An exploratory cluster randomised trial of a university halls of residence based social norms intervention in Wales, UK

Simon Murphy,Laurence Moore,Graham Moore,Annie Williams

doi:10.1186/1471-2458-12-186

Abstract

BackgroundExcessive alcohol consumption amongst university students has received increasing attention. A social norms approach to reducing drinking behaviours has met with some success in the USA. Such an approach is based on the assumption that student's perceptions of the norms of their peers are highly influential, but that these perceptions are often incorrect. Social norms interventions therefore aim to correct these inaccurate perceptions, and in turn, to change behaviours. However, UK studies are scarce and it is increasingly recognised that social norm interventions need to be supported by socio ecological approaches that address the wider determinants of behaviour.ObjectivesTo describe the research design for an exploratory trial examining the acceptability, hypothesised process of change and implementation of a social norm marketing campaign designed to correct misperceptions of normative alcohol use and reduce levels of misuse, implemented alongside a university wide alcohol harm reduction toolkit. It also assesses the feasibility of a potential large scale effectiveness trial by providing key trial design parameters including randomisation, recruitment and retention, contamination, data collection methods, outcome measures and intracluster correlations.Methods/designThe study adopts an exploratory cluster randomised controlled trial design with halls of residence as the unit of allocation, and a nested mixed methods process evaluation. Four Welsh (UK) universities participated in the study, with residence hall managers consenting to implementation of the trial in 50 university owned campus based halls of residence. Consenting halls were randomised to either a phased multi channel social norm marketing campaign addressing normative discrepancies (n = 25 intervention) or normal practice (n = 25 control). The primary outcome is alcohol consumption (units per week) measured using the Daily Drinking Questionnaire. Secondary outcomes assess frequency of alcohol consumption, higher risk drinking, alcohol related problems and change in perceptions of alcohol-related descriptive and injunctive norms. Data will be collected for all 50 halls at 4 months follow up through a cross-sectional on line and postal survey of approximately 4000 first year students. The process evaluation will explore the acceptability and implementation of the social norms intervention and toolkit and hypothesised process of change including awareness, receptivity and normative changes.DiscussionExploratory trials such as this are essential to inform future definitive trials by providing crucial methodological parameters and guidance on designing and implementing optimum interventions.Trial registration numberISRCTN: ISRCTN48556384

Highlights

Excessive alcohol consumption amongst university students has received increasing attention
Excessive alcohol consumption among university students has been linked to a range of adverse outcomes, including educational difficulties, psychosocial problems, antisocial behaviours, injuries, risky sexual behaviours and drink driving [1]
The need to address high levels of alcohol misuse amongst UK student populations has led to a range of possible preventive approaches, including social marketing campaigns that address misperceptions of social norms

Summary

Introduction

Excessive alcohol consumption amongst university students has received increasing attention. A social norms approach to reducing drinking behaviours has met with some success in the USA. Such an approach is based on the assumption that student’s perceptions of the norms of their peers are highly influential, but that these perceptions are often incorrect. Social norms interventions have typically involved provision of mailed, web-based or face-to-face feedback on individual’s drinking behaviour and how this compares to norms for their peer group, or social marketing campaigns to promote awareness of actual norms. A recent Cochrane review concluded that feedback-based interventions delivered via the internet or face-to-face on a one-to-one basis appeared to reduce student drinking behaviours, though mailed or group feedback were less effective, and findings for social marketing campaigns were equivocal [7]

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