Text-based Alcohol Prevention for First Year College Students

Correcting Exaggerated Drinking Norms With a Mobile Message Delivery System

This project aims to combat excessive perceived norms that contribute to high volume drinking by young adults, which adversely affects health and academic achievement. Campus-specific survey data will be used to craft accurate, pro-moderation campus norms, and deliver them to first-year students via daily text messages during the first semester of college. It is predicted that those receiving regular exposure to pro-moderation drinking norms will reduce their alcohol consumption and consequences, relative to students who receive non-alcohol-related control texts. This preliminary evaluation uses a novel method of delivering drinking norms and will lay the groundwork for future efforts to scale up this novel alcohol misuse prevention approach.

Study Overview

• Status: Completed
• Conditions: College Drinking
• Intervention / Treatment: Behavioral: Alcohol texts; Behavioral: Attention control

Detailed Description

Using mobile technology that most students already have in their pockets, this study evaluates a novel use of SMS text messages to change campus drinking norms. The aim is to correct exaggerated perceptions of drinking norms, and thereby reduce excessive drinking, by delivering daily text messages representing accurate, campus-specific, pro-moderation descriptive norms (what others do) and injunctive norms (what others approve of). It is predicted that with repeated exposure over time, this information will compete with other sources of normative information to which students are exposed during their first year of college. This exploratory study is designed to develop and refine message content and to pilot test the delivery methods.

First year students (N=120) who are underage but report risky drinking (>4/day or >14/week for men; >3/day or >7/week for women) will be randomly assigned to two conditions differing by text content: alcohol norms or attention control. All will receive daily text messages throughout 10 weeks in the first semester of college. Process measures, 3-month post-test, and 3-month follow-up assessments will yield feasibility, acceptability, and preliminary outcome data to inform future larger scale randomized trials. Specifically, baseline, post-test, and 3-month follow-up assessments will allow us to test the hypotheses that the corrective norms intervention will reduce (a) perceived descriptive and injunctive norms, (b) drinking behavior (including high-volume drinking and risky consumption practices), and (c) alcohol-related consequences, and increase (d) protective behavioral strategies, relative to the control condition.

At the end of this project the investigative team will have gathered data on both descriptive and injunctive norms on a range of drinking behaviors to identify topics in need of corrective normative feedback, refined the structure and content of the text messages, and pilot tested the text-delivered intervention in a small scale RCT. The proposed research will provide evidence of feasibility and efficacy of a text-based alcohol norms intervention for reducing excessive drinking among first-year students.

• Study Type: Interventional
• Enrollment (Actual): 121
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Rhode Island
    • Providence, Rhode Island, United States, 02903
      • Brown University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years to 18 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• 18-20 years of age
• enrolled as a first-year undergraduate student
• past month risky drinking
• possession of a mobile phone with text message capacity
• use text messaging at least weekly

Exclusion Criteria:

* currently engaged in alcohol treatment or in need of treatment (AUDIT score 20 or higher)

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Alcohol texts; Participants assigned to this arm will receive a text message each day for 10 weeks, containing factual information about campus drinking norms.	Behavioral: Alcohol texts; A text message each day for 10 weeks, containing factual information about campus drinking norms.
Placebo Comparator: Attention control; Participants assigned to this arm will receive a text message each day for 10 weeks, containing "this day in history" facts.	Behavioral: Attention control; A text message each day for 10 weeks, containing "this day in history" facts.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
drinks per week as assessed by the Daily Drinking Questionnaire	Number of standard drinks consumed in a typical week over the past 30 days; scores can be as low as zero but have not upper limit as they are counts of drinks	change from baseline to 3 month follow-up
alcohol-related consequences as assessed by the Brief Young Adult Alcohol Consequences Questionnaire	The total number of alcohol-related consequences experienced over the past 30 days is measured by the Brief Young Adult Alcohol Consequences Questionnaire (BYAACQ), which is a checklist of 24 items; scores range from 0-24; higher numbers of items endorsed indicate more problems experienced in the past 30 days	change from baseline to 3 month follow-up

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
protective behavioral strategies as assessed by the Strategies Questionnaire	self-reported frequency of using strategies to moderate drinking as reported on the Strategy Questionnaire; the Strategy Questionnaire has 3 sub scales including Selective Avoidance (0-70), Strategies While Drinking (0-100), and Alternatives to Drinking (0-40) and higher sub scale scores indicate more frequent use of those strategies	change from baseline to 3 month follow-up
perceived descriptive drinking norms as assessed by the Drinking Norms Rating Form	perceived descriptive norms are assessed using a variation on the Drinking Norms Rating Form, which asks respondents to estimate the number of standard drinks consumed by other students on campus for each day in a typical week in the past 30 days; daily estimates are summed to yield perceived number of drinks per week for student peers; range of scores can go from zero to no upper limit	change from baseline to 3 month follow-up
perceived injunctive drinking norms as assessed by an adaptation of the Drinking Norms Rating Form	perceived injunctive norms are assessed using the Krieger et al. (2016) adaptation of the Drinking Norms Rating Form, which asks respondents to estimate the how many standard drinks is deemed acceptable by other students on campus to drink on each day in a typical week in the past 30 days; estimates are summed to yield number of drinks per week approved of by student peers; the scores can range from zero to no upper limit	change from baseline to 3 month follow-up

Collaborators and Investigators

• Sponsor: Brown University

Publications and helpful links

General Publications

• Carey KB, Merrill JE, Boyle HK, Barnett NP. Correcting exaggerated drinking norms with a mobile message delivery system: Selective prevention with heavy-drinking first-year college students. Psychol Addict Behav. 2020 May;34(3):454-464. doi: 10.1037/adb0000566. Epub 2020 Mar 2.

Study record dates

Study Major Dates

• Study Start (Actual): September 5, 2018
• Primary Completion (Actual): April 1, 2019
• Study Completion (Actual): April 1, 2019

Study Registration Dates

• First Submitted: September 11, 2018
• First Submitted That Met QC Criteria: March 4, 2019
• First Posted (Actual): March 6, 2019

Study Record Updates

• Last Update Posted (Actual): July 30, 2019
• Last Update Submitted That Met QC Criteria: July 27, 2019
• Last Verified: July 1, 2019

More Information

Terms related to this study

• Keywords: text messages; college students; alcohol abuse; preventive programs
• Additional Relevant MeSH Terms: Drinking Behavior; Alcohol Drinking; Alcohol Drinking in College
• Other Study ID Numbers: R21AA024771 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Yes
• IPD Plan Description: After all data have been collected and results of the study have been published, de-identified data will be made available to other qualified investigators upon request. The request will be evaluated by the investigators to ensure that it meets reasonable expectations of scientific integrity.
• IPD Sharing Time Frame: within one year of study completion, for up to 3 years
• IPD Sharing Access Criteria: to be determined
• IPD Sharing Supporting Information Type: Study Protocol; Informed Consent Form (ICF); Clinical Study Report (CSR)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No