Alcohol Health Education Among College Drinkers
Condition: College Student Drinking
MeSH terms: Alcohol Drinking in College
Study type: Interventional
Phase: Phase 1

Summary: 
      Alcohol use among college students is both widespread and problematic. There are many
      negative consequences associated with frequent alcohol use, ranging from mild (e.g.,
      hangovers, missed classes) to severe (e.g., assault, even death). Online interventions
      targeting alcohol use among college students reduce alcohol consumption and associated
      problems. These interventions are popular among colleges because they are relatively
      inexpensive and easily disseminated. However, online interventions are not as efficacious as
      face-to-face interventions, such as brief motivational interviews. The proposed project
      employs emailed boosters in a randomized, controlled trial in an effort to improve the
      efficacy an existing, popular, free online intervention, while at the same time maintaining
      low cost and easy dissemination.

      Adding boosters after interventions is a common technique to improve the efficacy of the
      original intervention. Boosters have been used successfully for alcohol use interventions
      among those seeking injury treatment in emergency medical settings. However, prior research
      has not supported booster efficacy for college student alcohol interventions. The current
      project develops and evaluates the effectiveness of boosters for a widely-used college
      student alcohol intervention. Specifically, the present project improves boosters by
      providing easy access via email; providing succinct, personalized feedback; and providing
      reminders of protective behavioral strategies. To test the effectiveness of adding boosters,
      participants randomized to alcohol-intervention-plus-boosters receive emails 2 weeks after
      the intervention with tailored feedback based upon their reported alcohol consumption.
      Participants are assessed up to nine months. The current research addresses the following
      specific aims:

      Aim 1: Improve the efficacy of an easily-disseminated computerized intervention by adding
      personalized follow-up boosters, where efficacy is evidenced by reduced drinking and negative
      alcohol-related consequences (i.e., stronger effect sizes in the booster group immediately
      after receiving the booster).

      Aim 2: Extend the duration of the reduction in drinking and associated problems through the
      use of these personalized follow-up boosters (i.e., significant differences between the
      booster and control groups at later timepoints).

      Aim 3: Examine protective behavioral strategies highlighted by the booster as mediating
      behavioral mechanisms of change.
    

Detailed description: 
      Alcohol use within the college student population is both widespread and problematic. There
      are many negative consequences associated with frequent alcohol use, ranging from mild (e.g.,
      hangovers, missed classes) to severe (e.g., assault, even death). College student alcohol use
      is a significant problem, and reducing consumption and associated problems is a priority
      among researchers, educators, and mental health professionals who work with this population.

      Online interventions targeting alcohol use among college students reduce alcohol consumption
      and associated problems. These interventions are popular among colleges because they are
      relatively inexpensive and easily disseminated. However, online interventions are not as
      efficacious as face-to-face interventions, such as brief motivational interviews. The current
      project employs emailed boosters in a randomized, controlled trial in an effort to improve
      the efficacy an existing, popular, free online intervention, Alcohol 101 Plus (TM), while at
      the same time maintaining low cost and easy dissemination.

      Adding boosters after interventions is a common technique to improve the efficacy of the
      original intervention. Boosters have improved the efficacy or effect duration for
      interventions targeting smoking cessation, mammograms, dating violence, caregiver skills,
      binge eating, and many other behaviors. Boosters have been used successfully for alcohol use
      interventions among those seeking injury treatment in emergency medical settings. Despite
      these successes, prior research has not supported booster efficacy for college student
      alcohol interventions. The current project develops and evaluates the effectiveness of
      boosters for a widely-used college student alcohol intervention by improving on the design of
      boosters. Specifically, the present project improves boosters by providing easy access via
      email to minimize burden; providing succinct, personalized feedback; and providing reminders
      of protective behavioral strategies. To test the effectiveness of adding boosters,
      participants randomized to the alcohol-intervention-plus-boosters condition receive emails 2
      weeks after the intervention with tailored feedback based upon their reported alcohol
      consumption. Participants are initially assessed biweekly, then every three months up to nine
      months. The current research addresses the following specific aims:

      Aim 1: Improve the efficacy of an easily-disseminated computerized intervention by adding
      personalized follow-up boosters, where efficacy is evidenced by reduced drinking and negative
      alcohol-related consequences (i.e., stronger effect sizes in the booster group immediately
      after receiving the booster).

      Aim 2: Extend the duration of the reduction in drinking and associated problems through the
      use of these personalized follow-up boosters (i.e., significant differences between the
      booster and control groups at later timepoints after the significant differences between the
      intervention-only and control groups erode).

      Aim 3: Examine protective behavioral strategies highlighted by the booster as mediating
      behavioral mechanisms of change.

      3A: Determine if increased exposure to protective strategies through an emailed booster
      results in increased use of these strategies.

      3B: Determine if those who increase their use of protective behavioral strategies decrease
      their alcohol consumption and related problems they experience.

      3C: Assess the combination of these two effects (i.e., the indirect effect). The proposed
      study will be a critical first step to adapt existing online interventions. The findings from
      this study will be used to identify implications for modifying the protocol or booster.
    

Intervention name(s): Alcohol 101 Plus (TM); Booster; Lilly for Better Health
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): It is a combination of several intervention components, including alcohol education, personalized feedback, attitude-focused strategies, and skills training. It also included a virtual bar, where participants provide information such as sex, weight, and state so that the program can provide tailored information on blood alcohol content (BAC) as well as state regulations regarding legal limits. The program provides updated BACs based upon choices about what to consume and how quickly to consume it. The intervention is highly interactive, with text, photos, videos, and narratives for fictional students with decision points where the participant chooses what the fictional student should do. It is a non-linear environment, where participants choose which sections of the website to explore.; Personalized feedback was emailed to participants. Content included sex-specific descriptive normative information (i.e., drinks per week typically consumed by males and females at the same institution), as well as reminders of harm reduction strategies (i.e., techniques the participant reported using in their last survey, versus techniques not used).; This is an online education session directed at other health behaviors besides alcohol. The site provides practical tips on general well-being such as healthy eating, physical activity, and stress management, as well as provides information on managing health conditions such as diabetes, heart disease and depression. It was not expected to influence alcohol use.
Other intervention name(s): Personalized Normative Feedback
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment