Extension and Online Adaptation of the FITSTART Parent-based Intervention to Reduce Drinking Among First-year Students
Phase: NA
Conditions: Alcohol Drinking, Alcohol Problem Drinking, Parenting
Sponsor: Loyola Marymount University

PRS Cover Page for Study Protocol 
 
Title: Parent Feedback Intervention Targeting Student Transitions and 
Alcohol Related Trajectories (+) Efficacy Study (FITSTART+) 
 
Date: April 26, 2021 
 
ClinicalTrials.gov Identifier: NCT04549454 

LOYOLA MARYMOUNT UNIVERSITY 
 
IRB Application Questionnaire for “Extension and Online 
Adaptation of the FITSTART parent-based intervention to reduce 
drinking among first-year students.” 
All materials must be typed. 
1. RESEARCH BACKGROUND 
Please describe the purpose of your research.  Provide relevant background information and briefly state 
your research question(s).  You may provide relevant citations as necessary. (300 Word Max.) 
Despite a growing understanding that parents continue to shape adolescents’ alcohol 
use decisions even after students leave the home and matriculate to college, parent influence 
remains a severely underutilized resource in the fight to curb risky drinking on college 
campuses—partly because, to date, parent-based interventions (PBIs) have been ineffective at 
reducing heavy episodic drinking (HED). Recently, we were able to develop a PBI that 
influenced numerous indicators of student alcohol use, including HED, by combining the 
informational content that characterizes a typical PBI with a live group-based social norms 
intervention designed to motivate parents to engage with the informational content more deeply 
and to really apply it to their interactions with their child. The current project aims to adapt, 
optimize, and extend this successful intervention in 3 key ways: (1) by employing recent 
advances in “co-presence” technology that will allow us to move to online delivery of the 
intervention without sacrificing the benefits of a live group session, (2) by conducting a year-long 
documentation study to expand the scope of the intervention by identifying specific parenting 
behaviors that are most strongly associated with reduced student risk across the first year of 
college, (3) by delivering the intervention across the first semester of college rather than a single 
session delivered during the summer, and (4) by augmenting the norms and information with 
engaging professional-quality video content featuring top experts on adolescent parenting. 
2. SUBJECT RECRUITMENT 
How will subjects be selected?  What is the sex and age range of the subjects?  Approximately how many 
subjects will be studied? 
How will subjects be contacted?  Who will make initial contact with subjects?  Specifically, what will subjects 
be told in initial contact?  
If subjects will be screened, describe criteria and procedures. 
This study seeks to evaluate both feasibility and efficacy of the FITSTART+ app-based 
intervention for parents. The goal is to assess efficacy of the intervention version of the 
FITSTART+ app on student alcohol outcomes, relative to an active control version of the app. 
Participants in the clinical trial will ultimately be 400 to 600 LMU students who have a parent 
randomized to use either the intervention or control version of the app. The Registrar will 
provide student and parent contact information for the incoming freshman class (approx. 1600 
students and 3000 parents). Incoming traditional, non-international first-year students (i.e., first-
time college students aged 17–20 years) registered to attend LMU during the Fall semester and 
who have at least one parent/guardian email on file with the admissions office will be emailed an 
invitation to participate in a three-part web-based survey assessing experiences during their first 
year of college. Invitations to complete the baseline survey will be sent in July 2021 (T1) via the 
admissions office who will verify each student’s age, year in school, and whether they have a 
parent/guardian email on file. The baseline survey and each follow-up survey will be open for 

approximately 3 weeks. Student participants will receive a $25 electronic gift card for completing 
each study survey and an additional $10 bonus if they complete all three surveys.  
To participate in the study, students must:  
1) 
Be a first-year college student 17–20 years of age. 
2) 
Have a parent/guardian email on file with the admissions office. 
3)  
Be a domestic (i.e., non-international) student. 
4) 
Consent to participate (with parental consent for minors under age 18). 
3. PROCEDURES 
Summarize fully all procedures to be conducted with human subjects. 
This intervention study tests the feasibility of the FITSTART+ program and evaluates the 
effects of the parent-program on student drinking. That is, the program will be delivered to 
parents exactly as it might be delivered in the real world, out of the study context (no incentives, 
knowledge of condition assignment, or awareness of associated student survey study). 
Simultaneously, alcohol use outcomes will be assessed among the first-year students of 
participating parents with students incentivized to complete 3 surveys spanning their first year. 
Recruitment will begin in July 2021 prior to matriculation and will be identical to the IRB 
approved recruitment procedure in our successful previous R21 FITSTART project (LMU IRB 
2014 SP 45). In early summer, the Registrar will provide the research team with new student 
and parent contact information.  
Emails sent by the university’s admissions office will only invite students who meet our 
eligibility criteria to participate in a 3-part longitudinal survey study about their transition into 
college life. These invitations will mention that they will receive $25 for each 15-minute survey 
and an additional $10 bonus if they complete all three (for a total of $85). This email will contain 
a link for interested students to complete the IRB-approved informed consent form. When 
consenting, students indicate whether they are 18 years of age or older, or under 18. Students 
18 or older will provide consent while those under the age of 18 who wish to participate will 
provide assent and then will be asked for their parent’s email address and their parents will be 
sent a consent form (Consent Appendix). As part of the consent form, students will also agree to 
the potential linking of their data with data provided by their parent(s) who may also be 
participating in a separate study. The form will specify that their survey responses will NOT be 
shared with their parents under any circumstances and their participation in the study will be 
confidential. If students agree to the potential parent-data linkage, they will immediately be 
redirected (triggered automatically by Qualtrics) to begin the baseline survey. Incoming first-year 
student recruitment will continue until 700 students have completed the baseline survey.  
All parents of students who complete the baseline survey will be invited via email to take 
part in the FITSTART+ program. To sign up, parents will need to click a link in the email to visit 
the FITSTART+ landing page which will include a general description of the application (no 
information about alcohol), a description of the parenting experts featured in the application, and 
a parent verification form. The verification form, which will be a Qualtrics survey embedded in 
the landing page, will serve two important purposes: it will (1) match parents to their students in 
the dataset; and (2) randomize parents to the treatment or control version of the app. The 
randomizer will be set up in Qualtrics to balance assignment to an app condition by students’ 
birth sex. At the end of the verification form, parents will receive a web URL linking to the sign-
up page for the application to which they were randomized. Parents who click the link will be 
prompted to create their user account. In order to not artificially bias parents’ app use, parents 
will be unaware that there is more than one version of the app, they will not be incentivized to 
use the app, and they will not be told that their child is participating in a survey study. 
 

4. 
RISKS / BENEFITS 
What are the potential benefits to subjects and/or to others? 
What are the reasonably foreseeable risks to the subjects?  (Risks may include discomfort, 
embarrassment, nervousness, invasion of privacy, etc.)  If there are potential risks to subjects, how will 
they be minimized in advance?  How will problems be handled if they occur? 
A. Potential Risks 
 
Psychological risks posed by the research are primarily related to the sensitivity of some 
of the measures. Student participants will complete measures assessing alcohol-related beliefs 
and behaviors that may be private. These questions may make subjects uncomfortable or be 
perceived as an intrusion on their privacy. They also will be asked to report on potentially illegal 
behaviors, such as drinking under the legal age. Answers to these questions could pose a risk if 
the information were known and linked to identifiable individuals. To mitigate risks participants 
will be reminded that they are free to skip any questions that make them feel uncomfortable. 
Additionally, their responses will not be directly linked to any identifiable information. 
 
B. Potential Benefits 
 
The proposed study will evaluate the efficacy of a parent-based normative feedback 
intervention that aims to leverage parental influence to reduce the risk for heavy drinking and 
associated consequences among incoming first-year college students. Parents in the 
intervention group will learn about the risks of alcohol use among students and discuss 
strategies to maintain an open dialogue with their child regarding alcohol-related attitudes and 
expectations. It is anticipated that parents and students in the intervention condition will gain 
substantial benefit from participating in the study, with regard to parents learning about alcohol 
risk and communication, and students engaging in less risky alcohol use behaviors and 
negative alcohol-related consequences. In addition, all student participants in both the 
intervention and control groups will be monitored for high-risk drinking levels and endorsement 
of high levels of negative consequences, and will be provided appropriate referrals when 
necessary. Specifically, participants reporting consumption of potentially lethal doses of alcohol 
(BAC's above .30) or RAPI consequences scores (incidence) of 16 or above on the initial or any 
follow-up questionnaire will be contacted and informed of their risk, and provided referrals for 
clinical services. This is a benefit that would not otherwise occur without study participation.  
5. 
CONFIDENTIALITY 
Will subjects be identifiable by name or other means?  If subjects will be identifiable, explain the 
procedures that will be used for collecting, processing, and storing data.  Who will have access to data?  
What will be done with the data when the study is completed? If you are collecting visual images of your 
subjects please justify this. 
 
Parent/student dyads will be set up in order to link the data. To do this the parents and 
the students will share the same PIN. If more than one parent decides to participate their PINs 
will end in either -1 or -2. The sharing of PINs allows for the linkage of data without individuating 
information attached. This linkage is solely for analytic purposes and will only be used to look at 
student outcome data. 
 
To maintain confidentiality of data submitted over the internet, participants will submit all 
information via Qualtrics (Qualtrics has SAS 70 Certification and meets the rigorous privacy 
standards imposed on health care records by the Health Insurance Portability and 

Accountability Act). All Qualtrics accounts are hidden behind passwords and all data is 
protected with real-time data replication. Data transfer will be protected using a Secure Socket 
Layer with 128-bit encryption. This is the same level of encryption used for most banking 
transactions and offers the highest degree of protection available for data transfer. The server is 
physically located in a secure, commercially protected co-location facility with 24-hour locked 
and monitored keycard access, within a locked room, within a locked server rack, with a locking 
face-plate protecting the server itself from physical access without authorization. Electronic 
protection is provided by a commercial-grade firewall, with continuous monitoring of the server 
for any attempts at electronic invasion. Any associated paper documents will be stored in a 
locked file cabinet within the lab. Study results will be reported in aggregate, so that individual 
participants will not be identifiable in any research reports or presentations of the proposed 
study. As we often receive requests for our data to be used in meta-analyses, data from the 
study will be kept for 5 years after the completion of the project. After this period of time all data 
will be destroyed. 
 
6. 
INFORMED CONSENT 
Attach an informed consent form or a written request for waiver of an informed consent form.  Include 
waiver of written consent if appropriate.  If your research is being conducted in another language, please 
include copies of the translated “Informed Consent” or “Waiver of Written Consent” forms. 
 
Please see attached CONSENT APPENDIX for consent forms. 
7. 
STUDENT RESEARCH 
When a student acts as principal investigator, a faculty sponsor signature is required on the application 
form. 
 
N/A 
8.  
RENEWAL APPLICATIONS 
When the submission is a Renewal Application, include a summary of the research activities during the previous 
granting period specifically addressing:  number of subjects studied and any adverse reactions 
encountered, benefits which have been derived, any difficulty in obtaining subjects or in obtaining 
informed consent, and approximate number of subjects required to complete the study. 
N/A 
9. 
PAYMENTS 
If subjects are to be paid in cash, services, or benefits, include the specific amount, degree, and basis of 
remuneration. 
Students will receive a $25 gift card for each 15-minute survey and an additional $10 gift 
card bonus if they complete all three (for a total of $85). Gift cards will be sent to students 
via email within 48 hours of survey completion via an online gift card service called giftbit 
(www.giftbit.com).  

10. 
PSYCHOLOGY SUBJECT POOL 
When students from the Psychology Subject Pool (PSP) are to be involved as subjects, permission must 
be obtained from the PSP prior to running subjects.   
Forms are available from the Psychology Office in 4700 University Hall.  It is not necessary to inform the 
IRB of approval from the PSP, however the PSP requires IRB approval prior to permission for using the 
pool being granted. 
N/A  
 
11. 
QUALIFICATIONS AND TRAINING 
Describe the qualifications of, or method of training and supervision afforded student experimenters. This 
includes past experience, type and frequency of student/sponsor interactions during the experiment, and 
Human Subjects Protections Training. 
 
All experimenters have completed the NIH or CITI Protection of Human 
Subjects training course. We have attached copies of each researcher’s certificate. 
12. 
RANDOMIZATION 
Describe criteria for assigning subjects to sub-groups such as “control” and “experimental.” 
 
Although the participants among whom outcomes will be assessed are students, parents 
of these students will be the ones randomized to the treatment or control version of the app. A 
verification form on the informational FITSTART+ landing page, will serve two important 
purposes: (1) it will match parents to their students in the dataset; and (2) randomize parents to 
the treatment or control version of the app. The randomizer will be set up in Qualtrics to balance 
assignment to an app condition by students’ birth sex. At the end of the verification form, 
parents will receive a web URL linking to the sign-up page for the application to which they were 
randomized. The treatment condition will receive the FITSTART+ intervention while the control 
group will receive a similar program which covers all non-alcohol related resources included in 
the intervention version of FITSTART+ (e.g., general parenting information, university-specific 
resources).  
13. 
USE OF DECEPTION 
If the project involves deception, describe the debriefing procedures that will be used.   
Include, verbatim, the following statement in the consent form: "Some of the information with which I will 
be provided may be ambiguous or inaccurate.  The investigator will, however, inform me of any 
inaccuracies following my participation in this study." 
 
N/A 
 
14. 
QUESTIONNAIRES AND SURVEYS 
 

Include copies of questionnaires or survey instruments with the application (draft form is acceptable).   
If not yet developed, please so indicate and provide the Committee with an outline of the general topics 
that will be covered.  Also, when the questionnaire or interview schedule has been compiled, it must be 
submitted to the Committee for separate review and approval.  These instruments must be submitted for 
approval prior to their use. 
Consider your population. If they are foreign speakers, please include copies in the foreign language. 
Please see attached MEASURES APPENDIX 
 
15. 
PHYSICIAN INTERACTIONS 
To ensure that all patients receive coordinated care, the principal investigator is obligated to inform the 
primary physician (when not the principal investigator) of all studies on his/her patients.  
 
N/A 
 
16. 
SUBJECT SAFETY 
Describe provisions, if appropriate, to monitor the research data collected, to ensure continued safety to 
subjects. 
 
High-risk drinking levels and the endorsement of high levels of negative consequences by 
students will be continually monitored during all phases of the study. Specifically, students 
reporting consumption of potentially lethal doses of alcohol (BAC's above .30) or RAPI 
consequences scores (incidence) of 16 or above on the initial or any follow-up 
questionnaire will be contacted and informed of their risk and provided referrals for clinical 
services.  The research team will provide treatment referrals to participants who 
demonstrate significant increases in alcohol consumption in the follow-up phases 
compared to baseline assessment. See section 18 for more information about the referral 
process.  
17. 
REDUNDANCY 
To minimize risks to subjects, whenever appropriate, use procedures already being performed on the 
subjects for diagnostic or treatment purposes.  Describe provisions. 
 N/A 
 
18. 
COUNSELING 
In projects dealing with sensitive topics (e.g., depression, abortion, intimate relationships, etc.) 
appropriate follow-up counseling services must be made available to which subjects might be 
referred.   
The IRB should be notified of these services and how they will be made available to subjects. 
Although we do not foresee any Serious Adverse Events (SAE) or Adverse Events (AE) as a 
result of participating in this study, PI LaBrie will personally offer a brief one-time in-person or phone 
counseling and assessment session to all student participants reporting alcohol, drug, and mental 
health related Adverse Events (AEs) and Serious Adverse Events (SAEs) regardless of their relation 

to the intervention study in order to assess the situation and offer referral resources. If an AE or SAE 
occurs, PI LaBrie will first refer the student will be referred to the Community of Care. He will also 
provide participants with referrals to appropriate personnel at LMU’s Student Psychological Services 
(SPS), the Student Health Center (SHC), and/or outside non-LMU resources. If a SAE is life-
threatening, LaBrie will contact public safety if required. Should there be any unanticipated problems 
that detract from a positive parent or student participant experience in the study, issues will be 
addressed with participants immediately, and PI LaBrie will work with the University’s IRB to swiftly 
develop and enact a resolution plan. All SAEs, AEs and unanticipated problems will be managed 
consistent with University IRB guidelines. Additionally, any SAEs or AEs will be reported to the 
NIH/NIAAA within 24 hours. 
If data reveals a SAE or we learn of it through a student, their PIN number associated with 
their survey data will be located. We will then search the separate data file for the student’s 
contact information. Listed below are the specific resources which will be provided to students if 
an SAE or AE occurs. 
 
LMU Resources: 
Dr. Joseph LaBrie: jlabrie@lmu.edu; (310) 338-5238 
Community of Care: (310) 338-3756 
 
SPS: (310) 338-2868 
SHS: (310) 338-2881; 
https://studentaffairs.lmu.edu/wellness/studenthealthservices/scheduleanappointment/ 
 
Non-LMU Resources:  
Drug Addiction & Alcohol Abuse Help & Information Resources: https://www.addict-
help.com/ 
NIAAA Alcohol Treatment Navigator: https://alcoholtreatment.niaaa.nih.gov/ 
Substance Abuse and Mental Health Services Administration: 
https://www.samhsa.gov/ 
19. 
SAFEGUARDING IDENTITY  
When a research project involves the study of behaviors that are considered criminal or socially deviant 
(i.e., alcohol or drug use) special care should be taken to protect the identities of participating subjects.  
In certain instances, principal investigators may apply for "Confidentiality Certificates" from the 
Department of Health and Human Services or for "Grants of Confidentiality" from the Department of 
Justice. 
Please see response to question 5. Numerous safeguards will be put in place to protect 
participant’s identities.  
 
20. 
ADVERTISEMENTS 
If advertisements for subjects are to be used, attach a copy and identify the medium of display. 
N/A 
 
 

21. 
FOREIGN RESEARCH 
When research takes place in a foreign culture, the investigator must consider the ethical principles of 
that culture in addition to the principles listed above. 
N/A  
 
  
22. 
EXEMPTION CATEGORIES (45 CFR 46.101(b) 1-6) 
If you believe your study falls into any of the Exemption Categories listed below, please explain which 
category(ies) you believe it falls into and why.  
 
1) Research conducted in established or commonly accepted educational settings, involving normal 
educational practices, such as (i) research on regular and special instructional strategies, or (ii) 
research on the effectiveness of or the comparison among instructional techniques, curricula, or 
classroom management methods. 
 
2)  Research involving the use of educational tests (cognitive, diagnostic, aptitude, achievement), if 
information taken from these sources is recorded in such a manner that subjects cannot be identified, 
directly or through identifiers linked to the subjects. 
3)  Research involving survey or interview procedures, except where all of the following conditions exist: 
(i) responses are recorded in such a manner that the human subjects can be identified, directly or 
through identifiers linked to the subjects, (ii) the subject's responses, if they became known outside 
the research, could reasonably place the subject at risk of criminal or civil liability, or be damaging to 
the subject's financial standing, employability, or reputation, and (iii) the research deals with sensitive 
aspects of the subject's own behavior, such as illegal conduct, drug use, sexual behavior, or use of 
alcohol. 
 
All research involving survey or interview procedures is exempt, without exception, when the 
respondents are elected or appointed public officials, or candidates for public office. 
4)  Research involving the observation (including observation by participants) of public behavior, except 
where all of the following conditions exist: (i) observations are recorded in such a manner that the 
human subjects can be identified, directly or through the identifiers linked to the subjects, (ii) the 
observations recorded about the individual, if they became known outside the research, could 
reasonably place the subject at risk of criminal or civil liability, or be damaging to the subject's 
financial standing, employability, or reputation, and (iii) the research deals with sensitive aspects of 
the subject's own behavior such as illegal conduct, drug use, sexual behavior, or use of alcohol. 
5)  Research involving the collection or study of existing data, documents, records, pathological 
specimens, or diagnostic specimens, if these sources are publicly available or if the information is 
recorded by the investigator in such a manner that subjects cannot be identified, directly or through 
identifiers linked to the subjects. 
6)  Unless specifically required by statute (and except to the extent specified in paragraph (1)), research 
and demonstration projects which are conducted by or subject to the approval of the Department of 
Health and Human Services, and which are designed to study, evaluate, or otherwise examine: (i) 
programs under the Social Security Act or other public benefit or service programs, (ii) procedures for 
obtaining benefits or services under those programs, (iii) possible changes in or alternatives to those 
programs or procedures, or (iv) possible changes in methods or levels of payment for benefits or 
services under those programs. 

N/A 
 
Please deliver to: Julie Paterson, IRB Coordinator, University Hall, Suite 1718 or jpaterso@lmu.edu. 

MEASURES APPENDIX 
 
I was born... 
o Female  (0)  
o Male  (1)  
 
 
I identify as... 
o Female  (0)  
o Male  (1)  
o Other  (2)  
 
 
I am... 
o Heterosexual/Straight  (1)  
o Gay/Lesbian  (2)  
o Bisexual  (3)  
o Queer  (4)  
o I'm not sure  (5)  
 
 

I consider myself... 
o American Indian or Alaska Native  (1)  
o Asian  (2)  
o Black or African American  (3)  
o Native Hawaiian or Other Pacific Islander  (4)  
o White  (5)  
o Multiracial  (6)  
 
 
Ethnically, I am... 
o Hispanic/Latino  (1)  
o Not Hispanic/Latino  (0)  
 
 
My age is... 
o Under 17  (0)  
o 17  (1)  
o 18  (2)  
o 19  (3)  
o 20  (4)  
o 21 or over  (5)  
 
 
What is your height? 
  
 Feet: 
▼ 3 (3) ... 8 (8) 
 

Inches: 
▼ 0 (0) ... 11 (11) 
 
 
What is your weight in pounds? 
_____________________________________________________________ 
 
 
Are your parents... 
o Married  (1)  
o Divorced  (2)  
o Separated  (3)  
o Other (please explain):  (4) 
__________________________________________________ 
 
 
Were you living with your parents during your senior year of high school? 
o Yes  (1)  
o No  (0)  
 
 
Who were you living with most of the time during your senior year of high school? 
o Mother  (1)  
o Father  (2)  
o Other (please explain):  (3) 
__________________________________________________ 
 
 

Where are you currently living? 
o With my parent(s)  (1)  
o In the LMU dorms  (2)  
o Off campus with roommates  (3)  
o Off campus alone  (4)  
o Other  (5)  
 
 
How often do you see or communicate with your father in person or online? 
o Never  (0)  
o Less than monthly basis  (1)  
o Monthly basis  (2)  
o Weekly basis  (3)  
o Daily basis  (4)  
 
 
How often do you see or communicate with your mother in person or online? 
o Never  (0)  
o Less than monthly basis  (1)  
o Monthly basis  (2)  
o Weekly basis  (3)  
o Daily basis  (4)  
 
 

The next set of questions will ask about your drinking habits. You may not know the 
exact answer to all of these questions; in those cases, please make your best guess. 
Please keep in mind that your responses to the questions in this survey are confidential. 
 
 
How old were you when you had your first drink of alcohol (more than a sip or a taste)? 
▼ I have never tried alcohol (0) ... 21 or older (10) 
 
 
Who gave you your first drink of alcohol (more than just a sip or taste)?  
o Parent  (1)  
o Family member (not a parent)  (2)  
o Friend  (3)  
o Stranger  (4)  
o I have never tried alcohol  (0)  
 
 
Which best describes your alcohol use? 
o I have never tried alcohol  (0)  
o I am an abstainer (I do not drink at all, but have tried before)  (1)  
o I am a light drinker  (2)  
o I am a moderate drinker  (3)  
o I am a heavy drinker  (4)  
o I am a problem drinker  (5)  
 
 

This section asks you to report on your drinking over the past 30 days.   
    
For all questions, one drink equals:   
 
  
 
 
 
Consider a typical week during the past 30 days. How much alcohol, on average 
(measured in number of drinks), do you drink on each day of a typical week? If your 
answer is zero, please enter 0. 
 
Monday 
(1) 
Tuesday 
(2) 
Wednesday 
(3) 
Thursday 
(4) 
Friday 
(5) 
Saturday 
(6) 
Sunday 
(7) 
Number 
of drinks 
 
 
 
 
 
 
 
 
 
 
During the past 30 days, on average, how many days per week did you drink? 
▼ 0 (1) ... 7 (7) 
 
 
During the past 30 days, on average, how many drinks did you have each time you 
drank? 
▼ 0 (0) ... 25+ (25) 
 
 

During the past 30 days, what is the maximum number of drinks you drank during any 
one drinking occasion? 
▼ 0 (0) ... 25+ (25) 
 
 
Think of the occasion you drank the most in the past 30 days. How many hours did 
you spend drinking on that occasion? 
_____________________________________________________________ 
 
 
During the past 30 days, how many times did you have [four/give] or more drinks within 
a 2 hour period? 
▼ 0 occasions (0) ... 7+ occasions (7) 
 
 
During the past 30 days, how many times did you have [eight/ten] or more drinks within 
a 2 hour period? 
▼ 0 occasions (0) ... 7+ occasions (7) 
 
 

Note: The BYAACQ was used in place of the RAPI to measure alcohol consequences. 
 
 Below is a list of things that sometimes happen to people either during or after they 
have been drinking alcohol. Next to each item below, please indicate whether that item 
describes something that has happened to you in the past 30 days. 
 
No, 
never (0) 
1 time 
(1) 
2 times 
(2) 
3 times 
(3) 
4-6 
times (4) 
7+ times 
(5) 
I have had a hangover 
(headache, sick stomach) 
the morning after I had 
been drinking 
o  
o  
o  
o  
o  
o  
I've not been able to 
remember large stretches 
of time while drinking 
heavily 
o  
o  
o  
o  
o  
o  
The quality of my work or 
school work has suffered 
because of my drinking  o  
o  
o  
o  
o  
o  
My drinking has gotten me 
into sexual situations I 
later regretted  
o  
o  
o  
o  
o  
o  
I have felt very sick to my 
stomach or thrown up after 
drinking   
o  
o  
o  
o  
o  
o  
I have not gone to work or 
missed classes at school 
because of drinking, a 
hangover, or illness 
caused by drinking   
o  
o  
o  
o  
o  
o  
My drinking has created 
problems between myself 
and my 
boyfriend/girlfriend/spouse, 
parents, or other near 
relatives  
o  
o  
o  
o  
o  
o  
I have started a serious 
fight or argument with 
someone  
o  
o  
o  
o  
o  
o  
I have passed out from 
drinking   
o  
o  
o  
o  
o  
o  
I have become very rude, 
obnoxious, or insulting 
after drinking  
o  
o  
o  
o  
o  
o  

I have been pressured or 
forced to have sex with 
someone because I was 
too drunk to prevent it  
o  
o  
o  
o  
o  
o  
I have made inappropriate 
sexual advances toward 
someone after drinking  o  
o  
o  
o  
o  
o  
I have had less energy or 
felt tired because of my 
drinking  
o  
o  
o  
o  
o  
o  
I have neglected my 
obligations to work, family, 
or school because of 
drinking  
o  
o  
o  
o  
o  
o