Targeting young drinkers online: the effectiveness of a web-based brief alcohol intervention in reducing heavy drinking among college students: study protocol of a two-arm parallel group randomized controlled trial

Background  

The prevalence of heavy drinking among college students and its associated health related consequences highlights an urgent need for alcohol prevention programs targeting 18 to 24 year olds. Nevertheless, current alcohol prevention programs in the Netherlands pay surprisingly little attention to the drinking patterns of this specific age group. The study described in this protocol will test the effectiveness of a web-based brief alcohol intervention that is aimed at reducing alcohol use among heavy drinking college students aged 18 to 24 years old.     

The impact of truant and alcohol-related behavior on educational aspirations: a study of US high school seniors

BACKGROUND: Truancy and alcohol use are quality indicators of academic achievement and success. However, there remains a paucity of substantive research articulating the impact these deviant behaviors have on an adolescent's educational aspirations. The purpose of this study is to assess whether recent alcohol use and truancy impact students' educational aspirations among a nationally representative sample of US high school seniors. METHODS: This study conducted a secondary data analysis of the Monitoring the Future project data, 2006. Logistic regression was conducted to assess how alcohol use and truancy affected educational aspirations. Subsequent interaction effects were assessed in the final multivariable model. Demographic variables such as age, sex, race, and father and mother's educational level were included as covariates in the regression model. RESULTS: Results indicate that as students engage in increased alcohol use and/or truancy, educational aspirations decrease. Thus, students who indicated a desire to attend a 4‐year college/university were less likely to engage in high‐risk drinking behavior and/or truancy. Moreover, in testing the interaction between truancy and alcohol use, as it relates to educational aspirations, the logistic regression model found both of these independent variables to be statistically significant predictors of the likelihood students would attend a 4‐year college/university. CONCLUSIONS: To ensure that adolescents further their education and maximize their potential life opportunities, school and public health officials should initiate efforts to reduce alcohol consumption and truancy among students. Furthermore, future research should examine the risk and protective factors that may influence one's educational aspirations.     

Empowering students to respond to alcohol advertisements: results from a pilot study of an Australian media literacy intervention

Objective : Alcohol media literacy programs in the United States have increased students' media literacy skills and lowered pre‐drinking behaviour. In Australia, no such programs have yet been implemented or evaluated. This pilot study aimed to examine the feasibility and potential impact of an alcohol media literacy program for Australian upper‐primary school children. Methods : Thirty‐seven Year 5 and 6 students (aged 10–12) from one school in the Sydney region participated in 10 one‐hour media lessons. Teacher interviews, student exit slips, teacher observations and a researcher reflective journal were analysed to examine the implementation process, while a pre‐ and post‐questionnaire was analysed to measure outcome. Results : Key factors in implementation were the importance of school context; attainment of English and PDHPE learning outcomes to differing extents; program's useability provided flexibility; perceived complexity and achievability of the lessons and program's engagement and relevance for the students. The program significantly increased media literacy skills and understanding of persuasive intent; decreased interest in alcohol branded merchandise; and lowered perception of drinking norms. Conclusion and implications : An Australian alcohol media literacy program for upper‐primary school children appears feasible, and has potential to lead to measurable outcomes.     

The Effectiveness of Alcohol Policies in 4-Year Public Universities

The objective of this study was to evaluate the type of alcohol policy in place in 4-year public universities against the odds of heavy drinking. Data was collected during the months of April-June 2010 using the Core Alcohol and Drug Survey. The participants included a random sample of undergraduate students from 4 public universities in the Midwest. Two of the universities had policies in place allowing the sale and use of alcohol on campus, and 2 universities had policies in place prohibiting the sale and use of alcohol. There were a total of 186 participants which included 63 males and 123 females. There was statistical significance in gender, age, and participation in sports against the odds of heavy drinking (P < .05). The type of policy in place was not significantly associated with the odds of heavy drinking. Even though there was an association between gender, age, and participation in sports with the odds of heavy drinking among college students in this sample, the type of alcohol policy (wet or dry) had no association. The results demonstrate the need for the implementation of alcohol prevention strategies, in addition to policy, to reduce the number of college students who drink heavily. It may be beneficial to target those alcohol intervention programs to the high risk groups such as males, over the age of 21, and those students who participate in sports.     

Sensation Seeking and Alcohol Use by College Students: Examining Multiple Pathways of Effects

This study tests the proposition that peer influence mediates the effect of sensation seeking, a personality trait, on alcohol use among college students. Cross-sectional data to test this proposition were collected from a representative sample of college students at a large public northeastern university (N = 427). Results of hierarchical regression analyses showed that, as hypothesized, sensation seeking influenced personal alcohol use both directly and indirectly, through its impact on students' frequency of association with alcohol-using peers and the size of their drinking norm misperception. The findings suggest that interventions that seek to limit the frequency in which high sensation seekers associate with peers whose alcohol use is extreme or, alternatively, seek to facilitate social interactions of high sensation seekers with normative peers, may supplement efforts to influence sensation seekers' alcohol and other drug use through tailored mass media advertisements.     

上海市大学生使用烟草和酒精等成瘾物质状况

目的 了解上海市大学生使用烟草、酒精等成瘾物质的现状。方法 采用整群随机抽样的方法抽取7所大学1765名学生，用中国疾病预防控制中心提供的《中国城市青少年健康危险行为监测问卷（大学）》进行无记名调查。结果 不同年级和性别学生使用烟草、酒精的差异有显著意义，目前吸烟与目前饮酒二变量呈正相‰logistic多因素分层分析显示，父亲高学历是保护因素，男性和高年级相对女性和低年级及赌博是危险因素。结论 上海市大学生使用烟草、酒精等成瘾物质报告率高于本地中学生，但低于其他国内外的有关报道。应把开展以学校为基础的生活技能训练作为主要预防干预措施。     

Drinking and driving among college students: the influence of alcohol-control policies

BACKGROUND: Studies have reported high rates of heavy episodic drinking and alcohol-related problems, including drinking and driving, among college students. However, most studies have been conducted in single colleges or states. This study used a national sample to examine policy factors associated with alcohol-involved driving. METHODS: A random sample of full-time students (N=10,904) attending a nationally representative sample of 4-year colleges in 39 states (n=119) completed self-administered questionnaires. The questionnaire examined driving after consuming any alcohol, driving after > or = 5 drinks, and riding with a high or drunk driver. Individual-level data about driving after > or = 5 drinks were linked to information on the policy environment at both local and state levels and to ratings of enforcements for drunk driving laws. RESULTS: Drinking and driving behaviors are prevalent among a minority of college students and differ significantly among student subgroups. Students who attend colleges in states that have more restrictions on underaged drinking, high volume consumption, and sales of alcoholic beverages, and devote more resources to enforcing drunk driving laws, report less drinking and driving. CONCLUSION: The occurrence of drinking and driving among college students differs significantly according to the policy environment at local and state levels and the enforcement of those policies. Comprehensive policies and their strong enforcement are promising interventions to reduce drinking and driving among college students.     

Managing alcohol problems and risky drinking

While overall alcohol consumption and alcohol-related automobile deaths have declined, rates of alcohol dependence, liver cirrhosis, and alcohol-related problems remain high among adults, and binge drinking continues as a major health risk for high school and college students. Some individual-level downstream interventions have been evaluated with sufficient rigor to recommend widespread dissemination, and widened availability of new pharmacotherapies could further increase effectiveness. Midstream population-based programs, such as screening and brief interventions in hospitals and managed care organizations, may have greater public health impact than tertiary treatment because of early identification and low cost. Upstream programs and policies that place limits on alcohol availability (e.g., higher legal purchasing age) have the greatest potential to reduce morbidity and mortality at the least cost to society.     

Changing the College AOD Environment for Primary Prevention

Identifying environmental factors reflected to alcohol use is important for program planning and evaluation in college alcohol and drug prevention programs. Little has been written concerning uses of data in environmental prevention efforts. This paper presents four brief interrelated case studies of how environmental modifications were used by a college alcohol prevention project to 1) change the marketing practices and service policies of a student-oriented bar, 2) alter the sales practices of a campus bookstore concerning alcohol paraphernalia, 3) to develop a campaign with the goal of reducing risk factors related to heavy drinking at private student parties, and 4) stop an unsafe bus from transporting students to bars in Mexico. Creative use of such environmental prevention approaches has potential benefit to colleges and universities concerned with the primary prevention of alcohol-related problems experienced by students.     

Go out or stay in? The effects of zero tolerance laws on alcohol use and drinking and driving patterns among college students

Zero tolerance laws make it illegal per se for anyone under age 21 to drive with any measurable amount of blood alcohol. Although a link has been established between zero tolerance laws and lower motor vehicle fatalities, research has not produced strong evidence on how zero tolerance laws influence individual alcohol use and drinking and driving behaviors. Using a unique data set and a difference-in-difference-in-difference-type research design, we are able to analyze a number of pathways through which zero tolerance laws can work among an important underage population, college students. We find that zero tolerance laws reduce drinking and driving among college students. Further analysis of our detailed alcohol use measures suggests that zero tolerance laws are particularly effective at reducing the probability of driving after drinking for those who reported drinking away from home.     

Smoke-free Laws and Smoking and Drinking Among College Students

Little is known about the impact of smoke-free legislation on smoking and drinking alcohol among college students. The purpose was to examine whether strength and duration of municipal smoke-free laws are associated with cigarette and alcohol use among college students. Full-time undergraduates from two Southeastern universities participated in mailed (Site A) or electronic (Site B) surveys assessing tobacco and alcohol use and other risk behaviors pre and post comprehensive municipal smoke-free laws (Site A, N = 1,366. Site B, N = 1,404). The first cohort at each site participated prior to a municipal smoke-free law in the community. The second survey was conducted post-law (Site A, 3.5 years, Site B, 8 months). Past 30-day cigarette and alcohol use and other demographic and personal characteristics were assessed. At Site A, controlling for demographic differences and current alcohol use, the odds of being a current smoker were 32% lower post-law (28% pre-law vs. 19% post-law; odds ratio = 0.68, P = 0.02). At Site B, with demographics and drinking status in the model, the decrease in smoking rate from pre- to post-law was not significant. At both sites, controlling for demographics and current smoking status, change in the likelihood of drinking was not significant. Comprehensive smoke-free laws in the surrounding community may reduce smoking rates among college students who live, work and recreate there, particularly after the laws are well-established. While alcohol prevalence is very high among college students, enacting smoke-free legislation was not associated with alcohol use.     

大学生饮酒行为及动因研究

了解大学生的饮酒行为，饮酒动机与心理，探讨它们之间的相互关系，为干预问题饮酒，开展以学校为中心的社区预防工作提供必要的资料和依据。方法：采用不记名问卷对４４８名大学生进行了饮酒状况。支机与心理以及对饮酒危害性认识等方面的调查研究，结果男生的饮酒率为９２．９０％，女生饮酒率为８６．８２％，男女饮酒行为类型，饮酒情境和饮酒种类之间均有高度显著性差异；第一次饮酒动机主要是好奇心、家人同意和朋友劝；生活压     

Correlates of college student binge drinking.

OBJECTIVES. This study examines the individual correlates of college student binge drinking. METHODS. Questionnaires were completed by a representative national sample (n = 17,592) of students on 140 campuses in 1993. Binge drinking was defined as five or more drinks per episode for men and as four or more drinks per episode for women. RESULTS. Overall, 44% of the students (50% of the men and 39% of the women) binged. While demographic factors such as sex and race were significantly related to binge drinking, prior binging in high school was crucial, suggesting that for many students, binge drinking begins before college. The strongest predictors of college binge drinking were residence in a fraternity or sorority, adoption of a party-centered life-style, and engagement in other risky behaviors. CONCLUSIONS. Interventions must be targeted at high school binge drinking as well as at several characteristics of college life--most notably fraternity residence. Legal drinking age fails to predict binge drinking, raising questions about the effectiveness of the legal minimum drinking age of 21 in college alcohol policies.     

Reducing alcohol consumption among university students: recruitment and program design strategies based on Social Marketing Theory

Recruitment of program participants and development of appealing comprehensive alcohol abuse prevention programs is an exigent priority for university campuses due to the serious physical and emotional consequences related to alcohol consumption. A sample of 67 students from a large midwestern university completed a survey based on Social Marketing Theory (SMT) which was developed to improve recruitment and enhance the design of comprehensive alcohol abuse prevention programs. The results indicate that recruitment may be optimized by providing a flexible, convenient, low-cost program that encourages friends' participation, communicates alcohol-related risks and offers university credit or refund as participation incentives. The design of alcohol abuse prevention programs may be enhanced by emphasizing the positive outcomes of reducing alcohol consumption, improving the quality and quantity of alternatives to the social atmosphere connected with drinking, and soliciting respected opinion leaders (physicians and parents) to communicate alcohol reduction messages. This project is a first initiative to 'fill the gap' in the social marketing research literature by providing formative information pertinent to recruitment and design of alcohol reduction programs specifically for college students.     

The state sets the rate: the relationship among state-specific college binge drinking, state binge drinking rates, and selected state alcohol control policies

OBJECTIVES: We assessed the relationship between college binge drinking, binge drinking in the general population, and selected alcohol control policies. METHODS: We analyzed binge drinking rates from 2 national surveys, the Harvard School of Public Health College Alcohol Study and the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System. Binge drinking data were linked to a summary measure of 7 salient alcohol control policies and a rating of resources devoted to law enforcement. RESULTS: State-level college and adult binge drinking rates were strongly correlated (Pearson correlation coefficient=0.43; P<.01). Attending college in states with the lowest binge drinking rates (adjusted odds ratio [OR]=0.63; 95% confidence interval [CI]=0.41, 0.97) and presence of more stringent alcohol control policies (adjusted OR=0.57; 95% CI=0.33, 0.97) were independent predictors of student binge drinking, after adjusting for state law enforcement and individual-, college-, and state-level covariates. CONCLUSIONS: State of residence is a predictor of binge drinking by college students. State-level alcohol control policies may help reduce binge drinking among college students and in the general population.     

Alcohol use and abuse by adolescents: the impact of living in a border community.

PURPOSE: To determine the rates of alcohol consumption and alcohol-related risk behaviors among a sample of high school students living on the U.S.-Mexico border, as well as to investigate factors associated with alcohol use among this population. METHODS: A self-administered anonymous questionnaire was administered to students in grades 9-12 during Fall and Spring semesters of 2001 (n = 1366; 639 males and 722 females) in 16 high schools in a community along the U.S.-Mexico border. The questionnaire addressed demographic factors, alcohol consumption, and alcohol-related behaviors. Surveys were completed by Chi-square tests for homogeneity of the odds ratio and logistic regression models were used to identify factors significantly associated with the outcome variables. RESULTS: Rates of binge drinking (45%), drinking and driving (19%), and riding with a driver who had been drinking (46%) were higher for our study population when compared with state and national rates. Students who consumed alcohol were more likely to report alcohol-related problems and lower academic grades. Drinking while in Mexico was significantly associated with binge drinking (OR = 6.44), drinking and driving (OR = 5.39), and riding with a driver who has been drinking (OR = 3.12). CONCLUSIONS: The high rates of alcohol risk behaviors among students living on the U.S.-Mexico border underscore the need to develop and implement culturally appropriate prevention programs that address alcohol consumption in Mexico, particularly in terms of students driving back home.     

北京市高中生饮酒行为及其影响因素

目的探讨高中生的饮酒行为及父母、同伴对其饮酒的影响,为健康教育提供依据.方法采用整群抽样方法,对北京市5所高中高一～高三学生969名进行匿名问卷调查.调查内容包括饮酒行为,学生父母、同伴的饮酒行为,以及学生对高中生饮酒的态度.结果年级高的学生、男生、零花钱比较多的学生更容易成为饮酒者,重点中学学生报告的饮酒比例少于普通中学和职业中学,父母和同伴的饮酒行为及其对高中生饮酒的态度均与高中生的饮酒行为存在明显的相关.结论在开展减少过量饮酒危害的健康教育项目时,应该考虑父母方面的因素,并教给学生一些抵制同伴不良压力的方法.     

Environmental correlates of underage alcohol use and related problems of college students

BACKGROUND: Underage alcohol use is a major contributor to morbidity and mortality in adolescents and young adults. This study examined drinking levels and ensuing problems among college students and factors associated with binge drinking. METHOD: The Harvard School of Public Health College Alcohol Study conducted a self-administered survey. The participants include a random sample of 7061 students aged <21 years (defined as underage drinkers), and 4989 between ages 21 and 23 in 1997 at 116 nationally representative 4-year colleges in 39 states. The outcomes of the study include self-reports of alcohol use, binge drinking (defined as five or more drinks in a row for men and four or more for women at least once in a 2-week period), alcohol-related problems, preferred type of drink, access to alcohol, and price paid per drink. RESULTS: Underage students drink less often but have more drinks per occasion, are more likely to drink in private settings (off-campus, dormitory, and fraternity parties), and pay less per drink than do of-age students. Correlates of underage binge drinking include residence in a fraternity or sorority (odds ratio [OR]=6.2), very easy access to alcohol (OR=3.3), obtaining drinks at lower prices (OR=2.1, for under $1 each or a set fee for unlimited drinks), and drinking beer (OR=9.5). CONCLUSIONS: Effective controls on price, access, and fraternity and off-campus parties, and reinforcing minimum drinking age laws are needed to reduce the high levels of binge drinking and related health and behavioral problems of underage students.     

Pre-college Matriculation Risk Profiles and Alcohol Consumption Patterns During the First Semesters of College

Excessive alcohol consumption represents a significant concern on U.S. college campuses, and there is a need to identify students who may be at risk for engaging in risky alcohol use. The current study examined how variables measured prior to college matriculation, specifically alcohol-related decision-making variables drawn from the Theory of Reasoned Action (i.e., alcohol expectancies, attitudes, and normative beliefs), were associated with patterns of alcohol use prior to and throughout the first semesters of college. Participants were 392 undergraduate students (56 % female) from a large Northeastern U.S. university. Decision-making variables were assessed prior to college matriculation, and alcohol use was measured with five assessments before and throughout freshman and sophomore semesters. Latent profile analysis was used to identify types of students with distinct patterns of decision-making variables. These decision-making profiles were subsequently linked to distinct patterns of alcohol use using latent transition analysis. Four distinct decision-making profiles were found and were labeled “Anti-Drinking,” “Unfavorable,” “Mixed,” and “Risky.” Five drinking patterns were observed and included participants who reported consistently low, moderate, or high rates of alcohol use. Two patterns described low or non-drinking at the pre-college baseline with drinking escalation during the measurement period. Students’ likelihood of following the various drinking patterns varied according to their decision-making. Findings suggest the early identification of at-risk students may be improved by assessing decision-making variables in addition to alcohol use. The findings also have implications for the design of early identification assessments to identify at-risk college students and for the targeting of alcohol prevention efforts to students based on their alcohol-related attitudes and beliefs.     

河南省两城市高中生文化定位、饮酒期望、自我效能与饮酒行为的研究

目的 探讨河南省两城市高中生文化定位、饮酒期望、自我效能和饮酒行为之间的关系,为有针对性地设计预防控制青少年饮酒教育项目提供理论依据.方法 采用分层整群随机抽样方法,于2005年11月对河南省郑州、信阳两市6所高中2756名高一、二学生进行匿名问卷调查,利用SPSS 13.0和SAS 8.10软件完成数据分析.结果 调查学生饮酒率为56.5%.文化定位总均分为3.25(3.09,3.42);饮酒期望总均分为3.02(2.81,3.23);饮酒自我效能总均分为79.64(60.36,93.21).传统文化定位、西方文化定位、饮酒积极期望、饮酒消极期望、饮酒自我效能、饮酒行为各因素之间均存在直接或间接关联.过去30 d内较少的饮酒天数与较高的饮酒自我效能和饮酒消极期望、较低的饮酒积极期望和西方文化定位直接相关(相关系数分别是-0.346、-0.282、0.234和0.162),与中国传统文化定位无直接相关.结论 调查学生饮酒情况比较严重,不同饮酒信念和文化定位影响饮酒行为的发生,预防控制青少年饮酒教育活动可以此作为切入点进行.