College student alcohol use is a major public health concern (NIAAA, 2002b). Large scale surveys indicate that approximately 68% of college students drink alcohol every month (Johnston et al., 2006) and 40% of college students engage in heavy episodic drinking (NIAAA, 2004). Despite prevention/intervention efforts, problematic alcohol consumption among college students continues to result in an estimated 1,800 deaths and 600,000 injuries annually (Hingson, Zha, & Weitzman, 2009), and epidemiological studies demonstrate no appreciable decrease in risk among college students (e.g., Johnston et al., 2006). The purpose of the proposed research is to improve extant college-drinking interventions by advancing the dissemination methodology and the intervention content (Specific Aim 1). As a methodological improvement, rapid advances in mobile computing makes ecological momentary interventions (EMIs) increasingly feasible (Heron et al., 2012). EMIs refer to interventions that can be delivered multiple times and in the moment. EMIs can optimize the timing and location of the intervention while also increasing the dose of the intervention. To improve the intervention content, we focus our research on protective behavioral strategies (PBS) to reduce alcohol problems, not just alcohol use. PBS are behaviors that one can engage in immediately prior to, during, and immediately following alcohol use that limit alcohol use, alcohol intoxication, and/or alcohol-related harm (Pearson, 2013). Across multiple studies and investigators, research suggests that PBS use can protect individuals from alcohol problems above and beyond its effect on reducing alcohol use (Martens et al., 2005, 2007, 2009, 2011; Pearson, Kite, & Henson, 2012a; Pearson, Kite, & Henson, 2012b; Pearson, Kite, & Henson; 2013). The primary purpose of this research is to provide a more powerful test of a PBS intervention's effects on alcohol- related consequences by using a technology-based intervention methodology (i.e., EMI). Participants will be randomized by gender into to a fully crossed, 3 (Standard BMI, BMI with a PBS component, control) X 2 (PBS- based EMI, Ecological Assessment Only [EMA]) design. We selected these 6 conditions to answer several critically important research questions (Specific Aim 2): a) does the addition of a PBS component improve the efficacy of a standard BMI, b) does a PBS-based EMI improve efficacy over the standard, single session BMI, c) does the combination of motivation-based intervention (BMI) with a skills-based intervention (EMI) yield even greater decreases in consequences (i.e., moderation). A final purpose of this research is to identify mechanisms of behavior change to optimize intervention development. Specifically, we will be examining PBS norms, PBS perceived effectiveness, and motivation to change PBS use as novel mediators of the improved interventions. Results can be used to disseminate more effective college drinking interventions that are cheaper and more efficacious at reducing alcohol problems, not just use.

Public Health Relevance

The proposed study seeks to test the efficacy and mechanisms of technology-based alcohol interventions (i.e., delivered via a computer or mobile device). Two novel interventions will be developed that focus on increasing the effective use of protective behavioral strategies in high-risk alcohol-use situations. Because they would be cost-effective, easy to disseminate, and administered repeatedly, these interventions could have a broad impact on a serious public health concern if efficacy is demonstrated.

National Institute of Health (NIH)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Research Project (R01)
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National Institute on Alcohol Abuse and Alcoholism Initial Review Group (AA)
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Shirley, Mariela
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Old Dominion University
Schools of Arts and Sciences
United States
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Bravo, Adrian J; Pearson, Matthew R; Stevens, Leah E et al. (2018) Weighing the Pros and Cons of Using Alcohol Protective Behavioral Strategies: A Qualitative Examination among College Students. Subst Use Misuse 53:2190-2198