Reducing high-risk drinking in mandated college students: Evaluation of two personalized normative feedback interventions (original) (raw)
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Journal of Consulting and Clinical Psychology, 2013
Objectives: 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 repeatedassessment control in reducing risky drinking and associated consequences. Method: 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. Results: 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. Conclusions: 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.
Background Norms clarification has been identified as an effective component of college student drinking interventions, prompting research on norms clarification as a single-component intervention known as Personalized Normative Feedback (PNF). Previous reviews have examined PNF in combination with other components but not as a stand-alone intervention. Objectives To investigate the degree to which computer-delivered stand-alone personalized normative feedback interventions reduce alcohol consumption and alcohol-related harms among college students and to compare gender-neutral and gender-specific PNF. Data Sources Electronic databases were searched systematically through November 2014. Reference lists were reviewed manually and forward and backward searches were conducted. Selection Criteria Outcome studies that compared computer-delivered, stand-alone PNF intervention with an assessment only, attention-matched, or active treatment control and reported alcohol use and harms among college students. Methods Between-group effect sizes were calculated as the standardized mean difference in change scores between treatment and control groups divided by pooled standard deviation. Within-group effect sizes were calculated as the raw mean difference between baseline and follow-up divided by pooled within-groups standard deviation. Results Eight studies (13 interventions) with a total of 2,050 participants were included. Compared to control participants, students who received gender-neutral (dbetween = 0.291, 95% CI [0.159, 0.423]) and gender-specific PNF (dbetween = 0.284, 95% CI [0.117, 0.451]) reported greater reductions in drinking from baseline to follow-up. Students who received gender-neutral PNF reported 3.027 (95% CI [2.171, 3.882]) fewer drinks per week at first follow-up and gender-specific PNF reported 3.089 (95% CI [0.992, 5.186]) fewer drinks. Intervention effects were small for harms (dbetween = 0.157, 95% CI [0.037, 0.278]). Conclusions Computer-delivered PNF is an effective stand-alone approach for reducing college student drinking and has a small impact on alcohol-related harms. Effects are small but clinically relevant when considered from a public health perspective. Additional research is needed to examine computer-delivered, stand-alone PNF as a population-level prevention program.
Indicated prevention for incoming freshmen: Personalized normative feedback and high-risk drinking
Addictive Behaviors, 2007
This research evaluated the efficacy of a computerized, freshmen-specific personalized normative feedback (PNF) intervention on reducing alcohol consumption among high-risk drinking freshmen. Students (N = 316; 53.8% female) completed measures of perceived drinking norms and drinking behavior. After completing the baseline assessment, students were randomly assigned to receive either freshmen-specific PNF that was gender-specific or gender-neutral, or to assessment only control. Findings demonstrated that students exhibited normative misperceptions for typical freshmen drinking behavior and that perceptions of typical same-sex freshmen drinking were positively associated with riskier drinking behavior. At follow-up, students randomly assigned to receive PNF reduced perceptions of typical freshmen drinking behavior and personal drinking behavior relative to those who did not receive PNF. Findings extend previous evaluations of computer-based PNF and suggest that computer-based PNF for incoming freshmen using utilizing freshmen-specific norms that are gender-specific may constitute a promising prevention strategy.
Feedback interventions for college alcohol misuse: What, why and for whom?
Addictive Behaviors, 2005
In response to the persistent problem of college drinking, universities have instituted a range of alcohol intervention programs for students. Motivational feedback is one intervention that has garnered support in the literature and been adopted on college campuses. This article reviews published outcome studies that have utilized feedback as a major component of an alcohol intervention for college students. Overall, 11 of the 13 reviewed studies (77%) found a significant reduction in drinking as compared to a control or comparison group. While the studies varied widely in terms of population, follow-up period, and feedback content, it appears that feedback can be effective whether delivered by mail, the Internet, or via a face-to-face motivational interview. Feedback seems to change normative perceptions of drinking and may be more effective among students who drink for social reasons. The addition of a group or individual counseling session does not appear to increase the short-term impact of the feedback.
Journal of College Counseling, 2011
This study evaluated the effectiveness of a web-based personalized normative feedback program, electronic Check-Up to Go (e-CHUG), in decreasing heavy drinking among 1st-year university students. Results indicated high-risk students receiving the e-CHUG program during 1st-year orientation activities reported significantly greater reductions in heavy drinking and alcohol-related consequences than did students in an assessment-only control group at a 3-month follow-up. Recommendations for integrating e-CHUG into orientation activities are discussed.
Psychology of Addictive Behaviors
Personalized drinking feedback is an evidence-based and increasingly common way of intervening with high-risk college drinking. This article extends an earlier review by Walters and Neighbors (S. T. Walters & C. Neighbors, 2005, Feedback interventions for college alcohol misuse: What, why, and for whom? Addictive Behaviors, 30, 1168-1182) by reviewing the literature of published studies using personalized feedback as an intervention for heavy drinking among college students. This article updates and extends the original review with a more comprehensive and recent set of 41 studies, most of which were not included in the original article. This article also examines within-subject effect sizes for personalized feedback interventions (PFIs) for high-risk alcohol use and examines the content of PFIs more closely to provide insight on the most essential components that will guide the future development of feedback-based interventions. In general, PFIs appear to be reliably effective at r...
Journal of Studies on Alcohol and Drugs, 2016
Personalized normative feedback (PNF) interventions have received empirical support, are presumed to work by reducing normative misperceptions, and have been found to be particularly efficacious for those who drink for social reasons. However, PNF interventions also offer direct comparisons between one's own drinking and normative drinking, which may be especially important for coping drinkers. The present research evaluated whether reduced perceived norms and drinking at follow-ups varied as a function of coping motives. Method: Aims were examined as a secondary analysis of a PNF intervention study among 252 U.S. college students. Following baseline assessment, participants were randomly assigned to receive PNF or assessment only. Follow-up assessments occurred 3 and 6 months after baseline. Results: Findings indicated that the PNF intervention was more effective at both follow-ups in reducing drinking, but not alcohol use problems, for participants scoring higher in coping motives. Furthermore, coping motives were the only drinking motive that uniquely moderated PNF efficacy. Analyses indicated that intervention effects on drinking varied as a function of coping drinking motives; however, intervention effects on norms did not vary by coping motives. Finally, coping motives were found to moderate associations between perceived norms and drinking. Conclusions: These results suggest that coping motives may be useful for identifying young adults-and presumably others-who can most benefit from PNF approaches. Furthermore, PNF may influence future drinking behavior through mechanisms other than changes in perceived norms. Future investigations could examine other pathways through which PNF may reduce drinking.
Clinical Psychology & Psychotherapy, 2012
The present study used a randomized clinical trial design to examine the effectiveness of personalized alcohol feedback delivered individually, in a group and via computer on alcohol use and related negative consequences in a sample of 173 college students referred for alcohol-related violations. Findings revealed statistically significant reductions in alcohol use and related harms for the individually delivered intervention, with significant reductions in alcohol-related harms for the electronically delivered intervention. No statistically significant results were found for the group-delivered intervention or between groups, and a main effect of time was noted for all outcome variables. This study adds to the literature by being the first randomized clinical trial to include analyses of an empirically supported individually delivered personalized alcohol feedback intervention with more cost-effective group-delivered and electronically delivered feedback formats within a single research design, by expanding the range of participant drinking habits reported at baseline to include all drinking levels and not solely those classified as 'heavy drinking' and by providing anonymity pre-intervention and post-intervention given the potential demand characteristics to underreport illegal and/or illicit behaviours in this vulnerable population.
Two brief alcohol interventions for mandated college students
Psychology of Addictive Behaviors, 2005
Encouraging but limited research indicates that brief motivational interventions may be an effective way to reduce heavy episodic drinking in college students. At 2 campuses, students (83% male) mandated to a substance use prevention program were randomly assigned to 1 of 2 individually administered conditions: (a) a brief motivational interview (BMI; n = 34) or (b) an alcohol education session (AE; n = 30). Students in the BMI condition reported fewer alcohol-related problems than the AE students at 3-and 6-month assessments. Trends toward reductions in number of binge drinking episodes and typical blood alcohol levels were seen in both groups. Process measures confirmed the integrity of both interventions. The findings demonstrate that mandated BMIs can reduce alcohol problems in students referred for alcohol violations.
Journal of Substance Abuse Treatment, 2012
This study evaluated the efficacy of two brief personalized feedback interventions (PFIs) using identical feedback and motivational interviewing strategies aimed at reducing alcohol consumption and alcohol-related problems to two control conditions among a sample of high-risk drinking college students. Students (N = 152) were randomly assigned to a computer-delivered PFI with a video interviewer, a faceto-face PFI with a live interviewer, a comprehensive assessment condition, or a minimal assessment-only condition. At 10 weeks posttreatment, the face-to-face PFI significantly reduced weekly drinking quantity and peak and typical blood alcohol concentration compared with the comprehensive assessment and minimal assessment-only conditions (d values ranged from 0.32 to 0.61). No significant between-group differences were evidenced for the computer-delivered PFI condition, although effect sizes were comparable to other college drinking studies using computer-delivered interventions (d values ranged from 0.20 to 0.27). Results provide further support for the use of a face-to-face PFI to help reduce college students' alcohol consumption and suggest that a video interviewer in the context of a computerdelivered PFI is likely a helpful but not necessarily a complete substitute for a live interviewer.