ROLE OF PAR ENTS IN COLLEGE STUDENT REGULAR ALCOHOL USE IN THE CONTEXT OF ABSTINENT RELIGIOSITY By Alina Baltazar A DISSERTATION Submitted to Michigan State University i n partial fulfillment of the requirements for the degree of Human D evelopment and Family Studies Doctor of Philosophy 201 5 ABSTRACT ROLE OF PAR ENTS IN COLLEGE STUDENT REGULAR ALCOHOL USE IN THE CONTEXT OF ABSTINENT RELIGIOSITY By Alina Baltazar Heavy alcohol use is a problem on many college campuses with short - te rm and long - term consequences for students. Little is known about the role parents play in alcohol use prevention among college students in the context of alcohol abstinent religiosity. This study , based on the human ecology framework, hypothesized parental involvement and conflict and open communication have an effect on regular alcohol use, but will not have as strong an influence as religious faith and participation . Secondary analysis of a health - risk behaviors survey collected March 2012 on a conservative Christian college campus w as conducted for this manuscript style dissertation that included two separate studies . For study one, the multiple linear regression model include d parental involvement and conflict, age, gender, ethnicity, religious belief and participation as part of t he predictor model to explain the variance of regular alcohol use among those who self - identif ied as Sev enth - day Adventist, single, age 18 - 25, and not living at home . Results found mother not knowing what is done in t a relationship with using alcohol regularly , especially for those under age 21 Participation in Sabbath school and you nger age also were protective factors. Study two was an e xplanatory mixed method approach using step - wise logistic regression analysis of the same survey and secondary analysis of follow up focus groups . The step - wise logistic reg ression was used to assess the e ffect of parental communication, age, gender, ethnicity, and religious belief and participation on regular alcohol use among the same population . Results show ed that open communication with mother on the topic of drugs, sex, and alcohol decreased the chance of regular alcohol use by about 30% in the first set of models, age increased the odds of alcohol use by 50%, religious participation decreased the probability of alcohol use by 26%, and religious belief decreased the chance of regular alcohol use by about 60% in the last set of models. S ix follow - up focus groups were conducted , and themes identified were: abstinent environment vs. secular culture, authoritative pa renting, and drinking for recreation and coping that helped to explain the role parents and religiosity play in alcohol use among college students . These narrative themes helped to explain the complex interplay between the micro - , meso - , and macro - levels that influence college student alcohol use. In conclusion, there are multiple influences on alcohol use among a population of abstinent oriented Christian college students. Parents play many roles in college student alcohol use, but as young adults matur e, religiosity can play a stronger role. Individual and cultural factors influence alcohol use as well. There are implications for parents, family life educators, faith communities, and college administrators/counselors. Copyright by ALINA BALTAZAR 2015 v This dissertation is dedicated to my amazing family, friends, and colleagues who have provided immeasurable support in my journey. First, I want to thank my dear husband Joshua who has given emotional support and covered my duties at home, even when we we would lead to a positive outcome. I am so grateful to my three boys. Alex became a teenager at the beginning of my program. He was my sounding board for my understanding of adolescent development and decision making. Now we are g raduating at around the same time and moving even as he dealt with his own moving from elementary to high school in his developmental process. Lucas, my youngest, kept me grounded in my identity as a mother and reminded me why I wanted to study parent/child relationships. I could not have gotten this far without the unconditional supp research in this field was a wonderful example and a practical guide when I would get stuck and times w as invaluable. I want to thank my many friends and colleagues for the several things they did to provide practical help and assistance. From helping to keep me awake late in the evening as I drove the two+ hours home after class, giving emotional support , taking responsibilities off my plate at work, statistical analysis assistance, and your prayers; I will always be grateful. There are so many positive things that have happened in this journey that I can only attribute them to ! vi ACKNOWLEDGEMENTS I want to acknowledge the immeasurable support received from Dr. Barbara Ames, my advisor and chair. I have learned so much from you about the r esearch process and writing. I will always cheri sh and do my best to remember . You have excited in me a passion for rese arching parent/child relationships and sharing practical implications with a goal to strengthen the family. Next, I would like to thank my esteemed professors and committee members, Dr. Robert Griffore and Dr. Esther Onaga. Though I have been involved with research for years, Dr. Griffore helped me understand the big picture and learn practical skills to take my research abilities to the n e xt level. recommendation to make my research more practical. As my external committee member, Dr. Dennis Martell, provided invaluable insight into the alcohol use behaviors of college student s. Thank you for bei ng willing to give assistance at the beginning of my dissertation planning to the end by challenging my thinking and getting me dissertation committee, but you were always there when I needed you and even provided encouragement along the way. Finally, I want to thank the students and faculty of Andrews University, the research site and place of work. From cleaning up the statistical data by Dr. Jerry Thayer, to statistical analysis assistance by Dr. Jimmy Kijai and Dr. Gary Hopkins, qualitative question design help by Dr. Curt VanderWaal, research design guidance by Dr. Duane McBride, to my graduate assistants Kathryn Conopio for qualitative data collection and analysis assistance, and Karena Griffiths and Luned y Florveus for editing. vii TABLE OF CONTENTS LIST OF TABLES ................................ ................................ ................................ ........................... x LIST OF FIGURES ................................ ................................ ................................ ....................... xi CHAPTER I ................................ ................................ ................................ ................................ ..... 1 INTRODUCTION ................................ ................................ ................................ ........................... 1 Purpose of the Study and Research Questions ................................ ................................ ........... 1 Rationale ................................ ................................ ................................ ................................ .... 3 Emerging Adults ................................ ................................ ................................ .................. 3 Parental Roles ................................ ................................ ................................ ...................... 5 Seventh - day Adventist Church ................................ ................................ ............................ 7 Religiosity ................................ ................................ ................................ ............................ 8 Theoretical Framework ................................ ................................ ................................ .............. 9 Family E cology Framework ................................ ................................ .............................. 10 Bioecological Theory of Human Development ................................ ................................ . 11 Human Ecology in Youth Health Risk Assessment ................................ .......................... 14 Positive Y outh D evelopment ................................ ................................ ............................. 17 CHAPTER II ................................ ................................ ................................ ................................ .. 19 LITERATURE REVIEW ................................ ................................ ................................ .............. 19 Emerging A dults ................................ ................................ ................................ ...................... 19 Alcohol U se ................................ ................................ ................................ ............................. 23 Alcohol Consequences ................................ ................................ ................................ ............. 27 Risk F actors ................................ ................................ ................................ ............................. 28 Problematic F amily R elations ................................ ................................ ............................ 29 Mental H ealth ................................ ................................ ................................ ..................... 30 Trauma ................................ ................................ ................................ ............................... 31 Protective F actors ................................ ................................ ................................ ..................... 32 Parent - C hild Bonding and Communication ................................ ................................ ....... 32 Religiosity ................................ ................................ ................................ .......................... 34 Alcohol Abstinence ................................ ................................ ................................ ............ 35 Analysis of the L iterature ................................ ................................ ................................ ......... 36 Need for Human Ecological Approach ................................ ................................ .................... 36 Addressing At - Risk Alcohol Use Among College Students ................................ ................... 37 CHAPTER III ................................ ................................ ................................ ................................ 40 METHOD ................................ ................................ ................................ ................................ ...... 40 Hypothesis for Study One ................................ ................................ ................................ ........ 40 Sampling and Procedure for Study One ................................ ................................ ................... 41 Demographic Characteristics ................................ ................................ ................................ ... 41 Instruments ................................ ................................ ................................ ............................... 42 Parental Environment Questionnaire (PEQ) ................................ ................................ ...... 42 Religious Belief ................................ ................................ ................................ ................. 44 viii Religious Participation ................................ ................................ ................................ ....... 44 Demographic Questions ................................ ................................ ................................ ..... 45 Analysis ................................ ................................ ................................ ................................ .... 46 Hypothesis for Study Two ................................ ................................ ................................ ....... 46 Sampling and Procedure for Study T wo ................................ ................................ .................. 46 Survey Instrument ................................ ................................ ................................ .................... 46 Parental Communication ................................ ................................ ................................ .... 47 Religious Belief and Participation ................................ ................................ ..................... 47 Focus Group Participants ................................ ................................ ................................ ... 48 Focus Group Demographic Characteristics ................................ ................................ ............. 49 Focus Group Instrument ................................ ................................ ................................ .......... 49 Analysis ................................ ................................ ................................ ................................ .... 50 Survey Analysis ................................ ................................ ................................ ................. 51 Missing Data ................................ ................................ ................................ ...................... 52 Focus Group Analysis ................................ ................................ ................................ ........ 52 CHAPTER IV ................................ ................................ ................................ ................................ 53 MANUSCRIPT ONE: ROLE OF PARENTAL INVOLVEMENT AND CONFLICT IN COLLEGE STUDENT REGULAR ALCOHOL USE IN THE C ONTEXT OF ABSTINENT RELIGIOSITY ................................ ................................ ................................ ............................... 53 Abstract ................................ ................................ ................................ ................................ .... 53 Introduction ................................ ................................ ................................ .............................. 54 Emerging Adults ................................ ................................ ................................ ................ 55 Parental Involvement ................................ ................................ ................................ ......... 56 Par ental Conflict ................................ ................................ ................................ ................ 57 Seventh - day Adventist Church ................................ ................................ .......................... 58 Religiosity ................................ ................................ ................................ .......................... 59 Theoretical Framework ................................ ................................ ................................ ...... 60 Method ................................ ................................ ................................ ................................ ..... 61 Sampling and Procedure ................................ ................................ ................................ .......... 61 Instruments ................................ ................................ ................................ ............................... 62 Parental Environment Questionnaire (PEQ) ................................ ................................ ...... 62 Religious Belief ................................ ................................ ................................ ................. 63 Religious Participation ................................ ................................ ................................ ....... 64 Demographic Questions ................................ ................................ ................................ ..... 65 Analysis ................................ ................................ ................................ ................................ .... 65 Results ................................ ................................ ................................ ................................ ...... 66 Discussion ................................ ................................ ................................ ................................ 68 Limitations and Future Directions ................................ ................................ ........................... 73 Conclusion ................................ ................................ ................................ ............................... 73 CHAPTER V ................................ ................................ ................................ ................................ . 77 MANUSCRIPT TWO: ROLE OF PARENTS AND RELIGIOSITY IN REGULAR ALCOHOL USE AMONG CHRISTIAN COLLEGE ST UDENTS: A MIXED METHOD APPR OACH ..... 77 Abstract ................................ ................................ ................................ ................................ .... 77 Introduction ................................ ................................ ................................ .............................. 78 ix Literature Review ................................ ................................ ................................ ..................... 78 Emerging Adults ................................ ................................ ................................ ................ 78 Role of Parents in Alcohol Use ................................ ................................ .......................... 79 Alcohol Use ................................ ................................ ................................ ....................... 80 Role of Religiosity in Alcohol Use ................................ ................................ .......................... 82 Human Ecology Theory ................................ ................................ ................................ ........... 83 Aims of the Current Study ................................ ................................ ................................ ....... 85 Method ................................ ................................ ................................ ................................ ..... 85 Survey Particip ants ................................ ................................ ................................ ............ 85 Focus Group Participants ................................ ................................ ................................ ... 85 Survey Instrument ................................ ................................ ................................ .................... 86 Qualitative Instrument ................................ ................................ ................................ ............. 88 Survey Analysis ................................ ................................ ................................ ....................... 89 Qualitative Analysis ................................ ................................ ................................ ................. 89 Results ................................ ................................ ................................ ................................ ...... 90 Survey Demographics ................................ ................................ ................................ ........ 90 Alcohol Use Frequencies ................................ ................................ ............................. 91 Focus Group Demographics ................................ ................................ ........................ 91 Alcohol Step - wise Logistic Regression Models ................................ ................................ 91 Focus Group Results ................................ ................................ ................................ ................ 93 Abstinent Environment Vs. Secular Culture ................................ ................................ ............ 93 Authoritative Parenting Style ................................ ................................ ............................. 95 Drinking for Recreation and Coping ................................ ................................ .................. 96 Discussion of Focus Group Results ................................ ................................ ......................... 97 Discussion ................................ ................................ ................................ ................................ 99 Limitations ................................ ................................ ................................ ............................. 102 Implicatio ns and Recommendations ................................ ................................ ...................... 102 CHAPTER VI ................................ ................................ ................................ .............................. 112 CONCLUSIONS ................................ ................................ ................................ .......................... 112 Integration and Uniqueness ................................ ................................ ................................ .... 112 Relationship to Existing Research ................................ ................................ ......................... 114 Implications for Practice ................................ ................................ ................................ ........ 116 Research and Policy ................................ ................................ ................................ ............... 119 Future Considerations ................................ ................................ ................................ ............ 121 APPENDICES ................................ ................................ ................................ ............................. 124 APPENDIX A: The Health Risk and Protective Factors Study: Form A .............................. 125 APPENDIX B : The Health Risk and Protective Factors Study: Form B .............................. 138 REFERENCES ................................ ................................ ................................ ............................ 151 x LIST OF TABLES Table 1 National Ethnic Differences in Alcohol Use for T hose Aged 12 and Older .................... 25 Table 2 Demographics and Frequencies ................................ ................................ ........................ 75 Table 3 Linear Multiple Progression Revised Model ................................ ................................ .... 76 Table 4 Demographics and Frequencies ................................ ................................ ...................... 107 Table 5 Step - wise Logistics Regression Models ................................ ................................ ......... 108 xi LIST OF FIGURES Figure 1. ................................ ........................... 13 Figure 2. Explanatory Sequential Design Mixed Methods Framework ................................ ........ 51 Figure 3. Conceptual Map of Focus Group Results ................................ ................................ ..... 111 1 CHAPTER I INTRODUCTION Purpose of the Study and Research Questions The purpose of this study wa s to examine the role parents have in college student regular alcohol use in the context of a re ligious subculture that expects abstinence . In what ways do the parent/child relationship and religiosity predict regular alcohol use in a population of Christian college students attending an alcohol - abstinent university ? Much of the research conducted on the role of parents i n youth health risk - taking behavior is conducted among adolescents (Schwartz, et al., 2009). This study aims to build on the limited studies that have been conducted on the role of parents i n college student alcohol use behavior. In order to better understand the context in which the participants and their families live, t his study also examined different elements of religiosity to measure the strongest religiosity elements that may influence alcohol use in a n abstinence - oriented faith and whether religious variables influence parental effects . T here could be risk factors for this population to use alcohol that may not be understood. Many studies have examined gender and ethnic/racial effect s on alcohol use during the college years. There is a gap in the literature examining abstinen t religiosit gender and ethnic/racial differences in alcohol use among college students. There are two separate studies as part of this diss ertation. The first study examine d a survey conducted winter of 2012 that looked a t health risk behaviors (alcohol, substance abuse, and sexual behaviors) along with potential risk and protective fac tors that may affect those health risk behaviors. The author was the project director for the survey being used and was involved in all aspects of the design, data collection, analysis, and report writing for the survey. This study examine d college student involvement and conflict with parent s and its relationship with 2 regular use of alcohol using multiple linear r egressions with a model that included: parental involvement, parental conflict, gender, ethnicity, age, religious belief and involvement . For study one, i t was hypothesized that involvement with parents (stronger for younger college students ) will decrease regular alcohol use . In addition, it was hypothesized that conflict with parents (stronger for younger college students ) will increase regular alcohol u se by college students. The second study used explanatory mixed method looking at the same survey results with the goal of finding the strongest parental protective factors in the context of religiosity an d demographic variables and their relationship with regular alcohol use using step - wise logistical regression models . It was hypothesized tha t college students who have open communication wit h parents would be less likely to consume alcohol regularly . A second hypothesis for both studies wa s religious faith and participation will have a stronger effect on regular alcohol use than any parental variable. Both studies use d the selection criteria of those who self - identify as Seventh - day Adventist (an alcohol - abstinence religion) , single, not living at home, and age 18 - 25. A follow - up qualitative study , conducted winter of 2013, explored perception of alcohol use , and the role of parents and religiosity was analyzed . The author was the project director for this undertaking as well . The qualitative questions were developed with guidance from Dr. Dennis Martell and Dr. Desiree Qin from Mic higan State University , and Dr. Curt VanderWaal from Andrews University . Content analysis was conducted to find the most common themes identified by participants . The outcome of that analysis help ed to explain the results of the survey . Implications and recommendations on ways to increase collaboration between parents and college administrators and counselors in protecting youth from at - risk alcohol use are given. 3 Policy and program recommendations are given to college administrators, th e faith community, parents, and family life educators. Rationale Emerging Adults As a result of economic and social changes, young adults are delaying the typical route to adulthood through marriage with later average age for first marriage (Schwartz, et al., 2009). Arnett (2014) found in his research with individuals 18 - 2 5 years old that there is a transition period to what is conceptualized by society as adulthood where individuals finish schooling, get jobs, join in marriage, have childr en, buy a house, become involved in their com munity, and so on. Arnett (2000 identity exploration, instability, self - focus, feeling in - between, and optimism about the future (Arnet t, 2014). Since adulthood is being delayed, there also can be longer peri ods of experimentation and risk - taking similar to the adolescent years (Arnett, 2005). College students participate in numerous health risk behaviors that may negati vely alter their plans for the future and put them at risk for developing addictions, or even possible early death (American College Health Association [ACHA], 2011). Young adults in this age period may have a different relationship with their parents than in leave the parental nest, but for various reasons (typically economic), many return home (Goldfarb, 2014). Because of this and other societal changes, parents may be involved in their maintaining strong emotional and financial ties to their parents, it is important to study the 4 influence these parents could have on their emerging adult college - attending children (Schwartz et al., 2009). For the past few decades , there has been increased attention on und erage and binge drinking among college students and the consequences related to those behaviors (Turrisi, Wiersma, & H ughes, 2000 ; Schwartz, et al. , 2009 ). The Substance Abuse and Mental Health Services Administration (SAMHSA), which conducts the annual National Survey on Drug Use and Health (NSDUH), defines binge drinking as consuming five or more drinks in one setting on at least one day in the last 30 days (SAMHSA, 2014). National Institute on Alcohol abuse and Alcoholism (NIAA) differs in its definition of binge drinking , defining it as a pattern of drinking that brings blood alcohol concentration levels to 0.08 g/dL . For women that blood concentration level is reached with about four drinks , and for men it is five drinks consumed in about two hours (NIAA, 2004). This research study defines binge drinking using the SAMHSA definition. Alcohol abuse is considered the single biggest public health hazard on college and university campuses today by some authors (Misch, 2010). Research has found attending college is a risk factor for heavy alcohol use. Those evaluated at 18 who planned on attending college were more likely to be heavy drinkers by the age 22 (Merline, Jager, & Schulenberg, 2008). A vast majority of a college age research sample were drinkers (73 - 81%) with about 1/3 meeting the criteria for binge drinking in the previous month (Braitman et al. , 2009; R andolph, Torres, Gore - Felton, Lloyd, & McGarvey,2009; Roberts, Glod, Kim, & Hounchell, 2010 ) . Consuming alcohol also is a risk factor for using illicit drugs. College students who reported being non - drinkers only had a rate of 4.2 percent for using illic it drugs in the past month , compared to current alcohol users (non - binge drinkers) at 7.1 percent and binge drinkers at 18.5 percent (SAMHSA, 2013). 5 Parental Roles Some alcohol use patterns seen in college students bega n in the high school years when parents have more influence, but some use is initiated in college where there is more peer interaction and less parental monitoring (Arria et al. , 2008). Research has found parents can still play a role in the alcohol use patterns of their college age ch ildren. Schwartz, et al. (2009) saw the importance of looking at mother and father relationships with their college age children separately to gauge the distinct and important contributions each parent makes in the likelihood of using alcohol and substanc es. When thinking of college age student involvement with their parent s , many think of the , This phenomenon is more problematic if the child is technically an adult (over the age of 18 ) and away at college. Parent - that is reflected in communication, involvement with one another, and joint activities within the family (Kuendig & Kuntsche, 200 6). Research has found that parental involvement can be a protective factor in adolescent alcohol and substance use (Baltazar, Hopkins, McBride, VanderWaal, Pepper, & Mackey, 2013 & Johnson, McBride, Hopkins, & Pepper, 2014). Conflict with a parent is defined as a pattern of hostile, negative interactions between parent and child. Parent al negative attitudes and relationships with children have been correlated with high levels of substance use in a population of teens (Hayes, Smart, Toumbourou, & Sanso n, 2004). Fischer, Forthun, Pidcock, and Dowd (2007) found that psychological control and lack of connection with parents predicted college student alcohol problems. This may be due to higher levels of stress and perceived emotional harm due to these neg ative interactions (Drapela & Mosher, 2007). The question remains whether parental involvement and conflict still 6 have an influence on college student alcohol use when the young adult can move away from the home environment. Parent - child communication on the topic of alcohol is defined as general openness of parent - child communication or frequency of communication about alcohol (Jackson, Bijstra, Oostra, & Bosma, 1998). Miller - Day and Kam (2010) ha ve conducted extensive resea rch on the role of parent - child commun ication in relation to alcohol use. Miller - Day and Kam (2010) recommend a more multifaceted understanding of communication between parent and child in order to determine which approaches to communication yield the bes t outcomes for alcohol use in youth. S tudies have been conducted on the role of parents in a ffect ing their college student alcohol using patterns. Schwartz, et al., (2009) investigated the association of perceived parenting with health - risk behaviors. Abar and Turrisi (2008) reported that perceived parental disapproval of alcohol use during the adolescent years was strongly associat ed with lower rates of alcohol use in college. Since parents play a powerful role in socializing their children even through the emerging adult years, research suggests that relationships with mothers and fathers ma y explain some of the alcohol use varian ce during college (Schwartz, et al., 2009). also may have an influence on children s alcohol abuse. Cubbins and Klepinger (2007) found that childhood religious affiliation was associated with less past year drug use when they were young adults. In a sample of adolescents, parent religiosity of youth aged 15 - 25 living in New Zealand, one of the themes identified was that belonging to a church community made them concerned about standing in the community (Zuaalii - Sauni, Samu, Dunbar, Pulford, & Wheeler, 2012). 7 Seventh - day Adventist Church The college campus that was studied an d a vast majority (87 %) of the participants in this study were self - identified as Seventh - day Adventist. The Seventh - day Adventist Church is considered a conservative evangelical church group that teaches the abstinence of alcohol and other harmful substa nces ( Dudley, McBride, & Hernandez , 1997 ). There are 17,994,120 Seventh - day Adventists worldwide, with most of them residing outside of the United States (Seventh - day Adventist Church, 2013). The church was founded in 1863 (Schwartz, 1979) The early chu rch took on the cause of health reform , founding centers of healing that encouraged natural remedies, vegetarian diet, fresh air and sunlight, exercise, and trust in divine power for healing (Schwartz, 1979). ge Seventh - day Adventists not only teach substance use abstinence, but also are known for eating a healthier diet with higher rates of vegetarianism and veganism (not consuming any animal products including milk and eggs) than the average American, which has been shown in a recent issue of the Journal of the American Medical Association to be related to a decrease d mortality rates, especially from heart disease in that population (Orlich, et al., 2013). The Seventh - day Adventist church encourage s ce rtain health behaviors in its members that include lacto - ovo vegetarian diet (milk and eggs, but no meat) and abstinence from smoking, unnecessary drugs, alcohol, and caffeinated drinks (Taylor & Carr, 2009) . Seventh - day Adventists health message is based on the belief that the Bible teaches individual s to take care of their bodies because the body is should be cared for intelligently (General Conference of Seventh - day Adventists, 2010 ). The atement regarding substance use is as follows 8 irresponsible use of drugs and narcotics are harmful to our bodies, we are to abs tain from them. Instead, we are to engage in whatever brings our thoughts and bodies into the discipline of (General Conference of Seventh - day Adventists, 2010 ). The 2014 - 2015 u niversity b ulletin o f the Sev enth - day Adventist campus studied states that the institution has a distinctive Christian perspective, guided by their understanding of S cripture, which informs faith as well as practice. This becomes evident as students encounter the S eventh - day Sabbath day of rest and worship, wholesome recreational and entertainment choices, an emphasis on healthful living (that includes eating a healthy diet, abstinence from all substances, and sex reserved for marriage), concern for others through l ocal and global service, the care of dedicated staff and professors, and a hopeful view of the present and future as found in Jesus Christ (Andrews University, 2014). The literature on college student substance use is vast, but there are some populations where there is limited information regarding risk and protective factors of their alcohol use. Religiosity R ecent polic y changes at some alcohol abstinent colleges appear to r eflect a cultural shift that is more accepting of alcohol use on Christian co llege campuses with a long history of alcohol abstinence . Moody Bible Institute and Wheaton College have recently lifted the alcohol ban for faculty and staff in order to aid in recruitment and retention ; some wonder if there may be changes for the student body in the future (Oppenheimer, 2013). It is important to explore whether there is a cultural shift in attit udes towards alcohol on alcohol - abstinent colleges. In addition, t here may be elements of r eligiosity that are more helpful in protecting college students from the potentiall y dangerous aspects of alcohol use. This information will be helpful to family life educators, parents , and college administrators . It has been well 9 documented that religi ous and spiritual beliefs and practices are associated with positive well - being in youth (Urry & Poey, 2008). Researchers have found that internalization of religious beliefs and values can guide and modify behavior in youth (Ellison & Levin, 1998). Thes e behaviors may be due to religious doctrine or a general belief that the body is the temple of the Holy S pirit (George, Larson, Koenig, & McCullough, 2000). Though religiosity can have a positive influence on youth development, most college students are not secure in their beliefs (Astin, Astin, & Lindholm, 2011). Religiosity/s pirituality needs to be understood in the context - changing lives w here its influence may wax or wane (Nasir, 2008). Research has found that not all aspects of religion are helpful for an and physical health. In a national sample of African Americans ( N =2,370) who were an average age of 53 , researc hers found a complex relationship between religious involvement and beliefs (Holt, Clark, & Roth, 2014). Participants with strong religious beliefs were less likely to believe that illness is punishment for sin , which was linked with decreased binge drink ing . However , individuals who were religiously involved were more likely to believe that illness is punishment for sin , which translated into more binge drinking (Holt, Clar k , & Roth, 2014). This may be linked to a certain amount of fatalism in individua ls perception s of their life choices in relation Religion can turn toxic when it is turned into a form of abuse called spiritual abuse . Spiritual abuse negatively affects the bio/ps y cho/social and spiritual domai ns of the victim (Ward, 2010). There is a need to explore this topic further to aid in clarifying what elements of religiosity are helpful and which ones are potentially harmful. Theoretical Framework The ecological perspective on the family developed in the late 19 th century during a period of major societal change in industrializing countries (Bubolz & Sontag, 1993). There was 10 a concern about the effect of industrialization and urban migration on the health and welfare of indivi duals and families (White & Klein, 2008 ). Ernst Haeckel, a German biologist, coined the term ecology from the Greek root oik , which m . In addition, i , Ellen Swallow Richards , a chemist, saw how knowledge from science rder for them to have more perceived control over their lives and the technology in their environment (Bubolz & Sontag, 1993). This then led to the development of home economi cs. The term ecology is strongly linked to the early development of the field of home economics , and the fam ily was very much a part of home economics as a field (Bubolz & Sontag, 1993). the incr e ased empha sis on a holistic approach to understanding human behavior, the theory reemerged ( Ray , 1988 ). Buboz & Sontag report ed (p. 419). Family Ecology F ramework Bu bolz and Sontag (1993) buil t upon early conceptualization by Hook and Paol ucci (1970) that family was a major source of support to the individual , but the family depended on the environment to provide for physical needs and social interaction. There was a special emphasis on the family ecosystem . Family ecology is founded on the belief that the well - being of the family is essential to the well - being of an individual (Ray, 1988). F amily members were seen as interdependent biophysical and social individuals , and the family i s its own system that int eracts with its natural, social - cultural, and human - built environments ( Sontag & Bubolz , 2003). Deacon and Firebaugh (1988) proposed that the family is a system interacting with its environment , and this influenced family decision - making. The family syst em is made up of 11 individual subsystems within the family , and there are family managerial subsystems (Ray, 1988 ). These subsystems interact with all aspects of family decision - making (Bubolz & Sontag, 1993). Families do not merely reac t to environmental changes. They are a complex system that has links between parts and wholes with input between each other throughout the system (Bubolz & Sontag, 1993). W right and Herrin (1988) proposed that family ecology emphasizes: 1. A philosophical approach that follow s the changing relations among psycho - social - bio aspects of holistic entities. 2. Integrating a curriculum on the phenomenon of the family that is based on knowledge gathered by complementary disciplines. 3. Investigating the family with both quantitative and qu alitative methods that capture the dynamic of interactions between the family and their environment. 4. Promoting policy and intervention programs that apply the knowledge gained from the processes named above. Family science theories continue to evolve over the years. Lerner, Johnson, & Buckingham (2015) support the current evolution of human development theories into a relational developmental systems (RDS) metamodel. This metamodel emphasizes mutually influential relations between individuals and their co ntext. Boss (2015) suggests that the goal of RDS should be to generate evidence based approaches that are applicable to individuals and families in order to optimize human development among diverse youth, families, and communities around the world. Bioecological Theory of Human Development Bronfenbrenner (1979) built on an earlier work by Lewi n (1935) for his book entitled the The Ecology of Human Development . Bronfenbrenner (1979) asserted that starting from 12 conception , the individual is not only g rowi ng ontogenetically, but that the individual is al ways relating to somebody . Human development takes place in a set of nested and changing environments that have complex relations to one another (Bronfenbrenner, 1979). This central argument does not originate with Bronfenbrenner, but he is one of the more detailed and systematic in his exploration of this framework (White & Klein, 2008). approach focus es on individual development within different system levels and the interactions that occur (Ray, 1988 ). F amily ecology focuses more on the family as a system interacting with other systems (Ray, 1988 ). T he individual is viewed as interacting with microsystem s (role within the system and family and peer r elations), meso system s (interactions between two or more micro systems), exosystem s (outside systems that the individual does not belong to , but that affect the i macrosystem s (culture and policies ) (Bronfenbrenner, 1979 ). The chronosystem is overarching all of the systems and reflects the passage of time . 13 [Grab your with a great quote from the document or use this space to emphasize a key point. To place this text box anywhere on the page, just drag it.] [Cite your source here.] Mesosystem [Cite your source here.] Macrosystem F igure 1 . conceptual model . Bronfenbrenner continued to work on his theory of development throughout his life (Tudge, Mokrova, Hatfield, & Karnik, 2009). The final theory included more b iology and was entitled , t he b ioecolo g i cal m odel of h uman d evelopment (Bronfenbrenner & Morris , 2006 ) . There was a re - emphasis on the interaction between the biology of an individual and the Chronosystem Macrosystem Exosystem Mesosystem Neighbors Social Services Microsystem Individual (sex,age, health, etc.) School Family Church Peers Health Services Mass Media Industry Local Politics Mesosystem 14 development ( Bronfenbrenner & Morris, 1998 ). Bronfenbrenner put more focus on the proximal process as the center of a Process - Person - Context - Time model (Tudge, et al., 2009). This later multiple factors that influential factors include : 1. T he settings within which the developing individuals spend their time and relationships with others , 2. T haracteristics that develop over time , 3. T he historical context in which an individual lives , and 4. T he biological mechanisms that drive an 2013). Human Ecology in Youth Health Risk A ssessment Our environment has an influence on whether the biological tendencies with which we are born are activated. For example, individuals may have been born with the tendency to develop an addiction to alcohol , but if they do not use alcohol, they will not develop an alcohol addiction. Of course, there may be other things in their environment to which they could be addicted , su ch as other substances or pornography. Individuals are not blank slates that develop within a vacuum; they have interactions with others and their environment. Those interactions influence their in - born behavioral traits. In referencing back to Bronfen interactions at the micro - , meso - , exo - , and macrosystem levels. At the micro level, the dyadic relationship is usually between a paren t and child (Garbarino & Sherman, 1980 ). Parents provide a suppor t system for the child (Bubolz & Sontag, 1993). With families living and 15 ( Bronfenbrenner & Morris, 1998 on his/her parents which then, in turn, reciprocates and influences the child. These dyad interactions will change throughout the life course, with parents having less influence over the youth as they age into adu lthood (Bronfenbrenner, 1989). Families are only one microsystem influence on the developing individual. Peers have an effect, depending on characteristics of the individual and his/her peers and the strength of the parent/child bond (if there is a weak parent/child bond, peer relationships bec ome more important) (Brown & Larson, 2009). Significant others become more imp ortant as the child ages. Peer relationships are unstable at first, but become more stable with development (Brown & Larson, 2009). The influence of peer interactions on the d eveloping individual depend on the of time he/she spend s together, and the time in which he/she live s (Bronfenbrenner & Morris, 1998). School as a system has a major influence on a n adolescent education that then leads to the possibility of gett ing employment and living at a certain socioeconomic level (Eccles & Roeser, 1999). Schools have policies on school attendance, behavior, and what is required for academic achievement that are often set by larger macro systems (e.g. state and federal gove rnment) that, when enforced, will have an effect the school and his/her teachers (White & Klein, 2008). The interaction between the neighborhood and the school increases the chance that the neighborhood will be a support for the school (Eccles & Roeser, 1999). 16 At the macrosystem level, policies and culture have multiple influences on the developing youth. Youth live within a culture that is prominent in their country, but also may be part of an ethnic and/or religious subculture that may have different values from the majority culture. Culture influences morality, language and its symbolism, parenting styles, and allowable levels of autonomy (Maschinot, 2008) . Policies are a part of every ecosystem. Starting from birth, there are policies that influence parenting, access to healthcare, education, confidentiality, criminality, employment, transportation, substance use, food, religion, economics, entertainment , marriage, and even death. Though human ecology as a theory can be applied to many disciplines that study individuals and the environment, it can sometimes be difficult to use in actual research. There has not been an agreement among the disciplines of a single set of theoretical propositions (White & Klein, 2008). Though many have tried to apply the human ecology theory to the study of individuals interacting with their environment, they often focus on certain frameworks and elements of the theory as it applies to the topic being studied (White & Klein, 2008). This is especially true in the area of youth health risk assessment. In the area of youth health risk assessment, specifically youth alcohol use, Urie ology of human development have been used more often in research (Ennett, et al., 2008). Ennett et al. (2008) put forth the idea that, based on the ecology of human development, there are four social contexts that may influence adolescent alcohol and subs tance use. On the microsystem level, the contexts are family, peers, and school, then neighborhood on the exosystem level, and the interrelations between all these contexts is the mesosystem. The macrosystem level contexts are culture and policies. In regard to how the human ecology theor etical framework will be used in thi s study, 17 there will be a focus on the microsystem family influence on youth decision - making regarding the use of alcohol , while keeping in mind the macrosystem polici es of attending a n abstinent school . In this context, religion also has a microsystem influence at the individual level in regard to the personal relationship an individual has with God and what he/she believe s God expects of his/her behavior based on what the religion te aches. There is a need in the youth health risk framework that includes a specific focus on a Process - Person - Context - Time model, which this study will attempt to apply (Tudge, et al., 2009) . This study will examine the Process - Person - Context - Time model regarding the consumption of alcohol as it relates to: 1. The proximal process between parent and child, participant and religiosity, with some attention to peer pr ocess; 2. T he context of an abstinent conservative Christian religious school, 3. The person oriented predictor variables of gender, age, and ethnicity; 4. A n acknowledgement of the historical time in which the participants are currently living that normalizes alcohol consumption . Positive Y outh D evelopment The positive youth development perspective is a rejection of a deficit orientation towards youth and is a strength - based conception (Lerner, Abo - Zena, Bebiroglu, Bri ttian, Lynch, & Issac, 2009). According to Lerner, et al. (2009), positive youth development recognizes the importance of relationships between individuals and their ecological settings . These interactions then lead to the variations in human development, similar to the human ecology theory. Families, schools, and communities can support youth in the promotion of positive youth development (Lerner, et 18 al., 2009). Research has found that there are certain factors that lead to bette r youth outcomes, and these include : 1. P arents who give large quantities of quality time to their children , 2. H igh - quality, engaged teachers , 3. A ccess to community mentors , 4. E as e in access ing institutions that provi des safe and high quality after - school activities , 5. O pportunities for group projects with adult mento rs , and 6. S afe communities to live in where youth have better outcomes (Lerner, et al., 2009). Lerner, et al., (2009) ha ve proposed the Five Cs as a way to conceptualize positive youth development. These Five Cs are competence, confidence, connection, character, and caring . This study will focus on connection with parents and religion that leads to developing character , whi ch then foster s positive outcomes for youth. Parents should be considered the first and perhaps most essential part of positive youth development (Ward & Zabiskie , 2011). Parental involvement is one of the strongest predictors of a young person reaching his or her poten tial (Witt & Caldwell, 2005). Aspy, Tolma, Oman, & Vesely (2014) found that parental assets of family communication, relationship with mother and father, and parental monitoring led to lower rate s of drug use in adolescents. Parents are listed as one of the main sources of health information for college students (Vader, Walters, Roudsari, Nguyen, 2011). However, very little attention has been gi ven to parenting that facilitates positive youth development , and even less focus on college age youth (Chand , Farruggia, Dittman, Sanders, & Ting Wai Chu , 2013). 19 CHAPTER II LITERATURE REVIEW The concept of emerging adulthood and how this life stage affects substance use is introduced. This literature review will look at research that has studied the alcohol use among college students as a youth health risk behavior . Risk and protective factors included in this review are family dynamics, religiosity, and mental health; and college policies will be examined. By identifying risk and protective factors, parents and colleges can better focus their energies , to help prevent or limit possible short - term and long - term ne gative consequences of alcohol use. Next, this literatur e review will include a critical analysis of the literature followed by a summary of recommendations that address the problem of alcohol use by college students, based on research and theory . Emerging A dults Arnett (2000) proposed a new developmental pe riod between adolescence and young the qualitative interviews he conducted with individuals from that age group, he saw that they did not seem to have reached a period in their life that offered an amount of stability that would last until midlife. It used to be thought that adolescents go directly into a more settled young adulthood that would last until the next stage called middle adulthood (Arnett, 2014). A round the mid - late 1990s, it appeared that there was a new cohort who went through a new life stage that had unique characteristics, and the idea was readily accepted by the research community (Arnett, 2014). Arnett (2014) proposed five features unique to emerging adults which he found w ere supported from his quantitative and qualitative research: identity exploration, instability, 20 self - focus, feeling in between, and possibilities/optimism. There are researchers who challenge the universality of these five features , suggesting that this concept mainly applies to young adults in higher education, who were largely recruited from the middle class (Hendr y & Kloep, 2010 & Cote, 2014). Specifically, researchers have recently stated that emerging adulthood is dependent on cultural (e.g. Cheah & Nelson, 2004, Bynner 2005, Mitchell, 2006) and social instit utions (Heinz & Marshall, 2003 ), and it is not a universal stage for all youth aged 18 - 29 around the world. Since the population being studied is college stud ents in the U.S., the participants are assumed to have some of the characteristics of emerging adulthood as characterized by Arnett (2014). erging adults continue practicing identity exploration into their 20s (Arnett, 2014). It is a time when they actually have more freedom to try out different identities through love, work, and various ideologies (Arnett, 2004). This age group is now getti ng married on average at later a ges than any time in recorded U S history (US Census Bureau, 2014). Men are getting married at the age of 29 , an d women around the age of 27 (US Census Bureau, 2014). Arnett (2004) also found that individuals in this life s tage were often not settled into their career of choice. Many had a job for practical reasons, but had hopes to move to another career (Arnett, 2004). Since there are many different identity explorations, this also leads to higher rates of change and in stability. Part of this identity searching is exploring different romantic relationships. A significant proportion of women cohabitate with their first union (48%) (US Department of Health and Human Services, 2013). These first unions were typically sho rt - lasting, ranging from 19 - 33 months on average (with white women having the shortest average 21 and Hispanic women having the longest average) (US Department of Health and Human Services, 2013). One of the changes that often occurs during this life stage i s being in and out of higher education. There is an end to compulsory education, so education becomes optional, based on life circumstances and goals. According to the National Center for Education Statistics (NCES), only 59% of those who start at a four - year college will finish six years later (NCES, 2013). There also is job instability, with the average American holding 8 different jobs duri ng the years from 18 to 29 (US Department of Labor, 2012). The emerging adult years are a time when there are typically fewer responsibilities. Children and adolescents have to respond to the demands of parents, siblings, and school authorities. Older adults typically have demands of spouses, children, and work. Single emerging adults and those without children still have demands of work and/or school, but they often have more options in their response to those demands than those who are younger and older (Arnett, 2014). This allows them to focus more on their own needs. Twenge (2013) proposed that Millennials (those born after 1980) are more Generation Me than Generation We, based on a review of studies of college and child samples that show an increase in self - esteem and narcissism over the generations. Thi s perception has led to a negative view by general society . In an internet sample of individuals aged 18 - 87, there were more positive views towards adults and older adults than adolescents and emerging adults. The sample of 641 tended to think emerging a dults were more immoral, narcissistic, over confident, and less agreeable and emotionally stable than adults (Trzesniewski & Donnellan, 2014). Arnett (2013) challenged this notion, stating that narcissism scales conducted on college students are unreliab le, and higher self - esteem is a helpful coping tool to deal with difficulties that emerging adults face. In an annual survey of college freshmen, over 80% reported being 22 involved in volunteer work sometime in the past year, the highest rate in the history of the survey (Higher Educati on Research Institute, 2013). The volunteer work done by young adults may be compulsory or as a way to build the resume, thus it may not necessarily be altruistic. There may be religious influences affecting volunteer partic ipation. Mormon emerging adults were more likely to volunteer than Catholics or non - Catholics (Johnson, Okun, & Cohen, 2013). The authors believe that Mormon culture that puts a strong emphasis on caring for family , and fellow Mormons may have influenced the frequency and type of volunteering in which young adult Mormons engaged (Johnson, et al. , 2013). Becoming an adult is a gradual process through the age period of 18 - 29 (Arnett, 2014). In Arnett s (2014) work, 61% of t hose who were age 18 - 21 years old - 29 year olds responded that way. Thus, this age period can be characterized as being in - between adolescence and adulthood. Emerging adults sometimes need to rely on their parents financially, for example, as they sometimes have to move back with them (Goldfarb, 2014). Nevertheless, emerging adults are optimistic about their future. Some researchers challenge this notion , saying it is thos e who have access to education, support, and financial resources who are more optimistic (Hendry & Kloep, 2010). Arnett (2004) believes t hey want to do better than their parents and honestly believe that they can, especially those from lower soci oeconomic groups . One way they feel confident in their optimism is their increased focus on the importance of higher education to achieve success in adulthood (Pew Research Center, 2014). Arnett (2014), reports that t hey believe with more education they can have more occupational accomplishments and be happier than their parents . Alcohol use also may be part of the identity exploration that occurs during this life stage 23 (Arnett, 2005). Arnett (2005) believes e merging adults want to try a variety of identities before they settle down into a st able adult life. Alcohol can be used to cope with the stress of having to choose an identity (Arnett, 2005). In addition, alcohol also may help the emerging adult deal with the certain amount of instability that is typica l for that age (Arnett, 2005). Arnett (2005) reports that s ince they do not feel they have reached an age of responsibility , and emerging adulthood is seen as extended adolescence, there is an extended period of alcohol use . Though there is optimism and a certain amount of denial regarding the problem of using substances, a majority of lifetime substance abuse disorders will occur by the end of the third decade of life (Kessler, et al., 2005). The age span of 18 - 25 year olds includes the average college age student (Arnett, 2000). A majority (66%) of high school graduates enroll immediately in colleges, so a viable place to study emerging adults is among the college student population (U S Department of Education, 2014). Alcohol U se The college years i nvolve a lot of alcohol experimentation that usually starts in the adolescent years and expands during college; it is influenced by less parental supervision and a , but also may be a result of mental health issues related to past sexual abuse and depression (Klanecky, McChargue, & Bruggeman, 2012, Lamis & Lester, 2012), poor academic achievement (Ansari, Stock, & Mills, 2013), and easy access to alcohol (Wechsler, L ee, Nelson, & Kuo, 2002) . Many college students believe heavy drinking is part of the college experience (Luquis, Garcia, & Ashford, 2003). Full - time college students between the ages of 18 and 22 were more likely than their peers who do not attend colle ge full - time to report current and binge drinking (SAMHSA, 2013). The National Survey on Drug Use and Health (NSDUH) defines 24 current alcohol use as consuming alcohol at least once in the past 30 days and binge drinking as consuming five or more alcoholic drinks at one sitting at least one day in the last 30 prior to taking the survey (SAMHSA, 2013). However, the National Institute on Alcohol abuse and Alcoholism (NIAA) differs in its definition of binge drinking , defining it as a pattern of drinking that brings blood alcohol concentration levels to 0.08 g/dL. For women , th e blood concentration level is reached with about four drinks , and for men it is five drinks consumed in about two hours (NIAA, 2004). A 2012 NSDUH noted that 60.3% of college students said they were current drinkers , and 40.1% were binge drinkers . This compares to 51.9 and 35.0% for non - college students. The rates have decreased slightly since 2002 from 44.4 to 40.1%. Young adults who are under the age to consume alcohol legally, bet ween the ages of 18 to 20 (this includes college and non - college students), had a rate of 45.8 of alcohol use in the past 30 days. That rate has gone down from 51% in 2002. There are gender, ethnic, and age differences in alcohol consumption. Being a n older male has been associated with binge drinking (usually defined by researchers as five or more drinks in one sitting) and its associated problems (Oliver, Reed, & Smith, 2001; Randolph, et al, 2009). Men report more days of binge dr i nk ing and more binge drinking than women (Wells, Kelly, Golub, Grov, & Parsons, 2010). The NSDUH reported that all underage males were more likely than females to report binge drinking (1 6.5 vs. 14.0%) (SAMHSA, 2013). Males who were full - time college students were more likely to binge drink (in the last 30 days) than their female counterparts (45.5 vs. 35.3%). However, a review of college - student alcohol use trends comparing binge drinking gender differences has found that the gender gap is narrowing from 80% of males and 49% of females who reported in 1953 to getting drunk in their lifetime to 68% 25 of males and 68% of females who reported almost sixty years later in 2011 to getting drunk in their lifetime (White & Hingson, 2013). The NSDUH survey did not report ethnic /racial differences in alcohol use between college students , but did report on ethnic differences for those aged 12 and older and aged 12 - 17 , s ee Table 1 . T he survey found that generally w hites and those who were multi - racial had higher rates of alcohol consumption , and Asians had the lowest rates. Table 1 National Ethnic Differences in Alcohol U se for T hose Aged 12 and O lder --------------------------------------------------------------------------------------------------------------------- Ethnicity Current Drinkers 12 + Binge Drinkers 12 + Current 12 - 17 yrs ------------------------------------------------------------------------------------------------------------------- Whites 57.4% 23.9% 14.6% Multi - racial 51.9% 25.1% 11. 7% Blacks 43.2% 20.6% 9.3% Latinos 41.8% 23.2% 12.8% Native American/Alaskan 41.7% 30.2% 10% Asian 36.9% 12.7% 8% ---------------------------------------------------------------------------------------------------------------- ----- Note. This table is adapted from statistics reported by National Survey on Drug Use and Health (NSDUH) (SAMHSA, 2013). One study found some gender/racial differences. African - American females were found use d alcohol less often than white women (Randolph, et al., 2009). In summary, those who self - identify as white or being two or more races had the highest rate of current alcohol consumption , and Asians had the lowest for those aged 12 or older and youths age d 12 to 17. The only exception was for binge drinking where those who are American Indian or Alaskan Native had a higher rate than White or multi - racial, but Asians were still the lowest. 26 Age had an influence alcohol consumption as well . A s college stude nt s g e t closer to 21, it was found that their drinking increased . Instances of drinking and driving also increased by 72% during the two weeks after young adults turn ed 21 (SAMHSA, 2014) . Even though drinking increased as college students turned 21 , research has found that drinking decreased between the ages of 21 - 23 (Fromme, Wetherill, & Neal, 2010). There are other variables that have been studied recently such as parental alcohol use and lifestyle issues. Those who are adult children of alcoholic s started drinking earlier (Braitman, et al., 2009). High levels of energy drink consumption w as associated with a higher risk for alcohol dependence compared with those who did not consume or who used energy drinks infrequently (Arria, Caldeira, Kaspersk are lifestyle issues related to alcohol consumption. A study found that lack of sleep also was r elated to alcohol use among college students (Vail - Smith, Felts, & Becker, 2009). There are ti mes t hat alcohol is more likel y to be consumed. Weekends and celebratory drinking around events like tailgates for games showed higher alcohol consumption (Woodyard & Hallam, 2010; Tremblay, Graham, Wells, Harris, Pulford, & Roberts, 2010). Alcohol had higher use rates at the beginning and end of the school year (Dierker, et al., 2008). Tremblay, et each semester and less during exams. They also found that the hig hest rates of drinking during the academic year o ccur r ed Alcohol consumption is associated with lowering inhibition and increasing risk taking (Browne, Clubb, Wang, & Wagner, 2009; Phillips & Ogeil, 2010). Those who are socially anxious often feel drinking at a party can help them relax and enjoy the party more (Ham, 2009). Thus, they are less inhibited in social situations where there are more chances of participating in 27 other health risk b ehaviors. Some even drink before the party to facilitate their perceived enjoyment of the party a nd therefore end up with higher alcohol levels (Pedersen, LaBrie, & Kilmer, 2009). Alcohol use is associated with many other health risk behaviors. Those who drink alcohol regularly in college (14%) reported alcohol related injuries (Turner, Keller, & Bauerle, 2010). Merline, et al. (2008) evaluated predictor variables with alcohol use over time from age 18 through age 35. Their evaluation showed that cigarette and marijuana smoking, high school theft, property damage, and risk taking predicted heavy alcohol use in adulthood. Male college students who drank were less likely to use con doms (Certain, Harahan, Saewyc, & Fleming, 2009). Internet addictions were associated with harmful alcohol use among a population of college students (Ju - Yu, Chih - Hung, Cheng - Fang, Cheng - Sheng, & Cheng - Chung, 2009). It is hard to know which of these beha viors came first, but it appears they do influence each other in a problematic way. Alcohol Consequences Since a majority of college students drink alcohol in any given month (65%), research has found many consequences associated with this pattern of be havior (White & Hingson, 2013). Though it is considered alarming when college students consume excessively large amounts of alcohol that have been linked to alcohol poisoning, in a study of 9,000 college - student drinkers across 14 college campuses in Cali fornia, more than one - half of alcohol - related consequences occurred after college students consum ed only two to four alcoholic beverages at a sitting (Gruenewald, Johnson, Ponicki, & LaScala, 2010). Though heavy alcohol use is lower than in the past , ther e are still problematic consequenc es to the heavy drinking that are occurring on college campuses. Hingson, Zha, and Weitzman (2009) summa rized data from the National 28 Highway Traffic Safety Administration Fatality Analysis Reporting System, Centers for Di sease Control and Prevention Injury Mortality Data, National Coroner Studies, census and college enrollment data, the National Household Survey on Drug Use and Health, and the College Alcohol Study that estimates the number of college students effected by multiple consequences of alcohol use per year . The following is a list of alcohol - related consequences , with some being projections based on small amounts of data : Death up to 1,800 college st udents aged 18 to 24 die in alcohol - related unintentional injuries, including motor - vehicle crashes per year Injury around 599,000 are unintentionally injured while under the influence of alcohol Physical assault an estimated 646,000 college studen ts were assaulted by another student who had been drinking Sexual assault 97,000 of students reported being victims of alcohol - related sexua l assault or date rape Drunk driving around 3,360,000 drive while under th e influence of alcohol (Hingson, et al., 2009) Alcohol - use disorder 20% of college students diagnosed in one study (8% alcohol abuse, 13% alcohol dependence) (Blanco, et al., 2008) Risk Factors Literature points to mental health, problematic family issues, and trauma history as risk factors that may be present themselves during the college years. This study will examine th e following independent variables as potential risk factors in relation to alcohol use: problematic family relations, trauma, and problems with coping. 29 Problematic Family R elations There are multiple types of parent/child interactions that put an emerging adult child at risk of using substances in college. Conflict with parent has been studied in the context of emerging adulthood adjustment and alcohol u se. Castellani, et al., (2014) found that aggressive adulthood, especially when exposed to day - to - day difficulties and angry interactions with others. Volatile behavior of family members contributes to the development of adolescent alcohol consumption (Polen, Scholte, Willemsen, Boomsma, & Engels, 2007). Research has found correlations between family volatility and increased alcohol use in adolescents (Johnson, et al., 2 014). Parent - child conflict has been suggested as a pathway to alcohol use and risk for abuse. Chaplin, et al., (2012) examined fifty - eight 10 - 16 year olds and their parents discussing a mutually highly - rated conflict topic. Findings suggest that height ened emotional and physiological responses due to parent - child conflict may lead an adolescent to turn to alcohol to cope with these responses (Chaplin, et al., 2012). There were no studies found that examined parent - child conflict and college student alc ohol use. College age children of alcoholics were found to be current drug users and initiated alcohol earlier by comparison with college age children not reared in alcoholic families (Braitman, et al. 2009). When underage college students think their p arents approve of them drinking, it has been linked to drinking behavior problems (Boyle & Boekeloo, 2006). There is also a certain level of denial that parents seem to have . Parents tend to think their college age children are doing better than they ar e by underestimating their frequency of alcohol, smoking, - reports of general health (Bylund, Imes, & Baxter, 2005). 30 Certain types of parenting styles and parent/child relationships hav e been associated with health risk behaviors and mental health. It is important for college students to feel close to their parents, but also to have a certain level of independence. This is called individuation , and it has been associated with higher le vels of well - being (Yelle, Kenyon, & Koerner, 2009). Maternal overprotection and a cold parenting style ha s been linked to social anxiety, especially in the first semester (Spokas & Heimberg, 2009). Parental mental health issues have been associat ed with - esteem and McGuire, 2011). Mental H ealth D epression has been linked to a number of health risk behaviors. In a study of more than 1,800 students at four universities , 24% of college students had seriously considered attempting suicide , with 5% actually attempting while they were in college (Weste felt, et al., 2005). According to Hirsch & Barton (2011), s uicide attempts are more common among college age students compared to their non - collegiate peers, t hough college students ar e less likely to die from suicid e than the general population (Cerel, C olin, & Moore, 2013). Another characteristic that is associated with suicide is access to a firearm. Almost all (97%) schools have a policy of prohibiting firearms on campus, but one study found that there is not much awareness of the policy (Thompson, Price, Mrdjenovich, & Khubchandani, 2009). Lack of social support and social conflict puts college students at risk of attempting suicide (Hirsch & Barton, 2011). Sometimes it is a simple lifestyle issue , as t hose who do not get enough sleep are at grea ter risk for suicide ideation (Vail - Smith, et al., 2009). Depression is not only linked to suicide. Roberts, Glod, Kim, & Hounchell (2010) found in a study of 428 college students that moderate 31 depression was also related to cigarette smoking, physical, and verbal aggression. General feelings of well - being can help decrease participation in health risk behaviors. Well - being had the strongest negative association with casual sex, sex while drunk, drunk driving, and being a passenger of a drunk driver (Sc hwartz, et al., 2011). Trauma Trauma can come in many different forms and can come from different places and have long - term negative consequences . Two - thirds of college students from two different universities reported at least one form of trauma in their lifetime (Read, Ouimette, White, Colder, & Farrow, 2011). The most common type of trauma experienced was the sudden death of a loved one (30%); about 25% experienced a physical assault and/or an accident, natural disaster, or a fire, and 7% experien ced a sexual assault (Read, et al., 2011). There are about 10% of college students who meet the criteria of Post - Traumatic Stress Disorder (PTSD) (Read, et al., 2011). There are gender differences , with women experiencing more traumatic life events than men (Read, et al., 2011). Many who experience trauma turn to drugs and alcohol to numb the emotional pain , and this leads to poorer health outcomes (Flood, McDevitt - Murphy, Weathers, Eakin, & Benson, 2009; McDevitt - Murphy, Murphy, Monahan, Flood, & Weathe rs, 2010). There are various studies that looked at trauma among college students. In a study of college students who lived through Hurricanes Katrina and Rita, 47% were at the clinical level for depression, 6% had PTSD - like symptoms, and 16.9% reported substance use (Lemieux, Plummer, Richardson, Simon, & Ai, 2010). It has been theorized that early childhood traumatic events can lead to depression, anxiety, and poor coping through health risk behaviors (Ellis & Trumpower, 2008). Men who experienced ea rly high psychosocial stress (such as verbal, physical, sexual abuse, witnessing violence in the home, mental illness or substance abuse in the 32 home, experienced death of a close family member, or divorce in the first seven years of life) had more terminat ed short - term relationships and a higher amount of lifetime sex partners. Women who had similar childhood experiences had shorter current relationships, but not more lifetime sex partners or terminated short - term relationship s (Koehler & Chisholm, 2009). When studying those who had experienced a single incident of trauma as a child and those who experienced repeated or prolonged trauma , it was found that they had more tension, nervousness, insecurity, emotionality, and irritability compared to those who h ad not experienced trauma (Allen & Lauterbach, 2007). In a study of first - semester college students , those who had experienced past trauma and adverse events, more eating disorders at college entry were reported , and the disorder worsened over the course of the semester (Smyth, Heron, Wonderlich, Crosby, & Thompson, 2008). Protective Factors This study will examine the following independent variables that are considered protective factors in relation to reduced alcohol use: involvement with parents (par ental bonding) , parental communication regarding alcohol use, and religiosity (beliefs, participation, and abstinence) . Parent - Child Bonding and Communication Much of the research done on parental influence on youth risk - taking behavior is conducted on adolescents (Schwartz, et al., 2009). Some alcohol - use patterns seen in college students began in the high school years when parents have greater influence, but some use is initiated in college when there is more peer interaction along with more access to alcohol and less parental monitoring (Arria, et al., 2008). Parents can no longer monitor their college age 33 children who do not live at home, but parental monit oring can help decrease alcohol consumption in college indirectly. Parental monitoring of high school students has been associated with less alcohol and drug use. This actually has an indirect effect on high - risk drinking among older adolescents because they were drinking less to begin with (Arria, et al., 2008). The bond between parent s and their emerging adult child ren also has been studied in relation to alcohol . Schwartz, et al. (2009) saw the importance of looking at mother and father relationships with their college - age children separately to assess the distinct and important contributions each parent makes in the likelihood of substance use. A longitudinal study that measured parental involvement and alcohol - related risks across the first year of college found that greater attachment to mother was associated with less alcohol risk (Labrie & Sessoms, 2012). Weaker attachment to mother was associated with greater alcohol risk - taking and more consequences by the end of the year. The young men with w eaker attachments to parents had more alcohol - related consequences than males or females with stronger attachments (Labrie & Sessoms, 2012). Schwartz, et al. (2009) found that perceived acceptance by both parents, but especially father figures, was a prot ective factor against a number of health - risk behaviors, including alcohol consumption and binge drinking. Fischer, Forthun, Pidcock, and Dowd (2007) found that psychological control and lack of connection with parents predicted college student alcohol pr oblems. In addition, having family dinners , even with college age children , can play a positive role. Among college students aged 18 and 19, those who ate with their family five or more times per week were 40% less likely to have used alcohol in the past year (McBride, Hopkins, Baltazar, VanderWaal, & Conopio, 2013). Frequent family dinners were not protective for older children (20+) in college, however (McBride, et al., 2013). 34 Parents also can engage in ineffective strategies to reduce substance use. In a study of parent communication strategies regarding substance use among first year college students, the majority reported that their parents told them just to use their own judgment, but i t was found to be generally ineffective (Miller - Day, 2008). Miller - Day (2008) suggested implementing clear communication strategies as to what parents desire their children do in relation to alcohol. Abar and Turrisi (2008) reported that perceived parent al disapproval of alcohol use during the adolescent years was strongly associated with lower rates of alcohol use in college. In summary, research has found that parents have a role in e by having a close bond with their child, sharing clear communicatio n strategies regarding alcohol use, and frequent family dinners where bonding can be reinforced and communication takes place, while giving them a certain amount of freedom to make their own decisions. Religiosity Studi es have generally found religion to be a protective factor in relation to alcohol use . importance of religion - shaping alcohol choices. When comparing college studen ts at a religious college versus a state university, students at the religious college were found to have higher rates of religiosity while the state university students were 27 times more likely to be heavy alcohol users and 9 times more likely to use alc ohol moderately (Wells, 2010). Religious well - being has been found to be inversely associated with alcohol use, the likelihood of going to an event where alcohol is likely to be present, and the beliefs of the social benefits of alcohol (VonDras, Schmitt, & Marx, 2007). Those who had negative religious experiences (e.g., disagreement with friends reported more consequences related to their drinking (Brechting & Carlson, 2015). 35 Studies show that college students who are religious have lower rates of depression than those who are non - religious (Phillips & Henderson, 2006). In a longitudinal survey of college students, religiosity and/or spirituality had a dir ect and protect ive effect over time on depression (Berry & York, 2011). There are three main reasons for this: 1) religion offers people a variety of social interactions through various church activities, 2) religion helps people make sense of the many ty pes of tragedies that can happen in their lives, and 3) religion promotes healthy lifestyles that protect people from depression (avoiding alcohol and drugs) (Phillips & Henderson, 2006). College students who report religious influence and religiosity had less depression, but not anxiety, and religious service attendance was negatively correlated with depression and anxiety (Jansen, Motley, & Hovey, 2010). Religiosity has been found to have a significant link to positive college adjustment (Kneipp, Kelly, & Cyphers, 2009). Those who attend a Christian university are more likely to have protection against health risk behaviors. The norms and values of a subculture of a Christian university may influence their students to behave differently than the majority of the culture (Shuster & Mongetta, 2009). When comparing alcohol consumption among college students at a religious college compared to a secular university, the secular university stude nts were four times more likely to be heavy or binge drinkers (Wells, 2010). Alcohol A bstinence There are groups of people who choose to abstain from alcohol consumption. The United States ha d a higher rate of abstainers ( 31% ) in 2010 than many other W estern countries (Germany, United Kingdom, and Canada) (World Health Organization, 2011). There are many reasons individuals choose to not consume alcohol . F or some , it is health or medical reasons, for others it is the fear of loss of control, cultural or family tradition, or dislike of the taste . 36 R eligious beliefs was the most common reason cited in an unpublished survey conducted by the International Center for Alcohol Policies (ICAP) (ICAP, 2000). In a qualitative study of Pacific youth aged 15 - 25 l iving in New Zealand, key cultural factors that contributed to alcohol abstinence or responsible drinking were: positive and negative role models, how their alcohol consumption may affect th of respect, cultural taboo s, peer pressure to not drink, personal awareness that excessive drinking may seriously affect health or impede career aspirations, and the no - alcohol teachings of their church or religious faith (Suaalii - Sauni, Samu, Dunbar, Pulford, & Wheeler, 2012). According to ICAP (2000), among Christians the groups that are more likely to be abstainers are Mormon, Pentecostal, Baptist, and Seventh - day Adventist. Christian groups are not the only religious group that teaches alcohol abstinence. The largest religion to forbid alcohol use is Islam . The Quran forbids the consumption of alcohol . The Buddhist sutras texts speak of the disadvantages of alcohol consumption. For Hindus, alcohol is forbidden for Brahmins (highest priestly caste) and me mbers of the other upper - caste groups. Analysis of the Literature There are gaps in the literature when looking at risk and protective factors in regard to alcohol use . There was little research on the role of parent s in alcohol use among college student s. Since most college students do not live at home, it may be assumed that parents may play a minimum role , but they still may help protect their children from problematic alcohol consumption . Need for Human Ecological Approach In the area of youth health risk assessment, specifically youth substance use, Urie 37 often in research than his later writings in which he expanded into proximal proce ss as the center of a Process - Person - Context - Time model (Ennett, et al., 2008 ; Tudge, et al., 2009 ). Ennett, et al. (2008) put forth that, based on the ecology of human development, there are four social contexts that may influence adolescent substance us e. On the microsystem level, the contexts are family, peers, and school; neighborhood is on the ecosystem level, and the interrelation between all these contexts is the mesosystem. The macrosystem level contexts are culture and policies. This theory ha s been used to explore adolescent substance use. There is also a need to apply this approach to studying regular alcohol use in college students. College students still are affected by microsystem interactions with family, peers, and the school they are attending. The in which the typical college student lives is the college campus, so there may be less exosystem level influence for college students. At t he mesosystem level, there are direct and behavior. At the macrosystem, there is a broader cultural influence on the acceptance of substance use among college s tudents, but there are governmental laws and school policies that may have an influence as well. Addressing At - Risk Alcohol Use Among College Students Research ers have made recommendations and put forth evidence - based programs that can help address the high rates of alcohol use among college students. The literature points to alcohol being a problem on campuses that then leads to other problematic behaviors (binge drinking, drug use, sex risk behavior, date rape, dating violence, accidents, and even obe sity) because of the lowering of inhibitions and awareness (Misch, 2010). There are some alcohol treatment programs including parents that are evidence - based and recommended to be used on 38 college campuses . LaBrie, Napper, & Hummer (2014) piloted a progra m that educated parents on alcohol use among college students that then led to parents being more intentional about talking to their children about alcohol use at college. Donovan, Wood, Frayjo, Black, & Surette (2012) found that a Web - based intervention that encouraged parents to talk to their college bound teens about alcohol led to protective behavioral strategies related to the manner of drinking and stopping/limiting drinking. Since depression is so common and puts them at risk for risk behaviors, i t has been suggested that students be screened regularly (Roberts, et al., 2010). Many college students drink alcohol to cope with social anxiety or stress , so programs need to help students find other ways to cope with these issues (Ham, 2009). Positive, tangible social support has been linked to buffering against suicide risk for college students (Hirsch & Barton, 2011). Colleges should have trained couns elors available to address stress from responsibilities , address grief over relationship problems or loss of a loved one , assist in healing from rape and intimate partner violence , address past issues such as trauma and abuse; and manage chronic conditions such as ADHD, depression, anxiety, and bipolar disorder. According to the research literature, t here are other college/university administrative policies and programs that have or may appear to work in redu cing health risk behaviors. In addition, it wou ld be helpful for colleges/universities to have adequate on - campus activities on the weekend that are properly supervised to decrease the amount of off - campus partying (Scott - Sheldon, Carey, & Carey, 2008) . Schools should be very clear about their policie s regarding use of substances and resources available to students. In addition, it may be helpful for colleges and universities to point out that many students are participating less in alcohol use than students 39 realize to decrease the perception of norma lization of alcohol use . This study will add to the research literature with additional recommendations . 40 CHAPTER III METHOD T he purpose of this study was to examine the role of parents i n regular alcohol use among college students in the context of abstinent religiosity. This dissertation contains two manuscripts. Both studies were secondary analys e s from data collected from a health - risk behavior survey conducted March 2012 . In addition, both studies include d some descriptive statistics to describe the population being studied and regular use of alcohol . The author was the project director and was involved in the survey development, distribution, initial analysis, and writing of the report . For the f irst study, a multiple linear regression model included parental involvement and conflict, age, gender, ethnicity, religious belief and participation as part of the predictor model to explain the variance of regular alcohol use among those who self - identif ied as Seventh - day Adventist, single, age 18 - 25, and not living at home. Study two was an explanatory mixed method approach that used step - wise logistic regression analysis of the same survey and secondary analysis of follow up focus groups. The step - wi se logistic regression was used to assess the effect of parental communication, age, gender, ethnicity, and religious belief and participation on regular alcohol use among the same population . The author reflected on the role of being a graduate of and employed by the university under study and member ship in the religion being studied , and its effect on the analysis wa s explored in the discussion section . The goal wa s to better understand how college students perceive d the role of parents and religiosity i n drinking . Hypothesis for Study One The purpose of this study wa s t o examine the role parental involvement and conflict have 41 in college student regular alcohol use in the context of a religious subculture that expects ab stinence. W hat is the association between the parental involvement and conflict and religiosity with regular alcohol use in a population of Christian college students? It was hypothesized that involvement with parents (stronger for younger college studen ts) will decrease regular alcohol use. In addition, it was hypothesized that con flict with parents (stronger for younger college students) will increase regular alcohol use by college students. A second hypothesis was religious faith and participation will have a stronger effect on regular alcohol use than parental involvement and conflict. Sampling and Procedure for Study One The health - risk behavior survey was administered during class ti me in the month of March 2012 (before spring break) to students at a Seventh - day Adventist university in the Mid - West that is self - described as not allowing any alcohol use on campus. The study was approved Student participation was voluntary. If they chose not to participate in the study, the y were asked to remain in the class and read class related material . The classes chosen comprised a purposive sample of general education classes, upper division courses from several departments, and a sample of graduate level courses. The professor of the class was contacted a few weeks before the scheduled time to get permission to give the survey , and the students were not given prior knowledge of the survey. Demographic Chara cteristics The ethnicity of the respondents was as follows: White, 37%; African American, 17%; Asian, 12.4%; West Indian/Caribbean, 5.4%; and Latino, 14.3%. The gender breakdown was 57.2% female and 39.6% male. Students ranged in age from 18 to 63, with the majority between 42 the ages of 18 and 25 (75%) and having an average age of 22. A vast majority identified themselves as Seventh - day Adventist (87%). These demographic characteristics are representative of the general student body of the university being studied. Instruments The survey instrument consisted of 124 questions that measured various health - risk behaviors and potential risk and protective factors. In order to accommodate research colleagues various research interests, version A and B were created, to shorten the length of the survey. Both versions contained q uestions regarding alcohol use and parental and religiosity variables. The additional independent variables that were added in the tw o versions were: trauma, depression , social support, and domestic violence scales . The survey was put into Scantron format. Regular alcohol use was defined as use in the last week, determined by the respondent - reported average number of drinks con sumed per week on a 6 - point ratio scale from none, one, two, 3 - 5, 6 - 9, to 10 or more. A drink was defined as a bottle of beer, a glass of wine, a wine cooler, a shot glass of liquor, or a mixed drink. The regular alcohol use variable was turned into a bi nary variable of yes o r no in response to the question regarding consum ption of alcohol in the past week . There was a 7% missing response rate to the alcohol use question . Parental Environment Questionnaire (PEQ) Involvement with parent (12 questions) and conflict with parent (12 questions) questions were from the Parental Environment Questionnaire. This scale was developed by Elkins, McGue, & Iacono (1997). The original scale was developed to be used in the Minnesota Twin Family Studi es as an assessment of family environment with parallel forms for parents and children (Elkins, McGue, & Iacono, 1997). The PEQ was reduced from 93 items to 42 using 43 principal - components analysis. The analysis for the mother and father questions combined McGue, & Iacono, 1997). For this study, only conflict with pare nt (12 items) and involvement with parent (12 items) items were included. In addition, some of the questions were reversed to make negative my parent and mysel changed to have participants reflect on their relationship with both their mother and their father. The Likert - type interval scale gave participants the option of choosing defin itely false, probably false, probably true, or definitely true. Participants also not have a mother or father to rate. for mother and 7.5% for father. results f or mother involvement = .88, mother conflict = .89 , father involvement = .91, and father conflict = .89. Missing data rates were fairly high , ranging for the PEQ from 11.3 - 17.2%. This may be due to survey fati gue since the survey took up to 50 minutes to take , and the PEQ was near the end of the survey. The missing father variable rates were higher than mother (14.5 - 17.2% vs. 11.3 - 14.9%). The mother questions were listed on the left , and the father questions were listed (1998) Missing Completely at Random test was run using SPSS. The missing data were not random , with a significance of .00. The highest missing variable for mother and father was the same , with 14.9% missing for mother and 17.2% missing for father ( As a result, more missing cases were 44 Mis sing Completely at Random t est showed a significance of .06 , thus the revised sample had missing data that was at random . Religious Belief The religious belief questions were developed by social science researchers (Dudley, Mutch, & Cruise, 1987; McBride, Mutch, & Chitwood, 1996). much do you believe the following statements are true? , t hen there was a list of seven questions focusing on religious faith in a 5 - point Likert - type interval The was the only one used in the final ana lysis because it has shown the greatest statistical significance with alcohol use among the religious belief variables in initial data analysis. There was an 11.3% missing data rate for that question. The MCAR test showed the missing data for the religio us belief scale was completely at random with a significance of .81. Religious Participation The religious participation questions were developed by the same researchers. , t he n the re was a list of eight questions focusing on religious involvement . Participants were instructed to circle their answer on a ratio scale of 1 - 9 ranging from never to several times a week . The was .83. The attend Sabbath school (similar to Sunday school, but on Saturday) v ariable was the only religious participation variable included in the final analysis because it was shown to have the greatest statistical significance with alcohol use among the religious participation variables in initial data analysis. There was a 45 13.9 % missing rate for attending Sabbath school. The MCAR test showed the missing data for religious participation scale was completely at random , with a significan ce level of .33. The religious scale questions may have had fairly high missing rates also due to survey fatigue because these questions were near the end of the survey. Demographic Questions There were three demographic questions used as covariates : age, gender, and ethnicity. Ethnic origin options were: American Indian/Alaskan Native, African American, Asian/Pacific islander, West Indian, White (non - Hispanic), Latino, and Other. The health - risk and protective factors survey was developed by social science resea rchers at the Institute for the Prevention of Addiction at the study site institution over a period of 27 years (Helm, Lien, McBride, & Bell, 2009) . The survey was distributed about every five years on campus to measure rates and look for trends of youth health - risk behaviors. The survey instrument is considered reliable and valid because the substance - use rates have stayed relatively stable throughout the five times they have been analyzed. If there were slight increases or decreases in substance use, n ational trends also showed the same variations (Helm, Lien, McBride, & Bell, 2009). Students gave similar answers to the various questions related to alcohol use including age first used, whether they had ever used, frequency in the last year, frequency i n the last 30 days, and rates of binge drinking. All frequencies were in descending order as one would suspect for alcohol use (lifetime use had higher rates compared to binge drinking). The questions on the survey are similar to other health - risk behavi or surveys distributed on high school and college campuses around the United States (ACHA, 2011; 46 Analysis S tudy one used multiple linear regression models . The model only included participants who were aged 18 - 25, not living at home, single, and self - identify as Seventh - day Adventist in The models included parental involvement and conflict, age, ethnicity, gen der, religious participation, and religious faith. Hypothesis for Study Two It was hypothesized that college students who have open communication with parents on the to pic of drugs, sex, and alcohol would be less likely to consume alcohol regularly . A second hypothesis was religious belief and participation will have a greater effect on decreasing regular alcohol use among a population of abstinent - oriented college students than open communication with parents. Sampling and Procedure for Study Two Sampling fo llowed explanatory mixed method , with the survey being conducted first then follow up focus groups were used to help explain the results of the survey. The same survey instrument, sampling, and pr ocedure used in study one was used in study two. Survey Instrument The survey instrument consisted of 124 questions that measured various health - risk behaviors and potential risk and protective factors. The survey was put into Scantron format. Regular alcohol use defined as use in the last week - reported average number of drinks consumed in a week on a 6 - point scale from none, one, two, 3 - 5, 6 - 9, to 10 or more. A drink was defined as a bottle of beer, a glass of wine, a wine cooler, a 47 shot glass of liquor, or a mixed drink. The variable was recoded into a dichotomous variable of 1 for No and 2 for Yes for consuming alcohol in the past week. Parental Communication The one parental communication about health risk behavior question was developed by social science researchers at the university studied. Following the Parental Environment Questionnaire, participants were asked whether - type sca le gave participants the option of choosing : definitely false, probably false, probably true, or definitely true for both mother and father. Participants also There were 3.3% There was a 13.7% missing rate for the parental communication question. Religious Belief and Participation The religious belief and participation variables that were chosen to be included in the step - wise logisti c regression model were - point Likert - ath school at tendance was measured on a 9 - point scale ranging from never to once a week. The step - wise logistic regression model start ed with the parent communication v ariable then add ed the chosen demographic variables, and religious belief and participation variables . All of the logistic regression model s include d the demographic variables of ethnicity, age, and gender variables. Participants could choose between male and female gender. Age was chosen by filling in bubbles to report their act ual age. Those who identified as being below the age of 48 18 were eliminated in the final analysis because they were under age. Those under the age of 18 were asked not to participate, but a few did. Ethnic origin options were American Indian/Alaskan Nati ve, African American, Asian/Pacific Islander, West Indian, White (non - Hispanic), Latino, and Other. I t was hypothesized that college students who have open communication wit h parents would be less likely to consume alcohol regularly . A second hypothesis was parental communication influence on al cohol consumption will decrease when the religiosity variables are added to the model . Focus Group Participants method in conducting a study of undergraduate college students. Students were recruited to participate in one of six focus groups. Recruitment was conducted by accessing individuals participating in the behavioral science research pool. As a part of the general education social science experience, any student enrolled in a class housed in the Behavioral Sciences Department at the university was expected to part icipate in a research project. Students were required to participate in one to two research studies (for a total of two hours) of their choice from a pool of research studies being conducted in a given semester. Students were given a link to choose and sign up for a research study ( or two ) . If they objected to being a study participant, alternative means were provided to meet the educational requirement. This process was approved by the All informants in the focus groups were undergraduate students of the uni versity. In order to participate in this study, they had to be between the ages of 18 and 25 and unmarried. The reason for age limitation was to focus on the emerging adult population perception of alcohol. Single participants were more likely to perc eive themselves as emerging adults who are 49 still exploring and experimenting , compared to adults with traditional responsibilities such as having a marriage partner (Arnett, 2014) . Each group had members of both genders , and they were ethnically diverse. Participants were given pizza and refreshments since the group met from 6:00 - 7:30 p.m. in a conference room - like classroom on campus. In addition, participants were given $20 each for the time they spent participating in the study. Focus Group Demog raphic Characteristics There were a total of 53 participants. The focus groups varied in size from 6 - 15 in each group, with an average of 9 participants per group. There were 23 males (43%) and 30 females (56%). The ethnic breakdown was very similar to the survey: 23 White (4 3%), 13 West Indian/African American (25%), 8 Latino/a (15%), 6 Asian (11%), and 3 Asian/White (6%). Focus Group Instrument on college student health - risk behaviors a nd are marked with an *. All of the questions were based on suggestions from the research literature and the survey. The specific questions asked were as follows: Perception of College Life: What led to your decision to attend this university? What one word would you use to describe this university? What were your expectations about being a college student? Where did these expectations come from? Have those expectations been fulfilled or not? 50 Perception of Alcohol Use : What are the assumptions /beliefs about alcohol among your peers? What are the reasons for using/abusing alcohol?* What are the reasons for binge drinking or getting drunk?* participate in these be haviors? What role might a relationship with parents and close family members play in a It is important to note that with these types of questions, the respondent can elaborate on various motivations for student health behavior. In addition, the students were encouraged to interact with each other, and the interviewer also asked clarifying follow - up questions. Analysis Study one used multiple linear regression with involvement w ith mother and conflict with mother, and then in a separate model involvement with father and conflict with father as the primary independent variables . Age, ethnicity, gender, and religious belief and participation were included in each of the model sets . Then each of the four item types (involvement with mother, conflict with mother, involvement with father, and conflict with father were analyzed to measure the strength of each item on regular alcohol consumption using multiple linear regression. Selection criteria narrow ed down the participants to those who self - identif ied as Seventh - day Adventist, single, age 18 - 25, and not living at home. This was done to measure multiple microsystem influences. To avoid a type 1 error, significance levels wer e set for each test at .0 5 . 51 For study two, an explan atory mixed methods design inform ed the protocol for the secondary data analysis. This methodological design occurs when a quantitative study occurs first; then a qualitative study is conducted to expa nd upon and explain the results of the quantitative study. There was sequential timing where the quantitative strand and the qualitative strand were conducted in two distinct phases (Creswell & Clark, 2011). The collection and initial analy sis of the qua ntitative data were complete d first , then the qualitative data w ere collected . The mixing occur red during the data interpretation phase after data were collected and analyzed (Creswell & Clark, 2011). This method inform ed the survey research questions. The mixed - method design was as follows: Follow up with Interpretation Figure 2 . Explanatory s equential d esign m ixed m ethods f ramework . Survey Analysis All statistical analyses w ere performed using the Statistical Package for Social Science (SPSS) Version 21. The quantitat ive analysis for study two use d a step - wise logistic regression model. A logistic regression model was chosen instead of a linear regression model because an initial descriptive statistical analysis of the dependent variable showed a vast majority did not participate in regular alcohol consumption (80%). Thus the continuous variable did not have a normal distribution, which is recommended for linear regression (Howell, 2013). The regular alcohol use variable was put into a dichotomy of yes and no. Then the parent communication variab le along with gender, ethnicity, and age demographic variables w ere added one at a time. Quantitative Data Collection and Analysis Qualitative Data Collection and Analysis 52 Finally religious belief and participation variables were added one at a time. The goal was to report how each independent variable predict ed regular alcohol consump tion in relation to the other chosen variables (Howell, 2013). Missing Data The researcher replaced missing values with predicted value expectations by using the e xpectation - maximization algorithm (Dempster, Laird, & Rubin, 1977). Focus Group Analysis The interviewer and graduate assistant debriefed after each of six focus groups. The audio recordings were then transcribed. There were one hundred pages of typed transcripts. Once the transcripts were prepared, they were reviewed and themes identified t hrough an open coding process. A codebook was developed; then the transcripts were uploaded onto QDA miner version 4. The codebook was entered by hand into the software. Next, the interviewer and graduate assistant individually signed in with a user name and password and chose which codes described each response from the participants by conducting content analysis of the transcripts as suggested by Stemler (2001) . First there was an initial open coding process that led to the development of a codebook , then there was axial coding whe re the investigators assemble the data in new ways after the initial open coding process (Creswell, 2007). QDA miner calculated frequencies for all codes and measured the code agreement frequency. There was a 75% inter - coder agreement. Th e results secti on of this manuscript for study two will show were identified along with the results of the step - wise logistic regression model from the survey (Creswell, 200 7). Recommendations use d a positive youth development framework. 53 CHAPTER IV MANUSCRIPT ONE : ROLE OF PARENTAL INVOLVEMENT AND CONFLICT IN COLLEGE STUDENT REGULAR ALCOHOL USE IN THE CONTEXT OF ABSTINENT RELIGIOSITY Abstract College students participate in numerous health - risk behaviors that may put them at risk for developing addictions and/or chronic diseases, or even put them at risk for early death. This study examined the role of parental involvement and conflict in coll ege student regular alcohol use in the context of a religious subculture that expects alcohol abstinence. Secondary analysis was conducted using data from a health - risk behavior survey administered March 2012 on a conservative Christian college campus. T relationships with frequency of alcohol use in the past week were analyzed. This was done using multiple linear regression that included mother/father involvement, mother/father conflict, age, gender, ethnicity, religious belief, and participation as part of the predictor model. Only one parental involvement variable, re of my body by in Sabbath school and younger age also were protective factors. The model predicted 18 % of regular alcohol use variance. Based on these res ults, it is recommended family life educators educate parents on the benefits of certain level of involvement with their children as they transition away to college. In addition, college administrators and faith communities are encouraged to work together to provide a space where college students can practice their faith and find a supportive community. 54 Introduction Much of the research conducted on the role of parents in youth health risk - taking behavior has been conducted among adolescents (Schwartz, et al., 2009). This study aims to build on the limited studies that have been conducted on the role of parental invo lvement and conflict in college student alcohol use behavior in a population of alcohol abstinence - oriented Christian college students. In what ways do the parental involvement and conflict and religiosity predict regular alcohol use in a population of Ch ristian college students attending an alcohol - abstinent university? It was hypothesized that : I nvolvement with parents (stronger for younger college students) will decrease reg ular alcohol use. C onflict with parents (stronger for younger college students ) will increase regular alcohol use by college students. R eligious faith and participation will have a stronger effect on regular alcohol use than parental involvement and conflict. Alcohol abuse is considered by some authors to be the single biggest pub lic health hazard on college and university campuses (Misch, 2010). College students are at higher risk of binge drinking compared to non - college attend ing peers (Johnson, et al., 2014 ). Research has found that planning on and attending college is a risk factor for binge and heavy drinking (Merline, Jager, & Schulenberg, 2008). Those evaluated at 18 who planned on attending college were more likely to be heavy drinkers at age 22, but then this number went down by midlife (Merline et al., 2008). In studies of undergraduate students at three public universities, a vast majority were drinkers (73 - 81%), with about 31 - 58% meeting the criteria for binge drinking in the 55 previous month (Braitman et al., 2009; Randolph, Torres, Gore - Felton, Lloyd, & McGarvey, 2009; Roberts, Glod, Kim, & Hounchell, 2010). There are consequences associated with college student alcohol consumption, including death, injury, physical assault, sexual assault, and drunk driving (Hingson, Zha, & Weitzman, 2009). Blanco et al. (2008) reported that roughly 20% of college students can be diagnosed with having one alcohol - use disorder per year (8% alcohol abuse, 13% alcohol dependence). There also are higher rates of drug u se among alcohol consumers. College students who reported being non - drinkers only had a rate of 4.2% for using illicit drugs in the past month, compared to current alcohol users (non - binge drinkers) at 7.1% and binge drinkers at 18.5% (SAMHSA, 2013). Eme rging Adults As a result of economic and social changes, young adults are delaying the typical route to adulthood through marriage by later and later average ages (Schwartz et al., 2009). Arnett (2014) found in his research with individuals 18 - 25 years ol d that there is a transition period to what is conceptualized by society as adulthood in which individuals finish schooling, get jobs, join in marriage, have children, buy a house, become involved in their community, and so on. Arnett (2000) termed this p exploration, instability, self - focus, feeling in - between, and optimism about the future (Arnett, 2014). Since adulthood is being delayed, there also can be longer periods of experimenta tion and risk - taking similar to the adolescent years (Arnett, 2005). College students participate in numerous health risk behaviors that may negatively alter their plans for the future and put them at risk for developing addictions, or even possible early death (American College Health Association [ACHA], 2011). 56 Young adults in this age period may have a different relationship with their parents than leave the parental nest, but for various reasons (typically economic), many return home (Goldfarb, 2014). Because of this and other societal changes, college students may be more involved with their parents for longer periods than at any other time in history. Wit h many college students still maintaining strong emotional and financial ties to their parents, it is important to study the role parents play in their emerging adult college - development (Schwartz et al., 2009). Parental Involvement Parental involvement is related to parent - child bonding, defined as having a feeling of one another, and joint activities within the family (Kuendig & Kuntsche , 2006). In a population of rural junior - high students in Idaho, parental involvement was found to be a protective factor in adolescent alcohol and substance use (Baltazar, et al., 2013; Johnson, McBride, Hopkins, & Pepper, 2014). When examining parent/c hild relationships, Schwartz et al. (2009) saw the - age children to gauge the distinct and important contributions each parent makes in the likelihood of using alcoho l and other substances. Parental involvement typically leads to positive developmental outcomes, but it may be problematic when it becomes over - involvement with a college age child. Parental involvement research with college students found that over - inv olvement is related to negative mental health outcomes (Schiffrin, Liss, Miles - McLean, Geary, Erchull, & Tashner, 2014). However, there has not been research that has examined the role of parental involvement in alcohol use among 57 college students. Parent al involvement is a complex phenomenon that deserves further study. Parental Conflict Conflict with a parent takes place when there is a pattern of hostile, negative interactions between parent and child. Negative parental attitudes towards and rel ationships with teens have been correlated with high levels of substance use (Hayes, Smart, Toumbourou, & Sanson, 2004). Fischer, Forthun, Pidcock, and Dowd (2007) found that psychological control and lack of connection with parents predicted coll ege stud ent alcohol problems. This may be due to higher levels of stress and perceived emotional harm due to these negative interactions (Drapela & Mosher, 2007). There is a need to know if the relationship between parent/child conflict and alcohol use still has an effect on college students who can physically remove themselves from the conflictual relationship. Some studies have been conducted on the role of p s alcohol use patterns. Schwartz et al., (2009) investigated the asso ciation of perceived parenting with health - risk behaviors. Abar and Turrisi (2008) reported that believing parents disapproved of alcohol use during the adolescent years was strongly associated with lower rates of alcohol use in college. Since parents pl ay a powerful role in socializing their children even through the emerging adult years, research suggests that relationships with mothers and fathers may explain some of the alcohol use variance during college (Schwartz et al., 2009). Research has found Cubbins and Klepinger (2007) found that childhood religious affiliation was associated with less past - year drug use in young adults. In a sample of adolescents, parent religiosity had a robust 15 - 25 living in New Zealand, one of the themes identified was that belonging to a church 58 community made the youth concerned how their behavior may the community (Suaalii - Sauni, Samu, Dunbar, Pulford, & Wheeler, 2012). If the youth did There are some religious faiths that teach abstinence from a lcohol, for example, Islam, Latter Day Saints (LDS), Southern Baptists, and Seventh - day Adventists (Blazer, Hays, & Musick, 2002; Enstrom & Brewlow, 2008; Michalak & Trocki, 2006; Schwartz, 1979). One study done with college students that included LDS par ticipants , those of other religious faiths, and those with no religious preference found that family church attendance and religiosity among use for LDS parti cipants only (Merrill, Folsom, & Christopherson, 2005). These alcohol - Seventh - day Adventist Church The college campus that was studied and a vast majority (87 %) of the participants in this study were self - identified as Seventh - day Adventist. The Seventh - day Adventist Church is considered a conservative evangelical church group that teaches the abstinence of alcohol and other har mful substances (Dudley, McBride, & Hernandez, 1997). The Seventh - day Adventist church was officially founded in 1863 (Schwartz, 1979) The early church took on the cause of health reform by founding centers of healing that encouraged natural remedies, ve getarian diet, not consuming any harmful substances, fresh air and sunlight, exercise, and trust in a divine power for healing (Schwartz, 1979). As part of this healthy living, Seventh - day Adventists believe the Bible teaches individuals to take care of t heir bodies because the body is the temple of the living God, so it should be cared for (General Conference of Seventh - day Adventists, 59 2010). The literature on college student alcohol use is vast, but there are some populations for which there is limited information regarding risk and protective factors related to alcohol use. Christian alcohol - abstinent - oriented college student populations may have unknown risk factors and protective factors that may be applicable to reducing problematic alcohol use in t he general college student populations. Religiosity It has been well documented that religious and spiritual beliefs and practices are associated with positive well - being in youth (Urry & Poey, 2008). Researchers have found that internalization of religious beliefs and values can guide and modify behavior in youth (Ellison & Levin, 1998). These behaviors may be due to religious doctrine or a general belief that the body is the temple of the God (George, Larson, Koenig, & McCullough, 2000). Though religiosity can have a positive influence on youth development, most college students are not secure in their beliefs (Astin, Astin, & Lindholm, 2011). Religiosity/spirituality needs to be unde rstood in the - changing lives where its influence may wax or wane (Nasir, 2008). and physical health. In a national sample of African Ame ricans ( N =2370) with an average age of 53, researchers found a complex relationship between religious involvement and beliefs (Holt, Clark, & Roth, 2014). Participants with strong religious beliefs were less likely to believe that illness is punishment fo r sin which was linked with decreased binge drinking. However, using structural models, Holt et al. found that individuals who were religiously involved were more likely to believe that illness is punishment for sin, which translated into more binge drink ing (2014). This may be linked to a certain amount of fatalism. Religiosity can become a form of abuse called spiritual abuse. Spiritual abuse happens under the guise of religion. It can take the 60 form of harassment and humiliation that can negatively a ffect the bio/psycho/social and spiritual domains of the victim (Ward, 2010; Wright, 2001). There is a need to explore this topic further to aid in clarifying which elements of religiosity are protective and which are potentially harmful. Theoretical Framework Bubolz and Sontag (1993) built upon early conceptualization by Hook and Paolucci (1970) that family was a major source of support to the individual, but the family depended on the environment to provide for physical needs and social interaction. There was a special emphasis on the family ecosystem. Family ecology was founded on the belief that the well - being of the family is essential to the well - being of an individual (Ray, 1988). Family members were seen as interdependent biophysical and soci al individuals, and the family is its own system that interacts with its natural, social - cultural, and human - built environments (Sontag & Bubolz, 2003). Deacon and Firebaugh (1988) proposed that the family is a system interacting with its environment, and this influences family decision - making. The family system is made up of individual subsystems within the family, and there are family managerial subsystems (Ray, 1988). These subsystems interact with all aspects of family decision - making (Bubolz & Sonta g, 1993). Families do not merely react to environmental changes. They are a complex system that has links between parts and wholes with input between each other throughout the system (Bubolz & Sontag, 1993). Family science theories continue to evolve over the years. Lerner, Johnson, & Buckingham (2015) support the current evolution of human development theories into a relational developmental systems (RDS) metamodel. This metamodel emphasizes mutually influential relations between individuals and the ir contexts. Boss (2015) suggests that the goal of 61 RDS should be to generate evidence based approaches that are applicable to individuals and families in order to optimize human development among diverse youth, families, and communities around the world. This research will add to that discussion. Method This study examined the role of parental involvement (conceptualized as parent - child bonding) and conflict and weekly alcohol consumption as the dependent variable in a population of college students attending a conservative, alcohol - abstinent Christian un iversity. This was done using multiple linear regression that included mother involvement, mother conflict, father involvement, father conflict, gender, ethnicity, age, and religious belief and particip ation as the predictor model. It was hypothesized th at: Involvement with parents (stronger for younger college students) will decrease regular alcohol use. Conflict with parents (stronger for younger college students) will increase regular alcohol use by college students. Religious faith and participation will have a stronger effect on regular alcohol use than parental involvement and conflict. Sampling and Procedure The health - risk behavior survey was administered to students during class time in the March of 2012 (before spring break) at a Seventh - day Adventist university located in the mid - west that is self - described as not allowing any alcohol use on campus. The study was approved If they chose not to participate in the stud y, they were asked to remain in the class and read class - related material. The classes 62 chosen were a stratified sample of general education classes, upper division courses from several departments, and a sample of graduate level courses. The professor wa s contacted prior to the scheduled time for permission to administer the survey. Teaching assistants were trained to administer the survey without the class professor or faculty researchers in the room. The students were not given prior knowledge of the survey. Instruments The survey instrument consisted of 124 questions that measured various health - risk behaviors and potential risk and protective factors. Scantron format was used for recording responses. Regular alcohol use was defined as use in the past week, determined by the respondent - reported average number of drinks consumed per week on a 6 - point ratio scale from none, one, two, 3 - 5, 6 - 9, to 10 or more. A drink was defined as a bottle of beer, a glass of wine, a wine cooler, a shot glas s of liquor, or a mixed drink. There was a 7% missing response rate. Parental Environment Questionnaire (PEQ) Questions regarding involvement with parent (12 questions) and conflict with parent (12 questions) were from the Parental Environment Questionnaire. This scale was developed by Elkins, McGue, and Iacono (1997). The original scale was developed to be used in the Minnesota Twin Family Studies as an assessment of family environment with parallel forms for parents and children (Elkins, McGue, & Iacono, 1997). The PEQ was reduced from 93 items to 42 using principal - components analysis. The analysis for the m other and father questions combined yielded 5 factors: conflict with parent (12 items), involvement with parent (12 items), 63 (Elkins, McGue, & Iacono, 1997). For this study, only conflict with parent (12 items) and involvement with parent (12 items) items were included. Some adaptations were made to t he PEQ scale for this survey. Some of the questions were reversed to make negative statements into positive statem ents, and because it had low reliability. In addition, the scale was changed to have participants reflect on their relationship with both their mother and their f ather. The Likert - type interval scale gave not have a mother father. .89 and father involvement = .91, father conflict = .89. Missing data rates were fairly high, ranging for the PEQ from 11.3 - 17.2%. This may be due to survey fatigue since the survey took up to 50 minutes to take and the PEQ was near the using SPSS. The PEQ missing data were not random, with a significance of .00. Because of this, more missing (1998) Missing Completely at Random t est showed a significa nce of .06 . Thus the PEQ scale, with cases eliminated that had higher missing data rates, was completely at random. Religious Belief The religious belief scale was developed by social science researchers (Dudley, Mutch, & Cruise, 1987; McBride, Mutch, 64 a 5 - point Likert - question was the only one used in the final analysis because it has show n the greatest statistical significance with alcohol use among the religious belief variables in initial data analysis. There was an 11.3% missing data rate for that question. The MCAR test showed the missing data for the religious belief scale was compl etely at random with a significance of .81. Religious Participation The religious participation scale was developed by the same researchers as the religious belief scale (Dudley, Mutch, & Cruise, 1987; McBride, Mutch, & Chitwood, 1996). Participants were questions focusing on religious involvement was then presented. Participants were instructed to answer on a ratio scale of 1 - participation variable included in the final analysis because it has shown the greatest statistical significance with alcohol use among the religious participation variables in initial data analysis. There was a 13.9% missing rate for attending Sabbath school. The MCAR test showed the missing data for the religious participation scale was completely at random with a significance level of 0.33. The religious scale questions may have had fairly high missing rates also due to survey fatigue because these questions were near the end of the survey. 65 Demographic Questions There were three demographic questions used as covariates; age, gender , and ethnicity. Ethnic origin options were American Indian/Alaskan Native, African American, Asian/Pacific islander, West Indian, White (non - Hispanic), Latino, and Other. The health - risk and protective factors survey was developed by social science r esearchers at the Institute for the Prevention of Addiction at the study site institution over a period of 27 years. The questions measuring substance use on the survey are similar to other health - risk behavior surveys distributed on high school and colle ge campuses around the United States distributed about every five years on campus to measure rates and look for trends of youth health - risk behaviors. The survey instrumen t is considered reliable and valid because the substance - use rates have stayed relatively stable throughout the five analysis points. If there were slight increases or decreases in substance use, national trends also showed the same variations (Helm, Lien , McBride, & Bell, 2009). Students gave similar answers to the various questions related to alcohol use: age first used, whether they had ever used, frequency in the last year, frequency in the last 30 days, and rates of binge drinking. If they had not u sed alcohol, their questionnaires were not used. All frequencies were in descending order as one would expect for alcohol use (lifetime use had higher rates compared to binge drinking). Analysis Multiple linear regression was conducted using SPSS version 21 in order to identify a statistical model to predict the variance of regular alcohol use among conservative Christian college students. To identify the most important protective factors of alco hol use, a linear regression was calculated using predictors that are suggested by results of Pearson Correlations 66 with regular alcohol use as the dependent variable and various independent variables as suggested by previous research studies. A full model , then a revised model, was developed, based on initial results. The full model included the following predictor variables: mother involvement, mother conflict, father involvement, father conflict, age, gender, ethnicity, religious belief, and religious p articipation. The revised model included the two statistically significant questions from the PEQ after running Pearson Correlations in relation to regular alcohol use. my spare as then separated by age group. Results The ethnicity of the respondents was as follows: White, 3 5.8 %; African American, 24.6 %; Asian /Pacific Isl ander , 1 4.2 %; West Indian/Caribbean, 6.1 %; Latino, 1 3.7 % ; Other, 5.6% . The gender breakdown was 60.8 % female and 39.2 % male. Students ranged in age from 1 7 to 63, with the majority being between the ages of 18 and 25 (75%) and having an average age of 22 (see Table 2 ). Only those aged 18 - 25 , single, and living away from home were used themselves as Seventh - day Adventist (87% of participants ), the analysis included only those who self - identified as Seventh - day Adventist. This study involved determining what predicts regular alcohol use among students attending a conservative Christian college. A linear regression analysis was conducted . The variables ch osen for the model were results of the Parental Environment Questionnaire (mother conflict and involvement and father conflict and involvement were run separately), age, 67 and frequency of attending Sabbath school. The linear combination of conflict with mother, involvement with mother, conflict with my body by avoi (9, 307 ) 01) and explains about 17.7% (R=0.42 ) of the variance of the frequency of alcohol in the past week. The model had a low multicollinearity VIF score ranging from 1 - 2.3. The linear regression model was revised with only statistically significant variables. The variables from the PEQ that were found to be statistically significant after running Pearson Correlations and the average number of alcohol drinks consu med in a week were added to the of Sabbath school attendance. The linear combination of the revised model was F (5, 293 ) = 13.63 ) of the variance of the frequency of alcoh ol in the past week (see Table 3 ). The revised model had an even lower multicollinearity VIF score ranging from 1 - 1.5. had the highest effect - .27 lowest effect - 0.15 ) analys is is reported in Table 3 . The regression analysis result indicates that higher rates of 68 rates of regula r alcohol use. The final model was then separated by age group. For participants aged 18 - 20, only in relation to regular alcohol use. For participants aged 21 - 25, the parental variables were not - - statistically significant. Discussion The research question was, what is the association between the parental involvement and conflict and religiosity with regular alcohol use in a population of Christian college students attending an alcohol - abstinent university? This study found there is an association between mother involvement, religious belief and participation and regular alcohol use. The hypothes e s w ere as follows: P arental involvement w ill be a protective factor for regula r alcohol use. T his was only partially supported. One mother involvement variable was found to be statistically significant in relation to alcoho l use. When age was split, it was statistically significant for those aged 18 - 20 only . P arental conflict will be a risk factor for regular alcohol use . T hi s was not supported. R eligious belief and participation will have a stronger effect on decreasing regular alcohol use than parental involvement and conflict. This was supported with abbath 69 school showing a relationship with decreased alcohol use. These variables had a greater effect than even the strongest parental involvement variable. It is not surprising that the parental involvement (except one mother involvement variable) and conflict scale was not statistically significant in predicting regular alcohol use, even though parental involvement and conflict is related to alcohol and subs tance use among adolescents (Baltazar et al., 2013; Johnson et al., 2014). College is typically a time when students develop a level of autonomy which is developmentally appropriate and usually leads to better youth outcomes (Hunt, 2008; Schiffin et al., 2013). However, there is a transit ion period noted where one parental involvement variable was statistically significant for those aged 18 - 20. Other research has found this transitional period to be important in studying parental influence and health ris k behaviors. F requency of family meals was a protective variable for substance use in you nger college students aged 18 - 19 only (McBride, Hopkins, Baltazar, VanderWaal, & Conopio, 2013). As youth age, parents play less of a role with alcohol use choices. It is important to note that parental involvement also was not a predictor of regular alcohol use. This differs somewhat from the research that has been conducted lately on the damaging effects of parental involvement, which is really measuring over - i nvolvement, on college student developmental outcomes (Schiffin, et al., 2013). This may be due to the type of parental involvement the PEQ measured. This study conceptualized parental involvement as parent - child bonding, an overall benefit to youth deve lopment (Kuendig & Kuntsche, 2006). Research has found that psychological control, which is part of over - involvement, has been found to be particularly damaging to youth outcomes (Aunola & Nurmi, 2005). The PEQ does not specifically measure psychological control. The one parental involvement variable that was statistic ally significant was a mother 70 involvement variable. Research studies that examine parental involvement typically show high rates of mother involvement, which has been linked to positive o utcomes for youth (Finley, Mira, & Schwartz, 2008; Schwartz et al., 2009). The nature of the parental involvement variable predicted greater alcohol use. In additi on to the assumption that this question is measuring the strength of the mother - child relationship, this type of variable is reminiscent of parental monitoring that has been studied extensively as a protective factor in adolescent alcohol use (Tomay, Micha ud, Gmel, Wilson, Berchtold, & Sunis, 2013; Tomcikova, Veselska, Madarasova, Geckova, van Dijk, & Reijnevelt, 2013 2015 ). Though parents cannot physically monitor their children when they are away at coll ege, if a younger college student (aged 18 - 20) perceives his/her mother knows what he/she is doing in his /her leisure time, it may decrease alcohol consumption. Research studies that have examined parental monitoring and its relationship with alcohol use in college students have found that mother - daughter contact could moderate the norm of college alcohol consumption held among peers and mother - son monitoring had an indirect relationship with decreasing impulsiveness that was related to less alcohol - relat ed problems (LaBrie & Cal, 2011; Patock - Peckham, King, Morgan - Lopez, Ulloa, & Moses, 2011). LaBri e & Cal (2011) defined contact as daily or frequent contact with parents , and Patock - Peckh am et al., (2011) defined monitoring , it is easier for parents to monitor their A common way for college s tudents and their parents to commun icate is through face - to - face contact, phone calls, emails (declining), texting (increasing), and social media (increasing) (Ramsey, Gentzler, Morey, 71 Oberhauser, & Westerman, 2013). Ramsey et al. (2013) found that phone use was consistently associated with higher quality parent - college student relationship. As college students entered the age where alcohol use is legal, religiosity became a stronger protective factor . This would be developmentally appropriate considering the physical detachment of children from parents when away at college. The stronger relationship between religious belief and alcohol use may be due to the teachings of the Seventh - day Adventist church, that the body is the temple of the Lord and should be cared for (Schwartz, 1979). Another religious variable predictor was attending Sabbath school. Sabbath school occurs the hour before church and involves more active discussion about faith , thus an individual attending may show a commitment to the religion and its abstinence teachings. This study did and participation ; other studies have found parental religious beliefs play a role in decreasing - Sauni, Samu, eir children are younger. These beliefs and behaviors may continue into college. Age was another statistically significant predictor variable. Since the legal age to drink is 21, right in the middle of the age range for the participants studied, it i s not surprising that alcohol use increased with age. In fact, among the participants, from age 20 (4% use rate) to age 21 (13% use rate), regular alcohol use more than tripled, with regular alcohol use peaking at age 23 (20%), then decreasing, but never returning to pre - legal age levels. Of course, this is not longitudinal data, so this cross - sectional data may not be predictive. It is possible that students attending an alcohol - abstinent college would not want to admit to illegal alcohol consumption, 72 b ut other studies have found alcohol use increases after the age of 21 on college campuses (Wagenaar & Toomey, 2005). Unlike other studies, gender and ethnicity were not found to be statistically significant predictors in regular alcohol use. Males typically binge drink more than women, though this age gap is decreasing (SAMSHA, 2013). This study supports that trend. National data have found those who identify as being White have the highest alcohol consumption for those age 12 and older (57.4%), then 43.2% for Blacks, 41.8% for Latinos, 41.7% for American Indians or Alaska Natives, and 36.9% for Asians (SAMSHA, 2013). The participants in this study were ethnically diverse, and it may be suggested that the religious culture of abstinence may be st ronger than the According to this study, as children move away from home to attend college, there is less family interdependence in which parent - child relationships affect alcohol use than when youth are in thei r adolescent years. The relationship developmental systems model may support the parent/child relationship playing a role during this transitional period (Lerner, et al., 2015). The family is its own system that interacts with its natural, social - cultural, and human - built environments (Sontag & Bubolz, 2003). Individual family members are seen as interdependent biophysical and social individuals with children eventually leaving t heir family of origin to interact with different environments. If children are close to their parent it could lead to children internalizing the alcohol abstinence belief taught by their parents and increasing the chance they would want to attend a colleg e that does not allow alcohol use. An alcohol - abstinent college environment and believing one should take care of his/her body may, in turn, affect alcohol use even in college where alcohol use is the norm ( Luquia, et al., 2003; Johnson et al., 2014). 73 L imitations and Future Directions This cross - sectional study among conservative Christian college students limits application to the general college student population. Since alcohol is not allowed on the campus studied, it is possible that participants we re not entirely truthful about their alcohol use, knowing that admitting to it could lead to disciplinary action, including expulsion. The connection parents play with religiosity was not directly studied. It is recommended that this connection be explor ed further. This type of study would ideally be longitudinal, allowing causal relationships to be examined. In addition, a qualitative study would help to explain the nature of the parent - child relationship and its connection to religiosity as it relates to alcohol use. Conclusion involvement and conflict play in the use of alcohol by Christian college students who attended an alcohol - abstinent university. Findings from t his study suggest that conservative Christian college students who believe their mother knows what they do with their spare time, are younger, believe God wants them to take care of their body, and attend Sabbath school regularly are less lik ely to consume alcohol on a weekly basis . I t is suggested that parents be aware of their young adult to indirectly monitor the m and possib ly decrease regular alcohol use . P arents also can teach their children the value of taking care of their bodies as a way to express their religious faith and to encourage religious participation as another way to possibly decrease alcohol use. This study has implications for research, policy, and family life education regarding parental involvement. In the r esearch literature a distinction needs to be made between positive parental involvement that is conceptualized as parent - child bonding and negative over - 74 involvement that includes psychological control of children. Not all parental involvement has negative outcomes with college age children. College policy makers will want to consider encouraging positive parental involvement by giving parents the opportunity to know more about the lives of their college children, as allowed by FERPA. Family life educator s can suggest to parents the importance of being aware of how their children spend their spare time , as a potential protective factor against alcohol use when children are attending college , especially in the early college transition years . There also are implications regarding religiosity. This research supported religio us belief and involvement strongest protective factor in alcohol use. Faith traditions tha t teach alcohol abstinence may find these results helpful in their work with youth and suggest implications for the faith community. It is recommended that faith communities reach out to college students to help provide a sense of community and an opportu nity to practice their faith as a way to prevent at - risk alcohol use. The faith community not only can aid in prevention, but research has found it can help with substance abuse treatment. According to VanderWaal, Hernandez, and Sandman (2012), churches are an underutilized resource for identifying substance use problems. Individuals who struggle with substance abuse often feel more comfortable talking to a clergy member than a professional (VanderWaal, et al., 2012). For family life educators, it is im portant for parents to know that the faith environment in which they raise their children and encourage participation , may play a role in lower alcohol use rates when they attend college. As children age and move away, they start to move beyond the reach influence. A variation of parental monitoring can protect them f rom some problematic alcohol consumption during the early college years , but when alcohol becomes legal at the age of 21, 75 religious belief and participation becomes more im portant. Parents, family life educators, college policies, and the faith community can all play an important role in decreasing problematic alcohol consumption. Table 2 Demographics and Frequencies -------------------------------------------------------------------------------------------------------- Frequency Percent Gender Male 162 39.1 Female 251 60.6 Grade level Freshman 116 28.0 Sophomore 81 19.6 Junior 79 19.1 Senior 100 24.2 Grad/professional 34 8.2 Race/Ethnicity African American 97 23.4 Asian/Pacific Islander 56 13.5 West Indian/Caribbean 24 5.8 White (non - Hispanic) 141 34.1 Latino or Hispanic 54 13.0 Other 22 5.3 Regular Alcohol Use No ne 357 86.3 1 - 2 per week 22 5.4 3 - 5 per week 15 3.8 6 - 9 per week 2 .5 10+ per week 2 .5 Missing 16 3.9 76 Table 3 Linear Multiple Regression Revised Model (n=294 ) --------------------------------------------------------------------------------------------------------------------- b SE 95% CI ------------------------------------ *Body is the Temple - .27 .08 - .51 to - .21 *Age .18 .02 .03 to .12 * * Sabbath School - .15 .02 - .09 to - .02 * * Mother not monitoring .12 .05 .01 to .19 Father criticizes .04 .05 - .06 to .12 --------------------------------------------------------------------------------------------------------------------- 77 CHAPTER V MANUSCRIPT TWO : ROL E OF PARENTS AND RELIGIOSITY IN REGULAR ALCOHOL USE AMONG CHRISTIAN COLLEGE STUDENTS: A MIXED METHOD APPROACH Abstract College students participate in numerous health - risk behaviors that may put them at risk for developing addictions and/or chronic diseases, or even put them at risk for early death. This study focused on regular alcohol use, considered by some researchers to be the number one public health issue on college campuses today. Responses from a health risk behavior survey given on an alcohol - abstinent Christian campus were analyzed. Step - wise logistic regression analysis was used to develop models that explain the frequency of regular alcohol use. Results show open communication with mother on the topic of drugs, sex, and alcohol decreased the chance of regular alcohol use by about 30% in the first set of models, age increased the odds of alcohol use by 50%, religious participation decreased the probability of alcohol use by 26%, and religiou s belief decreased the chance of regular alcohol use by about 60% in the last set of models. Ethnicity, gender, and communication with father were not statistically significant. Follow - up focus groups supported these results, but individual reasons for c onsuming alcohol also were related to recreation and coping. Content analysis of the focus group transcripts built micro - system relationships (parents, peers, school , spirituality), meso - system interactions (peers - school and parents - religion), and macro - system cultural standards (br oader culture and religiosity). It is recommended that parents communicate openly about drugs, sex, and alcohol, model the behavior they expect from their children, follow authoritative parenting style, and have a close bond with their college bound children. College administrators are encouraged to 78 have programs that screen for problematic alcohol use and programs to address those problem s, counselors available to help with coping, and opportunities for on - campus recreation. Introduction College students participate in numerous health risk behaviors that may negatively alter their future plans, put them at risk for developing addictions, and increase morbidity and mortality from a wide variety of conditions (American College Health Association [ACHA], 2011). Excessive alcohol consumption by college students is considered by some researchers to be the number one public health problem on co llege campuses in the US (Misch, 2010). The purpose of this study is to examine the role of parents and religion in reducing regular alcohol use among college students in a religious environment that advocates alcohol abstinence. A mixed explanatory meth od using focus groups to understand and expand upon survey results was used. Content analysis of the transcripts helped to develop themes that explored the perception of alcohol in this population and the role parents and religion play in alcohol use. Th ese results are then explored from the fra mework of human ecology theory at micro - system, meso - system, and macro - system levels, keeping in mind proximal processes. Literature R eview Emerging A dults As a result of economic and social changes, young adults are delaying the typical route to adulthood through marriage (Schwartz et al., 2009). Arnett (2014) found in his research with individuals 18 - 25 years old that there is a transition period to what i s conceptualized by society as adulthood. During this period individuals traditionally finish schooling, get jobs, marry, have children, buy a house, become involved in their community, and so on. Arnett (2014) termed 79 d it is characterized by identity exploration, instability, self - focus, feeling in - between, and optimism about the future (Arnett, 2014). Since adulthood is being delayed, there also can be longer periods of experimentation and risk - taking similar to the adolescent years (Arnett, 2005). Young adults in this age period also may have a different relationship with their parents leave the parental nest, but for v arious reasons (typically economic), many return home (Goldfarb, 2014). Because of this and other societal changes, parents may be involved in their strong emotional and financial ties to their parents, it is important to study the influence these parents have on their emerging adult college - attending children (Schwartz et al., 2009). Role of Parents in Alcohol Use Much of the research done on parental influence on youth risk - taking behavior is conducted with adolescents (Schwartz et al., 2009). Some substance use patterns seen in college students began in the high school years where parents have greater influence, but some use is initiated in college where there is more peer interaction and less parental monitoring (Arria et al., 2008). Parental monitoring is not the only type of influence parents can have on their emerging adult children who are away at college. Schwartz et al. (2009) saw the importance of looking at mother and father relationships with their college - age children separately in order to assess the distinct and important contributions each parent makes in the likelihood of substance use. A longitu dinal study that measured parental involvement and alcohol - related risks across the first year of college found that greater attachment to mother was associated with less alcohol risk (Labrie & Sessoms, 80 2012). Weaker attachment to mother was associated wi th greater alcohol risk - taking and more consequences by the end of the year. The young men with weaker attachments to parents had more alcohol - related consequences than males or females with stronger attachments (Labrie & Sessoms, 2012). Schwartz et al. (2009) found that perceived acceptance by both parents, but especially father figures, was a protective factor against a number of health - risk behaviors, including alcohol consumption and binge drinking. Fischer, Forthun, Pidcock, and Dowd (2007) found th at psychological control and lack of connection with parents predicted college student alcohol problems . Parents also can engage in ineffective strategies to reduce substance use. In a study of parent communication strategies regarding substance use amon g first year college students, the majority reported that their parents told them just to use their own judgment, but it was found to be generally ineffective (Mil ler - Day, 2008). Miller - Day s uggested implementing clear communication strategies as to what parents desire their children to do in relation to alcohol. Abar and Turrisi (2008) reported that perceived parental disapproval of alcohol use during the adolescent years was strongly associated with lower rates of alcohol use in college. In summary, re attachment with their child, frequent family dinners, and sharing clear communication strategies regarding substance use, while giving a certain amount of freed om to make their own decisions. Alcohol U se The college years often involve experimentation with alcohol, with heavy drinking being the norm (Luquis, et al., 2003). A majority of a college age research sample was drinking alcohol (73 - 81%), with about one - third meeting the criteria for binge drinki ng in the previous month (Braitman, Kelley, Ladage, Gumieny, Morrow, & Klostermann, 2009; Randolph, Torres, 81 Gore - Felton, Lloyd, & McGarvey, 2009; Roberts, Glod, Kim, & Hounchell, 2010). Not only is alcohol consumption considered normal, but there is often an increase of heavy drinking that occurs during the college years (Amato & Kane, 2011). This leads to college being a peak time for experimentation and substance use (Miller - Day, 2008). There are some demographic variables that have been associated wi th alcohol consumption in youth, including gender, ethnicity, and age. Since there are greater physiological effects of large amounts of alcohol consumption on females, it is not surprising that men achman, & Schulenberg, 2010). Being an older male college student has been associated with binge drinking (usually defined by researchers as five or more drinks in one sitting) and its associated problems (Oliver, Reed, & Smith, 2001; Randolph, Torres, Go re - Felton, Lloyd, & McGarvey, 2009). Monitoring the Future (an ongoing study of the behaviors and attitudes related to substance use by American secondary school students, college students, and young adults) reports a gender difference among college stud ents, with those who admit to being drunk in the prior 30 days, 23% for females vs. 29% for males (Johnson, et al., 2010). There is a gender difference for daily drinking as well, 5.6% for males vs. 2.3% for females. There has been a change in the trend of gender differences over the years. A review of college - student alcohol use trends comparing binge drinking gender differences has found that the gap is narrowing from 80% of males and 49% of females who reported in 1953 to getting drunk in their lifeti me to 68% of males and 68% of females who reported almost sixty years later in 2011 to getting drunk in their lifetime (White & Hingson, 2013). There are some gender associated ethnic differences noted by researchers. African - American female college stud ents used alcohol less often than white female college students (Randolph, et al., 2009). There also are some ethnic differences in the youth population. Among 82 12 th graders, African - American students (13%) were less likely to report occasions of heavy dr inking than White (26%) or Latino students (22%) (Johnson, et al., 2010). Increasing age has been found to have an influence on alcohol consumption. As college students got closer to 21, it was found that their drinking increased, then decreased between 21 - 23 (Fromme, Wetherill, & Neal, 2010). Role of Religiosity in Alcohol U se In addition to parents as a protective factor, religiosity also has been studied as a protective variable against alcohol consumption during the college years. Religiosity has been found to shape choices around alcohol use (Ellison, Bradshaw, Ro te, Storch, & Trevino, 2008). Horton, Ellison, Loukas, Downey, and Barrett (2010) found an inverse relationship between religious attendance and health risk behaviors, but no relationship between a secure attachment to God and health risk behavior. Jankowski et al., (2015) conducted a study with a sample of 7412 college students at several state and private universities that found persons with high levels of quest and intrinsic religiousness scored significantly lower on hazardous alcohol use. According to Whitley and Kite (2010), per son s with intrinsic religious o rientation sincerely believes in their religion and all its teachings and attempt to live their lives as their religion dictates. Quest religious orientat ion refers to individual s who treat their religion not as a means or a n end, but a search for truth (Batson, 1982). There has been very little research done on Christian college campuses in relation to health risk behaviors. One study that compared state university and religious college alcohol use rates found that state un iversity students were four times more likely to be moderate to heavy drinkers (Wells, 2010). In addition, the study looked at religiosity and alcohol use of students in the state school and the religious school. The study found that students with the lo west rates of 83 religiosity were 27 times more likely to be heavy alcohol users and 9 times more likely to be moderate alcohol users (Wells, 2010). Frye, Allen, and Drinnon (2010) compared athletes with non - athletes on four Christian college campuses. They found that athletes participated in heavier episodic drinking than non - athletes. In addition, the athletes on Christian college campuses drank almost as frequently as athletes on secular college campuses. Thus, the context of a Christian campus did not The college campus that was studied and a vast majority (87%) of the participants in this study were self - identified as Seventh - day Adventist. The Seventh - day Adventist Church is considered a conservat ive evangelical church group that teaches the abstinence of alcohol and other harmful substances (Dudley, McBride, & Hernandez, 1997). The reasoning behind this is a desire to care for the body that was created by God (Seventh - day Adventist Church, 2015). Seventh - day Adventists also are known for eating a healthier diet with higher rates of vegetarianism than the average American (Orlich, et al., 2013). In a recently published research article in the Journal of the American Medical Association, Seventh - d ay Adventists have been shown to have decreased mortality rates, especially from heart disease (Orlich, et al., 2013). There are no known studies examining the effect of the role of parents and religion on college student consumption of alcohol among a po pulation of students attending an alcohol - abstinent college. Jankowski, et al., (2015) suggest future research should examine college environment and family dynamics in relation to college student alcohol consumption and religiosity. This study attempts to do that. Human Ecology T heory In the area of youth health risk assessment, specifically youth substance use, Urie 84 in research than his later writings when he focused more on human biology and proximal process (Ennett et al., 2008). Ennett et al. (2008) identified four social contexts that may influence adolescent substance use. On the microsystem level, the contexts are family, peers, and school; neighborhood is on the exosystem level, and the interrelation between all these contexts is the mesosystem. The macrosystem level contexts are culture and policies. This study built upon the microsystem family influence on youth decision - making regarding the use of alcohol, while keeping in mind the macrosystem policies of attending an alcohol abstinent school that adheres to a religion that teaches abstinence from all substances. In this context, religion has a microsyste m influence on the individual level in regard to the personal relationship an individual has with God and what he/she believes God expects of his/her behavior based on what the religion teaches. Bronfenbrenner continued to work on his theory of developme nt throughout his life (Tudge, Mokrova, Hatfield, & Karnik, 2009). The final theory included more biology and was entitled the bioecological model of human development (Bronfenbrenner & Morris, 2006). There was a re - emphasis on the interaction between th e biology of an individual and the development (Bronfenbrenner & Morris, 1998). In addition, Bronfenbrenner put more focus on the proximal process as the center of a Pro cess - Person - Context - time model (Tudge, et al., 2009). influences on development. This study will examine the Process - Person - Context - Time model regarding the consu mption of alcohol as it relates to 1. The proximal process between parent and child, participant and religiosity, with some attention to peer process; 85 2. The context of an abstinent conservative Christian religious school; 3. The person oriented predictor variables of gender, age, marital status, living arrangements, religion, and ethnicity; 4. An acknowledgement of the historical time in which the participants are currently living that normalizes alcohol consumption. Aims of the C urrent S tudy This study aimed to exam ine the role parents play in alcohol use in a college student population within the context of abstinent religiosity. The goal was to determine what, if any, direct or indirect parental behaviors may affect alcohol use in college students. This was done using explanatory mixed methods with for the secondary analysis . Method Survey Participants The survey was administered during class time in the month of March 2012 to students at a university in the mid - were not required to participate. The classes chosen were a representativ e sample of general education classes, upper division courses from several departments, and graduate level courses. Focus Group Participants (2003) qualitative method in conducting a similar study of undergraduate college students. Students were recruited to participate in one of six focus groups. Recruitment was conducted by accessing individuals participating in the behavioral science rese arch pool. As a part of the general education social 86 science experience, any student enrolled in a class housed in the Behavioral Sciences Department at the university was expected to participate in a research project. Students were required to participa te in one to two research studies (for a total of two hours) from a pool of th o se conducted in a given semester. If they objected to being a study participant, alternative means were provided to meet the educational requirement. This process was approved by the All informants in the focus groups were undergraduate students enrolled in the university. In order to participate in this study, they had to be between the ages of 18 and 25 and unmarried. The reason for the age limitation w as to focus on the emerging adult population perception of alcohol. Single participants were more likely to perceive themselves as emerging adults who are still exploring and experimenting, compared to adults with traditional responsibilities such as havi ng a marriage partner (Arnett, 2004). Each group had members of both genders, and were ethnically diverse. Survey I nstrument The survey instrument consisted of 124 questions that measured various health risk behaviors and potential risk and protective factors. The survey was put into Scantron format for easy analysis. Regular alcohol use was defined as use in the last week, and it was determined by the respondent - reported average number of drinks consumed in a week on a 6 - point scale from none, one, two, 3 - 5, 6 - 9, to 10 or more. A drink was defined as a bottle of beer, a glass of wine, a wine cooler, a shot glass of liquor, or a mixed drink. There was one parenting variable chosen to be added to the step - wise logistical regression analysis. Using a four - point scale, participants rated parental interaction, choosing 87 on regarding with a particular parent. There were two religious variables chosen for the step - wise logistic regression analysis religious participation and bel ief. Frequency of Sabbath school (similar to Sunday school, but on Saturday) attendance was measured on a 9 - point scale ranging from never to once per week and avo - point Likert - type scale ranging from In addition, the step - wise logistic regression analysis included measures for ethnic origin , age, and gender. Ethnic origin options were : American Indian/Alaskan Native, African American, Asian/Pacific islander, West Indian, White (non - Hispanic), Latino, and Other. Exact age was reported, and gender was a choice of male or female. The surv ey was developed by social science researchers at the Institute for the Prevention of Addiction at the study site institution over a period of 27 years. The survey was distributed about every five years on campus to measure rates and look for trends of yo uth health risk behaviors. The survey instrument is considered reliable and valid because the substance - use rates have stayed relatively the same throughout the five times they have been analyzed (Helm, Lien, McBride, & Bell, 2009). If there were slight increases or decreases in substance use, national trends also showed the same variations (Helm, et al., 2009). Students gave similar answers to the various questions related to alcohol use: age first used, whether they had ever used, frequency in the last year, frequency in the last 30 days, and rates of binge drinking. All frequencies were in descending order as one would suspect for alcohol use (lifetime use had 88 higher rates compared to binge drinking). The questions on the survey are similar to other health risk behavior surveys distributed on high school and college campuses around the United States Qualitative Instrument qualitative research on college student health - risk behaviors. All of the questions were based on suggestions from the research literature and the survey. The specific questions asked were as follows: Perception of College Life: What led to your decision to attend this university? What one word would you use to describe this university? What were your expectations about being a college student? Where did these expectations come from? Have those expectations been fulfilled or not? Perception of Alcohol Use What are the assumptions/beliefs about alcohol among your peers? What are the reasons for using/abusing alcohol? What are the assumptions/beliefs about alcohol use among students? What are the reasons for binge drinking (5+ drinks) or getting drunk? participate in these behaviors? What role might a relationship with parents and close family members play in a behaviors? 89 It is important to note that the respondent s were encouraged to elaborate on various motivations for their health behavior s and to interact with one another. T he interviewer also asked clarifying follow - up questions as needed . Survey Analysis All statistical analyses were performed using the Statistical Package for Social Science (SPSS) Version 21 with a goal of identifying parental protective factors , in the context of the relation to regular alcohol consumption. The model only included participants who were aged 18 - 25, not living at home, self - identified as Seventh - day Adventist, and single in order to study the typical college student and control for environmental factors . Regular alcohol use was recoded to be a dichotomous variable of no or yes. A logistic regression model was developed based on the research question, research, and results of Pearson Correlations (regular alcohol use was the dependent variable). The mo del included the following predictor variables: open communication with mother and father, age, gen der, ethnicity, religious participation, and religious belief . A step - wise logistic regression analysis was run one variable at a time in order to identify a statistical model to measure the strength of the role of parents , demographic variables, and religiosity on regular alcohol use behavior . Qualitative Analysis The original qualitative analysis was conducted with t he primary investigator and an assistant . This team debriefed after each of six focus groups, and notes were taken. The audio recordings were then transcribed. There were one hundred pages of typed transcripts. Once the transcripts were prepared, they were reviewed and themes identi fied through an open coding process. A codebook was developed, and then the transcripts were uploaded onto QDA miner 90 version 4. The codebook was entered by hand into the software. Next, the primary investigator and the assistant individually signed in w ith a user name and password and chose which codes described each response from the participants. This is a process called axial coding in which the investigators assemble the data in new ways after the initial open coding process (Creswell, 2007). QDA m iner calculated frequencies for all codes and measured the code agreement frequency. There was a 75% inter - coder agreement. The results section of this report will show fied (Creswell, 2007). The secondary analysis identified t hree themes based on frequency of responses to individual codes as determined by QDA Miner software. The type of secondary analysis of qualitative data used for this study is a supplementary analysis, which is the most common qualitative secondary analysis (Heaton, 1998). This study did a more in - depth analysis of alcohol use among this population than the original study by identifying themes as they relate to the role parents and religion pl ay in alcohol use in order to have a narrative to help explain the survey results . Results Survey Demographics A total of 750 surveys were distributed, with 737 sufficiently complete and eligible for - syste m relationships were homogenized by choosing only students who self - identified as Seventh - day Adventist (87% of the participants), aged 18 - 25 (75% of the participants), single, and not living at home (in order to focus on the emerging adult population); th is decreased the number of participants to N=414. The demo graphics are included in Table 4 . The ethnicity of the respondents was as follows: White 35.8%, African American, 24.5%, Asian 14.2%, Latino 13.7%, West Indian/Caribbean 6.1%, 91 and Other, 5.6%. Th e gender breakdown was 60.8% female and 39.2% male. Alcohol U se F requencies There were 10.5% of the participants reported having had at least one alcoholic beverage on average per week, with 89.5% reporting they do not consume alcohol on a weekly basis. Descriptive statistics for the dependent variable of regular alcohol use is pr esented at the bottom of Table 4 . Focus G roup D emographics There were a total of 53 participants, with groups varying in size from 6 - 15, averaging 9 participants. There wer e 23 males (43%) and 30 females (56%). Ethnic breakdown was very similar to the survey: 23 White (43%), 13 West Indian/African American (25%), 8 Latino/a (15%), 6 Asian (11%), and 3 Asian/White (6%). Alcohol Step - wise Logistic Regression M odels This study involved determining what influences the reduction of regular alcohol use behavior. A step - wise logistical regression analysis was conducted using regular alcohol use as the dichotomous dependent variable; results are in Table 5 . The model had low multi - collinearity VIF scores ranging from 1 - 1.15. The first step in the step - wise Model 1 used open communication with mother as the independent variable, then gender, ethnicity, attending e of my body by avoiding that step one began with open communication with father . The results for Model 1 step by step: 92 1. Open communication with mother showed statistical significance and decreased the likelihood of regularly consuming alcohol by 26% ( OR = 0.74; p . 2. Ethnicity was not statistically significant, but increased open communication with mother slightly to 29% less likely to drink ( OR =0.71; p . 3. Age increased the chance of consuming alcohol by 35% ( OR =1.35; p increased open communication with mother slightly to 30% less likely to drink ( OR =0.70; p . 4. Gender was added, showing that is was not statistically signifi cant with no change in the open communication with mother or age variable . 5. The religious participation variable of attending Sabbath school was statistically significant with 32% lower odds of consuming alcohol ( OR =0.68; p open communic ation with mother not statistically significant, but age increased slightly to 41% higher odds of consuming alcohol ( OR =1.41; p 6. body by avoiding alcohol, tobacco, an 60% ( OR =0.40; p ( OR =1.40; p ( OR =0.75; p o pen communication with mother stayed not statistically significant. The results for Model 2 step one step by step: 1. Open communication with father was not statistically significant in affecting the odds of consuming alcohol regularly. 2. Ethnicity was not statistically significant. 3. Age increased the chance of consuming alcohol by 39% ( OR =1.39; p 93 4. Gender was not statistically significant with no change in the age variable. 5. The religious participation variable of attending Sabbath school was statistically significant with 33% lower odds of consuming alcohol ( OR =0.67; p the age variable increasing slightly to 51% higher odds of consuming alcohol ( OR =1.51; p 6. e good care of my 59% ( OR =0.41; p ( OR =1.49; p less likely to consume alcohol ( OR =0.73; p Focus Group Results There were no ethnicity or gender differences noted by the researchers in the focus groups on the topic of alcohol consumption. No participant mentioned his or her gender or ethnicity as an influence on use or non - use of alcohol. In addition, researchers did not notice gender or ethnic differences among the participants in their responses through the coding and memoing process. This supports the results of the survey regarding gender or ethnicity. The religious culture which provides a unifying effect a ppears to have the greatest influence on this group. The most common identified themes are listed below: Abstinent Environment Vs. Secular C ulture The participants verbalized an awareness of a normalization of alcohol consumption in college in the broader culture. They see a certain amount of that culture even at an abstinence - oriented university. A Hispanic female acknowledged, Like, they know I mean most of them have been rai sed as SDA (Seventh - 94 and I k going towards The campus being studied does not allow alcohol consumption, f or religious reasons. tion of what was acceptable on campus. A participant . .then there are restrictions that a lot Many of the students chose to attend a Christian school in which the majority of the definitely was looking the participants had attended public high schools or colleges before and said they wanted to attend a school with other Seventh - day Adventists who had similar beliefs. An Asian femal e students reported wanting a more spiritual environment than they would get at a public for something more spiritually guarding and I wanted to go somewhere more spiritual, so I came 95 Parents and friends played the biggest role in choosing to attend an Adventist college. An African Am d previously or currently attended here, it also influenced the decision to attend. Friends also could be an example of what they did not want to become. Authoritative Parenting Style Participants reported a belief that it was important for parents not to be too strict or too lenient. When parents are too strict, the participants thought it would make children rebel against their parents. However, if parents are too lenient and permissive, they are not monitoring their adolescent children who may star t drinking in their teen years and continue their alcohol to A c lose relationship between parent and child was said to play an important role in alcohol consumption. The participants felt that if the children are close to their pare nts and know that their parents do not want them to consume alcohol, then the children are less likely to want my parents, but that influences many of the decis from adolescence have been telling you, educating you that shows that they care enough about consumption, according to the participants. A participant said, 96 not just enforcing a bunc actually having a rationale for the rules, or the thing that parents try to implement to their Drinking for R ecreation and C oping Upon reflecting on how they perceived alcohol use, the most common response was that it was done at parties or social occasions. Many thought it was part of the normal college experience. An African - r participant In addition, participants said that alcohol use varies tremendously from those who drink every day t o those who have never consumed alcohol. They did not feel there was peer pressure to drink. It was reported that it is easy to find a group of friends who party all the time and those here. I work here on - Caucasian male. Some mentioned that that they felt alcohol use was wrong, in the context of abstinent religiosity. A Hispanic male Individual reasons were given regarding what influences those perceptions of alcohol. It was reported that alcohol is a form of coping with stress, helps with sleep, and can be a way to - consuming peers at a social occasion will influence them to consume alcohol. An Asian/White 97 statement was that they felt alcohol was a form of experimentation and recreation for college s whatever and doing things people tell you, and you want to be a bit different and do something Binge drinking had a different set of responses. The info rmants believed that binge drinking may be accidental or part of an underlying problem. After a few drinks, they felt it is hard to keep track of consumption because of lowered inhibition and awareness. When one gets drunk, it may also be a way of escapi Though alcohol use was not uncommon, there was a perception that getting drunk was not normalized on campus. A Discussion of Focus Group Results The participants mainly focused on individual reasons for using or not using alcohol (coping, recreation, addiction, and/or escape). Through the memoing process, it became apparent that multiple factors play a role in their alcohol use behavior. These findings were revealed through the process of open, axial, a nd selective coding of the data, as proposed by Strauss and Corbin (1990). The multiple factors that played a role came from different layers in Model, in which the individual is viewed as interacting with micro - systems (role within the system, and family and peer relations), meso - systems (interactions between two or more micro systems), exo - systems (outside systems to which the individual does not belong, but affec t the 98 - systems (culture and policies). This study did not find exo - system influence. On the micro - system level, the relationships that played a role were parents, spirituality, school, and peers. Parents played a rol techniques that improved the parent/child relationship and increased the effect of modeling alcohol abstinence and choosing an abstinence - oriented college to attend. Spirituality created a feelin environment found on a Christian campus. School rules and standards that do not allow alcohol consumption increase the consequences of alcohol use because they could b e expelled from the school if those rules are violated. On the meso - system level, peers interacting in the school environment that does not allow alcohol and parents and school reinforcing religious standards were the system interactions. Peers may rein force the abstinence rules or encourage each other to break those rules. The religion sets the abstinence standards, and the school with its rules and parents with their modeling reinforce the standards that alcohol consumption is not acceptable. On the m acro system level, the broader culture and the abstinence religious culture are at odds. These two macro system level influences have opposing sway on the decision to consume alcohol. The broader culture normalizes alcohol consumption as a part of the co llege experience. The religious culture on the campus studied says you are to take care of your body by not consuming alcohol because that is what God would want. Being in an environment where there is less peer pressure to drink alcohol can aid in absti nence. These results are summarized and displayed in Figure 3. The primary author/P.I. for this study has lived in the community being studied since the 99 age of fourteen, is a graduate of and current faculty at the university where the study was originally conducted, and is a member of the Seventh - day Adventist church. At the time the focus groups were conducted, the P.I. was a part - time adjunct professor and not well known to the study participants. The author practices alcohol abstinence based on religi ous values and personal family history of alcoholism. In order to decrease the influence of this personal belief on the participants, the questions were read consistently with few follow up questions which were asked in an open - ended format in all of the focus groups. In addition, two graduate students, who were students of the same university the participants attended, assisted in the . A P.I. in this position has some advantages and disadvantages because there was personal experience attending and working at the university. The primary author was exposed to alcohol consumption on campus as an undergraduate, in the context of standards set by the Seventh - day Adventist church regardin g alcohol consumption, but was living at home at the time. This can aid in understanding the context experienced by focus group participants. Of course, this personal experience occurred over twenty years ago, so there may be a lack of awareness of cultu ral changes that have occurred over the decades. Being a current faculty member at the university a nd member of the church may encourage this researcher towards support of the niversity could have influenced the focus group participants to say what they thought the P.I. wanted to hear. Discussion The focus of this study was to examine the role of parents in reducing alcohol consumption among a population of students attending an abstinence - oriented Christian university. This mixed - method study found that parents play a role in alcohol consumption, but 100 this role is not as prominent as religiosity and individual factors (coping and recreation). The in decreasing regular alcohol consumption. The focus gr oup participants mentioned individual factors more often than any role played by parents or religiosity. An individual focus is typical still play an indirect ro internalization of self - care. Thus, if the parents raise their children in a broader contextual environment (like a faith community) that supports what they are teaching their childr en about alcohol consumption, the may increase the role parents play in alcohol consumption by their child. This is supported by research in a longitudinal study of childhood family characteristics and childhood religious affiliation and past year drug use (Cubbins & Klepinger, 2007). If the parents and the children attend an abstinence - oriented church, those standards also may encourage the parents to set that standard for their child. Parents can help in explaining what those standards are in such a way that their child feels comfortable talking a bout drugs, sex, and alcohol. The children are then more likely to want to maintain a connection to their abstinence - oriented church by staying in that environment even through the college years. According to the model, open communication with mother (not father) statistically reduced the odds of consuming alcohol. This supports LaBrie and Sessoms (2012) results in which they found attachment to mother reduced alcohol consumption more than attachment to father. The focus groups did not identify a differe alcohol consumption or binge drinking. Certain areas of religiosity had a strong protective value. Since these students chose to attend a Seventh - day Adventist educational institution, they are more likely to believe in 101 Adventist teaching. With 87% of the participants claiming Seventh - day Adventist affiliation, there are high rates of students who have an abstinence - oriented religiosity focus that has an overall message of living a healthy lifestyle. Many of the focus group participants stated that they wanted to attend an Adventist college for the spiritual atmosphere and to be around those tatistically significant religiosity variables that predicted regular alcohol use and binge drinking. Participants in this study, while very ethnically diverse, are a fairly homogeneous religious group, so it may be difficult to predict certain taboo beha viors among O n average , 56.4% of college students report consuming alcohol in the past month compared to the participants in this study who had a rate of 15.5% (Sub stance Abuse and Mental Health Services Administration, 2013). Since regular alcohol use N is low, it may be difficult to find other predictive variables. Attending Sabbath school regularly may be a protective factor because it takes a certain level of c ommitment . A person would need to plan to attend Sabbath school, and thus may be more likely to internalize the Adventist beliefs that include caring for the body and choosing to abstain from alcohol use. This variable was not a theme mentioned in the fo cus groups, but it may aid in internalization of religious values that was mentioned as being important. The strongest protective variable found in the quantitative portion and reinforced in God calls individuals to care for their bodies by avoiding all substances (General Conference of Seventh - day Adventists, 2010). The greatest risk factor found in the logistic regression models was age. It stands to reason t hat in a strong religious environment, students under the legal drinking age of 21 would 102 be less likely to report consuming alcohol. With the focus group participants reporting alcohol consumption as somewhat normalized for college students, especially in the context of coping and recreation, it makes sense that when a substance use is legal, one would be more likely to report consuming it on a regular basis. Odds ratios run to examine this variable more closely showed regular alcohol consumption went fro m 4% at age 20 to 13% at age 21, more than tripling in just one year. Regular alcohol consumption peaked by age 23 at 21% then decreased to 13% by the age of 25. This supports research by Substance Abuse and Mental Health Services Administration (2006) t hat showed binge drinking peaking between the ages of 21 - 23. Limitations There are limitations regarding this study being conducted on a conservative Christian campus. Though participants were guaranteed anonymity with the survey and confidentiality in the focus groups, they still may not have been completely honest in regard to their use of alcohol. The participants were not required to participate in the survey, but they could not leave the classroom during the in - class distributed survey if they cho se not to participate. The study is thought to be reliable, given the alcohol use trends from past health risk studies done on campus, how the trends compare to national trends, and questions that were used to test for honesty. The participants in this s tudy were from one university with a majority population of self - identified Seventh - day Adventists, and cannot be generalized to the general college population. However, the data may be useful for understanding how the religious context of other Christian colleges affects regular alcohol use, and the role parents and religiosity play. Implications and Recommendations High levels of alcohol use by college students can be a mystery for parents and college 103 administrators. This study found that parents do ha ve a role to play in their college student alcohol consumptions. While this study was conducted at a church affiliated university, religiosity is a variable that is included in national studies and consistently relates to lower rates of use. Religiosity is a complex concept, and this study suggests the importance of understanding what aspects of religiosity may be more beneficial to emerging adults. It was found that religiosity can have a lifestyle influence if it is reinforced by religious standards in a macro religious environment. Parents, on a micro - and meso - level, have a role in reinforcing those messages by modeling and communicating the same message in an open manner that fosters close parent/child relationships. Those who work with college stu dents and their parents can apply what has been learned in this study by targeting particular parenting behaviors and factors in religiosity that have a greater effect on decreasing alcohol use among college students. In this study the strongest roles par ents play in alcohol use were 1) a college age child feeling comfortable talking to his or her mother about drugs, sex, and alcohol , 2) parental modeling , 3) a n authoritative parenting style , and 4) a close parent - child relationship. For this population, religious teachings on the topic of maintaining a healthy lifestyle were the most beneficial. College administrators also can benefit from the results of this study in designing programs and setting policy. Though regular alcohol use and binge drinking ra tes are low, there is still a significant minority of students who participate in possibly dangerous alcohol consumption. The literature points to alcohol being the biggest public health problem on campuses that then leads to other problematic behaviors ( binge drinking, drug use, sex risk behavior, date rape, dating violence, accidents, and even obesity) because of the lowering of inhibitions and awareness (Misch, 2010). As this study found, parents play a part in alcohol prevention. LaBrie, Napper, and Hummer (2014) piloted a program that educated parents on 104 alcohol use among college students that then led to parents being more intentional about talking to their children about alcohol use at college. Donovan, Wood, Frayjo, Black, and Surette (2012) foun d that a Web - based intervention that encouraged parents to talk to their college bound teens about alcohol led to protective behavioral strategies related to the manner of drinking and stopping/limiting drinking. Many college students drink alcohol to co pe with social anxiety or stress, so programs need to help students find other ways to cope with these issues (Ham, 2009). This was mentioned in the focus groups. Research has found that parents play a role in adolescent adjustment by having a healthy bo nd with their child that leads to secure attachment (Scott, alcohol is a taboo subject. It would be good for Adventist and other conservative religious campuses to talk openly about dangerous alcohol use, the risks of accidental overconsumption, and alternative ways to cope with problems. Since peers have such a great influence over alcohol, the social norms theory suggests that social norms interventions can be use d to target high - risk groups (Martens, Page, Mowry, Danann, Taylor, & Cimini, 2006). University - wide programs do not work as well at targeting specific at - risk groups, except when setting the culture of the university (Thompson, McLerran, Livaudais, & Cor onado, 2010). The Adventist campus that was studied has set a health - oriented culture, which appears to play a role in alcohol consumption. Since depression is so common and puts college students at risk, it is suggested that students be screened regula rly (Roberts et al., 2010). The focus group participants believed some binge drinking behavior was associated with escaping emotional pain. Positive, tangible social support has been linked to buffering suicide risk for college students (Hirsch & Barton, 105 2011). Parents walk a fine line in providing emotional support to their college age children. in children, more prosocial behaviors and hope in adolescents, but higher rates of depression when parents are over - involved with their college age children (Joussemet, Landry, & Koestner, 2008; Day & Padilla - Walker, 2009; Schiffrin, Liss, Miles - McLean, Geary, Erchull, & Tashner, 2014). College campuses should have trained counselors available to address stress from responsibilities and grief over relationship problems or loss of a loved one , to assist in healing from rape and intimate partner violence , to address past issues such as trauma and abuse , and to manage c hronic conditions such as ADHD, depression, anxiety, and bipolar disorders. In summary, there are college based programs and policies that operate at the micro, meso, and macro levels that have worked or may work in reducing alcohol use, according to res earch and the results of this study. 1. Implement programs that educate parents on college drinking, provide guidance without being too strict or permissive , and encourage them to talk to their college - bound teen about alcohol use. 2. Use available alcohol screening tools, as necessary. 3. Provide evidence - based alcohol treatment programs by trained health care providers. 4. Provide mental health resources to aid with managing social anxiety, stress management, depression, trauma, and grief. 5. Educate on the dangers of overconsumption of alcohol. 6. Have clearly stated policies regarding use of substances. This will help with setting a safer campus culture. 106 7. Have on - campus activities during high alcohol use times that are properly supervised to decrease the amount of off - campus partying. Alcohol consumption does not have to be an automatic part of the college experience , like t he focus participants reported, where parents and religion can play a role as mentioned by a participant, - day The most successful efforts to combat problematic drinking are a healthy mixture of prevention and intervention that targets individuals, the student body as a whole , a nd the larger community. 107 Table 4 Demographics and Frequencies -------------------------------------------------------------------------------------------------------- Gender Frequency Percent Male 162 39.1 Female 251 60.6 Grade level Freshman 116 28.0 Sophomore 81 19.6 Junior 79 19.1 Senior 100 24.2 Grad/professional 34 8.2 Race/Ethnicity African American 97 23.4 Asian/Pacific Islander 56 13.5 West Indian/Caribbean 24 5.8 White (non - Hispanic) 141 34.1 Latino or Hispanic 54 13.0 Other 22 5.3 Regular Alcohol Use No 357 86.3 Yes 41 9.9 Missing 16 3.9 ------------------------------------------------------------------------------------------------------------ 108 Table 5 Step - wise Logistic Regression Models (n=363) --------------------------------- -------------------------------------------------------------------------- Variable Model 1 Model 2 ------------------------------ --------------------------- B Wald Odds Ratio B Wald Odds Ratio Step 1 Communication - 0.31 4.52 0.74* - 0. 12 0.77 0.89 Constan t - 1.38 13.17 0.25** - 1.87 27.46 0.15 ---------------------------------------------------------------------------------------------------------- Step 2 Co mmunication - 0.35 5.38 0.71* - 0.19 1.63 0.83 Ethnicity 0.13 1.28 1.14 0.08 0.49 1.08 Constant - 1.81 8.81 0.16* - 2.04 11.54 0.13 --------------------------------------------------------------------------------------------------------- Step 3 Co mmunication - 0.35 5.39 0.70* - 0.23 2.35 0.80 Ethnicity 0.10 0.71 1.11 0. 05 0.17 1.05 Age 0.30 10.05 1.35* 0.33 11.26 1.40** Constant - 7.97 14.98 0.00** - 8.69 17.21 0.00** --------------------------------------------------------------------------------------------------------- 1. Open communication with mother 2. Ope n communication with father 109 Table 5 ----------------------------------------------------------------------------------------------------------- Variable Model 1 Model 2 ------------------------------ ---------------- ----------- B Wald Odds Ratio B Wald Odds Ratio Step 4 Co mmunication - 0.35 5.32 0.70* - 0.26 3.01 0.77 Ethnicity 0.10 0.72 1.11 0.05 0.17 1.05 Age 0.30 9.82 1.35* 0.33 11.12 1.39** Gender - 0.24 0.45 0.78 - 0.39 1.09 0.68 Constant - 7.52 12.00 0.00** - 7.95 12.95 0.00** -------------------------------------------------------------------------------------------------------- Step 5 Communication - 0.20 1.43 0.82 - 0.30 2.74 0.76 Ethnicity 0.15 1.18 1.16 0.14 0.93 1.15 Age 0.34 9.78 1.41* 0.41 12.56 1.51** Gender - 0.45 1.24 0.64 - 0.50 1.46 0.61 Sabbath School - 0.38 17.55 0.68** - 0.40 18.48 0.70** Constant - 7.18 8.63 0.0 0* - 8.25 10.93 0.00** --------------------------------------------------------------------------- --------------------------- 1. Open communication with mother 2. Open communication with father 110 Table 5 ----------------------------------------------------------------------------------------------------------- Variable Model 1 Model 2 ------------------------------ --------------------------- B Wald Odds Ratio B Wald Odds Ratio Step 6 Communication - 0.11 0.38 0.90 - 0.15 0.73 0.86 Ethnicity 0.06 0.20 1.07 0.04 0.07 1.04 Age 0.34 8.44 1.40* 0.40 10. 65 1.49** Gender - 0.41 0.97 0.66 - 0.40 0.86 0.67 Sabbath School - 0.29 8.97 0.75* - 0.31 9.91 0.73* Body Temple - 0.91 11.03 0.40** - 0.90 10.36 0.41** Constant - 3.20 1.32 0.04 - 4.31 2.31 0.01 -------------------------------------------------- --------------------------------------------------------- 1. Open communication with mother 2. Open communication with father 111 [Cite your source here.] Figure 3 . Conceptual m ap of f ocus g roup r esults . Environmental Influence on Alcohol Use in College Students Attending an Abstinent University MICROSYSTEM Peer School Peers encourage to break rules Parents Religion Parents reinforce teachings MESOSYSTEM Spirituality Peers encourage to break rules or reinforce MACROSYSTEM --------------------- ----- ------ Modeling , democratic parenting ----------- - ------- --------------- INDIVIDUAL Coping Age Recreation Parents Religion Parents reinforce religious teaching Parents Peers College is a time to have fun and party Alcohol legal at 21 ------------- -------------------------- ------------ MICROSYSTEM Desire a spiritual atmosphere ---------------------------------- -- Alcohol not allowed -------------------- -- C onsequences Done together ------------------- Relationship with Parents ---- - --------------- --- ------- Secular Culture Abstinent culture teachings ------------------------ -------------------------- Religious Culture [Cite your source here.] School 112 CHAPTER V I CONCLUSIONS Integration and U niqueness The goal of t his research was t o determine the role parents play in alcohol use among conservative Christian university students who are attending an abstinen ce - oriented university. Strategies were suggested for parents, family life educators, c ollege administrators, and the faith community in addressing problematic alcohol consumption among college students . This was initially done using the Parental Environment Questionnaire that measure d parent - child involvement and parent - child conflict. T he initial results showed a weak to insignificant relationship between parental involvement and conflict and alcohol use . As a result, the author wanted to know what , if any , parental variable had a stronger relationship . After running Pearson Correlatio ns with all of the parenting variables in the survey, t he variable that showed statistical significance was feeling comfortable talking to parents about alcohol/drugs/sex. This variable was then put in to a logistic regression m odel that was used for the second study . When both study one and two showed the strongest predictor variable to be the religious belief of , it was decided to re - analyze the follow - up focus groups t o further explore whether parents had an influence on internalizing that value . The focus group inquiries were a combination of questions used in a similar study from Luquis, et al. (2003) , and questions developed in consultation with other researchers who have ex pertise in this area . The questions were open - ended to allow participants to define their own r eality of alcohol use on an abstinent - oriented university campus. Initially , the participants focused on personal reasons for using alcohol as a way to cope with the stresses of college life, 113 and acknowledged that i t is commonly a recreation that i s part of the normal college experience. They also recognized that binge drinking ca n be an expression of a possible addiction, driven by a desire to escape emotional distress. Students mention ed the school not allowing the use of alcohol , and they believed school officials felt that it led to unacceptable behavior in the student body, e specially binge drinking. Because alcohol use was not permitted on campus, students felt this led to alcohol being a taboo subject . According to the focus group participants , their s pirituality pl ayed a role in alcohol use . First , it influenced their choice to attend an abstinent - oriented university because they had a desire to be in a spiritual learning environment and to be with students of similar religious values. S econd , choosi ng not to use alcohol was linked to their personal r elationship with God . T hird , students abstained from alcohol use because of the standards set by the religion (connected to the belief that God wants individuals to care for their body by avoiding alcohol , tobacco, and drugs). relationship s wi th their parents an d their own spirituality were discussed in the focus group in relation to alcohol use. Parents abstinent - oriented university through authoritarian insistence, role modeling ( parents had attended the same university), or encouragement through a close parent - child relatio nship. The participants felt parents who had a more authoritative parenting style fostered a closer relationship , and there was more open communication about the topic of alcohol use . In addition , when parents modeled the practice of alcohol abst inence, the child was less likely to use alcohol. Some participants reported that problematic use of alcohol and other substa nces actually motivated them not to use such substances due to seeing firsthand the consequences and effects of alcohol use . This also helps to explain why 114 ohol and other drug problems were not statistically significant in relationship with alcohol use among university students in the survey . When a parent had an alcohol problem he/she was a model of what not to do , which could influence the child not to use alcohol . Relationship t o E xisting R esearch This research is unique due to the population studied. There are many research studies examining college student alcohol use, but few were found that specifically address this study population (Helm, et al., 2008) . Though this p opulation is not known to be at risk of developing alcohol - related problems, college students in general are at - risk , so any research that expands this knowledge base is a benefit to society (Randolph, et al., 2009) . E lements were suggested that could hel p prevent future problems for students who would be considered at - risk for alcohol - related abuse. In addition, risk and protective factors were discovered that could be of benefit to the general college student population in the United States. Another d istinctive aspect of this research is the examination of the role parents play in a lcohol use among college students. There has been some research studying the role of parents in college studen t alcohol use, but none was found that examined parent/child conflict and parenting style as a possible risk factor ( Abar & Turrisi, 2008 ; Fischer, et al., 2007; Labrie & Sessoms, 2012 ; McBride, et al., 2013 ; Miller - Day, 2008 ; Schwartz, et al., 2009). One study examine d parental involvement, b ut only studied alcohol - related risks across the first year of college (Labrie & Sessoms, 2012). Fischer, et al., (2007) reported that parental involvement in the form of psychological control was actually a risk factor for student alcohol problems. This study found parental involvement in the form of parent/child bonding was not a risk factor for regular alcohol use. I t is important for the research literature to differentiate between types of 115 parental involvement (controlling vs. bonding) in studies of the emerging adult/college student population. There have been studies that examined parent/child communication in relation to alcohol and reported on how perceived parental disapproval of alco hol use in the adolescent years w as a protective factor . However , parents allowing their college - attending child ren to use their own judgement did not work to discourage alcohol use ( Abar & Turrisi, 2008; Miller - Day, 2008 ). Consistent with other research , this study shows the importance of o pen communication about alcohol and drug use . Paradoxically, this may be a difficult conversation for some parents of college bound children, especially those from a con servative Christian background. In addition to communication, monitoring alcohol use may be another form of parental involvement. Though the parenta l involvement and conflict variables were not statistically significant, one variable was statistically significant in relation to regular alcohol use : t he . Th is variable is actually a type of parental monitoring. Parental monitoring is a commonly found protective factor in adolescent substance use, but has not been studied in col lege students (Ewing, et al., 2015; Tomay, et al., 2013; Tomcikova, et al., 2013). This study also examined the different roles played by mother and father. Other research has found both mothers and fathers can be involved in preventing alcohol - relate d problems in their college - attending children , but in different ways (L abrie & Sessom, 2012; Schwartz, et al., 2009). In this population of conservative Christian participants, only a mother involvement variable was statistically significant in relation to regular alcohol consumption. Research studies that examine parental involvement typically show high rates of mother involvement, which has been linked to positive outcomes for youth (Finley, et al., 2008; Schwartz et al., 2009). 116 The goal of this study was to examine the role that parents play in regular alcohol use of college students. However o take care of my body by avoiding drugs decreased alcohol use more significant ly than even the strongest parenting variable (6 0% vs. 30%). Abstinent - oriented religions credit the need for followers to take care of the body God gave them as a reason to avoid alcohol use, but this particular variable had never been studied in an abstinen t - oriented college student population. The follow - up focus group helped to explain the role parents can have in influencing the internalization of this religio us belief in their children by modeling alcohol abstinence themselves. A distinctive feature to study two is the use of mixed method s to examine alcohol use in college students. A study completed in 200 3 used qualitative research methods to examine this topic, but the vast majority of studies are quantitative surveys , with none found using mixed method s research (Luquis, et al., 2003) . With an increasing interest in mixed method s research as a way to maximize the benefits of and minimize the problems associated with quantitative and qualitative research , it is good to expand the mixed method s research field (Creswell & Tashakkori, 2007; Johnson & Onwuegbuzie, 2004). Another benefit to mixed method s research is the ability to report findings in an easier - to - use format for practitioners (Johnson & Onwuegbuzie, 2004). Implications for P ractice Parental involvement and conflict did not play a statistically significant role in co llege s tudent alcohol use. P arents should not feel pressured to have a continued involvement in their problematic alcohol use. T h is research study found that mothers knowing how their child ren spend their spare time and having open commu nication with their child ren on th e topic s of drugs, alcohol, and sex was important . It is 117 not recommend ed that mothers physically monitor their childre n, but they can be encouraged to have an awareness of and develop a close bond so the child is open and willing to share his or her daily activities. Open communication is related to the parent - child bond. Open communication may be difficult for some parents, especially those who belong to an alcohol - abstinent religion, but it app ears to be a protective factor . Other research has reported that the best time to have open communication regarding alcohol use is the summer before the child attends college . Parents should clarify what behavior they expect from their child in relation to alcohol use (Labrie, et al., 2014). The follow - up focus groups reported that i t was helpful when parent s explained the problems associated with alcohol use in a clear and reasonable way. Other p arental strategies were suggested in the focus groups. The participan ts recommended a more authoritative parentin g style in which the parents were no t so strict as to encourage rebellion - related alcohol use and , by contrast, not to o permissive to impl y pa rent s do not care what their child ren do in regard to alcohol use . Baumrind (1966) differentiated parental styles between authoritarian, authoritative, and permissive. Baumrind (1971) defined authoritative parenting style as parents discussing rules and their rationale, encouraging autonomy as well as adherence to rules, being high in control, but also high in warmth and responsive towards the need s of their children. An authoritative parenting style would more likely encourage open dialogue on the topic of drug and alcohol use , with clear explanations regarding concerns and a closer bond developed between parent and child. This is important for parent education because this is further evidence of the benefits of authoritative paren ting , which may be protective of problematic alcohol use. Another recommendation from the focus group was the importance of parental modeling 118 related to alcohol use . Parents should model the alcohol behavior they expect from their college - attending chil dren. If parents have an alcohol problem , they should make the consequences clear footsteps. This research also has implications for the faith communi ty. Th e study supports the literature regarding the benefits of religious belief and religious participation as a protective factor in alcohol use (Ellison & Levin, 1998; Ellison, et al., 2008; Urry & Poey, 2008; VonDras, et al., 2007; Wells, 2010). The Christian faith community should actively reach out to college student populations to encourage religious participation and provide opportunities for faith development . There can be special Sunday/Sabbath school classes and social activities specifically for college students to increase social interaction, which in turn can help students make sense of tragedies that may have happened in their lives , and to learn about healthy lifestyles (Phillips & Henderson, 2006 ). College administrators also can benefit from the results of this research. First, a college may want to encourage parents to communicate clear alcohol use expectations to their students (LaBrie et al., 2014). Donovan and colleagues (2012) developed a potentially helpful college - administered web - based intervention that encouraged parents to talk to their college - bound teens about alcohol. Additionally, college administrators can actively reach out to faith communities to develop a partnership to address the prevention of problematic alc ohol use in college students . In addition to family and faith involvement, regular scr eenings for depres sion also are recommended for students. The focus group participants identified alcohol as a means to cope with stress or emotional problems. S ince depression is common and is related to problematic alcohol use, it is suggested that mental health screen i ngs and access to trained counselors to 119 address any number of emotional, relationship, or substance use problems would be beneficial (Roberts et al., 2010). Research and P olicy This research support ed a human ecological theoretical lens . The mixed method s research study showed that there are multiple system s that play a role in college student alcohol use. Youth health risk resea rch literature has examined micro - , meso - , exo - , and macro - system levels to look at parent/child relationships, peer inte ractions, the school system, school/neighborhood interactions, cultural influences, and the interactions between all of these systems (Brown & Larson, 2009; Eccles & Roeser, 1999; Ennett, et al., 2008; Maschinot, 2008). Tudge , et al., (2009) recommended r esearchers examine the Process - Personal - Context - Time areer. This study supported this model by examining the process between parent and child ren , participant and religiosity, in the context of an abstinent - oriented religious school, with the person - oriented predictor variables of gender, age, marital status, and ethnicity . In addition, the historical time in which the participants are currently living and how the current culture normalize s alcohol consumption is acknowledged . Lerner, et al., (2015 ) support s the human development theories moving to relational developmental systems metamodel. This study indicates that the family system and i ts place with in the environment play s a role in alcohol u se among college students , thereby showing support for the family ecology theory , although it has not appeared in the literature for some time . The new metamodel should include elements of family ecology theory as it applies to the way the family system r elates and responds to its environment. This study showed the benefits and usefulness of using explanatory mixed method s research to further inform survey results on the topic of youth health risk behaviors. The mixed 120 method s study allowed a deeper understanding of alcohol use in the college student popula tion than the quantitative study alone. This understanding leads to implications for parents, the faith community, and college administrators, deans, and counselors to help addres s alcohol use problems on college campuses. Our s ociety and college campuse s have each developed policies relating to youth alcohol consumption. One such societal policy is the minimum legal drinking age of 21 (Voas, 2013) . This age is in the middle of the ty pical college age range of 18 - 25 y ea rs. This study found that regular alcohol consumption tripled between the age of 20 and the age of 21. There has been some discussion regarding the benefits to colleges and young adults of lower ing the legal age of alcohol consumption to the age of 18 (Voas, 2013) . The purpose of this study was not to specifically examine this policy, but it is interesting to note that in a population of abstinent - oriented college students , the participants tripled their regular alcohol consumption at the legal age of consumption. Other studies have found college students increased their alcohol consumption around the age of 21 (Fromme, et al., 2010). It may be potentially dangerous for young adults and the commun ity at large for adolescents to increase their alcohol consumption at the age of 18 . This could potentially increase the chance of alcohol dependency at a young age , which can cause adolescents to have higher rates of drinking and driving (Carpenter & Dop kin, 2009; Hingson, Heeren & Edwards, 2008) . In most European countries the legal drinking age is 18 or younger (Friese & Grube, 2010). According to the 2007 European School Survey Project on Alcohol and Other Drugs and the 2007 United States Monitoring the Future Survey , most European countries have a gr eater percentage of young people reporting drinking in the past 30 days, higher intoxication rates, and report a greater percentage of young people reporting having been intoxicated before the age of 13 t han the United States (Friese & Grube, 2010). When they 121 enter college, European young adults have similar problems with hazardous drinking as US college students (Karam, Kypri, & Salamoun, 2007). Individual c olleges establish their own alcohol use policies. Since this study was conducted on a n abstinence - oriented Christian university campus, the finding s cannot be generalized to other college campuses . Though the students in this study were found to have lower alcohol use ra tes than st udents on secular campuses, it does not imply that all colleges should have an alcohol - abstinen ce policy. What can be inferred from this study for college administrators is the importance of having an alcohol use policy that is clearly stated for the stud ents. The focus group participants showed an awareness of their co policy , which had an effect o n their alcohol consumption. Future C onsiderations This cross - sectional study was conducted on one abstinen ce - oriented Christian campus. Expansion of this study to other college campuses in different regions of the United States , especially of different religious faiths , will provide more breadth. Conversations already have begun about duplicat ing this study at ano the r Seventh - day Adventist college with lower rates o f Seventh - day Adventist students with a goal of reaching out to other colleges from different Christian faiths. Another future consideration is a longitudinal design to track students fro m before college admission through their senior year to understand the development of the multiple influences on alcohol use among college students. Based on this study , t he multiple influences on alcohol use may be directly related to the development of the paren t/child relationship and the religious fait h internalization throughout college . The questionnaire is set to be repeated on the campus that was studied , as it has been 122 every five years for the past 28 years. Bas ed on the results and the experien ce of conducting an analysis, there are a few recommended changes to the survey. It is recommended that the survey be made shorter , to lessen test - taker fatigue . , there were high missing value rates (around 15%) near the end of the questionnaire. Since the PEQ was not statistically significant, it is recommended that it not be included as a parent variable in the next questionnaire. The focus group participants i dentified the theme of parenting style as a possible risk or protective factor. This is a commonly discussed topic within Christian parenting circles . Therefore, identifying parenting style experienced by the college student would be important . Since th e definition of binge drinking as the consumption of five or more drinks in one setting is now outdated , the next questionnaire should include the newest definition as recommended by the National Institute on Alcohol Abuse and Alcoholism of five or more drinks for men and four or more drinks for females in about two hours (NIAA, 2004) . With religious faith being the strongest protective variable, a scale that measures this variable should be included in the next questionnaire, but it needs to have the option of not applicable for those who do not participate in a religious faith. A follow - up focus group should be planned from the beginning so participants in the survey can be further questioned to clarify the results from the actual questionnaire. The questionnaire could have a separate page so participants can put contact informati on if they are willing to participate in follow - up focus groups , and these follow - ups should be completed as soon as possible after the initial survey . The focus group questions should specifically extract clarification s of survey results to aid in more f ully understanding the result implications. Ideally , when stud ying parent/child relationships , both individuals in the dyad should be 123 included. Survey participants could give permission for researchers to contact them and their perspective. However, confidentiality may necessitate that the parents who pa rticipate would not necessarily have their children participate in the follow up focus groups. This study shows that the relationship between religious belief and al cohol will depend on the theological position of individual religions . The degree to which an individual has accepted the belief that God does not want you to use alcohol is a powerful predictor of regular alcohol use among members of an alcohol - abstinent religion . Even in a religious group that has been quite successful at maintaining lower levels of regular drinking, parental effects remain . This study found parents had an effect on regular alcohol use in the form of indirect monitoring, open communication on the topic of alcohol, and parenting style . What this suggests is even in an alcohol abstinent enviro nment parents play a role, especially during the early college transition years when alcohol consumption is still illegal . 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