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Efficacy of expectancy challenge interventions to reduce college student drinking: a meta-analytic review.

ABSTRACT: Interventions challenging alcohol expectancies may lead to reductions in alcohol consumption. We conducted a meta-analysis to examine the efficacy of alcohol expectancy challenge (EC) interventions for college alcohol abuse prevention. Included were 14 studies (19 EC interventions) that measured alcohol expectancies and consumption, provided sufficient information to calculate effect sizes, and were available as of June 2010 (N=1,415; M age=20 years; 40% women; 88% White). Independent raters coded participant characteristics, design and methodological features, and intervention content, and calculated weighted mean effect sizes at first follow-up, using both fixed and random effects models. Compared with controls, EC participants reported lower positive alcohol expectancies, reduced their alcohol use, and reduced their frequency of heavy drinking (d+s ranged from 0.23 to 0.28). Within-group improvements in alcohol expectancies and consumption emerged for the EC group only; relative to their own baseline, EC participants reported lower positive alcohol expectancies, reduced their alcohol use, and reduced their frequency of heavy drinking (d+s ranged from 0.13 to 0.36). Supplemental analyses found improvements in specific alcohol expectancies (social, sexual, tension, and arousal) both between groups and within group. The short-term effects of EC interventions on college student drinking are not maintained at follow-ups greater than 4 weeks.

SUBMITTER: Scott-Sheldon LA

PROVIDER: S-EPMC3381876 | biostudies-literature | 2012 Sep

REPOSITORIES: biostudies-literature

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Efficacy of expectancy challenge interventions to reduce college student drinking: a meta-analytic review.

Scott-Sheldon Lori A J LA Terry Danielle L DL Carey Kate B KB Garey Lorra L Carey Michael P MP

Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors 20120319 3

Interventions challenging alcohol expectancies may lead to reductions in alcohol consumption. We conducted a meta-analysis to examine the efficacy of alcohol expectancy challenge (EC) interventions for college alcohol abuse prevention. Included were 14 studies (19 EC interventions) that measured alcohol expectancies and consumption, provided sufficient information to calculate effect sizes, and were available as of June 2010 (N=1,415; M age=20 years; 40% women; 88% White). Independent raters cod ...[more]

PMID: 22428862

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Project description:For over 2 decades, brief motivational interventions (BMIs) have been implemented on college campuses to reduce heavy drinking and related negative consequences. Such interventions include in-person motivational interviews (MIs), often incorporating personalized feedback (PF), and stand-alone PF interventions delivered via mail, computer, or the Web. Both narrative and meta-analytic reviews using aggregate data from published studies suggest at least short-term efficacy of BMIs, although overall effect sizes have been small.This study was an individual participant-level data (IPD) meta-analysis of 17 randomized clinical trials evaluating BMIs. Unlike typical meta-analysis based on summary data, IPD meta-analysis allows for an analysis that correctly accommodates the sampling, sample characteristics, and distributions of the pooled data. In particular, highly skewed distributions with many zeroes are typical for drinking outcomes, but have not been adequately accounted for in existing studies. Data are from Project INTEGRATE, one of the largest IPD meta-analysis projects to date in alcohol intervention research, representing 6,713 individuals each with 2 to 5 repeated measures up to 12 months postbaseline.We used Bayesian multilevel over dispersed Poisson hurdle models to estimate intervention effects on drinks per week and peak drinking, and Gaussian models for alcohol problems. Estimates of overall intervention effects were very small and not statistically significant for any of the outcomes. We further conducted post hoc comparisons of 3 intervention types (individual MI with PF, PF only, and group MI) versus control. There was a small, statistically significant reduction in alcohol problems among participants who received an individual MI with PF. Short-term and long-term results were similar.This study questions the efficacy and magnitude of effects of BMIs for college drinking prevention and intervention and suggests a need for the development of more effective intervention strategies.

Project description:Norms clarification has been identified as an effective component of college student drinking interventions, prompting research on norms clarification as a single-component intervention known as Personalized Normative Feedback (PNF). Previous reviews have examined PNF in combination with other components but not as a stand-alone intervention.To investigate the degree to which computer-delivered stand-alone personalized normative feedback interventions reduce alcohol consumption and alcohol-related harms among college students and to compare gender-neutral and gender-specific PNF.Electronic databases were searched systematically through November 2014. Reference lists were reviewed manually and forward and backward searches were conducted.Outcome studies that compared computer-delivered, stand-alone PNF intervention with an assessment only, attention-matched, or active treatment control and reported alcohol use and harms among college students.Between-group effect sizes were calculated as the standardized mean difference in change scores between treatment and control groups divided by pooled standard deviation. Within-group effect sizes were calculated as the raw mean difference between baseline and follow-up divided by pooled within-groups standard deviation.Eight studies (13 interventions) with a total of 2,050 participants were included. Compared to control participants, students who received gender-neutral (dbetween = 0.291, 95% CI [0.159, 0.423]) and gender-specific PNF (dbetween = 0.284, 95% CI [0.117, 0.451]) reported greater reductions in drinking from baseline to follow-up. Students who received gender-neutral PNF reported 3.027 (95% CI [2.171, 3.882]) fewer drinks per week at first follow-up and gender-specific PNF reported 3.089 (95% CI [0.992, 5.186]) fewer drinks. Intervention effects were small for harms (dbetween = 0.157, 95% CI [0.037, 0.278]).Computer-delivered PNF is an effective stand-alone approach for reducing college student drinking and has a small impact on alcohol-related harms. Effects are small but clinically relevant when considered from a public health perspective. Additional research is needed to examine computer-delivered, stand-alone PNF as a population-level prevention program.

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Efficacy of expectancy challenge interventions to reduce college student drinking: a meta-analytic review.

Publications

Efficacy of expectancy challenge interventions to reduce college student drinking: a meta-analytic review.

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