Reinforcing Alcohol Prevention (RAP) Program: a secondary school curriculum to combat underage drinking and impaired driving.

Reinforcing Alcohol Prevention (RAP) Program: a secondary school curriculum to combat underage drinking and impaired driving. ABSTRACT The Reinforcing Alcohol Prevention (RAP) Program is an alcoholprevention curriculum developed in partnership with secondary schools toserve their need for a brief evidence-based, and straightforward programthat aligned with state learning objectives. Program components includedan educational lesson, video, and interactive activities deliveredduring a 90-minute period. RAP Program modules were delivered to 1,7208th, 9th, and 10th graders at four schools during health courses.Dependent T-tests on a pre-post alcohol-related knowledge surveyadministered to a subset of classes (N = 668) indicated that students'knowledge and awareness of alcohol-related risks and consequencesincreased significantly from pretest pre��test?n.1. a. A preliminary test administered to determine a student's baseline knowledge or preparedness for an educational experience or course of study.b. A test taken for practice.2. (M = 84. 96, SD = 8. 87) toposttest post��test?n.A test given after a lesson or a period of instruction to determine what the students have learned. (M = 97.25, SD = 12.39). The program was well received andshowed statistically significant improvements in students'knowledge and awareness of alcohol's harmful effects. Keywords: Alcohol education program, schools, underage drinking,driving under the influence ********** Alcohol use by underage drinkers is a persistent public healthproblem in the United States United States,officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area. , and alcohol is the most commonly used drugamong adolescents (Henry, Slater, & Oetting, 2005; Komro, 2002).Nearly 40% of children start drinking by the eighth grade, and 55% ofhigh school seniors report they have been drunk at least once in theirlifetime (Bandy bandy/ban��dy/ (band��e) bowed or bent in an outward curve. , 2008; L. D. Johnston, O'Malley, Bachman, &Schulenberg, 2009; National Institute on Alcohol Abuse and Alcoholism[NIAAA NIAAA National Institute on Alcohol Abuse and Alcoholism (National Institutes of Health)NIAAA National Interscholastic Athletic Administrators AssociationNIAAA Northwestern Illinois Area Agency on Aging ], 2004/2005b; O'Malley, 1998). While adolescents drink lessfrequently than adults, they drink more per occasion, consuming onaverage four to five drinks (NIAAA, 2004/2005b). Substance abuse amongteens is related to academic and social problems, unintentionalinjuries, homicides and suicides, depression, conduct disorder Conduct DisorderDefinitionConduct disorder (CD) is a behavioral and emotional disorder of childhood and adolescence. Children with conduct disorder act inappropriately, infringe on the rights of others, and violate the behavioral expectations of , memoryloss, unplanned and unwanted sexual activity, alterations in braindevelopment, and future alcohol dependence (Bandy, 2008; Brown, 2008;Griffin, 2004; Hingson, 2003; NIAAA, 2004/2005a, 2004/2005b, 2006;Spear, 2002). Additionally, drinking early in life is also associatedwith an increased risk of developing an alcohol use disorder at sometime during the life span (NIAAA, 2004/2005b). Direct consequences of drinking include driving under the influenceof alcohol (DUI) and other risk-taking behaviors. Alcohol is a leadingcontributor to injury/death, and is the main cause of death for peopleunder age 21 (NIAAA, 2004/2005b). Despite well-needed increases inperception of risk and stricter laws and penalties, DUI andmisperceptions regarding alcohol-impaired driving continue among highschool and college students. Zero tolerance The policy of applying laws or penalties to even minor infringements of a code in order to reinforce its overall importance and enhance deterrence.Since the 1980s the phrase zero tolerance has signified a philosophy toward illegal conduct that favors strict imposition of laws (e.g., .02% BAC BACabbr.blood alcohol concentration limitsfor under age 21) in the United States are associated with a 20%reduction in single vehicle nighttime crashes among drivers age 15 to 20years (DeJong & Hingson, 1998). Yet, alcohol-involved crashes remaina leading cause of morbidity and mortality Morbidity and Mortality can refer to: Morbidity & Mortality, a term used in medicine Morbidity and Mortality Weekly Report, a medical publication See alsoMorbidity, a medical term Mortality, a medical term . Numerous education programshave been developed to raise awareness and combat DUI and otheralcohol-related risks. This paper details the development andapplication of one program in a locality that suffered from poorutilization of existing model programs. Existing School-based Programs Preventing the emergence of alcohol-related risk-taking behaviorsand reducing the severity of existing behaviors are essential during theeighth through tenth grades when students are receiving theirdriver's licenses and confronting extreme levels of peer pressure(O'Malley, 1998). Numerous school-based programs have emerged overthe years to combat underage drinking and driving. Recent evidence hashighlighted a number of factors that strengthen the efficacy ofschool-based substance abuse prevention/education programs (e.g., Komro,2002; Tobler, 1992; Tobler et al., 2000; Tobler & Stratton, 1997).It is advised that school-based curricula should (a) be based inbehavioral theory; (b) focus on development of resistance skills; (c)emphasize normative education; (d) use developmentally appropriateinformation; (e) incorporate broad-based skills training; (f) useinteractive teaching techniques; (f) include multiple sessions overmultiple years; (g) provide teacher training and support; (h)incorporate family and community involvement; and (i) be culturallysensitive (Komro, 2002). Interactive curricula such as role-playing,discussions, and small-group activities are more effective thannoninteractive curricula at preventing alcohol, tobacco, and other druguse among youth (Komro, 2002; Tobler et al., 2000; Tobler &Stratton, 1997). Unfortunately, school-based efforts are not always developed inaccordance with these guidelines; and even when they are, they are notalways user-friendly for the schools. For instance, Students AgainstDestructive Decisions (SADD SADD Students Against Destructive Decisions (formerly Students Against Drunk Driving)SADD Students Against Drunk Driving (now Students Against Destructive Decisions)SADD Sexual Attention Deficit Disorder ) is popular in high schools, but there islittle evidence of effectiveness beyond increased awareness (Klitzner,Gruenewald, Bamberger, & Rossiter, 1994). Other programs do haveempirical support as model programs but are underutilized by schools.Underutilization is due in large part to the increasing demand onschools to focus their time and efforts on the "basics" pushedby education benchmarks (Kaftarian, 2004; Thaker, 2008). For instance,Substance Abuse and Mental Health and Human Services Noun 1. Health and Human Services - the United States federal department that administers all federal programs dealing with health and welfare; created in 1979Department of Health and Human Services, HHS (SAMHSA SAMHSA Substance Abuse and Mental Health Services Administration ) details onits website many model programs targeting secondary school students(e.g., Class Action, Project Towards no Drug Abuse) that are effectiveat reducing substance abuse (SAMHSA, 2006b). Although these SAMHSA modelprograms are effective, most are taught over multiple weeks and as suchare not conducive to already crammed school schedules. Further, a commondeficiency of multi-week prevention programs is the failure to strictlyimplement interventions, often because program providers (e.g.,teachers, students) shorten or otherwise change the intervention to meetschool needs (Botvin, 1990; Cahill, 2007; Ennett, 2003; Hallfors, 2002;Kaftarian, 2004; McBride, 2005; Ringwalt, 2003; Thaker, 2008). The Reinforcing Alcohol Prevention (RAP) Program was created forthe needs of a southeastern Virginia locality. The program uses atwo-pronged approach to intervene regarding impaired driving amongteens: (a) court-based programming, and (b) school-based programming.This paper focuses on the development and evaluation of the school-basedcomponent, and outlines the interim steps and results of the process ofworking with the schools to create an alcohol prevention curriculum thatis not only evidence-based, but serves the schools' practicalneeds. The Reinforcing Alcohol Prevention (RAP) Program The RAP Program was developed in accordance with evidence-basedguidelines for effective school-based programming, as well as for theneeds and desires of the local school system to maximize impact andfeasibility in the schools. Social Cognitive Theory Social Cognitive Theory utilized both in Psychology and Communications posits that portions of an individual's knowledge acquisition can be directly related to observing others within the context of social interactions, experiences, and outside media influences. (SCT Sacrococcygeal teratoma (SCT)A tumor occurring at the base of the fetus's tailbone.Mentioned in: Prenatal Surgery ) provided theoverarching o��ver��arch��ing?adj.1. Forming an arch overhead or above: overarching branches.2. Extending over or throughout: "I am not sure whether the missing ingredient . . . theory and delineated de��lin��e��ate?tr.v. de��lin��e��at��ed, de��lin��e��at��ing, de��lin��e��ates1. To draw or trace the outline of; sketch out.2. To represent pictorially; depict.3. the key constructs that shapedintervention conceptualization con��cep��tu��al��ize?v. con��cep��tu��al��ized, con��cep��tu��al��iz��ing, con��cep��tu��al��iz��esv.tr.To form a concept or concepts of, and especially to interpret in a conceptual way: . SCT combines stimulus response andcognitive theories and suggests that behavior is the result ofreciprocal interactions among behavioral, personal (e.g., cognitive),and environmental factors (Bandura ban`dur´an. 1. A traditional Ukrainian stringed musical instrument shaped like a lute, having many strings. , 1977, 1986, 2004). For example,social disinhibition dis��in��hi��bi��tionn.1. A loss of inhibition, as through the influence of drugs or alcohol.2. A temporary loss of an inhibition caused by an unrelated stimulus, such as a loud noise. (personal factor) in addition to peer pressure(environmental factor) can result in binge drinking binge drinkingAn early phase of chronic alcoholism, characterized by episodic 'flirtation' with the bottle by binges of drinking to the point of stupor, followed by periods of abstinence; BD is accompanied by alcoholic ketoacidosis–accelerated lipolysis and (behavioral factor),which is a main contributor to driving under the influence of alcohol.When developing the RAP Program and its curricula, the research teamconcentrated on translating personal, behavioral, and environmentalfactors into tangible intervention goals. For example, to equip teenswith the proper refusal skills Refusal skills are a set of skills designed to help children avoid participating in high-risk behaviors. Programs designed to discourage drug use, violence, and/or sexual activity frequently include refusal skills in their curriculums to help students resist peer pressure while and bolster self-efficacy, the RAPProgram modeled and provided practice of skills for refusing an offer ofan alcoholic product. Further, erroneous normative beliefs about thehigh number and frequency of peers drinking alcohol were challenged byproviding teens with accurate information about peer rates of drinking. The RAP Program addresses teens' alcohol knowledge andperceptions and teaches awareness of alcohol's harmful effectsthrough packaged curricula, presentations, interactive learningactivities, and threat-appeal tactics employing crash photos andpersonal testimonials. The overall goal of the project was to produce abrief, evidence-based, straightforward program that would be used by theschool system. The program was developed in partnership with schoolpersonnel and judicial partners who gave ongoing input regardingrelevance and ease of use by teachers within the classrooms. Theefficacy of the curriculum was evaluated via pretest/posttest design atfour large representative schools in two cities in southeasternVirginia. Due to funding constraints and the fact that the focus of thisproject was on curriculum development, control schools were not includedin this evaluation. It was hypothesized that students who received theRAP Program would report greater knowledge and awareness ofalcohol-related risks and consequences compared to their pre-programlevels. METHOD Development of the RAP Program Because the success of school-based programs depends upon a strongalliance among the scientists creating the curriculum, school personnel,and key stakeholders StakeholdersAll parties that have an interest, financial or otherwise, in a firm-stockholders, creditors, bondholders, employees, customers, management, the community, and the government. in the community, an advisory board was convened toassist with development and implementation of the RAP Program. Membersof the advisory board included Juvenile and Domestic Relations Court domestic relations courtn.In certain U.S. states, a court with jurisdiction over family disputes, especially those involving the custody, support, and welfare of children.Noun 1. judges, the local Department of Motor Vehicles In the United States of America, Department of Motor Vehicles (or DMV) is a commonly used name of the government agency of a U.S. state which administers the registration of automobiles (e.g., by issuing license plates), and/or the licensing of drivers (e.g. Community Traffic SafetyProgram Manager, school personnel, law enforcement personnel, and thebehavioral/social science researchers who were leading the developmentof the curriculum. The advisory board worked closely with theresearchers creating the curriculum to propose intervention ideas,strategize strat��e��gize?v. strat��e��gized, strat��e��giz��ing, strat��e��giz��esv.tr.To plan a strategy for (a business or financial venture, for example).v.intr. and prioritize pri��or��i��tize?v. pri��or��i��tized, pri��or��i��tiz��ing, pri��or��i��tiz��es Usage Problemv.tr.To arrange or deal with in order of importance.v.intr. goals, create RAP curricula and components,network with partnering agencies, develop a school-friendly evaluationinstrument, and plan for implementation of the RAP Program. While theresearch staff in charge of curriculum development performed much of theday-to-day work necessary to bring the program to fruition, advisoryboard members provided valuable knowledge and experience regarding theneeds and constraints of working with area schools and teens. Refinement according to according toprep.1. As stated or indicated by; on the authority of: according to historians.2. In keeping with: according to instructions.3. focus groups. Two focus groups of students(N = 14) were held at a local school with parent permission and studentconsent. Students were shown all RAP components and asked to providefeedback both freely and according to open-ended questions in themoderator's guide. Focus groups were facilitated by tworesearchers, one who led discussion and one who served as the recorder.Additionally, the focus groups were audio-recorded to ensure accuracy ofnotes. Overall, the RAP Program was well received by the student focusgroups as they reported liking the presentations and videos. Studentsgave constructive feedback regarding which slides in the presentationwere impactful versus boring and gave helpful suggestions for theoverall program. Both focus groups agreed with the presumption thathands-on activities would be better received than lecture style andsuggested revising our educational component to be more of a discussion.The focus groups thought the presentation was straightforward and thatthe information they obtained was helpful and would be well received bytheir peers. Importantly, they thought the RAP Program was needed, asthey did not believe they received adequate alcohol education in theschool curricula with the exception of short-lived prom seasonactivities. The participants reported that RAP activities weremeaningful and served as good techniques for testing the teenagers'knowledge. The videos and crash photo presentation (see Materialssection) were thought to be very powerful. They thought these types ofphotos should be included in all grades' modules. Based on feedbackfrom focus groups, program components were revised as appropriate inpreparation for implementation. PARTICIPANTS AND SETTINGS Due to the pilot/exploratory nature of the project and our need tobe considerate con��sid��er��ate?adj.1. Having or marked by regard for the needs or feelings of others. See Synonyms at thoughtful.2. Characterized by careful thought; deliberate. of the school district's needs, non-randomassignment was used to determine which schools would be administered theRAP Program. With assistance of the advisory board, the research teamworked with school administrators to obtain permission to implement theRAP Program in selected schools in the two cities. The schools chosenfor the study were ethnically and socio-economically diverse andgenerally representative of the two school districts. At the schools inCity 1, 53% of students were Caucasian, 36% were African American African AmericanMulticulture A person having origins in any of the black racial groups of Africa.See Race. , and6% were of other ethnicity. Further, 19% of students received free orreduced lunch. As for the schools in City 2, 56% were Caucasian, 30%were African American, and 13% were of other ethnicity. Twenty-sixpercent of students received free or reduced lunch. The study enrolledeighth, ninth, and tenth grade Tenth grade is a year of education in many nations. United StatesThe tenth grade is the tenth school year after kindergarten and is called Grade 10 in some regions. Students are usually 15–16 years old. students (age 13-16 years) from 55 middleschool and high school classrooms. School-based RAP components weredelivered to approximately 1,720 students in small and large groupsettings during Health and Physical Education classes. Pre-postknowledge surveys were administered to a subset (N = 668) of classes. MATERIALS The research team worked with school personnel and administrationto develop modules tailored to district needs. Working with schoolpersonnel increased teacher buy-in and helped ensure that components metstate standards of learning objectives and fit easily within blockscheduling Block scheduling is a type of academic scheduling in which each student has fewer classes per day for a longer period of time. This is intended to result in more time for teaching due to less time wasted due to class switching and preparation. . The advisory board and research team developed a uniquemodule for each grade level. While the key information conveyed wassimilar across grade levels, it was important to develop distinctlessons and activities for each progressive grade level to avoidrepetition. The RAP curricula are one-session 90-min modules for each ofeighth, ninth, and tenth grades. In order to maintain student interestand avoid the "lecture" approach, each module was 90 minseparated into 3-4 segments. Specifically, each RAP curricula moduleincludes (a) a student education component (15-20 min MicrosoftPowerPoint presentation), (b) a short 5-min video of a crash victim orconvicted at-fault driver who discusses the personal impact thatalcohol-impaired driving has had on his or her life, and (c) one or twointeractive activities that educate students through hands-on learningand reinforce the alcohol prevention message. Table 1 describes thevarious intervention goals (per SCT) that were infused throughout theRAP Program. Eighth grade module. A short 10-minute PowerPoint presentation wasdeveloped for delivery to eighth grade classes, which focused on thestate's laws and penalties, and consequences associated with risksfor underage alcohol consumption and driving under the influence ofalcohol. These slides detail an estimate of the amount of money teenswill spend (e.g. fines, court costs court costsn. fees for expenses that the courts pass on to attorneys, who then pass them on to their clients or, in some kinds of cases, to the losing party. , alcohol education courses,insurance), how long they will lose their driver's license (6months to 1 year), and the burden of how much time they will spend inalcohol classes, community service, and in court. Everyday factorsrelated to having the DUI on their permanent record, and how this mightaffect their college scholarships and job applications are alsodiscussed. Teens are then exposed to an abbreviated (7-minute) version of theCentury Council's Brandon Tells his Story video, which details theaftermath of a teen who crashed his car while driving impaired, with afollow-up slide of "How do you avoid ending up like the guy in thevideo?" This is a discussion slide that focuses on planning aheadand explores alternatives to drunk driving such as using a designateddriver designated driverPublic health A person at a social function who volunteers, or is 'volunteered' to chauffeur inebriated revellers chez elles at festivity's end. Cf Squash it. , calling a taxi cab, calling a sober driver, or staying at yourlocation. Lastly, the eighth grade module includes a mock trial A simulated trial-level proceeding conducted by students to understand trial rules and processes. Usually tried before a mock jury, these proceedings are different from Moot Court proceedings, which simulate appellate arguments. whichconstitutes the bulk of the RAP Program presentation in the classroom.This mock trial involves a drunken driving incident including afatality fa��tal��i��tyn.1. A death resulting from an accident or disaster.2. One that is killed as a result of such an occurrence. . Teachers assign students in advance to act out the 12 roles.The remainder of the class acts as the jury and decides the fate of thedefendant. At the end of this exercise students gain an appreciation andunderstanding of (a) the responsibilities of law enforcement personnel,(b) the difficulties in defending a drinking driver, (c) the costs andpenalties associated with DUI, (d) factual information aboutalcohol-related hazards (via "expert testimony Testimony about a scientific, technical, or professional issue given by a person qualified to testify because of familiarity with the subject or special training in the field. ") and (e) theprocess used by a jury to decide the outcome of a trial. Ninth grade module. Similar to the eighth grade module, a 15-minPowerPoint presentation was developed that utilizes educational slidesas well as crash photo slides to maintain ninth grade students'interest. The educational slides inform teens about general alcoholfacts, risks, and consequences. The crash photo slides present multiplephotos and details (e.g., BAC, speed, belt use, location, victim andat-fault driver outcomes, and legal consequences) of local-area alcohol-and speed-related crashes obtained from the local police department.Local crashes were used to maximize students' feelings of personalconnection to the situation. The PowerPoint presentation is accompanied by a local PoliceDepartment's video-taped interview with a young adult serving 10years in jail for killing two local individuals while driving drunk.This 7-min video is followed by a discussion slide which highlights hismistakes (all too common) and the importance of using a designateddriver. Lastly, the ninth grade module also utilizes the Fatal Visiongoggles goggles,n the protective eyewear worn by dental personnel and patients during dental procedures.gogglessee periocular leukotrichia. for an activity. The Fatal Vision Goggles simulate theperception of being impaired by alcohol. Teens attempt various fieldsobriety tests while wearing the fatal vision goggles including (a)balancing on one leg, (b) walking a straight line heel to toe, and (c)hand-eye coordination tests. Tenth grade module. A 20-min educational PowerPoint presentationwas developed for tenth graders. The presentation reviewsalcohol-related crash facts and statistics, then defines and estimatesblood alcohol content Blood alcohol content (BAC) or blood alcohol concentration is the concentration of alcohol in blood. It is usually measured as mass per volume. For example, a BAC of 0.02% means 0.02 grams of alcohol per 100 grams of individual's blood, or 0. (BAC) level based on body size, gender, and numberof drinks. The BAC section of the presentation corrects themisperception mis��per��ceive?tr.v. mis��per��ceived, mis��per��ceiv��ing, mis��per��ceivesTo perceive incorrectly; misunderstand.mis that an individual can drive safely if he or she drinksone alcoholic beverage per hour. Students are also taught how differentparts of their bodies and motor skills are affected at different BAClevels. The final slides review the risks and penalties of underagedrinking and impaired driving, content that is similar to the materialfrom the eighth grade module. Lastly, students are taught different waysto say no and resist peer pressure. Students who view this presentationview a brief 5-7 min video such as Brandon Tells His Story or theinterview with the incarcerated incarcerated/in��car��cer��at��ed/ (in-kahr��ser-at?ed) imprisoned; constricted; subjected to incarceration. in��car��cer��at��edadj.Confined or trapped, as a hernia. drunk driver. Interactive activities for this module include the Fatal Visiongoggles and Toxic Jeopardy, which is similar to the game show Jeopardy.Question categories include (a) Alcohol Autopsy autopsy:see post-mortem examination. autopsyor necropsy or postmortemDissection and examination of a dead body to determine cause of death and learn about disease processes in ways that are not possible with the living. , which examines howalcohol affects different body organs; (b) Liquid Lies, which are factor myth questions; (c) Cold Hard Truth, which reviews statistics relatedto alcohol; (d) Legal Lingo, which inquires about the legal penaltiesfor impaired driving and underage drinking, and; (e) Know yourNo's, which reviews various ways to say "no" to peerpressure. MEASURE To assist in gauging immediate changes in knowledge following theRAP Program, a program-specific pre-post alcohol-related knowledgequestionnaire was developed. This questionnaire specifically testedparticipants' knowledge on materials taught in the RAP Program. Dueto time and logistical/political constraints within schools, theresearch team was not permitted to ask students about sell-reporteddrinking and other high-risk behaviors. Therefore, the research teamdeveloped a one-page, 25-item questionnaire which asked program specificquestions (e.g., Alcohol is a stimulant stimulant,any substance that causes an increase in activity in various parts of the nervous system or directly increases muscle activity. Cerebral, or psychic, stimulants act on the central nervous system and provide a temporary sense of alertness and well-being as ; Alcohol kills more than allother illegal drugs combined) using a Likert-type response format(ranging from 1 = Strongly Disagree to 5 = Strongly Agree). In addition,four demographic questions were included to collect basic informationsuch as gender, race, age, and year in school. This anonymousquestionnaire was administered immediately before and after RAP Programpresentations to all students with parental consent and with verbalstudent assent An intentional approval of known facts that are offered by another for acceptance; agreement; consent.Express assent is manifest confirmation of a position for approval. . Internal consistency In statistics and research, internal consistency is a measure based on the correlations between different items on the same test (or the same subscale on a larger test). It measures whether several items that propose to measure the same general construct produce similar scores. reliability ([alpha]) was .66 atpretest and .82 at posttest. In all phases of this program, the researchteam provided protection of human subjects and submitted all protocolsinvolving human subjects to the Institutional Review Board. PROCEDURE Working closely with schools, the research staff and advisoryboards scheduled RAP presentations in 55 classrooms of fourparticipating schools. The number of presentations was adequate to reachthe entire eighth, ninth, and tenth grade student body at participatingschools in small groups (Student N = 1720). Core programming wasdistinct for each grade level and included informational presentations,videos, and interactive learning activities as discussed above in thevarious module descriptions. Presentations filled approximately 90minutes of class time, because a longer program presented schedulingdifficulty for schools. Administration of an immediate pre-postevaluation survey coincided with a subset of the presentations (Survey N= 668). Data collected for this program were entered using a Teleformscanning machine for fast processing of large numbers of surveys intothe SPSS A statistical package from SPSS, Inc., Chicago (www.spss.com) that runs on PCs, most mainframes and minis and is used extensively in marketing research. It provides over 50 statistical processes, including regression analysis, correlation and analysis of variance. system database. Validity checks for data accuracy wereperformed. Data were analyzed using SPSS (release 13.0; SPSS Inc.,Chicago, IL). Descriptive statistics descriptive statisticssee statistics. were run first to verify that noassumptions were violated and to address outliers or missing data.Dependent t-tests were performed to measure any change inalcohol-related knowledge between the pre- and posttests. RESULTS The RAP Program was delivered in 55 middle school and high schoolclassrooms (N = 1,720). Table 2 presents the demographic makeup of theRAP participants who completed the prepost tests (N = 668). Dependentt-tests were performed on students' responses to the pre-posttests. Results indicated test scores improved significantly across time:t(667) = -21.32, p < .001, [[eta].sup.2] = 0.41. Specifically,students' knowledge and awareness of alcohol risks increasedsignificantly from the pretest (M = 84.96, SD = 8.87) to posttest (M=97.25, SD = 12.39). Additional follow-up dependent t-tests (usingBonferroni's method for correcting for Alpha inflation) on the 25individual questions revealed that students were misinformed aboutalcohol and many related risks prior to the RAP Program but not afterthe program. For instance, many teens mistakenly believed prior to theprogram that (a) alcohol is a stimulant; (b) license revocation The recall of some power or authority that has been granted.Revocation by the act of a party is intentional and voluntary, such as when a person cancels a Power of Attorney that he has given or a will that he has written. lawsonly applied to drinking and driving, not underage drinking; (c) 5ounces of wine did not contain the same amount of alcohol as 12 ouncesof beer; (d) the majority of youth (ages 12-17) drink alcohol more thanonce a month; (e) drinking large amounts of alcohol in a short period oftime could not lead to death; and (f) two beers in an hour could notimpair their visual judgment. Students also had great misconceptionsregarding laws and penalties related to underage alcohol use and drivingunder the influence. They had false impressions regarding fines,incarceration Confinement in a jail or prison; imprisonment.Police officers and other law enforcement officers are authorized by federal, state, and local lawmakers to arrest and confine persons suspected of crimes. The judicial system is authorized to confine persons convicted of crimes. time, community service, license revocations, and manywere not aware of the zero-tolerance law. These misperceptions declinedsignificantly after the RAP Program. Table 3 presents mean pre-postdifferences in student's alcohol-related knowledge for all surveyquestions. Further exploratory analyses were conducted to measure anydifferences among gender, ethnicity, and grade levels of students whoparticipated in the RAP Program. Independent t-tests indicated nosignificant differences between gender and the overall pretest [t(638) =-1.36, ns] or posttest [t(638) = .06, ns] scores. In addition, a MixedAnalysis of Variance (ANOVA anovasee analysis of variance.ANOVAAnalysis of variance, see there ) was conducted to examine ethnicitydifferences for overall pre-post test scores. Results from this analysiswere not significant [Pretest F(2, 638) = 2.22, ns; Posttest F(2, 638) =2.87, ns]. A Mixed ANOVA conducted for grade level (i.e., eighth, ninth, andtenth) and overall pre-post test scores was significant [pretest F(2,665) = 15.51, p < .001 and posttest F(2, 665) = 22.47, p < .001],but homogeneity HomogeneityThe degree to which items are similar. of variance was violated; p < .005 for pretest andposttest. Therefore, Friedman's non-parametric test was run, whichindicated significant differences between student's grade level andpre-post test scores [Pretest [X.sup.2](2) = 14.06, p < .001;Posttest [X.sup.2](2) = 6.88, p = .03]. Since there was an overalldifference among the groups, pairwise comparisons were conducted toidentify which groups differed from each other. Pairwise Friedman'stests revealed eighth graders (M= 82.45, SD = 9.53) scored significantlylower than ninth (M = 86.55, SD = 8.05) and tenth graders (M = 87.87, SD= 8.69) at pretest [S.xup.2](1) = 16.67, p < .001. However, atposttest [X.sup.2](1) = 34.25, p < .001, eighth graders (M= 92.65, SD= 12.69) again scored significantly lower than the ninth graders (M =100.96, SD = 11.98), but there were no significant differences betweenthe eighth and tenth graders [X.sup.2] (1 ) = 2.25, ns. In addition,there were no significant differences between ninth graders and tenthgraders on the pretest [X.sup.2] (1) = 0.61, ns, and posttest [X.sup.2](1) = 0.12, ns. DISCUSSION The overall goal of this project was to produce a brief,evidence-based, straightforward alcohol prevention curriculum that wouldbe used by the school system. The main hypothesis was supported in thatteens who received the RAP Program curriculum increased their knowledgeand awareness of alcohol-related risks and consequences. The RAP Programwas able to increase overall alcohol knowledge, correct misperceptionsof alcohol, and raise awareness of alcohol-related risks andconsequences upon program completion. The research team succeeded increating a user-friendly program that schools utilized, and the programwas well received by both students and teachers in pilot schools. Therewere no significant differences among ethnicity and gender on thestudents' knowledge; thus, the program has preliminary evidencethat it is generalizable gen��er��al��ize?v. gen��er��al��ized, gen��er��al��iz��ing, gen��er��al��iz��esv.tr.1. a. To reduce to a general form, class, or law.b. To render indefinite or unspecific.2. across genders and a variety of ethnic groups. The RAP Program was successful in educating teens about alcohollaws and penalties in order to increase awareness of the consequences ofconsuming alcohol. For instance, teens who participated in the RAPProgram did not know a zero-tolerance law existed before the program wasimplemented. However, teens were significantly more aware of this law bythe end of the program. Awareness and knowledge of alcohol laws areimportant in order for laws to have any effect on the population (Berger& Marelich, 1997; Ferguson & Williams, 2002). Comparable to the findings of Royal (2000), the RAP pretestindicated that teens had misperceptions regarding how many drinks teensmust consume before alcohol begins to impair their driving ability.Following the RAP Program, teen participants were aware that they couldnot tolerate one drink per hour without impairment and violatingzero-tolerance driving limits. Similar to Johnson and colleagues'findings (L. Johnston, O'Malley, & Bachman, 2003), results fromthe RAP Pretest indicated that teens did not perceive great risk inheavy episodic episodicsporadic; occurring in episodes. e. falling a paroxymal disorder described in Cavalier King Charles spaniels in which affected dogs, starting at an early age, experience episodes of extensor rigidity, possibly brought on by stress. e. binge drinking. Teens erroneously believed, prior to theprogram, that drinking a large amount of alcohol in a short period oftime could not result in respiratory paralysis and death. LIMITATIONS Self-reported data. This preliminary study does not provideevidence for effectiveness beyond self-reported increases in knowledge.Survey questions examining use/prevalence of alcohol and related riskswere declined by the school district. The school administrators thoughtthat querying teens about their drinking behaviors was a sensitivesubject and an unnecessary use of class time. Crash and driving incidentreports were not a viable alternative because most had not receivedlicenses at the time of the program. Group-based survey completion. Due to group-based administration ofsurveys, it is possible a few students did not read survey questionscarefully. Attrition was also an issue because more students chose tocomplete pretests (N = 781) than the posttests (N = 668). To rectify rec��ti��fyv.1. To set right; correct.2. To refine or purify, especially by distillation. this discrepancy, SPSS automatically adjusts to make sample sizes equal,which resulted in discarding extra pretests, making the final samplesize 668. One-group design. Due to funding constraints and the fact that thefocus of this project was on curriculum development, control schoolswere not included in this evaluation. Therefore, the lack of acomparison group limits the internal validity Internal validity is a form of experimental validity [1]. An experiment is said to possess internal validity if it properly demonstrates a causal relation between two variables [2] [3]. of the study. Additionalresearch is needed to determine if the pre-post differences are indeeddue to the program. Non-random selection. Schools and classrooms were not chosenrandomly; rather, interested schools and personnel in SoutheasternVirginia were invited to participate. Thus, the results from this studymay not be generalizable to other schools and participants in otherareas of the United States. CONCLUSIONS AND FUTURE DIRECTIONS The RAP research team worked with school partners to createinnovative curriculum modules, presentations, interactive learningactivities, and components employing crash photos and personaltestimonials. It is clear that the program has had a significant andbeneficial impact on students' alcohol-related knowledge andperceptions, including the dangers of drinking and driving. Further, theprogram has been well-received by teachers, and students as evidenced byanecdotal, focus group, and objective survey data. Since itsdevelopment, the program has continued to be used within schools in thestudy area, and has now been packaged on CD/DVD and distributedthroughout the state to other schools. As mentioned previously, the program was piloted via a one-groupdesign and would benefit from further evaluation that includes a controlgroup. Further, surveys of self-reported alcohol use, impaired driving,and riding with an intoxicated in��tox��i��cate?v. in��tox��i��cat��ed, in��tox��i��cat��ing, in��tox��i��catesv.tr.1. To stupefy or excite by the action of a chemical substance such as alcohol.2. driver are all essential data for properanalysis of the impact of this program. Although teens targeted by this program have yet to receive theirlicenses, it would be ideal to follow-up participants to comparealcohol-related crashes and violations. AUTHOR NOTE Cynthia Shier shi��er?adj.A comparative of shy1. Sabo is now with the Department of Biostatistics biostatistics/bio��sta��tis��tics/ (-stah-tis��tiks) biometry. bi��o��sta��tis��ticsn.The science of statistics applied to the analysis of biological or medical data. atVirginia Commonwealth University Formed by a merger between the Richmond Professional Institute and the Medical College of Virginia in 1968, VCU has a medical school that is home to the nation's oldest organ transplant program. , Richmond, Virginia Richmond IPA: [ɹɯʒmɐnɖ]is the capital of the Commonwealth of Virginia, in the United States. . This study was supported by grants from the United StatesDepartment of Transportation The United States Department of Transportation (DOT) is a federal Cabinet department of the United States government concerned with transportation. It was established by an act of Congress on October 15, 1966 and began operation on April 1, 1967. and the Virginia Department of MotorVehicles (Grants 154AL-05-51280; J8-06-52181; 154AL-2007-57022-2494).The contents are solely the responsibility of the authors and do notnecessarily represent the official views of the U.S. Department ofTransportation or the Virginia Department of Motor Vehicles. We greatlyacknowledge the contributions from our partnering cities, includingpublic school personnel, Juvenile and Domestic Relations courtpersonnel, Department of Motor Vehicles, and the police departments. Wewould like to especially thank Judy Best, Honorable Randell Blow,Honorable Deborah Bryan, Craig England, Linda Jacocks, Steve Knott, JohnLourenco, Mary Ann Rayment, Tommy Rhodes, Scott Witchtendahl, HonorableLarry Willis Lawrence Elliott Willis (born December 20 1940 in New York, NY) is an American jazz pianist and composer. He has performed in a wide range of styles, including jazz fusion and rock. , and our student volunteers for their assesstance. Please address all correspondence to Kelli England Will, EasternVirginia Medical School Coordinates: Eastern Virginia Medical School, in Norfolk, Virginia is a public medical school. , Williams Hall Department of Pediatrics, 855West Brambleton Avenue, Norfolk, Virginia Norfolk is an independent city in the Commonwealth of Virginia, in the United States of America. With a population of 234,403 as of the 2000 census, Norfolk is Virginia's second-largest incorporated city. 23510-1001; Phone: (757)668-6449; Fax: (757) 668-6475; Email: willke@evms.edu. REFERENCES Bandura, A. (1977). Social Learning Theory. Upper Saddle River Saddle River may refer to: Saddle River, New Jersey, a borough in Bergen County, New Jersey Saddle River (New Jersey), a tributary of the Passaic River in New Jersey , NJ:Prentice Hall Prentice Hall is a leading educational publisher. It is an imprint of Pearson Education, Inc., based in Upper Saddle River, New Jersey, USA. Prentice Hall publishes print and digital content for the 6-12 and higher education market. HistoryIn 1913, law professor Dr. . Bandura, A. (1986). Social Foundation of Thought and Action: ASocial Cognitive Theory. Englewood Cliffs, NJ: Prentice Hall. Bandura, A. (2004). Health promotion by social cognitive meansHealth Education & Behavior, 31, 143-164. Bandy, T., & Moore, K. A. (2008). What works for preventing andstopping substance use in adolescents: Lessons from experimentalevaluations of programs and interventions., Child Trends Fact Sheet (pp.Accessed at www.childtrends.org). Berger, D. E., & Marelich, W. D. (1997). Legal and socialcontrol of alcohol- impaired driving in california. Journal of Studieson Alcohol, 58, 518-523. Botvin, G. J., Baker, E., Dusenbury, L, Tortu, S., & Botvin, E.M. (1990). Preventing adolescent drug abuse through a multimodalcognitive-behavioral approach: Results of a 3-year study. Journal ofConsulting and Clinical Psychology The Journal of Consulting and Clinical Psychology (JCCP) is a bimonthly psychology journal of the American Psychological Association. Its focus is on treatment and prevention in all areas of clinical and clinical-health psychology and especially on topics that appeal to a broad , 58(4), 437-446. Brown, S. A., McGue, M., Maggs, J., Schulenberg, J., Hingson, R.,Swartzwelder, S., Martin, C., Chung, T., Tapert, S. F., Sher, K.,Winters, K. C., Lowman, C., & Murphy, S. (2008). A developmentalperspective on alcohol and youths 16 to 20 years of age. Pediatrics,121, 290-310. Cahill, H. W. (2007). Challenges in adopting evidence-based schooldrug education programmes. Drug and Alcohol Review. 26(6), 673-679. DeJong, W., & Hingson, R. (1998). Strategies to reduce drivingunder the influence of alcohol Annual Review of Public Health, 19,359-378. Ennett, S. T., Ringwalt, C. L., Thorne, J., Rohrback, L. A.,Vincus, A., Simons-Rudolph, A., & Jones, S. (2003). A comparison ofcurrent practice in school-based substance use prevention programs withmeta-analysis findings. Prevention Science, 4(1), 1-14. Ferguson, S. A., & Williams, A. F. (2002). Awareness of zerotolerance laws in three states. Journal of Safety Research, 33, 293-299. Griffin, K. W., Botvin, G. J., & Nichols, T. R. (2004).Long-term follow-up effects of a school-based drug abuse preventionprogram on adolescent risky driving. Prevention Science, 5(3), 207-212. Hallfors, D., & Godette, D. (2002). Will the 'principlesof effectiveness' improve prevention practice? Early findings froma diffusion study. Health Education Research, 17(4), 461-470. Henry, K. L., Slater, M. D., & Oetting, E. R. (2005). Alcoholuse in early adolescence: the effect of changes in risk taking,perceived harm and friends' alcohol use. Journal of the Study ofAlcohol, 66, 275-283. Hingson, R., & Winter, M. (2003). Epidemiology and consequencesof drinking and driving. Alcohol Research & Health, 27(1), 63-78. Johnston, L., O'Malley, P., & Bachman, J. (2003).Monitoring the Future Monitoring the Future is an annual survey given to 50,000 8th, 10th and 12th graders in the United States to determine drug use trends and patterns. The survey started in 1975, with 12th graders. It was expanded in 1991 to include 8th and 10th graders as well. national results on adolescent drug use: Overviewand key findings, 2002 (No. 03-5374). Bethesda, MD: National Instituteon Drug Abuse. Johnston, L. D., O'Malley, P. M., Bachman, J. G., &Schulenberg, J. E. (2009). Monitoring the Future national results onadolescent drug use: Overview of key findings, 2008 (NIH "Not invented here." See digispeak. NIH - The United States National Institutes of Health. Publication No.09-7401). Bethesda, MD: National Institute on Drug Abuse. Kaftarian, S., Robertson, E., Compton, W., Davis, B. W., &Volkow, N. (2004). Blending prevention research and practice in schools:Critical issues and suggestions. Prevention Science, 5(1), 1-3. Klitzner, M., Gruenewald, P. J., Bamberger, E., & Rossiter, C.(1994). A quasi-experimental evaluation of Students Against DrivingDrunk. American Journal of Drug and Alcohol Abuse. 20, 57-74. Komro, K. A., & Toomey, T. L. (2002). Strategies to preventunderage drinking. Alcohol Research & Health, 26(1), 5-14. McBride, N. (2005). The evidence base for school drug educationinterventions. In T. Stockwell, Gruenewald, P. J., Toumbourou, J. W.,& Loxley, W. (Ed.), Preventing harmful substance use: The evidencebase for policy and practice. (pp. 101-112). New York New York, state, United StatesNew York,Middle Atlantic state of the United States. It is bordered by Vermont, Massachusetts, Connecticut, and the Atlantic Ocean (E), New Jersey and Pennsylvania (S), Lakes Erie and Ontario and the Canadian province of : Jonh Wiley &Sons, Ltd. National Institute on Alcohol Abuse and Alcoholism. (2004/2005a).The effects of alcohol on physiological processes and biologicaldevelopment. Alcohol Research & Health, 28(3), 125-131. National Institute on Alcohol Abuse and Alcoholism. (2004/2005b).The scope of the problem. Alcohol Research & Health, 28(3), 111-120. National Institute on Alcohol Abuse and Alcoholism. (2006). Make adifference: Talk to your child about alcohol. (Vol. Publication #06-4314). Rockville, MD: National Institutes of Health. O'Malley, P. M., Johnston, L. D., & Bachman, J. G. (1998).Alcohol use among adolescents. Alcohol Research & Health, 22(2),85-94. Ringwalt, C. L., Ennett, S., Johnson, R., Rohrbach, L. A.,Simons-Rudolph, A. Vincus, A., & Thorne, J. (2003). Factorsassociated with fidelity to substance use prevention curriculum guidesin the nation's middle schools. Health Education and Behavior, 30,375-391. Royal, D. (2000). Racial and ethnic group comparisons."National surveys of drinking and driving. Attitudes and Behavior: 1993,1995, and 1997. Volume 1: Findings; Volume 2: Methods. Washington, DC:Department of Traffic Safety, National Highway Traffic SafetyAdministration. Spear, L. (2002). Adolescent brain and the college drinker:Biological basis of propensity to use and misuse alcohol. Journal of theStud), of Alcohol(14), 71-81. Substance Abuse and Mental Health and Human Services. (2006a).Class Action. from http://modelprograms.samhsa.gov/pdfs/Details/ClassAction.pdf Substance Abuse and Mental Health and Human Services. (2006b).Model Programs. Substance Abuse and Mental Health and Human Services. (2006c).Project Toward No Drug Abuse. Thaker, S., Steckler, A. Sanchez, V., Khatapoush, S., Rose, J.,& Hallfors, D. D. (2008). Program characteristics and organizationalfactors affecting the implementation of a school-based indicatedprevention program. Health Education Research, 23(2), 238-248. Tobler, N. S. (1992). Drug prevention programs can work: Researchfindings. Journal of Addictive Diseases, 11(3), 1-28. Tobler, N. S., Roona, M. R., Ochshorn, P., Marshall, D. G., Streke,A. V., & Stackpole, K. M. (2000). School-based adolescent drugprevention programs: 1998 meta-analysis. The Journal of PrimaryPrevention, 20(4), 275-336. Tobler, N. S., & Stratton, H. H. (1997). Effectiveness ofschool-based drug prevention programs: A meta-analysis of the research.The Journal of Primary Prevention, 18(1), 71-128. Kelli England Will and Cynthia Shier Sabo Department of Pediatrics, Eastern Virginia Medical School, Norfolk,VirginiaTABLE 1Intervention Goals to Reduce Factors Contributing to Alcohol-RelatedProblemsFactors Intervention GoalsBeliefs about * Reinforce beliefs about harmful effectsalcohol use (e.g. of drinkingharmfulness ofdrinking alcohol, * Give accurate information about immediateprevalence of and long-term health effects of drinkingalcohol use) and about drinking prevalence among youth and adults * Emphasize benefits of not drinking alcohol * Experiential learning and interactive exercises * Underscore the personal risks and consequences of dring and driving using local crash photos and victim testimonialsBehavioral skills * Teach and model skills for refusing(e.g. refusal offers of alcohol products (e.g., teachskills) and practice different ways to say no to alcohol) * Teach general problem solving skills to enhance coping with difficult social situations * Exploring alternatives to drunk driving (e.g., using a designated driver, distributing wallet cards bearing taxi company phone numbers)Peer attitudes * Help teens identify peers who share& behaviors strong non-drinking attitudes and norms * Encourage teens to get involved in alcohol prevention activities (e.g., alcohol-prevention homework assignments, after-prom activity sponsored by school) * Normative beliefs feedbackRole Models * Involve influential adults (e.g., teachers, coaches, and judges) in programTABLE 2Frequency Table of DemographicsVariable n %Gender Male 295 42.4 Female 373 53.4Class Year 8th Grade 225 32.2 9th Grade 366 52.5 10th Grade 70 10.0 11th Grade 7 1.0Ethnicity White 319 46.0 Black 173 24.9 Pac. Islander/Asian 56 7.9 Hispanic 25 3.6 Mixed Origin 63 9.0 Other 32 4.6Note. N = 668TABLE 3Pre-Post Changes in Survey Items Pretest Posttest RAP Program Question M (SD) M (SD)1. A 12 oz. beer and a oz. 3.24 (1.06) 4.21 (1.06) glass of table wine contain the same amount of alcohol in it.2. Mixing alcoholic beverages 3.37 (l.14) 2.46 (l.28) (wine, beer, and liquor) helps obtain a quicker buzz. (Reverse Coded)3. A first-offense DUI can cost 3.01 (1.09) 3.39 (l.28) over $15,000.4. The brain is the only organ 1.76 (l.08) 1.75 (1.12) affected by alcoholic beverages. (Reverse Coded)5. Alcohol related car crashes 4.10 (0.91) 4.24 (l.00) are the leading cause of death for teenagers.6. It is unsafe to ride in a car 4.15 (l.05) 4.25 (0.97) with a driver who has had more than one drink.7. The majority of youth between 3.33 (0.98) 2.79 (l.33) the ages of 12 and 17 use alcohol at least once a month. (Reverse Coded)8. Using a fake ID can cost you 3.81 (0.94) 4.12 (0.90) $500 and cause you to lose your license.9. Drinking alcohol at an early 3.89(l.12) 4.13(l.03) age is linked with becoming an alcoholic during adult years.10. If a person is a little buzzed 2.17(l.12) 1.99(l.09) but not drunk, it's ok for s/he to drive. (Reverse Coded)11. An officer can incarcerate a 3.48 (0.94) 4.05(l.06) driver under the age of 21 if their BAC reading is higher than .02%.12. Alcohol kills five times more 3.18 (l.10) 4.08 (1.05) people than all other illegal drugs combined.13. Teens feel comfortable calling 2.06 (1.18) 2.35 (1.32) parents for a ride home if they are too intoxicated to drive.14. It is appropriate to drink 2.41 (1.27) 2.16 (l.21) alcohol before one's 21st birthday. (Reverse Coded)15. Drinking large amounts of 3.72 (l.02) 4.29 (0.93) alcohol in a short period of time can result in respiratory paralysis and death.16. My parents are legally allowed 3.29(l.26) 4.23 (1.01) to take my driver's license away at any time.17. Your license is immediately 3.39 (l.00) 4.08 (l.04) revoked for a week when you get pulled over for a DUI.18. Most drunk drivers can tell 2.36 (l.27) 2.12 (l.23) when they are too drunk to safely drive. (Reverse Coded)19. Regardless of size, females 3.08 (l.00) 3.90 (l.23) break down alcohol more slowly than males.20. Two beers in an hour would 3.29 (0.99) 4.05 (0.97) impair my visual judgment.21. If you're caught drinking at 3.53 (0.99) 4.13 (l.03) age 14, you can be denied your license at age 16.22. You can go to jail for up to 3.84 (1.00) 4.03 (1.09) 30 years if you kill someone while drunk driving.23. As a teen, your license can be 3.64 (0.87) 3.88 (1.10) revoked for 6 months if you're caught driving with a BAC of .02.24. Alcohol is a stimulant. 3.24 (l.17) 2.09 (l.31) (Reverse Coded)25. The average person can 3.10 (l.05) 2.81 (1.23) tolerate one drink per hour without substantial impairment. (Reverse Coded) RAP Program Question t [[eta].sup.2]1. A 12 oz. beer and a oz. -16.20 * 0.28 glass of table wine contain the same amount of alcohol in it.2. Mixing alcoholic beverages -14.05 * 0.23 (wine, beer, and liquor) helps obtain a quicker buzz. (Reverse Coded)3. A first-offense DUI can cost -5.97 * 0.05 over $15,000.4. The brain is the only organ -0.18 0.00 affected by alcoholic beverages. (Reverse Coded)5. Alcohol related car crashes -2.55 0.01 are the leading cause of death for teenagers.6. It is unsafe to ride in a car -1.80 0.01 with a driver who has had more than one drink.7. The majority of youth between -8.41 * 0.10 the ages of 12 and 17 use alcohol at least once a month. (Reverse Coded)8. Using a fake ID can cost you -6.39 * 0.06 $500 and cause you to lose your license.9. Drinking alcohol at an early -4.19 * 0.03 age is linked with becoming an alcoholic during adult years.10. If a person is a little buzzed -3.02 0.01 but not drunk, it's ok for s/he to drive. (Reverse Coded)11. An officer can incarcerate a -10.53 * 0.14 driver under the age of 21 if their BAC reading is higher than .02%.12. Alcohol kills five times more -15.23 * 0.26 people than all other illegal drugs combined.13. Teens feel comfortable calling -4.37 * 0.03 parents for a ride home if they are too intoxicated to drive.14. It is appropriate to drink -3.79 * 0.02 alcohol before one's 21st birthday. (Reverse Coded)15. Drinking large amounts of -10.64 * 0.15 alcohol in a short period of time can result in respiratory paralysis and death.16. My parents are legally allowed -14.89 * 0.25 to take my driver's license away at any time.17. Your license is immediately -12.17 * 0.18 revoked for a week when you get pulled over for a DUI.18. Most drunk drivers can tell -3.60 * 0.02 when they are too drunk to safely drive. (Reverse Coded)19. Regardless of size, females -13.39 * 0.21 break down alcohol more slowly than males.20. Two beers in an hour would -14.61 * 0.24 impair my visual judgment.21. If you're caught drinking at -10.99 * 0.15 age 14, you can be denied your license at age 16.22. You can go to jail for up to -3.58 * 0.02 30 years if you kill someone while drunk driving.23. As a teen, your license can be -4.52 * 0.03 revoked for 6 months if you're caught driving with a BAC of .02.24. Alcohol is a stimulant. -16.98 * 0.30 (Reverse Coded)25. The average person can -4.65 * 0.03 tolerate one drink per hour without substantial impairment. (Reverse Coded)Note. Participants (N = 668) responded using a Likert-type scale,where 1 = Strongly Disagree and 5 = Strongly Agree. Reverse codeditems were reverse coded prior to all statistical analyses. ABonferroni adjusted alpha level of .002 was used to assessstatistical significance.* p < .001.