Evaluating the effect of a campus-wide social norms marketing intervention on alcohol-use perceptions, consumption, and blackouts

Lessons learned: Implementing and adapting a multimedia campaign to promote heart health to college students

Objective: This one-year pilot study investigated the effectiveness of a multimedia campaign, Heart Healthy U (HHU), to increase awareness about the link between unhealthy behaviors and risk for heart disease among emerging adults on a college campus. This paper describes the implementation of HHU. Participants: The HHU campaign was implemented from the Fall of 2019 through Spring 2020 and during this time there were approximately 15,043 enrolled students at the south eastern U.S. college campus. Methods: The HHU campaign employed print (e.g., banners, posters, and yard signs) and electronic formats (e.g., email, Instagram). We designed the methods across three phases: (1) relationship building and formative research, (2) campaign development, and (3) the Heart Healthy U campaign launch. Results: The HHU encountered challenges when the novel coronavirus (COVID-19 or SARS-co-V2) interrupted campus life, however we relied on the electronic formats to reach students during the state-wide lockdown/quarantine mandates. In addition, there were two changes to the HHU health messages. First, we updated the health messages to illustrate that eating healthy and engaging in physical activity supports immune function. Next, we developed new health messages to address effects of physical isolation and anxiety by promoting psychological well-being during this historic public health crisis. Conclusions: We asked whether a multimedia campaign on a college campus could encourage emerging adults to consume fruits and vegetables and engage in physical activity according to the federally-recommended guidelines. It is essential that interventions intended to reach today's emerging adults be presented in formats that they use (e.g., social media platforms), supported by campus administrators, and endorsed by peer influencers. In conclusion, more intervention studies are needed to counter the unhealthy social norm behaviors common to college campus life that increase heart disease risk, particularly among marginalized populations.

Support for policies restricting alcohol exposure in films: Does feeding back the amount of alcohol in films increase support?

INTRODUCTION

Alcohol exposure is common in popular films, and research has demonstrated a link between alcohol exposure and use. The likelihood of implementing specific policies to reduce the amount of film exposure is dependent on the level of public support; however, evidence is currently lacking. This study investigated how supportive people are of film-related alcohol policies and whether providing information about the amount of film exposure increased support.

METHODS

Australian adults (N = 252) first provided estimates of how much alcohol they thought were in popular films and then were randomised to either see an infographic about the amount of alcohol in films or not. All participants rated how supportive they were of eight policies.

RESULTS

The items 'alcoholic beverages and consumption should not be shown in G or PG rated films' (M = 3.54) and 'alcohol should not be glorified in films' (M = 3.49) were rated significantly higher than the scale's midpoint of 3 (p < 0.001). Participants who were older, female or reported lower alcohol use were more supportive of the policies. Only one policy item, 'information about alcohol sponsorship should be provided' received higher support from those who received the infographic compared to those who did not (M = 3.53 vs. M = 3.05; t(250) = -3.09, p = 0.002).

DISCUSSION AND CONCLUSION

Participants were relatively supportive of film alcohol policies. However, providing information about the amount of alcohol in films did not make a difference on the level of support for most film alcohol policies.

The interaction between Greek affiliation and religiosity on problem drinking in college students

Objective: Greek affiliation is associated with increased problem drinking in college, while religiosity typically offers protective benefits. The current study examined the interaction between Greek status and religiosity-both public (e.g., religious attendance) and private (e.g., prayer frequency)-on problem drinking. Participants and Methods: Undergraduates (N = 477) completed an online survey battery in late spring 2019, at the end of their freshman year. Results: Analyses focused on prayer frequency were not significant; however, the two-way interaction between Greek affiliation and religious attendance was significant. There was no difference in problem drinking across Greek and non-Greek students when religious attendance was low. As frequency of religious attendance increased, Greek students engaged in increased problem drinking compared to non-Greek students. Conclusions: Greek involvement may undermine the protective authority of religious practices on problem drinking, in part through moral licensing, whereby morally sound behaviors (i.e., religious attendance) may justify past or future problem drinking.

How Does Being under the Influence Affect Willingness to Experience Overlapping Effects of Alcohol and Marijuana?

OBJECTIVE

This study tested how individuals anticipate they will respond to opportunities to engage in simultaneous alcohol and marijuana (SAM) use.

METHODS

Two studies utilizing a within-subjects design were conducted. Study 1 was conducted in Spring 2021 and a replication (Study 2) was conducted in Fall 2021. Participants were presented with pairs of scenarios. One scenario pair compared how willing participants expected to be to get drunk if they were sober vs. high. Another pair compared how willing participants would be to take a hit of marijuana if they were sober vs. drunk. College attending young adults (Study 1: N = 173; female = 81%; Study 2: N = 212; female = 49.1%) with varying degrees of substance use experience were recruited.

RESULTS

In Study 1 participants reported greater willingness to get drunk when sober than when high. This was qualified by a statistically significant interaction whereby differences were greater among those who had more experience with past 30-day heavy drinking. Similar findings emerged for willingness to use marijuana. Participants anticipated greater willingness to use marijuana when sober than when drunk. This was also qualified by a statistically significant interaction whereby differences were greater among experimental or established users of marijuana than among abstainers. Study 2 findings replicated those from Study 1.

CONCLUSIONS

College attending young adults state greater willingness to remain under the influence of one substance than to engage in SAM use when opportunities arise. Simultaneous use of alcohol and marijuana among college students is likely an exception, not the rule. Implications for prevention are discussed.

College student gratitude: A silver lining while evaluating a yearlong bathroom stall messaging campaign

OBJECTIVE

Mental health concerns of college students are on the rise, prompting a need for communication campaigns to address ways to assist students. The current campaign utilized weekly bathroom stall messaging to address five key themes developed by a university's mental wellness task force.

Participants: Undergraduate students at a large Midwestern university.

Methods: A survey at pre and post-campaign implementation.

Results: No significant shifts in attitudes, and only one significant behavioral increase (i.e., reaching out to academic advisers), were revealed. One silver lining was that college students were found to express gratitude to someone new a median of 5 times per month. Gratitude tended to be displayed most recently to those in their social circles, and primarily for receiving instrumental support.

Conclusions: Narrowing the focus of future mental wellness campaigns is recommended. Additional recommendations for developing future mental wellness campaigns are also addressed.

Trait- and State-Fear of Missing Out: Influences on Alcohol Craving and Drinking Likelihood

OBJECTIVE

A growing body of research implicates Fear of Missing Out (FoMO) as a risk factor for collegiate alcohol use. However, little research has explored the causal mechanisms of this association, which may depend on examining FoMO at both trait and state levels. We therefore examined how predispositions toward experiencing FoMO (i.e., trait-FoMO) interacted with state-level cues indicating that one was "missing out" (i.e., state-FoMO) and cues indicating the presence or absence of alcohol.

METHOD

College students (n = 544) participating in an online experiment completed a measure of trait-FoMO and were then randomly assigned to one of four guided-imagery script conditions (FoMO/Alcohol cue, FoMO/No Alcohol cue, No FoMO/Alcohol cue, No FoMO/No Alcohol cue). Participants then completed measures of alcohol craving and drinking likelihood for the given scenario.

RESULTS

Two hierarchical regressions (one per dependent variable) revealed significant two-way interactions. Greater trait-FoMO demonstrated the strongest, positive associations with alcohol craving following scenarios with FoMO cues present. Reported drinking likelihood was strongest when state-level cues for FoMO and alcohol were both present, moderate when either cue was independently present, and lowest when both cues were absent.

CONCLUSIONS

FoMO's impact on alcohol craving and drinking likelihood varied across trait/state levels. Although trait-FoMO was associated with alcohol craving, state-level cues indicating "missing out" affected both alcohol-related variables and interacted with alcohol cues in imagery scenarios to predict drinking likelihood. Although additional research is needed, targeting psychological variables related to meaningful social connection may reduce collegiate alcohol use with respect to FoMO.

Recent alcohol-induced blackouts among heavy drinking college students: A qualitative examination of intentions, willingness, and social context

One-third to half of emerging adult drinkers report experiencing alcohol-induced blackouts in the past year, and blackouts increase the risk for negative consequences. Qualitative methods provide valuable tools for scientific inquiry, allowing for in-depth understanding of lived experiences. The goal of the present study was to gain insight into emerging adults' recent blackout experiences. One hundred heavy drinking college students (age 18-20) completed a baseline survey, 28 days of ecological momentary assessment (EMA) of their alcohol use and consequences, and a follow-up interview. A subset of 37 (46% female, 13.5% Hispanic/Latinx, 54% non-Hispanic ethnicity/White race) endorsed a blackout (forgot what they did during or after drinking) and were interviewed regarding their recent blackout experience. A semi-structured interview guide focused on several key questions regarding intentions and/or willingness to black out, how friends reacted to their blackout, and social norms for blacking out. A priori as well as emergent themes were generated from review of coded data. Qualitative themes included: blackouts are often unintentional, heavy drinking young adults express willingness to black out, friends react in a variety of ways to blackouts, and blackouts are perceived as common and acceptable. Data provide insight into the phenomenology of blackouts among college students, revealing that although college students may not intend to, they are often willing to black out. Future qualitative studies on blackouts among non-college-attending emerging adults are warranted. Such work can inform theory and future survey studies to better understand this high-risk behavior. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Deviant peer affiliation mediates the prospective association from impulsivity to alcohol use in late adolescence

INTRODUCTION

Previous research has found that impulsivity and deviant peer affiliation predict alcohol use among adolescents. However, it remains unclear to what extent these risk factors predict alcohol use in conjunction with one another, and to what extent they predict over and above correlated risk factors, such as pre-existing externalizing problems and sociodemographic characteristics. The present study tested the hypothesis that deviant peer affiliation would mediate the prospective association between impulsivity and alcohol use in adolescence (ages 13-18 years), controlling for a wide range of family and child-level covariates.

METHODS

Analyses were conducted using data from 2318 participants from the Longitudinal Cohort Study of the Project on Human Development in Chicago Neighborhoods. Participants were approximately 9, 12, or 15 years of age at wave 1 of the study, with waves 2 and 3 taking place at approximately 2-year intervals. The sample composition was 50.3% male, 46.1% Hispanic, 35.6% Black, non-Hispanic, 14.4% White, non-Hispanic, and 3.9% other race/ethnicity.

RESULTS

Results from path analyses indicated that the prospective association between impulsivity and alcohol use was mediated by peer deviance, but only for the oldest (age 15) cohort.

CONCLUSIONS

Findings from the present study suggest that despite impulsivity being a dispositional characteristic, its effects on alcohol use in later adolescence are achieved through a social pathway, via affiliation with deviant peers. It further suggests that this pathway, especially the link from impulsivity to affiliation with deviant peers, may not operate until late adolescence. Findings suggest that alcohol use may be prevented or reduced among impulsive adolescents by reducing their exposure to delinquent peers.

Leveraging dynamic norms to reduce alcohol use among college students: A proof-of-concept experimental study

BACKGROUND

Norm-correcting interventions are an effective alcohol harm-reduction approach, but innovation is needed to increase modest effect sizes. Recent social psychology research shows that individuals may be influenced by social norms that are increasing in prevalence. Contrary to static norms that reflect the current state of normative behavior, dynamic norms reflect behavioral norms that are shifting over time. This proof-of-concept study tested the utility of dynamic norms messages within norm-correcting interventions.

METHOD

Undergraduate student drinkers (N = 461; Mage  = 19.97; 64.43% female) were randomly assigned to receive (a) dynamic norms messages highlighting a steady decrease over the past six years in heavy drinking among college students; (b) static norms messaging stating only the current norms; or (c) a control condition without normative information. Proximal outcomes assessed immediately following the experimental paradigm included intentions for total weekly drinks and heavy episodic drinking. Self-reported information on alcohol use behavior was collected at 1-month follow-up.

RESULTS

Following the experimental paradigm, participants in the dynamic norms condition estimated that future drinking norms would decrease, while those in the static norms and control groups estimated that future drinking norms would increase. Participants in the dynamic norms condition reported lower intentions for weekly drinks and heavy episodic drinking than those in the static norms and control conditions. No significant differences between conditions were found on alcohol use indices reported at the 1-month follow-up. However, dynamic norms messaging had a favorable indirect effect on heavy episodic drinking intentions mediated through lower perceived future drinking norms.

CONCLUSIONS

These findings provide proof-of-concept that dynamic norms messaging may be a prudent strategy for reducing alcohol use intentions, which can be integrated into or used alongside existing norm-correcting strategies.

Frequency of Binge Drinking and Perception of Peer Alcohol Use: A Survey of University Students in a Western Canadian Province

OBJECTIVES

College and university student binge drinking is a critical health issue, and studies demonstrate students perceive high rates of drinking among their peers. High alcohol consumption and binge drinking are normalized throughout college and university, and there are gross misperceptions of perceived alcohol use among peers. The purpose of our study was to examine differences in perceptions of peer alcohol use after grouping students based on their frequency of binge drinking over a 2-week period.

METHODS

A one-way analysis of variance test was used to compare the differences in the perception of peer alcohol use after grouping students by their frequency of binge drinking.

RESULTS

Students who binge drink have significantly higher perceptions of peer alcohol use than their non-binge-drinking and abstaining peers.

CONCLUSIONS

These findings provide direction toward the feasibility of using perceptions of peer alcohol use to identify at-risk students to curtail dangerous drinking behavior.

Effects of a Brief Web-Based "Social Norms"-Intervention on Alcohol, Tobacco and Cannabis Use Among German University Students: Results of a Cluster-Controlled Trial Conducted at Eight Universities

Background and Aim: "Social norms" (SN)-interventions are aimed at changing existing misperceptions regarding peer substance use by providing feedback on actual norms, thereby affecting personal substance use. It is unknown whether SN-intervention effects previously demonstrated in US students can be replicated in German students. The aim of the INSIST-study was to examine the effects of a web-based SN-intervention on substance use. Design: Cluster-controlled trial. Setting: Eight Universities in Germany. Participants and Measurements: Students were recruited at four intervention vs. four delayed intervention control Universities. 4,463 students completed baseline, 1,255 students (59% female) completed both baseline and 5-months follow-up web-based surveys on personal and perceived peer substance use. Intervention participants received feedback contrasting personal and perceived peer use with previously assessed use and perceptions of same-sex, same-university peers. Intervention effects were assessed via multivariable mixed logistic regression models. Findings: Relative to controls, reception of SN-feedback was associated with higher odds for decreased alcohol use (OR: 1.91, 95% CI 1.42-2.56). This effect was most pronounced in students overestimating peer use at baseline and under or accurately estimating it at follow-up (OR: 6.28, 95% CI 2.00-19.8). The OR was 1.33 (95% CI 0.67-2.65) for decreased cannabis use in students at intervention Universities and was statistically significant at 1.70 (95% CI 1.13-2.55) when contrasting unchanged and decreased with increased use. Regarding tobacco use and episodes of drunkenness, no intervention effects were found. Conclusions: This study was the first cluster-controlled trial suggesting beneficial effects of web-based SN-intervention on alcohol and cannabis use in a large sample of German University students. Clinical Trial Registration: The trial registration number of the INSIST-study is DRKS00007635 at the "German Clinical Trials Register."

A Social Ecological Approach to Hazardous Alcohol Use among Flemish Higher Education Students

Hazardous use of alcohol is a global public health concern. Statistics suggest that this is particularly common in Europe, and among higher education students. Although it has been established that various factors—ranging from the individual to the overarching societal level—are associated with misuse of alcohol, few studies take multiple levels of influence into account simultaneously. The current study, therefore, used a social ecological framework to explore associations between variables from multiple levels of influence and the hazardous use of alcohol. Data were obtained from a representative sample of higher education students from Flanders, Belgium (n = 21,854), and explored using hierarchical multiple regression analyses. The results demonstrated that the individual, interpersonal, organizational, community, and policy levels, were all associated with risky alcohol consumption. When devising interventions, policymakers should, therefore, take into consideration that variables from multiple levels of influence are at play. Students’ capacities to change or maintain their alcohol consumption behaviors may be undermined if social settings, overarching environments, social norms, and policies are not conducive to their motivations and social expectations.

Donors, authors, and owners: how is genomic citizen science addressing interests in research outputs?

BACKGROUND

Citizen science is increasingly prevalent in the biomedical sciences, including the field of human genomics. Genomic citizen science initiatives present new opportunities to engage individuals in scientific discovery, but they also are provoking new questions regarding who owns the outputs of the research, including intangible ideas and discoveries and tangible writings, tools, technologies, and products. The legal and ethical claims of participants to research outputs become stronger-and also more likely to conflict with those of institution-based researchers and other stakeholders-as participants become more involved, quantitatively and qualitatively, in the research process. It is not yet known, however, how genomic citizen science initiatives are managing the interests of their participants in accessing and controlling research outputs in practice. To help fill this gap, we conducted an in-depth review of relevant policies and practices of U.S.-based genomic citizen science initiatives.

METHODS

We queried the peer-reviewed literature and grey literature to identify 22 genomic citizen science initiatives that satisfied six inclusion criteria. A data collection form was used to capture initiative features, policies, and practices relevant to participants' access to and control over research outputs.

RESULTS

This analysis revealed that the genomic citizen science landscape is diverse and includes many initiatives that do not have institutional affiliations. Two trends that are in apparent tension were identified: commercialization and operationalization of a philosophy of openness. While most initiatives supported participants' access to research outputs, including datasets and published findings, none supported participants' control over results via intellectual property, licensing, or commercialization rights. However, several initiatives disclaimed their own rights to profit from outputs.

CONCLUSIONS

There are opportunities for citizen science initiatives to incorporate more features that support participants' access to and control over research outputs, consistent with their specific objectives, operations, and technical capabilities.

Using Social Norms to Change Behavior and Increase Sustainability in the Real World: A Systematic Review of the Literature

Behavioral change interventions based on social norms have proven to be a popular and cost-effective way in which both researchers and practitioners attempt to transform behavior in order to increase environmental and social sustainability in real-world contexts. In this paper, we present a systematic review of over 90 empirical studies that have applied behavioral change interventions based on social norms in field settings. Building on previous research about the sources of information that people use to understand social norms and other local determinants of behavior, we propose a framework organized along two axes that describe intervention context (situated interventions applied in the same context where the target behavior happens versus remote interventions that are applied away from that context) and type of normative information leveraged (interventions that provide summary information about a group versus interventions that expose participants to the opinions and behaviors of others). We also illustrate successful applications for each dimension, as well as the social, psychological and physical determinants of behavior that were leveraged to support change. Finally, based on our results, we discuss some of the elements and practical mechanisms that can be used by both researchers and practitioners to design more integral, effective and sustainable social norm intervention in the real world.

Using electronic audience response technology to track e-cigarette habits among college freshmen

PURPOSE

The use of e-cigarette devices, specifically JUUL, is on the rise on college campuses. Traditional means of collecting and analyzing research may not be fast enough for health professionals to effectively assess, plan, and implement effective prevention/intervention strategies.

PROCEDURES

In August 2018, during incoming student orientation sessions at seven different college campuses, data was collected on a specific e-cigarette, JUUL. Data on use and knowledge of JUUL, as well as traditional cigarette use, was collected via immediate electronic audience response devices. Analyses included calculating descriptive statistics for questions of interest.

RESULTS

Because response on each item was optional and anonymous, participation on specific questions varied and the total sample size for the questions of interest ranged from 1940 to 2027 students. Mean daily use rates were 13.7% (11.6-18.0%) for JUUL and 1.7% (1.3-2.5%) for cigarettes. Most students (67.3%) knew that JUUL always contained nicotine (38.4-84.5%), although 30.1% believed that it just contained nicotine and/or flavored vapor (15.5-50.0%), and 2.1% thought it was flavored vapor only (0.0-5.9%).

CONCLUSIONS

This study reports the highest daily use of e-cigarettes among college students in the literature to date, with past-month e-cigarette use and daily cigarette use on par with previous estimates. Findings also highlight the knowledge gaps that some users have about JUUL specifically. In order for college health educators and professionals to best help students, adoption of methods that allow for more rapid assessment of e-cigarette trends is needed. This will help campuses more effectively address this issue, closing the research-to-practice gap in college health.

Cigarette and e-cigarette use and social perceptions over the transition to college: The role of ADHD symptoms

Cigarette and electronic cigarette (e-cigarette) use prevalence increases during adolescence and peaks in young adulthood, with substantial increases during the transition from high school to college especially more recently for e-cigarette use. It is important to identify the underlying factors that serve as risk factors for tobacco use and social perceptions about cigarette and e-cigarette use. It is unknown whether attention-deficit/hyperactivity disorder (ADHD) symptoms are associated with social perceptions about tobacco or increased tobacco use during the high school to college transition. This three timepoint prospective longitudinal study evaluates the reciprocal relationship between ADHD symptoms and social perceptions about tobacco as well as the frequency of cigarette and e-cigarette use in a sample of 150 high school seniors (Mage = 18.25, 66.0% female, 65.3% White) across the transition to college. ADHD symptoms in high school predicted increases in e-cigarette use during the first semester of college, and this association maintained through the end of the first year. ADHD symptoms predicted changes in social perceptions about cigarette and e-cigarette use after the transition to college. ADHD symptoms were predicted by social perceptions about e-cigarettes at the beginning of college. Understanding the psychosocial mechanisms underlying the pathways from ADHD symptoms to e-cigarette use may advance tobacco use etiology and prevention efforts, which is important considering the rapid growth in e-cigarette use among emerging adults. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Ideal, expected and perceived descriptive norm drunkenness in UK nightlife environments: a cross-sectional study

Background

Drunkenness is common in nightlife environments and studies suggest it can be considered both desirable and normal by nightlife users. We aimed to compare UK nightlife users’ ideal levels of drunkenness to their expected drunkenness on a night out and their perceptions of descriptive nightlife norms.

Methods

A cross-sectional survey with nightlife patrons (n = 408, aged 18–35) in three cities. Using a scale from 1 (completely sober) to 10 (very drunk), participants rated: personal drunkenness at survey; expected drunkenness on leaving nightlife; perceived descriptive drunkenness norm in the city’s nightlife; and ideal personal drunkenness. Analyses were limited to those who had or were intending to consume alcohol.

Results

Almost half of participants (46.8%) expected to get drunker than their reported ideal level on the night of survey, rising to four fifths of those with the highest levels of expected drunkenness. 77.9% rated typical nightlife drunkenness ≥8 but only 40.9% expected to reach this level themselves and only 23.1% reported their ideal drunkenness as ≥8. Higher expected drunkenness was associated with higher ideal drunkenness, higher perceived drunkenness norm and later expected home time.

Conclusions

Nightlife users’ perceptions of typical drunkenness in nightlife settings may be elevated and many of the heaviest drinkers are likely to drink beyond their ideal level of drunkenness. Findings can support emerging work to address cultures of intoxication in nightlife environments and suggest that interventions to correct misperceptions of normal levels of nightlife drunkenness may be of benefit.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-6802-5) contains supplementary material, which is available to authorized users.

Distinctions in Alcohol-Induced Memory Impairment: A Mixed Methods Study of En Bloc Versus Fragmentary Blackouts

BACKGROUND

Blackouts-or memory loss for all or part of a drinking event-are reliable predictors of alcohol-related consequences. Studies suggest a distinction between en bloc (complete memory loss) and fragmentary (off-and-on memory loss) blackouts; however, research has not consistently differentiated between these 2 forms of blackout. This study aimed to validate the distinction between en bloc and fragmentary blackouts among young adults.

METHODS

Data were collected using qualitative (Study 1) and quantitative (Study 2) research methods. Participants in both studies were college students with a history of alcohol-induced memory impairment. They were recruited using community advertisement (Study 1, N = 50, 56% female) and Qualtrics survey panels (Study 2, N = 350, 56% female). Study 1 participants engaged in 8 focus groups. Discussions were audio-recorded, transcribed verbatim, and coded using applied thematic analysis. Findings guided assessment of en bloc and fragmentary blackout in Study 2. In Study 2, a separate sample of participants completed an online survey assessing drinking behavior, alcohol-induced memory impairment, and theoretical correlates of en bloc and fragmentary blackouts.

RESULTS

Study 1 participants differentiated between en bloc and fragmentary blackouts (which they referred to as "blackouts" and "brownouts," respectively) based on duration and extent of memory loss. They indicated that blackouts occur along a continuum, with en bloc "blackouts" at the extreme. They also stated that the term "blackout drinking" does not always imply memory loss. Study 2 participants reported higher rates of "brownouts" (81%) than "blackouts" (54%). They reported less negative outcome expectancies and attitudes, greater personal approval, higher prevalence estimates, lower self-efficacy, and stronger intentions for "brownouts" than "blackouts" (p < 0.001). Women perceived "blackouts/brownouts" as more prevalent than men and reported lower intentions to experience "blackouts" (p < 0.005).

CONCLUSIONS

Young adults are more permissive of fragmentary than en bloc blackout. En bloc blackouts may be a target for future interventions.

Blackouts as a Moderator of Young Adult Veteran Response to Personalized Normative Feedback for Heavy Drinking

BACKGROUND

Blackouts-or periods of alcohol-induced amnesia for all or part of a drinking event-have been identified as independent predictors of alcohol-related harm that may be used to identify individuals who would benefit from intervention. However, little is known about the prevalence and impact of blackouts among Veterans. This study examined blackouts as a moderator of young adult veteran response to a brief, online personalized normative feedback (PNF) intervention for heavy drinking.

METHODS

Veterans scoring ≥3/4 (women/men) on the Alcohol Use Disorders Identification Test completed a baseline and 1-month assessment as part of a larger intervention trial (N = 571; 83% male; age M = 28.9, SD = 3.3). Participants were randomized to alcohol PNF (n = 285) or a video game attention control (n = 286). Hierarchical regression was used to examine the interaction between intervention condition and blackouts on alcohol-related outcomes at 1-month follow-up.

RESULTS

At baseline, 26% of participants reported loss of memory for drinking events in the past 30 days. The interaction between condition and blackouts was significant, such that PNF participants who had experienced blackouts at baseline reported greater decreases in drinking quantity at 1 month than those who had not, and only PNF participants who had experienced baseline blackouts reported a decrease in alcohol problems at follow-up.

CONCLUSIONS

PNF appears to be particularly effective for individuals who have experienced alcohol-induced blackout, perhaps because blackouts prime them for feedback on their alcohol use. While other negative consequences may also prime individuals for behavior change, blackouts are posited as a particularly useful screening tool because they are prevalent among young adults, have a strong association with alcohol-related harm, and are assessed in widely used clinical measures.