Elsevier

Addictive Behaviors

Volume 36, Issue 5, May 2011, Pages 539-542
Addictive Behaviors

Short Communication
Using personalized feedback to reduce alcohol use among hazardous drinking college students: The moderating effect of alcohol-related negative consequences

https://doi.org/10.1016/j.addbeh.2011.01.005Get rights and content

Abstract

Web-based screening and brief interventions that include personalized feedback about their alcohol use have proven to be particularly promising for reducing hazardous drinking among university students. Despite the increasing use of these approaches, there is still relatively little known about how the content of these interventions may influence outcomes and who may benefit most from these approaches. The current study sought to address these issues by examining how individual differences in alcohol consequences influence outcomes of a laboratory-based computerized intervention.

Methods

One-hundred and nineteen introductory psychology students who either had two episodes of heavy episodic drinking in the past month or scored ≥ 8 on the AUDIT participated in this randomized controlled trial for course credit. Participants were assigned to 1 of 4 conditions in this 2 Intervention (Alcohol Feedback vs. Control) × 2 Assessment (Motivational Assessment vs. No Motivational Assessment) between-subjects design. Quantity of alcohol consumed per week and heavy episodic drinking one month later were the primary dependent variables.

Results

Controlling for corresponding baseline alcohol measures, hierarchical linear regression analyses showed a significant interaction between intervention condition and baseline alcohol-related consequences. For those who reported more alcohol consequences at baseline, the alcohol intervention resulted in significantly less alcohol use and fewer heavy drinking episodes at follow-up, while no difference was observed between intervention conditions for those with few baseline consequences. Assessment did not moderate intervention effects.

Discussion

These findings suggest that a feedback-based computerized intervention that includes normative information about alcohol use and consequences may be more effective for hazardous drinking students who are experiencing higher levels of alcohol-related consequences.

Research Highlights

► Effect of personalized feedback on student drinking moderated by alcohol consequences. ► Computerized alcohol intervention influences those with more alcohol consequences. ► Assessments regarding alcohol-related motivation did not influence alcohol outcomes.

Introduction

A large proportion of college students drink in a manner that puts them at risk for alcohol related harm (Hingson et al., 2002, Wechsler et al., 2000). Such findings have led to increasing efforts to develop effective intervention approaches that may be widely disseminated to a population of drinkers who typically do not seek treatment or identify their drinking behavior as problematic. One of the more promising approaches has been the use of web-based, personalized feedback about alcohol use (Elliott, Carey, & Bolles, 2008). Interventions that have included alcohol feedback (e.g., comparison of participant use to descriptive norms regarding alcohol frequency and quantity) have been shown to be effective at reducing alcohol use among college students (Neighbors et al., 2004, Walters et al., 2007). In addition to providing corrective information about peer drinking norms in a salient manner, personalized feedback may be used to enhance motivation to change by making individuals aware of the discrepancies between current alcohol use behavior and personal goals, standards, and values (Walters & Neighbors, 2005).

Although there is increasing evidence that students may be responsive to feedback-based interventions for alcohol use, there are a number of unanswered questions regarding how to optimize the efficacy of these approaches. Feedback-based interventions for college students have included different types of information (e.g., drinking norms, costs, and consequences) that have been delivered over varying durations. Despite the wide range of available interventions for college students, there is relatively little known about what information is most effective for promoting change in alcohol use behavior and whether this information may depend on individual differences (Carey et al., 2007, Elliott et al., 2008, Zisserson et al., 2007).

Previous work has suggested that students who are heavier drinkers may be more responsive to brief alcohol interventions (see Elliott et al., 2008, Murphy et al., 2001), as heavier drinking students may be more influenced by information provided in feedback and have greater discrepancies with perceived drinking norms. The main objective of the current study was to examine the question of whether a web-based alcohol intervention that provided personalized feedback about both alcohol use and alcohol-related consequences would be differentially effective for hazardous drinkers who had experienced more frequent alcohol-related consequences. A secondary objective of this study was to examine whether assessments would differentially influence the effect of the intervention. Given previous work on assessment reactivity effects (e.g., Kypri et al., 2006, Walters et al., 2009), we sought to examine whether the influence of the intervention would be moderated by whether students completed additional assessment instruments about psychological processes related to alcohol use and change.

Section snippets

Participants

Hazardous drinking students (30% male) volunteered to participate in the present study as part of their introductory psychology class. The study was approved by the institutional review board and students provided written informed consent. One hundred and nineteen students were enrolled in the study based on screening instruments completed in the first month of the academic year as part of a “health behaviors and college life” study. Hazardous drinking students were identified as those who

Alcohol involvement at baseline

At baseline, students reported a mean of 12.14 (SD = 7.2) drinks per week, 5.3 (SD = 3.2) heavy drinking episodes in the past month, and 6.40 (SD = 3.8) alcohol-related consequences in the past month. Of the 119 students, 77% had AUDIT scores of 8 or greater. There were no differences by intervention or assessment condition at baseline on these variables.

Weekly drinking

Hierarchical linear regression analysis was used to examine whether the effects of the intervention on weekly drinking was moderated by negative

Discussion

The current study suggests that providing web-based personalized feedback about alcohol use and consequences may be a particularly effective strategy for reducing alcohol use among hazardous drinking students who have experienced high levels of alcohol-related negative consequences. Hazardous drinkers who reported high levels of alcohol-related negative consequences showed less weekly alcohol use and heavy episodic drinking if they were exposed to the alcohol intervention compared to controls.

Role of Funding Sources

Funding for this research study was provided in part by NIAAA Grant P60 AA013759 (David Rosenbloom, PI). NIAAA had no role in the study design, collection, analysis, interpretation of data, writing of the manuscript, or decision to submit the paper for publication.

Contributors

The first author contributed to all aspects of the research including the study design, intervention development, analysis and manuscript writing. Author #2 contributed to the study design and writing of the manuscript. Author #3 contributed to the intervention development, analysis planning, and writing of the manuscript.

Conflict of Interest

There are no conflicts of interest for any of the authors.

References (21)

There are more references available in the full text version of this article.

Cited by (33)

  • Shyness and susceptibility to social influence: Stronger concordance between norms and drinking among shy individuals

    2021, Addictive Behaviors
    Citation Excerpt :

    Personalized normative feedback interventions have been found to reduce perceived drinking norms and alcohol use from one-month (Dimeff & McNeely, 2000; Doumas, McKinley, & Book, 2009; Lewis & Neighbors, 2006) to up to 2-years post-intervention (Neighbors et al., 2010). These reductions in drinking have been replicated among different delivery methods (feedback through mail, email, text messages, social media; Agostinelli, Brown & Miller, 1995; Bernstein et al., 2018; Neighbors, Larimer & Lewis, 2004; Palfai et al., 2011; Ridout & Campbell, 2014), as well as for specific events (21st birthdays and Mardi Gras; Bernstein et al., 2018; Buckner et al., 2019; Lewis et al., 2008). To further refine and extend this research area, social and contextual factors that may influence drinking norms and alcohol use are being considered.

  • Working memory moderates the association between perceived norms and heavy episodic drinking among college students

    2018, Addictive Behaviors
    Citation Excerpt :

    Although replication will be important, these findings show WM can act as a buffer against the influence of perceived peer norms on both quantity and frequency of personal alcohol use. In addition, norms predicted heavy drinking among students, which is consistent with previous research and supports efforts to address norms in brief interventions for college students who engage in hazardous drinking (McNally & Palfai, 2003; Neighbors, Larimer, & Lewis, 2004; Palfai, Zisserson, & Saitz, 2011). Interventions or prevention programs incorporating direct norm assessment and feedback/correction may be of benefit to those with lower WM capacity, who have less ability to inhibit the impact of social informational cues on their own drinking behavior.

  • Electronic communication based interventions for hazardous young drinkers: A systematic review

    2016, Neuroscience and Biobehavioral Reviews
    Citation Excerpt :

    Nine papers discussed delivering interventions using the Web, varying in length from 5 min to 35 min. Personalised feedback was found to reduce possible effectiveness among specific sub-groups of students (Cunningham et al., 2012; Palfai et al., 2011), with some evidence to suggest that this type of feedback could prevent the uptake of alcohol among those who do not drink (Palfai et al., 2014). Hester et al.⿿s (2012) study comprising of personalised feedback along with decisional balance exercises, social norms and risk factors, found that reductions in drinking and alcohol-related problems tended to be significantly greater in the intervention group compared to the assessment only control group (p < 0.01).

  • The efficacy of a web-based gambling intervention program for high school students: A preliminary randomized study

    2016, Computers in Human Behavior
    Citation Excerpt :

    To the authors' knowledge, this is the first study to examine a WBI implemented via the school for ninth grade students. In addition, since previous studies have suggested that the effectiveness of the intervention is moderated by individual differences at baseline, such as alcohol-related negative consequences (Canale, Vieno, Chieco, Santinello, & Andriolo, 2015; Palfai, Zisserson, & Saitz, 2011), a secondary objective was to examine whether the intervention would be differentially effective for frequent gamblers (FGs) at baseline (i.e., before intervention). It is hypothesized that compared to the control condition at follow-up, students receiving the WBI would report: (i) lower rates of gambling (gambling frequency, gambling problems, and gambling expenditure), and (ii) more realistic attitudes about the profitability of gambling as assessed using the Gambling Attitudes Scale (GAS; Delfabbro & Thrupp, 2003; Italian version: Primi, Donati, Bellini, Busdraghi, & Chiesi, 2013).

View all citing articles on Scopus
View full text