Do brief personalized feedback interventions work for mandated students or is it just getting caught that works?

Studies evaluating the efficacy of brief interventions with mandated college students have reported declines in drinking from baseline to short-term follow-up regardless of intervention condition. A key question is whether these observed changes are due to the intervention or to the incident and/or reprimand. This study evaluates a brief personalized feedback intervention (PFI) for students (N = 230) who were referred to a student assistance program because of infractions of university rules regarding substance use to determine whether observed changes in substance use are attributable to the intervention. Half the students received immediate feedback (at baseline and after the 2-month follow-up), and half received delayed feedback (only after the 2-month follow-up). Students in both conditions generally reduced their drinking and alcohol-related problems from baseline to the 2-month follow-up and from the 2-month to the 7-month follow-up; however, there were no significant between-group differences at either follow-up. Therefore, it appears that the incident and/or reprimand are important instigators of mandated student change and that written PFIs do not enhance these effects on a short-term basis but may on a longer term basis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A randomized clinical trial of a brief, mailed intervention for symptoms of depression.

This research evaluated the efficacy of a brief, mailed personalized feedback intervention designed to alleviate depressed mood and antecedents (ineffective coping and hopelessness). College students (N = 177) were randomly assigned to intervention or control group following a baseline assessment. A week after completing the baseline assessment, participants in the intervention condition were mailed feedback and information detailing their mood, coping strategies, as well as suggestions for enhancing mood. Results indicated that feedback was effective in reducing depressive symptoms, hopelessness, and among men, increasing willingness to use coping strategies at the 1-month follow-up. Hopelessness mediated reductions in depressive symptoms. Results support the use of personalized feedback as a low-cost, initial intervention for college students suffering from symptoms of depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Being controlled by normative influences: Self-determination as a moderator of a normative feedback alcohol intervention.

The objectives of this research were to evaluate the efficacy of computer-delivered personalized normative feedback among heavy drinking college students and to evaluate controlled orientation as a moderator of intervention efficacy. Participants (N = 217) included primarily freshman and sophomore, heavy drinking students who were randomly assigned to receive or not to receive personalized normative feedback immediately following baseline assessment. Perceived norms, number of drinks per week, and alcohol-related problems were the main outcome measures. Controlled orientation was specified as a moderator. At 2-month follow-up, students who received normative feedback reported drinking fewer drinks per week than did students who did not receive feedback, and this reduction was mediated by changes in perceived norms. The intervention also reduced alcohol-related negative consequences among students who were higher in controlled orientation. These results provide further support for computer-delivered personalized normative feedback as an empirically supported brief intervention for heavy drinking college students, and they enhance the understanding of why and for whom normative feedback is effective. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief alcohol intervention with college student drinkers: Face-to-face versus computerized feedback.

Research has demonstrated that brief interventions featuring personalized feedback can be used to decrease alcohol use among heavy-drinking college students. The current study investigated the efficacy of face-to-face and computer delivered interventions relative to an assessment-only control condition. The content of the personalized feedback was identical across the face-to-face and computerized conditions. There were 84 at-risk students assessed before, and 4 weeks after, the delivery of the interventions. The results suggest that both face-to-face and computerized interventions were equally successful in reducing the quantity and frequency of alcohol consumption, and that both interventions were more effective than the control condition. Participants also rated both interventions as acceptable, although the face-to-face intervention was given a more favorable rating. These initial results suggest that computerized interventions can be used to efficiently reduce alcohol use among college students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Internet-based personalized feedback to reduce 21st-birthday drinking: A randomized controlled trial of an event-specific prevention intervention.

This article presents an initial randomized controlled trial of an event-specific prevention intervention. Participants included 295 college students (41.69% male, 58.31% female) who intended to consume 2 or more drinks on their 21st birthday. Participants completed a screening/baseline assessment approximately 1 week before they turned 21 and were randomly assigned to receive Web-based personalized feedback or assessment only. Feedback included normative information, protective behaviors, and personalized blood alcohol concentration information. A follow-up assessment was completed approximately 1 week after a student's birthday. Results indicated a significant intervention effect in reducing estimated blood alcohol concentration (d = 0.33). The intervention effect was moderated by 21st-birthday drinking intentions, and the intervention was primarily effective among those who intended to reach higher levels of intoxication. Results provide some support for normative information as a mediator of intervention efficacy. Overall results provide support for Web-based personalized feedback as an intervention approach for specific events associated with extreme drinking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Targeting Misperceptions of Descriptive Drinking Norms: Efficacy of a Computer-Delivered Personalized Normative Feedback Intervention.

The authors evaluated the efficacy of a computer-delivered personalized normative feedback intervention in reducing alcohol consumption among heavy-drinking college students. Participants included 252 students who were randomly assigned to an intervention or control group following a baseline assessment. Immediately after completing measures of reasons for drinking, perceived norms, and drinking behavior, participants in the intervention condition were provided with computerized information detailing their own drinking behavior, their perceptions of typical student drinking, and actual typical student drinking. Results indicated that normative feedback was effective in changing perceived norms and alcohol consumption at 3- and 6-month follow-up assessments. In addition, the intervention was somewhat more effective at 3-month follow-up among participants who drank more for social reasons. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pilot test of Project CHOICE: A voluntary afterschool intervention for middle school youth.

The current study reports findings from a pilot evaluation of a voluntary alcohol and marijuana intervention for young teens. Students at 2 middle schools completed 4 surveys over 2 years. During Year 2, an intervention, Project CHOICE (PC), was implemented at 1 school and was voluntarily attended by 13% of adolescents. Participants ranged from 10 to 15 years of age and were approximately 45% male, 45% White, 30% Latino, and 15% of mixed ethnic origin. Outcomes included assessments of self use and perceptions of friends' and schoolmates' past-month use of alcohol and marijuana. Analyses that compared PC participants (n=64) with a matched control sample of students (n=264) revealed that PC participants reported lower rates of alcohol use and lower perceptions of friends' marijuana use and of schoolmates' use of these substances. Random-effects growth models indicated that self use and perceptions of friends' use of alcohol and marijuana increased more sharply among control school students (n=178) relative to students from the PC school (n=270), regardless of participation. Results suggest that a brief voluntary intervention attended by a small proportion of students can impact both individual and schoolwide substance-related outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The efficacy of a targeted personalized drinking feedback intervention among intercollegiate athletes: A randomized controlled trial.

College athletes are an at-risk population for excessive alcohol use and subsequent alcohol-related harms. The purpose of this study was to test the efficacy of an electronically delivered personalized drinking feedback (PDF) intervention targeted specifically to college athletes, both in comparison with a standard (i.e., nontargeted) PDF intervention and an education-only (EO) condition that also included targeted information. Data were collected on 263 intercollegiate athletes from three colleges (76% women, 86% White) who were randomly assigned to one of the conditions. Results provided partial support for the efficacy of the targeted PDF intervention. Students in the targeted PDF condition reported a lower peak blood alcohol concentration (BAC) at the 6-month follow-up than those in the other conditions. Heavy drinking students in the targeted PDF condition reported a lower peak BAC than those in the other conditions at the 1-month follow-up and a lower peak BAC than those in the EO condition at the 6-month follow-up. Finally, in-season athletes in the targeted PDF condition reported fewer drinks per week than those in the PDF-standard condition at the 1-month follow-up. These findings provide preliminary support for the use of targeted PDF interventions with at-risk alcohol users, such as college athletes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Randomized controlled trial of motivational enhancement therapy with nontreatment-seeking adolescent cannabis users: A further test of the teen marijuana check-up.

Cannabis use adversely affects adolescents and interventions that are attractive to adolescents are needed. This trial compared the effects of a brief motivational intervention for cannabis use with a brief educational feedback control and a no-assessment control. Participants were randomized into one of three treatment conditions: Motivational Enhancement Therapy (MET), Educational Feedback Control (EFC), or Delayed Feedback Control (DFC). Those who were assigned to MET and EFC were administered a computerized baseline assessment immediately following randomization and completed assessments at the 3- and 12-month follow-up periods. Participants in the DFC condition were not assessed until the 3-month follow-up. Following the completion of treatment sessions, all participants were offered up to four optional individual treatment sessions aimed at cessation of cannabis use. The research was conducted in high schools in Seattle, Washington. The participant s included 310 self-referred adolescents who smoked cannabis regularly. The main outcome measures included days of cannabis use, associated negative consequences, and engagement in additional treatment. At the 3-month follow-up, participants in both the MET and EFC conditions reported significantly fewer days of cannabis use and negative consequences compared to those in the DFC. The frequency of cannabis use was less in MET relative to EFC at 3 months, but it did not translate to differences in negative consequences. Reductions in use and problems were sustained at 12 months, but there were no differences between MET and EFC interventions. Engagement in additional treatment was minimal and did not differ by condition. Brief interventions can attract adolescent cannabis users and have positive impacts on them, but the mechanisms of the effects are yet to be identified. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Comparison of extended versus brief treatments for marijuana use.

Adult marijuana users (N?=?291) seeking treatment were randomly assigned to an extended 14-session Cognitive–behavioral group treatment (relapse prevention support group; RPSG), a brief 2-session individual treatment using motivational interviewing (individualized assessment and intervention; IAI), or a 4-month delayed treatment control (DTC) condition. Results indicated that marijuana use, dependence symptoms, and negative consequences were reduced significantly in relation to pretreatment levels at l-, 4-, 7-, 13-, and 16-month follow-ups. Participants in the RPSG and IAI treatments showed significantly and substantially greater improvement than DTC participants at the 4-month follow-up. There were no significant differences between RPSG and IAI outcomes at any follow-up. The relative efficacy of brief versus extended interventions for chronic marijuana-using adults is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Improving the effectiveness of computer-delivered personalized drinking feedback interventions for college students.

This study evaluated methods of enhancing college students' retention of information provided to them in a computer-delivered personalized drinking feedback intervention and whether enhanced retention reduced alcohol consumption during the two-week period following the intervention. Participants were 98 college students who reported at least one heavy drinking episode in the past two weeks. After participating in an online, personalized drinking feedback intervention, students were randomly assigned to one of three experimental conditions: 1) typical, in which they were simply sent home, 2) reading, in which they were asked to spend the next 20 minutes re-reading the feedback, and 3) recall, in which they were asked to spend the next 20 minutes writing down as much of the information from the feedback as they could remember. Two weeks following the intervention, participants completed a recall test and provided information on their alcohol use during the previous two weeks. Results indicated that participants in the reading and recall conditions retained more of the feedback information than did participants in the typical condition. In addition, participants in the reading and recall conditions reported reduced alcohol consumption in the two-week period following the intervention, compared to those in the typical condition. Information retention partially mediated the effects of the reading and recall conditions on drinking outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Short-term effects of a brief motivational intervention to reduce alcohol and drug risk among homeless adolescents.

The short-term results of a randomized trial testing a brief feedback and motivational intervention for substance use among homeless adolescents are presented. Homeless adolescents ages 14-19 (N = 285) recruited from drop-in centers at agencies and from street intercept were randomly assigned to either a brief motivational enhancement (ME) group or 1 of 2 control groups. The 1-session motivational intervention presented personal feedback about patterns of risks related to alcohol or substance use in a style consistent with motivational interviewing. Follow-up interviews were conducted at 1 and 3 months postintervention. Youths who received the motivational intervention reported reduced illicit drug use other than marijuana at 1-month follow-up compared with youths in the control groups. Treatment effects were not found with respect to alcohol or marijuana. Post hoc analyses within the ME group suggested that those who were rated as more engaged and more likely to benefit showed greater drug use reduction than did those rated as less engaged. Limitations of the study are discussed as are implications for development of future substance use interventions for this high-risk group. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Help-seeking for alcohol-related problems in college students: Correlates and preferred resources.

Despite the development of a variety of efficacious alcohol intervention approaches for college students, few student drinkers seek help. The present study assessed students' history of help-seeking for alcohol problems, as well as their estimates of how likely they would be to use various help-seeking resources, should they wish to change their drinking. Participants were 197 college students who reported recent heavy drinking (46% male, 68.5% White, 27.4% African-American). Participants completed measures related to their drinking and their use (both past use and likelihood of future use) of 14 different alcohol help-seeking options. Repeated-measures analyses of variance revealed that students preferred informal help-seeking (e.g., talking to friends and family) over formal (e.g., talking with a counselor or medical provider) and anonymous resources (e.g., internet- or computer-based programs). Higher self-ideal discrepancy, greater depressive symptoms, and more alcohol-related consequences were positively associated with actual past help-seeking. Alcohol-related problems and normative discrepancy were negatively associated with hypothetical likelihood of utilizing all three help-seeking resources. These results suggest that heavy drinking college students prefer low-threshold intervention options including peer, family, computerized, and brief motivational interventions. Only 36 participants (18.3% of the sample) reported that they had utilized any of the help-seeking options queried, suggesting that campus prevention efforts should include both promoting low-threshold interventions and attempting to increase the salience of alcohol-related risk and the potential utility of changing drinking patterns. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief motivational interventions for heavy college drinkers: A randomized controlled trial.

In this randomized controlled trial, the authors evaluated brief motivational interventions (BMIs) for at-risk college drinkers. Heavy drinking students (N = 509; 65% women, 35% men) were randomized into 1 of 6 intervention conditions formed by crossing the baseline Timeline Followback (TLFB) interview (present versus absent) and intervention type (basic BMI, BMI enhanced with a decisional balance module, or none). Assessments completed at baseline, 1, 6, and 12 months measured typical and risky drinking as well as drinking-related problems. Relative to controls, the TLFB interview reduced consumption but not problems at 1 month. The basic BMI improved all drinking outcomes beyond the effects of the TLFB interview at 1 month, whereas the enhanced BMI did not. Risk reduction achieved by brief interventions maintained throughout the follow-up year. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Peer enhancement of a brief motivational intervention with mandated college students.

In this pilot study, the authors evaluated whether incorporating a peer in a brief motivational intervention would lead to significant reductions in alcohol use and problems in students mandated to receive treatment after violating campus alcohol policy. Thirty-six participant-peer dyads (66% male) were randomly assigned to receive either two 45-min sessions of an individual motivational intervention (IMI, n = 18) or a peer-enhanced motivational intervention (PMI, n = 18). The IMI included exploration of motivation to change alcohol use, perceived positive and negative effects of drinking, personalized feedback, and goals for changing alcohol consumption and related behaviors. The PMI included all elements of the IMI plus the presence of a supportive peer of the participant during both sessions. Although both groups significantly reduced number of drinking days and heavy drinking days at 1-month follow-up, the magnitude of within-group reductions in alcohol use and problems was 3 times larger on average for the PMI group than for the IMI group, based on effect-size calculations. Peers and participants endorsed high satisfaction ratings on the PMI. Findings indicate the promise of including peers in brief motivational interventions for mandated students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Efficacy of web-based personalized normative feedback: A two-year randomized controlled trial.

Objective: Web-based brief alcohol interventions have the potential to reach a large number of individuals at low cost; however, few controlled evaluations have been conducted to date. The present study was designed to evaluate the efficacy of gender-specific versus gender-nonspecific personalized normative feedback (PNF) with single versus biannual administration in a 2-year randomized controlled trial targeting a large sample of heavy-drinking college students. Method: Participants included 818 freshmen (57.6% women; 42% non-Caucasian) who reported 1 or more heavy-drinking episodes in the previous month at baseline. Participants were randomly assigned in a 2 (gender-specific vs. gender-nonspecific PNF) × 2 (single vs. biannual administration of PNF) + 1 (attention control) design. Assessments occurred every 6 months for a 2-year period. Results: Results from hierarchical generalized linear models provided modest effects on weekly drinking and alcohol-related problems but not on heavy episodic drinking. Relative to control, gender-specific biannual PNF was associated with reductions over time in weekly drinking (d = ?0.16, 95% CI [?0.02, ?0.31]), and this effect was partially mediated by changes in perceived norms. For women, but not men, gender-specific biannual PNF was associated with reductions over time in alcohol-related problems relative to control (d = ?0.29, 95% CI [?0.15, ?0.58]). Few other effects were evident. Conclusions: The present research provides modest support for the use of biannually administered web-based gender-specific PNF as an alternative to more costly indicated prevention strategies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Motivational enhancement therapy for adolescent marijuana users: A preliminary randomized controlled trial.

This study's aims were (a) to investigate the feasibility of a school-based motivational enhancement therapy (MET) intervention in voluntarily attracting adolescents who smoke marijuana regularly but who are not seeking formal treatment and (b) to evaluate the efficacy of the intervention in reducing marijuana use. Ninety-seven adolescents who had used marijuana at least 9 times in the past month were randomly assigned to either an immediate 2-session MET intervention or to a 3-month delay condition. Two thirds of the sample characterized themselves as in the precontemplation or contemplation stages of change regarding marijuana use. Participants' marijuana use and associated negative consequences were assessed at baseline and at a 3-month follow-up. Analyses revealed that both groups significantly reduced marijuana use at the 3-month follow-up ( p = .001); however, no between-group differences were observed. Despite the absence of a clear effect of MET, this study demonstrated that adolescents could be attracted to participate in a voluntary marijuana intervention that holds promise for reducing problematic levels of marijuana use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Live interactive group-specific normative feedback reduces misperceptions and drinking in college students: A randomized cluster trial.

This research evaluated the efficacy of a live and interactive group-specific normative feedback intervention designed to correct misperceptions of alcohol-related group norms and subsequently reduce drinking behavior. Campus organizations (N = 20) containing 1,162 college students were randomly assigned to intervention or assessment-only control conditions. Participants in the intervention condition attended an intervention during their organization's regular standing meeting. Data were gathered in vivo using computerized handheld keypads into which participants entered personal responses to a series of alcohol-related questions assessing perceptions of normative group behavior as well as actual individual behavior. These data were then immediately presented in graphical form to illustrate discrepancies between perceived and actual behavioral group norms. Results indicated that compared with the control group, the intervention group reduced drinking behavior and misperceptions of group norms at 1-month and 2-month follow-ups. Changes in perceived norms mediated the reductions in drinking. Results demonstrate the effectiveness of a novel, technologically advanced, group-based, brief alcohol intervention that can be implemented with entire groups at relatively low cost. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using Behavioral Theories of Choice to Predict Drinking Outcomes Following a Brief Intervention.

Behavioral theories of choice predict that substance use is partly a function of the relative value of drugs in relation to other available reinforcers. This study evaluated this hypothesis in the context of predicting drinking outcomes following an alcohol abuse intervention. Participants (N=54, 69% female, 31% male) were college student heavy drinkers who completed a single-session motivational intervention. Students completed a baseline measure of substance-related and substance-free activity participation and enjoyment. Only women showed a significant reduction in drinking at the 6-month follow-up, and the ratio of substance-related to substance-free reinforcement accounted for unique variance in their drinking outcomes. Women who at baseline derived a smaller proportion of their total reinforcement from substance use showed lower levels of follow-up drinking, even after the authors controlled for baseline drinking level. Male and female participants who reduced their drinking showed increased proportional reinforcement from substance-free activities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)