Short CommunicationUsing personalized feedback to reduce alcohol use among hazardous drinking college students: The moderating effect of alcohol-related negative 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)
- et al.
Individual-level interventions to reduce college student drinking: a meta-analytic review
Addictive Behaviors
(2007) - et al.
Computer-based interventions for college drinking: A qualitative review
Addictive Behaviors
(2008) - et al.
Personal strivings, binge drinking, and alcohol problems
Addictive Behaviors
(2004) - et al.
Feedback intervention for college alcohol misuse: what, why, and for whom?
Addictive Behaviors
(2005) - et al.
Applied multiple regression/correlation analysis for the behavioral sciences
(1983) Motivations for alcohol use among adolescents: Development and validation of a four-factor model
Psychological Assessment
(1994)- et al.
Systematic motivational counseling
- et al.
Brief alcohol screening and intervention for college students (BASICS): A harm reduction approach
(1999) - et al.
Magnitude of alcohol-related mortality and morbidity among US college students ages 18–24
Journal of Studies on Alcohol
(2002) - et al.
Assessing alcohol problems in college students
Journal of American College Health
(1992)
Cited by (33)
Shyness and susceptibility to social influence: Stronger concordance between norms and drinking among shy individuals
2021, Addictive BehaviorsCitation 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.
The prevalence and impact of elevated anxiety sensitivity among hazardous drinking college students
2020, Drug and Alcohol DependenceWorking memory moderates the association between perceived norms and heavy episodic drinking among college students
2018, Addictive BehaviorsCitation 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 ReviewsCitation 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 BehaviorCitation 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).