Personalized Normative Feedback Intervention Research Articles

A pilot study of the acceptability, efficacy, and iatrogenic effects of a brief dynamic norms intervention for reducing young adult alcohol use.

Alcohol use and its related consequences are a public health problem among young adults. Building upon efficacious personalized normative feedback interventions, dynamic norms can be used to highlight the decreasing prevalence of alcohol use over time among young adults' peers, thereby increasing their motivation to change drinking consistent with the trend. Because limited research has examined dynamic norms feedback interventions for alcohol use, we examined the acceptability and initial efficacy of such an intervention, and potential iatrogenic effects of showing norms feedback about drinking to light drinkers and nondrinkers. Participants were 546 unvaccinated young adults ages 18-24 who completed a baseline survey, intervention, and 1-month follow-up assessment. Participants were block randomized to receive a brief web-based dynamic norms intervention, with feedback content focused on either (a) alcohol-related behaviors (intervention) or (b) COVID-19 vaccine behaviors (the attention-matched control for the present study). On average, participants who received the alcohol intervention rated it as generally engaging, helpful, and acceptable, with the majority (90.8%) indicating that they would recommend it to a friend. Supporting initial efficacy, in generalized linear models controlling for demographics and baseline alcohol outcomes, at 1-month follow-up the alcohol intervention was associated with statistically and clinically significant reductions in all indices of perceived drinking norms, drinking quantity, drinking frequency, and driving after drinking occasions. Lighter drinkers showed no adverse iatrogenic effects. Presenting alcohol-related personalized normative feedback using dynamic trends is a promising intervention for reducing alcohol use in a community sample of young adults. Further research clarifying the optimal presentation of dynamic norms is needed.

Injunctive and descriptive normative feedback for college drinking prevention: Is the whole greater than the sum of its parts?

Single-component personalized normative feedback (PNF) interventions and multicomponent personalized feedback interventions (PFI) have been shown to reduce alcohol consumption among college students. The present study compared the efficacy of PNF interventions targeting descriptive norms alone (descriptive PNF), injunctive norms alone (injunctive PNF), or their combination (combined PNF), against a multicomponent PFI and an attention control condition. Undergraduates (N = 1,137) across two universities who reported a minimum of one past-month episode of heavy episodic drinking (i.e., 4 +/5 + drinks on a single occasion for females/males) completed assessments at baseline and 3, 6, and 12 months postintervention. Relative to the attention control, participants in each of the four intervention conditions showed greater reductions in perceived descriptive/injunctive norms, total drinks per week, and alcohol-related consequences. Peak estimated blood alcohol concentration was also reduced in the injunctive PNF, combined PNF, and multicomponent PFI conditions, with the latter two conditions showing an advantage for duration of effects. The multicomponent PFI condition also evidenced greater reductions than the injunctive PNF in descriptive norms at 3-month and injunctive norms at 6- and 12-month follow-ups. No other group comparisons on any outcome were significant. Each intervention has merit for use in college student harm reduction efforts. Single-component or combined PNF could be considered a potential starting point, as PNF is less burdensome than a multicomponent PFI when considering ease and length of delivery. Results can inform optimization of norms-based interventions and guide recommendations on efficacious components for reducing alcohol use and harms on college campuses. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Integrating social media inspired features into a personalized normative feedback intervention combats social media-based alcohol influence

BackroundResearch suggests that the social media platforms popular on college campuses may reflect, reinforce, and even exacerbate heavy drinking practices among students. The present study was designed to directly examine: (1) whether exposure to alcohol-related content on social media diminishes the efficacy of a traditional web-based personalized normative feedback (PNF) alcohol intervention among first-year drinkers; and (2) if social media inspired features and digital game mechanics can be integrated into a PNF intervention to combat social media-based alcohol influence and increase efficacy. MethodAlcohol experienced first-year college students (N = 223) completed a pre-survey that assessed exposure to alcohol-related content and social media and were randomized to 1 of 3 web-based alcohol PNF conditions (traditional, gamified only, or social media inspired gamified). One month later, participants’ alcohol consumption was reassessed. ResultsAmong participants who received traditional PNF, social media-based alcohol exposure interacted with pre-intervention drinking such that traditional PNF was less effective in reducing drinking among heavier drinkers reporting greater exposure to alcohol-related social media content. Further, when regression models compared the efficacy of all three conditions, the social media inspired gamified PNF condition was significantly more effective in reducing drinking than was traditional PNF among moderate and heavy drinkers reporting greater exposure to alcohol on social media. ConclusionAlthough additional research is needed, these findings suggest that representing the population of students on whom normative statistics are based with social media-like user avatars and profiles may enhance the degree to which alcohol PNF is relatable and believable among high-risk students.

A Gamified, Social Media-Inspired, Web-Based Personalized Normative Feedback Alcohol Intervention for Lesbian, Bisexual, and Queer-Identified Women: Protocol for a Hybrid Trial.

BackgroundSexual minority women are more likely to drink alcohol, engage in heavy drinking, and experience alcohol-related problems than heterosexual women. However, culturally tailored interventions for this population have been slow to emerge.ObjectiveThis type 1 effectiveness-implementation trial examines the feasibility and efficacy of a gamified, culturally tailored, personalized normative feedback (PNF) alcohol intervention for sexual minority women who psychologically identify as lesbian, bisexual, or queer (LBQ).MethodsThe core components of a PNF intervention were delivered within LezParlay, a fun, social media–inspired, digital competition designed to challenge negative stereotypes about LBQ women and increase visibility. The competition was advertised on the web through social media platforms and collaboration with LBQ community organizations. After 2 rounds of play by a large cohort of LBQ women, a subsample of 500 drinkers already taking part in the competition were invited to participate in the evaluation study. Study participants were randomized to receive 1 of 3 unique sequences of PNF (ie, alcohol and stigma coping, alcohol and control, or control topics only) over 2 intervention rounds. Randomization was fully automated by the web app, and both researchers and participants were blinded.ResultsAnalyses will evaluate whether PNF on alcohol use reduces participants’ drinking and negative consequences at 2 and 4 months postintervention; examine whether providing PNF on stigma-coping behaviors, in addition to alcohol use, further reduces alcohol use and consequences beyond PNF on alcohol alone; identify mediators and moderators of intervention efficacy; and examine broader LezParlay app engagement, acceptability, and perceived benefits.ConclusionsThis incognito intervention approach is uniquely oriented toward engaging and preventing alcohol-related risks among community populations of LBQ women who may view their heavy drinking as normative and not in need of change because of the visibility of alcohol use in sexual minority community spaces. Thus, this intervention strategy diverges from, and is intended to complement, more intensive programs being developed to meet the needs of LBQ women already motivated to reduce their consumption.Trial RegistrationClinicalTrials.gov NCT03884478; https://clinicaltrials.gov/ct2/show/NCT03884478International Registered Report Identifier (IRRID)DERR1-10.2196/24647

Reducing Alcohol Use among High School Athletes: A Randomized Controlled Trial of a Brief, Web-Based Personalized Normative Feedback Intervention.

High school athletes are at risk for heavy alcohol use, which is associated with consequences that may negatively impact performance and eligibility to participate in sports. This study evaluated the efficacy of a web-based personalized normative feedback (PNF) intervention on reducing alcohol use among high school athletes in their senior year. Class periods were randomized to the intervention or an assessment-only control group. Athletes completed surveys at baseline and a 6-week follow-up. Athletes were classified as high-risk or low-risk drinkers based on baseline reports of binge drinking. Results indicated for athletes classified as high-risk drinkers, those in the intervention group reported significantly greater reductions in quantity of weekly drinking and peak drinking quantity compared to those in the assessment-only control group. There were no significant intervention effects for frequency of alcohol use. Findings provide support the efficacy of web-based PNF intervention for reducing alcohol use among high school senior athletes.

Personalized normative feedback interventions targeting hazardous alcohol use and alcohol-related risky sexual behavior in Swedish university students: A randomized controlled replication trial

IntroductionThis study replicates two US intervention studies using personalized normative feedback (PNF) on alcohol-related risky sexual behavior (RSB). MethodsIn a randomized controlled trial, 654 Swedish university students were assigned to an alcohol only intervention, an alcohol-related RSB only intervention, a combined alcohol and alcohol-related RSB intervention, an integrated alcohol and alcohol-related RSB intervention, or control. Follow-up assessments were made at 3 and 6 months post-intervention. ResultsIn comparison to controls, drinks per week were reduced at 3 months in the Alcohol Only, Combined, and Integrated intervention groups. Frequency and quantity of drinking before sex were reduced at 3- and 6-month follow-up for the Sex Only, Combined, and Integrated intervention groups. The Alcohol Only intervention showed significant results on frequency of drinking before sex at 3 months, and on quantity of drinking before sex at 6 months. The Combined intervention had reduced outcomes on alcohol-related consequences and on alcohol-related sexual consequences at both follow-ups. Alcohol Only and Integrated interventions showed effects on both outcomes regarding consequences at 6 months, and the Sex Only group showed effects on sexual consequences at 6 months. ConclusionsIt is concluded that PNF interventions offer considerable positive effects, and could be used to reduce alcohol-related RSB in Swedish university students.

Online personalized normative feedback intervention to reduce event-specific drinking during Mardi Gras.

High-risk drinking events (e.g., Mardi Gras) are associated with heavy and problematic drinking behaviors in college students. Online personalized normative feedback (PNF) interventions have been found to reduce college drinking, yet few studies have investigated the effect of event-specific PNF on drinking. The present study investigated the impact of a Mardi Gras-specific PNF intervention on Mardi Gras drinking and normative beliefs. Undergraduate students who reported intending to drink during Mardi Gras were randomly assigned to receive PNF (n = 74) or nondrinking control feedback (n = 73), both delivered online. Compared to those in the control condition, those in the PNF condition reported lower normative beliefs at follow-up. Follow-up beliefs mediated the relation between condition and peak estimated blood alcohol content (eBAC) during Mardi Gras such that the PNF condition was related to lower follow-up maximum estimated eBAC via lower follow-up normative beliefs. Baseline drinking moderated treatment effects such that the PNF was related to lower follow-up eBAC among heavier but not lighter baseline drinkers. This is the first known study to find that an event-specific stand-alone PNF intervention administered online in anticipation of a university-wide holiday associated with drinking can result in decreased event-specific drinking via changes in event-specific normative beliefs. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Leveraging copresence to increase the effectiveness of gamified personalized normative feedback

Virtual copresence, or the sense of being with others in an online space, is a feeling induced on many apps and websites through user avatars and browsable profile pages. Despite the small/modest effect sizes observed in popular web-based personalized normative feedback (PNF) alcohol interventions for college students, previous research has yet to consider how copresence might boost efficacy. This study builds on previous PNF gamification work to investigate whether specific copresence features (visual and text-based information about peers) increase PNF's ability to reduce alcohol use relative to a standard PNF condition and a gamified PNF condition. Copresence and perceptions of drinking norms (average drinks, peak drinks, and binge episodes) were assessed during a 3-week period following random assignment of college students (N = 235) to 1 of the 4 web-based PNF conditions (Standard PNF, Gamified PNF Only, Gamified PNF + Visual Copresence, and Gamified PNF + Maximum Copresence). These conditions asked the same questions about drinking and delivered identical PNF on alcohol use, but differed in the level of visual and text-based information about peers. Overall, only the gamified condition that featured maximum copresence significantly reduced drinking outcomes relative to standard PNF. However, conditional effects were moderated by pre-intervention drinking. Among heavier pre-intervention drinkers, both gamified conditions that featured copresence significantly improved upon Standard PNF in reducing alcohol use at follow-up. Findings suggest that including social media-like copresence features to visually represent and provide basic information about the peers contributing to the norms can enhance the efficacy of gamified PNF interventions, especially among high-risk heavy drinkers.

Incorporating Writing into a Personalized Normative Feedback Intervention to Reduce Problem Drinking Among College Students.

Personalized normative feedback (PNF) interventions have repeatedly been found to reduce drinking among undergraduates. However, effects tend to be small, potentially due to inattention to and inadequate processing of the information. Adding a writing component to PNF interventions may allow for greater cognitive processing of the feedback, thereby boosting intervention efficacy. Additionally, expressive writing (EW) has been shown to reduce drinking intentions; however, studies have not examined whether it can reduce drinking behavior. The present experiment evaluated whether including a writing task would improve the efficacy of PNF and whether EW alone can be used to reduce drinking and alcohol-related problems. Heavy drinking undergraduates (N=250) were randomized to receive either: (i) PNF about their alcohol use; (ii) EW about a negative, heavy drinking occasion; (iii) PNFplus writing about the norms feedback; or (iv) attention control feedback about their technology use in an online brief intervention. Participants (N=169) then completed a 1-month follow-up survey about their past month alcohol use and alcohol-related problems online. PNFplus writing reduced alcohol-related problems compared to all other conditions. No significant reductions were found for EW. Both PNF and PNFplus writing reduced perceived norms and perceived norms mediated intervention effects for both feedback conditions. The current findings suggest that adding a writing component to traditional norms-based feedback approaches might be an efficacious strategy, particularly for reducing alcohol-related consequences.

Testing a motivational model of delivery modality and incentives on participation in a brief alcohol intervention

ObjectivesThe current research evaluated delivery modality and incentive as factors affecting recruitment into a personalized normative feedback (PNF) alcohol intervention for heavy drinking college students. We also evaluated whether these factors were differentially associated with participation based on relevance of the intervention (via participants' drinking levels). MethodCollege students aged 18–26 who endorsed at least one heavy drinking episode and one alcohol-related consequence in the past month (N = 2059; 59.1% female) were invited to participate in a PNF intervention study. In this 2 × 2 design, participants were randomized to: (1) complete the computer-based baseline survey and intervention procedure remotely (i.e., at a time and location of their convenience) or in-person in the laboratory, and (2) receive an incentive ($30) for their participation in the baseline/intervention procedure or no incentive. ResultsConsistent with hypotheses, students were more likely to participate when participation occurred remotely (OR = 1.87, p < .001) and when an incentive (OR = 1.64, p = .007) was provided. Moderation analyses suggested that incentives were only associated with higher recruitment rates among remote participants (OR = 2.10, p < .001), consistent with cognitive evaluation theory. Moreover, heavier drinkers were more likely to participate if doing so remotely, whereas drinking was not associated with likelihood of participation among in-person participants. DiscussionThe present results showed a strong selection bias for participation in a web-based intervention study relative to one in which participants were required to participate in-person. Results have implications for researchers recruiting college students for alcohol interventions.

Drinking to cope moderates the efficacy of changing veteran drinking norms as a strategy for reducing drinking and alcohol-related problems among U.S. veterans.

Heavy and problematic drinking is a concern among young adult military veterans. Personalized normative feedback (PNF) interventions that target normative misperceptions regarding drinking have been efficacious among young adults and have recently begun to be implemented among veteran populations in an effort to reduce heavy drinking. However, moderators of PNF intervention efficacy among veterans are largely unexplored. This study is a secondary data analysis that evaluated whether a PNF intervention would work better at reducing perceived norms, drinking, and alcohol-related problems specifically for young adult veterans who drink to cope with negative affect. Veterans of the United States (U.S.) military (86% male; Mean age = 28.9 years, SD = 3.4) were randomly assigned to receive either: 1) PNF comparing their drinking and perceived norms to actual drinking rates for same sex veterans; or 2) feedback about same sex veteran video game play (control condition). Seven hundred eighty-four individuals completed baseline and 622 completed 1-month follow-up assessments (79% follow-up), including measures of alcohol use, alcohol-related problems, and drinking motives. Moderated mediation analyses indicated that changes in normative misperceptions as a result of the intervention were more strongly associated with reductions in drinking and problems among veterans scoring higher on drinking to cope. These findings suggest that PNF may be an especially efficacious brief intervention for veterans who drink for coping reasons. (PsycINFO Database Record

Interventions for alcohol-related risky sexual behaviors among college students: A systematic review.

Alcohol-related risky sexual behaviors are common among college students. Though various interventions targeting these behaviors have been examined, the literature does not currently include a review of these strategies. A comprehensive literature search was conducted, yielding 7 randomized controlled trials. Relevant outcome variables included unprotected sex, alcohol in conjunction with sex, and number of sexual partners. Findings suggested that interventions utilizing reminder cues or motivational interviewing-based techniques were largely found to be effective in increasing condom use behaviors among intoxicated individuals, while support for personalized normative feedback (PNF) for the same outcome was mixed. However, PNF interventions were generally effective in reducing alcohol use in conjunction with sex. Finally, though few studies examined number of sexual partners, there are mixed findings for interventions (i.e., motivational interviewing, PNF) targeting this outcome. Overall, there is promising, albeit mixed, evidence of the effectiveness of interventions targeting various alcohol-related risky sexual behaviors among college students. Strengths, limitations, and implications of the findings of this systematic review for future research are discussed. (PsycINFO Database Record

Prototype Willingness Model Drinking Cognitions Mediate Personalized Normative Feedback Efficacy.

Personalized normative feedback (PNF) interventions have been shown to be efficacious at reducing college student drinking. Because descriptive norms have been shown to mediate PNF efficacy, the current study focused on examining additional prototype willingness model social reaction cognitions, namely, prototypes and willingness, as mediators of intervention efficacy. We expected the PNF interventions to be associated with increased prototype favorability of students who do not drink, which would in turn be associated with decreased willingness to drink and subsequently, less drinking. The current study included 622 college students (53.2% women; 62% Caucasian) who reported one or more heavy drinking episodes in the past month and completed baseline and three-month follow-up assessments. As posited by the framework of the prototype willingness model, sequential mediation analyses were conducted to evaluate increases in abstainer prototype favorability on willingness on drinking, and subsequently willingness to drink on drinking behavior. Mediation results revealed significant indirect effects of PNF on three-month drinking through three-month prototypes and willingness, indicating that the social reaction pathway of the prototype willingness model was supported. Findings have important implications for PNF interventions aiming to reduce high-risk drinking among college students. Study findings suggest that we should consider looking at additional socially-based mediators of PNF efficacy in addition to perceived descriptive norms.

PNF 2.0? Initial evidence that gamification can increase the efficacy of brief, web-based personalized normative feedback alcohol interventions

Gamified interventions exploit the motivational characteristics of a game in order to provide prevention information and promote behavior change. Despite the modest effect sizes observed in increasingly popular web-based personalized normative feedback (PNF) alcohol interventions for college students, previous research has yet to consider how gamification might be used to enhance efficacy. This study examines whether a novel, gamified PNF intervention format, which includes a point-based reward system, the element of chance, and personal icons to visually represent users, is more effective in reducing short-term alcohol use than the standard web-based style of PNF currently used on college campuses. Two-hundred and thirty-seven college students were randomly assigned to receive either a standard brief, web-based PNF alcohol intervention or the same alcohol intervention components delivered within a Facebook-connected social game called CampusGANDR (Gamified Alcohol Norm Discovery and Readjustment). In both study conditions participants answered identical questions about their perceptions of peer drinking norms and own drinking and then received the same PNF slides. Two weeks following PNF delivery, participants again reported their perceptions of peers' alcohol use and own drinking. Students in the CampusGANDR condition reported significantly reduced peer drinking norms and alcohol use at the two-week follow-up relative to students who received identical PNF delivered by standard online survey. Further, a mediation model demonstrated that this effect was driven by larger reductions in perceived drinking norms among participants assigned to receive CampusGANDR, relative to control. As web-based PNF is becoming an increasingly universal prevention strategy, findings from this study suggest gamification may represent one method by which intervention efficacy could be substantially improved. The potential methodological and economic benefits associated with gamified PNF interventions are emphasized and directions for future research are discussed.

Examining the Role of Source Credibility and Reference Group Proximity on Personalized Normative Feedback Interventions for College Student Alcohol Use: A Randomized Laboratory Experiment

ABSTRACTBackground: Personalized normative feedback (PNF) interventions are designed to reduce misperceived drinking norms by delivering feedback regarding the actual drinking behavior of college students, thereby leading to subsequent reductions in one's own drinking. Objective: We examined the roles of data source credibility and reference group proximity in the effectiveness of a laboratory-based PNF intervention to reduce perceived drinking norms and thereby decrease intentions to drink. Method: Following completion of an online preintervention survey and using a 2 (highly credible data source/low credible data source) × 2 (proximal reference group/distal reference group) between-subjects factorial design, 104 college student drinkers were randomly assigned to condition. Participants then completed a postintervention questionnaire to assess for changes in various aspects of drinking. Results: Highly credible feedback was associated with greater reductions in perceived weekly drinking by American college students compared to feedback with low credibility. Similarly, more proximal than distal reference group feedback led to greater reductions in perceived weekly drinking by a same-gender/same-class year students at one's university. No condition effects emerged for intended drinks per week. Conclusions: PNF interventions may benefit from considering data source credibility and reference group proximity to reduce misperceptions of college student drinking, depending on the goals and resources of practitioners implementing such programs. Even the use of such a distal reference group as American college students can indeed lead to a reduction of normative perceptions provided there is an emphasis on the credibility of the data source.

Do As I Say, Not As I Do.

Little is known about the drinking behaviors and perceptions of the peers facilitating campus alcohol interventions. The current study examined these trajectories in peer counselors ( N = 12) providing personalized normative feedback interventions to undergraduates mandated to clinical services. Peer counselors completed four monthly self-assessments. In spite of facilitating interventions to reduce drinking and associated harms, peer drinking behaviors and expectancies did not change, although significant between subjects effects suggest various trajectories. Peer counselors did correct overestimates of binge drinking but progressively underestimated abstinence norms. Despite the lack of change in the peer counselor behaviors, the mandated clients significantly reduced their drinking, suggesting it may be more important to "Do as I Say" rather than as the facilitator does.

Study protocol for a web-based personalized normative feedback alcohol intervention for young adult veterans.

Background Young adult veterans from the wars in Iraq and Afghanistan represent a population at-risk for heavy and problematic alcohol use. Unfortunately, few seek treatment for alcohol concerns and those that do seek care may drop out from lengthy multicomponent treatments. Additionally, veterans who live in rural areas and those who are not engaged in the Veterans Affairs Healthcare System are often overlooked, difficult to engage in treatment, and may not be actively seeking treatment for heavy patterns of use that may develop into an alcohol use disorder. The objective of this proposed randomized controlled trial is to develop and pilot test a brief, stand-alone Internet-based alcohol intervention with young adult veterans to help them reduce their drinking and prevent the development of problematic alcohol use.Methods/designRecruitment and intervention is delivered entirely over the Internet to address barriers to seeking care among this at-risk group. The online intervention consists of an assessment followed by a single module of personalized normative feedback (PNF), which provides individuals with accurate information to reduce misperceptions regarding the frequency and acceptability of risky peer behavior. PNF has established efficacy as included within multicomponent interventions targeting military populations or as a stand-alone intervention with young adult college students, but has not yet been empirically supported for the at-risk veteran population. This paper describes the development of the PNF intervention content and details the protocol for the intervention study, which will utilize a sample of 600 young adult veterans to examine the efficacy of the brief PNF intervention targeted toward reducing perceived norms, intentions to drink, actual drinking behavior, and consequences. Specific subpopulations of this veteran population, including those with mental health concerns and those differentiated by level of drinking problems, reasons for drinking, and connection to peers, will be examined to support generalizability of the intervention.DiscussionThis intervention has the potential to improve veteran health care by utilizing a novel approach to increase access to care, assist with drinking reductions, and prevent alcohol-related problems.Trial registration ClinicalTrials.gov Identifier NCT02187887

Coping Motives Moderate Efficacy of Personalized Normative Feedback Among Heavy Drinking U.S. College Students.

Personalized normative feedback (PNF) interventions have received empirical support, are presumed to work by reducing normative misperceptions, and have been found to be particularly efficacious for those who drink for social reasons. However, PNF interventions also offer direct comparisons between one's own drinking and normative drinking, which may be especially important for coping drinkers. The present research evaluated whether reduced perceived norms and drinking at follow-ups varied as a function of coping motives. Aims were examined as a secondary analysis of a PNF intervention study among 252 U.S. college students. Following baseline assessment, participants were randomly assigned to receive PNF or assessment only. Follow-up assessments occurred 3 and 6 months after baseline. Findings indicated that the PNF intervention was more effective at both follow-ups in reducing drinking, but not alcohol use problems, for participants scoring higher in coping motives. Furthermore, coping motives were the only drinking motive that uniquely moderated PNF efficacy. Analyses indicated that intervention effects on drinking varied as a function of coping drinking motives; however, intervention effects on norms did not vary by coping motives. Finally, coping motives were found to moderate associations between perceived norms and drinking. These results suggest that coping motives may be useful for identifying young adults-and presumably others-who can most benefit from PNF approaches. Furthermore, PNF may influence future drinking behavior through mechanisms other than changes in perceived norms. Future investigations could examine other pathways through which PNF may reduce drinking.

Stand-Alone Personalized Normative Feedback for College Student Drinkers: A Meta-Analytic Review, 2004 to 2014.

BackgroundNorms clarification has been identified as an effective component of college student drinking interventions, prompting research on norms clarification as a single-component intervention known as Personalized Normative Feedback (PNF). Previous reviews have examined PNF in combination with other components but not as a stand-alone intervention.ObjectivesTo investigate the degree to which computer-delivered stand-alone personalized normative feedback interventions reduce alcohol consumption and alcohol-related harms among college students and to compare gender-neutral and gender-specific PNF.Data SourcesElectronic databases were searched systematically through November 2014. Reference lists were reviewed manually and forward and backward searches were conducted.Selection CriteriaOutcome studies that compared computer-delivered, stand-alone PNF intervention with an assessment only, attention-matched, or active treatment control and reported alcohol use and harms among college students.MethodsBetween-group effect sizes were calculated as the standardized mean difference in change scores between treatment and control groups divided by pooled standard deviation. Within-group effect sizes were calculated as the raw mean difference between baseline and follow-up divided by pooled within-groups standard deviation.ResultsEight studies (13 interventions) with a total of 2,050 participants were included. Compared to control participants, students who received gender-neutral (d between = 0.291, 95% CI [0.159, 0.423]) and gender-specific PNF (d between = 0.284, 95% CI [0.117, 0.451]) reported greater reductions in drinking from baseline to follow-up. Students who received gender-neutral PNF reported 3.027 (95% CI [2.171, 3.882]) fewer drinks per week at first follow-up and gender-specific PNF reported 3.089 (95% CI [0.992, 5.186]) fewer drinks. Intervention effects were small for harms (d between = 0.157, 95% CI [0.037, 0.278]).ConclusionsComputer-delivered PNF is an effective stand-alone approach for reducing college student drinking and has a small impact on alcohol-related harms. Effects are small but clinically relevant when considered from a public health perspective. Additional research is needed to examine computer-delivered, stand-alone PNF as a population-level prevention program.

Remote versus in-lab computer-delivered personalized normative feedback interventions for college student drinking.

Computer-based interventions aimed at reducing college student drinking have shown positive effects. The authors compare differences in effects of computer-based personalized normative feedback (PNF) interventions based on delivery modality (in-person vs. remotely) across six previously evaluated studies with similar content. Three studies included evaluations of a computer-based PNF intervention in which baseline and intervention procedures took place inside a laboratory setting; three separate studies included evaluations of the same intervention in which participants completed the procedures remotely over the Web. Thus, we tested for differences in intervention efficacy by delivery modality. Outcomes included drinks per week, drinking-related consequences, and the putative intervention mechanism, perceived drinking norms. Evidence from hierarchical linear models indicated that computer-based interventions are less effective at reducing drinking and related consequences when delivered remotely than when delivered in person. The advantages of interventions delivered remotely are not without cost. Suggestions for why remote computer-based interventions may be less effective are discussed.