Web-based alcohol prevention for incoming college students: A randomized controlled trial

College students are an at-risk population based on their heavy alcohol consumption and associated consequences. First-year students are at particular risk due to greater freedom and access to alcohol on campus. Web-based (electronic) interventions (e-interventions) are being rapidly adopted as a universal approach to prevent high-risk drinking, but have not been well evaluated. The objective of this study was to investigate the effectiveness of the two most widely adopted EIs, AlcoholEdu and The Alcohol eCHECKUP TO GO (e-Chug), in reducing both alcohol use and alcohol-related consequences in incoming college students. To do so, we conducted a 3-group randomized trial (N = 82) comparing AlcoholEdu and e-Chug to an assessment-only control group. Compared to the assessment-only control group, participants in the AlcoholEdu and e-Chug groups reported lower levels of alcohol use across multiple measures at 1-month follow-up. Participants who received AlcoholEdu showed significantly fewer lower alcohol-related consequences than assessment-only controls, while there was a trend for reduced consequences in participants who received e-Chug versus assessment-only. Findings indicate that e-intervention is a promising prevention approach to address the problem of college student alcohol consumption, especially for campuses that have limited resources.     

A randomized clinical trial comparing the efficacy of two active conditions of a brief intervention for heavy college drinkers

Brief interventions for college heavy drinkers have shown promise in reducing drinking and alcohol-related negative consequences. However, intervention duration, content, method of delivery, and follow-up length vary across studies. It therefore remains unclear whether intervention length significantly influences the interventions' efficacy. The present study is a randomized clinical trial systematically evaluating the efficacy of two brief interventions aimed at reducing alcohol use and alcohol-related negative consequences among college student drinkers. Treatment mediators were also evaluated. Participants (N = 278) were, on average, 20.1 years old (SD = 2.4), mostly Caucasian (87%) and female (71%). They were randomly assigned to a 10-minute brief intervention, a 50-minute brief intervention, or an attention-control group. Both active interventions were provided by clinical graduate students trained in Brief Alcohol Screening and Intervention for College Students (BASICS). As hypothesized, participants in both active conditions significantly reduced their alcohol consumption, as compared to the control group participants F(2,264) = 9.84, p = .00, η² = .07. There were no significant differences in alcohol-related negative consequences F(2,264) = 3.08, p = .06, η² = .02. The hypothesized mediators, alcohol drinking norms and coping behavioral strategies, explained significant variance in intervention efficacy, but neither self-efficacy nor alcohol expectancies were significant mediators. Given the preliminary nature of our investigation, more research is warranted to determine parameters of the critical mechanisms of change within brief alcohol interventions with college student drinkers.     

A test of the efficacy of a brief,web-based personalized feedback intervention to reduce drinking among 9th grade students

Alcohol use increases substantially during the transition from middle school to high school. This study tested a brief, web-based personalized feedback program aimed at reducing risk factors for drinking, alcohol use, and alcohol-related consequences among 9th grade students. At a 3-month follow-up, students in the intervention group showed positive results relative to those in the control group on variables associated with reduced risk, including positive alcohol expectancies and positive beliefs about alcohol. Students in the intervention group also reported a reduction in drinking frequency and alcohol-related consequences relative to those in the control group. There were, however, no differences in normative beliefs regarding peer drinking or quantity of weekly drinking between the two groups. Results indicate that a brief, web-based personalized normative feedback program delivered in the school setting is a promising approach to reducing alcohol use and the associated consequences among 9th grade students.     

A randomized controlled trial of a group motivational interviewing intervention for adolescents with a first time alcohol or drug offense

Group motivational interviewing (MI) interventions that target youth at-risk for alcohol and other drug (AOD) use may prevent future negative consequences. Youth in a teen court setting [n = 193; 67% male, 45% Hispanic; mean age 16.6 (SD = 1.05)] were randomized to receive either a group MI intervention, Free Talk, or usual care (UC). We examined client acceptance, and intervention feasibility and conducted a preliminary outcome evaluation. Free Talk teens reported higher quality and satisfaction ratings, and MI integrity scores were higher for Free Talk groups. AOD use and delinquency decreased for both groups at 3 months, and 12-month recidivism rates were lower but not significantly different for the Free Talk group compared to UC. Results contribute to emerging literature on MI in a group setting. A longer term follow-up is warranted.     

Phone-delivered brief motivational interventions for mandated college students delivered during the summer months

Objective

Across the United States, tens of thousands of college students are mandated to receive an alcohol intervention following an alcohol policy violation. Telephone interventions may be an efficient method to provide mandated students with an intervention, especially when they are away from campus during summer vacation. However, little is known about the utility of telephone-delivered brief motivational interventions.

Method

Participants in the study (N = 57) were college students mandated to attend an alcohol program following a campus-based alcohol citation. Participants were randomized to a brief motivational phone intervention (pBMI) (n = 36) or assessment only (n = 21). Ten participants (27.8%) randomized to the pBMI did not complete the intervention. Follow-up assessments were conducted 3, 6, and 9 months post-intervention.

Results

Results indicated the pBMI significantly reduced the number of alcohol-related problems compared to the assessment-only group. Participants who did not complete the pBMI appeared to be lighter drinkers at baseline and randomization, suggesting the presence of alternate influences on alcohol-related problems.

Conclusion

Phone BMIs may be an efficient and cost-effective method to reduce harms associated with alcohol use by heavy-drinking mandated students during the summer months.     

Drinking motives for self and others predict alcohol use and consequences among college women: The moderating effects of PTSD

Although drinking motives have been shown to influence drinking behavior among women with trauma histories and PTSD, no known research has examined the influence of drinking motives on alcohol use and alcohol-related consequences for women with PTSD as compared to women with a trauma history but no PTSD and women with no trauma history. Therefore, the present study sought to examine the associations between drinking motives women held for themselves as well as their perception of the drinking motives of others and their own alcohol use and consequences, and whether this was moderated by a history of trauma and/or PTSD. College women (N = 827) were categorized as either having no trauma exposure (n = 105), trauma exposure but no PTSD (n = 580), or PTSD (n = 142). Results of regression analyses revealed that women with trauma exposure and PTSD consume more alcohol and are at greatest risk of experiencing alcohol-related consequences. A diagnosis of PTSD moderated the association between one's own depression and anxiety coping and conformity drinking motives and alcohol-related consequences. PTSD also moderated the association between the perception of others' depression coping motives and one's own consequences. These findings highlight the importance of providing alternative coping strategies to women with PTSD to help reduce their alcohol use and consequences, and also suggest a possible role for the perceptions regarding the reasons other women drink alcohol and one's own drinking behavior that may have important clinical implications.     

Age of Drinking Initiation as a Moderator of the Efficacy of a Brief,Web-Based Personalized Feedback Alcohol Intervention

ABSTRACT

Early initiation of alcohol use is associated with high-risk drinking and an increased risk of adult alcohol dependence. The current study tested age of drinking initiation as a moderator of the efficacy of a brief, Web-based intervention on frequency of drinking and alcohol-related consequences among ninth-grade students (N = 513). At a three-month follow-up, students in the intervention group reported a reduction in drinking frequency and alcohol-related consequences relative to those in the control group. In addition, age of drinking initiation was a significant moderator of intervention efficacy. Intervention effects were greatest among two groups of students—those who reported abstinence at baseline and those who initiated drinking at age 11 or younger. Results support a brief, Web-based intervention as a promising strategy for reducing frequency of drinking and the associated consequences as a prevention strategy for students who report no drinking history and as an intervention strategy for early initiators who are at the highest risk for developing alcohol-related problems.     

Electronic screening and brief intervention for risky drinking in Swedish university students--a randomized controlled trial

Background

The limited number of electronic screening and brief intervention (e-SBI) projects taking place in young adult student populations has left knowledge gaps about the specific methods needed to motivate reduced drinking. The aim of the present study was to compare differences in alcohol consumption over time after a series of e-SBIs was conducted with two groups of young adult students who were considered risky drinkers. The intervention group (IG) (n = 80) received extensive normative feedback; the control group (CG) (n = 78) received very brief feedback consisting of only three statements.

Method

An e-SBI project was conducted in naturalistic settings among young adult students at a Swedish university. This study used a randomized controlled trial design, with respondents having an equal chance of being assigned to either the IG or the CG. The study assessed changes comparing the IG with the CG on four alcohol-related measurements: proportion with risky alcohol consumption, average weekly alcohol consumption, frequency of heavy episodic drinking (HED) and peak blood alcohol concentration (BAC). Follow-up was performed at 3 and 6 months after baseline.

Results

The study documented a significant decrease in the average weekly consumption for the IG over time but not for the CG, although the differences between the groups were non-significant. The study also found that there were significant decreases in HED over time within both groups; the differences were about equal in both groups at the 6-month follow-up. The proportion of risky drinkers decreased by about a third in both the CG and IG at the 3- and 6-month follow-ups.

Conclusions

As the differences between the groups at 6 months for all alcohol-related outcome variables were not significant, the shorter, generic brief intervention appears to be as effective as the longer one including normative feedback. However, further studies in similar naturalistic settings are warranted with delayed assessment groups as controls in order to increase our understanding of reactivity assessment in email-based interventions among students.     

Project Reduce: Reducing alcohol and marijuana misuse: Effects of a brief intervention in the emergency department

Study objective

Brief interventions (BI) for alcohol misuse and recently for marijuana use for emergency department patients have demonstrated effectiveness. We report a 12-month outcome data of a randomized controlled trial of emergency department (ED) patients using a novel model of BI that addresses both alcohol and marijuana use.

Methods

ED research assistants recruited adult patients who admitted alcohol use in the last month, and marijuana use in the last year. In the ED, patients received an assessment of alcohol and marijuana use and were randomized to treatment (n = 249) or standard care (n = 266). Treatment consisted of two sessions of BI. At 3 and 12 months, both groups had an assessment of alcohol and marijuana use and negative consequences of use.

Results

515 patients were randomized. We completed a 12-month follow-up assessments on 83% of those randomized. Measures of binge drinking and conjoint marijuana and alcohol use significantly decreased for the treatment group compared to the standard care group. At 12-month binge alcohol use days per month in the treatment group were (M = 0.72:95% CI = 0.36–1.12) compared to standard care group (M = 1.77:95% CI = 1.19–1.57) Conjoint use days in the treatment group (M = 1.25.1:95% CI = 0.81–1.54) compared to standard care group (M = 2.16:95% CI = 1.56–2.86). No differences in negative consequences or injuries were seen between the treatment and standard care groups.

Conclusions

BI for alcohol and marijuana decreased binge drinking and conjoint use in our treatment group. BI appears to offer a mechanism to reduce risky alcohol and marijuana use among ED patients but expected reductions in consequences of use such as injury were not found 12 months after the ED visit.     

A cross-lagged panel model examining protective behavioral strategies: Are types of strategies differentially related to alcohol use and consequences?

Protective behavioral strategies (PBS) are skills that can be used to reduce the risk of alcohol-related negative consequences. Studies have shown that, in general, PBS are related to less alcohol consumption and fewer negative consequences; however, other studies have suggested that not all types of PBS (e.g., stopping/limiting drinking [SLD], manner of drinking [MOD] and serious harm reduction [SHR]) are equally effective at reducing alcohol risk. In addition, few studies have explored the longitudinal relationships among PBS, alcohol use and consequences. Using a sample of heavy drinking college students (N = 338), the current study examined PBS use, alcohol consumption and consequences across two time points three months apart. Cross-lagged panel models revealed that MOD predicted a reduction in alcohol use and negative consequences. SHR was longitudinally related to fewer negative consequences, but unrelated to alcohol use. SLD was not associated with drinking or consequences at follow-up. These results highlight the need for future research to examine the effects of different types of PBS and have implications for alcohol intervention programs that incorporate PBS skills training.     

The impact of elevated posttraumatic stress on the efficacy of brief alcohol interventions for heavy drinking college students

Brief alcohol interventions (BAIs) have been widely adopted for use with college students and are associated with significant reductions in drinking and problems. However, many students do not respond to these approaches and little is known about risk factors for poor response. The current study investigated one possible risk factor by examining the impact of posttraumatic stress (PTS) symptoms on BAI efficacy. This study presents pooled data from two randomized clinical trials that examined the efficacy of counselor-administered BAIs compared with computerized interventions. Participants were 207 college students (53.1% women, 68.1% White/Caucasian, 16.9% with elevated post-traumatic stress) who reported past-month heavy episodic drinking. Follow-up assessments were completed six months post-intervention. Analyses testing differences in frequency of past-month heavy episodic drinking revealed a significant post-traumatic stress by time interaction (F(1,165) = 8.27, p = .005) such that individuals screening positive for PTS showed larger reductions in heavy episodic drinking at follow-up. A significant three-way interaction between time, PTS, and intervention condition (F(2,167) = 5.76, p = .004) was found for alcohol related consequences. Specifically, among individuals screening positive for PTS, only those that received the counselor-administered BAI showed a significant reduction in consequences at follow-up. These results suggest that overall college students with PTS may respond well to BAIs and that counselor-delivered BAIs may be more efficacious than computer-delivered interventions for reducing alcohol problems for these high-risk students.     

Social–cognitive correlates of protective drinking behaviors and alcohol-related consequences in college students

Although heavy episodic drinkers are at risk to experience alcohol-related consequences, studies show that a large percentage of student drinkers do not experience problems as a result of their drinking. The present study was a more in-depth examination of factors beyond just drinking quantity and frequency to explain why students experience consequences. The current research examined the relationship between the use of protective behaviors, alcohol use, and alcohol related consequences, as well as the relationship between attitudinal and cognitive predictors of engaging in protective behaviors when drinking. We hypothesized there would be a significant direct effect of protective behaviors on consequences after taking into account the effect of alcohol use and that cognitive predictors, including perceived self-efficacy, perceived effectiveness, and subjective norm, would be associated with the attitude and frequency of engaging in protective behaviors. Results supported both hypotheses, indicating good model fit for all models and significant paths between constructs (p's < .05). These findings extend the literature on protective behaviors by providing insight as to their utility in preventing harm and why students choose to engage in these behaviors. Implications for interventions are also discussed.     

Pre-teen alcohol use initiation and suicide attempts among middle and high school students: Findings from the 2006 Georgia Student Health Survey

Early alcohol use initiation has been linked to suicide attempts among youth. However, very little is known about the potential impact of alcohol-related norms and beliefs and how these may impact the association between alcohol use and suicide attempt. This study examines the associations between early alcohol use and suicide attempts while controlling for demographic characteristics, and alcohol-related beliefs and norms (e.g., believing alcohol causes harm to health or that adults or friends disapprove of alcohol use) and potential confounders. Analyses were based on the 2006 Georgia Student Health Survey (N = 175,311) of students in grades 6, 8, 10 and 12. The current analyses were limited to students in grades 8, 10 and 12, who either began drinking prior to age 13 or who were non drinkers (n = 87,349). Pre-teen alcohol use initiation was associated with suicide attempts (Adj.OR = 1.51; 95%CI:1.38–1.66) relative to not drinking with similar associations for boys (Adj.OR = 1.72; 95%CI:1.52–1.94) and girls (Adj.OR = 1.26; 95%CI:1.08–1.45). Students who believed that alcohol was harmful to their health, or that friends or adults disapproved of their alcohol use, or who had been taught about substance use in school were less likely to make a suicide attempt, although findings differed for boys and girls. Pre-teen alcohol use initiation is an important risk factor for suicide attempts among boys and girls in Georgia. Increased efforts to delay and reduce early alcohol use through clinical interventions, education, and policies that impact norms and knowledge related to alcohol use are needed and may in turn reduce suicide attempts.     

The impact of motives-related feedback on drinking to cope among college students

Motives for alcohol use are associated with distinct antecedents and consequences. Drinking alcohol to cope with negative affect is consistently associated with the most problematic patterns of use. Interventions targeting drinking to cope are needed. This randomized controlled treatment trial is an initial attempt to evaluate the impact of a brief coping motive-specific personalized feedback intervention on motives and problematic outcomes associated with drinking. The study randomized 170 participants to receive either a brief Standard Feedback Condition (SFC; n = 83) or a Motives Feedback Condition (MFC; n = 87) that added education and feedback on drinking to cope as well as alternative coping strategies. Significant reductions in drinking to cope with anxiety and with depression were greater in the MFC at the 2-month follow-up. Significant reductions in drinking and negative consequences were observed but did not differ significantly by condition. Indirect tests showed that the MFC, relative to SFC, was associated with outcomes of drinking and negative consequences through change in drinking to cope with depression. Moderation analyses revealed that there were no differential outcomes according to baseline level of coping. This study is a promising new direction in motives research, providing support for brief personalized feedback interventions incorporating motives-related feedback.     

Collecting data on alcohol use and alcohol-related victimization: a comparison of telephone and Web-based survey methods

OBJECTIVE: Traditionally, personal contact with an experienced interviewer has been thought to facilitate collection of data on alcohol use and victimization experiences. Recent studies indicate that Web-based surveys may be an efficient alternative for gathering these sensitive data. To date, telephone interviewing and Web-based collection of data on alcohol-related negative consequences, particularly victimization, have not been compared. This study was designed to compare data from an interviewer-administered and Web-based survey on alcohol use and alcohol-related negative consequences in a sample of college women. METHOD: Seven hundred women from a second semester freshmen college class were randomly selected to participate in either the telephone interview or Web-based modes of survey administration. RESULTS: Fifty-three percent of invited women (N = 370) completed the survey. Completion rates were higher, and estimated dollar costs were significantly lower, for the Web-based survey. There were no differences in reported rates of alcohol or drug use by survey method; however, there were differences in several specific alcohol-related negative consequences. CONCLUSIONS: These findings suggest that, for college women, Web-based surveys versus telephone interviews can be an effective and more cost-efficient means for collecting data on alcohol use and related negative consequences, particularly victimization. In addition, we found some evidence that women may be more forthcoming when responding to a Web-based survey as compared with an interviewer-administered telephone survey.     

A pilot test of an alcohol skills training programme for Mexican-American college students

The alcohol skills training program for college students (ASTP) is an empirically supported intervention to reduce the harmful consequences of drinking behaviour among college students in the United States (US). However, ASTP had not been previously tested among college student samples in other cultures. In addition, very little is known about how to intervene upon risky alcohol use among Mexican-American college students, although this population is at high risk for alcohol abuse. In this study, the ASTP was revised to meet the cultural and language needs of bilingual Mexican-American college students. Mexican-American undergraduates (N = 109) attending a predominantly Latino university located along the US-Mexico border were randomly assigned to one of two intervention groups (manual-only and full ASTP). Participants were assessed at three time points (baseline, 3-month follow-up, and 12-month follow-up) to determine drinking patterns and alcohol-related consequences. Study results found that Mexican-American college students in both conditions consumed less alcohol and experienced fewer alcohol-related consequences after the intervention. The culturally relevant ASTP may be a promising harm reduction programme for Mexican-American college students, and ASTP strategies appear to be transportable into other cultures.     

Heavier drinking American college students may self-select into study abroad programs: An examination of sex and ethnic differences within a high-risk group

As with other heavier drinking groups, heavier drinking American college students may self-select into study abroad programs with specific intentions to use alcohol in the foreign environment. This cross-sectional study used a sample of 2144 students (mean age = 20.00, SD = 1.47) to explore differences in alcohol use and related negative consequences among (1) students intending to study abroad while in college, (2) students not intending to study abroad, and (3) students reporting prior study abroad participation. Results revealed that participants with no intention to study abroad drank less and experienced fewer alcohol-related consequences than participants intending to study abroad. In addition, students reporting prior completion of study abroad programs drank more and reported more hazardous alcohol use than those not intending to study abroad. Ethnic and sex differences existed; with White students, males, and females intending to study abroad and non-White students who previously completed study abroad programs demonstrating the most risk. These findings provide empirical support that study abroad students may be a heavier drinking subgroup necessitating intervention prior to beginning programs abroad.