The neighbourhood social environment and its role in adolescent alcohol use and drinking motives
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In Scotland, adolescent alcohol consumption represents a major public health concern. The overarching aim of this research was to identify neighbourhood characteristics associated with adolescent alcohol use behaviours and motivations for drinking with a focus on the neighbourhood social environment. A systematic review identified and synthesised studies that operationalised the neighbourhood social environment from the adolescents' perspective. Using Scottish Health Behaviours in School-aged Children Survey data, exploratory and confirmatory factor analysis were conducted to derive measures of adolescents' perceptions of their local neighbourhood and test for urban/rural invariance. Multilevel models were used to estimate ecometric properties and generate neighbourhood scores. These measures were then used in models to explore associations between various physical and social conditions of the local area with adolescent alcohol use and drinking motivations. Path analysis explored for potential mediating effects of drinking motivations on drinking outcomes. The findings from this thesis indicate that where adolescents live is associated with their alcohol use behaviours and motivations. Neighbourhood social cohesion, urban/rural status and neighbourhood deprivation may give rise to inequalities in alcohol use. Evidence of drinking to cope as a mediator in the relationship between deprivation and weekly alcohol use suggests that drinking as a coping strategy differs by geographic subgroups. Findings support that targeted prevention and intervention strategies are needed to reduce inequalities. Programmes developed to encourage coping skills should be implemented, principally in deprived neighbourhoods and accessible small-towns. Future research is needed to develop and assess strategies to reduce inequalities in adolescent drinking in Scotland.
Thesis, PhD Doctor of Philosophy
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