Improving Brief Alcohol Interventions With a Behavioral Economic Supplement
Condition: Alcohol Abuse
MeSH terms: Alcoholism
Study type: Interventional

Summary: 
      The purpose of this study is to evaluate the efficacy of a Substance-Free Activity Session
      (SFAS) as a supplement to a brief motivation intervention (BMI) in reducing alcohol use and
      alcohol-related consequences in college students.
    

Detailed description: 
      BMIs are associated with reductions in alcohol consumption and related problems, but effect
      sizes are generally small. One BMI trial indicated that behavioral economic variables such as
      low levels of proportionate substance-free reinforcement and inelastic demand for alcohol
      predicted poor intervention response, and that participants who successfully reduced their
      drinking increased their participation in academic and other substance-free activities. A
      subsequent NIAAA R21 developed a substance-free activity session (SFAS) supplement to
      traditional alcohol BMIs that attempted to increase engagement in constructive alternatives
      to drinking by enhancing the salience of delayed rewards (academic and career success) and
      the patterns of behavior (academic engagement) leading to these outcomes. This study
      indicated that a two session (alcohol BMI + SFAS) preventive intervention resulted in
      significantly greater reductions in alcohol problems relative to a two session (alcohol BMI +
      Relaxation) active control condition. The BMI+ SFAS was also associated with significantly
      greater reductions in heavy drinking for participants with lower levels of substance-free
      reinforcement at baseline. This was the first controlled study to demonstrate that a
      supplement to traditional BMIs can improve outcomes. The current study will extend these
      promising pilot results by (a) increasing the efficacy of the behavioral economic SFAS by
      including booster contact, (b) increasing power and generalizability by recruiting 425
      students from two universities and including a no-treatment control group, (c) measuring
      drinking, as well as behavioral economic mechanisms as mediators and moderators of
      intervention outcomes (delay discounting, alcohol reinforcing efficacy, substance-free
      reinforcement) at 5 time points over a sixteen month period, and (d) evaluating the economic
      costs and benefits associated with the SFAS. The goals of the SFAS - increasing student
      engagement in academic, campus, and career-related activities- are consistent with the
      priorities of most colleges.
    

Intervention name(s): Brief Motivational Intervention (BMI); Substance-Free Activity Session (SFAS); Relaxation Session
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): This session includes a discussion related to harm reduction and the student's autonomy to make decisions about the information provided in the session; an alcohol use decisional balance exercise; personalized alcohol-related feedback, and goal-setting. Elements included in the feedback are: (a) comparison of the student's perception of how much college students drink and actual student norms, (b) a comparison of the student's alcohol consumption vs. norms, (c) an estimate of the student's peak blood alcohol content in the past month, (d) alcohol-related problems experienced, (e) money spent on alcohol, and (f) calories consumed from alcohol. Participants discuss the personalized feedback with the clinician and review protective behavioral strategies if he or she indicates interest.; The clinician initiates a discussion of the student's college and career goals. Students discuss the values that motivate them as well as how alcohol use may interfere with their ability to accomplish these goals. Students then receive information on graduation rates and income benefits for those who attend and excel in college. They receive personalized feedback on (a) the requirements for their major and intended career, (b) a list of extracurricular activities tailored to their goals, (c) a graph showing time they allocate to their activities, (d) information on stress and depressive symptoms (if applicable) and possible adaptive coping responses and (e) a list of substance-free recreational activities in which they would like to start or continuing engaging.; The session includes a clinician-led diaphragmatic breathing exercise, followed by a progressive muscle relaxation protocol (~30 minutes). At the end of the session, participants will be asked about their reaction to the relaxation techniques and provided with relaxation training handouts.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment