Alcohol Health Education With Personalized Feedback Boosters
Condition: College Student Drinking
MeSH terms: Alcohol Drinking in College
Study type: Interventional
Phase: Phase 1/Phase 2

Summary: 
      Heavy episodic alcohol use within the college student population is widespread, creating
      problems for student drinkers, their peers, and their institutions. Negative consequences
      from heavy alcohol use can be mild (e.g., hangovers, missed classes), to severe (e.g.,
      assault, even death). Although online interventions targeting college student drinking reduce
      alcohol consumption and associated problems, they are not as effective as in-person
      interventions. Online interventions are cost-effective, offer privacy, reduce stigma, and may
      reach individuals who would otherwise not receive treatment.

      In a recently completed randomized, controlled trial, an emailed booster with personalized
      feedback improved the efficacy of a popular online intervention (Braitman & Henson, 2016).
      Although promising, the booster incorporated in the study needs further empirical refinement.
      In addition, the intervention originally tested (Alcohol 101 Plus) is no longer widely
      available.

      The current project seeks to build on past progress by further developing and refining the
      booster. In addition, it examines the utility of the booster after a different, widely-used,
      empirically-supported online intervention (e-checkup to go). e-checkup to go directly
      provides personalized normative feedback, but not protective strategies, the two components
      of the examined booster. Hence, the current study compares the reinforcing content (normative
      feedback) to the combination of reinforcing and novel content (norms PLUS protective
      strategies). There are 3 conditions: all participants receive the initial online intervention
      targeting college drinking. Condition 1 does not receive a booster email. Condition 2
      receives an emailed booster with normative feedback only. Condition 3 receives an emailed
      booster with normative feedback plus protective strategies. The aims of the current study are
      as follows:

      Aim 1: Examine if novel feedback in the form of protective strategies enhances the
      reinforcing normative feedback received via booster email (i.e., a comparison of reinforcing
      normative feedback only versus reinforcing normative feedback plus novel protective strategy
      feedback).

      Aim 2: Examine previously identified potential moderators and mediators of reductions in
      alcohol use and related problems.
    

Detailed description: 
      Heavy episodic alcohol use within the college student population is widespread, creating
      problems for student drinkers, their peers, and their institutions. Negative consequences
      from frequent or heavy alcohol use can be mild (e.g., hangovers, missed classes), moderate
      (e.g., poor grades, damaged relationships), or severe (e.g., assault, even death). Given the
      potentially dangerous consequences, reducing alcohol use and associated problems is a major
      health priority. Although online interventions targeting college student drinking reduce
      alcohol consumption and associated problems, they are not as effective as in-person
      interventions. The benefits of online interventions include cost-effectiveness and ease of
      administration, plus they offer privacy, reduce stigma, and may reach individuals who would
      otherwise not receive treatment.

      Although post-intervention boosters have been shown to be effective for individuals seeking
      treatment for alcohol-related injuries in emergency medical settings, limited studies have
      investigated the efficacy of boosters for college students who have received alcohol
      interventions. In a recently completed randomized, controlled trial, an emailed booster with
      personalized feedback improved the efficacy of a popular online intervention, while at the
      same time maintaining low cost and easy dissemination (Braitman & Henson, 2016). Although
      promising, the booster incorporated in the study needs further empirical refinement. In
      addition, the intervention originally tested (Alcohol 101 Plus) is no longer widely
      available.

      The current project seeks to build on past progress reducing the gap between online and more
      efficacious in-person interventions. The current study further develops and refines the
      booster to identify optimal administration for maximum efficacy. In addition, it examines the
      utility of the booster after a different, widely-used, empirically-supported online
      intervention (e-checkup to go). The new intervention (e-checkup to go) directly provides
      personalized normative feedback, but not protective strategies, the two components of the
      examined booster. Hence, the current study compares the reinforcing content (personalized
      normative feedback) to the combination of reinforcing and enhancing/novel content (norms PLUS
      protective strategies). This addresses a major question of the relatively new booster
      literature for college drinking regarding if reinforcing content is sufficient to boost
      efficacy versus if novel information is an important supplementary component. There are 3
      conditions: all participants receive the initial online intervention targeting college
      drinking. Condition 1 does not receive a booster email. Condition 2 receives an emailed
      booster with normative feedback only. Condition 3 receives an emailed booster with normative
      feedback plus protective strategies feedback. The booster content of tailored norms alone
      (reinforcing content) may alone be efficacious, or receiving tailored norms and strategies
      students can use to reduce consumption and related harm (protective behavioral strategies;
      novel content) may enhance the effect.

      Thus, the aims of the current study are as follows:

      Aim 1: Examine if novel feedback in the form of protective strategies enhances the
      reinforcing tailored normative feedback received via booster email (i.e., a comparison of
      reinforcing normative feedback only versus reinforcing normative feedback plus novel
      protective strategy feedback).

      Hypothesis 1a: Both groups receiving emailed feedback will reduce drinking and
      alcohol-related problems as compared to the intervention-only control condition.

      Hypothesis 1b: Reductions in drinking and problems will be stronger for those who receive
      emails with novel protective strategy feedback rather than reinforcing norms alone.

      Aim 2: Examine previously identified potential moderators and mediators of reductions in
      alcohol use and related problems (i.e., gender, norms, strategies).
    

Intervention name(s): e-checkup to go; Norms-only booster; Norms-plus-Strategies booster
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): The e-checkup to go substance program is designed to motivate individuals to reduce their consumption using personalized information about their own use and risk factors. The program is a combination of several components including alcohol education, personalized feedback, attitude-focused strategies, and skills training. It is self-guided and requires no face-to-face time with an administrator. It provides tailored feedback regarding quantity and frequency of alcohol use, normative comparisons, physical health information, amount and percent of income spent on alcohol, negative consequences feedback, explanation and advice for how to reach their goals, and resources.; Booster emails will contain normative feedback indicating average consumption for students at the same institution by sex, their perceptions of student drinkers at the same institution, their own reported consumption, and how they compare.; Booster emails will contain normative feedback indicating average consumption for students at the same institution by sex, their perceptions of student drinkers at the same institution, their own reported consumption, and how they compare. These booster emails will also contain reminders of strategies they can use to protect themselves from alcohol-related harm, both ones they've reported using in the past and others they might consider using in the future.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment