College students are at risk for engaging in heavy alcohol use, affecting academic performance and mental and physical health. Brief motivational interventions reduce alcohol use and consequences, but intervention gains decay 3-6 months post-intervention. Mandated college students, who have violated university alcohol policy, are an important intervention target; they drink more, experience more alcohol-related consequences, and are less likely to maintain reduced drinking than typical students. To promote student health, brief motivational interventions need to be improved to promote maintenance of reduced drinking. This K01 outlines the necessary research and training experiences to prepare the PI to become an independent researcher focused on developing interventions that promote not only initiation, but also maintenance of reduced drinking among young adults. Notably, the PI will learn the innovative, engineering-inspired multiphase optimization strategy (MOST), which uses the factorial experimental design to develop highly efficacious interventions. The proposed research consists of three stages. First, a systematic review will examine theories of and empirical research on maintenance of behavior change. This will yield recommendations for mechanisms that are likely to improve maintenance of reduced alcohol use among young adults. In the subsequent stages, all participants will be mandated students who receive a brief motivational intervention, providing a context for studying maintenance-enhancing constructs and intervention strategies. In the second stage, the utility of constructs for predicting maintenance will be examined in 475 mandated students, followed 1-, 3-, and 6-months post- intervention. Constructs proposed by two prominent models of maintenance?coping motives, parent-student communication, maintenance self-efficacy, and recovery self-efficacy?in addition to promising constructs identified in the systematic review, will be examined as predictors of maintenance trajectories. Third, intervention strategies targeting identified maintenance enhancement constructs will be developed and pilot tested for acceptability among 60 mandated students; a mandated-specific parent handbook will be piloted among 20 of their parents. A pilot optimization trial will also be conducted with 80 mandated students and their parents. Students will be randomly assigned to one of up to 16 conditions in a factorial experimental design. Results of the proposed research will yield important information on the factors that promote maintenance of reduced alcohol use, supporting subsequent grant applications to further develop a maintenance-enhancement intervention. The PI will work with a highly skilled mentoring team (Drs. Kate Carey, Katie Witkiewitz, Linda Collins, Rebecca Spencer) to gain expertise in: 1) maintenance of behavior change theories; 2) intervention development; 3) MOST; 4) management and analysis of longitudinal research; 5) grant writing. The research and training activities proposed in this K01 will produce both an independent research scientist and important scientific knowledge on maintenance of health behavior change, an understudied topic.
Heavy alcohol use remains a serious problem among college students. Brief motivational interventions reduce college students' alcohol use but effects are not sustained. This research seeks to identify the psychosocial factors that affect college students' maintenance of intervention gains over time and to conduct the formative research needed to develop a maintenance-enhancement alcohol intervention for college students.
