1
|
Vadhan NP, Padovano HT, Muench FJ, Levak S, Allen N. Self-reported alcohol consumption during participation in a text messaging-based online drinking moderation platform. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024. [PMID: 39177720 DOI: 10.1111/acer.15414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 06/15/2024] [Accepted: 07/15/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND Many individuals with excessive alcohol consumption desire moderation but do not seek formalized treatment. Commercially available, technology-assisted options are flexible and highly accessible, yet often not empirically validated. METHODS Individuals desiring alcohol moderation (age 21+) self-selected to use Sunnyside®, a web application with tailored and adaptive text messaging. The evaluable dataset included 46,411 members who completed a baseline assessment, enrolled in the program, and tracked their drinking at least once. An adaptive and customizable weekly plan was generated from typical drinking patterns, goals, and weekly reported progress. Personalized daily messages included reminders for real-time drink tracking, plans, and available interactive messaging with peer coaches. Generalized mixed-effect growth models characterized change in drinks per week and daily drinking for 12 weeks after enrollment. Models allowed for nonlinear change and individual variability across members and weeks. RESULTS A majority (64.3%) of members reported typically drinking 7 of 7 days per week at baseline. During tracking, drinks per week decreased most in the initial weeks and slowed thereafter, with an overall 33% reduction in weekly drink counts. More severe alcohol-use patterns and concern over drinking at baseline were associated with greater relative benefit. CONCLUSIONS Drinking patterns appeared amenable to change during 12 weeks of daily drink tracking with Sunnyside®, a tailored web program to reduce drinking and improve overall wellness. Overall, the findings of this naturalistic study, one of the first of its kind, supplement data from randomized clinical trials and support the use of adaptive, technology-assisted tools for alcohol moderation.
Collapse
Affiliation(s)
- Nehal P Vadhan
- Northwell, New Hyde Park, New York, USA
- Department of Psychiatry, Zucker School of Medicine at Hofstra University, Hempstead, New York, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, New York, USA
- Department of Psychology, Hofstra University, Hempstead, New York, USA
| | - Hayley Treloar Padovano
- Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island, USA
- Department of Behavioral and Social Sciences, Brown University, Providence, Rhode Island, USA
| | - Frederick J Muench
- Northwell, New Hyde Park, New York, USA
- Department of Psychiatry, Zucker School of Medicine at Hofstra University, Hempstead, New York, USA
- Clear30 LLC, Hastings on Hudson, New York, USA
| | - Svetlana Levak
- Northwell, New Hyde Park, New York, USA
- Department of Psychiatry, Zucker School of Medicine at Hofstra University, Hempstead, New York, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, New York, USA
| | | |
Collapse
|
2
|
Muench F, Madden SP, Oommen S, Forthal S, Srinagesh A, Stadler G, Kuerbis A, Leeman RF, Suffoletto B, Baumel A, Haslip C, Vadhan NP, Morgenstern J. Automated, tailored adaptive mobile messaging to reduce alcohol consumption in help-seeking adults: A randomized controlled trial. Addiction 2024; 119:530-543. [PMID: 38009576 PMCID: PMC10872985 DOI: 10.1111/add.16391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 10/10/2023] [Indexed: 11/29/2023]
Abstract
AIMS To test differential outcomes between three 6-month text-messaging interventions to reduce at-risk drinking in help-seeking adults. DESIGN A three-arm single-blind randomized controlled trial with 1-, 3-, 6- and 12-month follow-ups. SETTING United States. A fully remote trial without human contact, with participants recruited primarily via social media outlets. PARTICIPANTS Seven hundred and twenty-three adults (mean = 39.9 years, standard deviation = 10.0; 62.5% female) seeking to reduce their drinking were allocated to 6 months of baseline 'tailored statically' messaging (TS; n = 240), 'tailored adaptive' messaging (TA; n = 239) or 'drink tracking' messaging (DT; n = 244). INTERVENTIONS TS consisted of daily text messages to reduce harmful drinking that were tailored to demographics and alcohol use. TA consisted of daily, tailored text messages that were also adapted based on goal achievement and proactive prompts. DT consisted of a weekly assessment for self-reported drinking over the past 7 days. MEASUREMENTS The primary outcome measure was weekly sum of standard drinks (SSD) at 6-month follow-up. Secondary outcome measures included drinks per drinking day (DDD), number of drinking days (NDD) per week and heavy drinking days (HDD) at 1-, 3-, 6- and 12-month follow-ups. FINDINGS At 6 months, compared with DT, TA resulted in significant SSD reductions of 16.2 (from 28.7 to 12.5) drinks [adjusted risk ratio (aRR) = 0.80, 95% confidence interval (CI) = 0.71, 0.91] using intent-to-treat analysis. TA also resulted in significant improvements in DDD (aRR = 0.84; 95% CI = 0.77-0.92) and drinking days per week (b = -0.39; 95% CI = -0.67, -0.10), but not HDD compared with DT at 6 months. TA was not significantly different from TS at any time-point, except DDD at 6 months. All groups made improvements in SSD at 12-month follow-up compared with baseline with an average reduction of 12.9 drinks per week across groups. CONCLUSIONS Automated tailored mobile messaging interventions are scalable solutions that can reduce weekly alcohol consumption in remote help-seeking drinkers over time.
Collapse
Affiliation(s)
| | - Sean P Madden
- Zucker School of Medicine at Hofstra/Northwell, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | | | | | | | | | - Alexis Kuerbis
- Silberman School of Social Work, Hunter College at CUNY, The Graduate Center at CUNY, New York, NY, USA
| | - Robert F Leeman
- Department of Health Sciences, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | | | - Amit Baumel
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - Cameron Haslip
- Zucker School of Medicine at Hofstra/Northwell, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Nehal P Vadhan
- Zucker School of Medicine at Hofstra/Northwell, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Jon Morgenstern
- Zucker School of Medicine at Hofstra/Northwell, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| |
Collapse
|
3
|
Bush R, Staiger PK, McNeill IM, Brown R, Orellana L, Lubman D, McNair R. Evaluation of an SMS Based Alcohol Intervention for Same Sex Attracted Women: A Randomized Controlled Trial to Examine Feasibility, Acceptability, and Efficacy. Subst Use Misuse 2024; 59:1157-1166. [PMID: 38407160 DOI: 10.1080/10826084.2024.2321257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
PURPOSE The purpose of this randomized controlled trial (Trial registration ID: redacted) was to examine the feasibility, acceptability, and efficacy of the Step One program, an SMS-based alcohol intervention for same-sex attracted women (SSAW). METHODS Ninety-seven SSAW who scored ≥8 on the Alcohol Use Disorders Identification Test (AUDIT) were randomly allocated to receive the Step One program (n = 47; mean age = 36.79) or a weekly message containing a link to a website with health information and support services for LGBT individuals (n = 50; mean age = 34.08). Participants completed questionnaires on alcohol use, wellbeing, and help-seeking at baseline (T1), intervention completion (T2; 4 wk after baseline) and 12 wk post-intervention (T3). In addition, participants in the intervention condition completed feasibility and accessibility measures at T2, and a subsample (n = 10) was interviewed about acceptability at T3. RESULTS Across conditions, participants significantly reduced their alcohol intake and improved their wellbeing and help-seeking over time. However, there were no significant differences between the intervention and control condition. Furthermore, frequency of help-seeking was low; only four intervention group participants and three control group participants began accessing support between T1 and T3. Overall, our findings indicate the intervention would benefit from revision prior to implementation. CONCLUSIONS Our approach was consistent with best practice in the development of an ecologically valid intervention; however, this intervention, in its current form, lacks the complexity desired by its users to optimally facilitate alcohol reduction among SSAW. Keywords: Alcohol intervention; Intervention mapping framework; Randomized controlled trial (RCT); Same-sex attracted women; Short-message service (SMS).
Collapse
Affiliation(s)
- Rachel Bush
- School of Psychology, Deakin University, Geelong, Australia
| | | | - Ilona M McNeill
- School of Psychology, Deakin University, Geelong, Australia
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Rhonda Brown
- School of Nursing and Midwifery, Deakin University, Geelong, Australia
| | | | - Dan Lubman
- Turning Point, Monash University, Eastern Health, Richmond, Australia
| | - Ruth McNair
- Department of General Practice, The University of Melbourne, Carlton, Australia
| |
Collapse
|
4
|
Piccirillo ML, Graupensperger S, Schultz NR, Larimer ME. Whose Approval Matters Most? Examining Discrepancies in Self- and Other- Perceptions of Drinking. Subst Use Misuse 2023; 59:58-68. [PMID: 37735917 PMCID: PMC11162250 DOI: 10.1080/10826084.2023.2259458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
BACKGROUND Research demonstrates that perceptions of others' attitudes toward drinking behaviors (injunctive norms) are strong predictors of alcohol consumption and problems. Personalized normative feedback (PNF) aims to reduce the discrepancy between one's perception of others' attitudes toward drinking and others' actual attitudes toward drinking. An implicit assumption of PNF is that self and (perceived) other attitudes toward drinking are aligned (thus, shifting one's perceptions of others' attitudes shifts one's own attitudes). However, there is minimal research on the extent to which alignment (or discrepancy) in self-other attitudes toward drinking is associated with alcohol-related outcomes. METHODS College students (N = 1,494; Mage = 20.11, 61.0% female, 66.4% White) who endorsed past-month heavy episodic drinking reported injunctive norms toward drinking on weekends, drinking daily, drinking to black out, and drinking and driving. Participants reported their perceptions of attitudes toward these drinking behaviors for three reference groups: close friends, typical university-affiliated peers, and parents. Outcomes included weekly drinking, alcohol problems, and alcohol-related risk. RESULTS Response surface analyses indicated that alignment in approval (versus alignment in disapproval) of drinking demonstrated a linear association with alcohol-related outcomes. Discrepancies in self-peer and self-parent attitudes were associated with alcohol-related outcomes and one's own attitudes (versus one's ratings of others' attitudes) of drinking were more strongly associated with outcomes. CONCLUSIONS Results provide evidence of how self-other discrepancies in attitudes toward drinking are associated with alcohol-related outcomes. Future work is needed to test whether self-other discrepancies in attitudes toward drinking impacts response to norms-based interventions.
Collapse
Affiliation(s)
| | | | - Nicole R. Schultz
- University of Washington, Department of Psychiatry and Behavioral Sciences
- University of California, Davis, Department of Psychiatry and Behavioral Sciences
| | - Mary E. Larimer
- University of Washington, Department of Psychology
- University of Washington, Department of Psychiatry and Behavioral Sciences
| |
Collapse
|
5
|
Hultgren BA, Guttmannova K, Cadigan JM, Kilmer JR, Delawalla MLM, Lee CM, Larimer ME. Injunctive Norms and Driving Under the Influence and Riding With an Impaired Driver Among Young Adults in Washington State. J Adolesc Health 2023; 73:852-858. [PMID: 37530684 DOI: 10.1016/j.jadohealth.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 05/18/2023] [Accepted: 06/09/2023] [Indexed: 08/03/2023]
Abstract
PURPOSE Alcohol- and cannabis-impaired driving behaviors remain a public health concern especially among young adults (i.e., ages 18-25). Limited updates to prevention efforts for these behaviors may be due, in part, to limited understanding of malleable psychosocial predictors. The current study assessed associations between perceived injunctive norms (i.e., acceptability) of driving under the influence of alcohol (DUI-A) and cannabis (DUI-C), and riding with a driver under the influence of alcohol (RWI-A) and cannabis (RWI-C) in Washington State young adults. METHODS Participants included 1,941 young adults from the 2019 cohort of the Washington Young Adult Health Survey. Weighted logistic regressions assessed the associations between peer injunctive norms and impaired driving-related behaviors. RESULTS A weighted total of 11.5% reported DUI-A, 12.4% DUI-C, 10.9% RWI-A, and 20.9% RWI-C at least once in the past 30 days. Overlap between the outcomes was observed, indicating some young adults had engaged in multiple impaired driving-related behaviors. After controlling for substance use frequency, weighted logistic regressions indicated more positive perceived injunctive norms were associated with nearly 2 ½ times higher odds of DUI-A, 8 times higher odds of DUI-C, 4 times higher odds of RWI-A and six and a half times higher odds of RWI-C. DISCUSSION Results increase the understanding of how injunctive norms-a potentially malleable psychosocial factor-are associated with four impaired driving-related outcomes. Prevention programs that focus on assessing and addressing the norms of these outcomes individually and collectively, such as normative feedback interventions and media campaigns, may be helpful in reducing these behaviors.
Collapse
Affiliation(s)
- Brittney A Hultgren
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, School of Medicine, University of Washington, Seattle, Washington.
| | - Katarina Guttmannova
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, School of Medicine, University of Washington, Seattle, Washington
| | - Jennifer M Cadigan
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, School of Medicine, University of Washington, Seattle, Washington
| | - Jason R Kilmer
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, School of Medicine, University of Washington, Seattle, Washington; Department of Psychology, University of Washington, Seattle, Washington
| | - Miranda L M Delawalla
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, School of Medicine, University of Washington, Seattle, Washington
| | - Christine M Lee
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, School of Medicine, University of Washington, Seattle, Washington
| | - Mary E Larimer
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, School of Medicine, University of Washington, Seattle, Washington; Department of Psychology, University of Washington, Seattle, Washington
| |
Collapse
|
6
|
Sohi I, Shield KD, Rehm J, Monteiro M. Digital interventions for reducing alcohol use in general populations: An updated systematic review and meta-analysis. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:1813-1832. [PMID: 37864535 DOI: 10.1111/acer.15175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/03/2023] [Accepted: 08/11/2023] [Indexed: 10/23/2023]
Abstract
This article updates a 2017 review on the effectiveness of digital interventions for reducing alcohol use in the general population. An updated systematic search of the MEDLINE database was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria to identify randomized controlled trials (RCTs) published from January 2017 to June 2022 that evaluated the effectiveness of digital interventions compared with no interventions, minimal interventions, and face-to-face interventions aimed at reducing alcohol use in the general population and, that also reported changes in alcohol use (quantity, frequency, quantity per drinking day, heavy episodic drinking (HED), or alcohol use disorders identification test (AUDIT) scores). A secondary analysis was performed that analyzed data from RCTs conducted in students. The review was not preregistered. The search produced 2224 articles. A total of 80 studies were included in the review, 35 of which were published after the last systematic review. A total of 66, 20, 18, 26, and 9 studies assessed the impact of digital interventions on alcohol quantity, frequency, quantity per drinking day, HED, and AUDIT scores, respectively. Individuals randomized to the digital interventions drank 4.12 (95% confidence interval (CI): 2.88, 5.36) fewer grams of alcohol per day, had 0.17 (95% CI 0.06, 0.29) fewer drinking days per week, drank approximately 3.89 (95% CI: 0.40, 7.38) fewer grams of alcohol per drinking day, had 1.11 (95% CI: 0.32, 1.91) fewer HED occasions per month, and had an AUDIT score 3.04 points lower (95% CI: 2.23, 3.85) than individuals randomized to the control condition. Significant reductions in alcohol quantity, frequency, and HED, but not quantity per drinking day, were observed among students. Digital interventions show potential for reducing alcohol use in general populations and could be used widely at the population level to reduce alcohol-attributable harms.
Collapse
Affiliation(s)
- Ivneet Sohi
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
| | - Kevin D Shield
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, Ontario, Canada
| | - Jürgen Rehm
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Center for Clinical Epidemiology and Longitudinal Studies, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | | |
Collapse
|
7
|
Waldron KA, Lewis MA, Fairlie AM, Litt DM, Zhou Z, Bryant D. Daily-level associations between alcohol use cognitions and normative perceptions among adolescents: An intensive longitudinal study. Addict Behav 2023; 143:107697. [PMID: 36965214 PMCID: PMC10122708 DOI: 10.1016/j.addbeh.2023.107697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 03/01/2023] [Accepted: 03/16/2023] [Indexed: 03/27/2023]
Abstract
BACKGROUND Adolescence is an important developmental period in which to understand the cognitive underpinnings of risky alcohol use. Normative perceptions, such as descriptive and injunctive norms, are one of the strongest and most consistent predictors in adolescent drinking research. Thus, it is essential to examine which drinking cognitions (e.g., attitudes, prototypes, perceived vulnerability) are associated with normative drinking perceptions using repeated daily-level data among adolescents. The present study assessed associations between drinking cognitions and normative perceptions using an intensive daily longitudinal design. METHODS Participants were ages 15-17 years (N = 306; 61.4% female; Mage (SD) = 16.0 (0.8)) who were part of a larger ecological momentary assessment study (EMA) on drinking cognitions and alcohol use. The study design consisted of a 3-week EMA burst design (8 surveys per week, up to 2x/day) that was repeated quarterly over the 12-month study. The present analyses used the afternoon assessment for all measures. RESULTS Our multilevel model results demonstrated that drinking attitudes, prototypes of a typical drinker, and perceived vulnerability were positively associated with both descriptive and injunctive drinking norms between individuals and within individuals across days. CONCLUSIONS Current findings have important clinical implications as they demonstrated how specific drinking cognitions were associated with variability in normative perceptions at the daily level. Findings support the delivery of intervention messaging to adolescents on days when drinking attitudes, prototypes of a typical drinker, and perceived vulnerability are elevated.
Collapse
Affiliation(s)
- Katja A Waldron
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA 16802.
| | - Melissa A Lewis
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX 76107
| | - Anne M Fairlie
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195
| | - Dana M Litt
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX 76107
| | - Zhengyang Zhou
- Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX 76107
| | - Dwalyn Bryant
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA 16802
| |
Collapse
|
8
|
Larimer ME, Graupensperger S, Lewis MA, Cronce JM, Kilmer JR, Atkins DC, Lee CM, Garberson LA, Walter T, Ghaidarov TM, Hummer JF, Neighbors C, LaBrie JW. Injunctive and descriptive normative feedback for college drinking prevention: Is the whole greater than the sum of its parts? PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2023; 37:447-461. [PMID: 36480396 PMCID: PMC11162751 DOI: 10.1037/adb0000893] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Single-component personalized normative feedback (PNF) interventions and multicomponent personalized feedback interventions (PFI) have been shown to reduce alcohol consumption among college students. The present study compared the efficacy of PNF interventions targeting descriptive norms alone (descriptive PNF), injunctive norms alone (injunctive PNF), or their combination (combined PNF), against a multicomponent PFI and an attention control condition. METHOD Undergraduates (N = 1,137) across two universities who reported a minimum of one past-month episode of heavy episodic drinking (i.e., 4 +/5 + drinks on a single occasion for females/males) completed assessments at baseline and 3, 6, and 12 months postintervention. RESULTS Relative to the attention control, participants in each of the four intervention conditions showed greater reductions in perceived descriptive/injunctive norms, total drinks per week, and alcohol-related consequences. Peak estimated blood alcohol concentration was also reduced in the injunctive PNF, combined PNF, and multicomponent PFI conditions, with the latter two conditions showing an advantage for duration of effects. The multicomponent PFI condition also evidenced greater reductions than the injunctive PNF in descriptive norms at 3-month and injunctive norms at 6- and 12-month follow-ups. No other group comparisons on any outcome were significant. CONCLUSIONS Each intervention has merit for use in college student harm reduction efforts. Single-component or combined PNF could be considered a potential starting point, as PNF is less burdensome than a multicomponent PFI when considering ease and length of delivery. Results can inform optimization of norms-based interventions and guide recommendations on efficacious components for reducing alcohol use and harms on college campuses. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Collapse
Affiliation(s)
- Mary E Larimer
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | | | - Melissa A Lewis
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center
| | - Jessica M Cronce
- Department of Counseling Psychology and Human Services, University of Oregon
| | - Jason R Kilmer
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | - David C Atkins
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | - Christine M Lee
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | | | - Theresa Walter
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | | | | | | | | |
Collapse
|
9
|
Abstract
Objective: The current study investigates the effects of an alcohol-prevention program delivered to college students in a formal classroom setting. Participants: The sample comprised 231 first-year college students who enrolled in a multisection “First Year Experience” course at a large northeastern university in the United States. Method: A naturalistic experiment was conducted, with a baseline evaluation at the beginning of the semester and a post-experiment evaluation near the end of the semester. Results: Social drinking attitudes, proximal drinking norm and the college effect are significant predictors of pre- and post-intervention episodic drinking frequency. The intervention reduced episodic drinking frequency as well as perceived distal and proximal drinking norms. It also increased drinking attitudes and did not change perceived efficacy or drinking-outcome expectancies. Conclusions: Practitioners could consider implementing a similar intervention to allow students to learn and practice safe drinking skills in the first year of their college life.
Collapse
|
10
|
Insight into Selecting Adolescents for Drinking Intervention Programs: a Simulation Based on Stochastic Actor-Oriented Models. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 23:48-58. [PMID: 34117976 DOI: 10.1007/s11121-021-01261-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2021] [Indexed: 10/21/2022]
Abstract
Adolescent drinking remains a prominent public health and socioeconomic issue in the USA with costly consequences. While numerous drinking intervention programs have been developed, there is little guidance whether certain strategies of participant recruitment are more effective than others. The current study aims at addressing this gap in the literature using a computer simulation approach, a more cost-effective method than employing actual interventions. We first estimate stochastic actor-oriented models for two schools from the National Longitudinal Study of Adolescent to Adult Health (Add Health). We then employ different strategies for selecting adolescents for the intervention (either based on their drinking levels or their positions in the school network) and simulate the estimated model forward in time to assess the aggregated level of drinking in the school at a later time point. The results suggest that selecting moderate or heavy drinkers for the intervention produces better results compared to selecting casual or light drinkers. The intervention results are improved further if network position information is taken into account, as selecting drinking adolescents with higher in-degree or higher eigenvector centrality values for intervention yields the best results. Results from this study help elucidate participant selection criteria and targeted network intervention strategies for drinking intervention programs in the USA.
Collapse
|
11
|
Bendtsen M, McCambridge J, Åsberg K, Bendtsen P. Text messaging interventions for reducing alcohol consumption among risky drinkers: systematic review and meta-analysis. Addiction 2021; 116:1021-1033. [PMID: 33047865 PMCID: PMC8247265 DOI: 10.1111/add.15294] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 05/20/2020] [Accepted: 10/02/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND AIMS The global growth of mobile phone use has led to new opportunities for health interventions, including through text messaging. We aimed to estimate the effects of text messaging interventions on alcohol consumption among risky drinkers. METHODS Systematic review and meta-analysis of reports on randomized controlled trials (RCTs) published in English. Searches were conducted on 23 May 2019 in PubMed; PubMed Central; CENTRAL; CDSR; DARE; NHS-EED; Scopus; PsycINFO; PsycARTICLES; CINAHL; and Web of Science. Measurements included number of episodes of heavy drinking (HED) per month and weekly alcohol consumption (WAC) in grams. Trials among risky drinkers who were not receiving co-interventions were included in the review (n = 3481, mean age 29 years, 41% female). Data were extracted from reports and authors were contacted for additional data. RESULTS Ten trials were included and all analyses were based on random-effects models. Primary analyses, including seven trials (n = 2528) for HED and five trials (n = 2236) for WAC, found that the interventions may reduce self-reported HED [-0.33 episodes per month; 95% confidence interval (CI) = -0.79, 0.12] and WAC (-18.62 g per week; 95% CI = -39.61, 2.38), although both estimates included the null. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) quality of evidence was judged to be low for both HED and WAC, primarily due to risk of attrition and performance bias, heterogeneity and influence of pilot trials on estimates. CONCLUSIONS Text messaging alcohol interventions may reduce alcohol consumption compared with no or basic health information; however, there are doubts about the overall quality of the evidence.
Collapse
Affiliation(s)
- Marcus Bendtsen
- Department of Health, Medicine and Caring SciencesLinköping UniversitySweden
| | | | - Katarina Åsberg
- Department of Health, Medicine and Caring SciencesLinköping UniversitySweden
| | - Preben Bendtsen
- Department of Health, Medicine and Caring SciencesLinköping UniversitySweden,Department of Medical SpecialistMotalaSweden
| |
Collapse
|
12
|
Timko C, Schonbrun YC, Anderson B, Johnson JE, Stein M. Perceived Substance Use Norms Among Jailed Women with Alcohol Use Disorders. Alcohol Clin Exp Res 2020; 44:1834-1841. [PMID: 32876998 PMCID: PMC7722182 DOI: 10.1111/acer.14403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 06/15/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Social norms regarding substance use predict substance use behaviors. In a sample of jailed women with alcohol use disorders (AUDs), we compared (i) jailed women's perceptions of the US women population's rates of substance use, with US women's actual rates of substance use; (ii) jailed women's perceived rates of substance use by US women, with their perceptions of use by their own friends; and (iii) US women's actual rates of substance use, with observed sample substance use rates. METHODS Participants were 205 jailed women who met criteria for an AUD. We used the 1-sample or dependent-samples t-test to make the comparisons. RESULTS Participants overestimated US women's rates of substance use and incarceration rates. They perceived their friends' substance use as less common than US women's. The jailed women reported higher rates of their own substance use than actual rates by US women. In addition, jailed women self-reported less cannabis use, but more alcohol and cocaine use and cigarette smoking, than they perceived their friends to have used. The more women perceived their friends as drinking, the less they had a goal to drink less or abstain from drinking postincarceration; in contrast, perceptions of US women's drinking were not related to personal goals for drinking. CONCLUSIONS Interventions that correct misperceptions about substance use norms may have utility for jailed women with AUDs.
Collapse
Affiliation(s)
- Christine Timko
- Center for Innovation to Implementation, VA Palo Alto
Health Care System and Stanford University School of Medicine, 795 Willow Road,
Menlo Park, CA 94025 USA
| | - Yael Chatav Schonbrun
- Department of Psychiatry and Human Behavior, Warren Alpert
Medical School, Brown University, 222 Richmond St, Providence, RI 02903 USA
- Behavioral Medicine and Addictions Research, Butler
Hospital, 345 Blackstone Boulevard, Providence, RI 02906 USA
| | - Bradley Anderson
- Behavioral Medicine and Addictions Research, Butler
Hospital, 345 Blackstone Boulevard, Providence, RI 02906 USA
| | - Jennifer E. Johnson
- Division of Public Health, College of Human Medicine,
Michigan State University, 200 East 1st Street, Flint, MI 48502 USA
| | - Michael Stein
- Behavioral Medicine and Addictions Research, Butler
Hospital, 345 Blackstone Boulevard, Providence, RI 02906 USA
- Department of Health Law, Policy, & Management, Boston
University School of Public Health, 715 Albany Street, Boston, MA 02118 USA
- Boston University School of Public Health, Boston, MA 02118
USA
| |
Collapse
|
13
|
Carey KB, Merrill JE, Boyle HK, Barnett NP. Correcting exaggerated drinking norms with a mobile message delivery system: Selective prevention with heavy-drinking first-year college students. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2020; 34:454-464. [PMID: 32118463 PMCID: PMC7148196 DOI: 10.1037/adb0000566] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Many efficacious interventions designed to reduce college student drinking aim to correct misperceptions of peers' drinking behavior. The present study tested the efficacy of a novel delivery strategy, namely text messages, for promoting promoderation descriptive and injunctive drinking norms. Participants included 121 college students who were randomly assigned to receive daily text messages containing accurate drinking norms (experimental group, n = 61) or historical facts (control group, n = 60) for 10 weeks following a baseline assessment. Participants completed 3-month postbaseline and 6-month postbaseline follow-up assessments. The 3-month assessment revealed that promoderation text messages were effective for reducing peak consumption and alcohol consequences. Changes in descriptive norms and injunctive norms aligned with these two behavioral outcomes. The intervention group reported perceiving others as drinking less on their heaviest drinking day and perceived others as being less approving of alcohol-related consequences than the control group. The intervention group also reported more peer approval of using protective behavioral strategies. Yet intervention effects were not maintained. None of the outcome measures differed by condition at the 6-month postbaseline assessment. Thus, the intervention had short-term effects on self-reported drinking behavior as well as on perceptions of drinking norms. However, the behavioral changes were not maintained when participants were assessed in the second semester after the daily text messages intervention had stopped. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Collapse
Affiliation(s)
- Kate B Carey
- Department of Behavioral and Social Sciences and Center for Alcohol and Addiction Studies, Brown University School of Public Health
| | - Jennifer E Merrill
- Department of Behavioral and Social Sciences and Center for Alcohol and Addiction Studies, Brown University School of Public Health
| | - Holly K Boyle
- Department of Behavioral and Social Sciences and Center for Alcohol and Addiction Studies, Brown University School of Public Health
| | - Nancy P Barnett
- Department of Behavioral and Social Sciences and Center for Alcohol and Addiction Studies, Brown University School of Public Health
| |
Collapse
|
14
|
Bush R, Brown R, McNair R, Orellana L, Lubman DI, Staiger PK. Effectiveness of a culturally tailored SMS alcohol intervention for same-sex attracted women: protocol for an RCT. BMC Womens Health 2019; 19:29. [PMID: 30728002 PMCID: PMC6364437 DOI: 10.1186/s12905-019-0729-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 01/28/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a large disparity between alcohol treatment access and prevalence of hazardous drinking among same-sex attracted women (SSAW). Yet, this population typically report low satisfaction with care and a reluctance to attend mainstream health services. Currently, there are few culturally tailored services for SSAW available despite evidence indicating that many feel uncomfortable in mainstream services. This paper describes the protocol of a randomised controlled trial aimed at examining the impact of a culturally sensitive four-week short message service (SMS) alcohol intervention on SSAW's alcohol intake, wellbeing, and engagement with alcohol treatment. METHODS A randomised controlled trial comparing a culturally tailored SMS intervention (The Step One Program) with a generic 'thank you' message, and a nested qualitative study to further explore the intervention's feasibility and acceptability. The Step One Program was co-designed using an Intervention Mapping framework and engaging potential consumers in the developmental process. Participants are block randomised (1:1 ratio) and followed up at the completion of the intervention and at 12 weeks post-intervention. The primary outcomes are alcohol reduction (as measured by the Alcohol Use Disorders Identification Test and self-reported alcohol intake), wellbeing (as measured by the Personal Wellbeing Index - Adult), and help-seeking (as measured by the number of alcohol services accessed and frequency of access). Upon completion of the 12-week post-intervention survey, participants in the intervention group were contacted via email regarding a phone interview on intervention acceptability. DISCUSSION This study may have important implications for clinical practice, improve healthcare access and equity for SSAW, and provide direction for future research in this field. The outcomes of the current study may stimulate the development of other culturally tailored health programs for SSAW. The results will inform whether individually tailoring the messages according to content and delivery frequency may be warranted to increase its acceptability. TRIAL REGISTRATION This trial was registered with the Australian New Zealand Clinical Trials Registry (trial ID: ACTRN12617000768392 ).
Collapse
Affiliation(s)
- Rachel Bush
- School of Psychology, Deakin University, 221 Burwood Highway, Burwood, Australia
| | - Rhonda Brown
- School of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Burwood, Australia
| | - Ruth McNair
- Department of General Practice, The University of Melbourne, 200 Berkeley Street, Carlton, Australia
| | - Liliana Orellana
- Biostatistics Unit, Deakin University, 221 Burwood Highway, Burwood, Australia
| | - Dan I. Lubman
- Turning Point, Eastern Health and Eastern Health Clinical School, Monash University, 110 Church St, Fitzroy, Australia
| | - Petra K. Staiger
- School of Psychology, Deakin University, 221 Burwood Highway, Burwood, Australia
- Centre for Drug Use, Addiction and Anti-Social Behaviour Research (CEDAAR), Deakin University, Geelong, Australia
| |
Collapse
|
15
|
Tomko RL, McClure EA. Introduction to the special issue: Utilizing ambulatory assessment to better understand the etiology, maintenance, treatment, and remission of addictive disorders. Addict Behav 2018; 83:1-4. [PMID: 29661656 DOI: 10.1016/j.addbeh.2018.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Rachel L Tomko
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, Charleston, SC, USA.
| | - Erin A McClure
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, Charleston, SC, USA
| |
Collapse
|
16
|
Bernstein MH, Stein LAR, Neighbors C, Suffoletto B, Carey KB, Ferszt G, Caron N, Wood MD. A text message intervention to reduce 21st birthday alcohol consumption: Evaluation of a two-group randomized controlled trial. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2018; 32:149-161. [PMID: 29369673 DOI: 10.1037/adb0000342] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Twenty-first birthdays are associated with extreme levels of heavy drinking and alcohol-related harm. Effective preventive interventions that are acceptable to young adults are needed. The current study tested the efficacy of a brief text-message intervention for reducing 21st birthday alcohol involvement designed to correct perceived 21st birthday drinking norms and provide protective behavioral strategies (PBS). We also examined potential moderators and mediators. College students (n = 200) with an upcoming 21st birthday completed a baseline assessment and were randomized to a text-message intervention or an assessment-only control condition. For participants in the intervention group, Message 1 (sent one day before the birthday celebration) focused on personalized normative feedback, and Message 2 (sent day of the birthday celebration) discussed PBS to minimize risk. Primary outcomes were assessed using responses to a follow-up assessment the day after their birthday celebration (93% completion rate). Zero-inflated negative binomial regression analyses did not reveal an overall intervention effect for estimated Blood Alcohol Content (eBAC) or alcohol problems on the 21st birthday celebration. In partial support of our hypothesis, there was an indirect effect of perceived 21st birthday norms on 21st birthday eBAC. The intervention was associated with reduced perceived norms, which was, in turn, related to a lower eBAC. There was a 3-way interaction between drinks per week, anticipated eBAC, and intervention condition for the count portion of actual eBAC such that the intervention reduced eBAC among a high-risk subset of the sample. Future research may benefit from further refining the personalized normative feedback (PNF) component of 21st birthday interventions. (PsycINFO Database Record
Collapse
Affiliation(s)
| | - L A R Stein
- Department of Psychology, University of Rhode Island
| | | | | | | | | | - Nicole Caron
- Department of Psychology, University of Rhode Island
| | - Mark D Wood
- Department of Psychology, University of Rhode Island
| |
Collapse
|