? All interventions
| Kate Carey, Michael Carey, Stephen Maisto, James Henson|
Journal of consulting and clinical psychology [74:943-54] (2006)
In this randomized controlled trial, the authors evaluated brief motivational interventions (BMIs) for at-risk college drinkers. Heavy drinking students (N = 509; 65% women, 35% men) were randomized into 1 of 6 intervention conditions formed by crossing the baseline Timeline Followback (TLFB) interview (present versus absent) and intervention type (basic BMI, BMI enhanced with a decisional balance module, or none). Assessments completed at baseline, 1, 6, and 12 months measured typical and risky drinking as well as drinking-related problems. Relative to controls, the TLFB interview reduced consumption but not problems at 1 month. The basic BMI improved all drinking outcomes beyond the effects of the TLFB interview at 1 month, whereas the enhanced BMI did not. Risk reduction achieved by brief interventions maintained throughout the follow-up year.
| Nancy Barnett, James Murphy, Suzanne Colby, Peter Monti|
Addictive behaviors [32:2529-48] (2007)
The purpose of this study was to evaluate the efficacy of two brief interventions and the inclusion of a 1-month booster session with college students who were referred to attend alcohol education following an alcohol-related incident. Participants (N=225; 48.9% male) were randomly assigned to receive one session of a Brief Motivational Interview (BMI) or computer-delivered intervention (CDI) with the Alcohol 101 CD-ROM. Participants were also randomly assigned to booster/no booster. At 3-month follow up, participants in BMI reported greater help seeking and use of behavioral strategies to moderate drinking. At 12-month follow up, BMI participants were drinking more frequently and CDI participants were consuming a greater number of drinks per occasion than at baseline. Mediation analyses showed that the use of specific behavioral strategies mediated the effect of the BMI condition on drinking volume. There was no intervention effect on alcohol problems, and the booster condition did not significantly affect outcomes. Promoting specific behaviors in the context of in-person brief interventions may be a promising approach to reducing drinking volume among identified at-risk students.
| Diana Doumas, Camille Workman, Diana Smith, Anabel Navarro|
Journal of substance abuse treatment [40:376-85] (2011)
This study evaluated the efficacy of two brief personalized normative feedback interventions aimed at reducing heavy drinking among mandated college students (N = 135). Students were randomly assigned to one of two conditions: Web-based assessment with self-guided personalized normative feedback (SWF) or Web-based assessment with counselor-guided personalized normative feedback (CWF). Results indicated that students in the CWF condition reported significantly greater reductions in weekly drinking quantity and binge drinking frequency than those in the SWF group at follow-up (M = 8 months). Students in the CWF group also reported significantly greater reductions in estimates of peer drinking from baseline to the follow-up assessment than students in the SWF group. In addition, changes in estimates of peer drinking partially mediated the effect of the intervention on changes in drinking. Results suggest that counselor-guided feedback may be more effective in reducing drinking among mandated students relative to self-guided feedback in the long term.
| M Dolores Cimini, Matthew Martens, Mary Larimer, Jason Kilmer, Clayton Neighbors, Joseph Monserrat|
Journal of studies on alcohol and drugs. Supplement (2009)
This study examined the effectiveness of three peer-facilitated brief alcohol interventions-small group motivational interviewing, motivationally enhanced peer theater, and an interactive alcohol-education program-with students engaging in high-risk drinking who were referred for alcohol policy violations.
Undergraduate students referred for alcohol policy violations (N = 695) at a large northeastern public university were randomized to one of the three conditions. Six-month follow-up data were collected on drinking frequency and quantity, negative consequences, use of protective behaviors, and perceptions of peers' drinking norms.
There were no statistically significant overall pre-post effects or treatment effects. However, exploratory analyses indicated that decreases in perceived norms and increases in use of protective behavioral strategies were associated with reductions in alcohol use and alcohol-related problems at follow-up (p < .01).
The presence of nonsignificant pre-post or main effects is, in part, consistent with recent research indicating that sanctioned college students may immediately reduce drinking in response to citation and that brief interventions may not contribute to additional behavioral change. The presence of statistically significant correlations between alcohol use and related problems with corrections in norms misperceptions and increased use of protective behaviors at the individual level holds promise for both research and practice. The integration of elements addressing social norms and use of protective behaviors within brief cognitive-behavioral intervention protocols delivered by trained peer facilitators warrants further study using randomized clinical trials.
| Clayton Neighbors, Christine Lee, Melissa Lewis, Nicole Fossos, Theresa Walter|
Journal of consulting and clinical psychology [77:51-63] (2009)
This article presents an initial randomized controlled trial of an event-specific prevention intervention. Participants included 295 college students (41.69% male, 58.31% female) who intended to consume 2 or more drinks on their 21st birthday. Participants completed a screening/baseline assessment approximately 1 week before they turned 21 and were randomly assigned to receive Web-based personalized feedback or assessment only. Feedback included normative information, protective behaviors, and personalized blood alcohol concentration information. A follow-up assessment was completed approximately 1 week after a student's birthday. Results indicated a significant intervention effect in reducing estimated blood alcohol concentration (d = 0.33). The intervention effect was moderated by 21st-birthday drinking intentions, and the intervention was primarily effective among those who intended to reach higher levels of intoxication. Results provide some support for normative information as a mediator of intervention efficacy. Overall results provide support for Web-based personalized feedback as an intervention approach for specific events associated with extreme drinking.
| Clayton Neighbors, Christine Lee, David Atkins, Melissa Lewis, Debra Kaysen, Angela Mittmann, Nicole Fossos, Irene Geisner, Cheng Zheng, Mary Larimer|
Journal of consulting and clinical psychology [80:850-62] (2012)
While research has documented heavy drinking practices and associated negative consequences of college students turning 21, few studies have examined prevention efforts aimed at reducing high-risk drinking during 21st birthday celebrations. The present study evaluated the comparative efficacy of a general prevention effort (i.e., Brief Alcohol Screening and Intervention for College Students, or BASICS) and event-specific prevention in reducing 21st birthday drinking and related negative consequences. Furthermore, this study evaluated inclusion of peers in interventions and mode of intervention delivery (i.e., in-person vs. via the Web).
Participants included 599 college students (46% male): men who intended to consume at least 5 drinks and women who intended to consume at least 4 drinks on their 21st birthday. After completing a screening/baseline assessment approximately 1 week before turning 21, participants were randomly assigned to 1 of 6 conditions: 21st birthday in-person BASICS, 21st birthday web BASICS, 21st birthday in-person BASICS plus friend intervention, 21st birthday web BASICS plus friend intervention, BASICS, or an attention control. A follow-up assessment was completed approximately 1 week after students' birthdays.
Results indicated a significant intervention effect for BASICS in reducing blood alcohol content reached and number of negative consequences experienced. All 3 in-person interventions reduced negative consequences experienced. Results for the web-based interventions varied by drinking outcome and whether a friend was included.
Overall, results provide support for both general intervention and ESP approaches across modalities for reducing extreme drinking and negative consequences associated with turning 21. These results suggest there are several promising options for campuses seeking to reduce both use and negative consequences associated with 21st birthday celebrations.
| Kate Carey, James Henson, Michael Carey, Stephen Maisto|
Clinical psychology : a publication of the Division of Clinical Psychology of the American Psychological Association [17:58-71] (2010)
The present study is a secondary analysis of a randomized trial of brief motivational interventions (BMIs) for 198 college students sanctioned for alcohol-related violations of school policy (Carey, Henson, Carey, & Maisto, 2009). Using multivariate latent growth curve models, we evaluated theoretically-derived mediators of the observed BMI effect: motivation to change (readiness-to-change, costs and benefits of drinking), and drinking norms (injunctive norms for peers, and descriptive norms for friends, local peers, and national peers). Results provided partial support for mediation by changes in perceptions of descriptive but not injunctive norms, a pattern that varied by gender and norm type. We found no evidence of a mediating role for any of the motivational variables.
| Melissa Lewis, Clayton Neighbors|
Journal of studies on alcohol and drugs [68:228-37] (2007)
Many brief interventions include personalized normative feedback (PNF) using gender-specific or gender-neutral referents. Several theories suggest that information pertaining to more socially proximal referents should have greater influence on one's behavior compared with more socially distal referents. The current research evaluated whether gender specificity of the normative referent employed in PNF related to intervention efficacy.
Following baseline assessment, 185 college students (45.2% women) were randomly assigned to one of three intervention conditions: gender-specific feedback, gender-neutral feedback, or assessment-only control. Immediately after completing measures of perceived norms, alcohol consumption, and gender identity, participants in the gender-neutral and gender-specific intervention conditions were provided with computerized information detailing their own drinking behavior, their perceptions of student drinking, and actual student drinking.
After a 1-month follow-up, the results indicated that normative feedback was effective in changing perceived norms and reducing alcohol consumption for both intervention groups for women and men. The results provide support, however, for changes in perceived gender-specific norms as a mediator of the effects of normative feedback on reduced drinking behavior for women only. Additionally, gender-specific feedback was found to be more effective for women higher in gender identity, relative to the gender-neutral feedback. A post-assessment follow-up telephone survey administered to assess potential demand characteristics corroborated the intervention effects.
Results extend previous research documenting efficacy of computer delivered PNF. Gender specificity and gender identity appear to be important elements to consider for PNF intervention efficacy for women.
| Melina Bersamin, Mallie Paschall, Melodie Fearnow-Kenney, David Wyrick|
Journal of American college health : J of ACH [55:247-54] ()
In the current study, the authors assessed whether a new online alcohol-misuse prevention course (College Alc) is more effective at reducing alcohol use and related consequences among drinkers and nondrinkers.
The authors compared incoming college freshmen who reported any past 30-day alcohol use before the beginning of the semester with those who did not.
The authors randomly assigned students who completed a precollege baseline survey to either complete a 3-hour noncredit version of College Alc or serve as members of a control group. The authors conducted a follow-up survey 3 months later.
Findings indicated that among freshmen who were regular drinkers before college, College Alc appeared to reduce the frequency of heavy drinking, drunkenness, and negative alcohol-related consequences. Among freshmen who did not report any past-30-day alcohol use before college, College Alc did not appear to have any beneficial effects.
Results suggest that College Alc may be an effective program for students with a history of alcohol use.
| Andrew Prestwich, Ian Kellar, Mark Conner, Rebecca Lawton, Peter Gardner, Liz Turgut|
Journal of consulting and clinical psychology [84:845-60] (2016)
Past research has suggested that social influences on drinking can be manipulated with subsequent reductions in alcohol intake. However, the experimental evidence for this and the best strategies to positively change these social influences have not been meta-analyzed. This research addressed these gaps.
Randomized controlled trials testing social influence-based interventions on adults' drinking were systematically reviewed and meta-analyzed. The behavior change techniques used in each study were coded and the effect sizes showing the impact of each intervention on (a) social influence and (b) alcohol intake were calculated. Metaregressions identified the association between these effect sizes, as well as the effect of specific behavior change techniques on social influences.
Forty-one studies comprising 17,445 participants were included. Changes in social influences were significantly associated with changes in alcohol intake. However, even moderate-to-large changes in social influences corresponded with only a small change in drinking behavior and changing social influences did not reduce alcohol-related problems. Providing normative information about others' behavior and experiences was the most effective technique to change social influences.
Social influences and normative beliefs can be changed in drinkers, particularly by providing normative information about how much others' drink. However, even generating large changes in these constructs are likely to engender only small changes in alcohol intake. (PsycINFO Database Record
| James Murphy, Ashley Dennhardt, Jessica Skidmore, Matthew Martens, Meghan McDevitt-Murphy|
Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors [24:628-39] (2010)
The authors conducted two randomized clinical trials with ethnically diverse samples of college student drinkers in order to determine (a) the relative efficacy of two popular computerized interventions versus a more comprehensive motivational interview approach (BASICS) and (b) the mechanisms of change associated with these interventions. In Study 1, heavy drinking participants recruited from a student health center (N = 74, 59% women, 23% African American) were randomly assigned to receive BASICS or the Alcohol 101 CD-ROM program. BASICS was associated with greater post-session motivation to change and self-ideal and normative discrepancy relative to Alcohol 101, but there were no group differences in the primary drinking outcomes at 1-month follow-up. Pre to post session increases in motivation predicted lower follow-up drinking across both conditions. In Study 2, heavy drinking freshman recruited from a core university course (N = 133, 50% women, 30% African American) were randomly assigned to BASICS, a web-based feedback program (e-CHUG), or assessment-only. BASICS was associated with greater post-session self-ideal discrepancy than e-CHUG, but there were no differences in motivation or normative discrepancy. There was a significant treatment effect on typical weekly and heavy drinking, with participants in BASICS reporting significantly lower follow-up drinking relative to assessment only participants. In Study 2, change in the motivation or discrepancy did not predict drinking outcomes. Across both studies, African American students assigned to BASICS reported medium effect size reductions in drinking whereas African American students assigned to Alcohol 101, e-CHUG, or assessment did not reduce their drinking.
| Mary Larimer, Christine Lee, Jason Kilmer, Patricia Fabiano, Christopher Stark, Irene Geisner, Kimberly Mallett, Ty Lostutter, Jessica Cronce, Maggie Feeney, Clayton Neighbors|
Journal of consulting and clinical psychology [75:285-93] (2007)
The current study was designed to evaluate the efficacy of a mailed feedback and tips intervention as a universal prevention strategy for college drinking. Participants (N = 1,488) were randomly assigned to feedback or assessment-only control conditions. Results indicated that the mailed feedback intervention had a preventive effect on drinking rates overall, with participants in the feedback condition consuming less alcohol at follow-up in comparison with controls. In addition, abstainers in the feedback condition were twice as likely to remain abstinent from alcohol at follow-up in comparison with control participants (odds ratio = 2.02), and feedback participants were significantly more likely to refrain from heavy episodic drinking (odds ratio = 1.43). Neither gender nor severity of baseline drinking moderated the efficacy of the intervention in these analyses, but more conservative analyses utilizing last-observation carryforward suggested women and abstainers benefited more from this prevention approach. Protective behaviors mediated intervention efficacy, with participants who received the intervention being more likely to use strategies such as setting limits and alternating alcohol with nonalcoholic beverages. Implications of these findings for universal prevention of college drinking are discussed.
| Mark Wood, Anne Fairlie, Anne Fernandez, Brian Borsari, Christy Capone, Robert Laforge, Rosa Carmona-Barros|
Journal of consulting and clinical psychology [78:349-61] (2010)
Using a randomized factorial design, we examined the efficacy of a brief motivational intervention (BMI) and a parent-based intervention (PBI) as universal preventive interventions to reduce alcohol use among incoming college students.
Participants (N = 1,014) were assessed prior to matriculation and at 10 months and 22 months postbaseline. Two-part latent growth modeling was used to simultaneously examine initiation and growth in heavy episodic drinking and alcohol-related consequences.
This study retained 90.8% (n = 921) of randomized students at the 10-month follow-up and 84.0% (n = 852) of randomized students at the 22-month follow-up. BMI participants were significantly less likely than non-BMI participants to initiate heavy episodic drinking and to begin experiencing alcohol-related consequences. Effect sizes were minimal at 10 months (Cohen's h ranged from 0.02 to 0.07) and were small at 22 months (hs ranged from 0.15 to 0.22). A significant BMI x PBI interaction revealed that students receiving both the BMI and the PBI were significantly less likely to report the onset of consequences beyond the sum of the individual intervention effects (h = 0.08 at 10 months, and h = 0.21 at 22 months). Hypothesized direct BMI effects for reductions in heavy episodic drinking and consequences were not observed. Significant mediated effects via changes in descriptive norms were present for both growth and initiation of heavy episodic drinking and consequences.
To our knowledge, the current study is the first to provide support for BMI as a universal preventive intervention for incoming college students. Although hypothesized PBI main effects were not found, mediation analyses suggest future refinements could enhance PBI effectiveness.
| Sophie Attwood, Hannah Parke, John Larsen, Katie Morton|
BMC public health [17:394] (2017)
Smartphone applications ("apps") offer promise as tools to help people monitor and reduce their alcohol consumption. To date, few evaluations of alcohol reduction apps exist, with even fewer considering apps already available to the public. The aim of this study was to evaluate an existing publically available app, designed by Drinkaware, a UK-based alcohol awareness charity.
We adopted a mixed-methods design, analysing routinely collected app usage data to explore user characteristics and patterns of usage. Following this, in-depth interviews were conducted with a sub-sample of app users to examine perceptions of acceptability, usability and perceived effectiveness, as well as to provide recommendations on how to improve the app.
One hundred nineteen thousand seven hundred thirteen people downloaded and entered data into the app over a 13-month period. High attrition was observed after 1 week. Users who engaged with the app tended to be "high risk" drinkers and to report being motivated "to reduce drinking" at the point of first download. In those who consistently engaged with the app over time, self-reported alcohol consumption levels reduced, with most change occurring in the first week of usage. Our qualitative findings indicate satisfaction with the usability of the app, but mixed feedback was given regarding individual features. Users expressed conflicting views concerning the type of feedback and notifications that the app currently provides. A common preference was expressed for more personalised content.
The Drinkaware app is a useful tool to support behaviour change in individuals who are already motivated and committed to reducing their alcohol consumption. The Drinkaware app would benefit from greater personalisation and tailoring to promote longer term use. This evaluation provides insight into the usability and acceptability of various app features and contains a number of recommendations for improving user satisfaction and the potential effectiveness of apps designed to encourage reductions in alcohol consumption.
| Abigail McNally, Tibor Palfai, Christopher Kahler|
Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors [19:79-87] (2005)
The authors examined the effects of a brief motivational intervention for heavy, episodic alcohol use on discrepancy-related psychological processes. Heavy-drinking college students (N=73) were randomly assigned to a motivationally based intervention (MBI) or an assessment-only control (AC) condition. Cognitive (actual-ideal discrepancy) and affective (2 forms of cognitive dissonance) discrepancy processes were assessed at baseline and immediately following the experimental manipulation. At 6-week follow-up, MBI participants demonstrated significantly greater reductions in problematic drinking than AC participants. Moreover, actual-ideal discrepancy and negative, self-focused dissonance were significantly increased following the intervention (discomfort-related dissonance was not) and were correlated with outcome alcohol involvement. These discrepancy processes did not, however, mediate the relationship between condition and outcome. The findings lend some support to the role of discrepancy enhancement in drinking-related behavior change among college students.
| Clayton Neighbors, Megan Jensen, Judy Tidwell, Theresa Walter, Nicole Fossos, Melissa Lewis|
Group processes & intergroup relations : GPIR [14:651-669] (2011)
Social-norms approaches to alcohol prevention are based on consistent findings that most students overestimate the prevalence of drinking among their peers. Most interventions have been developed for heavy-drinking students, and the applicability of social-norms approaches among abstaining or light-drinking students has yet to be evaluated. The present research aimed to evaluate the impact of two types of online social-norms interventions developed for abstaining or light-drinking students. Identification with other students was evaluated as a moderator. Participants included 423 freshmen and sophomore college students who reported never or rarely drinking at screening. Students were randomly assigned to one of three conditions: (a) personalized-norms feedback, (b) social-norms marketing ads, or (c) attention control. Data were analyzed using generalized linear mixed models. Results provided some support for both interventions but were stronger for social-norms marketing ads, particularly among participants who identified more closely with other students.
| Clayton Neighbors, Melissa Lewis, Rochelle Bergstrom, Mary Larimer|
Health psychology : official journal of the Division of Health Psychology, American Psychological Association [25:571-9] (2006)
The objectives of this research were to evaluate the efficacy of computer-delivered personalized normative feedback among heavy drinking college students and to evaluate controlled orientation as a moderator of intervention efficacy. Participants (N = 217) included primarily freshman and sophomore, heavy drinking students who were randomly assigned to receive or not to receive personalized normative feedback immediately following baseline assessment. Perceived norms, number of drinks per week, and alcohol-related problems were the main outcome measures. Controlled orientation was specified as a moderator. At 2-month follow-up, students who received normative feedback reported drinking fewer drinks per week than did students who did not receive feedback, and this reduction was mediated by changes in perceived norms. The intervention also reduced alcohol-related negative consequences among students who were higher in controlled orientation. These results provide further support for computer-delivered personalized normative feedback as an empirically supported brief intervention for heavy drinking college students, and they enhance the understanding of why and for whom normative feedback is effective.
| Dorothy Newbury-Birch, Simon Coulton, Martin Bland, Paul Cassidy, Veronica Dale, Paolo Deluca, Eilish Gilvarry, Christine Godfrey, Nick Heather, Eileen Kaner, Ruth McGovern, Judy Myles, Adenekan Oyefeso, Steve Parrott, Robert Patton, Katherine Perryman, Tom Phillips, Jonathan Shepherd, Colin Drummond|
Alcohol and alcoholism (Oxford, Oxfordshire) [49:540-8] ()
To evaluate the effectiveness of different brief intervention strategies at reducing hazardous or harmful drinking in the probation setting. Offender managers were randomized to three interventions, each of which built on the previous one: feedback on screening outcome and a client information leaflet control group, 5 min of structured brief advice and 20 min of brief lifestyle counselling.
A pragmatic multicentre factorial cluster randomized controlled trial. The primary outcome was self-reported hazardous or harmful drinking status measured by Alcohol Use Disorders Identification Test (AUDIT) at 6 months (negative status was a score of
| Clayton Neighbors, Melissa Lewis, David Atkins, Megan Jensen, Theresa Walter, Nicole Fossos, Christine Lee, Mary Larimer|
Journal of consulting and clinical psychology [78:898-911] (2010)
Web-based brief alcohol interventions have the potential to reach a large number of individuals at low cost; however, few controlled evaluations have been conducted to date. The present study was designed to evaluate the efficacy of gender-specific versus gender-nonspecific personalized normative feedback (PNF) with single versus biannual administration in a 2-year randomized controlled trial targeting a large sample of heavy-drinking college students.
Participants included 818 freshmen (57.6% women; 42% non-Caucasian) who reported 1 or more heavy-drinking episodes in the previous month at baseline. Participants were randomly assigned in a 2 (gender-specific vs. gender-nonspecific PNF) × 2 (single vs. biannual administration of PNF) + 1 (attention control) design. Assessments occurred every 6 months for a 2-year period.
Results from hierarchical generalized linear models provided modest effects on weekly drinking and alcohol-related problems but not on heavy episodic drinking. Relative to control, gender-specific biannual PNF was associated with reductions over time in weekly drinking (d = -0.16, 95% CI [-0.02, -0.31]), and this effect was partially mediated by changes in perceived norms. For women, but not men, gender-specific biannual PNF was associated with reductions over time in alcohol-related problems relative to control (d = -0.29, 95% CI [-0.15, -0.58]). Few other effects were evident.
The present research provides modest support for the use of biannually administered web-based gender-specific PNF as an alternative to more costly indicated prevention strategies.
| Irene Markman Geisner, Clayton Neighbors, Christine Lee, Mary Larimer|
Addictive behaviors [32:2776-87] (2007)
This research evaluated a brief mailed intervention for alcohol use as an adjunct to a brief treatment for college students with depression symptoms. The intervention aimed to correct normative misperceptions and reduce students' drinking and related consequences.
One hundred seventy seven college students (70% Female) with elevated scores on the Beck Depression Inventory were randomly assigned to intervention or control group. Participants in the intervention were mailed feedback and information detailing their reported alcohol use, moderation strategies, and accurate normative information regarding student drinking.
Results indicated no main effects of the intervention on drinking or related problems but students receiving feedback showed significant reductions in their perception of drinking norms compared to the control group. Furthermore, students whose normative perceptions reduced showed significant reductions in total drinks per week and total alcohol related problems compared to those whose norms did not reduce.
Results support the importance of correcting normative perceptions and provide direction for selective prevention of alcohol use and related problems among college students with depressed mood.
| Melissa Lewis, Clayton Neighbors, Christine Lee, Laura Oster-Aaland|
Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors [22:176-85] (2008)
This research was designed to evaluate a personalized normative feedback birthday card intervention aimed at reducing normative perceptions, alcohol consumption, and negative consequences associated with 21st birthday celebrations among college students (N=281; 59.15% women). Students were randomly assigned to receive or not receive a birthday card about 1 week prior to their 21st birthday. Approximately 1 week following their birthday, students were asked to complete a brief survey concerning their birthday celebration activities. Findings indicated that the birthday card intervention was not successful at reducing drinking or consequences; however, the card did reduce normative misperceptions. Additional findings indicated that many students experienced negative consequences, such as passing out or driving after consuming alcohol. Combined, these findings suggest that prevention is needed for drinking associated with turning 21. However, prevention efforts should consist of more than a birthday card.
| Aisha Holloway, Hazel Watson, Antony Arthur, George Starr, Angus McFadyen, Jean McIntosh|
Addiction (Abingdon, England) [102:1762-70] (2007)
(i) To evaluate the effect of receiving one of two brief interventions in reducing alcohol consumption among general hospital patients compared with usual care. (ii) To assess whether a brief intervention of self-efficacy enhancement was superior to a self-help booklet in reducing alcohol consumption.
A three-arm cluster randomized controlled trial.
Seven general medical, six general surgical, one dermatology and two otolaryngology wards of a large teaching hospital covering a large urban and rural area.
A total of 215 of 789 in-patients aged 18-75 years, who screened positive for alcohol consumption in excess of national recommended limits according to a 7-day retrospective drinking diary.
Participants were allocated to receive one of three interventions: (i) face-to-face self-efficacy enhancement; (ii) a self-help booklet; or (iii) usual care.
The primary outcome measure was change in reported alcohol consumption at 6-month follow-up as measured by a 7-day retrospective drinking diary. Secondary outcomes were change in: number of alcohol drinking days in last week; the maximum units of alcohol consumed on any one day in last week; and Drinking Refusal Self-efficacy Expectancy Questionnaire score.
Compared to the usual care group the self-efficacy enhancement group (-10.1 units 95% CI -16.1 to -4.1) and the self-help booklet group (-10.0 units 95% CI -16.0 to -3.9) had greater reductions in self-reported weekly alcohol consumption. There was no evidence that self-efficacy enhancement was superior to the self-help booklet (P = 0.96).
Brief interventions delivered in hospital offer simple means of helping heavy drinkers to reduce their alcohol consumption.
| Jenn Scott, Alexandra Brown, Jessica Phair, Josh Westland, Benjamin Schüz|
Alcohol and alcoholism (Oxford, Oxfordshire) [48:458-63] ()
This study tests whether enhancing alcohol risk messages with self-affirmation, the process of focusing on cherished aspects of oneself, increases intentions to reduce alcohol consumption and reduces actual alcohol consumption. It was also examined whether these effects differed by risk status as indicated by standard drinks consumed in an average week.
Participants (n = 121) were randomly allocated to a self-affirmation or matched control condition before viewing emotive graphic alcohol warning posters in a questionnaire-based study.
There were significant increases in intentions to reduce alcohol consumption in self-affirmed participants, and these effects were stronger in participants with higher behavioural risk. Intentions in turn significantly predicted a reduction in self-reported alcohol consumption.
These findings support the use of self-affirmation to enhance alcohol awareness campaigns, particularly in individuals with high behavioural risk.
| Joseph Labrie, Melissa Lewis, David Atkins, Clayton Neighbors, Cheng Zheng, Shannon Kenney, Lucy Napper, Theresa Walter, Jason Kilmer, Justin Hummer, Joel Grossbard, Tehniat Ghaidarov, Sruti Desai, Christine Lee, Mary Larimer|
Journal of consulting and clinical psychology [81:1074-86] (2013)
Personalized normative feedback (PNF) interventions are generally effective at correcting normative misperceptions and reducing risky alcohol consumption among college students. However, research has yet to establish what level of reference group specificity is most efficacious in delivering PNF. This study compared the efficacy of a web-based PNF intervention using 8 increasingly specific reference groups against a Web-BASICS intervention and a repeated-assessment control in reducing risky drinking and associated consequences.
Participants were 1,663 heavy-drinking Caucasian and Asian undergraduates at 2 universities. The referent for web-based PNF was either the typical same-campus student or a same-campus student at 1 (either gender, race, or Greek affiliation), or a combination of 2 (e.g., gender and race), or all 3 levels of specificity (i.e., gender, race, and Greek affiliation). Hypotheses were tested using quasi-Poisson generalized linear models fit by generalized estimating equations.
The PNF intervention participants showed modest reductions in all 4 outcomes (average total drinks, peak drinking, drinking days, and drinking consequences) compared with control participants. No significant differences in drinking outcomes were found between the PNF group as a whole and the Web-BASICS group. Among the 8 PNF conditions, participants receiving typical student PNF demonstrated greater reductions in all 4 outcomes compared with those receiving PNF for more specific reference groups. Perceived drinking norms and discrepancies between individual behavior and actual norms mediated the efficacy of the intervention.
Findings suggest a web-based PNF intervention using the typical student referent offers a parsimonious approach to reducing problematic alcohol use outcomes among college students.
| Mark Wood, Christy Capone, Robert Laforge, Darin Erickson, Nancy Brand|
Addictive behaviors [32:2509-28] (2007)
This study is the first reported test of the unique and combined effects of Brief Motivational Intervention (BMI) and Alcohol Expectancy Challenge (AEC) with heavy drinking college students. Three hundred and thirty-five participants were randomly assigned in a 2x2 factorial design to either: BMI, AEC, BMI and AEC, and assessment only conditions. Follow-ups occurred at 1, 3, and 6 months. Unconditional latent curve analyses suggested that alcohol use (Q-F), heavy episodic drinking, and alcohol problems were best modeled as quadratic effects. BMI produced significant decreases in Q-F, heavy drinking, and problems, while AEC produced significant decreases in Q-F and heavy drinking. There was no evidence of an additive effect of combining the interventions. Intervention effects decayed somewhat for BMI and completely for AEC over 6 months. Multi-group analyses suggested similar intervention effects for men and women. BMI effects on alcohol problems were mediated by perceived norms. These findings extend previous research with BMI and AEC but do not support their utility as a combined preventive intervention to reduce collegiate alcohol abuse.
| Clayton Neighbors, Mary Larimer, Melissa Lewis|
Journal of consulting and clinical psychology [72:434-47] (2004)
The authors evaluated the efficacy of a computer-delivered personalized normative feedback intervention in reducing alcohol consumption among heavy-drinking college students. Participants included 252 students who were randomly assigned to an intervention or control group following a baseline assessment. Immediately after completing measures of reasons for drinking, perceived norms, and drinking behavior, participants in the intervention condition were provided with computerized information detailing their own drinking behavior, their perceptions of typical student drinking, and actual typical student drinking. Results indicated that normative feedback was effective in changing perceived norms and alcohol consumption at 3- and 6-month follow-up assessments. In addition, the intervention was somewhat more effective at 3-month follow-up among participants who drank more for social reasons.
| B Borsari, K Carey|
Journal of consulting and clinical psychology [68:728-33] (2000)
This study consisted of a randomized controlled trial of a 1-session motivational intervention for college student binge drinkers. Sixty students who reported binge drinking 2 or more times in the past 30 days were randomly assigned to either a no-treatment control or a brief intervention group. The intervention provided students with feedback regarding personal consumption, perceived drinking norms, alcohol-related problems, situations associated with heavy drinking, and alcohol expectancies. At 6-week follow-up, the brief intervention group exhibited significant reductions on number of drinks consumed per week, number of times drinking alcohol in the past month, and frequency of binge drinking in the past month. Estimates of typical student drinking mediated these reductions. This study replicates earlier research on the efficacy of brief interventions with college students and extends previous work regarding potential mechanisms of change.
| Iain Crombie, Linda Irvine, Brian Williams, Falko Sniehotta, Dennis Petrie, Josie Evans, Carol Emslie, Claire Jones, Ian Ricketts, Gerry Humphris, John Norrie, Peter Rice, Peter Slane|
Trials [15:494] (2014)
Socially disadvantaged men are at a substantially higher risk of developing alcohol-related problems. The frequency of heavy drinking in a single session is high among disadvantaged men. Brief alcohol interventions were developed for, and are usually delivered in, healthcare settings. The group who binge drink most frequently, young to middle-aged disadvantaged men, have less contact with health services and there is a need for an alternative method of intervention delivery. Text messaging has been used successfully to modify other adverse health behaviours. This study will test whether text messages can reduce the frequency of binge drinking by disadvantaged men.
Disadvantaged men aged 25 to 44 years who drank >8 units of alcohol at least twice in the preceding month will be recruited from the community. Two recruitment strategies will be used: contacting men listed in primary care registers, and a community outreach method (time-space sampling). The intended sample of 798 men will be randomised to intervention or control, stratifying by recruitment method. The intervention group will receive a series of text messages designed to reduce the frequency of binge drinking through the formation of specific action plans. The control group will receive behaviourally neutral text messages intended to promote retention in the study. The primary outcome measure is the proportion of men consuming >8 units on at least three occasions in the previous 30 days. Secondary outcomes include total alcohol consumption and the frequency of consuming more than 16 units of alcohol in one session in the previous month. Process measures, developed during a previous feasibility study, will monitor engagement with the key behaviour change components of the intervention. The study will incorporate an economic evaluation comparing the costs of recruitment and intervention delivery with the benefits of reduced alcohol-related harm.
This study will assess the effectiveness of a brief intervention, delivered by text messages, aimed at reducing the frequency of binge drinking in disadvantaged men. The process measures will identify components of the intervention which contribute to effectiveness. The study will also determine whether any benefit of the intervention is justified by the costs of intervening.
ISRCTN07695192. Date assigned: 14 August 2013.
| Martin Hagger, Adam Lonsdale, Andre Koka, Vello Hein, Heidi Pasi, Taru Lintunen, Nikos Chatzisarantis|
International journal of behavioral medicine [19:82-96] (2012)
Excessive alcohol consumption has been linked to deleterious health consequences among undergraduate students. There is a need to develop theory-based and cost-effective brief interventions to attenuate alcohol consumption in this population.
The present study tested the effectiveness of an integrated theory-based intervention in reducing undergraduates' alcohol consumption in excess of guideline limits in national samples from Estonia, Finland, and the UK.
A 2 (volitional: implementation intention vs. no implementation intention) × 2 (motivation: mental simulation vs. no mental simulation) × 3 (nationality: Estonia vs. Finland vs. UK) randomized-controlled design was adopted. Participants completed baseline psychological measures and self-reported number of alcohol units consumed and binge-drinking frequency followed by the intervention manipulation. One month later, participants completed follow-up measures of the psychological variables and alcohol consumption.
Results revealed main effects for implementation intention and nationality on units of alcohol consumed at follow-up and an implementation intention × nationality interaction. Alcohol consumption was significantly reduced in the implementation intention condition for the Estonian and UK samples. There was a significant main effect for nationality and an implementation intention × nationality interaction on binge-drinking frequency. Follow-up tests revealed significant reductions in binge-drinking occasions in the implementation intention group for the UK sample only.
Results support the implementation intention component of the intervention in reducing alcohol drinking in excess of guideline limits among Estonian and UK undergraduates. There was no support for the motivational intervention or the interaction between the strategies. Results are discussed with respect to intervention design based on motivational and volitional approaches.
| Dennis Thombs, R Scott Olds, Cynthia Osborn, Sarah Casseday, Kevin Glavin, Alan Berkowitz|
Journal of American college health : J of ACH [55:325-32] ()
The authors tested a prototype intervention designed to deter alcohol use in residence halls.
Approximately 384 freshmen participated in the study over a 2-year period.
The authors devised a feedback method that assessed residents' blood alcohol concentration (BAC) at night and allowed the readings to be retrieved the next day via the Web. Residents in an intervention hall received their BAC readings as well as normative feedback. In a comparison hall, residents could retrieve only the BAC readings.
The authors found statistically significant hall differences, but they were small in size and not meaningful.
Qualitative findings suggest the intervention had an overall positive impact, but the actions of a subgroup of rebellious drinkers might have obscured the effect. Social norms interventions could provoke some episodes of excessive drinking in students who find these messages objectionable. More research is needed to evaluate delayed BAC feedback.