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Bahji A, Boonmak P, Koller M, Milani C, Sutherland C, Horgan S, Chen SP, Patten S, Stuart H. Associations between Gender Expression, Protective Coping Strategies, Alcohol Saliency, and High-Risk Alcohol Use in Post-Secondary Students at Two Canadian Universities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:107. [PMID: 38248569 PMCID: PMC10815432 DOI: 10.3390/ijerph21010107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/04/2024] [Accepted: 01/10/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND This study, conducted in October 2017 at two Canadian universities, aimed to explore the relationships between gender expression, protective coping strategies, alcohol saliency, and high-risk alcohol use. METHODS Validated scales were employed to assess these variables using survey data. Multivariate analyses were conducted to investigate the associations between these factors and high-risk drinking. RESULTS This study revealed significant associations between high-risk drinking and androgynous gender roles (OR = 1.58, 95% CI: 1.19-2.10) as well as among self-reported males (OR = 2.21; 95% CI: 1.77-2.75). Additionally, protective behavioural strategies were inversely related to high-risk drinking (OR = 0.95; 95% CI: 0.94-0.96), while higher alcohol saliency exhibited a positive correlation with high-risk drinking (OR = 1.12; 95% CI: 1.11-1.14). CONCLUSIONS These findings underscore the importance of considering gender, alcohol saliency beliefs, and protective behavioural strategies in the development and refinement of interventions aimed at reducing high-risk alcohol use on Canadian campuses.
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Affiliation(s)
- Anees Bahji
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada;
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Paul Boonmak
- Department of Public Health Sciences, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Michelle Koller
- Department of Public Health Sciences, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Christina Milani
- Department of Public Health Sciences, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Cate Sutherland
- Department of Public Health Sciences, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Salinda Horgan
- School of Rehabilitation Therapy, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Shu-Ping Chen
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Scott Patten
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada;
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Heather Stuart
- Department of Public Health Sciences, Queen’s University, Kingston, ON K7L 3N6, Canada
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Schwenker R, Dietrich CE, Hirpa S, Nothacker M, Smedslund G, Frese T, Unverzagt S. Motivational interviewing for substance use reduction. Cochrane Database Syst Rev 2023; 12:CD008063. [PMID: 38084817 PMCID: PMC10714668 DOI: 10.1002/14651858.cd008063.pub3] [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: 12/18/2023]
Abstract
BACKGROUND Substance use is a global issue, with around 30 to 35 million individuals estimated to have a substance-use disorder. Motivational interviewing (MI) is a client-centred method that aims to strengthen a person's motivation and commitment to a specific goal by exploring their reasons for change and resolving ambivalence, in an atmosphere of acceptance and compassion. This review updates the 2011 version by Smedslund and colleagues. OBJECTIVES To assess the effectiveness of motivational interviewing for substance use on the extent of substance use, readiness to change, and retention in treatment. SEARCH METHODS We searched 18 electronic databases, six websites, four mailing lists, and the reference lists of included studies and reviews. The last search dates were in February 2021 and November 2022. SELECTION CRITERIA We included randomised controlled trials with individuals using drugs, alcohol, or both. Interventions were MI or motivational enhancement therapy (MET), delivered individually and face to face. Eligible control interventions were no intervention, treatment as usual, assessment and feedback, or other active intervention. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane, and assessed the certainty of evidence with GRADE. We conducted meta-analyses for the three outcomes (extent of substance use, readiness to change, retention in treatment) at four time points (post-intervention, short-, medium-, and long-term follow-up). MAIN RESULTS We included 93 studies with 22,776 participants. MI was delivered in one to nine sessions. Session durations varied, from as little as 10 minutes to as long as 148 minutes per session, across included studies. Study settings included inpatient and outpatient clinics, universities, army recruitment centres, veterans' health centres, and prisons. We judged 69 studies to be at high risk of bias in at least one domain and 24 studies to be at low or unclear risk. Comparing MI to no intervention revealed a small to moderate effect of MI in substance use post-intervention (standardised mean difference (SMD) 0.48, 95% confidence interval (CI) 0.07 to 0.89; I2 = 75%; 6 studies, 471 participants; low-certainty evidence). The effect was weaker at short-term follow-up (SMD 0.20, 95% CI 0.12 to 0.28; 19 studies, 3351 participants; very low-certainty evidence). This comparison revealed a difference in favour of MI at medium-term follow-up (SMD 0.12, 95% CI 0.05 to 0.20; 16 studies, 3137 participants; low-certainty evidence) and no difference at long-term follow-up (SMD 0.12, 95% CI -0.00 to 0.25; 9 studies, 1525 participants; very low-certainty evidence). There was no difference in readiness to change (SMD 0.05, 95% CI -0.11 to 0.22; 5 studies, 1495 participants; very low-certainty evidence). Retention in treatment was slightly higher with MI (SMD 0.26, 95% CI -0.00 to 0.52; 2 studies, 427 participants; very low-certainty evidence). Comparing MI to treatment as usual revealed a very small negative effect in substance use post-intervention (SMD -0.14, 95% CI -0.27 to -0.02; 5 studies, 976 participants; very low-certainty evidence). There was no difference at short-term follow-up (SMD 0.07, 95% CI -0.03 to 0.17; 14 studies, 3066 participants), a very small benefit of MI at medium-term follow-up (SMD 0.12, 95% CI 0.02 to 0.22; 9 studies, 1624 participants), and no difference at long-term follow-up (SMD 0.06, 95% CI -0.05 to 0.17; 8 studies, 1449 participants), all with low-certainty evidence. There was no difference in readiness to change (SMD 0.06, 95% CI -0.27 to 0.39; 2 studies, 150 participants) and retention in treatment (SMD -0.09, 95% CI -0.34 to 0.16; 5 studies, 1295 participants), both with very low-certainty evidence. Comparing MI to assessment and feedback revealed no difference in substance use at short-term follow-up (SMD 0.09, 95% CI -0.05 to 0.23; 7 studies, 854 participants; low-certainty evidence). A small benefit for MI was shown at medium-term (SMD 0.24, 95% CI 0.08 to 0.40; 6 studies, 688 participants) and long-term follow-up (SMD 0.24, 95% CI 0.07 to 0.41; 3 studies, 448 participants), both with moderate-certainty evidence. None of the studies in this comparison measured substance use at the post-intervention time point, readiness to change, and retention in treatment. Comparing MI to another active intervention revealed no difference in substance use at any follow-up time point, all with low-certainty evidence: post-intervention (SMD 0.07, 95% CI -0.15 to 0.29; 3 studies, 338 participants); short-term (SMD 0.05, 95% CI -0.03 to 0.13; 18 studies, 2795 participants); medium-term (SMD 0.08, 95% CI -0.01 to 0.17; 15 studies, 2352 participants); and long-term follow-up (SMD 0.03, 95% CI -0.07 to 0.13; 10 studies, 1908 participants). There was no difference in readiness to change (SMD 0.15, 95% CI -0.00 to 0.30; 5 studies, 988 participants; low-certainty evidence) and retention in treatment (SMD -0.04, 95% CI -0.23 to 0.14; 12 studies, 1945 participants; moderate-certainty evidence). We downgraded the certainty of evidence due to inconsistency, study limitations, publication bias, and imprecision. AUTHORS' CONCLUSIONS Motivational interviewing may reduce substance use compared with no intervention up to a short follow-up period. MI probably reduces substance use slightly compared with assessment and feedback over medium- and long-term periods. MI may make little to no difference to substance use compared to treatment as usual and another active intervention. It is unclear if MI has an effect on readiness to change and retention in treatment. The studies included in this review were heterogeneous in many respects, including the characteristics of participants, substance(s) used, and interventions. Given the widespread use of MI and the many studies examining MI, it is very important that counsellors adhere to and report quality conditions so that only studies in which the intervention implemented was actually MI are included in evidence syntheses and systematic reviews. Overall, we have moderate to no confidence in the evidence, which forces us to be careful about our conclusions. Consequently, future studies are likely to change the findings and conclusions of this review.
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Affiliation(s)
- Rosemarie Schwenker
- Institute of General Practice and Family Medicine, Center of Health Sciences, Martin Luther University Halle Wittenberg, Halle (Saale), Germany
| | - Carla Emilia Dietrich
- Institute of General Practice and Family Medicine, Center of Health Sciences, Martin Luther University Halle Wittenberg, Halle (Saale), Germany
| | - Selamawit Hirpa
- Institute of General Practice and Family Medicine, Center of Health Sciences, Martin Luther University Halle Wittenberg, Halle (Saale), Germany
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Monika Nothacker
- Institute for Medical Knowledge Management, Association of the Scientific Medical Societies in Germany, Berlin, c/o Philipps University Marburg, Berlin & Marburg, Germany
| | | | - Thomas Frese
- Institute of General Practice and Family Medicine, Center of Health Sciences, Martin Luther University Halle Wittenberg, Halle (Saale), Germany
| | - Susanne Unverzagt
- Institute of General Practice and Family Medicine, Center of Health Sciences, Martin Luther University Halle Wittenberg, Halle (Saale), Germany
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Pedersen ER, Hummer JF, Davis JP, Fitzke RE, Tran DD, Witkiewitz K, Clapp JD. A mobile-based pregaming drinking prevention intervention for college students: A pilot randomized controlled trial. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2023; 37:841-852. [PMID: 37053413 PMCID: PMC10570401 DOI: 10.1037/adb0000925] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
OBJECTIVE Pregaming is among the riskiest drinking behaviors in which college students engage, often leading to elevated blood alcohol levels and negative alcohol-related consequences. Yet, tailored interventions to reduce risk associated with pregaming are lacking. The present study was designed to develop and evaluate the efficacy of a brief, mobile-based intervention targeting heavy drinking during pregaming among college students, called Pregaming Awareness in College Environments (PACE). METHOD PACE was developed using two innovations to facilitate behavior change: (a) a mobile-based application to increase intervention accessibility and (b) personalized pregaming-specific intervention content delivered using a harm reduction approach with cognitive behavioral skills training. After development and β-testing, we employed a randomized clinical trial with 485 college students who reported pregaming at least once per week in the past month (Mage = 19.98; 52.2% from minoritized racial and/or ethnic groups; 65.6% female). Participants were randomly assigned to PACE (n = 242) or a control condition website (n = 243), which consisted of general information about the effects of alcohol. Analysis assessed intervention effects on pregaming drinking, global drinking, and alcohol-related consequences at 6 and 14 weeks postintervention. RESULTS Although participants in both conditions reduced drinking, small and significant intervention effects favoring PACE were found at 6-week follow-up for overall drinking days, pregaming days, and alcohol-related consequences. CONCLUSIONS Findings suggest the brief mobile PACE intervention has potential to address risky drinking, but more intensive pregaming-focused efforts may be necessary to achieve stronger and lasting effects among college students. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Eric R. Pedersen
- University of Southern California, Keck School of Medicine, Department of Psychiatry and Behavioral Sciences
- USC Institute for Addiction Science
| | | | - Jordan P. Davis
- USC Institute for Addiction Science
- University of Southern California, Suzanne Dworak-Peck School of Social Work
| | - Reagan E. Fitzke
- University of Southern California, Keck School of Medicine, Department of Psychiatry and Behavioral Sciences
| | - Denise D. Tran
- University of Southern California, Keck School of Medicine, Department of Psychiatry and Behavioral Sciences
| | | | - John D. Clapp
- USC Institute for Addiction Science
- University of Southern California, Suzanne Dworak-Peck School of Social Work
- University of Southern California, Keck School of Medicine, Department of Population and Public Health Sciences
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Zamboanga BL, Van Hedger K, George AM. Prologue to the special issue on predrinking and drinking game behaviors among adolescents and young adults in the United States and across the globe: Definitions and overview of prevalence rates. Addict Behav 2023; 144:107731. [PMID: 37163887 DOI: 10.1016/j.addbeh.2023.107731] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Predrinking and drinking games (DGs) are common risky drinking practices among adolescents and young adults in many different countries around the world. However, most studies on these behaviors have been conducted with university student samples in a limited number of countries. Despite the risks of negative alcohol-related consequences associated with predrinking and DGs, these activities are quite prevalent among young people. In this prologue, we provide definitions for predrinking and DGs and an extensive overview of the known prevalence rates of predrinking and DGs among young people around the world. This special issue addresses known gaps in the literature by including articles which (a) use differing methodologies to examine predrinking or DGs behavior, (b) consider psychosocial and contextual factors that influence these behaviors, and (c) examine young people's perceptions of alcohol policies and interventions. Taken together this Special Issue offers an international view on how and why young people around the world engage in these risky drinking practices, and potential ways to address these behaviors.
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Affiliation(s)
- Byron L Zamboanga
- Department of Psychological Science, University of Arkansas, United States.
| | | | - Amanda M George
- Discipline of Psychology, School of Health Sciences, University of Canberra, Australia
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5
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Ardinger CE, Lapish CC, Czachowski CL, Grahame NJ. A critical review of front-loading: A maladaptive drinking pattern driven by alcohol's rewarding effects. Alcohol Clin Exp Res 2022; 46:1772-1782. [PMID: 36239713 PMCID: PMC9588658 DOI: 10.1111/acer.14924] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 08/09/2022] [Accepted: 08/14/2022] [Indexed: 01/31/2023]
Abstract
Front-loading is a drinking pattern in which alcohol intake is skewed toward the onset of reward access. This phenomenon has been reported across several different alcohol self-administration protocols in a wide variety of species, including humans. The hypothesis of the current review is that front-loading emerges in response to the rewarding effects of alcohol and can be used to measure the motivation to consume alcohol. Alternative or additional hypotheses that we consider and contrast with the main hypothesis are that: (1) front-loading is directed at overcoming behavioral and/or metabolic tolerance and (2) front-loading is driven by negative reinforcement. Evidence for each of these explanations is reviewed. We also consider how front-loading has been evaluated statistically in previous research and make recommendations for defining this intake pattern in future studies. Because front-loading may predict long-term maladaptive alcohol drinking patterns leading to the development of alcohol use disorder (AUD), several future directions are proposed to elucidate the relationship between front-loading and AUD.
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Affiliation(s)
- Cherish E. Ardinger
- Addiction Neuroscience, Department of Psychology and Indiana Alcohol Research CenterIndiana University – Purdue University IndianapolisIndianapolisIndianaUSA
| | - Christopher C. Lapish
- Addiction Neuroscience, Department of Psychology and Indiana Alcohol Research CenterIndiana University – Purdue University IndianapolisIndianapolisIndianaUSA,Stark Neuroscience Research InstituteIndiana University – Purdue University IndianapolisIndianapolisIndianaUSA
| | - Cristine L. Czachowski
- Addiction Neuroscience, Department of Psychology and Indiana Alcohol Research CenterIndiana University – Purdue University IndianapolisIndianapolisIndianaUSA
| | - Nicholas J. Grahame
- Addiction Neuroscience, Department of Psychology and Indiana Alcohol Research CenterIndiana University – Purdue University IndianapolisIndianapolisIndianaUSA
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Pedersen ER, Hummer JF, Davis JP, Fitzke RE, Christie NC, Witkiewitz K, Clapp JD. A mobile-based pregaming drinking prevention intervention for college students: study protocol for a randomized controlled trial. Addict Sci Clin Pract 2022; 17:31. [PMID: 35717303 PMCID: PMC9206220 DOI: 10.1186/s13722-022-00314-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 05/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pregaming is a high-drink context popular among college students that often leads to elevated blood alcohol levels and negative consequences. Over 15 years of research studies have demonstrated that pregaming represents one of the riskiest known behaviors among college students, yet no pregaming-specific interventions have been developed to help prevent this behavior. General brief interventions for students do not reduce pregaming behavior and may not be appropriate, as they do not help students develop skills unique to the pregaming context that could help them drink less. We developed a brief, mobile-based intervention that is proposed to prevent heavy drinking during pregaming for college students, with the ultimate goal that behavioral reductions in this risky practice will ultimately affect global drinking and prevent consequences. METHODS/DESIGN The intervention, Pregaming Awareness in College Environments (PACE), was developed by combining two innovations to facilitate behavior change: (1) a mobile-based application that increases accessibility, is easy and engaging to use, and broadens the reach of the intervention content and (2) personalized pregaming-specific intervention content with harm reduction and cognitive behavioral skills proven to be mechanisms preventing and reducing heavy drinking among college students. After a develop and beta-test phase, we propose to test the efficacy of PACE in a preliminary randomized controlled trial with 500 college students who pregame at least once per week. Pregaming, general drinking, and alcohol-related consequences outcomes will be examined in the immediate (2 weeks post-intervention) and short-terms (six and 14-week post-intervention). We will also evaluate moderator effects for age, sex, and heaviness of drinking to allow for more refined information for a planned larger test of the intervention to follow this initial trial of PACE. DISCUSSION This pregaming intervention clinical trial, if found to be efficacious, will culminate with an easily-disseminated mobile-based intervention for college student drinkers. It has the potential to reach millions of college students, perhaps as a clinical tool used by college counseling centers as an adjunct to formal care or as a preventive tool for first-year students or other high-risk groups on campus. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT04016766.
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Affiliation(s)
- Eric R Pedersen
- Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, USC Institute for Addiction Science, University of Southern California, 2250 Alcazar Street, Suite 2200, Los Angeles, CA, 90033, United States.
| | | | - Jordan P Davis
- Suzanne Dworak-Peck School of Social Work; USC Center for Artificial Intelligence in Society; USC Center for Mindfulness Science; USC Institute for Addiction Science, University of Southern California, Los Angeles, United States
| | - Reagan E Fitzke
- Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, USC Institute for Addiction Science, University of Southern California, 2250 Alcazar Street, Suite 2200, Los Angeles, CA, 90033, United States
| | - Nina C Christie
- Department of Psychology, University of Southern California, Los Angeles, United States
| | - Katie Witkiewitz
- Department of Psychology, University of New Mexico, Albuquerque, United States
| | - John D Clapp
- Suzanne Dworkak-Peck School of Social Work; Department of Population and Public Health Sciences, Keck School of Medicine; USC Institute for Addiction Science, University of Southern California, Los Angeles, United States
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Williams CM, Reynolds LM, Mastroleo NR. Comparison of Pregaming Alcohol Use and Consequences by Season Status and Sex in College Student Athletes. JOURNAL OF DRUG EDUCATION 2020; 49:71-86. [PMID: 33256426 DOI: 10.1177/0047237920976658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
As student athletes exhibit unique alcohol use patterns based on being in- versus out-of-season and biological sex, we aimed to explore student athlete (N = 442) alcohol use, pregaming behaviors, and associated negative outcomes. Results suggest being out-of-season and male are positively associated with negative alcohol-related consequences, and male athletes report greater numbers of pregame specific alcohol-related consequences than female athletes (p < .05). Female athletes indicated significantly higher estimated blood alcohol concentrations than male athletes on pregaming nights. No differences emerged between in- and out-of-season athletes on pregame consequences. Results suggest that further emphasis on the role season status and sex has on pregaming behaviors and experiencing negative outcomes may be an important next step toward enhancing prevention and intervention approaches.
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Affiliation(s)
- Callon M Williams
- College of Community and Public Affairs, Binghamton University, Binghamton, New York, United States
| | - Linda M Reynolds
- College of Community and Public Affairs, Binghamton University, Binghamton, New York, United States
| | - Nadine R Mastroleo
- College of Community and Public Affairs, Binghamton University, Binghamton, New York, United States
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Pedersen ER, Davis JP, Hummer JF, DiGuiseppi G, Sedano A, Rodriguez A, Clapp JD. Development of a Measure to Assess Protective Behavioral Strategies for Pregaming among Young Adults. Subst Use Misuse 2020; 55:534-545. [PMID: 31847662 PMCID: PMC7310598 DOI: 10.1080/10826084.2019.1686025] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Although most young adults drink alcohol, there are specific drinking contexts that are associated with increased risk for alcohol-related consequences. One such drinking context is pregaming, which typically involves heavy drinking in brief periods of time and has consistently been linked to consequences within the pregaming event itself, on a night after pregaming, and in the long-term. Intervention efforts that specifically target this risky behavior are needed, but these efforts need to be informed by empirical work to better understand what behaviors young people engage in that can protect them from pregaming-related harms. Purpose: We designed this study to create a measure of protective behavioral strategies that young people use before, during, and after pregaming to inform future intervention work. Methods: We tested an item pool with 363 young adult college students who engaged in pregaming in the past year and conducted exploratory factor analysis to develop a 19-item Protective Behavioral Strategies for Pregaming (PBSP) scale, which featured four subscales of safety and familiarity, setting drink limits, pacing strategies, and minimizing intoxication. Results: Each subscale negatively and significantly correlated with measures of alcohol use and consequences, though subscales differed in their associations with specific pregaming outcomes and by sex. Conclusion: This initial exploratory examination of the PBSP scale's psychometric properties suggests that use of protective behavioral strategies used specifically during pregaming events may protect young people from heavy drinking and harms. More research with the PBSP scale is encouraged to determine its practical utility as a clinical and assessment tool with young people.
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Affiliation(s)
| | - Jordan P Davis
- University of Southern California, Suzanne Dworak-Peck School of Social Work; USC Institute for Addiction Science, Los Angeles, California, USA
| | | | - Graham DiGuiseppi
- University of Southern California, Suzanne Dworak-Peck School of Social Work; USC Institute for Addiction Science, Los Angeles, California, USA
| | - Angeles Sedano
- University of Southern California, Suzanne Dworak-Peck School of Social Work; USC Institute for Addiction Science, Los Angeles, California, USA
| | | | - John D Clapp
- University of Southern California, Suzanne Dworak-Peck School of Social Work; Department of Preventive Medicine, Keck School of Medicine; USC Institute for Addiction Science, Los Angeles, California, USA
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9
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Zamboanga BL, Merrill JE, Olthuis JV, Milroy JJ, Sokolovsky AW, Wyrick DL. Secondary effects of myPlaybook on college athletes' avoidance of drinking games or pregaming as a protective behavior strategy: A multisite randomized controlled study. Soc Sci Med 2019; 228:135-141. [PMID: 30909157 PMCID: PMC7117876 DOI: 10.1016/j.socscimed.2019.02.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 01/01/2019] [Accepted: 02/10/2019] [Indexed: 11/28/2022]
Abstract
RATIONALE Student-athletes are at risk for engaging in drinking games and pregaming. Research suggests that brief motivational and alcohol education intervention approaches designed to reduce harmful drinking behaviors may not be effective in lowering students' participation in drinking games or pregaming. METHOD We evaluated the effects of myPlaybook (a student-athlete-specific web-based alcohol intervention) on student-athletes' avoidance of drinking games and pregaming over a 4-month period. Seventy-three NCAA member institutions were randomly assigned to the treatment condition or a no-intervention control. Student-athletes at these schools (N = 2449) completed assessments at baseline, 1-, and 4-months post-intervention. At each assessment, participants indicated how often they used each of several harm prevention strategies when they drank in the past month including "avoided drinking games" and "avoided drinking before going out (i.e., pregaming or pre-drinking)." RESULTS Controlling for gender and race/ethnicity, treatment condition was not associated with change in avoidance of drinking games and pregaming between baseline and either follow-up. Athletic season did not moderate treatment effects on avoidance of either behavior. We found no evidence that myPlaybook, a general alcohol-reduction intervention, is efficacious in influencing student-athletes' avoidance of drinking games or pregaming as a protective strategy. CONCLUSIONS Findings from the present study as well as other research suggest that general alcohol-focused interventions may not have secondary effects on reducing students' participation in drinking games and pregaming and as such, more specific targeted interventions should be investigated.
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Affiliation(s)
- Byron L Zamboanga
- Smith College Department of Psychology, 44 College Lane, Bass Hall, Northampton, MA, 01063, USA.
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10
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Chaney BH, Martin RJ, Barry AE, Lee JGL, Cremeens-Matthews J, Stellefson ML. Pregaming: A Field-Based Investigation of Alcohol Quantities Consumed Prior to Visiting a Bar and Restaurant District. Subst Use Misuse 2019; 54:1017-1023. [PMID: 30614346 DOI: 10.1080/10826084.2018.1558252] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Investigations examining the association between pregaming, or the consumption of alcohol prior to attending a social gathering or drinking establishment, and blood alcohol concentrations have primarily relied on estimations (i.e., Widmark equation), rather than objective biologic samples, such as breath alcohol concentration (BrAC). OBJECTIVES The current study assessed: (1) pregaming, using quantity-based measures, among a sample of college and non-college affiliated bar patrons, (2) associations between pregaming intensity/status and participant intoxication (BrAC), and (3) whether participants who pregamed were more likely to identify as a hazardous drinker. METHODS 548 bar patrons provided data on the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) and a single pregaming item assessing quantity of alcohol consumed prior to visiting a bar/restaurant district in 2015. BrAC samples were collected post interview. We used hierarchical linear regression models, respectively, to assess whether pregaming significantly impacted BrAC and whether presence of hazardous drinking predicted pregaming behavior. RESULTS After controlling for sex, race/ethnicity, age, student status, and Greek affiliation, the linear regression model explained 32.3% (R2 = .323) of the variance of BrAC levels (F(12) = 21.162, p < .001), with 4.30% of the variance explained solely by pregaming (β = 0.014; p < .001). The linear regression model to assess if harzardous drinking behavior (AUDIT-C) significantly predicted pregaming explained 31.2% (R2 = .312) of the variance of pregaming behavior (F(18) = 13.276, p < .001), with 4.2% of the variance explained solely by AUDIT-C scores (β = 0.280; p < .001). CONCLUSION Findings further highlight pregaming as a harmful risk behavior linked to elevated levels of hazardous drinking and intoxication.
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Affiliation(s)
- Beth H Chaney
- a Department of Health Education & Promotion , East Carolina University , Greenville , North Carolina , USA
| | - Ryan J Martin
- a Department of Health Education & Promotion , East Carolina University , Greenville , North Carolina , USA
| | - Adam E Barry
- b Division of Health Education, Department of Health & Kinesiology , Texas A&M University , College Station , Texas , USA
| | - Joseph G L Lee
- a Department of Health Education & Promotion , East Carolina University , Greenville , North Carolina , USA
| | - Jennifer Cremeens-Matthews
- a Department of Health Education & Promotion , East Carolina University , Greenville , North Carolina , USA
| | - Michael L Stellefson
- a Department of Health Education & Promotion , East Carolina University , Greenville , North Carolina , USA
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Howard AR, Albery IP, Frings D, Spada MM, Moss AC. Pre-partying Amongst Students in the UK: Measuring Motivations and Consumption Levels Across Different Educational Contexts. Subst Use Misuse 2019; 54:1519-1529. [PMID: 31068033 DOI: 10.1080/10826084.2019.1590414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We sought to explore the motivations for pre-partying amongst UK student drinkers who reported pre-partying at least once per month. Two distinct educational settings were included: colleges, where the majority of students are below the legal age for drinking, and university, where all students would be legally allowed to drink. A cross-sectional correlational design was adopted. Ninety-four college (16-18 years) and 138 university students (18-28 years) from the UK completed an online survey, of whom 54.7% and 86.9% reported pre-partying at least once per month, respectively. Alcohol use was measured using the Alcohol Use Disorders Identification Test - Consumption (AUDIT-C) and pre-partying motivations were assessed using the Pre-partying Motivations Inventory (PMI). Frequency of pre-partying behavior and the number of units consumed was also recorded. Hierarchical regression analyses showed that, for college students, AUDIT-C positively predicted pre-partying frequency, while gender and AUDIT-C positively predicted the units of alcohol consumed but Barriers to Consumption (BC) negatively predicted units consumed. Among university students AUDIT-C and Interpersonal Enhancement predicted pre-partying frequency, and AUDIT-C predicted the amount of pre-partying units consumed. Different motives for pre-partying motives were identified across two distinct educational settings. The finding that BC negatively correlated with the amount of alcohol consumed amongst younger college students requires further study, as it contradicts previous work in this area, but is consistent with findings that availability predicts alcohol intake. Understanding differences in drinking behavior between age groups is a key finding, which will allow future research to track developmental influences on the effectiveness of interventions.
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Affiliation(s)
- Ashley R Howard
- a Centre for Addictive Behaviours Research, School of Applied Sciences , London South Bank University , London , UK
| | - Ian P Albery
- a Centre for Addictive Behaviours Research, School of Applied Sciences , London South Bank University , London , UK
| | - Daniel Frings
- a Centre for Addictive Behaviours Research, School of Applied Sciences , London South Bank University , London , UK
| | - Marcantonio M Spada
- a Centre for Addictive Behaviours Research, School of Applied Sciences , London South Bank University , London , UK
| | - Antony C Moss
- a Centre for Addictive Behaviours Research, School of Applied Sciences , London South Bank University , London , UK
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Haas AL, Wickham RE, Zamboanga BL, Read JP, Borsari B. Heterogeneity of Pregamers by Consumption and Reinforcement Reasons: A Latent Profile Analysis. Alcohol Res 2018; 42:1217-1227. [PMID: 29912479 DOI: 10.1111/acer.13773] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 04/15/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Pregaming is a common, high-risk drinking activity among college students that has been largely unchangeable despite targeted intervention approaches. Therefore, identifying profiles of pregamers could enhance understanding of the risks associated with this practice and inform intervention development. METHODS This study identified subtypes of pregamers in undergraduates (N = 911; 60% female, 42.9% White) attending 3 U.S. universities in 2012. Self-report data assessed recent alcohol use (overall, heavy, and pregaming), pregaming motives, and demographics. Alcohol-related consequences were assessed via the Young Adult Alcohol Consequences Questionnaire. RESULTS Latent profile analysis using pregaming-specific indicators assessing motives (e.g., to avoid getting caught) and consumption (e.g., estimated pregaming blood alcohol concentration) yielded 5 unique profiles. Three profiles were characterized by pregaming on 50% or more of all drinking events that differed by pregaming consumption and motives: Instrumental (5.3%; heavy consumption, intoxication-driven motives), Global (16.0%; moderate consumption, indistinct motives), and Risk-averse (18.3%; moderate-to-heavy consumption, negatively reinforcing motives). Two profiles reported lower levels of pregaming: Occasional (32.4%; moderate consumption, indistinct motives) and Infrequent (28.0%; lowest pregaming involvement). Cross-profile differences were then examined for demographics, general drinking and pregaming-specific motives, and alcohol-related consequences. Profile comparisons indicated differences in overall alcohol consumption, ethnicity, gender, current living arrangements, Greek involvement, and a variety of alcohol-related consequences (ps < 0.01). CONCLUSIONS Overall, pregaming is a very heterogeneous behavior among college students in that some students utilize this drinking practice as a means to mitigate risk and others use it to promote intoxication. Results suggest that distinguishing pregamers by consumption as well as motives can facilitate the development of more tailored intervention approaches for students who engage in this high-risk practice.
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Affiliation(s)
- Amie L Haas
- Pacific Graduate School of Psychology, Palo Alto University, Palo Alto, California
| | - Robert E Wickham
- Pacific Graduate School of Psychology, Palo Alto University, Palo Alto, California
| | - Byron L Zamboanga
- Department of Psychology , Smith College, Northampton, Massachusetts
| | - Jennifer P Read
- Department of Psychology , University at Buffalo, State University of New York, Buffalo, New York
| | - Brian Borsari
- San Francisco VA Medical Center , San Francisco, California.,Department of Psychiatry , University of California, San Francisco, San Francisco, California
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Riordan BC, Conner TS, Flett JAM, Droste N, Cody L, Brookie KL, Riordan JK, Scarf D. An intercept study to measure the extent to which New Zealand university students pre-game. Aust N Z J Public Health 2017; 42:30-34. [PMID: 29281165 DOI: 10.1111/1753-6405.12754] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 08/01/2017] [Accepted: 10/01/2017] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE We aimed to quantify the degree to which students pre-gamed in New Zealand, using self-report and breathalysers. METHODS A total of 569 New Zealand undergraduate students were interviewed (men = 45.2%; first year = 81.4%) entering three university-run concerts. We asked participants to report how many drinks they had consumed, their self-reported intoxication and the duration of their pre-gaming session. We then recorded participants' Breath Alcohol Concentration (BrAC; µg/L) and the time they arrived at the event. RESULTS The number of participants who reported consuming alcohol before the event was 504 (88.6%) and the number of standard drinks consumed was high (M=6.9; median=6.0). A total of 237 (41.7%) participants could not have their BrAC recorded due to having consumed alcohol ≤10 minutes before the interview. The remaining 332 participants (57.3%) recorded a mean BrAC of 288.8µg/L (median=280.0 µg/L). Gender, off-campus accommodation, length of pre-gaming drinking session, and time of arrival at the event were all associated with increased pre-gaming. Conclusion and implications for public health: Pre-gaming was the norm for students. Universities must take pre-gaming into account; policy implications include earlier start times of events and limiting students' access to alcohol prior to events.
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Affiliation(s)
| | | | | | - Nic Droste
- School of Psychology, Faculty of Health, Deakin University, Victoria
| | - Louise Cody
- Department of Psychology, University of Otago, New Zealand
| | - Kate L Brookie
- Department of Psychology, University of Otago, New Zealand
| | | | - Damian Scarf
- Department of Psychology, University of Otago, New Zealand
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Pedersen ER. Using the Solid Research Base on Pregaming to Begin Intervention Development: An Epilogue to the Special Issue on Pregaming. Subst Use Misuse 2016; 51:1067-73. [PMID: 27232647 DOI: 10.1080/10826084.2016.1187533] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The pregaming research to date, up to and including the innovative studies included in this special issue, has centered on defining the behavior, learning which students may be most at-risk for pregaming, exploring which contexts may be most risky for pregaming, and quantifying the function of pregaming so that individual-level programs can be developed to target the risky practice. Although there is room for continuing to expand and refine our understanding of pregaming, much of the formative work has been conducted-primarily by the researchers highlighted in this special issue. Now it is time to use the understanding we have of this risky behavior to develop and empirically test programs specifically directed toward reducing or eliminating the behavior, not just at the individual level, but by targeting the social, cultural, economic, environmental, and policy level factors that sustain the behavior in the population. This may include targeting the behavior directly through use of techniques that are shown to be effective for young adult behavior change, but this may also require broadening beyond the psychological literature and utilizing expertise from other domains to affect behavior change.
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Affiliation(s)
- Eric R Pedersen
- a Behavioral and Policy Sciences , RAND Corporation , Santa Monica , California , USA
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