Reduce College Student Drinking Research Articles

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).

Deeply Tailored Adaptive Interventions to Reduce College Student Drinking: a Real-World Application of Q-Learning for SMART Studies.

M-bridge was a sequential multiple assignment randomized trial (SMART) that aimed to develop a resource-efficient adaptive preventive intervention (API) to reduce binge drinking in first-year college students. The main results of M-bridge suggested no difference, on average, in binge drinking between students randomized to APIs versus assessment-only control, but certain elements of the API were beneficial for at-risk subgroups. This paper extends the main results of M-bridge through an exploratory analysis using Q-learning, a novel algorithm from the computer science literature. Specifically, wesought to further tailorthe two aspects of the M-bridge APIs to an individual and test whether deep tailoring offers a benefit over assessment-only control. Q-learning is a method to estimate decision rules that assign optimal treatment(i.e., to minimize binge drinking) based on student characteristics. For the first aspect of the M-bridge API (when to offer), we identified the optimal tailoring characteristic post hoc from a set of 20 candidate variables. For the second (how to bridge), we used a known effect modifier from the trial. The results of our analysis are two rules that optimize (1) the timing of universal intervention for each student based on their motives for drinking and (2) the bridging strategy to indicated interventions (i.e., among those who continue to drink heavily mid-semester) based on mid-semester binge drinking frequency.We estimate that this newly tailored API, if offered to all first-year students, would reduce binge drinking by 1 occasion per 2.5 months (95% CI: decrease of 1.45 to 0.28 occasions, p < 0.01) on average. Our analyses demonstrate a real-world implementation of Q-learning for a substantive purpose, and, if replicable in future trials, our results have practical implications for college campuses aiming to reduce student binge drinking.

Correcting exaggerated drinking norms with a mobile message delivery system: Selective prevention with heavy-drinking first-year college students.

Many efficacious interventions designed to reduce college student drinking aim to correct misperceptions of peers' drinking behavior. The present study tested the efficacy of a novel delivery strategy, namely text messages, for promoting promoderation descriptive and injunctive drinking norms. Participants included 121 college students who were randomly assigned to receive daily text messages containing accurate drinking norms (experimental group, n = 61) or historical facts (control group, n = 60) for 10 weeks following a baseline assessment. Participants completed 3-month postbaseline and 6-month postbaseline follow-up assessments. The 3-month assessment revealed that promoderation text messages were effective for reducing peak consumption and alcohol consequences. Changes in descriptive norms and injunctive norms aligned with these two behavioral outcomes. The intervention group reported perceiving others as drinking less on their heaviest drinking day and perceived others as being less approving of alcohol-related consequences than the control group. The intervention group also reported more peer approval of using protective behavioral strategies. Yet intervention effects were not maintained. None of the outcome measures differed by condition at the 6-month postbaseline assessment. Thus, the intervention had short-term effects on self-reported drinking behavior as well as on perceptions of drinking norms. However, the behavioral changes were not maintained when participants were assessed in the second semester after the daily text messages intervention had stopped. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

A Daily-Level Analysis of Moderators of the Association between Alcohol Expectancies and Alcohol Use among College Student Drinkers

Background: Alcohol expectancies, or the perceived likelihood of experiencing certain effects after consuming alcohol, are associated with college student drinking such that heavier drinkers expect a greater likelihood of positive effects. However, less is known as to whether day-to-day within-person deviations in expectancies are associated with drinking that same day and for whom and when these associations may be strongest. Objectives: The aim of this study was to examine daily-level associations of positive and negative alcohol expectancies with alcohol use, and whether associations differed according to demographic characteristics and additional alcohol-related constructs. Methods: College student drinkers (N = 327, 53.8% female) participated in an intensive longitudinal study that captured daily-level data. Alcohol use and expectancy measures were utilized from a baseline session and at the daily-level using Interactive Voice Response (IVR). Results: Results found that on days when participants reported stronger positive and negative expectancies than their average, they were more likely to drink as well as consume more alcohol when drinking. Moderation analyses revealed that positive expectancies were more positively associated with the likelihood of any drinking for women relative to men, and more positively associated with the quantity of alcohol consumption for younger students, students with lower baseline rates of drinking, and students with greater overall positive alcohol expectancies. Conclusions/Importance: The findings demonstrate that alcohol expectancies fluctuate within-person across days and these fluctuations are meaningful in predicting same-day drinking. Interventions that seek to modify expectancies proximal to drinking events may be considered to reduce college student drinking.

Parent Intervention to Reduce College Student Drinking and Consequences

Parent Intervention to Reduce College Student Drinking and Consequences

Evaluative conditioning: A brief computer-delivered intervention to reduce college student drinking

BackgroundRecent research suggests that a brief computer-delivered intervention based on evaluative conditioning (EC) can change the implicit evaluation of alcohol and reduce drinking behaviors among college students. We tested whether we could obtain similar findings in a high-powered preregistered study and whether hazardous drinking moderates these effects. MethodBefore the intervention, 122 French college students were screened for hazardous drinking using the Alcohol Use Disorder Identification Test (AUDIT). Implicit evaluation of alcohol was assessed before and immediately after the intervention using an Implicit Association Test (IAT). Drinking behavior was assessed before the intervention and approximately two weeks after using the TimeLine Follow Back (TLFB) method. The EC consisted of 120 trials of words (related to alcoholic beverages, soft drinks or neutral) paired with pictures (neutral, positive or negative). In the EC condition, alcohol-related words were systematically paired with negative pictures. In the control condition, alcohol-related words were systematically paired with neutral pictures. ResultsThe EC did not change the implicit evaluation of alcohol, Cohen's d = 0.01, 95CI [−0.35, 0.35]. However, the EC reduced drinking behavior, Cohen's d = 0.37, 95CI [0.01, 0.72]. This effect was independent of hazardous drinking behavior, but it was especially pronounced among participants with the most positive implicit evaluation of alcohol before the intervention. ConclusionThis preregistered study suggests that evaluative conditioning can successfully reduce drinking behavior among college students by 31% (compared to 4% in the control condition) without causing an immediate change in the implicit evaluation of alcohol.

Integrating Self-Affirmation and Implementation Intentions: Effects on College Student Drinking.

High levels of alcohol consumption are an enduring health risk among college students. Integrating multiple, complementary behavior change theories may offer a promising approach to promote reductions in alcohol consumption. The current study tested if integrating self-affirmation and implementation intentions would be more effective than a self-affirmation only, implementation intentions only, or control condition at reducing alcohol consumption in college students over a 2-week period. Two hundred and ninety-three college students who reported drinking in the past month were randomly assigned to a condition in a 2 (self-affirmation: values vs. control writing task) × 2 (implementation intentions: formed vs. not formed) between-subjects factorial design. Participants first completed a self-affirmation or control writing task, then read an article describing the risks of drinking. Next, all participants reported their common drinking behaviors and contexts, and then selected two harm-reduction strategies forming (or not forming) implementation intentions to use the strategies. Alcohol consumption was measured 1 and 2 weeks after the experiment. Participants in the integrated self-affirmation and implementation intention condition were most likely to abstain from drinking 1 week later. Affirmed participants continued to be more likely to abstain from drinking 2 weeks later. The findings support the efficacy of integrating self-affirmation and implementation intentions to reduce college student drinking (ClinicalTrials.gov number NCT02926794).

Delivering normative feedback to heavy drinking college students via text messaging: A pilot feasibility study

Correcting misperceptions in drinking norms is an established method of reducing college student drinking; however, delivery of accurate norms has typically been limited to a single dose within the confines of an alcohol intervention. The present study tests the feasibility, acceptability, and preliminary efficacy of using text messages to promote pro-moderation descriptive and injunctive norms. Following a baseline survey, 68 heavy drinking college students were randomly assigned to receive 28 daily messages with either accurate norms information (experimental group, n=34) or fun facts (control group, n=34). Participants rated each message on a 5-point scale of interest, and at the end of the 28days completed a follow-up assessment of normative perceptions and drinking behavior. The study protocol was feasible: 87% of invited students completed the screener, 64% of eligible students completed the consent form, and 93% agreed to participate. All messages were delivered and 98% were rated. Regarding acceptability, the mean interest rating for the alcohol-related text messages was 2.84 (SD=1.30), and no participants withdrew from the study. Although between-group differences were not observed at follow-up, participants in the experimental group showed significant reductions between baseline and follow-up on peak drinks, frequency of heavy episodic drinking (HED), negative consequences, and injunctive norms (ps<0.01). Results lay the groundwork for development of a text-based prevention strategy for use in college settings.

Prototypes of drinkers and accessibility of injunctive norms predict college drinking.

A self-report survey of first-year college students ( n = 421; 46% female) included measures of perceived prototype, attitude and injunctive norm accessibility, past drinking behavior, and future drinking intention. Both norm accessibility and prototype perception were significant predictors of intention to drink in the future among first-year college students. The effect of prototypes on drinking diminished as pro-drinking norms became more accessible, indicating greater automaticity of drinking decision-making. Theoretical models of drinking intention should include both normative constructs and prototypes. Implications for interventions to reduce college student drinking are discussed.

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.

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.

Qualitatively Assessing the Experiences of College Students Completing AlcoholEdu: Do Participants Report Altering Behavior After Intervention?

To reduce college student drinking and associated alcohol-related consequences, many universities are turning to e-interventions, such as AlcoholEdu. To date, however, results of evaluations examining the impact of AlcoholEdu are mixed. Among these evaluations, few qualitative assessments have examined the experiences and perceptions of students who complete AlcoholEdu. This investigation aimed to assess whether students (a) find the program educational and engaging, (b) implemented specific strategies learned from participation, and (c) self-report altering their behavior as a result of participation. Even though respondents universally reported an increase in alcohol-related knowledge, there was an evident disconnect between this knowledge and their actual behavior. In other words, respondents reported that they did not implement what was taught in AlcoholEdu. Moreover, students highlighted several limitations associated with the program that would have influenced its overall impact, such as ignoring video segments of the program and clicking through assessments simply to complete the task. If used, college administrators and health professionals should implement e-interventions such as AlcoholEdu as one component of a multifaceted approach rather than a panacea for the current high-risk drinking practices of college students.

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.

Optimizing Timing and Dosage: Does Parent Type Moderate the Effects of Variations of a Parent-Based Intervention to Reduce College Student Drinking?

Research on parent-based interventions (PBIs) to reduce college student drinking has explored the optimal timing of delivery and dosage. The present study extended this work by examining the effectiveness of three different PBI conditions on student drinking outcomes as a function of parenting types and students' pre-college drinking patterns. Four hypotheses were evaluated (early intervention, increased dosage, invariant, and treatment matching risk). A random sample of 1,900 college students and their parents was randomized to four conditions: (1) pre-college matriculation, (2) pre-college matriculation plus booster, (3) post-college matriculation, or (4) control, and was assessed at baseline (summer prior to college) and 5-month follow-up. Baseline parent type was assessed using latent profile analysis (positive, pro-alcohol, positive, anti-alcohol, negative mother, and negative father). Student drinking patterns were classified at baseline and follow-up and included: non-drinker, weekend light drinker, weekend heavy episodic drinker, and heavy drinker. Consistent with the treatment matching risk hypothesis, results indicated parent type moderated the effects of intervention condition such that receiving the intervention prior to college was associated with lower likelihood of being in a higher-risk drinking pattern at follow-up for students with positive, anti-alcohol, or negative father parent types. The findings are discussed with respect to optimal delivery and dosage of parent-based interventions for college student drinking.

A randomized trial evaluating a parent based intervention to reduce college drinking

This study evaluated the effectiveness of a parent based intervention (PBI) in reducing drinking among first year college students (N=443). Students were assigned to one of three conditions: PBI, PBI plus booster brochures (PBI-B), and an assessment only control group (CNT). At a 4-month post-intervention follow-up, results indicated students in the PBI-B group reported significantly less drinking to intoxication and peak drinking relative to the PBI group and CNT group. No significant differences were found between the PBI group and CNT group. Results provide further support for PBIs to reduce college student drinking and suggest that a booster brochure increases the effectiveness of PBIs.

Efficacy of expectancy challenge interventions to reduce college student drinking: a meta-analytic review.

Interventions challenging alcohol expectancies may lead to reductions in alcohol consumption. We conducted a meta-analysis to examine the efficacy of alcohol expectancy challenge (EC) interventions for college alcohol abuse prevention. Included were 14 studies (19 EC interventions) that measured alcohol expectancies and consumption, provided sufficient information to calculate effect sizes, and were available as of June 2010 (N=1,415; M age=20 years; 40% women; 88% White). Independent raters coded participant characteristics, design and methodological features, and intervention content, and calculated weighted mean effect sizes at first follow-up, using both fixed and random effects models. Compared with controls, EC participants reported lower positive alcohol expectancies, reduced their alcohol use, and reduced their frequency of heavy drinking (d+s ranged from 0.23 to 0.28). Within-group improvements in alcohol expectancies and consumption emerged for the EC group only; relative to their own baseline, EC participants reported lower positive alcohol expectancies, reduced their alcohol use, and reduced their frequency of heavy drinking (d+s ranged from 0.13 to 0.36). Supplemental analyses found improvements in specific alcohol expectancies (social, sexual, tension, and arousal) both between groups and within group. The short-term effects of EC interventions on college student drinking are not maintained at follow-ups greater than 4 weeks.

A randomized trial of a brief intervention for obesity in college students.

• Brief motivational interventions have been found to be efficacious for obesity in older adult populations. • Brief motivational interventions including delivery of personalized feedback have been found to be efficacious for reducing college student drinking. • First study to test the efficacy of a one-session, brief motivational intervention for obesity among college students. • One session brief motivational interventions may have an impact on the reduction of calorie-dense foods and beverages. • A brief, one-session motivational interview with personalized feedback may not be an intensive enough intervention for obesity treatment among college students. Young adults are at an increased risk for weight gain as they begin college and this has implications for the onset of future health consequences. Brief motivational interventions (BMIs) have been found to be effective with college students for reducing risky health behaviours such as alcohol consumption, but have not been developed and tested with a primary goal of reducing obesity. BMIs have been developed and tested for the treatment of obesity and weight-related health behaviours (WRHB) in other populations, such as adults and adolescents, with promising results. The purpose of the following study was to develop and test the efficacy of a BMI for weight loss among overweight and obese college students. Seventy undergraduate students (85.7% female, 57.1% African-American) completed an assessment about WRHBs and then were randomized to either receive a single 60-min BMI plus a booster phone call or to assessment only. At 3 months post-intervention, effect sizes within the intervention group were twice as large as within the assessment-only group on reductions in high-calorie foods and beverages. However, there were no statistically significant differences between groups on body mass index or WRHBs. The one-session nature of the session might not have been enough to produce significant change in weight.

Alcohol Prevention on College Campuses: The Moderating Effect of the Alcohol Environment on the Effectiveness of Social Norms Marketing Campaigns

Evaluations of social norms marketing campaigns to reduce college student drinking have produced conflicting results. This study examines whether the effectiveness of such campaigns may be moderated by on-premise alcohol outlet density in the surrounding community. Multilevel analyses were conducted of student survey responses (N= 19,838) from 32 U.S. colleges that took part in one of two 4-year randomized, controlled trials completed for the Social Norms Marketing Research Project (SNMRP). In the models, students by year were nested within treatment (n = 16) and control group (n = 16) campuses, which were characterized by the on-premise outlet density in their surrounding community. The moderating effect of outlet density was introduced into the models as an interaction between the treatment effect (i.e., the effect of the social norms marketing campaigns over time) and outlet density. The models were also stratified by campus alcohol outlet density (high vs. low) to examine the effect of the intervention in each type of setting. There was a significant interaction between the treatment effect and on-premise alcohol outlet density for one of the drinking outcomes targeted by the SNMRP intervention, the number of drinks when partying, and marginal evidence of interaction effects for two other outcomes, maximum recent consumption and a composite drinking scale. In stratified analyses, an intervention effect was observed for three of the four outcomes among students from campuses with lower on-premise alcohol outlet density, whereas no intervention effect was observed among students from campuses with higher on-premise alcohol outlet density. The findings suggest that the campus alcohol environment moderates the effect of social norms marketing interventions. Social norms marketing intervention may be less effective on campuses with higher densities of on-sale alcohol outlets.

Efficacy of a Web-Based, Tailored, Alcohol Prevention/Intervention Program for College Students: Initial Findings

Objective: Reduce college student at-risk drinking (ARD) using a Web-based brief motivational alcohol prevention/intervention called Michigan Prevention and Alcohol Safety for Students (M-PASS). Participants: Participants included 1,137 randomly sampled first-year college students, including 59% female, 80% white, and averaged age 18.1 years. Methods: Intervention group participants (n = 616) attended 4 online M-PASS sessions, receiving feedback tailored to individual drinking patterns and concepts from 4 behavior change theories. Control group participants (n = 521) completed a mid-phase survey, and both groups were surveyed at baseline and posttest. Results: Evidence of M-PASS's efficacy was found. The intervention was associated with advanced stage of change, lower tolerance of drinking and drink/driving, fewer reasons to drink, and use of more strategies to avoid ARD. Preliminary evidence of behavioral change was also found. Efficacy was greater for women than men. Conclusions: Web-based programs may be useful in reducing alcohol-related risk among college students. Further evaluation is needed.

Computer-delivered interventions to reduce college student drinking: a meta-analysis.

This meta-analysis evaluates the efficacy of computer-delivered interventions (CDIs) to reduce alcohol use among college students. We included 35 manuscripts with 43 separate interventions, and calculated both between-group and within-group effect sizes for alcohol consumption and alcohol-related problems. Effects sizes were calculated for short-term (< or =5 weeks) and long-term (> or =6 weeks) intervals. All studies were coded for study descriptors, participant characteristics and intervention components. The effects of CDIs depended on the nature of the comparison condition: CDIs reduced quantity and frequency measures relative to assessment-only controls, but rarely differed from comparison conditions that included alcohol-relevant content. Small-to-medium within-group effect sizes can be expected for CDIs at short- and long-term follow-ups; these changes are less than or equivalent to the within-group effect sizes observed for more intensive interventions. CDIs reduce the quantity and frequency of drinking among college students. CDIs are generally equivalent to alternative alcohol-related comparison interventions.