College Drinking
Conditions
Keywords
alcohol abuse, college students, preventive programs, text messages
Brief summary
This project aims to combat excessive perceived norms that contribute to high volume drinking by young adults, which adversely affects health and academic achievement. Campus-specific survey data will be used to craft accurate, pro-moderation campus norms, and deliver them to first-year students via daily text messages during the first semester of college. It is predicted that those receiving regular exposure to pro-moderation drinking norms will reduce their alcohol consumption and consequences, relative to students who receive non-alcohol-related control texts. This preliminary evaluation uses a novel method of delivering drinking norms and will lay the groundwork for future efforts to scale up this novel alcohol misuse prevention approach.
Detailed description
Using mobile technology that most students already have in their pockets, this study evaluates a novel use of text messages to change campus drinking norms. The aim is to correct exaggerated perceptions of drinking norms, and thereby reduce excessive drinking, by delivering daily text messages representing accurate, campus-specific, pro-moderation descriptive norms (what others do) and injunctive norms (what others approve of). It is predicted that with repeated exposure over time, this information will compete with other sources of normative information to which students are exposed during their first year of college. This exploratory study is designed to develop and refine message content and to pilot test the delivery methods. First year students (N=120) who are underage but report risky drinking (\>4/day or \>14/week for men; \>3/day or \>7/week for women) will be randomly assigned to two conditions differing by text content: alcohol norms or attention control. All will receive daily text messages throughout 10 weeks in the first semester of college. Process measures, 3-month post-test, and 3-month follow-up assessments will yield feasibility, acceptability, and preliminary outcome data to inform future larger scale randomized trials. Specifically, baseline, post-test, and 3-month follow-up assessments will allow us to test the hypotheses that the corrective norms intervention will reduce (a) perceived descriptive and injunctive norms, (b) drinking behavior (including high-volume drinking and risky consumption practices), and (c) alcohol-related consequences, and increase (d) protective behavioral strategies, relative to the control condition. At the end of this project the investigative team will have gathered data on both descriptive and injunctive norms on a range of drinking behaviors to identify topics in need of corrective normative feedback, refined the structure and content of the text messages, and pilot tested the text-delivered intervention in a small scale randomized controlled trial (RCT). The proposed research will provide evidence of feasibility and efficacy of a text-based alcohol norms intervention for reducing excessive drinking among first-year students.
Interventions
BEHAVIORALAlcohol texts
A text message each day for 10 weeks, containing factual information about campus drinking norms.
BEHAVIORALAttention control
A text message each day for 10 weeks, containing this day in history facts.
Sponsors
Brown University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 20 Years
Healthy volunteers
Yes
Inclusion criteria
* 18-20 years of age * enrolled as a first-year undergraduate student * past month risky drinking * possession of a mobile phone with text message capacity * use text messaging at least weekly
Exclusion criteria
\* currently engaged in alcohol treatment or in need of treatment (AUDIT score 20 or higher)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Drinks Per Week as Assessed by the Daily Drinking Questionnaire | Assessed over prior 30 days at 3 month follow-up | Sum of standard drinks consumed on each day in a typical week over the past 30 days; scores can be as low as zero but there is no upper limit as they are counts of drinks |
| Alcohol-related Consequences as Assessed by the Brief Young Adult Alcohol Consequences Questionnaire | Assessed over prior 30 days at 3 month follow-up | The total number of alcohol-related consequences experienced over the past 30 days is measured by the Brief Young Adult Alcohol Consequences Questionnaire (BYAACQ), which is a checklist of 24 items; scores range from 0-24; higher numbers of items endorsed indicate more problems experienced in the past 30 days |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Perceived Injunctive Drinking Norms as Assessed by an Adaptation of the Drinking Norms Rating Form | Assessed over prior 30 days at 3 month follow-up | perceived injunctive norms are assessed using the Krieger et al. (2016) adaptation of the Drinking Norms Rating Form, which asks respondents to estimate the how many standard drinks is deemed acceptable by other students on campus to drink on each day in a typical week in the past 30 days; estimates are summed to yield number of drinks per week approved of by student peers; the scores can range from zero to no upper limit |
| Protective Behavioral Strategies as Assessed by the Strategies Questionnaire - Alternative Sub Scale | Assessed over prior 30 days at 3 month follow-up | self-reported frequency of using strategies to moderate drinking as reported on the Strategy Questionnaire; the Strategy Questionnaire has 3 sub scales including Selective Avoidance (0-70), Strategies While Drinking (0-100), and Alternatives to Drinking (0-40) and higher sub scale scores indicate more frequent use of those strategies |
| Protective Behavioral Strategies as Assessed by the Strategies Questionnaire - Strategies Sub Scale | Assessed over prior 30 days at 3 month follow-up | self-reported frequency of using strategies to moderate drinking as reported on the Strategy Questionnaire; the Strategy Questionnaire has 3 sub scales including Selective Avoidance (0-70), Strategies While Drinking (0-100), and Alternatives to Drinking (0-40) and higher sub scale scores indicate more frequent use of those strategies |
| Protective Behavioral Strategies as Assessed by the Strategies Questionnaire - Selective Avoidance Sub Scale | Assessed over prior 30 days at 3 month follow-up | self-reported frequency of using strategies to moderate drinking as reported on the Strategy Questionnaire; the Strategy Questionnaire has 3 sub scales including Selective Avoidance (0-70), Strategies While Drinking (0-100), and Alternatives to Drinking (0-40) and higher sub scale scores indicate more frequent use of those strategies |
| Perceived Descriptive Drinking Norms as Assessed by the Drinking Norms Rating Form | Assessed over prior 30 days at 3 month follow-up | perceived descriptive norms are assessed using a variation on the Drinking Norms Rating Form, which asks respondents to estimate the number of standard drinks consumed by other students on campus for each day in a typical week in the past 30 days; daily estimates are summed to yield perceived number of drinks per week for student peers; range of scores can go from zero to no upper limit |
Countries
United States
Participant flow
Recruitment details
Eligibility was determined via an online screening survey distributed by email during the first few weeks of the fall 2018 semester to all first-year students enrolled at the university. Eligible participants were directed to an online consent form and then emailed a link to an online baseline survey.
Participants by arm
| Arm | Count |
|---|---|
| Alcohol Texts Participants assigned to this arm will receive a text message each day for 10 weeks, containing factual information about campus drinking norms.
Alcohol texts: A text message each day for 10 weeks, containing factual information about campus drinking norms. | 61 |
| Attention Control Participants assigned to this arm will receive a text message each day for 10 weeks, containing this day in history facts.
Attention control: A text message each day for 10 weeks, containing this day in history facts. | 60 |
| Total | 121 |
Baseline characteristics
| Characteristic | Alcohol Texts | Attention Control | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 61 Participants | 60 Participants | 121 Participants |
| Age, Continuous | 18.5 years STANDARD_DEVIATION 0.36 | 18.1 years STANDARD_DEVIATION 0.3 | 18.12 years STANDARD_DEVIATION 0.33 |
| Alcohol-related consequences | 4.95 consequences STANDARD_DEVIATION 2.87 | 4.35 consequences STANDARD_DEVIATION 2.67 | 4.65 consequences STANDARD_DEVIATION 2.78 |
| Drinks per week | 11.42 drinks per week STANDARD_DEVIATION 6.15 | 12.79 drinks per week STANDARD_DEVIATION 7.13 | 12.10 drinks per week STANDARD_DEVIATION 6.66 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 10 Participants | 9 Participants | 19 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 51 Participants | 51 Participants | 102 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 13 Participants | 9 Participants | 22 Participants |
| Race (NIH/OMB) Black or African American | 5 Participants | 5 Participants | 10 Participants |
| Race (NIH/OMB) More than one race | 3 Participants | 4 Participants | 7 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 8 Participants | 4 Participants | 12 Participants |
| Race (NIH/OMB) White | 32 Participants | 38 Participants | 70 Participants |
| Region of Enrollment United States | 61 participants | 60 participants | 121 participants |
| Sex: Female, Male Female | 31 Participants | 30 Participants | 61 Participants |
| Sex: Female, Male Male | 30 Participants | 30 Participants | 60 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 61 | 0 / 60 |
| other Total, other adverse events | 0 / 61 | 0 / 60 |
| serious Total, serious adverse events | 0 / 61 | 0 / 60 |
Outcome results
Primary
Alcohol-related Consequences as Assessed by the Brief Young Adult Alcohol Consequences Questionnaire
The total number of alcohol-related consequences experienced over the past 30 days is measured by the Brief Young Adult Alcohol Consequences Questionnaire (BYAACQ), which is a checklist of 24 items; scores range from 0-24; higher numbers of items endorsed indicate more problems experienced in the past 30 days
Time frame: Assessed over prior 30 days at 3 month follow-up
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Alcohol Texts | Alcohol-related Consequences as Assessed by the Brief Young Adult Alcohol Consequences Questionnaire | 4.44 consequences | Standard Deviation 3.52 |
| Attention Control | Alcohol-related Consequences as Assessed by the Brief Young Adult Alcohol Consequences Questionnaire | 5.32 consequences | Standard Deviation 4.08 |
p-value: 0.07795% CI: [-0.13, 2.59]Regression, Linear
Primary
Drinks Per Week as Assessed by the Daily Drinking Questionnaire
Sum of standard drinks consumed on each day in a typical week over the past 30 days; scores can be as low as zero but there is no upper limit as they are counts of drinks
Time frame: Assessed over prior 30 days at 3 month follow-up
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Alcohol Texts | Drinks Per Week as Assessed by the Daily Drinking Questionnaire | 9.55 drinks per week | Standard Deviation 6.02 |
| Attention Control | Drinks Per Week as Assessed by the Daily Drinking Questionnaire | 10.87 drinks per week | Standard Deviation 6.24 |
p-value: 0.56895% CI: [-1.31, 2.37]Regression, Linear
Secondary
Perceived Descriptive Drinking Norms as Assessed by the Drinking Norms Rating Form
perceived descriptive norms are assessed using a variation on the Drinking Norms Rating Form, which asks respondents to estimate the number of standard drinks consumed by other students on campus for each day in a typical week in the past 30 days; daily estimates are summed to yield perceived number of drinks per week for student peers; range of scores can go from zero to no upper limit
Time frame: Assessed over prior 30 days at 3 month follow-up
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Alcohol Texts | Perceived Descriptive Drinking Norms as Assessed by the Drinking Norms Rating Form | 11.46 drinks per week | Standard Deviation 6.43 |
| Attention Control | Perceived Descriptive Drinking Norms as Assessed by the Drinking Norms Rating Form | 12.74 drinks per week | Standard Deviation 6.87 |
p-value: 0.4495% CI: [-1.31, 3]Regression, Linear
Secondary
Perceived Injunctive Drinking Norms as Assessed by an Adaptation of the Drinking Norms Rating Form
perceived injunctive norms are assessed using the Krieger et al. (2016) adaptation of the Drinking Norms Rating Form, which asks respondents to estimate the how many standard drinks is deemed acceptable by other students on campus to drink on each day in a typical week in the past 30 days; estimates are summed to yield number of drinks per week approved of by student peers; the scores can range from zero to no upper limit
Time frame: Assessed over prior 30 days at 3 month follow-up
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Alcohol Texts | Perceived Injunctive Drinking Norms as Assessed by an Adaptation of the Drinking Norms Rating Form | 15.72 drinks per week | Standard Deviation 8.79 |
| Attention Control | Perceived Injunctive Drinking Norms as Assessed by an Adaptation of the Drinking Norms Rating Form | 16 drinks per week | Standard Deviation 8.7 |
p-value: 0.84595% CI: [-2.81, 2.3]Regression, Linear
Secondary
Protective Behavioral Strategies as Assessed by the Strategies Questionnaire - Alternative Sub Scale
self-reported frequency of using strategies to moderate drinking as reported on the Strategy Questionnaire; the Strategy Questionnaire has 3 sub scales including Selective Avoidance (0-70), Strategies While Drinking (0-100), and Alternatives to Drinking (0-40) and higher sub scale scores indicate more frequent use of those strategies
Time frame: Assessed over prior 30 days at 3 month follow-up
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Alcohol Texts | Protective Behavioral Strategies as Assessed by the Strategies Questionnaire - Alternative Sub Scale | 14.54 score on a scale | Standard Deviation 5.75 |
| Attention Control | Protective Behavioral Strategies as Assessed by the Strategies Questionnaire - Alternative Sub Scale | 13.53 score on a scale | Standard Deviation 8.15 |
p-value: 0.395% CI: [-3.52, 1.11]Regression, Linear
Secondary
Protective Behavioral Strategies as Assessed by the Strategies Questionnaire - Selective Avoidance Sub Scale
self-reported frequency of using strategies to moderate drinking as reported on the Strategy Questionnaire; the Strategy Questionnaire has 3 sub scales including Selective Avoidance (0-70), Strategies While Drinking (0-100), and Alternatives to Drinking (0-40) and higher sub scale scores indicate more frequent use of those strategies
Time frame: Assessed over prior 30 days at 3 month follow-up
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Alcohol Texts | Protective Behavioral Strategies as Assessed by the Strategies Questionnaire - Selective Avoidance Sub Scale | 5.9 score on a scale | Standard Deviation 6.66 |
| Attention Control | Protective Behavioral Strategies as Assessed by the Strategies Questionnaire - Selective Avoidance Sub Scale | 5.67 score on a scale | Standard Deviation 5.64 |
p-value: 0.7795% CI: [-1.72, 2.31]Regression, Linear
Secondary
Protective Behavioral Strategies as Assessed by the Strategies Questionnaire - Strategies Sub Scale
self-reported frequency of using strategies to moderate drinking as reported on the Strategy Questionnaire; the Strategy Questionnaire has 3 sub scales including Selective Avoidance (0-70), Strategies While Drinking (0-100), and Alternatives to Drinking (0-40) and higher sub scale scores indicate more frequent use of those strategies
Time frame: Assessed over prior 30 days at 3 month follow-up
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Alcohol Texts | Protective Behavioral Strategies as Assessed by the Strategies Questionnaire - Strategies Sub Scale | 12.90 score on a scale | Standard Deviation 7.75 |
| Attention Control | Protective Behavioral Strategies as Assessed by the Strategies Questionnaire - Strategies Sub Scale | 13.51 score on a scale | Standard Deviation 8.16 |
p-value: 0.2195% CI: [-1, 4.54]Regression, Linear