Detroit Area Study of College Student Lifestyles
Condition: Excessive Alcohol Consumption
MeSH terms: Alcohol Drinking
Study type: Interventional

Summary: 
      The goal of this research study is to compare three harm reduction approaches for at-risk
      college student drinkers. One approach provides generic risk-related information after an
      initial interview/questionnaire assessment session. A second approach uses an established
      motivational interviewing framework (Brief Alcohol Screening and Intervention for College
      Students; BASICS) that provides personalized feedback in a follow-up session. A third
      approach also uses BASICS, but tests the utility of a personality-informed module for this
      approach that is informed by the social investment hypothesis.
    

Detailed description: 
      While individual difference factors, such as trait self-control and subjective college
      student role investment, appear to be important predictors of excessive alcohol consumption
      and related problems, these factors are not typically incorporated into indicated prevention
      strategies. Indicated prevention usually focuses on groups or individuals who already express
      some aspects of a health-related problem (e.g., heavy episodic drinking), or who, at the very
      least, exhibit markers of risk (e.g., early age of first drink) associated with the
      development of a health-related problem (Gordon, 1987). The primary aim of the current
      proposal is to incorporate a personality-informed module into an existing motivational
      interviewing framework for alcohol-related harm reduction and test its efficacy compared to
      an information-only approach (i.e., informational packet) and a conventional strategy for
      indicated prevention (i.e., Brief Alcohol Screening and Intervention for College Students,
      BASICS; Dimeff et al., 1999) that has provided evidence for reduced risk of alcohol-related
      problems in randomized controlled trials (Borsari & Carey, 2000; 2005).

      Motivational interviewing is a common technique used to address ambivalence and/or resistance
      to behavioral change. Motivational interviewing is commonly used in the context of
      health-related behaviors, such as excessive alcohol consumption, where an individual might
      not have experienced any serious consequences (e.g., driving while intoxicated), but may
      still be at risk for problems (Miller & Rollnick, 2002). In motivational interviewing, a tone
      of collaboration and attentiveness is considered critical to the success of the interaction.
      The primary goal is to guide an individual toward increased motivation to change (and actual
      behavioral change) by being responsive to the desires and concerns of the individual as it
      relates to change, and by having an individual commit to even the most modest of change goals
      (e.g., consuming beverages with reduced alcohol by volume in situations that are known to be
      high-risk, rather than a favorite, higher alcohol-by-volume beverage). Motivational
      interviewing is well-suited to accommodate a personality-informed module for change due to
      its emphasis on an individual's unique profile of factors.

      In BASICS, a harm reduction approach is used to inform the assessment and content of the
      initial assessment session, as well as the follow-up feedback session (Dimeff et al., 1999).
      Consistent with research showing there to be a continuum of problems for alcohol and other
      externalizing behaviors (Bogg & Finn, 2010; Krueger et al., 2002), the harm reduction
      approach emphasizes that any movement toward reduced risk and harm, regardless of its impact,
      is positive movement, even if a person might be farther along the continuum of harm (Marlatt,
      1998). The current proposal seeks to test an augmentation of the harm reduction approach of
      BASICS with a normative enhancement approach derived from the social investment hypothesis of
      the Cumulative Continuity Model of personality development (Roberts & Caspi, 2003).

      According to the social investment hypothesis, the process of commitment to normative roles,
      such as college student, is ''thought to exact a form of social control through the role
      demands embedded in these contexts that call on individuals to act with more responsibility
      and probity'' (Roberts & Caspi, 2003; p. 203). To the extent that further commitment,
      investment, and involvement in the college student role can be fostered, then a concomitant
      increase in trait self-control should be expected as well, independent of harm reduction
      effects. As suggested by the findings described above, the effect of increased subjective
      college student role investment could be to deflect a risky trajectory for alcohol-related
      problems - an effect that could be further amplified by corresponding increases in trait
      self-control. This normative enhancement (NE) approach is posited to be particularly useful
      for those individuals who do not recognize or are steadfastly resistant to even minor harm
      reduction efforts conveyed through the motivational interviewing framework of BASICS. The
      strategy of the normative enhancement approach is to capitalize on an individual's goals for
      involvement in roles - especially those roles, such as college student, which are nominally
      voluntary in nature.
    

Intervention name(s): BASICS motivational interview; BASICS plus normative enhancement motivational interview; Self-directed: Information only
Intervention type(s): Behavioral; Behavioral; Behavioral
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Prevention