Storytelling in addiction prevention: A basis for developing effective programs from a systematic review

S o y elling in addic ion p e en ion: a basis o de eloping e ec i e p og ams om a sys ema ic e iew He e a-Sánchez, Isabel Ma ía, Medina-Anzano, Sil ia, and Rueda-Méndez, Samuel Abs ac In oduc ion: D ug misuse is a complex social and heal h p oblem. People who use d ugs ha e e y speci ic p o iles acco ding o hei li e cycle and sociocul u al ci cums ances. Fo his eason, con ex ualized app oaches a e needed in he in e en ion o addic ions ha ake on boa d he pa icula i ies o consump ion pa e ns and hei ci cums ances. The s o y elling echnique as a na a i e communica ion s a egy can se e as a main me hodological in e en ion componen ha enhances his con ex ualized app oach. This echnique ecognizes how he s o ies we ell om ou expe iences help us o o ganize and make sense o ou li es. Me hods: A sys ema ic e iew o he li e a u e wi h na a i e analysis is pe o med o iden i y he adop ed app oaches in esea ch s udies ha speci ically use he s o y elling echnique and o lay he basis o a s o y elling-based p e en i e s a egy. Resul s: In he scien i ic li e a u e, communi y and pe sonal na a i es ha e been app oached as ans o ma i e and change p ocesses in mu ual help g oups, mainly wi h alcohol p oblems, using na a i e esea ch me hodology. O he opics o in e es ha e included: he e alua ion o in e en ions and he apeu ic p ocesses o d ug use a ge ing high- isk popula ions using di e en me hodologies (pilo esea ch, quasi-expe imen al designs, pa icipa o y communi y esea ch); and he analysis o he p ocesses behind iden i y cons uc ion and econs uc ion coupled wi h he explo a ion o sha ed isions, alues and consump ion knowledge in high- isk popula ions using he e hnog aphic echnique o g ounded heo y. Conclusion: Na a i es based on communi y and pe sonal s o ies, when a e sha ed, inco po a e he con ex ual and cul u al issues associa ed wi h d ug addic ion. I is acco dingly p oposed o examine whe he s o y elling-based in e en ion gene a es a g ea e iden i ica ion and a willingness o change, especially in mo e ulne able g oups wi h ema kable li e ajec o ies. Keywo ds: s o y elling, d ug misuse, sys ema ic e iew The au ho s decla e ha hey ha e no con lic o in e es . Wo kplace add ess Depa amen o de Psicología Social. Facul ad de Psicología. Uni e sidad de Se illa C/ Camilo José Cela, s/n, 41018, Se illa (España) Tel. (34) 954557201. Fax. (34) 954557111 ihe e [email protected] This is an Accep ed manusc ip o : He e a-Sánchez, I., Rueda-Méndez, S. & Medina-Anzano, S. (2019). S o y elling in addic ion p e en ion: A basis o de eloping e ec i e p og ams om a sys ema ic e iew. Human A ai s, 29(1), 32-47. h ps:// doi.o g/10.1515/huma -2019-0004 INTRODUCTION The la es Eu opean epo on d ugs opens wi h a meaning ul poin o depa u e: he dynamic cha ac e o d ug p oblems ep esen s a majo challenge ha needs o be add essed (Eu opean Moni o ing Cen e o D ugs and D ug Addic ion, 2018). People who ake d ugs de elop di e en consump ion pa e ns associa ed wi h mul iple isk ac o s and a ying ci cums ances. By adop ing he communi y psychology app oach, ecological di e si y should be aken in o accoun when dealing wi h he p oblems o use and misuse o subs ance, e e ing o “an app ecia ion o cul u e, con ex , and di e ences, including he complex in e sec ionali ies o iden i y and subs ance misuse” (Olson, B adley, Emsho , & Ri e a, 2017, p. 402). Resea ch in o he p e en ion o d ug abuse has shown signi ican p og ess by allowing he de elopmen o e idence-based p og ams. Howe e , he li e a u e has documen ed how many o hese p og ams ha ha e wo ked well in one social con ex ha e no gene a ed he same esul s when a emp ed o be ex ended o o he con ex s (Biglan & Hinds 2009; Toble e al., 2000). These p oblems a e mos e idenced when p og ams ha e been adap ed om he u al con ex o he u ban con ex (Kom o e al., 2008), o ha e been a emp ed o ex apola e hei co e mechanisms o in e en ion o mino i y and low-income g oups (Cho, Hal o s, & Sánchez, 2005; Spo h, Guyll, Chao, & Molgaa d 2003). Once again, he indings o hese s udies poin o he impo ance o he in e en ion con ex . Fo his eason, i is necessa y o concep ualize he p oblem by app oaching i om i s his o ical, social and pe sonal pe spec i es in o de o unde s and he issue and o e e ec i e esponses. A na a i e communica ion s a egy like s o y elling a o s his con ex ualized and idiog aphic app oach. This echnique acknowledges how elling s o ies abou ou li es is a na u al human p ocess. These s o ies a e in insically linked o ou own iden i y (McAdams, 2001); hey c ea e sha ed meanings o heal h and illness (Mu ay, 1999); and hey os e a sense o belonging. F om an empowe men app oach (Rappapo , 1995), na a i es based on s eng hs and capabili ies encou age ac i e and posi i e de elopmen . Thus, he cha ac e is ics ha he na a i es p ojec can exe an in luence on p ocesses o change. This echnique has expe ienced g owing applica ion in ields such as educa ion, communi y-based in e en ion, public heal h and social ma ke ing. In o mal educa ion, he expe ience o s o y elling can, among o he unc ions, help o shape one's own expe ience in an unde s andable way, pa icula ly in childhood, o o e a easible model o language and hough (Collins, 1999). In communi y se ing, s o ies a e iewed as a c i ical awa eness ool add essing issues ha a ec social well-being and social s abili y (G ego i-Signes & Alcan ud-Díaz, 2016). Di e en p oblem a eas ha e been add essed in he ield o public heal h. These include ini ia i es aimed a empowe ing young people o p e en ing diabe es; gaining a be e unde s anding o as hma; and helping pa icipan s a he ea ly s ages o demen ia o build hei con idence and communica ion skills (Gub ium, Hill, & Flicke , 2014). In he a ea o heal h communica ion, na a i e- based s a egies as opposed o scien i ic logic-based communica ion s a egies a e easie o audiences o comp ehend, hey gene a e mo e in e es , and hey in i e mo e oppo uni ies o iden i ica ion (Dahls om, 2014). S o ies ha e always been p esen in s udies ha analyze he issue o d ugs and in in e en ions ha p e en o ea addic ion. The aim o his sys ema ic e iew is o iden i y he di e en adop ed app oaches in esea ch s udies ha speci ically use he s o y elling echnique. These include empi ical s udies co e ing ac o s associa ed wi h d ug use and eco e y as well as in e en ions ha ackle p e en i e addic ions. The end goal is o conduc a na a i e syn hesis o de e mine he bases and s a egies ha unde lie a s o y elling-based in e en ion o a undamen ally p e en i e na u e. METHOD A sys ema ic sea ch o a icles was pe o med ac oss six da abases using he P oQues pla o m: Nu sing & Allied Heal h Da abase, PsycINFO, MEDLINE®, Heal h & Medical Collec ion, PsycARTICLES, and Psychology Da abase. The e m “s o y elling” was used in combina ion (AND) wi h each o he ollowing e ms: addic *, d ug*, subs ance abuse, obacco, smoking, alcohol*, d inking, cocaine, he oine, cannabi*, MDMA, and amphe amine*. A icles e alua ed by expe s ( om pee - e iew jou nals) and published be o e 1 Janua y 2018 we e chosen as an “Addi ional Limi ”. All pai ed sea ches we e hen un using a single sea ch command (OR) o gene a e a single ou pu ile o all he esul s, hus allowing us o elimina e duplica es. We equi ed ha all s udies we e w i en in English. A e an ini ial e iew o he i les, abs ac s and main subjec s, we emo ed hose a icles ha did no add ess he main opic o s udy. This ask was pe o med by jus one esea che . Du ing he subsequen eligibili y phases, wo u he esea che s pa icipa ed as a highe le el o consensus was equi ed o selec ion pu poses. The s udies included in his e iew had o mee he ollowing c i e ia: a) isk ac o s udies; b) s udies ha analyze he p ocesses su ounding addic ion and addic ion eco e y; and c) s udies on he implemen a ion and e ec s o in e en ion. All had o clea ly iden i y he s o y elling echnique and mee he me hodological quali y equi emen s o he esea ch. Theo e ical e iews, commen a ies, epo s, desc ip ions o echniques and case s udies we e excluded. These c i e ia we e included o easibili y easons, o co e he wides possible numbe o s udies wi hou comp omising quali y. To de e mine he quali y o he s udy, a plu alis app oach was adop ed o encompass he mul iple admissible angles and pe spec i es, using quali y-d i en c i e ia speci ic o each app oach (Wong, G eenhalgh, Wes ho p, & Pawson, 2014). Resea ch s udies ha lacked igo acco ding o hei speci ic s anda ds we e ejec ed. Gi en he a ie y o s udies subjec o e iew, a na a i e syn hesis was conduc ed (Popay e al., 2006), which consis ed o “an app oach o he sys ema ic e iew and syn hesis o indings om mul iple s udies ha elies p ima ily on he use o wo ds and ex o summa ize and explain he indings o he syn hesis” (p.5). The analysis p ocess co e ed he ollowing s ages: a) a p elimina y syn hesis; b) an explo a ion o ela ionships; c) an e alua ion o syn hesis obus ness; and d) he de elopmen o an eme ging heo y o sugges ion-based in e en ion. RESULTS The da abase sea ch esul ed in 3,719 eco ds once he duplica es we e il e ed ou . Following a p elimina y e iew o each eco d, 184 we e p eselec ed; we we e le wi h 29 a e applying he inclusion and exclusion c i e ia. The low diag am is shown in Figu e 1. The na a i e analysis o he selec ed a icles ocused on: de ec ing he app oaches unde lying hese s udies; he s o y elling me hods; he me hodological aspec s (me hod, con ex , popula ion, subs ance); and he esul s o e ec s eached. Fo each o hese elemen s, hema ic ca ego ies we e iden i ied as shown in Table 1. In he case o he esul s o e ec s, due o he di e si y o he s udies, he main conclusions we e sys ema ized. These ca ego ies se ed as a ub ic o he na a i e syn hesis o he s udy. Table 2 is he esul o he na a i e syn hesis which eme ged om he analysis. We now mo e on o he main indings by commen ing on he app oaches unde lying he s udies yielded and how he p ac ice o s o y elling akes shape. The esul s sec ion closes by p esen ing he main p emises ha eme ged om he analysis. (Inse Figu e 1) (Inse Table 1) (Inse Table 2) Rega ding he app oaches unde lying he s udies yielded, a i s ca ego y made up o esea ch ocused on cons uc ing meanings ha e ol e a ound consume p ac ices ( isions, alues, my hs, belie s, schema). In ligh o his, an analysis o discu si e p ac ices has helped de ec he cul u ally sha ed meanings su ounding consume p ac ices om a gene a ional pe spec i e (Tol anen & Jylhä, 2005; Tu enges & Rod, 2009; Bu ne , O Wal e , & Balle , 2016; Mompe , Dennis, & Muelle -Williams, 2017), analyzing hei implica ions o consump ion i sel (Tu enges & Sandbe g, 2013). On ano he le el, Mi e (2007) se ou o iden i y how implici my hology is p ojec ed in li e a y wo ks wi hin use s’ pe sonal na a i es, whe eas Kean and Albada (2003) sough o de e mine he e ec s by looking o a connec ion be ween media, pe sonal expe ience and schema o ma ion. Conside ing socially isola ed and disad an aged g oups, Roche, Neaigus, and Mille (2005) wan ed o iden i y a o m o adap a ion o he en i onmen in he sha ed s o ies among d ug-using women who engage in sex wo k, whe eas Rance, G ay, and Hopwood (2017) ocused on how people who injec d ugs, ic ims o s igma and social hos ili y a e pu a a disad an age when i comes o making sense o hei social expe ience. A second ca ego y ga e us s udies ha explo e how elling pe sonal and communi y- based s o ies a e an impo an pa o eco e y p ocesses in mu ual help g oups, mainly Alcoholics Anonymous (AA) g oups. Ra alo ich (1999) analyzed he iden i y ans o ma ion p ocess h ough sha ing s o ies. Lede man and Menega os (2011) ocused on he in ape sonal impac o AA na a i es by adop ing a e ospec i e app oach much like Weegmann and Piwowoz-Hjo (2009). A minen (2004) examined he unc ions o second s o ies in econs uc ing g oup iden i y and in ein e p e ing sha ed p oblems. Ch is ensen and Elmeland (2015) ound di e ences in how na a i es o addic ion eco e y play ou be ween people who a end sel -help g oups and hose who decide o do i alone. S obbe and Ku z (2012) and Humph eys (2000) placed ans o ma i e s o y elling a communi y na a i e le els, whe eas Swo a (2002) posi ioned hese s o ies as social p ac ices ha build hei own social s uc u e. These p ocesses o change a e also conside ed in Dunlop and T acy’s (2013) s udy, which analyzed posi i e sel - ans o ma ion p ocesses ollowing a di icul expe ience, iden i ying he ela ionship be ween sel - edemp ion and beha io change in he na a i es. Based on a na a i e pe suasion app oach, Ma and Nan (2017) wan ed o see how non-smoke s espond o heal h messages (na a i e s. non-na a i e) wi h he in en ion o pe suade o he s o qui smoking, examining he mode a ing ole o social dis ance. In in e en ion s udies, na a i es we e in oduced alongside e idence-based in e en ions wi h an aim o con ex ualize he messages (Leuke eld e al., 2003; Hous on e al., 2011; Che ing on e al., 2015). Moghadam, Sa i, Balouchi, Mada shahian, and Moghadam (2016) add essed s o y elling-based educa ion as a co e componen in p e en ion. Las ly, we no ably ind s udies ha inco po a e s o y elling wi h he suppo o communi y-based pa icipa o y s a egies o de elop cul u ally adap ed in e en ions. Nelson and A hu (2003) de eloped he p og am “S o y elling o Empowe men ” as a way o encou aging posi i e cul u al iden i y. This p og am was la e adap ed wi hin he amewo k o he mHeal h pla o m, inco po a ing he p inciples o communi y-based pa icipa o y esea ch (Co do a e al., 2015, 2016). In a s udy conduc ed by And ews, Ben ley, C aw o d, P e low, and Tingen (2007), membe s o he communi y we e enlis ed o help de elop a cul u ally sensi i e in e en ion in ol ing A ican Ame ican women who li e in subsidized housing. The p og am “Li e S o y In e en ion” by Haigh , Black, and She idan (2010) was de ised in collabo a ion wi h communi y p o essionals, in oducing sociocul u al heo y as a key p emise o e idence-based in e en ions and local na a i e adi ions in o de o add ess he men al heal h symp oms o child en whose pa en s ake amphe amines. Mon gome y, Manueli o, Nass, Chock, and Buchwald (2012) exp essed he iew ha an in e en ion is mo e likely o succeed i i s me hods a e consis en wi h he cul u al p ac ices o he na i e communi ies and i young people a e seen as ac i e p oduce s o he educa ional con en . Fu he analysis in his na a i e e iew is how he p ac ice o s o y elling akes shape when ga he ing na a i e da a o as an in e en ion componen . The i s ca ego y o s udies we e hose in which esea che s in i ed pa icipan s o ela e hei expe iences o di e en pu poses: o analyze he e en s ha un old in he na a i es (Tu enges & Sandbe g, 2013); o iden i y he mo al discou ses and sha ed cul u al expec a ions be ween gene a ions (Tol anen & Jylhä, 2005); and o see how hey mimic li e a y plo s (comedy, omance, agedy, i ony) be ween he e en s and he di e en ways o elling s o ies (Mi e , 2007). In challenging con ex s, s o y elling has se ed o iden i y posi i e sel -change expe iences ollowing a nega i e expe ience as sel - edemp ion na a i es (Dunlop & T acy, 2013). In he apeu ic se ings, people a e in i ed o alk abou hei li es o o simply alk (Haigh e al., 2010). Bu ne e al. (2016), Hous on e al. (2011), and Che ing on e al. (2015) used digi al o ma as opposed o ace- o- ace s a egies. S o ies old in social ci cles and which o en su ace in in o mal con e sa ions (Tu enges & Rod, 2009), o hose cha ac e is ic o in e pe sonal communica ion in na i e communi ies (Mompe e al., 2017), a e also a sou ce o analysis. This is also he case in in e en ions. In And ews e al. (2007), in o mal and in e ac i e g oup sessions ha p omo ed s o y elling we e used as a eaching me hod. Mon gome y e al. (2012) in oduced na i e elde adi ions o pass on knowledge h ough s o ies in hei educa ional in e en ions. S o y elling as a speci ic p ac ice in mu ual help se ings becomes i s own en i y in he scien i ic addic ions li e a u e. S o ies a e old o emphasize helping o he s and o include pe sonal li e s o ies in communi y-based na a i es. Lede man and Menega os (2011) analyzed he e lec i e accoun s o membe s o AA o s ay sobe , whe eas S obbe and Ku z (2012) used pe sonal s o ies in he Big Book o AA as he sole sou ce. A minen (2004) ocused on he “second s o ies” ha eme ged in esponse o an o iginal s o y and which con ibu ed o mu ual help and social suppo . Humph eys (2000) ocused his analysis on he con en , s uc u es and unc ion(s) o AA s o ies. Fic ional s o ies a e also pa o s o ies ha a e old o di e en pu poses. Kean and Albada (2003) asked pa icipan s o w i e a s o y o cap u e hei ep esen a ion o he objec . Ma and Nan (2017) used simula ed s o ies o illus a e heal h consequences. Co do a e al. (2015) in oduced cul u ally cong uen s o ies in o a mHeal h applica ion. And in Moghadam e al. (2016), al eady o mula ed s o ies we e complemen ed by g oup s o y elling. By examining hese esea ch s udies and as a esul o he ou come analysis, he ollowing p emises eme ged which poin o he sui abili y o s o y elling in p e en i e in e en ions: 1. S o ies a e a ga eway o heal h in e en ion e o s and pa icula ly when wo king wi h ma ginalized communi ies by inco po a ing isk educ ion and heal h p omo ion messages in o al adi ions (Nelson & A hu , 2003; Roche e al., 2005; Haigh e al., 2010). These may include opics deemed h ea ening o which emain hidden (Tu enges & Rod, 2009) and which call o close sc u iny o and a en ion o he communi y’s alues and cul u e (And ews e al., 2007). 2. Na a i es should be based on s eng hs and capabili ies o encou age ac i e and posi i e de elopmen . Thus, p og ams need o adop a posi i e social unc ion (Bu ne e al., 2016) and con empla e communi y in ol emen whe eby he pa icipan s hemsel es can decide how o sha e hei pe sonal s o ies o d ug and alcohol use. Al hough hese expe iences a e di e en and unique o he indi idual, hey ollow a clea ly iden i iable cause and e ec ajec o y (Tu enges & Sandbe g, 2013), which play a con ibu ing ole in sel - e lec ion on pe sonal and social iden i y (Ra alo ich, 1999; A minen, 2004; Tu enges & Rod, 2009; Mompe e al., 2017). These s o ies enable a c i ical assessmen o nega i e consequences (Tu enges & Rod, 2009) and ha e he po en ial o delinea e he bounda ies and es ablish le els o accep abili y ega ding isk beha io s (Roche e al., 2005). Howe e , hey also p ojec mo al discou ses ha hold o e ime o each gene a ion (Tol anen & Jylhä, 2005) whe e he eal and he imagina y mee (Hump eys, 2000; Kean & Albada, 2003; Roche e al., 2005). The s o ies emain ied o he con ex in which hey occu (Bu ne e al., 2016; Che ing on e al., 2015; Mompe e al., 2017), meaning ha i is pa icula ly ele an o ake on boa d he po en ial injus ices and challenges ha his p ocess en ails in ma ginalized g oups (Rance e al., 2017). 3. Na a i es ac as mo i a o s ha go beyond he in ape sonal impac ha he s o y elling p ocess i sel gene a es (Lede man & Menega os, 2011). These s o ies boas a conside able po en ial o change among hose who lis en o and sha e hese expe iences (Nelson & A hu , 2003; A minen, 2004; Weegmann & Piwowoz-Hjo , 2009; S obbe & Ku z, 2012; Moghadam e al., 2016), and which p o e mo e e ec i e when coupled wi h o he echniques (Hous on e al., 2011; Che ing on e al., 2015; Co do a e al., 2015). These old s o ies ein o ce addic ion eco e y h ough a p ocess o sha ing posi i e accoun s o people’s pe sonal li es in mu ual help con ex s. They u n in o pe suasi e s o ies a an in ape sonal le el (Lede man & Menega os, 2001; Dunlop & T acy, 2013), an in e pe sonal le el (A minen, 2004; Weegmann & Piwowoz-Hjo , 2009), and a he le el o he communi y’s own social s uc u e (Swo a, 2002). In en ionally ansmi ed s o ies, which e lec a desi ed communi y na a i e, a e in ended o be seen as p o o ypes (S obbe & Ku z, 2012). CONCLUSION These esul s lead us o e lec on cu en p ac ices in addic ion p e en ion and heal h p omo ion, which end o o e segmen ed in o ma ion ela i e o he concep ual cons uc s ha de i e om heo e ical models. This cons i u es a gene alized p ac ice o selec ing heal h messages acco ding o he emphasis ha heo e ical models place on wha should be changed and how, wi hou aking in o accoun he su ounding ci cums ances in an a emp o se e gene aliza ion. The li e a u e p o ides examples o p og ams ha ail when de eloped in con ex s di e en o whe e he in e en ion o igina ed. Fo his eason, s a egies o change should be sensi i e o he cul u e; hey should conside he obs acles o pa icipa ion ha highly s igma ized g oups mus o e come; and hey should ein o ce he discu si e p ac ices ha un old when expe iences a e sha ed. The s o ies a e ull o meanings ha ap in o pe sonal expe iences and he cul u al, social and his o ical alues o he g oup o belonging. As such, i would be easonable o assume ha i iden i ica ion is s eng hened h ough hese s o ies, hen a willingness o change is mo e likely. The main limi a ion o he sys ema ic e ision comes om using he e m s o y elling as he only sea ch desc ip o , excluding o he possible ela ed e ms such as na a i e communica ion. This p ocedu e may ha e excluded o he s udies o ele ance. The di e si y o he selec ed s udies is ano he limi a ion, ha is, hey a e no exclusi ely implemen a ion o e ec i eness s udies. Fo his eason, a na a i e syn hesis has been used ha could ex ac he mos ele an aspec s acco ding o he objec i e o he e iew. Despi e his, his e iew allows o he delinea ion o a u u e line o esea ch aimed a de e mining he e ec i eness o he s o y elling-based s a egy as a mo i a ing mechanism o change by elici ing he iden i ica ion wi h his o y. This is especially ele an wi h speci ic g oups (low esou ces, a isk g oups, e hnic g oups...) because hey enhance hei own pe sonal s o ies o imp o emen . As a di ec p ac ical implica ion, he designe s o p e en i e p og ams wi h mul iple componen s a e encou aged o inco po a e his s a egy as a me hod o de eloping a cul u ally adap ed in e en ion. REFERENCES And ews, J. O., Ben ley, G., C aw o d, S., P e low, L., & Tingen, M. S. (2007). Using communi y-based pa icipa o y esea ch o de elop a cul u ally sensi i e smoking cessa ion in e en ion wi h public housing neighbo hoods. E hnici y & Disease, 17(2), 331–337. A minen, I. (2004). Second s o ies: The salience o in e pe sonal communica ion o mu ual help in Alcoholics Anonymous. Jou nal o P agma ics, 36(2), 319-347. Biglan, A. & Hinds, E. (2009). E ol ing p osocial and sus ainable neighbo hoods and communi ies. Annual Re iew o Clinical Psychology, 5, 169-196. Table 2. Na a i e syn hesis o selec ed s udies be o e 1 Janua y 2018 App oaches unde lying he s udies S o y elling Me hodology Con ex / Pa icipan s / Subs ance Resul s / E ec s Cons uc ion o meanings su ounding consume p ac ices Fic ional s o ies Kean & Albada (2003) Expe imen al design Kean & Albada (2003) College campus / College s uden s / Alcohol Kean & Albada (2003). USA The s o ies connec he eal wo ld wi h scenes ma ked by ele ision (Kean & Albada, 2003). Sha ed expe iences Roche e al. (2005) Tol anen & Jylhä (2005) Mi e (2007) Tu enges & Sandbe g (2013) Rance e al. (2017) In digi al s o y elling Bu ne e al. (2016) Na a i e s udy Tol anen & Jylhä (2005) Mi e (2007) Rance e al. (2017) G ounded Theo y Roche e al. (2005) Bu ne e al. (2016) Mixed me hods Tu enges & Sandbe g (2013) College campus / College s uden s / Alcohol Mi e (2007). Hunga y Bu ne e al. (2016). USA Homes, se ice housing o nu sing homes / Elde ly people / Alcohol Tol anen & Jylhä (2005). Finland Ma ginalized g oups / D ug use Roche e al. (2005). USA Rance e al. (2017). Aus alia Tou is des ina ion / Young ou is s / Alcohol Tu enges & Sandbe g (2013). Bulga ia The s o ies delinea e he bounda ies and es ablish accep abili y o isk beha io s (Roche e al., 2005). The s o ies injec unal e able mo al discou se o e ime (Tol anen & Jylhä, 2005). C edible s o ies can be cons uc ed by elying on li e a y plo s (Mi e , 2007). The s o ies ac as a sc ip in beha io (Tu enges & Sandbe g, 2013). Inequali y discou se as ano he o m o social injus ice (Rance e al., 2017). The s o ies c ea e meaning a ound he excessi e alcohol consump ion beha io o ame i in an accep able way (Bu ne e al, 2016). S o ies sha ed in social ci cles Tu enges & Rod (2009) Mompe e al. (2017) Thema ic analysis wi h ocus g oups Mompe e al. (2017) E hnog aphic me hod Tu enges & Rod (2009) Indian ese a ion / Ame ican Indians / Alcohol Mompe e al. (2017). USA U ban and u al a eas / Teenage s / Alcohol Tu enges & Rod (2009). Denma k In e gene a ional ans e o lea nings and pe sonal expe iences (Mompe e al., 2017). Iden i y, c i ical awa eness (Tu enges & Rod, 2009). Table 2 (con inued) App oaches unde lying he s udies S o y elling Me hodology Con ex / Pa icipan s / Subs ance Resul s / E ec s Na a i es and p ocesses o change in addic ion eco e y S o ies o suppo Humph eys (2000) Swo a (2002) A minen (2004) Weegmann & Piwowoz-Hjo (2009) Lede man & Menega os (2011) S obbe & Ku z (2012) Na a i e s udy Humph eys (2000) Swo a (2002) Weegmann & Piwowoz-Hjo (2009) A minen (2004) S obbe & Ku z (2012) G ounded Theo y Lede man & Menega os (2011) AA membe s / Alcohol Humph eys (2000). USA Swo a (2002). USA Lede man & Menega os (2011). USA AA mee ings / Alcohol A minen (2004). Finland Addic ion T ea men Cen e / Alcohol Weegmann & Piwowoz-Hjo (2009). UK Big Book 4 h edi ion/Alcohol S obbe & Ku z (2012) Comp ising pe sonal s o ies om o me membe s ha also gi e shape o he pe sonal accoun s o new membe s (Humph eys, 2000). A pe o mance gen e ha c ea es a sense o communi y (Swo a, 2002). They a e he basis o mu ual help and social suppo ia co-cons uc ing expe iences (A minen, 2004). S o ies ebuild sel -iden i y (Weegmann & Piwowoz-Hjo , 2009). Na a i e cohe ence and ideli y in AA s o ies (Lede man & Menega os, 2011). Communi y na a i es ac as p o o ypes in sel - help con ex s (S obbe & Ku z, 2012). Sha ed expe iences Ra alo ich (1999) Dunlop & T acy (2013) Ch is ensen & Elmeland (2015) G ounded heo y Ra alo ich (1999) Mixed me hods (wi h na a i e) Dunlop & T acy (2013) Ch is ensen & Elmeland (2015) Na co ics Anonymous mee ings Ra alo ich (1999). USA AA mee ings / Alcohol Dunlop & T acy (2013). Canada AA membe s / Alcohol Ch is ensen & Elmeland (2015). Denma k The addic ’s iden i y in sel -help con ex s is a icula ed h ough momen s o equali y, unde s anding and pe sonal in es men (Ra alo ich, 1999). Na a i es explo ing nega i e expe iences in e p e ed as conduci e o a posi i e change in sel -explain long- e m beha io change (Dunlop & T acy, 2013). Iden i ica ion is impo an in AA membe s o s aying sobe , whe eas hose who seek unaided eco e y a e conce ned abou showing abusi e use bu no p oblema ic use (Ch is ensen & Elmeland, 2015). Table 2 (con inued) App oaches unde lying he s udies S o y elling Me hodology Con ex / Pa icipan s / Subs ance Resul s / E ec s Na a i e pe suasion Fic ional s o ies Ma & Nan (2017) Expe imen al design Ma & Nan (2017) College campus / College s uden s / Tobacco Ma & Nan (2017). USA Wi hou con i ming ha he na a i es ( s. non- na a ed) would be mo e pe suasi e han non- na a i es when people hough abou socially close smoke s (Ma & Nan, 2017). Na a i es and p ocesses o change in eg a ed wi h o he e idence- based p og ams S o ies o expe ience Leuke eld e al. (2003) Accoun s o expe iences in digi al s o y elling Hous on e al. (2011) Che ing on e al. (2015) Expe imen al design Leuke eld e al. (2003) Pilo p ojec and e alua ion Hous on e al. (2011) Randomized con olled ial Che ing on e al. (2015) Ru al coun ies/ A - isk g oups/ D ug use Leuke eld e al. (2003). USA Hospi al / A ican Ame ican / Tobacco Hous on e al. (2011). USA Che ing on e al. (2015). USA Gaining access o a g oup o u al people a a high isk o con ac ing HIV/AIDS (Leuke eld e al., 2003). Success ela i e o ga he ing na a i es o be mapped o beha io al cons uc ions (Hous on, 2011). Insu icien as an independen in e en ion (Che ing on e al., 2015). Na a i es and p ocesses o change as co e in e en ion componen T ue s o y cons uc ion Moghadam e al. (2016) Quasi-expe imen al Moghadam e al. (2016) High school / S uden s / D ug use Moghadam e al. (2016). I an Signi ican all in willingness owa d addic ion among adolescen s who pa icipa ed in he in e en ion (Moghadam e al., 2016). Table 2 (con inued) App oaches unde lying he s udies S o y elling Me hodology Con ex / Pa icipan s / Subs ance Resul s / E ec s Cul u ally adap ed p e en ion Fic ional s o ies Nelson & A hu (2003) Co do a e al. (2015) Co do a e al. (2016) Quasi-expe imen al Nelson & A hu (2003) Communi y-based pa icipa o y esea ch Co do a e al. (2015) Co do a e al. (2016) Schools / You h wi h isk ac o s / D ug use Nelson & A hu (2003). USA You h-cen e ed communi y heal h ca e/ Adolescen s and young people / D ug use Co do a e al. (2015). USA Co do a e al. (2016). USA Reduc ion in he consump ion o alcohol and ma ijuana and a co ela ion wi h he numbe o p og am con ac hou s (Nelson & A hu , 2003). Highligh he ba ie s and acili a o s (Co do a e al., 2015). P og am usabili y and accep abili y (Co do a e al., 2016). D ug in e en ions cul u ally adap ed S o ies o suppo And ews e al. (2007) S o ies o expe ience Haigh e al. (2010) Fic ional s o ies Mon gome y e al. (2012) Communi y-based pa icipa o y esea ch And ews e al. (2007) Mixed me hods Haigh e al. (2010) Pilo p ojec and e alua ion Mon gome y e al. (2012) Public housing neighbo hoods/ A ican Ame ican women / Tobacco And ews e al. (2007). USA Fos e ca e / Child en om me hamphe amine-in ol ed amilies. Haigh e al. (2010). USA Na i e communi ies / Ame ican Indian and Alaskan Na i e you h / Tobacco Mon gome y e al. (2012). USA Su ace s uc u e changes enhanced in e es , accep ance and iabili y, whe eas he deep s uc u e acili a ed con ex adap a ion and s eng hened he s udy’s impac and gene al e icacy (And ews e al. 2007). Sligh imp o emen in beha io p oblems among child en pa icipa ing in he in e en ion (Haigh e al., 2010). In ol ing na i e you h in he in e en ion (Mon gome y e al., 2012).