Personalized Feedback Interventions for College Alcohol Misuse: An Update of Walters & Neighbors (2005) (original) (raw)
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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.
2009
Little is known about individual and situational factors that moderate the efficacy of Personalized Feedback Interventions (PFIs). Mandated college students (N = 348) were randomly assigned to either a PFI delivered in the context of a brief motivational interview (BMI; n = 180) or a written PFI only (WF) condition and followed up at 4 months and 15 months post-intervention. We empirically identified heterogeneous subgroups utilizing mixture modeling analysis based on heavy episodic drinking and alcohol-related problems. The four identified groups were dichotomized into an improved (53.4%) and a non-improved (46.6%) group. Logistic regression results indicated that the BMI was no more efficacious than the WF across all mandated students. However, mandated students who experienced a serious incident requiring medical or police attention and those with higher levels of alcohol-related problems at baseline benefited more from the BMI than from the WF. It may be an efficacious and cost-effective approach to provide a written PFI for low-risk mandated students and an enhanced PFI with a BMI for those who experience a serious incident or with higher baseline alcohol-related problems. Keywords alcohol; college students; brief intervention; personalized feedback intervention; evidence-based treatment Over 40% of college students report heavy episodic drinking (HED) at least once in the past two weeks and over 20% report HED three or more times in the past two weeks (Wechsler, Lee, Kuo, Seibring, Nelson, & Lee, 2002). Consequences of excessive drinking among college students include injuries, motor vehicle accidents, unprotected sex, sexual victimization, academic problems, health problems, suicide attempts, destructive behavior, and police involvement (Engs, Diebold,
Personalized mailed feedback for college drinking prevention: A randomized clinical trial
Journal of Consulting and Clinical Psychology, 2007
The current study was designed to evaluate the efficacy of a mailed feedback and tips intervention as a universal prevention strategy for college drinking. Participants (N = 1,488) were randomly assigned to feedback or assessment-only control conditions. Results indicated that the mailed feedback intervention had a preventive effect on drinking rates overall, with participants in the feedback condition consuming less alcohol at follow-up in comparison with controls. In addition, abstainers in the feedback condition were twice as likely to remain abstinent from alcohol at follow-up in comparison with control participants (odds ratio = 2.02), and feedback participants were significantly more likely to refrain from heavy episodic drinking (odds ratio = 1.43). Neither
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.
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.
Journal of Substance Abuse Treatment, 2011
This study evaluated the efficacy of two brief personalized normative feedback interventions aimed at reducing heavy drinking among mandated college students (N = 135). Students were randomly assigned to one of two conditions: Web-based assessment with self-guided personalized normative feedback (SWF) or Web-based assessment with counselor-guided personalized normative feedback (CWF). Results indicated that students in the CWF condition reported significantly greater reductions in weekly drinking quantity and binge drinking frequency than those in the SWF group at follow-up (M = 8 months). Students in the CWF group also reported significantly greater reductions in estimates of peer drinking from baseline to the follow-up assessment than students in the SWF group. In addition, changes in estimates of peer drinking partially mediated the effect of the intervention on changes in drinking. Results suggest that counselor-guided feedback may be more effective in reducing drinking among mandated students relative to self-guided feedback in the long term.
Addiction Science & Clinical Practice, 2012
Background: There is a growing body of evidence indicating that web-based personalized feedback interventions can reduce the amount of alcohol consumed in problem drinking college students. This study sought to evaluate whether providing voluntary access to such an intervention would have an impact on drinking. Methods: College students responded to an email inviting them to participate in a short drinking survey. Those meeting criteria for risky drinking (and agreeing to participate in a follow-up) were randomized to an intervention condition where they were offered to participate in a web-based personalized feedback intervention or to a control condition (intervention not offered). Participants were followed-up at six weeks. Results: A total of 425 participants were randomized to condition and 68% (n = 290) completed the six-week follow-up. No significant difference in drinking between conditions was observed. Conclusions: Web-based personalized feedback interventions that are offered to students on a voluntary basis may not have a measurable impact on problem drinking. Trial Registration: ClinicalTrials.gov: NCT01521078
Alcohol and Alcoholism, 2010
Aims: To examine the impact of a web-based personalized feedback intervention, the Check Your Drinking (CYD; www. CheckYourDrinking.net) screener at 12-month follow-up. Methods: Respondents (N = 185) were recruited from a general population telephone survey of Ontario, Canadian adults (≥18 years) by asking risky drinkers if they were willing to help develop and evaluate Internet-based interventions for drinkers. Those randomly assigned to the intervention condition were provided with the web address and a unique password to a study-specific copy of the CYD. Respondents assigned to the control condition were sent a written description of the different components of the CYD and asked how useful they thought each of the components might be. Respondents were followed up at 3, 6 and 12months. Results: By the 12-month follow-up, the impact of the intervention previously reported at 3 and 6months of CYD on problem drinkers' alcohol consumption was no longer apparent (P > 0.05). Conclusions: Recognizing that many people with alcohol concerns will never seek treatment, recent years have seen an increase in efforts to find ways to take treatment to problem drinkers. The CYD is one such intervention that has a demonstrated effect on reducing alcohol consumption in the short term (i.e. 6months). Other more intensive Internet-based interventions or interventions via other modalities may enhance this positive outcome over the short and long term among problem drinkers who would be otherwise unlikely to access treatment for their alcohol concerns. www.ClinicalTrials.gov registration #NCT00367575.
Psychology of Addictive Behaviors, 2010
This study evaluated methods of enhancing college students' retention of information provided to them in a computer-delivered personalized drinking feedback intervention and whether enhanced retention reduced alcohol consumption during the two-week period following the intervention. Participants were 98 college students who reported at least one heavy drinking episode in the past two weeks. After participating in an online, personalized drinking feedback intervention, students were randomly assigned to one of three experimental conditions: 1) typical, in which they were simply sent home, 2) reading, in which they were asked to spend the next 20 minutes re-reading the feedback, and 3) recall, in which they were asked to spend the next 20 minutes writing down as much of the information from the feedback as they could remember. Two weeks following the intervention, participants completed a recall test and provided information on their alcohol use during the previous two weeks. Results indicated that participants in the reading and recall conditions retained more of the feedback information than did participants in the typical condition. In addition, participants in the reading and recall conditions reported reduced alcohol consumption in the two-week period following the intervention, compared to those in the typical condition. Information retention partially mediated the effects of the reading and recall conditions on drinking outcomes.
Evaluation of a Brief Personalised Intervention for Alcohol Consumption in College Students
PLOS ONE, 2015
In the current study we investigated the effect of a brief personalised feedback intervention (BPI), compared to an active control intervention, on outcome measures of (i) alcohol consumption (ii) frequency of binge drinking and (iii) readiness to change (RTC). A sample of 103 college students (mean age=23.85) who consumed alcohol regularly provided baseline measures of drinking behaviour and readiness to change before completing an alcoholrelated quiz on the UK Department of Health's Change4Life website (active control). The study was a between subjects design and half the participants were randomly allocated to the BPI group (N=52), who received 10 minutes personalised feedback on their drinking in addition to the alcohol-related quiz. At a two-week follow-up, participants (N=103) repeated the questionnaire battery, and attempted to recall the answers to the alcohol quiz. Results indicated that both groups significantly reduced their alcohol consumption and frequency of binge drinking but there were no significant group differences in either of these measures. We conclude that the provision of generalised information can be as efficient as a BPI for the reduction of alcohol consumption in students.