Efficacy of a web-based, tailored, alcohol prevention/intervention program for college students: 3-month follow-up

This study presents the results of an efficacy evaluation of a web-based brief motivational alcohol prevention/intervention program called Michigan Prevention and Alcohol Safety for Students (M-PASS). Four on-line sessions providing individually-tailored feedback were delivered to first-year college students over 9 weeks. Non- and low-risk drinking participants received risk prevention, while high-risk drinking participants received a risk-reduction intervention. Both intervention and control groups were surveyed at baseline and at a 3-month follow-up. Analysis showed positive effects for both men and women on stage of change, drinking behavior, drinking motivation and attitudes, and use of risk-reduction strategies. These results provided evidence of efficacy and found that M-PASS had both intervention and prevention effects, making it unique among currently developed brief alcohol interventions for college students.     

Pregaming: An Exploratory Study of Strategic Drinking by College Students in Pennsylvania

Abstract

Objectives: This exploratory study examined pre-event drinking, or pregaming, by US college students. Participants: 112 undergraduates from 10 Pennsylvania colleges participated. Method: A focus group, including a written questionnaire, was conducted at each institution. Results: Only 35.7% of the participants had not pregamed during the last 2 weeks. Pregamers consumed an average of 4.9 (SD = 3.1) drinks during their most recent session. Gender, class year, and other demographic variables did not predict pregaming. Heavier drinkers, and those stating that the average student pregamed 3+ times in the last 2 weeks, were more likely to report pregaming in the last 2 weeks. How much students drink when pregaming is influenced by how much they expect to drink later on. Conclusion: Pregaming presents a growing challenge for campus officials. Additional research is needed on the nature of the problem and which combination of prevention strategies might best address this behavior.     

Randomized controlled trial of the Resilience and Coping Intervention (RCI) with undergraduate university students

Objective: The purpose of this pilot study was to evaluate the Resilience and Coping Intervention (RCI) with college students. Participants: College students (aged 18–23) from a large Midwest US university who volunteered for a randomized controlled trial during the 2015 spring semester. Methods: College students were randomly assigned to an intervention (n = 64) or a control (n = 65) group. Intervention participants received three 45-minute RCI sessions over subsequent weeks. All participants completed pre- and post-intervention assessments at the beginning of Week 1 and end of Week 3. Student resilience, coping, hope, stress, depression, and anxiety were assessed. Results. RCI participants reported significantly more hope and less stress and depression from Week 1 to Week 3 compared with control participants. Results for resilience also approached statistical significance. Effect sizes were small to moderate. Conclusions: This study found preliminary evidence that RCI is an effective resilience intervention for use with college students.     

Effectiveness of the Brief Alcohol and Screening Intervention for College Students (BASICS) Program With a Mandated Population

Abstract

Objective: This study evaluated the effectiveness of a large-scale intervention designed to reduce alcohol abuse among adjudicated college students. Participants: Participants were college students mandated to attend a Brief Alcohol Screening and Intervention for College Students (BASICS) program and a randomly selected comparison group of high-risk drinkers. Methods: Data were collected from January 2006 through December 2008. A total of 1,390 (67%) students in the intervention group and 508 (61%) students in the comparison group completed baseline and 6-month follow-up surveys. Results: Male students in the intervention group significantly decreased their drinking at follow-up, whereas those in the comparison group increased their drinking. Women in both the intervention and comparison groups decreased their drinking at 6 months. Conclusions: When implemented with fidelity, BASICS is a generally effective intervention, especially for male adjudicated college students. The intervention was most effective for moderate- and high-risk drinkers.     

Safer sex in a digital world: A Web-based motivational enhancement intervention to increase condom use among college women

ABSTRACT

Objective: This study is a randomized trial of a Web-based intervention to increase condom use among college women. Participants: From October 2012 to March 2013, N = 422 completed baseline questionnaires and intervention procedures. n = 216 completed 3-month follow-up. Methods: Participants completed a decisional balance exercise examining their sex acts over the past 3 months and wrote an essay encouraging young girls to use condoms. All procedures were conducted online. Results: The intervention improved intentions to use and attitudes towards condoms for 3 subscales of condom attitudes. Attitudes following the intervention significantly predicted condom use at 3-month follow-up, and this relationship was mediated by condom intentions immediately post intervention. The relationship between intentions and condom use was moderated by group. Conclusions: The intervention improved condom attitudes and intentions immediately post intervention, and immediately post intervention intentions had a greater impact on condom use at 3-month follow-up among those in the condom intervention compared with those in the control group.     

Calorie Restriction on Drinking Days: An Examination of Drinking Consequences Among College Students

Objective: This study examined the association between restricting calories on intended drinking days and drunkenness frequency and alcohol-related consequences among college students.

Participants: Participants included a random sample of 4,271 undergraduate college students from 10 universities.

Methods: Students completed a Web-based survey regarding their high-risk drinking behaviors and calorie restriction on intended drinking days.

Results: Thirty-nine percent of past 30-day drinkers reported restricting calories on days they planned to drink alcohol, of which 67% restricted because of weight concerns. Restricting calories on drinking days was associated with greater odds of getting drunk in a typical week. Women who restricted were more likely to report memory loss, being injured, being taken advantage of sexually, and having unprotected sex while drinking. Men were more likely to get into a physical fight.

Conclusions: These results highlight the importance of considering weight control behaviors in the examination of high-risk college drinking.     

Associations among trauma,depression, and alcohol use profiles and treatment motivation and engagement in college students

ABSTRACT

Objective: This study examined how profiles of alcohol use and symptoms of common mental health disorders (depression and posttraumatic stress disorder [PTSD]) influenced the perceived need for and actual seeking of different types of treatment (for alcohol versus psychological distress) in college student drinkers. Participants: Undergraduate students (n = 164) were assessed between September 2009 and August 2015. Methods: We classified students into different symptom profiles using model-based clustering and compared these profiles on a variety of variables. Results: The cluster model yielded three profiles: Low Risk (n = 66), Concomitant (n = 35), and Heavy Drinking (n = 63). Students in these profiles significantly differed in alcohol consumption, alcohol-related cognitions and problems, and perceptions of need and prior engagement in treatment. Conclusion: A variety of strategies can be used to engage students experiencing heavy drinking and/or mental health problems into treatment on campus.     

Protective Effects of Parent–College Student Communication During the First Semester of College

Abstract

Objective: Recent studies suggest that parents maintain influence as their adolescents transition into college. Advances in communication technology make frequent communication between parents and college students easy and affordable. This study examines the protective effect of parent–college student communication on student drinking behaviors, estimated peak blood alcohol concentration (eBAC), and serious negative consequences of drinking. Participants: Participants were 746 first-year, first-time, full-time students at a large university in the United States Methods: Participants completed a baseline and 14 daily Web-based surveys. Results: The amount of time spent communicating with parents on weekend days predicted the number of drinks consumed, heavy drinking, and peak eBAC, consistent with a protective within-person effect. No association between communication and serious negative consequences was observed. Conclusions: Encouraging parents to communicate with their college students, particularly on weekend days, could be a relatively simple, easily implemented protective process to reduce dangerous drinking behaviors.     

Pilot study of a Web-based acceptance and commitment therapy intervention for university students to reduce academic procrastination

Objective: This pilot study pursued two aims. The first was to investigate the feasibility and acceptability of a Web-based acceptance and commitment therapy (ACT) intervention to reduce academic procrastination among university students. The second aim was to test the effectiveness of the intervention on procrastination and committed actions. Participants: The sample was comprised of Canadian university students (n?=?36) that participated in the intervention between September 2016 and April 2017. Methods: The study relied on a prepost research design. Results: The intervention appears feasible, acceptable, and valuable to students. A significant reduction in procrastination and a significant improvement in committed actions were found between pre and postintervention. The effect sizes for these results were medium. Conclusions: Results provide preliminary support for the feasibility and effectiveness of a Web-based ACT intervention for academic procrastination. Results also highlight some aspects that need to be improved for further development.     

Alcohol Use in Students Seeking Primary Care Treatment at University Health Services

Abstract

Objective: Given the high rate of at-risk drinking in college students, the authors examined drinking behaviors and associated factors in students being seen in student health services for primary care visits from October 30, 2004, to February 15, 2007. Methods: Analyses were based on a Health Screening Survey completed by 10,234 college students seeking general medical treatment. Results: Alcohol use was similar to other studies with 57% (n = 5,840) meeting the National Institute on Alcohol Abuse and Alcoholism criteria for at-risk drinking. Twenty-six percent of the students reported smoking at least once in the last 3 months. Risk factors for at-risk drinking included young age, white males, drinking at a fraternity/sorority house, and use of tobacco. Conclusions: These findings support the widespread implementation of alcohol screening and intervention in university health services.     

The role of age and setting in adolescents’ first drinking experience for predicting college problem drinking

Objective: The purpose of this study was to determine the reliability of longitudinally reporting age at first drink (AFD), and to test AFD and setting of first drink (SFD) as predictors of collegiate problem drinking. Participants: 338 first-year college students were interviewed multiple times during their first academic year, from May 2011 through August 2012. Methods: AFD, SFD, and problem drinking were measured using the Alcohol Use Disorders Identification Test (AUDIT) during the first year of college. Bivariate analysis and parsimonious multivariate linear regression model were conducted. Results: 62% of respondents were inconsistent in reporting AFD over time. Social SFD was the strongest independent predictor for higher AUDIT scores (b = 4.74, 95% confidence interval; 1.91, 7.57; p = .002). Conclusions: Findings suggest caution should be used in relying upon using AFD as a sole predictor of problem drinking. SFD may be a complementary measure to identify students at high risk of collegiate problem drinking.     

Variability in measures of health and health behavior among emerging adults 1 year after high school according to college status

Objective: To examine changes in health behaviors among US emerging adults 1 year after high school. Participants: The national sample of participants (N = 1,927), including those attending 4-year college/university (n = 884), 2-year colleges/technical schools (n = 588), and no college (n = 455), participated in annual spring surveys 2013–2014. Methods: Health behaviors were assessed the last year of high school and first year of college; differences by college status controlling for previous-year values were estimated using regression analyses. Results: Relative to 4-year college attendees, those attending technical school/community college were less likely to binge drink (odds ratio [OR] = 0.57, confidence interval [CI] = 0.38–0.86) but more likely to speed (OR = 1.26, CI = 1.0–2.84), consume sodas (OR = 1.57, CI = 1.0–2.47), and report lower family satisfaction (p < .01), with marginally more physical and depressive symptoms. College nonattendees reported more DWI (driving while intoxicated; OR = 1.60, CI = 1.05–2.47), soda drinking (OR = 2.51, CI = 1.76–3.59), oversleeping (OR = 4.78, CI = 3.65–8.63), and less family satisfaction (p < .04). Conclusions: Health risk behaviors among emerging adults varied by college status.     

Perfectionism and Binge Drinking in Canadian Students Making the Transition to University

Objective: In September 2005, the authors explored the relationship between perfectionism and binge drinking in a sample of first-year college students. Participants: The authors recruited 207 first-year college students (76 men, 131 women) to complete the Multidimensional Perfectionism Scale (MPS) and Frost Multidimensional Perfectionism Scale (F-MPS). Methods: The authors divided participants into 3 groups on the basis of frequency of binge drinking and conducted multivariate analyses of variance to compare the binge drinking groups on the 3 MPS subscales and the 5 F-MPS subscales. Results: The group with 2 or more binge drinking episodes in the past 2 weeks had higher levels of parental criticism and lower levels of self-oriented perfectionism, but they did not have lower scores on a measure of personal standards. Conclusions: These findings suggest that certain perfectionists binge drink in response to harsh parental treatment and that, at least initially, the pursuit of extreme standards of personal perfection is incompatible with binge drinking. The authors discuss the theoretical and practical implications of these findings.     

Decision making processes and alcohol use among college students

Abstract

Objective: The neurobiological model of risk-taking and the dual-process model of decision making each provide possible explanations of risky behavior among youth, but their interconnections have rarely been explored, especially among college students, a time of increased alcohol use. Participants: n?=?382; Mage?=?19.25, SD?=?1.33. Method: Participants completed a survey about their deliberative and intuitive decision making style (based on the dual-process model), their socioemotional and cognitive control processes (based on the neurobiological model), and alcohol use. Results: Structural equation modeling showed that dual-process variables and neurobiological variables were positively related. Deliberative decision making and cognitive control were negatively related to alcohol use whereas intuitive decision making was not. Comment: Discussion focuses on the integration of theoretical models with real-world health behaviors and considers implications of the current findings in terms of prevention and intervention to reduce drinking among college students.     

Drunkorexia: Understanding the Co-occurrence of Alcohol Consumption and Eating/Exercise Weight Management Behaviors

Abstract

Objective: Examine the co-occurrence of alcohol consumption, physical activity, and disordered eating behaviors via a drunkorexia perspective. Participants: Nationally representative sample (n = 22,488) of college students completing the Fall 2008 National College Health Assessment. Methods: Hierarchical logistic regression was employed to determine if physical activity and disordered eating behaviors uniquely predicted binge drinking, while controlling for age, race, gender, year in college, Greek membership, and place of residence. Results: Physical activity and disordered eating made unique, statistically significant contributions. Moreover, including physical activity and disordered eating behaviors allowed for the correct classification of an additional 431 cases (ie, binge drinkers) over and above the predictive ability of the covariate-only model. Conclusions: Findings corroborate prior research indicating highly active college students are more likely to binge drink than their nonactive peers, and highlight the potential of a drunkorexia perspective in explaining the counterintuitive alcohol–activity association among college students.     

The Inability of Self-affirmations to Decrease Defensive Bias Toward an Alcohol-Related Risk Message Among High-Risk College Students

Abstract

Objective: To examine the efficacy of a self-affirmation task in deterring college alcohol misuse and the importance of preexisting beliefs in predicting subsequent behavior change. Participants: Heavy-drinking undergraduates (N = 110) participated during the 2011–2012 academic year. Methods: Participants were randomized to complete an affirmation or control task before reading an alcohol risk message. Alcohol-related beliefs and behaviors were assessed. Participants completed a 2-week online follow-up assessing alcohol-related behaviors. Results: Both groups reported increased perceived problem importance, but neither group displayed changes in personal risk. Follow-up assessment revealed similar, significant declines in peak consumption in both groups, with no significant between-group differences. Preexisting beliefs accounted for 5% to 10% of variance in drinking outcomes. Conclusions: An affirmation task does not seem to decrease defensive processing or alter high-risk drinking behaviors among college students and should not be utilized in lieu of more effective strategies.     

Declining Negative Consequences Related to Alcohol Misuse Among Students Exposed to a Social Norms Marketing Intervention on a College Campus

Objective: The authors examined whether alcohol-related negative consequences decreased among students exposed to an intervention. Participants: Beginning in 1999, approximately 2,500 randomly selected undergraduates from a 4-year US university annually participated in a Web-based survey over 6 years. Methods: The educational intervention used social norms initiatives. Main outcome measures included recall of intervention, estimated blood alcohol content (eBAC) when drinking, and 10 negative consequences from alcohol within the past year. Results: First-year students recalling exposure had lower odds of negative consequences (odds ratio [OR] = 0.78, 95% confidence interval [CI] = 0.64-0.95) and of having an eBAC higher than .08 (OR = 0.76, 95% CI = 0.62-0.92). Over the 6 study years, the odds among all participants of experiencing (a) none of 10 alcohol consequences nearly doubled (OR = 2.13, 95% CI = 1.82-2.49) and (b) multiple consequences decreased by more than half (OR = 0.43, 95% CI = 0.36-0.50). Conclusions: These findings have important implications for US colleges and universities engaged in the reduction of harm associated with alcohol misuse.     

Screening and Brief Intervention for Tobacco Use by Student Health Providers on College Campuses

Abstract

Objective: This study assessed college students’ reports of tobacco screening and brief intervention by student health center providers. Participants: Participants were 3,800 students from 8 universities in North Carolina. Methods: Web-based survey of a stratified random sample of undergraduates. Results: Fifty-three percent reported ever visiting their student health center. Of those, 62% reported being screened for tobacco use. Logistic regression revealed screening was higher among females and smokers, compared to nonsmokers. Among students who were screened and who reported tobacco use, 50% reported being advised to quit or reduce use. Brief intervention was more likely among current daily smokers compared to current nondaily smokers, as well as at schools with higher smoking rates. Screening and brief intervention were more likely at schools with lower clinic caseloads. Conclusions: Results highlight the need to encourage college health providers to screen every patient at every visit and to provide brief intervention for tobacco users.     

Moderators of the Relationship Between Physical Activity and Alcohol Consumption in College Students

Abstract

Objective: Among college students, several studies have found a positive relationship between physical activity and alcohol use. The current study tested gender, Greek status, and ethnicity as potential moderators of the physical activity-alcohol use relationship. Participants: Participants were college freshmen (n = 310) endorsing alcohol/drug use. Methods: Students completed questionnaires assessing a number of health behaviors. Results: Results indicated that gender and Greek status were significant moderators of the relationship between physical activity and alcohol consumption. There was a positive relationship between physical activity and alcohol use for men and Greeks, but not for females and non-Greeks. Conclusions: These findings suggest that exercise does not serve as a protective factor for any of the subgroups of college students studied and is positively associated with drinking among college students who are men and/or involved with the Greek system.     

Condom Use in Heavy Drinking College Students: The Importance of Always Using Condoms

Abstract

Objective: The authors examined whether alcohol use decreased condom use. Participants: The subjects were heavy-drinking students on 5 different college campuses. Methods: A face-to-face interview, administered between November of 2004 and February of 2007, gathered information about condom use, alcohol use, and other behaviors. Multivariate logistic regression was used to assess predictors of condom use. Results: Of the 1715 participants, 64% reported that they did not always use condoms. Male students who drank heavily were less likely to always use condoms (adjusted odds ratio [AOR] 0.61). Participants with more sexual partners used condoms less when drinking (AOR 1.93 for men, 1.45 for women). Conclusions: Many students do not use condoms consistently, especially those who drink heavily or have multiple sexual partners. Clinicians at student health need to encourage all students to use condoms every time they have intercourse.