Narrative Writing to Promote Healthy Decisions About Alcohol During the Transition Out of High School

Evaluating Narrative Writing as a Potential Intervention to Promote Healthy Decisions About Alcohol During the Transition Out of High School

The purpose of the proposed research is to evaluate (1) whether a future possible self task (FPST) can lead to changes drinking identity (DI; how much one associates one's self with drinking) and (2) whether the FPST and changes in drinking identity also change indicators of alcohol misuse . This study focuses on individuals who are graduating from highly school, which is a time of transition and identity change. If such changes can be demonstrated, DI may be a mechanism for alcohol misuse and the FPST may be an additional, novel intervention strategy to reduce alcohol misuse during the post-high school transition.

The goal of this clinical trial is to test the future possible self task (FPST) in individuals who are about to graduate from high school.

The main questions it aims to answer are:

• Can the FPST change drinking identity (a risk factor for alcohol misuse)?
• Can the FPST reduce risks for alcohol misuse?

Participants will complete the FPST, a task that involves writing for 20 minutes, and will answer a series of questionnaires and computer-based word categorization tasks. Participants will be followed for a year after completing the FPST.

Researchers will compare different versions of the FPST and different doses (one writing sessions vs. 3 writing sessions) to see which are more effective for changing drinking identity and reducing risks for alcohol misuse.

Study Overview

• Status: Active, not recruiting
• Conditions: Alcohol Use, Unspecified
• Intervention / Treatment: Behavioral: Most hoped for future self; Behavioral: Most feared future self; Behavioral: Balanced future self; Behavioral: Control (trip to zoo)

Detailed Description

This study will evaluate changes in drinking identity and changes in drinking during the transition out of high school in a sample of 528 soon-to-graduate or recently graduated high school seniors via the future possible self task (FPST). We will test whether an adapted version of the FPST can induce change in drinking identity and reduce risk of alcohol misuse. The study will have a 2 (write about future desired self in relation to drinking vs. no), x 2 (write about future feared self in relation to drinking vs. no) x 2 (write 1x only vs.1x per week for 3 weeks) design. Participants will be randomly assigned to a condition. The study will occur entirely online, with virtual baseline and intervention sessions hosted by a research assistant and with online surveys for the 1-, 3-, 6-, and 12-month follow-ups. Participants, who report at least some alcohol consumption and some interest interest in changing or not increasing their drinking, will be recruited, in equal numbers, from two sites -- one at the University of Washington and one at the University of Houston. Participants will be recruited in two waves (264 each wave, with 132 from each site during each wave).

The study will test for changes in drinking identity (primary), in indicators of alcohol misuse (primary & secondary), and in associated risk factors (secondary; changes in self-efficacy, identification with future self, and craving at baseline, 1-, 3-, 6-, and 12-month follow-ups

• Study Type: Interventional
• Enrollment (Estimated): 468
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Texas
    • Houston, Texas, United States, 77204
      • University of Houston

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Senior in high school and expecting to graduate at the end of the academic year or individuals who recently (i.e., within the past three months) graduated high school or earned a GED
• Between the ages of 17-19
• Currently reside in WA State (UW Site) or State of Texas (UH Site)
• Fluent in English
• Willing to attend three weekly virtual laboratory sessions (hosted on Zoom)
• Willing to provide contact information, including phone number (for text messages and reminders), email (reminders), and mailing address (payment)
• Has consumed alcohol at least 1 time in last year
• Reports at least some interest in NOT increasing one's drinking or at least some interest in reducing drinking

Exclusion Criteria:

• N/A

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Factorial Assignment
• Masking: Double

Number of Arms

8

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Most hoped for future self, 3 dose; Participants complete a writing task in which they think and write about their most hoped for future self, weekly for 3 weeks (i.e., at each session).	Behavioral: Most hoped for future self; Participants in this condition complete a version of the future possible self task in which they think and write about their most hoped for future self for 20 minutes.
Experimental: Most hoped future self, 1 dose; Participants complete a writing task in which they think and write about their most hoped for future self one time (on the third session).	Behavioral: Most hoped for future self; Participants in this condition complete a version of the future possible self task in which they think and write about their most hoped for future self for 20 minutes.
Experimental: Most feared future self, 3 dose; Participants complete a writing task in which they think and write about their most feared future self, weekly for 3 weeks (i.e., at each session).	Behavioral: Most feared future self; Participants in this condition complete a version of the future possible self task in which they think and write about their most feared future self for 20 minutes.
Experimental: Most feared future self, 1 dose; Participants complete a writing task in which they think and write about their most feared future self one time (on the third session).	Behavioral: Most feared future self; Participants in this condition complete a version of the future possible self task in which they think and write about their most feared future self for 20 minutes.
Experimental: Balanced self (hoped and feared self), 3 dose; Participants complete a writing task in which they think and write about their most hoped for and feared future self, weekly for 3 weeks (i.e., at each session).	Behavioral: Balanced future self; Participants in this condition complete a version of the future possible self task in which they think and write about their most hoped for and feared future self for 20 minutes.
Experimental: Balanced self (hoped and feared self), 1 dose; Participants complete a writing task in which they think and write about their most hoped for and feared future self one time (on the third session).	Behavioral: Balanced future self; Participants in this condition complete a version of the future possible self task in which they think and write about their most hoped for and feared future self for 20 minutes.
Placebo Comparator: Control, 3 dose; Participants in this condition complete a task in which they think and write about a trip to the zoo weekly for 3 weeks (i.e., at each session).	Behavioral: Control (trip to zoo); Participants in this condition think and write about a future trip to the zoo
Placebo Comparator: Control, 1 dose; Participants in this condition complete a task in which they think and write about a trip to the zoo one time (on the third session).	Behavioral: Control (trip to zoo); Participants in this condition think and write about a future trip to the zoo

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Explicit drinking identity	This is will be evaluated by the Alcohol Self-Concept Scale. A mean score will be calculated. Scores range from -3 to +3. Higher scores indicate stronger alcohol self-concept	Will be assessed at baseline, post-intervention, 1-month follow up, 3-month follow up, 6 month-follow up, & 12-month follow up
Implicit drinking identity	This is will be evaluated by the Drinking Identity Implicit Association Test (IAT). A summary score, called a D score, which is similar to a Cohen's d effect size, will be calculated. Scores range from -2 to +2; higher scores indicate stronger implicit drinking identity.	Will be assessed at baseline,post-intervention, 1-month follow up, 3-month follow up, 6 month-follow up, & 12-month follow up
Drinks per week	This is will be evaluated by the Daily Drinking Questionnaire (DDQ). It assesses drinks consumed each day of the week during a typical week during the last month. A sum of drinks over the course of the week will be calculated.	Will be assessed at baseline, 1-month follow up, 3-month follow up, 6 month-follow up, & 12-month follow up
Peak drinks per month	This is will be evaluated by the Quantity/Frequency Measure (Q/F). It includes an assessment of the number of drinks consumed when one drank the most during the last month.	Will be assessed at baseline, 1-month follow up, 3-month follow up, 6 month-follow up, & 12-month follow up
Typical drinks per occasion	This is will be evaluated by the Quantity/Frequency Measure (Q/F). It includes an assessment of the number of drinks consumed on a typical drinking occasion during the last month.	Will be assessed at baseline, 1-month follow up, 3-month follow up, 6 month-follow up, & 12-month follow up
Alcohol-related problems	This is will be evaluated by the Brief Young Adult Alcohol Consequences Questionnaire. It assesses the consequences of drinking (happened yes or no) that occurred during the last month. A sum will be calculated. Higher scores indicate more experiencing more negative consequences from drinking. Scores range from 0 to 24	Will be assessed at baseline, 1-month follow up, 3-month follow up, 6 month-follow up, & 12-month follow up

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Risk of Alcohol Use Disorder	This will be evaluated by the Alcohol Use Disorder Identification Test. A total score will be calculated. Scores range from 0 to 40.Higher scores indicate higher risk of having an alcohol use disorder	Will be assessed at baseline and at 12-month follow-up
Alcohol Craving - Momentary	This will be evaluated by the Alcohol Urge Questionnaire. A mean score will be calculated. Scores range from 1 to 7; higher scores indicate stronger urges to drink right now.	Will be assessed at baseline and 2 weeks after baseline
Alcohol Craving - Retrospective	This will be evaluated by the Penn Alcohol Craving Scale (PACS). The PACS evaluate alcohol craving over the last week. A total score will be calculated.Scores range from 0 to 30. Higher scores indicate stronger craving.	Will be assessed at baseline, 1-month follow up, 3-month follow up, 6 month-follow up, & 12-month follow up
Alcohol Expectancies	The Brief Comprehensive Effects of the Outcomes of Alcohol Questionnaire [BCEOA] will assess alcohol expectancies. Mean scores for the BCEOA subscales will be created. Scores range from 1 to 4. Higher scores indicate stronger expectancies about alcohol's effects.	Will be assessed at baseline, 1-month follow up, 3-month follow up, 6 month-follow up, & 12-month follow up
Drinking Motives	The drinking motives questionnaire will assess common motives for drinking. Mean scores for the subscales will be created. Scores range from 1 to 5. Higher scores indicate stronger motives for drinking.	Will be assessed at baseline, 1-month follow up, 3-month follow up, 6 month-follow up, & 12-month follow up
Social Norms	The Drinking Norms Rating Form will assess descriptive norms for drinking. Total drinks per week that a typical same age/same gender person drinks per week will be calculated.	Will be assessed at baseline, 1-month follow up, 3-month follow up, 6 month-follow up, & 12-month follow up
Identification with Future Self	A future self continuity measure (single item) will assess the degree to which one's current and future selves are similar. Scores ranges from 1 to 7; higher scores indicate greater concordance between one's current and future selves.	Will be assessed at baseline, post-intervention, 1-month follow up, 3-month follow up, 6 month-follow up, & 12-month follow up
Readiness to Change	A single item readiness to change ruler will assess readiness to reduce one's drinking. Scores range from 0 to 6; higher scores indicate greater readiness to reduce one's drinking.	Will be assessed at baseline, post-intervention, 1-month follow up, 3-month follow up, 6 month-follow up, & 12-month follow up
Drinking Refusal Self-efficacy	Ability to resist drinking will be assessed by the Drinking Refusal Self-efficacy Questionnaire. A mean score will be calculated. Scores range from 0 to 6. Higher scores indicate greater self-efficacy to resist drinking.	Will be assessed at baseline, post-intervention, 1-month follow up, 3-month follow up, 6 month-follow up, & 12-month follow up

Collaborators and Investigators

• Sponsor: University of Washington
• Collaborators: National Institute on Alcohol Abuse and Alcoholism (NIAAA)
• Investigators: Principal Investigator: Kristen Lindgren, PhD, University of Washington

Publications and helpful links

General Publications

• Lindgren KP, Shah V, de Luna F, Hall NA, Weinstein AP, Wu D, Fairlie AM, Lee CM, Calhoun BH, Neighbors C. Protocol of a randomized controlled trial evaluating the impact of an adapted future possible selves task on drinking identity and hazardous drinking in graduating high school students. BMC Public Health. 2025 Dec 3;26(1):94. doi: 10.1186/s12889-025-25827-x.

Study record dates

Study Major Dates

• Study Start (Actual): March 29, 2024
• Primary Completion (Estimated): November 30, 2026
• Study Completion (Estimated): November 30, 2026

Study Registration Dates

• First Submitted: December 8, 2023
• First Submitted That Met QC Criteria: January 2, 2024
• First Posted (Actual): January 5, 2024

Study Record Updates

• Last Update Posted (Actual): March 5, 2026
• Last Update Submitted That Met QC Criteria: March 3, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: alcohol misuse; high school; drinking identity; developmental transitions
• Additional Relevant MeSH Terms: Drinking Behavior; Behavior; Alcohol Drinking
• Other Study ID Numbers: STUDY00017212; R01AA030750 (U.S. NIH Grant/Contract)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No