Development and Feasibility of Parenting Now: A Digital Adaptation of a Parent-Based Intervention to Prevent Alcohol Use Among High School Seniors

Introduction: Parents are a powerful source of influence on adolescent alcohol use behaviors, despite growing independence and salience of peer relationships during this time. Unfortunately, prevention programs that incorporate parents are by and large non-existent for adolescents in high school and beyond. Studies have demonstrated evidence of efficacy for a parent-handbook targeting parents of college-bound students, but its potential for widespread impact and dissemination is limited by its narrow focus on college students and outdated format. The goal of this study was to demonstrate the feasibility of an interactive, digital parent-based intervention –Parenting Now (PN)– for parents of high school seniors to reduce alcohol use and related harm among teens during the post high-school transition, an established high-risk period.

Methods: First, parents of 16 to 20-year-old teens (N=278; 75% female; 76% White) were surveyed to measure how they discussed alcohol use with their teens and gauge their interest in the PN program. Next, the curriculum was adapted in collaboration with a technology firm to maximize interactivity and engagement. Finally, an independent usability test consisting of ten in-depth interviews was conducted with a convenience sample of participants to assess the three most common usability metrics including efficiency, effectiveness, and user satisfaction.

Results: Survey results yielded several themes, which were subsequently organized by parent communication style: 1) all parents gathered and shared information from the web or television; 2) partnership parents discussed the effect of alcohol on decision-making, addiction, sexual risk, social pressure and drinking, the effect of alcohol on the body, refusal strategies, keeping your drink "safe", alternative activities to drinking, and having a safety plan; 3) forceful parents discussed moderation of use, telling the teen to pace him or herself if drinking alcohol, and telling them to eat food when drinking alcohol; and 4) forceful and avoidant parents offered rewards for non-use. A digital prototype was built and consisted of the first two of three “core” modules. Unique features of the prototype included personalization of content by parent communication style, as well as provision of optional content on topics parents could choose to explore if interested. Overall findings from the usability test were positive, with mean ratings of the prototype at 4.8, where 5 was the highest, most positive rating.

Conclusion: All objectives were successfully accomplished. First, we verified parents of all communication styles use the web to gather information for conversations supporting the efficiency of the digital format. Second, our findings revealed not all parents addressed the same topics supporting the development of core modules (so all parents have the most critical elements), as well as optional modules (so that parents with specific interests will seek information on those topics). Third, we observed differences in the communication styles, which suggests that personalization is engaging. The independent evaluation and comments from the expert panel also support the usability of the prototype.