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Single-Parent Families: An Underserved Population for Adolescent Alcohol Interventions?

  • Racheal Reavy
    Correspondence
    Address correspondence to: Racheal Reavy, Ph.D., Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, Biobehavioral Health Building, University Park, PA 16802.
    Affiliations
    Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania
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  • Rob Turrisi
    Affiliations
    Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania

    Department of Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania
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  • Kimberly Mallett
    Affiliations
    Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania
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      Adolescent drinking continues to be a significant concern in the U.S. national epidemiological studies, which suggest that there are substantial increases among 16- to 17-year-olds for the past 30-day use (22.7%), heavy episodic drinking (HED; ≥5 drinks, 13.1%), and heavy use (>5 HED occasions, 2.7%) [
      Substance Abuse and Mental Health Services Administration
      Results from the 2013 National Survey on Drug Use and Health: Summary of national findings.
      ]. This is concerning, as the consequences for adolescents, the people around them, and society as a whole have been well documented [
      National Center for Education Statistics
      Fast facts: Back to school statistics.
      ].
      Research has shown that parent-based interventions (PBIs) have a potentially powerful role to play in reducing the scope of the adolescent drinking problem [
      • Spoth R.
      • Greenberg M.
      • Turrisi R.
      Preventive interventions addressing underage drinking: State of the evidence and steps toward public health impact.
      ]. Despite the utility of PBIs, efficacy studies examining programs, such as Strengthening Families, Project STAR, and Raising Healthy Children, reveal that their content focuses primarily on parenting behaviors (e.g., communication, monitoring) of two-parent households. We could not identify any articles examining the effects of these programs on single-parent (SP) families raising teenagers. As such, their content does not fully address the specific unique needs of SPs (widowed, divorced, separated, or never married; and not currently married or living with a partner). This is concerning because SPs make up approximately one third of U.S. households [
      • Duffin E.
      Number of U.S. children living in a single parent family 1970-2019.
      ]. Furthermore, approximately one in four U.S. children (∼20 million per year) have been raised by an SP and no other adult (80.4% of custodial SPs are mothers) [
      • Duffin E.
      Number of U.S. children living in a single parent family 1970-2019.
      ]. Numerous studies have provided evidence showing teens raised in SP homes are more likely to engage in delinquent behaviors that include alcohol and other substance use [
      • Amato P.R.
      Children of divorce in the 1990s: An update of the Amato and Keith (1991) meta-analysis.
      ,
      • Tomčíková Z.
      • Veselská Z.D.
      • Madarasova Gecková A.
      • et al.
      Adolescents’ drinking and drunkenness more likely in one-parent families and due to poor communication with mother.
      ,
      • Ruutel E.
      • Sisask M.
      • Varnik A.
      • et al.
      Alcohol consumption patterns among adolescents are related to family structure and exposure to drunkenness within the family: Results from the SEYLE Project.
      ,
      • Tomčíková Z.
      • Madarasova Gecková A.
      • Orosova O.
      • et al.
      Parental divorce and adolescent drunkenness: Role of socioeconomic position, psychological well-being and social support.
      ]. Although there are exceptions, the overwhelming majority of studies have provided evidence of increased risk for early alcohol initiation, drinking more frequently, and consuming alcohol in greater quantities, warranting intervention efforts specifically tailored or adapted for SPs and their adolescent children [
      • Tomčíková Z.
      • Veselská Z.D.
      • Madarasova Gecková A.
      • et al.
      Adolescents’ drinking and drunkenness more likely in one-parent families and due to poor communication with mother.
      ,
      • Ruutel E.
      • Sisask M.
      • Varnik A.
      • et al.
      Alcohol consumption patterns among adolescents are related to family structure and exposure to drunkenness within the family: Results from the SEYLE Project.
      ,
      • Tomčíková Z.
      • Madarasova Gecková A.
      • Orosova O.
      • et al.
      Parental divorce and adolescent drunkenness: Role of socioeconomic position, psychological well-being and social support.
      ]. We use the remainder of this commentary to address the issues and potential solutions.
      First, PBIs tend not to take into consideration the specific needs of SPs. We examined the content of the PBIs for adolescents that the Spoth et al.’s [
      • Spoth R.
      • Greenberg M.
      • Turrisi R.
      Preventive interventions addressing underage drinking: State of the evidence and steps toward public health impact.
      ] review identified as having the most rigorous evidence of efficacy for reducing underage drinking, mentioned previously. Their content focused primarily on parenting behaviors and rarely addressed parental risk and protective factors (e.g., emotional distress [re: anxiety, depressed mood, and stress]; support [social, money, and time]; self-care [re: sleep, healthy eating, exercise, and mindfulness]; conflict with other parent; and coping [re: adaptive and maladaptive]). SP families are diverse, and while networks of extended family and friends are available to some, other families lack the additional support resulting in overtaxed resources. This is even more concerning during the COVID-19 pandemic, as parents are experiencing new or enhanced risk factors, as they are juggling work issues, health concerns, parenting, relationships, and in-home schooling, often without childcare. For SPs, this often means having to make choices about working to support their families versus providing their children with adult supervision or education. The content of PBIs must be enhanced to meet the needs of SPs; therefore, research is needed to identify content that informs adaptations targeting PBIs for SPs.
      Second, little is known about how SP parenting behaviors and SP risk and protective factors are interrelated. For the purposes of identifying the content to inform adaptations to PBIs for SPs, we conducted a review of etiological studies on SPs' parenting behaviors and risk and protective factors and observed several trends. First, most studies examined either parenting behaviors or parental risk and protective factors, but not both at the same time [
      • Ruutel E.
      • Sisask M.
      • Varnik A.
      • et al.
      Alcohol consumption patterns among adolescents are related to family structure and exposure to drunkenness within the family: Results from the SEYLE Project.
      ,
      • Tomčíková Z.
      • Madarasova Gecková A.
      • Orosova O.
      • et al.
      Parental divorce and adolescent drunkenness: Role of socioeconomic position, psychological well-being and social support.
      ]. Second, among the few reports that studied both parenting behaviors and parental risk and protective factors concurrently, only a small number of constructs were included (e.g., communication or stress) and used poor methodologies that limited conclusions and generalizability [
      • Tomčíková Z.
      • Madarasova Gecková A.
      • Orosova O.
      • et al.
      Parental divorce and adolescent drunkenness: Role of socioeconomic position, psychological well-being and social support.
      ]. Research that broadly examines both parenting behaviors and parental risk and protective factors of SPs (and their interrelationships) using rigorous methods is needed.
      Third, longitudinal research on SPs is needed. There is evidence of increases and changes in drinking throughout adolescence (e.g., transitioning to high school and driving). According to Monitoring the Future 2019, the rates of past-year alcohol use nearly doubles from eighth grade (19.3%) to 10th grade (37.7%) and then again in the 12th grade (52.1%) [
      Monitoring the Future
      Monitoring the future 2019 survey results: Overall findings.
      ]. We could not locate any peer-reviewed articles that report exact figures for these changes in adolescents raised by SPs. Drawing on the findings that adolescents who live in SP homes are at increased risk for early initiation and problematic drinking [
      • Tomčíková Z.
      • Veselská Z.D.
      • Madarasova Gecková A.
      • et al.
      Adolescents’ drinking and drunkenness more likely in one-parent families and due to poor communication with mother.
      ,
      • Ruutel E.
      • Sisask M.
      • Varnik A.
      • et al.
      Alcohol consumption patterns among adolescents are related to family structure and exposure to drunkenness within the family: Results from the SEYLE Project.
      ,
      • Tomčíková Z.
      • Madarasova Gecková A.
      • Orosova O.
      • et al.
      Parental divorce and adolescent drunkenness: Role of socioeconomic position, psychological well-being and social support.
      ], it is likely that increases in drinking are even more dramatic in adolescents from SP homes, but, without data, this remains an important empirical question. Research is desperately needed to understand how a comprehensive examination of parenting factors influence adolescent psychosocial and developmental factors during different critical stages of development. Examples of research questions that would move the prevention field forward could include (1) Which SP parenting behaviors and parental risk and protective factors will have the most impact on their adolescents' psychosocial development at different time points? (2) What is the manner in which SP parenting behaviors and risk and protective factors result in the least and most adolescent drinking-related harm? and (3) What are the potential optimal points for PBIs for SPs of adolescents? Answers to these questions will provide necessary information to tailor the PBI content and optimal timing for SPs and their adolescent children.
      Furthermore, our review of research studies on SP families extended beyond adolescent drinking to smoking/vaping, marijuana use, age of first intercourse, externalizing behaviors, and self-harm. We could find very few empirical examinations of SP households and adolescent risky behaviors and even fewer that report more than sample demographics. A notable exception is in the area of sex communication [
      • Padilla-Walker L.M.
      • Rogers A.A.
      • McLean R.D.
      Is there more than one way to talk about sex? A longitudinal growth mixture model of parent–adolescent sex communication.
      ].
      In sum, many adolescent children of SPs are at significant risk. To effectively address this, comprehensive research is needed to inform prevention efforts that examine the processes by which parenting behaviors and risk and protective factors (and their interrelationships) of SPs influence their adolescents' psychosocial/developmental variables and subsequent drinking outcomes.

      Acknowledgments

      All who contributed significantly to the commentary are named as authors.

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