Reducing Hazardous Alcohol Use in Social Networks Using Targeted Intervention

July 31, 2019 updated by: Nancy Barnett, Brown University

Alcohol use is almost ubiquitous on college campuses and first-year students are at particularly high risk of alcohol-related harm when they first make the transition to college. Peers are important agents in socializing both healthy and unhealthy behaviors, but despite the clear role of peer behavior in the maintenance of college problem drinking, there have been no efforts to measure the effect of individual change on the reduction of alcohol-related risks in the broader student body. That is, despite the importance of social connections for inducing and maintaining alcohol use in youth, intervention approaches have not measured nor capitalized on the potential of social influences for changing this problem behavior. It is essential that we understand the indirect effects of individual interventions and the impact such interventions have on the social structure and social connections. The best way to evaluate such effects is to use a research design that experimentally manipulates drinking using the best available intervention and measures its effects on the social network and its members.

The purpose of this research is to investigate whether using an established individual Brief Motivational Intervention (BMI) administered to a small number of influential network members embedded in a social network significantly reduces heavy drinking and alcohol consequences among close peers who do not receive any intervention. In addition, the investigators will investigate social influence mechanisms of this transmitted effect, investigate how specific types of network connections and relationships moderate the indirect intervention effect, and investigate the effects of the intervention on network position and structure. First-year students at Brown will be enrolled and assessed early in their fall 2016 academic semester. Heavy drinkers in each dormitory who are in the top quartile of betweenness centrality, a social network construct that reflects high connectivity and potential influence, will either receive BMI or serve as controls, according to their dormitory's intervention assignment. All participants will be assessed again 5 and 12 months after baseline to measure changes in behavior and in peer ties. The long-term objective of this research is to understand how peer influences function in social networks in order to leverage those mechanisms to reduce problematic alcohol use in heavy drinking populations.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The proposed design and network analytic methods will allow the investigators to investigate the extent to which an intervention conducted with careful attention to network connection is transmitted to others (Aim 1), how those effects occur (Aim 2), conditions under which those effects are more likely (Aim 3), and how the connections themselves change as a function of the intervention (Aim 4).

AIM 1. To investigate the efficacy of targeted Brief Motivational Intervention for reducing heavy drinking and alcohol consequences in network members who received no intervention. The investigators expect that heavy drinking participants residing in dormitories assigned to BMI but who receive no intervention will show lower frequency of heavy drinking and alcohol consequences at follow-up than their comparison group in NHC dormitories (n = 480; 240 in each condition).

AIM 2. To identify the social influence mechanisms through which the intervention effect is conveyed. The investigators expect that reductions in the following social influence mechanisms will mediate the indirect intervention effect: (1) behavioral modeling of heavy drinking; (2) social reinforcement for drinking or not drinking; (3) offers and provision of alcohol; (4) the perception of peer heavy drinking (descriptive norms); and (5) the perception of peer approval of heavy drinking (injunctive norms).

AIM 3. To identify the network and relationship features that moderate intervention efficacy.

3A. Proximity to Intervention. The investigators expect that heavy drinking network members who: (1) have first-degree ties (i.e., a direct tie) with intervention recipients, (2) have a higher proportion of intervention recipients in their close network (i.e., have the highest exposure to transmitted intervention effects), and (3) have an intervention recipient as a roommate will show the strongest indirect intervention effect.

3B. Quality of Peer Relationships. The investigators expect that stronger relationships with intervention recipients as measured by: (1) best-friend status, (2) higher perceived relationship closeness, (3) higher perceived social support, and (4) reciprocated network nominations, will be related to greater indirect intervention effects.

AIM 4. To investigate the intervention effect on personal-level network position and on drinking-based selection in the network.

4A. Network position. Differences between the intervention recipients in the BMI and NHC groups at follow-up will be investigated on: (1) betweenness centrality (how often the participant falls on the shortest path between two others) and (2) prestige (number of nominations of the participant by others). There is little literature on how network positions change following behavioral intervention, so directional hypotheses are not proposed.

4B. Drinking-based selection. At follow-up, the investigators expect less drinking-based selection in the BMI group compared to the NHC group.

Study Type

Interventional

Enrollment (Actual)

1424

Phase

  • Not Applicable

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Students enrolled as full-time first-year students at Brown University

Exclusion Criteria:

  • Students not enrolled as full-time first-year students at Brown University

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Brief Motivational Intervention (BMI)
The intervention recipients in the BMI group will receive a 1-hour single-session alcohol intervention (BMI) with personalized normative feedback.
Behavioral: Single-session alcohol intervention (BMI)
The intervention recipients will receive a 1-hour individual BMI. The BMI will follow the central principles of Motivational Interviewing (MI) and will include all the components determined to be efficacious in existing multi-component BMIs (e.g., personalized feedback on indicators of alcohol-related risk, including signs of alcohol dependence and family history of alcohol risk; normative comparisons of the participant's alcohol consumption with same-sex peers in his/her dorm and throughout campus, and protective behavioral strategies). Additional components will include reviewing the pros and cons of the participant's current pattern of alcohol use, providing estimates of the participant's recent Blood Alcohol Concentration (BAC), and providing information about risks of specific negative outcomes at different levels of drinking. Participants will identify goals for behavior change, and with the counselor will develop a plan to achieve the goals and to address barriers to success.
No Intervention: Natural History Control (NHC)
Students in the NHC group will receive no contact.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in frequency of heavy drinking
Time Frame: baseline, 5-months post baseline, 12-months post-baseline
Heavy episodic drinking (HED) frequency is defined as the number of occasions in which participants drank 4+ (for females) or 5+ (for males) standard alcoholic drinks per drinking occasion during the past 30 days.
baseline, 5-months post baseline, 12-months post-baseline
Change in endorsed negative alcohol consequences
Time Frame: baseline, 5-months post baseline, 12-months post-baseline
24-item (no/yes) response on the Brief Young Adult Alcohol Consequences Questionnaire
baseline, 5-months post baseline, 12-months post-baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Brown University

Collaborators

University of Massachusetts, Worcester
Oregon Research Institute
Smith College

Investigators

  • Principal Investigator: Nancy P Barnett, PhD, Brown University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

August 1, 2016

Primary Completion (Actual)

October 31, 2017

Study Completion (Actual)

October 31, 2017

Study Registration Dates

First Submitted

August 22, 2016

First Submitted That Met QC Criteria

September 6, 2016

First Posted (Estimate)

September 12, 2016

Study Record Updates

Last Update Posted (Actual)

August 2, 2019

Last Update Submitted That Met QC Criteria

July 31, 2019

Last Verified

July 1, 2019

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 1R01AA02352201A1

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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