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Social cognitive theory: Adolescent alcohol initiation decision

Dissertation
Author: Skip Camp
Abstract:
Many adolescents in the US make the decision to initiate alcohol use in early adolescence despite much attention to intervention efforts to prevent such use. Hence, the research purpose was to explore factors involved in potentially influencing the adolescent alcohol initiation and abstinence decision processes. The target population for this two-phase study with adolescents ages 11 to 14 years old. Phase one exploratory interviews were conducted with thirteen adolescents after securing informed consent and assent. This phase results guided development of a survey instrument that was tested in Phase Two. The snowball sampling strategy was used for both phases as part of the sampling process in the selection of participants to the study. Phase One data revealed adolescents cognitively process the seven theory factors and use these factors to formulate decisions, specifically about alcohol initiation or abstinence. Phase Two snowball sampling techniques resulted in a sample of size N = 22. Phase Two results confirmed Phase One findings. Phase Two results also indicated adolescents have capacity for each of the seven theory factors and that this capacity can be trained on the alcohol initiation or abstinence decision. Phase Two results also revealed that adolescents who responded to the survey were often thinking about alcohol use, wonder what it tasted like, believed other kids their age consumed alcohol, and experienced conflict between the don't drink message often prescribed by adults to them. Future research suggest the use of a focus group setting could further understand and evaluate the above concerns raised in the study leading to adolescents use of alcohol.

v Table of Contents Acknowledgments........................................................................................................iv List of Tables.............................................................................................................viii

CHAPTER 1: INTRODUCTION........................................................................................1 Introduction to the Problem..........................................................................................1 Background of the Problem..........................................................................................4 Statement of the Problem..............................................................................................7 Purpose of the Study.....................................................................................................8 Rationale, Relevance, and Significance of the Study.................................................10 Research Question......................................................................................................11 Nature of the Study.....................................................................................................14 Definition of Terms.....................................................................................................19 Assumptions and Limitations.....................................................................................24 CHAPTER 2. LITURATURE REVIEW.........................................................................26 Introduction to the Literature Review.........................................................................26 Review of Critical Liturature......................................................................................30 Evaluation of Viable Research Designs......................................................................42 Critical Theoretical/Conceptual Debates....................................................................44 Bridging the Gap.........................................................................................................46 Chapter 2 Conclusion..................................................................................................46 CHAPTER 3. METHODOLOGY....................................................................................48 Introduction.................................................................................................................48

Researcher’s Philosophy.............................................................................................50

vi Research Design Model..............................................................................................53 Research Design Strategy Introduction......................................................................53 Research Design Strategy – Phase One......................................................................55 Research Design Strategy – Phase Two......................................................................64 Measures.....................................................................................................................69

Data Collection Procedures.........................................................................................72 Limmitations...............................................................................................................90 Internal Validity..........................................................................................................91 External Validity.........................................................................................................91 Expected Findings.......................................................................................................92 Ethical Issues..............................................................................................................92 Chapter 3 Summary....................................................................................................95 CHAPTER 4. DATA COLLECTION AND ANALYSIS...............................................97 Phase One Results.......................................................................................................97 Phase Two Results....................................................................................................134 CHAPTER 5. RESULTS, CONLCUTI ONS, AND RECCOMENDATIONS.............148 Study Summary.........................................................................................................148 Phase One Discussion...............................................................................................151 Phase Two Discussion..............................................................................................159 Concluding Discussion.............................................................................................160 Significance of the Study..........................................................................................161 Limitations................................................................................................................163 Recommendations for Future Research....................................................................163

vii REFREANCES...............................................................................................................165 APPENDIX A. PHASE ONE INTERVIEW GUIDE.....................................................170 APPENDIX B. PHASE TW O SURVEY INSTRUMENT..............................................176

viii List of Tables Phase One Table 1. Completed Interview Gender Distribution .................................................99 Table 2. Completed Interview Age Distribution .......................................................99 Table 3. Completed Interview Grade Distribution ...................................................99 Table 4. Completed Interview Household Income ...................................................99 Table 5. Completed Interv iew State Distribution .....................................................100 Table 6. Completed Interview Regional Distribution ...............................................100 Table 7. Completed Interview Mode of Interview ....................................................101 Table 8. Completed Interv iew Date Distribution ......................................................101 Table 9. Interview Completion Times in Minutes ....................................................101 Table 10. Alcohol Initiation Phase ............................................................................102 Table 11. Initiation Reason .......................................................................................102 Table 12. Abstention Reason ....................................................................................102

Phase Two Table 13. Completed Intervie w Gender Distribution ...............................................135 Table 14. Completed Interv iew Age Distribution .....................................................135 Table 15. Completed Interv iew Grade Distribution .................................................135 Table 16. Completed Interview Household Income .................................................135 Table 17. Completed Interv iew State Distribution ...................................................136 Table 18. Completed Interview Alcohol Initiation Phase .........................................137

1 CHAPTER 1: INTRODUCTION

Introduction to the Problem

Delaying adolescent alcohol initiation is a national c oncern and challenge. The legal age to purchase, use, consume, or posse ss alcohol in all 50 stat es is 21 years of age (NIAAA, 2007), yet in 2003, the Centers fo r Disease Control and Prevention Middle School Youth Risk Behavior Surveillance Surv ey (YRBS) reported that 28% of students in sixth grade, 43.8% of students in seventh grade, and 53.8% of students in eighth grade had consumed alcohol (CDC, 2007). As adolescen ts matured into adults, early alcohol initiation increased five-fold their probability for developing alcohol pr oblems in the areas of health, socialization, and academic pursuits, as well as encounteri ng serious life-altering legal sanctions, incarceration, a nd even death (SAMHSA, 2007). The social cognitive theory offers a reci pe for behavior modification, but more importantly, for sustained behavior change. Th is theory is grounded in seven cognitive factors, including (a) self-efficacy, (b) symbo lizing capacity, (c) vicar ious capability, (d) forethought capability, (e) self-r egulating capability, (f) self-r eflective capability, and (g) outcome expectancy (Bandura, 1986). These seven factors form the foundation for an interactive relationship of person, behavior, an d environment to direct behavior (Bandura, 1986, 1977, 1978, 2001). Research exists that demons trates adults respond to interventions grounded in one or more social cognitive theory factors (Bandura, 1999, Graves, 2003, Hallam & Petosa, 2004, Keller, Fleury, Gregor-Holt & Thompson, 1999). Research also exists demonstrating that social cognitive th eory-driven adult intervention successes do not

2 necessarily translate to adolescents by applyi ng the same theory-driven principles (Callas, Flynn, & Worden, 2004; Flynn, Worden, B unn, Dorwaldt, Dana, & Callas, 2006; Rinderknecht & Smith, 2004). When specifically focused on adolescents, social cognitive theory supported adolescent research predom inantly produces margin al support for theory factors, but promising correlation for some individual factors (Sharma & Petosa, 1999; Rinderknecht & Smith, 2004; Flynn et al., 2006). Re stricting this focus to adolescents and narrowing it to alcohol, research is just star ting to distinguish betw een onset, the focus of this research, and use, specifica lly for adolescents ages 11-14. Literature has demonstrated that adol escent alcohol use or initiation may be influenced by a number of contributing f actors including parenting, family, siblings, gender, socioeconomic factors, living envir onment, community, perceptions, expectations, problem-solving skills, exposure, risk tolerance, psychiatric factors, psychosocial factors, social networks or the lack thereof, and othe rs; or the interaction of any combination of factors (Donovan, 2004; Amonini & Donova n, 2005; Deas & Thomas, 2002; Perry, Williams, Komro, Veblen-Mortenson, Stigler, Munson, et al., 2002; Nash, McQueen & Bray, 2005; D’Amico & Fromme , 2002; Komro, Perry, Williams, Stigler, Farakhsh & Mortenson, 2001). What is not known and is an assumption of this research is that regardless of influencing factor s, at the very core of any action is a decision to act. Therefore, before the social cognitive theory can be evaluated for its behavioral change model applicability to adolescen ts, it must first be established that adolescents have the capacity for each of the seven theo ry factors, the goal of Phase One. Once this is explored, each social cognitive factor must then be ma pped to each cognitive decision factor and an

3 understanding gained concerning how these factors are involved or may influence the onset or abstention decision, the goal of Phase Two. This research seeks to understand how adolescents describe the seven social cognitive theory factors as they relate to the initiation or abstention of alcohol use. In addition, it will attempt to explore adoles cent capacity for executing any one or combination of these factors, sp ecifically in relation to delaye d onset of alcohol use. Both desired outcomes from this re search may service a call by researchers not only to examine the relationship of social cogni tive theory factors and thei r adolescent alc ohol use onset influence, but also to offer some small insight into the call for adolescent research focused in this area with adolescents, the res earch gap (Donovan, 2004; Bandura, 1999; Amonini & Donovan, 2005; Deas & Thomas, 2002; Perry et al., 2002; Komro et al, 2001). This research is expected to contribute to a better understanding of adolescent decision factors involved in alcohol initiation or abstention, specifically focused around the seven social cognitive theory fact ors. It is also expected that as a result of this research, adolescent capacity for social cognitive theory-grounded intervention designs may be better informed. Lastly, this research will be an instrument for surveying larger groups of adolescents to better understand if inform ation learned during in-depth interviews translates to a larger gr oup of adolescents. Ultimately, the inte nt of this research is to assist practitioners in identif ying adolescents’ predisposition for early alcohol use onset so that services, education, and interventi ons may be better designed to ta rget alcohol use triggers. To service these goals, two phases are required. Phase One, grounded in the qualitative methodology, is focused on conduc ting in-depth exploratory adolescent interviews guided by themes developed from th e literature. Informati on learned as a result

4 of Phase One will guide survey question development. Survey question development will support survey instrument development, and onc e the instrument is developed, it will be reviewed by an expert panel. The product of Phase One will be an expert-reviewed survey instrument. The purpose of Phase Two, grounde d in the quantitative methodology, is to test the instrument developed in Phase One by collecting data from a larger sample of adolescents ages 11 -14 and analyzing that da ta to assess instrument performance and to gain new knowledge about this population in relation to how they think, what they may know, and what their percepti ons are about alcohol. This dissertation may also identify, or na rrow, areas for further study, specifically in the area of adolescent intervention design for alcohol initiation or use. Results may reveal adolescent onset factors not previously considered, and may shed a glimmer of light on the feasibility of applying the social cognitive theory to adolescent intervention design. A targeted focused effort with adolescents may service the growing demand for study in this area. Finally, it is hoped that this re search may contribute in some small way to servicing policy agenda calling for improve d healthy living and quality of life for Americans, including adolescents (D HHS Healthy People, 2010: 2007). Background of the Problem

In 2005, 25% of seventh and eighth grader s reported engaging in binge drinking (Guilamo, Jaccard, Turrisi, & Johansson, 2005). Adolescents who drink before the age of 15 are five times more likely to develop a drinking problem (SAMHSA, 2007). Problem drinking is associated with health, behavior , and social problems, resulting in over 100,000 youth deaths within the United States a nnually (Grant & Dawson, 1997; O’Connor, 2007).

5 Research such as this demonstrates that legislated efforts to enforce abstinence until 21 years of age are not effective with adol escents; adolescents are engaging in early alcohol initiation; early initiation may lead to problem drinking, increa se risks, behavioral problems, and serious physical and mental harm , or even death. To limit adolescents’ risk exposure from consuming alcohol, early effective intervention is required. Youth targeted alcohol use and delayed ons et intervention strategies have focused on psychological, sociological, environmental, behavioral, and educat ion strategies to effect change (Williams & Perry, 1998; DARE, 2007; Wilhelmsen, Laberg & Klepp, 1994). These types of programs, or interventi on strategies, have focused primarily on linear input-output model (Williams & Perry, 1998). In the past, these strategies were designed to assure or transfer perceived alcohol use resistan ce skills, such as knowledge and problem solving (DARE, 2007; Amonini & Donavan, 2005). Recent research has led to more integr ated intervention strategies using a combination of cultural, community, and educat ion, for example the Northland Project, to support intervention development for alcohol and drug use (Williams & Perry, 1998; DARE, 2007). Although these type s of strategies have demons trated promise in periodic suspension of youth alcohol use, they have faile d to realize sustained abstinence or delayed onset, specifically for adolescents (Williams & Perry, 1998), one goal of this research. To achieve past results, researchers ha ve focused on effects of alcohol use, prevalence rates, alcohol use patterns, predic tive use factors, interv ention strategies, and problems resulting from alcohol use in a dolescents, youths, young adults, and adults (Williams & Perry, 1998; Wilhelmsen et al., 1994; SAMHSA, 2007; CDC 2007). They have also focused on psychological factors, such as peer infl uence, self-worth,

6 assertiveness, outcome expectancy, moral perceptions, and self-efficacy influencing alcohol use in adolescents, youths, young adults, and adults (Williams & Perry, 1998; Radin, Neighbors, Walker, Walker, Marla tt & Larimer, 2006; Bandura, Caprara, Barbaranelli, Gerbino & Past orelli, 2003; and Donavan & Amonini, 2006). Finally, they focused primarily on youth and young adults, on us e rather than initiat ion, and have relied on the assumption of transferability from drugs to alcohol and from youth to adolescents to formulate assumptions about adolescents that have guided intervention strategy designs (Donavan & Amonini, 2006). Doing so has create d a gap in the litera ture specifically focused on adolescents ages 11-14, the onset ages (CDC, 2007), and decision factors involved in or influencing th e onset of alcohol use. This research seeks to service the resear ch gap by making a small, but potentially valuable contribution. First, by focusing sp ecifically on adolescents and the point of alcohol use initiation, then the decision proce ss, and finally by seek ing to understand what role, if any, the seven social cognitive theory factors have in that pr ocess. Exploring these areas may also serve to better inform th e design of future adolescent intervention strategies; specifically strategies that target the onset of alcohol use.

7 Statement of the Problem

The research literature clearly demonstr ates that many adolescents make the decision to initiate alcohol use in early adol escence (CDC, 2007) despite much attention to intervention efforts to prevent such use. It is not clear what factors contribute to the adolescent alcohol initiation deci sion, and this is the area that needs to be researched in order to understand this problem to the extent th at more effective, or targeted, interventions can be developed. Why do youth make the decision to dri nk alcohol in early adolescence? How do adolescents describe the factors that contribute to th is decision? One theory that might help both in understanding and interv ening or predicting early alc ohol initiation is the social cognitive theory. A behavioral change model, the social cognitive theory is grounded in seven factors, they are, (a) self-efficacy, (b ) symbolizing capacity, (c ) vicarious capability, (d) forethought capability, (e) self-regulating capabil ity, (f) self-reflectiv e capability, and (g) outcome expectancy (Bandura, 1986). The primary research problem is a lack of information about the adolescent alcohol use initiation or abstinence deci sion. The secondary research problem is to understand how adolescents formulate their alcohol use initia tion or abstinence decision and what theory factors influence, or are involve d in that decision process. The tertiary research problem is to understand how adolescents describe the seven social cognitive factors, specifically related to this decision. The quaternary probl em is exploring the role and extent of involvement of any or all of these seven fact ors in the adolescent alcohol initiation or abstinence decision.

8 To service these objectives, this resear ch is focused on exploring adolescent perceptions of theory factors influencing the alcohol initia tion decision. This information will then be used to tailor survey question development. Finally, the developed survey instrument will be tested to a ssess its ability to peer into the adolescent world of alcohol initiation or abstention, forming a broader pers pective on the process that leads to onset. Purpose of the Study

The primary purpose of this research is to explore adolescent alcohol initiation or abstinence decision factors in order to understa nd what role the seven social cognitive factors have in this process. Secondary will be a defining or describing of the seven theory factors through an adolescent lens. Therefore, this resear ch is grounded in the social cognitive theory, guided by a postpositive pers pective, and uses two methodologies to support its mixed-methods design. Each method is implemented using two phases, one qualitative and the ot her quantitative. Phase One relies on in-depth exploratory in terviews with 14 adolescents ages 11-14 years of age. This range of ages was chosen because previous research suggests that the initiation point for adolescent alcohol use fa lls within grades 6 and 7 (CDC, 2007). The primary purpose of Phase One is to explore adolescent alcohol initiation and abstinence habits in the hope that decision factors w ill emerge from discussions. This type of information, it is believed, may support evaluati on of the usefulness of applying the social cognitive theory to interven tion design (Berg, 2007). Phase On e data collection is a semi- structured individual case study model that relies on in-dep th interview (Berg, 2007). The goal of each interview is to explore each of the seven factors and th eir adolescent elements,

9 and to become immersed in adolescent cognitive processing of each theory factor in general, and specifically as it is rela ted to alcohol init iation or abstention. Phase One sampling strategy is a modifi ed purposeful design, incorporating snowball sampling techniques for selecting research participants. Collected data will be organized around themes, using the seven theory factors as the prim ary themes. Emerging themes, if identified, will be evaluated for their relation to or impact on primary themes, theory factors, and specifically on the alc ohol initiation or abstin ence decision process. Once themes are created, they will guide development of survey questions. Survey questions will be organized by theory themes . The instrument will be reviewed by an expert panel and their suggestions reviewed by the researcher, who will decided which adjustments to make to the instrument. To es timate burden, the instrument will be pretested with two population members. The product of Ph ase One is the expert reviewed pretested survey instrument. The purpose of Phase Two is to pilot te st the survey instrument. Phase Two, grounded in the quantitative methodology, uses surv ey to conduct a Pilot Test. The sample size will be n=25 and the population is defined as adolescent’s ages 11-14 years of age. The sampling method is non-probability. This sampling method will not produce representativeness. The snowball sampling stra tegy will incorporate posting of flyers in public places, or places that give permission to post, and distributed via email to personal and professional colleagues of the researcher. Flyers distributed via email will contain a request that the receiver forward the message to others they may know. The purpose is to assess instrument performance, validation of Phase One result s, and to assess reliability and data collection methods (Sproull, 2002). Ho wever, it is expected that validation and

10 reliability may only be informed because of the small sample size. From the Pilot Test, it is believed that the survey instrument will produ ce useful data for understanding whether or not Phase One results translate to a larg er segment of the adolescent population. In addition, it is hoped that Phase Two will enlight en the feasibility of applying the social cognitive theory to adoles cent intervention design to delay alcohol initiation. Rationale, Relevance, and Significance of the Study

The importance of this research is fo und in its attempt to extend knowledge or advance theory. The theory this research seeks to advance is the social cognitive theory, by exploring its application to adolescent al cohol abstinence. The knowledge it seeks to extend is an understanding of adolescent decision factors involved in alcohol initiation or abstinence. It is assumed that the Human Services industry dedicates countless human capital and economic resources to assisting adolescents who engage in alcohol use, particularly as patterns of use mature. Th is assumption is supported by the dedicated efforts to research adolescent alcohol use a nd onset (Williams & Perry, 1998; Radin et al., 2006; Bandura et al., 2003; Donavan, 2004; Warn er & White, 2003). If these types of resources were better informed, clients may be better served, or at th e very least, spared exposure to alcohol-related risky behavior or related social and development consequences, even death. This research is al so important because at the fundamental core stands the possibility of unloc king a better way to inform adol escents how to resist alcohol initiation or use. Deas and Thomas (2002) characterize adol escence as a changing time that includes dynamic influences from multiple internal and external forces. Amonini and Donovan

11 (2006) found that by the age of 14, youths can per ceive the use of alcohol and illegal drugs as morally and legally wrong. Reyna and Farely (2006) found that adolescents are capable of rational decision making, that greater risk aversion is adaptable dur ing adolescence, and that the adolescent decision processes that suppo rt risk aversion are more advanced than those for risk taking, specifically for alcohol and drug use (p.1.). They also found a lack of adolescent risk behavior, speci fically for alcohol initiation and use, research that was theory driven. Clark, Vanyukov, and Cornelius ( 2007) recognized researchers’ efforts to understand behavioral issues asso ciated with adoles cent alcohol use, bu t called for further research into the mechanism that drives these behaviors. Warner and White (2003) suggested further research is required that focuses on the a dolescent alcohol initiation and Williams and Perry (2002) confirmed this position. This research seeks to service the areas cal led for by scholars. First, it is focused on adolescents 11-14 years of age. Second, it is th eory-driven, relying on the social cognitive theory to inform theme construction. Third, it seeks to understand the mechanism that triggers action, or the decision to act. Fourth, it seeks to expand theory and inform knowledge, specifically focused on factors involve d in the adolescent al cohol initiation or abstinence decision. Finally, this research seeks to shed light on the possibility of using the social cognitive theory to guide development of intervention strategies focused on delaying adolescent alcohol initiation. Research Question

The primary research problem is to explor e factors involved in, or that influence, the adolescent decision to initiate, or not to initiate, alcohol use. The secondary research

12 problem is to explore the extent to which the social cognitive theory factors are present or influence this decision. To develop research questions, the type desired for each phase was explored. For Phase One, the goal is to explore adolescent d ecision factors involved in or influencing the onset of alcohol use. Mertens (2005) implies th at descriptive resear ch questions produce information about what is or has been happening in relation to the target of the research (p. 107) and notes these types of questions can also be used to estimate prevalence. Gall, Gall & Borg (2007) confirm this us e of descriptive research for educational settings and extend the definition to include social phenomena composed of their form, structure, activity, and relationships to other phenomena. Because Phas e One is focused on exploration rather than prevalence, it is descriptive research. Normative research extends descriptiv e research by using comparison to an expected finding (Mertens, 2005). An expect ed result of Phase One research is the identification and evolution of an expected finding, or findings for comparison with Phase Two (Mertens, 2005). Therefore, Phase Tw o touches on normative research; however, because instrument development will evolve fr om Phase One research, the results are not known at this time. Therefore, Phase Two will al so be descriptive research and be used to pilot test the newly designed Phase One instrument. Phase One Problem Statement To explore how adolescents set about deciding whether to drink or not to drink alcohol, how they describe the seven soci al cognitive factors, a nd the extent to which the seven social cognitive factors are represented in these decision factors.

13 Phase One Primary Research Question

What is the adolescent capacity for each of the seven social cognitive theory factors and how is this capacity represented in the alcohol initiation or abstention decision? Phase One Secondary Research Questions

What roles do the seven social cognitive theory factors play in the adolescent alcohol initiation or abstention decision, and to what extent? How does the theory factor reciprocal determinant mitigate theory factors in the adolescent alcohol initiati on or abstinence decision? Phase Two Problem Statement The primary problem in Phase Two is to test the newly-created survey instrument to better understand if Phase One results tr anslate to a larger se gment of the population using a pilot test. Primary Question

What is the relationship between adolescen t alcohol initiation decision factors and social cognitive theory factors? Secondary Questions How do adolescents describe social cogni tive theory factors in general, and specifically in relation to the alcohol initiation or abstinence decision? What gender differences are there in the wa ys adolescents descri be social cognitive theory factors in general, and specifically in relation to the alcohol initiation or abstinence decision?

14 What are the differences between those w ho have initiated alcohol use and those who have not in the way they describe social cognitive theory factors in general, and specifically in relation to the alcohol initiation or abstinence decision? What is adolescent capacity for each of the seven social cognitive theory factors and how is this capacity represented in the alcohol initiation or abstention decision? Nature of the Study

This research relies on a two phased mixed-methods approach of qualitative exploratory in-depth interviews to develop th e instrument, and a quantitative approach to pilot test the developed survey instrument. The population is 11-, 12- , 13-, and 14-year-old adolescents residing in the Un ited States. The target populati on is 11-, 12-, 13-, and 14- year-old adolescents residing in the Unite d States who agree to participate. For Phase One of this research, a modified purposeful sampling design incorporating snowball sampling techniques for se lecting research partic ipants is used. To ensure that completed interviews mirror national prevalence for alcohol initiation, purposeful sampling is used if at the midway point or after eight completed interviews, 30% have not initiated. Purposeful sampling t echniques require targeted selection based on a difficult to reach target population. However, because screening is not used until the end of the interview, these effort s will be directed towards sampling from groups that may have a high incidence of initiation or use, for exam ple, lower income areas or areas with high incidence reports of use. Using this method should achieve a reasona ble representation of those who have and have not drunk alcohol. Reasonable represen tation is considered to be 30% who have

15 initiated alcohol use and 70% who have not (CDC, 2007). Non-probability purposeful sampling techniques are ideally suited for Ph ase One to accommodate a range of methods to reach highly specified or difficult to reach populations (Neumann, 2006). The sample size for Phase One is n=14. This sample si ze will accommodate analysis of two groups within the guiding principles of the qualitative methodology, but will not support generalization to the population (Neuman, 2006). Sampling and Response Rate For Phase One, a non-probability sampling strategy modified snowball technique is used that incorporates a purposeful technique for initiators if at the midpoint completed interviews do not contain at least 30% who ha ve initiated alcohol use. To accomplish the snowball segment, the researcher will com pose a list of all personal and professional contacts. This list will be stratified by contact group and within each group, the lists randomly assigned to three waves. Each wave is expected to contain one hundred contacts. The researcher will first release wave one to assess cooperation. If releasing wave one does not produce desirable results, or interested contacts, subsequent waves will be released, as needed. For Phase Two, the Pilot Test, a non-proba bility sampling strategy is also used. Non-probability sampling is suitable to pilo t test the survey instrument because the researcher is not trying to achie ve representativeness, but rather gain preliminary insight to validity and reliability and to assess instrume nt performance with a larger segment of the target population. The Phase Two sampling strategy will incorporate the snowball technique used in Phase One, but will be supplemented with a purposeful element, posting.

Full document contains 191 pages
Abstract: Many adolescents in the US make the decision to initiate alcohol use in early adolescence despite much attention to intervention efforts to prevent such use. Hence, the research purpose was to explore factors involved in potentially influencing the adolescent alcohol initiation and abstinence decision processes. The target population for this two-phase study with adolescents ages 11 to 14 years old. Phase one exploratory interviews were conducted with thirteen adolescents after securing informed consent and assent. This phase results guided development of a survey instrument that was tested in Phase Two. The snowball sampling strategy was used for both phases as part of the sampling process in the selection of participants to the study. Phase One data revealed adolescents cognitively process the seven theory factors and use these factors to formulate decisions, specifically about alcohol initiation or abstinence. Phase Two snowball sampling techniques resulted in a sample of size N = 22. Phase Two results confirmed Phase One findings. Phase Two results also indicated adolescents have capacity for each of the seven theory factors and that this capacity can be trained on the alcohol initiation or abstinence decision. Phase Two results also revealed that adolescents who responded to the survey were often thinking about alcohol use, wonder what it tasted like, believed other kids their age consumed alcohol, and experienced conflict between the don't drink message often prescribed by adults to them. Future research suggest the use of a focus group setting could further understand and evaluate the above concerns raised in the study leading to adolescents use of alcohol.