This revised application evaluates a new approach to decrease heavy drinking and alcohol problems among drinking university students by addressing an individual's specific vulnerability toward these difficulties. We build upon a successful pilot protocol that focused on a relatively prevalent preexisting risk factor for heavy drinking, the low level of response (LR) to alcohol, to diminish the vulnerability toward heavy drinking related to this genetically-influenced need for a higher number of drinks to feel effects. By incorporating existing methods to create a novel and potentially more effective approach, we optimize our ability to compare results to existing state-of-the-art (SOTA) programs, and can use elements of interventions with which university administrators are already familiar and can be instituted at little cost. The proposal is the next logical step from the small pilot project described in A.6213 to determine if the prior positive outcomes remain with a larger population and a 1-yr follow-up, thus setting the potential basis for a more definitive study in the future. questionnaire will be distributed to >4,000 freshmen at UCSD to gather their demography, alcohol histories, and LR. The latter is measured by the retrospective SRE questionnaire where LR is the number of drinks required for a range of effects. Subjects matched on drinking histories will be randomly assigned to: 1) a Low Response-Based Intervention Group (LRB, N=200) where they receive five 45-min. Internet-based videotapes that incorporate the SOTA drinking intervention techniques, but with information structured around the model demonstrating how a low LR to alcohol contributes to later heavy drinking and alcohol problems;2) a SOTA Group (N=200) where they receive similar state-of-the-art information, but are not taught about LR;or 3) a comparison Assessment Only (AO) Group (N=100) where they receive neither LRB nor SOTA-based information, but will be evaluated on the same time frame as the 2 intervention groups. All subjects will be followed for 12 months. As supported by the pilot data in A.6, Hypothesis 1 is that individuals with lower LRs to alcohol will demonstrate the greatest decreases in heavy drinking and subsequent problems when participating in the LRB Group that focuses on their specific vulnerability. Hypothesis 2 is that those with high LR (while also decreasing heavy drinking in the LRB Group) will show the greatest decreases in a SOTA Group that addresses their vulnerability that is not related to LR, but to impulsivity, mood dysregulation, and other risk factors.11 Hypothesis 3 is that the interventions incorporated in LRB and SOTA protocols will be associated with less future heavy drinking and alcohol problems than are seen in the AO Group. If the hypotheses prove correct, the results may serve as an example of how universities might improve drinking outcomes by tailoring prevention efforts to additional specific preexisting risk factors.
Heavy drinking and associated problems are highly prevalent in university settings. Recent research has identified key elements of programs aimed at preventing alcohol-related morbidity and mortality, but such programs, while effective, have only had a modest impact. This project proposes to enhance the effectiveness of prevention programs by recognizing the higher vulnerability toward alcohol-related problems in individuals with low levels of response (or low sensitivity) to alcohol, and tailoring the usual prevention protocol to address the needs of these students with elevated risks for alcohol problems.
