiness, over-reliance on escape as a means of coping with stress, erroneous beliefs about one's ability to win and the experience of winning early in one's gambling career. Our research suggests that none of these factors is necessary for development of a gambling problem; however, the more these factors are present, the higher the risk of gambling problems.

This knowledge on the causes of problem gambling is also being applied to the development of a problem gambling prevention curriculum. In collaboration with CAMH's Problem Gambling Service, Dr. Turner has helped develop and evaluate a curriculum resource of information on problem gambling. Dr. Turner has recently completed an evaluation of the retention of information from this curriculum in a school setting, which found significant improvements in the students' understanding of randomness and coping skills.

Dr. Turner's work has also included developing new psychometric tools to measure erroneous beliefs about random events (Random Events Knowledge Test), gambling experiences (Winning Experiences Questionniare) and experiences of mood across the lifespan (Life Charts).

Dr. Paul Tremblay has been funded by the Canadian Institutes of Health Research to conduct a study at four universities, looking at alcohol and aggression among students.

Using a Web-based questionnaire, our researchers will study students' perceptions about the effects of alcohol intoxication on aggression, and determine if these perceptions are influenced by dispositions toward aggression and various socio-environmental factors within the drinking environment.

A pilot study, conducted by Ms Laura Ewart under Dr. Tremblay's supervision as part of her fourth-year honours thesis, revealed that students think intoxication affects aggression in certain situations and that their likelihood of becoming aggressive is influenced by motivational factors, such as self-confidence, in provoking situations and level of anger.

Ms Samantha Wells is conducting secondary analyses of data from young adults who participated in the U.S. National Longitudinal Survey of Youth. The main focus of her analyses will be to explore the roles of drinking patterns, drinking contexts, social roles adopted during young adulthood and individual characteristics, including early anti-social behaviour and risk-taking, in terms of their association with alcohol-related aggression.

This extension of Ms Wells's previous research on alcohol-related aggression is part of her PhD dissertation in the Department of Epidemiology and Biostatistics at the University of Western Ontario. She presented preliminary results at a recent international conference.

Personality, Provoking Situations and Aggression

Dr. Paul Tremblay, with others at CAMH and the University of Western Ontario, is investigating the role of personality in responding to provoking situations. In this work, researchers will develop a taxonomy of aggression-provoking situations, covering domains such as workplace aggression, schoolyard bullying, intimate conflict and driver aggression.

Our research papers and reviews have been presented at conferences and submitted for publication; Ms Mirjana Belchevski has completed an empirical study on this topic as part of an honours thesis.

Social Factors and Prevention Interventions: Research Annual Report 2003

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