Examining the viewing pattern of Web-delivered personalized feedback interventions aimed at reducing alcohol-related risky sexual behavior among young adults

Examining Community Preferences for Adaption and Dissemination of an Efficacious Brief Intervention on Alcohol Use and Sexual Behavior

Compared to other age groups, 18- to 25-year olds (young adults) are more likely to engage in heavy alcohol use and inconsistent contraceptive use, increasing their susceptibility to sexually transmitted infections (STIs) and unintended pregnancy. The Studying Alcohol and Related Risks (STARR) intervention was efficacious in reducing young adult alcohol-related risky sexual behavior, including reducing the number of casual sexual partners and alcohol use prior to sex. We conducted a qualitative study to guide the adaptation of the STARR intervention to include additional content on contraceptive use and prepare for dissemination of the intervention to a community audience. We conducted 10 focus groups with young adults (n = 16) and semistructured interviews with local community stakeholders (n = 12) to examine: (a) intervention characteristics, such as compatibility, adaptability, and design and packaging and (b) dissemination and communication channels. Focus groups and interviews were audio-recorded, transcribed, and thematically analyzed. Participants found the proposed intervention acceptable and highlighted the need to promote STI prevention among young adults. Participants viewed text-based interventions as accessible and effective. Key considerations included developing personalized messages from credible sources, using gender-inclusive language, and sending messages at strategic timepoints. Social media (Instagram, Twitter, Snapchat, TikTok), events, and campus resources were described as avenues to create awareness and disseminate information about the proposed intervention. Findings demonstrate the need for innovative and tailored young adult health programs that incorporate multilevel dissemination strategies. This study highlights the need for implementation activities that will improve the adoption and dissemination of evidence-based programs, particularly among young adults.

Cross-Tailoring Integrative Alcohol and Risky Sexual Behavior Feedback for College Students: Protocol for a Hybrid Type 1 Effectiveness-Implementation Trial

BACKGROUND

Underage drinking and related risky sexual behavior (RSB) are major public health concerns on United States college campuses. Although technology-delivered personalized feedback interventions (PFIs) are considered a best practice for individual-level campus alcohol prevention, there is room for improving the effectiveness of this approach with regard to alcohol-related RSB.

OBJECTIVE

The aims of this study are to (1) evaluate the impact of a brief PFI that integrates content on alcohol use and RSB and is adapted to include a novel cross-tailored dynamic feedback (CDF) component for at-risk first-year college students and (2) identify implementation factors critical to the CDF's success to facilitate future scale-up in campus settings.

METHODS

This study uses a hybrid type 1 effectiveness-implementation design and will be conducted in 3 phases. Phase 1 is a stakeholder-engaged PFI+CDF adaptation guided by focus groups and usability testing. In phase 2, 600 first-year college students who drink and are sexually active will be recruited from 2 sites (n=300 per site) to participate in a 4-group randomized controlled trial to examine the effectiveness of PFI+CDF in reducing alcohol-related RSB. Eligible participants will complete a baseline survey during the first week of the semester and follow-up surveys at 1, 2, 3, 6, and 13 months post baseline. Phase 3 is a qualitative evaluation with stakeholders to better understand relevant implementation factors.

RESULTS

Recruitment and enrollment for phase 1 began in January 2022. Recruitment for phases 2 and 3 is planned for the summer of 2023 and 2024, respectively. Upon collection of data, the effectiveness of PFI+CDF will be examined, and factors critical to implementation will be evaluated.

CONCLUSIONS

This hybrid type 1 trial is designed to impact the field by testing an innovative adaptation that extends evidence-based alcohol programs to reduce alcohol-related RSB and provides insights related to implementation to bridge the gap between research and practice at the university level.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05011903; https://clinicaltrials.gov/ct2/show/NCT05011903.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/43986.

Does abstaining from alcohol in high school moderate intervention effects for college students? Implications for tiered intervention strategies

Brief motivational intervention (BMI) and personalized feedback intervention (PFI) are individual-focused brief alcohol intervention approaches that have been proven efficacious for reducing alcohol use among college students and young adults. Although the efficacy of these two intervention approaches has been well established, little is known about the factors that may modify their effects on alcohol outcomes. In particular, high school drinking may be a risk factor for continued and heightened use of alcohol in college, and thus may influence the outcomes of BMI and PFI. The purpose of this study was to investigate whether high school drinking was associated with different intervention outcomes among students who received PFI compared to those who received BMI. We conducted moderation analyses examining 348 mandated students (60.1% male; 73.3% White; and 61.5% first-year student) who were randomly assigned to either a BMI or a PFI and whose alcohol consumption was assessed at 4-month and 15-month follow-ups. Results from marginalized zero-inflated Poisson models showed that high school drinking moderated the effects of PFI and BMI at the 4-month follow-up but not at the 15-month follow-up. Specifically, students who reported no drinking in their senior year of high school consumed a 49% higher mean number of drinks after receiving BMI than PFI at the 4-month follow-up. The results suggest that alcohol consumption in high school may be informative when screening and allocating students to appropriate alcohol interventions to meet their different needs.