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Table 3 Results for items related to effectiveness of strategies to reduce binge drinking in 16- to 18-year-old adolescents in an intervention targeting adolescents

From: Web-based interventions to decrease alcohol use in adolescents: a Delphi study about increasing effectiveness and reducing drop-out

Strategy Second round Third round
  N = 61   N = 35  
  Mdn IQD Mdn IQD
1. Present dramatic portrayals that adolescents can identify with 4 2.75 4 1.50
2. Provide normative data regarding peer drinking 5 2 5 2
3. Lessen the “coolness” factor of drinking: use role models that are cool without alcohol 5 2 5 2
4. Place an emphasis on how adolescents make meaning of their own drinking and how that relates to their own drinking (e.g., “this happens to others but not to me”) 5 2 5 1
5. Adolescents should be reminded that the choice to drink is theirs and theirs alone 5 2 5 1.25
6. Explain why choosing not to drink is a good choice 5 1.75 5 1
7. Add or remove alcohol cues in a pictorial scenario to demonstrate how social environmental cues can manipulate alcohol consumption 5 2 5 1
8. Use prevalence overestimates reduction (present their own use, their perception of peer use and actual peer use of every 100 peers) 5 2 5 2
9. Role playing games creating your own avatar 4.50 3 4 2
10. Present social situations and ask them how they would react and present the different (positive and negative) consequences 5 1 - -
11. *Provide the opportunity to try out different reactions and their consequences in social situations 6 1 - -
12. Show a movie with victims that have been significantly affected by drinking (for example road accidents) 3 2 2 1
13. Improving skills in dealing with general life issues 6 3 6 2
14. Encouraging adolescents’ interests in other activities that do not involve alcohol consumption 5 2 5 1
15. Increase knowledge about detrimental effects of alcohol before the age of 24 years 4 2.75 5 1.25
16. *Increasing refusal skills (ability to say “no”) 6 1 - -
17. *Increase self-efficacy over their ability to refuse to engage in binge drinking 6 2 6 0
18. *Increase their levels of perceived control whether or not they could refuse to engage in binge drinking 6 1.25 6 0
19. *Train self-control (the ability to set limits for oneself) 6 2 6 0.50
20. Provide knowledge about the harm of binge drinking / negative consequences of alcohol 5 2 5 1
21. Increasing the sense of risk through emphasizing the short term consequences 5 1.50 5 1
22. Provide accurate information about alcohol expectancies 5 2 5 1
23. *Provide ways to cope with negative mood states other than drinking 6 1 - -
24. Stress that there are alternatives to alcohol and binge drinking 5 2 5 1
25. Focus on how adolescents make meaning of their own drinking (arguments that adolescents use to defend their alcohol consumption) 5 2 5 1
26. Show good graphic vomit shots 1 2 1 0
27. Show them embarrassing behavior due to binge drinking 2 3.75 2 2
28. Develop planning and communication skills 5 2 5 1
29. *Develop decision making skills 5 1.25 6 1
30. Giving advice to others on the topic 4 2.50 3.50 1
31. Emphasize the benefits of positive choices 5 2 5 1.25
32. Check out their personality and tailor the intervention on this personality: fearful personality 4 3 4 2
33. Check out their personality and tailor the intervention on this personality: having negative thinking patterns 5 3 4.50 1.75
34. Check out their personality and tailor the intervention on this personality: sensation seeking personality 6 2 6 2
35. Check out their personality and tailor the intervention on this personality: impulsive personality 6 2 5.50 2
36. Discriminate motives to drink and tailor intervention on these: drinking to deal with negative emotions (coping motives) 6 2 5 2
37. Discriminate motives to drink and tailor intervention on these: drinking to enhance positive emotions (enhancement motives) 6 2 5.50 2
38. Discriminate motives to drink and tailor intervention on these: drinking to be social (social motives) 6 2 5.50 2
39. Discriminate motives to drink and tailor intervention on these: drinking to conform to the group (conformity motive) 6 2 5 2
40. Changing adolescents’ positive attitude towards binge drinking 5 2 5 1
41. Creating awareness of ambivalence (balance between positive and negative consequences of drinking) 5 2 5 2
42. Strengthening those aspects that are already seen by the adolescent as positive consequences of not drinking 5 1 - -
43. Strengthening those aspects that are already seen by the adolescent as negative consequences of drinking 5 1 - -
44. Emphasize the possibility of getting high status by acting healthy 5 3 5 1.25
45. Stimulate action planning skills on preventing binge drinking 5 2 5 1
46. Stimulate to plan moderate drinking beforehand (e.g., special events or holiday) 5 2 5 1
47. Encouraging the adolescents’ sense of autonomy and self esteem 5 2 5 1
  1. Mdn: median scores.
  2. IQD: interquartile deviation.
  3. -: these items had an IQD ≤ 1 in the second round and did not reappear in the third round.
  4. Strategies that are in italics and marked with an asterisk were identified as important (Mdn ≥ 6) and experts had reached consensus on (IQD ≤ 1).