College Student Drinking Research Articles

How do mandated college student drinkers characterize binge drinking?

ABSTRACT Background Within the past 30 days, a quarter of U.S. college students reported binge drinking (i.e., consuming ≥ five drinks (male) or ≥ four drinks (female), in about 2 hours). While scholars have refined binge drinking parameters/definitions over time, determining college students’ personal characterization of binge drinking is important as misperceptions can directly impact students’ alcohol use and associated consequences. Objective This study explored differences in college students’ characterization of binge drinking and the effect of overestimating standardized parameters. Methodology This study was conducted at a large public university in the Southeast U.S. among college students who violated campus alcohol-use policies (n = 816). Respondents anonymously completed measures of alcohol frequency and quantity, and binge drinking characterization. Analyses explored the relationship between binge drinking parameters and personal alcohol use. Results Statistically significant differences existed for alcohol consumption between students who underestimated/accurately characterized binge drinking parameters and those who overestimated. Moreover, students who overestimated participated in binge drinking more frequently (p < .001) and were nearly 3.5 times more likely to binge drink than their counterparts. Conclusions Correcting misperceptions, establishing clear and accurate understandings, and eliminating ambiguity associated with alcohol behaviors and norms should be a priority for college health practitioners and administrators.

Individual Differences in Affect Dynamics and Alcohol-Related Outcomes

Background: To examine whether individual differences in intensive longitudinal data-derived affective dynamics (i.e. positive and negative affect variability and inertia and positive affect-negative affect bipolarity) – posited to be indicative of emotion dysregulation – are uniquely related to drinking level and affect-regulation drinking motives after controlling for mean levels of affective states. Method: We used a large sample of college student drinkers (N = 1640, 54% women) who reported on their affective states, drinking levels and drinking motives daily for 30 days using a web-based daily diary. We then calculated from the daily data positive and negative affect variability, inertia, affect bipolarity and mean levels of affect and used these as predictors of average drinking level and affect-regulation drinking motives (assessed using both retrospective and daily reporting methods). Results: Findings from dynamic structural equation models indicated that mean levels of affect were uniquely related to drinking motives, but not drinking level. Few dynamic affect predictors were uniquely related to outcomes in the predicted direction after controlling for mean affect levels. Conclusion: Our results add to the inconsistent literature regarding the associations between affective dynamics and alcohol-related outcomes, suggesting that any effects of these indicators, after controlling for mean affect levels, might be more complex than can be detected with simple linear models.

Alcohol-induced blackouts among college student drinkers: A multilevel analysis

ObjectiveTo identify factors (manner of drinking, combined alcohol and other substance use, physiology) that are associated with alcohol-induced blackouts (AIBs) over and above estimated blood alcohol concentration (eBAC). MethodsStudents (N = 462, 51.7 % female, 87.7 % White, Mage = 20.1) were assessed across 6 weekends via e-surveys (80–97 % response rate). eBAC was calculated using standard number of drinks, drinking duration, sex, and weight. Three-level multilevel models (days, weeks, persons) were conducted to test for main effects, controlling for eBAC. ResultsProtective behavioral strategies (PBS) were associated with decreased odds of AIBs on the daily (OR = 0.64, 95 % CI: 0.53, 0.77), weekly (OR = 0.84, 95 % CI: 0.72, 0.98), and person-levels (OR = 0.62, 95 % CI: 0.51, 0.74). Combined cannabis with alcohol was associated with increased odds of AIBs on the weekly (OR = 2.13, 95 % CI 1.13, 4.07) and person-levels (OR = 3.56, 95 % CI 1.60, 7.93). People who more frequently played drinking games (OR = 1.41, 95 % CI: 1.12, 1.77), pregamed (OR = 1.55, 95 % CI: 1.19, 2.03), and showed higher tolerance (OR = 1.22, 95 % CI: 1.08, 1.37) showed increased risk of AIBs, over and above eBAC levels. ConclusionWe identified a number of daily-, weekly-, and person-level factors that uniquely contribute to the prediction of AIBs even at equivalent eBACs. Many of these factors were behavioral, suggesting that they may serve as malleable prevention targets for AIBs in college student drinkers.

Longitudinal associations between descriptive and injunctive norms on college drinking

Perceived norms of drinking prevalence (descriptive norms) and approval (injunctive norms) are among the most robust predictors of college student drinking, but the dynamic fluctuations of these relationships over time are less understood. We examined longitudinal associations of descriptive and injunctive norms on alcohol consumption, disaggregating within-person fluctuations from between-person associations. Participants were 593 heavy drinking college students who completed measures of perceived descriptive and injunctive norms and drinking at baseline, one month, three months, six months, and 12 months. Longitudinal multilevel model analyses revealed that, at the between-person level, only descriptive norms predicted drinking. In contrast, both descriptive and injunctive norms at the within-person level predicted weekly drinking. The findings are the first to examine between- and within-person effects of descriptive and injunctive norms simultaneously on drinking and suggest that future college drinking interventions using normative influence would benefit from recognizing and incorporating within-person fluctuations in perceived norms.

Real-time and next-morning correlates of subjective alcohol consequence evaluations.

There is considerable variation in how college student drinkers evaluate alcohol-related consequences across time and consequence type. Previous qualitative work suggested that students perceive consequences less negatively under certain circumstances (i.e., higher intoxication, when less time has passed, positive mood, after discussing with friends). The present study sought to confirm these patterns, using ecological momentary assessment (EMA) during drinking episodes paired with retrospective next-day assessments. For 28 days, heavy-drinking college students (n = 90, 50% female) completed self-reports during drinking episodes and the next morning. Measures included alcohol use, subjective intoxication, mood, negative consequences (e.g., being aggressive) and positive consequences (e.g., new friend), and consequence-specific evaluations. Consistent with hypotheses, multilevel models revealed that during drinking events compared to the next morning, average evaluations of negative and positive consequences were less negative and more positive, respectively. During drinking events, neither subjective intoxication nor estimated blood alcohol concentration (eBAC) was associated with positive or negative evaluations. In morning reports, more positive mood was associated with less negative evaluations of negative consequences and more positive evaluations of positive consequences. Next-day discussion with friends was not significantly associated with consequence evaluations. This study is the first to assess subjective consequence evaluations in real time as well as retrospectively, for the same events. Findings continue to support the role of context (timing, mood) on subjective consequence evaluations, and suggest that ecological momentary interventions targeting alcohol consequences and related cognitions might best be delivered the morning after drinking, to capitalize on relatively more negative perceptions of one's drinking experiences. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Daily impulsivity and alcohol expectancies: A multilevel examination of the acquired preparedness model.

The acquired preparedness model (APM) integrates personality traits and psychosocial learning to posit amechanism whereby individuals initiate and continue alcohol use. The present study examined within-person associations between impulsivity, alcohol expectancies, alcohol use, and alcohol problems to inform daily process models of drinking and test the APM. Participants were 89 college student drinkers who completed momentary reports (three random and two user-initiated reports) for 14 days. Multilevel mediation analyses examined whether daily associations between impulsivity and alcohol use and problems were mediated by positive and negative expectancies. Daily impulsivity was positively associated with daily positive expectancies, prior to drinking. Greater daily positive expectancies were associated with more alcohol consumed and alcohol problems that day. The indirect effects were significant, indicating greater than usual impulsivity was associated with greater alcohol use and alcohol problems through greater positive expectancies. Impulsivity was positively associated with negative expectancies at the within-subject and between-subject levels, but negative expectancies did not serve as a mediator between impulsivity and either alcohol outcome. This is the first study to test the APM at the day level. Findings supported daily fluctuations in beliefs regarding the positive effects of alcohol as a salient mechanism explaining the link between daily impulsivity and level of alcohol use. Because impulsivity was linked to changes in expectancy states that were proximal to drinking that day, this information may be used to develop prevention and intervention programs to reduce alcohol harms.

Perceptions of Using Instant Messaging Apps for Alcohol Reduction Intervention Among University Student Drinkers: Semistructured Interview Study With Chinese University Students in Hong Kong.

Mobile instant messaging (IM) apps (eg, WhatsApp and WeChat) have been widely used by the general population and are more interactive than text-based programs (SMS text messaging) to modify unhealthy lifestyles. Little is known about IM app use for health promotion, including alcohol reduction for university students. This study aims to explore university student drinkers' perceptions of using IM apps for alcohol reduction as they had high alcohol exposure (eg, drinking invitations from peers and alcohol promotion on campus) and the proportion of IM app use in Hong Kong. A qualitative study was conducted with 20 Hong Kong Chinese university students (current drinkers) with Alcohol Use Disorder Identification test scores of ≥8 recruited using purposive sampling. Semistructured individual interviews were conducted from September to October 2019. Interview questions focused on drinking behaviors, quitting history, opinions toward IM app use as an intervention tool, perceived usefulness of IM apps for alcohol reduction, and opinions on the content and design of IM apps for alcohol reduction. Each interview lasted approximately 1 hour. All interviews were audio-taped and transcribed verbatim. Two researchers independently analyzed the transcripts using thematic analysis with an additional investigator to verify the consistency of the coding. Participants considered IM apps a feasible and acceptable platform for alcohol reduction intervention. They preferred to receive IMs based on personalized problem-solving and drinking consequences with credible sources. Other perceived important components of instant messages included providing psychosocial support in time and setting goals with participants to reduce drinking. They further provided suggestions on the designs of IM interventions, in which they preferred simple and concise messages, chat styles based on participants' preferences (eg, adding personalized emojis and stickers in the chat), and peers as counselors. Qualitative interviews with Chinese university student drinkers showed high acceptability, engagement, and perceived utility of IM apps for alcohol reduction intervention. IM intervention can be an alternative for alcohol reduction intervention apart from traditional text-based programs. The study has implications for developing the IM intervention for other unhealthy behaviors and highlights important topics that warrant future research, including substance use and physical inactivity. ClinicalTrials.gov NCT04025151; https://clinicaltrials.gov/ct2/show/NCT04025151?term=NCT04025151.

The socio-ecological context of U.S. college student drinking: A latent class analysis

BackgroundU.S. college student drinking typologies often consider quantity and frequency but not the socio-environmental contexts in which students obtain alcohol and drink. Understanding context could be important for preventive interventions. MethodsWe used latent class analysis (LCA), a person-centered approach to understanding behavior patterns, to identify drinking typologies among 1390 college student drinkers from a representative survey at two interconnected private colleges in the Northeast. Classes were derived from drinking frequency and quantity as well as how students obtain alcohol, where they drink, and their perceptions of peer drinking. Resulting classes were correlated with demographic and developmental characteristics, participation in campus activities and connectedness, and alcohol consequences and protective behaviors. ResultsFour distinct drinking profiles emerged. ‘Tasters’ (n = 290) included infrequent and low quantity drinkers who drank in dorms with alcohol provided by others. ‘Bargoers’ (n = 271) included low quantity and moderate frequency drinkers who purchased their own alcohol and drank at bars. ‘Partiers’ (n = 483) included moderate frequency and quantity drinkers who obtained alcohol from several sources and drank in many locations. ‘Bingers’ (n = 345) included high frequency and quantity drinkers and binge drinkers, who drank in many locations with alcohol obtained from multiple sources. Classes differed in demographics, age of first drink, campus activities and connectedness, alcohol protective behaviors, and alcohol problems. ConclusionHeterogeneous patterns of drinking based on quantity, frequency and social/environmental context emerged and suggested the need for different tailored interventions.

Alcohol demand assessed daily as a predictor of same day drinking.

In this investigation, baseline (trait) and daily (brief) alcohol purchase task (APT) indices (intensity: consumption at zero cost; Omax: maximum expenditure; breakpoint: cost suppressing consumption to zero) were used to investigate the influence of morning demand on subsequent alcohol consumption. Heavy drinking college students (n = 92, age 18-20, 50% female) completed 28 daily morning reports including demand and prior day drinking. Hierarchical linear modeling, with days (Level 1) nested within-person (Level 2) were used to test the effect of morning demand on number of drinks consumed on planned drinking days, with Level 1 (study day, survey time, weekend/weekday) and Level 2 (spending money, typical drinks) covariates. Subsequently, the relative impact on daily drinking of (a) the average of each daily demand index on planned drinking days versus (b) the matched trait demand index was assessed. Higher morning intensity was related to increased alcohol consumption later that night. This finding held in sensitivity analyses wherein demand was assumed to be zero on unplanned drinking days. When tested individually, both aggregate daily and baseline trait intensity were significantly associated with average drinks measured daily. However, in the same model, only aggregate daily intensity was significant. Neither daily aggregate nor trait breakpoint or Omax were significant. Findings replicate previous work suggesting that brief demand (intensity) can predict same day drinking. Elevation in intensity in particular may denote greater risk for elevated alcohol consumption at subsequent episodes, thus intervention among at-risk drinkers may be possible prior to drinking initiation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Supplemental Material for Examining Engagement Effects in an Adaptive Preventive Intervention for College Student Drinking

Supplemental Material for Examining Engagement Effects in an Adaptive Preventive Intervention for College Student Drinking

Negative but Not Positive Alcohol-Related Consequences Tend to Occur Above the Heavy Episodic Drinking Threshold: A Daily Study of Young Adult Heavy Drinkers.

This study used event-level data to identify the threshold (i.e. number of standard alcoholic drinks) at which specific negative and positive alcohol-related consequences are likely to occur. Ninety-six college students aged 18-20 reporting weekly heavy episodic drinking (HED) or at least one negative alcohol-related consequence in the past 2weeks completed ecological momentary assessment over 28days. Participants reported number of standard drinks consumed and negative (e.g. nausea) and positive (e.g. new friend) alcohol-related consequences on 492 drinking nights. The area under the receiver operating characteristic (AUROC) curve measured the ability of an increasing number of drinks consumed to discriminate between nights with versus without a given consequence. The Youden Index method was used to identify the optimal threshold of drinks for each consequence. Thresholds were examined for each consequence by participants' biological sex and heavy drinking status. Across subgroups, most consequences occurred on nights where participants reported higher consumption levels relative to nights where consequences did not occur. Thresholds for negative consequences ranged between four and nine drinks and thresholds for positive consequences were between three and six drinks. Many negative consequences are likely to occur following the traditional HED threshold of 4+/5+ drinks (females/males), with more severe consequences occurring at slightly higher thresholds. Positive consequences are likely to occur at lower thresholds. There may be an optimal number of drinks that maximize positive while minimizing negative consequences for heavy drinking college students.

Recent alcohol-induced blackouts among heavy drinking college students: A qualitative examination of intentions, willingness, and social context.

One-third to half of emerging adult drinkers report experiencing alcohol-induced blackouts in the past year, and blackouts increase the risk for negative consequences. Qualitative methods provide valuable tools for scientific inquiry, allowing for in-depth understanding of lived experiences. The goal of the present study was to gain insight into emerging adults' recent blackout experiences. One hundred heavy drinking college students (age 18-20) completed a baseline survey, 28 days of ecological momentary assessment (EMA) of their alcohol use and consequences, and a follow-up interview. A subset of 37 (46% female, 13.5% Hispanic/Latinx, 54% non-Hispanic ethnicity/White race) endorsed a blackout (forgot what they did during or after drinking) and were interviewed regarding their recent blackout experience. A semi-structured interview guide focused on several key questions regarding intentions and/or willingness to black out, how friends reacted to their blackout, and social norms for blacking out. A priori as well as emergent themes were generated from review of coded data. Qualitative themes included: blackouts are often unintentional, heavy drinking young adults express willingness to black out, friends react in a variety of ways to blackouts, and blackouts are perceived as common and acceptable. Data provide insight into the phenomenology of blackouts among college students, revealing that although college students may not intend to, they are often willing to black out. Future qualitative studies on blackouts among non-college-attending emerging adults are warranted. Such work can inform theory and future survey studies to better understand this high-risk behavior. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Exploring the Role of Social Networking Sites in Alcohol Consumption among College Students: Which Platforms Have the Greatest Influence?

ABSTRACT Excessive alcohol use among college students is associated with a host of deleterious physical, mental, and academic outcomes. Social Networking Sites (SNS) are thought to influence norms around alcohol consumption, leading to increased college student drinking. We utilized a sample of 330 college students to investigate the effects of Facebook, Instagram, Twitter, and Snapchat on college student drinking behavior. Only Snapchat use was associated with college student drinking even while controlling for confounders such as the amount of time spent on SNS. Interventions attempting to lower college student drinking should focus on Snapchat to have the most effective platform.

The role of alcohol and cannabis co-use in drinking rate and its impact on consequences.

The impact of alcohol and cannabis co-use on college student drinking and related outcomes is complex. Specific characteristics or patterns of co-use events beyond drinking quantity may be important to the experience of consequences. The present studyused repeated daily surveys to examine the association between co-use (versus use of alcohol only) and drinking rate on negative consequences. The sample included 318 college students (Mage =19.8, 47% female, 76% non-Hispanic White) who were co-users of alcohol and cannabis, recruited from three U.S. college campuses. Participants completed 56 days of data collection (number of drinking days ranged from 1 to 38). Two measures of drinking rate were examined: (1) daily rate (number of drinks divided by number of hours spent drinking per day); and (2) peak hour rate (maximum number of drinks consumed in a single hour) to account for anomalous drinking days of long duration. Generalized linear mixed models examined: (1) associations of co-use with peak hour rate (model 1a) and daily rate (model 1b); (2) associations of peak hour rate (model 2a) and daily rate (model 2b) with experiencing any negative consequence; and (3) interactions of co-use with peak hour rate (model 3a) and daily rate (model 3b) on experiencing a consequence. Co-use was positively associated with peak hour rate but not daily rate. Both peak hour and daily rate positively predicted likelihood of experiencing a negative consequence. The interaction of both peak hour and daily rate by co-use was significant such that the association of rate with experiencing a consequence was stronger on alcohol-only days compared to co-use days. Daily drinking rate and peak hour drinking rate are unique and should be considered when discussing drinking patterns. Both predict negative consequences and may be important aspects of interventions for negative drinking-related outcomes among college students.

Quantifying heterogeneity in mood-alcohol relationships with idiographic causal models.

Ecological momentary assessment (EMA) studies have provided conflicting evidence for the mood regulation tenet that people drink in response to positive and negative moods. The current study examined mood-to-alcohol relationships idiographically to quantify the prevalence and intensity of relationships between positive and negative moods and drinking across individuals. We used two EMA samples: 96 heavy drinking college students (sample 1) and 19 young adults completing an ecological momentary intervention (EMI) for drinking to cope (sample 2). Mood and alcohol use were measured multiple times per day for 4-6 weeks. Mood-alcohol relationships were examined using three different analytic approaches: standard multilevel modeling, group causal modeling, and idiographic causal modeling. Both multilevel modeling and group causal modeling showed that participants in both samples drank in response to positive moods only. However, idiographic causal analyses revealed that only 63% and 21% of subjects (in samples 1 and 2, respectively) drank following any positive mood. Many subjects (24% and 58%) did not drink in response to either positive or negative mood in their daily lives, and very few (5% and 16%) drank in response to negative moods throughout the EMA protocol, despite sample 2 being selected specifically because they endorse drinking to cope with negative mood. Traditional group-level analyses and corresponding population-wide theories assume relative homogeneity within populations in mood-alcohol relationships, but this nomothetic approach failed to characterize accurately the relationship between mood and alcohol use in approximately half of the subjects in two samples that were demographically and clinically homogeneous. Given inconsistent findings in the mood-alcohol relationships to date, we conclude that idiographic causal analyses can provide a foundation for more accurate theories of mood and alcohol use. In addition, idiographic causal models may also help improve psychosocial treatments through direct use in clinical settings.

A Comparison of Parents' and Students' Reports of General and Alcohol-Specific Parenting Behaviors Across the Four Years of College.

Whether college students' reports of their parents' behaviors are as reliable a predictor of student drinking as their parents' own reports remains an open question and a point of contention in the literature. To address this, the current study examined concordance between college student and mother/father reports of the same parenting behaviors relevant to parent-based college drinking interventions (relationship quality, monitoring, and permissiveness), and the extent to which student and parental reports differed in their relation to college drinking and consequences. The sample consisted of 1,429 students and 1,761 parents recruited from three large public universities in the United States (814 mother-daughter, 563 mother-son, 233 father-daughter, and 151 father-son dyads). Students and their parents were each invited to complete four surveys over the course of the students' first 4 years of college (one survey per year). Paired samples t tests revealed that parental reports of parenting constructs were typically more conservative than student reports. Intraclass correlations revealed moderate associations between parental and student reports on relationship quality, general monitoring, and permissiveness. The associations between parenting constructs and drinking and consequences were also consistent when using parental and student reports of permissiveness. Results were generally consistent for all four types of dyads, and at each of the four time points. Taken together, these findings provide additional support for the use of student reports of parental behaviors as a valid proxy of parents' actual reports and as a reliable predictor of college student drinking and consequences.

Race- and university-specific norms associated with alcohol use among Black college students

Approximately one-third of college students engage in heavy episodic drinking. Although White students drink more than Black students, White individuals are more likely to mature out of heavy drinking, whereas Black individuals drink more as they age and experience disproportionate alcohol-related consequences. Compared to their White counterparts, limited research has examined factors associated with alcohol use among Black college students. Descriptive drinking norms based on the typical college student are strong predictors of college student drinking, but previous research found that this association was weaker for Black college students. Therefore, the current study is a preliminary examination of perceived drinking norms (descriptive) and approval (injunctive) based on race for Black college students. Further, we explored likelihood of excessive drinking around other Black students. The current study included survey responses of 192 Black college students from a large southeastern US university. Results indicated that university and race-specific descriptive norms, but not university and race-specific injunctive norms, were associated with more drinks per week. These findings suggest that descriptive norms with Black students at the participant’s university as the normative reference group are associated with alcohol use among Black students. Further, greater likelihood of drinking excessively around peers who share the same racial identity may impact alcohol consumption for this population. Current prevention programs for college student drinking are tailored by gender rather than race; however, preliminary findings from the current study suggests that tailoring by race may be an effective way to prevent alcohol misuse among Black college students.

Adverse childhood experiences and alcohol related negative consequence among college student drinkers

ObjectiveDespite increasing college campus prevention efforts, and identification of effective strategies to reduce drinking, reducing alcohol related negative consequences (ARNC, e.g., regrets, blackouts, self- and other- injury, law enforcement exposure, sexual assault, and considering suicide) continues to be a challenge. While college students with a history of adverse childhood experiences (ACE) are at greater risk for alcohol misuse, research regarding the association between ACE and ARNC remains limited. MethodsData are responses of currently drinking students on the American College Health Association-National College Health Assessment (ACHA-NCHA II) and College Student Health Survey (CSHS), administered in 2018 to students in California and Minnesota (N = 6,667). ResultsOn average, students reported one ARNC (SD = 1.30) although 13 % experienced three or more different types of ARNC in the past year. Every ACE was associated with a 19 % to 41 % increase in the IRR of ARNC. Students with 1–3 ACE experienced significantly more types of ARNC events (IRR 1.55, 95 % CI: 1.44–1.67) than students with no ACE and students with ≥ 4 ACE experienced statistically significantly more types of ARNC events (IRR 2.04, 95 % CI: 1.82–2.31) than their peers with 1–3 or no ACE. The ACE-ARNC relationship did not vary by drinking frequency or binge drinking. ConclusionsThe consistent ACE - ARNC relationship across drinking behaviors suggests alcohol consumption does not fully explain the association between ACE and ARNC and that early adversity heightens vulnerability for ARNC. Implications for future prevention and intervention efforts are discussed.

Test of a deviance regulation theory intervention among first-year college student drinkers: Differential effects via frequency and quantity norms.

First-time-in-college (FTIC) students are relatively inexperienced with alcohol and have pressure to assimilate to new norms, and, therefore, are at a heightened risk of alcohol-related consequences. The present study investigates the use of a brief deviance regulation theory (DRT) intervention to increase the use of protective behavioral strategies (PBS) among FTIC students. Participation took place completely online. Participants were first-year college students (n = 147, Mage = 18.11, 77.68% female) at a large southwest U.S. university. Participants were randomly assigned one of three conditions: (a) a positive message about individuals who use PBS, (b) a negative message about individuals who do not use PBS, or (c) an assessment-only control group. Participants then completed weekly assessments for 5 weeks, examining alcohol use and consequences, PBS use, and perceived PBS norms. Contrasting previous research, the present study investigated weekly effects of the intervention. In addition, norm type (quantity vs. frequency) was examined as moderators of intervention messaging. Across conditions, both quantity and frequency norms increased over time. The positive message produced immediate and lasting effects on SLD PBS among those with higher (+ 1 SD) frequency norms. The intervention effects for the negative message, using the quantity norm, grew across time on all PBS. These results provide initial support for the use of a DRT prevention program for FTIC students. Negative messages may promote long-term PBS use, while positive messages may be most effective in addressing immediate and lasting changes in the use of alcohol protective strategies. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Examining the added value of harm reduction strategies to emailed boosters to extend the effects of online interventions for college drinkers.

Objective: Brief computer-delivered interventions (CDIs) reduce college student drinking and related problems but can be less efficacious and enduring than in-person interventions. The present study examined: (a) the utility of emailed personalized boosters after an evidence-based online CDI for alcohol (i.e., eCHECKUP TO GO), and (b) the added value of including protective behavioral strategies (PBS) in boosters containing personalized normative feedback (PNF) versus PNF alone. Method: 528 young adult (ages 18-24) college drinkers (71.6% female; 52.5% Black, 40.3% White) with a mean age of 19.9 years (SD = 1.65) were randomized to receive: CDI-only; CDI plus a PNF-only booster; or CDI plus a booster containing both PNF and PBS feedback. Booster emails were sent 2 weeks post-intervention. Online surveys completed pre-intervention and at 1 and 3 months assessed alcohol consumption, problems, descriptive normative perceptions, and PBS use. Results: The CDI led to significant reductions in alcohol consumption across all conditions, with no effect of boosters on drinking. Controlling for quantity, no reductions in problems were observed. Descriptive norms reduced significantly, with no condition differences. Only PBS use showed condition effects, such that the CDI-only and PNF-only booster groups reported reduced PBS use at 1 month, but the norms-plus-PBS booster group did not. Conclusions: The CDI was sufficient to change alcohol consumption and perceived norms without boosters, although the inclusion of boosters with PBS feedback may mitigate against PBS use reductions. Longer follow-ups may detect delayed booster benefits, or a larger dose through repeated exposure over time may be needed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).