Justification Part 2 (Section B, C, D, E)

Health Education Curriculum

Manjeet Kaur, Vanessa Medrano, Cherith Mendoza, Harry Ta

California State University, Long Beach

Professor Mara Bird

February 7, 2017
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B. Study of Contemporary Society and Learners

Prevalent Health Problems in Society Based upon the Study of Contemporary Society and
Learners, the prevalent health problems in society related to alcohol use includes:

1. Cirrhosis: According to the National Institutes of Diabetes, Digestive and Kidney diseases
(2014), the liver is an important organ due to its ability to store and process nutrients from food;
create new proteins; and help remove waste products from the body. When a person abuses
alcohol, fat will accumulate and there will be inflammation in the liver and over time, this can
lead to cirrhosis; a disease that deteriorates the liver causing the organ to lose function. (National
Institute of Diabetes and Digestive and Kidney Diseases, 2014). Cirrhosis is the 12th leading
cause of death in the United States, and accounts for about 32,000 deaths annually (Murphy, Xu,
& Kochanek, 2013).

2. Car Accidents/Drunk Driving: In society driving under the influences has become life
threatening. According to the National Highway Traffic Safety administration (2010), every 2
minutes, someone will be affected or injured by a drunk driving accident. This statistic illustrates
the impact that alcohol has on a societal level. Someone could have never had any alcohol can
die or be affected by a drunk driving accident.

3. Heart Disease: Heart disease is the leading cause of death for men and women in the United
States (Whitman, I.R., Agarwal, V., Nah, G., Dukes, J.W., Vittinghoff, E., Dewland, T.A., &
Marcus, G.M., 2017). The Journal of the American College of Cardiology (2017) discovered that
alcohol abuse doubles risk of heart disease, such as heart failure and atrial fibrillation. People
that abuse alcohol are also 45 times more likely to get a heart attack than those that do not abuse
alcohol. (Whitman et al., 2017)

4. Violent crimes: According to the National Council on Alcoholism and Drug Dependence
(2015), binge drinking is associated with increased risk of committing violent crimes. This states
approximately 40% of inmates who are incarcerated for violent crimes were under the influence
of alcohol at the time of their crime. They also state about three million violent crimes occur
each year in which the offender has been drinking.

5. Intimate partner violence: Studies from National Institute on Alcohol Abuse and Alcoholism
(2001) suggests a positive correlation between drinking and intimate partner violence. This study
also shows about 30-40% of men who assaulted their partners were drinking at the time of the
assault and over 80% of men who abused or killed a female partner were problem drinkers.

6. Sexually Transmitted Infections: Excessive alcohol consumption is associated with higher

rates of sexually transmitted infections (Erbelding, Hutton, McCaul, & Santora, 2008). In a study
by Erbelding, Hutton, McCaul & Santora (2008), women have been reported to have contracted
more sexually transmitted infections due to alcohol than men. This study discovered that women
 2

binge drinkers are three times more likely to engage in anal sex than women who abstained from
alcohol, two times more likely to have multiple sex partners, and five times more likely to have
gonorrhea (Erbelding, Hutton, McCaul, & Santora, 2008).

7. Suicide: Alcohol is linked to having a negative self-image (Montgomery County Emergency

Service, n.d.). Alcohol deepens depression and increase impulsivity. This will increase as the
amount and length of time alcohol is consumed. According to the National Violent Deaths
Reporting System (2014), 33.4% of those who committed suicide tested positive for alcohol use.

8. Fetal Alcohol Spectrum Disorders (FASD): Any pregnant woman that drinks alcohol is at risk
of having a child born with FASD (National Organization on Fetal Alcohol Syndrome, 2014). In
addition, women who have given birth to children with FASD are at high risk of having
additional children with FASD. According to the National Organization on Fetal Alcohol
Syndrome (2014), approximately 40,000 infants are affected by FASD each year and the least
common disability, Fetal Alcohol Syndrome (FAS), costs the United States $5.4 billion annually.

9. Alcohol Poisoning: Alcohol poisoning shuts down the bodys essential processes such as
breathing. Alcohol poisoning makes it difficult for the body to maintain temperature, also known
as hypothermia. The Center of Disease Control and Prevention (2015) reported that on average,
there are six alcohol poisoning related deaths a day and more than 2,200 in the United States
each year.

10. Alcohol Dependence: Alcohol dependence or alcoholism is a condition where a person has a
craving to drink and cannot control the amount he or she drinks. A study by Steven D. Ehrlich
(2015) suggests that over 70 million Americans have faced alcoholism in their families. Having a
family history of alcohol abuse creates greater risk of developing alcohol dependence.

Prevalent Health Problems in Population

Based upon the Study of Contemporary Society and Learners, the prevalent health problems in
high school seniors related to alcohol use includes:

1. Brain Development: Throughout elementary and high school, the brain is undergoing
development. Alcohol will hinder or prevent full brain development. Alcohol affects different
parts of the brain such as the cerebral cortex, frontal lobe, hippocampus and cerebellum. These
parts of the brain are important because it allows for synthesizing thoughts, making decisions,
 3

making memories, maintaining body functions and coordination. (Substance Abuse and Mental
Health Services Administration, n.d. & Trudeau, 2010).

2. Risky Sexual Behaviors: According to Kann, Kinchen, Shanklin, Flint, Hawkins, Harris, et al.,
in 2014, brain development continues into the twenties where important communication
connections are refined. Scientists now believe this developmental period may explain why some
teens who drink seek out new and potentially dangerous situations. These potentially dangerous
situations may include risky sexual behavior and impulsivity where the teen is experimenting
with alcohol, often not recognizing the following consequences. According to the Morbidity and
Mortality Weekly Report (MMWR) published by the Centers for Disease Control and
Prevention, (2013), 1 in 5 (22.4%) sexually active high school students drank alcohol or used
drugs before their last sexual intercourse.

3. Drunk Driving: Teen drivers are 40% more likely to be in a fatal car crash than more
experienced drivers, and drinking alcohol dramatically increases that risk (National Highway
Traffic Safety Administration, n.d.). Young drivers are 17 times more likely to die in a crash
when they have been drinking compared to when they have not been drinking (Centers for
Disease Control and Prevention, 2012). The reason for this is because alcohol impairs thinking,
reasoning, and muscle coordination.

4. Alcohol Dependence: Dependency on alcohol is known as alcoholism, and is considered an

alcohol addiction. Some of the most common signs and symptoms of alcohol dependence are:
strong cravings for alcohol, the inability to limit the consumption of alcohol, and continuing the
use of alcohol regardless of the physical, interpersonal, or psychological issues of an individual
(Centers for Disease Control and Prevention, 2016).

5. Sexual assault: Alcohol is the most common substance used to commit sexual assault because it
is a sedative. Alcohol also impairs thinking and reasoning, making it more difficult to not give
consent to sexual activity. According to the National Child Traumatic Stress Network (n.d.),
more than one third of acquaintance rape victims are between the ages for 14 and 17.
Furthermore, about 9% of high school students are physically abused by a boyfriend or
girlfriend.

6. Mental Health: There was a study held in Europe called the Young-HUNT study. Within the
specified population, almost 30% of the youth reported more than 10 drinking episodes of
intoxication. The study explored the associations of mental health problems and alcohol use in
adolescence and suggests that adolescents with attention and conduct problems are at high risk
for alcohol problems. (BioMed, 2009).

7. Binge Drinking: Binge drinking is consuming large amounts of alcohol in a short amount of
time (TeensHealth, 2016). A study show that over 22% of high school seniors binge drink, with
 4

an average of 26.1% of males and 18.1% of females binge drinking (National Center for Health
Statistics, 2010).

8. Alcohol poisoning: Teens consume 90% of their alcohol through binge drinking, making
adolescents vulnerable to alcohol poisoning (Teen Rehab Center, 2016). Alcohol poisoning
causes the body to shut down essential systems. For instance, alcohol poisoning can stop
breathing, affect temperature maintenance, and water retention. Almost 250 adolescents die from
alcohol poisoning and other alcohol-related incidents each year (Teen Rehab Center, 2016).

9. Unintended Pregnancies: Alcohol plays a major role on a teens cognitive thinking and thus
impairs the ability to make good decisions. One of the results of underage drinking is that teens
engage in unprotected sexual intercourse resulting in unintentional pregnancies. According to the
Centers for Disease Control and Prevention (2015) between the years 2001 and 2006, unintended
pregnancies increased from 79% to 83% among women aged 18 and 19.

10. Violent Crimes: Alcohol and drugs affect and influence adolescents to commit crimes. About
three million violent crimes occur each year involving drinking offenders. Four out of five
children and teen arrestees in state juvenile justice systems are under the influence of alcohol or
drugs while committing their crimes. Almost two million of 2.4 million juvenile arrests had
substance abuse and addiction involvement.

Religious, Cultural and/or Ethnic Beliefs

a. There is a relationship between religion and alcohol use. Specifically, patterns suggest that
having religious affiliation during childhood may affect alcohol use into adulthood. A study
which assessed drinking across lifespan, examined the relationship between childhood religious
affiliation and alcohol use. Significant differences were not found between affiliations; however,
findings did confirm the association between alcoholism and religion. The study was also able to
identify some aspects of childhood upbringing that had a subsequent influence on lifespan
alcohol use behaviors. (Haber, J. R., Jacob, T. & Koenig, L. B., 2012)

b. There is a relationship between cultural beliefs and alcohol abuse. Specifically, Cubans have a
stricter attitude about drinking alcohol than Puerto Ricans and Mexican Americans due to
different lifestyles and education. Cubans attitude towards alcohol accounts for having the
 5

lowest average number of drinks per week and percent of drinkers who binge drink compared to
Puerto Ricans and Mexicans.

Myths and Facts

MYTH #1: An individual cant get drunk from only consuming one drink.
FACT: It is possible for an individual to get drunk from only consuming one alcoholic beverage.
(SAMHSA, 2007)

MYTH #2: It isnt possible to drink too much.

FACT: Drinking too much can negatively affect your health. (CDC 2013)

MYTH #3: Underage drinking is harmless.

FACT: Underage drinking has consequences. In 2010, there were almost 200 thousand hospital
visits by people under 21 for injuries and other conditions related to alcohol. (CDC)

MYTH #4: I already know everything there is to know about alcohol.

FACT: There is an endless amount of both new and old information to be
learned regarding alcohol. (NIH)

MYTH #5: Everyone drinks, if I dont, Ill miss the fun.

FACT: Not everyone drinks. If you do not drink, that doesnt mean you will
miss all the fun. (SAMHSA)

Physical, Mental-Emotional, Social, Growth/Development, and Learning Characteristics

a. Physical growth and development characteristics: According to Understood.org (2017), the
physical growth and development characteristics of high school seniors include: having a big
appetite, needing more sleep, better hand-eye coordination to learn to drive.

b. Mental/emotional characteristics: According to the Sutter Health Palo Alto Medical

Foundation (2013), the mental/emotional characteristics of high school seniors include:
challenging their self-sacrifice, dedication, patience, sense of humility, sense of selfishness,
identity crisis. High school seniors are excited for what their future has in store for them, but
they may also get depressed as they face new challenges in life.

c. Social characteristics: According to the Sutter Health Palo Alto Medical Foundation (2013), the
social characteristics of high school seniors include: their parents, race and social class
differences, friends, community. Older teens are more self-assured and better able to resist peer
 6

pressure. These high school seniors spend less time with their families and more time with their
friends or even alone.

d. Learning characteristics: According to the American Academy of Pediatrics (2010) and Jane
Tyne (n.d.), the learning characteristics of high school students include: media and kinesthetic
learning. Youth are now spending more than seven hours a day using media. Thus, the media can
greatly influence the youths thoughts and ideas. Alcohol ads are made to appeal to adolescents
by using images of sexy and successful individuals having fun. Youth is viewing about 1000 to
2000 alcohol ads every year. Fifty percent of students are kinesthetic learners meaning they like
to take things apart, put them together, and see how things work.

Needs and Interests

a. The health needs for high school seniors are:
- Stress coping
- Mental Health Education
- Family Communication
- Social Norms Education (Uses survey data to counter students misconceptions regarding alcohol
use among their peers)
- Relationship Building
- Motivational Tips
b. The health interests for high school seniors are:
- Strategies to reduce consumption of alcohol
- Rehabilitation facility locations
- Stress Management
- Technology
- Peer Pressure prevention

Survey of Health Needs and Interests of Target Population

a. APPENDIX A - Blank copy of the Survey
b. Include frequency report and completed surveys
c. To properly analyze the target population, a total of ten surveys were distributed for an inside
source. That source was able to distribute and then collect the surveys and return them back to
our team. The survey shows 90% of the participants disapprove of someone having one or two
drinks of alcohol per day. From this sample, we find this specific group understands that intaking
alcohol every day is a sign of a problem. However, the survey also revealed approximately 50%
of students say it's fairly easy to obtain alcohol and 60% of students believe that underage
drinking is a minor problem. Our survey responses are skewed due to limiting our participants to
a group of friends. Snowball sampling provides biased results.

C. Foundation Factors, Laws, Mandates, Codes or Initiatives

1. As reported by Federal Trade Commission, The National Minimum Drinking Age Act was
approved in 1984. (Federal Trade Commission, 2013)
a. This measure establishes 21 as the legal age of purchase and consumption within United States.
 7

b. This measure could affect a curriculum on alcohol abuse among high school seniors by limiting
accessibility of this harmful drug.
c. Based on this measure, topics of a curriculum on alcohol abuse use among high school seniors
should include ways to delay the consumption of alcohol but still educating teens to be
responsible and exclude the promotion or glorification of alcohol use as demonstrated through
the media.

2. As reported by the Office of Legislative Policy and Analysis, Sober Truth on Preventing
Underage Drinking Act (STOP Underage Drinking Act) was approved in 2006.
a. This measure allows modified enforcement of drinking laws, reduce availability and access of
alcohol to teenagers, increase research on underage drinking, and provide additional resources
for local community efforts.
b. This measure could affect a curriculum on alcohol abuse among high school seniors by further
limiting access and availability of alcohol.
c. Based on this measure, topics of a curriculum on alcohol abuse among high school seniors
should include the consequences of attaining alcohol, underage drinking and alcohol abuse,
while excluding any influences that encourage the consumption of alcohol.

D. Summary
Alcohol abuse affects all ages, but the impacts and consequences of alcohol are the most
detrimental to a persons health when that person is an adolescent. During high school years,
seniors experience many challenges and peer pressures. Students interest remains aimed towards
technology and stress management as they deal with their everyday trials. Within these trials,
many teens are innocently introduced to alcohol while some may seek alcohol due to its
reputation. While many high school seniors are aware of alcohol and its effects, little seems to be
known about the negative impacts and consequences associated with alcohol abuse.
Alcohol abuse can lead to many health problems. These include heart disease, violent
crimes, sexual assault, drunk driving, sexually transmitted infections and alcohol poisoning.
Every population has a physical and developmental characteristic; mental and emotional
characteristic; social characteristic; and learning characteristic. Knowing the characteristics of a
population enables one to understand the population and how the population functions. Being
able recognize the physical, mental, and social characteristics and grasp how the population
learns best will allow one to develop a curriculum to better address the needs and interests of that
population.
Based on the findings of the sample population of a local high school in Long Beach,
California, alcohol is accessible to high school students. In addition, a majority
of the high school seniors do not believe underage drinking is a serious
problem. This expresses the importance of alcohol accessibility and need for
further education on alcohol. Laws have been passed to reduce accessibility
of alcohol to minors. The National Minimum Drinking Age Act and Sober Truth on
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Preventing Underage Drinking Act (STOP Underage Drinking Act) are two examples of laws
that have been implemented to reduce the rates underage drinking.
In conclusion, by knowing the characteristics of the high school senior population and
health problems that are associated with alcohol abuse, an improved curriculum can be
developed. High school seniors need to be aware of the consequences of alcohol abuse and its
effects on their lives. By increasing knowledge and awareness, high school seniors will have a
better understanding and new perspective towards alcohol.

1. Findings suggest the following five topics should be included in the curriculum:
a. Peer Pressure prevention
b. Technology
c. Stress Management
d. Family Communication
e. Strategies to reduce consumption of alcohol
2. Goal: High school seniors will demonstrate assertive communication skills by speaking with
their parents/guardian, teacher, and classmates regarding the effects of alcohol and how to resist
negative peer pressure.

References
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Federal Trade Commission. (2013). 21 is the legal drinking age. Federal Trade
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legal-drinking-age
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Montgomery County Emergency Service. (n.d.). Facts about alcohol & suicide. Montgomery
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Morin, A. (2017). Developmental milestones for typical high-schoolers. Understood.org.
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Murphy, S.L., Xu, J., Kochanek, K.D. (2013). Deaths: final data for 2010. Centers for Disease
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Control and Prevention. Retrieved from https://www.cdc.gov/nchs/data/nvsr/nvsr61/

Nvsr61_04.pdf
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Binge-drinking-high-school-seniors_1435/Profile
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National Council on Alcoholism and Defense. (2015). Alcohol, drugs and crime. National
Council on Alcoholism and Defense. Retrieved from https://www.ncadd.org/about-
addiction/alcohol-drugs-and-crime
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driving/drunk-driving
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know. National Organization on Fetal Alcohol Syndrome. Retrieved from
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ow_old_chart-new-chart1.pdf
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NHTSA. https://www.nhtsa.gov/sites/nhtsa.dot.gov/files/np_appen3.pdf
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Preventing Underage Drinking Act. Office of Legislative Policy and Analysis.Retrieved
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htm.
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growth-development/growth.html#Physical%20Growth
TeensHealth. (2016, September). Binge drinking. TeensHealth. Retrieved from
http://kidshealth.org/en/teens/binge-drink.html#
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Appendix

Alcohol Use Survey

Instructions: Please complete the following survey and answer the
questions to the best of your abilities. Your participation in this survey is
voluntary and your answers will remain completely anonymous.

Categor Question Response Source

y
Demogr 1 How old are you? a. 15
aphics b. 16
c. 17
Multiple d. 18
choice e. 19
Multiple 2 What is your gender? a. Female
choice b. Male
c. Other
Check 3 What is your race? ___ Caucasian
all that (check all that apply) ___ African
apply American
___ Asian
___ Native American
___ Other
 13

Short 4 What is your Ethnicity?

answer

Multiple 5 What grade are you in? a. 9

choice b. 10
c. 11
d. 12
Likart 6 How much do you think a. No risk Youth Risk
scale people risk harming b. Slight risk Behavior
themselves if they take c. Moderate risk Survey (YRBS)
one or two drinks of an d. Great risk Spring 2013,
alcoholic beverage Maryland (High
nearly every day? school)
Ease of 7 If you wanted to get a. Very hard Community
Access some beer, wine or hardb. Sort of hard That Care
to liquor (for example, c. Sort of easy Youth Survey -
Alcohol vodka, whiskey, or gin), d. Very easy 2004
how easy would it be for
Likart you get some?
scale
Multiple 8 How many times in the a. None NHTSA
choice last two months has b. Once Underage
someone offered to givec. 2-3 times Drinking
you, buy for you, or sell d. 4 or more times Questionnaire-
you alcohol? 2001
Percepti 9 Do your parents permit a. Never NHTSA
on of you to drink alcohol in b. On special Underage
Parental your home? occasions only Drinking
Disappr c. Under parental Questionnaire-
oval supervision 2001
d. Any time I want to
Multiple
choice

Likart 10 In my family, there are a. Strongly agree Frederick City

scale clear rules about what I b. Agree Alcohol
can do and cannot do c. Disagree Prevention
when around other d. Strongly disagree Initiative
people who are drinking.
Percepti 11 What are the chances a. No or very little Community
on/Attit you would be seen as chance That Care
 14

udes cool if you: Began b. Little chance Youth Survey -

Toward drinking alcoholic c. Some chance 2004
Individu beverages regularly, d. Pretty good chance
al or that is, at least once or e. Very good chance
Peer twice a month?
Use

Likart
scale
Multiple 12 How do you feel about a. Neither approve nor Frederick City
choice someone your age Disapprove Alcohol
having one or two drinksb. Somewhat Prevention
of an alcoholic beverage Disapprove Initiative
nearly every day? c. Strongly Disapprove
d. Dont know or cant
say
Multiple 13 Do you think alcohol usea. Serious problem NHTSA
choice by underage youth is a...
b. Not at all a problem Underage
c. Minor problem Drinking
Questionnaire-
2001
Multiple 14 Do you think seeing a. Yes Washington
choice pictures of teens b. No County 10th
drinking encourages Grade Survey
other teens to want to 2012
drink?
Conseq 15 Within the last 12 a. Yes National
uences months, have you b. No College Health
experienced any of the c. Don't drink Assessment II
following when drinking (ACHA- NCHA) -
alcohol? (Mark one for 2011
each line):
a. Did something you
later regretted
b. Forgot where you
were or what you did
c. Got in trouble with the
police
d. Had sex with someone
without giving your
consent
e. Had sex with someone
without getting their
consent
 15

f. Had unprotected sex

g. Physically injured
yourself
h. Physically injured
another person
i. Seriously considered
suicide

16 Have you ever.... ? __Been absent from NHTSA

(Check all that apply) school because you Underage
used alcohol Drinking
__ Been drunk at Questionnaire -
school 2001
__ Done poorly in
school because you
used alcohol
__ Had family
problems because
you used alcohol
__ Been arrested
because you used
alcohol
__ Driven under the
influence of alcohol
__ Been a passenger
in a vehicle in which
the driver was
under the influence
of alcohol
__ Been drunk at a
party
__ Had an injury
because you used
alcohol.
 16

17 Have you EVER engageda. Yes Washington

in sex under the b. No County 10th
influence of alcohol or Grade Survey
drugs? 2012

Thank you for your time and participation in this survey!