Sexual minority women in the United States are more likely to drink alcohol, engage in heavy drinking, and experience alcohol-related problems than are heterosexual women. Yet, to date, no evidence-based intervention or prevention efforts have been developed to reduce alcohol consumption in female sexual minority community settings. The proposed research seeks to narrow the disparity in alcohol intervention research by examining an innovative gamified personalized normative feedback (PNF) intervention to reduce drinking among members of a local sexual minority women community found to frequent Facebook and overestimate norms related to peers? general alcohol use and drinking to cope with sexual minority stigma. Our newly developed GANDR (Gamified Alcohol Norm Discovery and Readjustment) PNF format takes the well- established core components of a PNF alcohol intervention and delivers these components within an inviting, Facebook-connected, social game. This intervention format is designed to be more appealing, engaging, believable, positively received, and thus, effective than standard web-based PNF and can be culturally tailored to appeal to a number of different populations, including those typically hard to recruit into alcohol interventions. GANDR LA, the version developed for sexual minority women residing in Los Angeles County, delivers PNF on alcohol use and stigma-coping behaviors within the context of an online game about sexual minority stereotypes which incorporates users? Facebook photos to increase believability and a point-based reward system to increase motivation and engagement. In addition, to decrease defensive reactions and increase appeal, feedback topics are ostensibly selected by chance in GANDR LA with treatment PNF on alcohol use and stigma-coping behaviors provided alongside feedback on control topics of high interest to community members (e.g., activism, relationships, etc.). Additional appeal and credibility are gained through GANDR LA?s sponsorship and promotion by a collaborating sexual minority community non-profit organization viewed as a trusted source for health and social information by members of the target community. After documenting sexual minority community norms (AIM 1) through an initial round of play (N=1275), a sub-sample of 675 sexual minority female drinkers will be randomized to receive 1 of 3 unique sequences of feedback (i.e., Alcohol & Stigma-Coping, Alcohol & Control, or Control topics only) during 3 intervention rounds taking place over a 6-month period. The randomized feedback sequences and multiple rounds of play will allow us to determine whether PNF on alcohol use corrects drinking norms, and reduces sexual minority women?s alcohol consumption and negative consequences relative to PNF on control topics (AIM 2: H1), examine whether providing PNF on stigma-coping behaviors in addition to alcohol use further reduces alcohol use and consequences beyond standard alcohol PNF (AIM 2: H2), and identify mediators and moderators of intervention effectiveness (AIM 3).
The proposed project partners an expert research team with a trusted sexual minority community non-profit organization to deliver an innovative gamified web-based personalized normative feedback (PNF) alcohol and stigma-coping intervention to local sexual minority women, thus narrowing the disparity in alcohol intervention research and practice. Specifically, this research implements and evaluates the ability of a novel, Facebook-integrated PNF intervention disguised as an online game about harmful sexual minority female stereotypes to reduce sexual minority womens? alcohol use and negative consequences over a 6-month period.