Brief Alcohol Intervention for School-to-Work Transitions

Status

Completed

Phases

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT01546025

Enrollment

168

Registered

2012-03-07

Start date

2010-06-30

Completion date

2011-10-31

Last updated

2025-06-12

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Binge Drinking

Brief summary

This is a 2-year research project to test the efficacy of brief motivational intervention for reducing heavy alcohol use in young adults transitioning out of high school. Participation occurs within 3 months prior to graduation or within 1 year following graduation or dropout from high school. Heavy drinkers ages 17-20 will be randomly assigned to receive one session of BMI or one session of relaxation training. All participants complete identical assessments at baseline and immediately post-intervention (during session 1). Participants also complete in-person 6-week and 3-month follow up assessments to evaluate intervention effects. Study aims involve: a) testing the comparative efficacy of BMI; b) identifying moderators (person-level predictors) of intervention response; and c) identifying mediators (mechanisms) of intervention effects, that is, how BMI exerts its effect on outcomes.

Detailed description

This study tested the efficacy of a single session of BMI for reducing heavy drinking and related adverse consequences among underage young adult drinkers not attending a 4-year college or university. We designed the intervention to be delivered proximal to the transition out of high school (with or without graduation), because such periods of transition and discontinuity in the life course present opportunities to positively alter developmental paths (Masten et al., 2009). Thus, interventions timed to co-occur with naturalistic transition points may have great potential for decreasing drinking trajectories or preventing harmful escalations in trajectories going forward. To increase the applicability of our findings to the heterogeneous population of community-dwelling young adults, our recruitment targeted a purposefully inclusive non-4-year-college population. We hypothesized that, compared to a time and attention-matched control condition (i.e., relaxation training \[REL\]), BMI would result in significantly reduced heavy drinking and reduced adverse consequences of alcohol use at 6-week and 3-month follow-up.

Interventions

BEHAVIORALBrief Motivational Counseling

One hour session of brief motivational counseling focused on reduction of heavy drinking.

BEHAVIORALRelaxation training

One hour training in relaxation techniques

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

TREATMENT

Masking

SINGLE (Investigator)

Eligibility

Sex/Gender

ALL

Age

17 Years to 20 Years

Healthy volunteers

Yes

Inclusion criteria

* high school students anticipating graduation within 3 months, drop outs or graduates * males must report at least one day drinking 5 or more standard drinks in past month * females must report at least one day drinking 4 or more standard drinks in past month

Exclusion criteria

* plans to enroll at traditional 4-year college within 12 months * plans to enter military within next 12 months * plans to move more than 1 hour from current location in within 12 months

Design outcomes

Primary

Measure	Time frame	Description
Timeline Follow Back Assessing Number of Standard Drinks	3 months	This is a calculation of the number of standard alcohol drinks consumed per week, based on data collected via the timeline follow back interview

Secondary

Measure	Time frame	Description
Help Seeking	6 week and 3 month follow ups	Count of participants reporting receiving any type of counseling for alcohol in the prior 6 weeks
Drinking Reduction Strategies	6 week and 3 month follow ups	Total score on the Strategies to Limit Drinking 31-item scale. Likert response for each item ranges from 1 = never to 5 = always; range = 31 to 155; higher scores indicate better outcomes: higher scores reflect greater frequency of using various strategies to deliberately limit one's drinking over the past 6 weeks
Brief Young Adult Alcohol Consequences Questionnaire	6 week and 3 month follow ups	Measure of problem severity in young adult drinkers. Respondents indicated on the Brief Young Adult Alcohol Consequences Questionnaire (BYAACQ; Kahler et al., 2005) whether they had experienced each of 24 adverse alcohol-related consequences in the prior 6 weeks; items are summed for a total score (Cronbach's α = 0.81 at BL), with a minimum score of 0 and a maximum score of 24. Higher scores indicate worse outcome.
Satisfaction With Life	6 week and 3 month follow ups	This is a mean score on the Satisfaction With Life Scale (SWLS), a 5-item instrument designed to measure global cognitive judgments of life satisfaction, using a 7-point Likert scale (1=strongly disagree to 7=strongly agree), with higher scores indicating better outcomes, i.e., higher scores indicate greater life satisfaction at the time of assessment. Range = 1 to 7.
Adolescent Reinforcement Survey Schedule (ARSS)	6 week and 3 month follow ups	The ARSS contains a list of 45 rewarding activities. Participants rate the frequency with which they participate in each activity WITH and then WITHOUT alcohol/drug use, and then rate their enjoyment of each activity WITH and WITHOUT alcohol/drug use. The outcome measure represents the percentage of reinforcement participants get (i.e., the cross product of frequency X enjoyment) from activities involving alcohol/drug use divided by the total reinforcement they get from all activities with or without alcohol/drug use. Range = 0 to 100; higher scores indicate worse outcomes, i.e., higher scores reflect a greater percentage of enjoyable activities involving alcohol and/or use.
Employment Outcomes	6 week and 3 month follow ups	Mean score on the Your Workplace questionnaire: Negative Effects on Work Performance subscale. Range = 0 to 5. Response options for each item on the subscale are 0 = never; 1 = once or twice, 2 = about once every 2 weeks, 3 = about once a week, 4 = 2-4 times a week, 5 = about daily. Higher scores indicate worse outcomes: Higher scores reflect more frequent negative effects of alcohol use on work performance in the past 6 weeks.

Participant flow

Recruitment details

The study was promoted via posted flyers in the community; advertisements on buses, websites, and in newspapers; and recruitment events at high schools, community colleges, vocational/technical programs, social service agencies, and GED classes. Research staff described the study to groups/classes or at information booths set up in a lobby or cafeteria. Data collection took place in Rhode Island and Southeastern Massachusetts from June 2010 to October 2011.

Pre-assignment details

168 were consented and enrolled. One person was determined to be ineligible because they were simultaneously participating in another alcohol intervention research study simultaneously. That were person was withdrawn from the study, resulting in a sample of 167 participants.

Participants by arm

Arm	Count
Relaxation Training Relaxation training (REL): One hour training in relaxation techniques REL was designed to control for nonspecific therapeutic effects by providing equivalent levels of attention from and rapport with a counselor. REL began with an introduction to the intervention and general rapport building. The counselor asked about the participant's typical experiences with daily stress, and reviewed various strategies the participant had used to cope with stress. Past experiences with meditation and relaxation were explored. To promote positive treatment expectancies, the counselor presented a rationale for the use of REL for alcohol reduction. Participants were told: (i) the transition to adulthood can be stressful, and stress can lead to increased alcohol use; and (ii) alternative approaches to coping with stress, such as meditation and relaxation techniques, can reduce stress and thereby prevent excessive alcohol use. For the remainder of the session, 2 strategies for coping with stress were introduced and practiced: the first was a simple, guided breathing meditation; and the second was a full-body progressive muscle relaxation. Both exercises were scripted and read aloud by the counselor as the participant followed the counselor instructions. The session concluded with a review of the participant's experiences during the 2 exercises and a counselor recommendation to practice the techniques regularly.	84
Brief Motivational Counseling Brief Motivational Intervention (BMI) Counseling: One hour session of BMI focused on reduction of heavy drinking. The counselor built rapport while eliciting information about the developmental context of the participant's drinking behavior, discussing current experiences, goals, and plans for the next several years in different domains (education/training, work, financial independence, social transitions, romantic relationships). The counselor explored how alcohol and drinking fit into the participant's life, and how the participant expected their drinking to change into adulthood. Assessing motivation involved exploring the positive and negative aspects of drinking for participants. Enhancing motivation consisted of providing a personalized feedback report including normative feedback, and personalized risk factors and other elements like time and money allocation. Participants were asked to envision themselves in the future if they decided to make a change, and again if they decided not to change. The counselor drew upon participants' goals (e.g., social, recreational, occupational, financial) to highlight discrepancies between drinking behavior and proximal life goals. The participant identified goals for change related to drinking. The BMI reviewed strategies for reducing heavy drinking. Participant strengths, protective factors, and autonomy/ability to make changes were elicited and supported. Throughout the session, counselors used MI principles and techniques.	83
Total	167

Withdrawals & dropouts

Period	Reason	FG000	FG001
Overall Study	Lost to Follow-up	0	1

Baseline characteristics

Characteristic	Relaxation Training	Brief Motivational Counseling	Total
Age, Customized age 17	22 Participants	24 Participants	46 Participants
Age, Customized age 18	30 Participants	29 Participants	59 Participants
Age, Customized age 19	24 Participants	19 Participants	43 Participants
Age, Customized age 20	8 Participants	11 Participants	19 Participants
Avg Number of Standard Drinks per week	12.14 standard drinks per week STANDARD_DEVIATION 8.85	14.85 standard drinks per week STANDARD_DEVIATION 14.41	13.49 standard drinks per week STANDARD_DEVIATION 12.36
Race/Ethnicity, Customized American Indian/Native American	0 Participants	1 Participants	1 Participants
Race/Ethnicity, Customized Asian/Pacific Islander	6 Participants	1 Participants	7 Participants
Race/Ethnicity, Customized Hispanic/Latino	8 Participants	10 Participants	18 Participants
Race/Ethnicity, Customized missing	0 Participants	3 Participants	3 Participants
Race/Ethnicity, Customized More than 1 race	12 Participants	11 Participants	23 Participants
Race/Ethnicity, Customized Non-Hispanic Black/African American	7 Participants	9 Participants	16 Participants
Race/Ethnicity, Customized Non-Hispanic White	51 Participants	48 Participants	99 Participants
Sex: Female, Male Female	36 Participants	34 Participants	70 Participants
Sex: Female, Male Male	48 Participants	49 Participants	97 Participants

Adverse events

Event type	EG000 affected / at risk	EG001 affected / at risk
deaths Total, all-cause mortality	0 / 84	0 / 83
other Total, other adverse events	0 / 84	0 / 83
serious Total, serious adverse events	0 / 84	0 / 83

Outcome results

Primary

Timeline Follow Back Assessing Number of Standard Drinks

This is a calculation of the number of standard alcohol drinks consumed per week, based on data collected via the timeline follow back interview

Time frame: 3 months

Arm	Measure	Value (MEAN)	Dispersion
Relaxation Training	Timeline Follow Back Assessing Number of Standard Drinks	8.93 standard drinks/week	Standard Deviation 10
Brief Motivational Counseling	Timeline Follow Back Assessing Number of Standard Drinks	5.56 standard drinks/week	Standard Deviation 5.91

Secondary

Adolescent Reinforcement Survey Schedule (ARSS)

The ARSS contains a list of 45 rewarding activities. Participants rate the frequency with which they participate in each activity WITH and then WITHOUT alcohol/drug use, and then rate their enjoyment of each activity WITH and WITHOUT alcohol/drug use. The outcome measure represents the percentage of reinforcement participants get (i.e., the cross product of frequency X enjoyment) from activities involving alcohol/drug use divided by the total reinforcement they get from all activities with or without alcohol/drug use. Range = 0 to 100; higher scores indicate worse outcomes, i.e., higher scores reflect a greater percentage of enjoyable activities involving alcohol and/or use.