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Pnf 2.0? Initial Evidence That Gamification Can Increase The Efficacy Of Brief, Web-Based Personalized Normative Feedback Alcohol Interventions, Sarah C. Boyle, Andrew M. Earle, Joseph W. Labrie, Daniel J. Smith

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Gamified interventions exploit the motivational characteristics of a game in order to provide prevention information and promote behavior change. Despite the modest effect sizes observed in increasingly popular web-based personalized normative feedback (PNF) alcohol interventions for college students, previous research has yet to consider how gamification might be used to enhance efficacy. This study examines whether a novel, gamified PNF intervention format, which includes a point-based reward system, the element of chance, and personal icons to visually represent users, is more effective in reducing short-term alcohol use than the standard web-based style of PNF currently used on college campuses. Two-hundred …

A Multi-Site Randomized Trial Of Normative Feedback For Heavy Drinking: Social Comparison Versus Social Comparison Plus Correction Of Normative Misperceptions, Clayton Neighbors, Melissa A. Lewis, Joseph W. Labrie, Angelo M. Dibello, Chelsie M. Young, Dipali V. Rinker, Dana Litt, Lindsey M. Rodriguez, C. Raymond Knee, Ezekiel Hamor, Jessica M. Jerabeck, Mary E. Larimer

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Objective

Given widespread alcohol misuse among college students, numerous intervention programs have been developed, including personalized normative feedback (PNF). Most research evaluating PNF assumes that presenting one's own perceived norms is necessary to correct normative misperceptions and thereby reduce drinking. Alternatively, simply providing social comparison information showing that one drinks more than others may be sufficient. The present study evaluated the efficacy of full PNF (one's own drinking, campus drinking rates, and perceived norms) and a partial personalized social comparison feedback (PSCF; one's own drinking and campus drinking rates) in a randomized trial among heavy-drinking college students.

Method

Participants included …

Trajectories Of Alcohol Use And Consequences In College Women With And Without Depressed Mood, Shannon Kenney, Caitlin C. Abar, Kimberly O'Brien, Gabrielle Clark, Joseph W. Labrie

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College students with depressed mood face heightened risk for experiencing drinking-related negative consequences. However, few studies have examined prospective patterns of alcohol consequences among depressed students. In the present investigation, we assessed how first-year college women’s trajectories of heavy episodic drinking (HED) and alcohol consequences differed as a function of depressed mood at college entry. Participants were 233 heavy drinking incoming first-year college females (61% White) at a mid-sized west coast university. Participants completed an online baseline survey, attended a single brief group intervention session, and completed 1- and 6-month post-intervention follow-up surveys. Depressed mood, alcohol consumption, and alcohol consequences …

Comparing The Unmatched Count Technique And Direct Self-Report For Sensitive Health-Risk Behaviors In Hiv+ Adults, Alyssa Arentoft, Kathleen Van Dyk, April D. Thames, Philip Sayegh, Nicholas Thaler, Daniel Schonfeld, Joseph W. Labrie, Charles H. Hinkin

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Researchers often rely on self-report measures to assess sensitive health-risk behaviors in HIV+ individuals, yet the accuracy of self-report has been questioned, particularly when inquiring about behaviors that may be embarrassing, risky, and/or taboo. We compared an anonymous reporting method—the Unmatched Count Technique (UCT)—to direct self-report in order to assess reporting differences for several health-risk behaviors related to medication adherence and sexual risk. Contrary to hypotheses, the UCT only produced a significantly higher estimated base rate for one sensitive behavior: reporting medication adherence to one's physician, which may have been contextually-primed by our study design. Our results suggest that anonymous …

The Efficacy Of A Standalone Protective Behavioral Strategies Intervention For Students Accessing Mental Health Services, Joseph W. Labrie, Lucy Napper, Elizabeth M. Grimaldi, Shannon R. Kenney, Andrew Lac

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Objective

Students with poor mental health are at increased risk for problematic alcohol use. These students also tend to underutilize alcohol-related protective behavioral strategies (PBS). Cross-sectional studies indicate that PBS use may be particularly useful for students with mental health challenges; however, it is unclear whether training these students to use PBS is an effective approach for reducing alcohol use and consequences. The current study evaluated the efficacy of a standalone PBS skills training and personalized feedback (PBS-STPF) intervention among students accessing mental health services.

Method

Participants (N = 251) were randomly assigned to either an individual facilitator-led PBS-STPF …

Alcohol Abstinence Or Harm-Reduction? Parental Messages For College-Bound Light Drinkers, Joseph W. Labrie, Sarah C. Boyle, Lucy Napper

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Parental communications about alcohol can have a significant impact on college students’ alcohol use; however, it is unclear what types of communication may be most beneficial for reducing alcohol risk, particularly among students who have already initiated alcohol use. The present research examines differences in alcohol use and employment of drinking protective behavioral strategies between pre-college matriculation high school seniors receiving predominantly abstinence parent messaging and students primarily receiving harm-reduction parent messaging. Students who identified as light drinkers were recruited during their last month in high school and completed an online assessment of alcohol use and parent alcohol communication. Analyses …

Gender As A Moderator Of The Relationship Between Preparty Motives And Event-Level Consequences, Lucy E. Napper, Shannon R. Kenney, Kevin S. Montes, Leslie J. Lewis, Joseph W. Labrie

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Prepartying is often associated with increased alcohol consumption and negative alcohol-related consequences among college students. General drinking motives are often only weakly related to preparty alcohol use, and few studies have examined the associations between preparty-specific drinking motives and alcohol-related consequences that occur during or after a preparty event. The current study utilizes event-level data to address this gap in the literature by examining the relationship between four types of preparty motives (prepartying to relax or loosen up, to increase control over alcohol use, to meet a dating partner, and to address concerns that alcohol may not be available later) …

The Longitudinal Relationships Among Injunctive Norms And Hooking Up Attitudes And Behaviors In College Students, Lucy Napper, Shannon R. Kenney, Joseph W. Labrie

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Limited research has explored the influence of perceived injunctive norms for distal (e.g., typical student) and proximal (e.g., close friend and parents) referents on hooking up. The current study examined the longitudinal relationships among perceived injunctive norms, personal approval and hooking up behavior, and the moderating effects of gender in a sample of heavy drinking college students. At Time 1, participants completed web-based assessments of personal approval of hooking up and perceptions of close friend, parent, and typical student approval. Three months later, participants reported on whether they had hooked up. The results of a path analysis indicated that greater …

Brief Motivational Interventions For College Student Drinking May Not Be As Powerful As We Think: An Individual Participant-Level Data Meta-Analysis, David Huh, Eun-Young Mun, Mary E. Larimer, Helene R. White, Anne E. Ray, Isaac C. Rhew, Su-Young Kim, Yang Jiao, David C. Atkins, The Project Integrate Team

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Background

For over two 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.

Method

The present 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 …

Project Integrate: An Integrative Study Of Brief Alcohol Interventions For College Students, Eun-Young Mun, Jimmy De La Torre, David C. Atkins, Helene R. White, Anne E. Ray, Su-Young Kim, Yang Jiao, Nickeisha Clarke, Yan Huo, Mary E. Larimer, David Huh, The Project Integrate Team

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This paper provides an overview of a study that synthesizes multiple, independently collected alcohol intervention studies for college students into a single, multisite longitudinal data set. This research embraced innovative analytic strategies (i.e., integrative data analysis or meta-analysis using individual participant-level data), with the overall goal of answering research questions that are difficult to address in individual studies such as moderation analysis, while providing a built-in replication for the reported efficacy of brief motivational interventions for college students. Data were pooled across 24 intervention studies, of which 21 included a comparison or control condition and all included one or more …

Parents' And Students' Perceptions Of College Alcohol Risk: The Role Of Parental Risk Perception In Intentions To Communicate About Alcohol, Lucy E. Napper, Elizabeth M. Grimaldi, Joseph W. Labrie

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Introduction: The current study aims to examine discrepancies in parents' and college students' perceptions of alcohol risk and the role of perceived risk in predicting parents' intentions to discuss alcohol with their child.

Methods: In total, 246 college student–parent dyads (56.1% female students, 77.2% mothers) were recruited from a mid-size university. Participants completed measures of absolute likelihood, comparative likelihood, and severity of alcohol consequences.

Results: In comparison to students, parents perceived the risks of alcohol poisoning (p < .001), academic impairment (p < .05), and problems with others (p < .05) to be more likely. In addition, parents rated the majority of alcohol consequences (e.g., passing out, regrettable sexual situation, throwing up) as more severe than students (all ps < .001). However, parents tended to be more optimistic than their child about the comparative likelihood of alcohol consequences. After controlling for demographics and past alcohol communication, greater absolute likelihood (β = .20, p = .016) and less confidence in knowledge of student behavior (β = .20, p = .013) predicted greater intentions to discuss alcohol.

Conclusions: Providing parents of college students with information about college drinking norms and the likelihood of alcohol consequences may help prompt alcohol-related communication.

Development And Validation Of The Hookup Motives Questionnaire (Hmq), Shannon R. Kenney, Andrew Lac, Justin F. Hummer, Joseph W. Labrie

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Despite the high prevalence rates and growing research on hooking up among college students, no multidimensional inventory exists in the literature to assess motivations for hooking up. In the current study, we report on the development and validation of the Hookup Motives Questionnaire (HMQ), designed to assess the various reasons for hooking up. Exploratory and confirmatory factor analyses were conducted using 2 samples of college students (Campus 1, N = 401; Campus 2, N = 367). Exploratory factor analysis was undertaken to explore the psychometric properties of an initial set of 25 items, and confirmatory factor analysis was conducted to …

Not Just Fun And Games: A Review Of College Drinking Games Research From 2004 To 2013, Byron L. Zamboanga, Shannon R. Kenney, Kathryne Van Tyne, Janine V. Olthuis, Christopher J. Correia, Lindsay S. Ham, Brian Borsari

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Drinking games are a high-risk social drinking activity consisting of rules and guidelines that determine when and how much to drink (Polizzotto et al., 2007). Borsari's (2004) seminal review paper on drinking games in the college environment succinctly captured the published literature as of February 2004. However, research on college drinking games has grown exponentially during the last decade, necessitating an updated review of the literature. This review provides an in-depth summary and synthesis of current drinking games research (e.g., characteristics of drinking games, and behavioral, demographic, social, and psychological influences on participation) and suggests several promising areas for future …

What Are Other Parents Saying? Perceived Parental Communication Norms And The Relationship Between Alcohol-Specific Parental Communication And College Student Drinking, Lucy Napper, Justin F. Hummer, Andrew Lac, Joseph W. Labrie

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This study examined parents’ normative perceptions of other college parents’ alcohol-specific communication, and how parents’ perceived communication norms and alcohol-specific communication relate to student drinking outcomes. A sample of 457 student-parent dyads were recruited from a mid-size university. Students completed web-based assessments of alcohol-related attitudes and behaviors. Parents completed alcohol-specific measures of communication norms and parent-child communication, including communication content (i.e., targeted communication) and frequency of communication. Results indicated that parents overestimated how much other parents talked to their college students about the frequency and quantity of alcohol use, but underestimated how often parents initiated conversations about alcohol. In a …

A Cross-Lagged Panel Model Examining Protective Behavioral Strategies: Are Types Of Strategies Differentially Related To Alcohol Use And Consequences?, Lucy E. Napper, Shannon R. Kenney, Andrew Lac, Leslie J. Lewis, Joseph W. Labrie

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Protective behavioral strategies (PBS) are skills that can be used to reduce the of risk alcohol-related negative consequences. Studies have shown that, in general, PBS are related to less alcohol consumption and fewer negative consequences; however, other studies have suggested that not all types of PBS (e.g., stopping/limiting drinking [SLD], manner of drinking [MOD] and serious harm reduction [SHR]) are equally effective at reducing alcohol risk. In addition, few studies have explored the longitudinal relationships among PBS, alcohol use and consequences. Using a sample of heavy drinking college students (N = 338), the current study examined PBS use, alcohol consumption …

Normative Feedback For Parents Of College Students: Piloting A Parent Based Intervention To Correct Misperceptions Of Students’ Alcohol Use And Other Parents’ Approval Of Drinking, Joseph W. Labrie, Lucy E. Napper, Justin F. Hummer

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Objective

Multi-component parent-based interventions (PBIs) provide a promising avenue for targeting alcohol use and related consequences in college students. Parents of college-aged children can have a significant influence on their children’s alcohol use decisions. However, parents tend to underestimate their own child’s alcohol use and overestimate other similar parents’ approval of student drinking. These misperceptions could have important implications for parents’ own attitudes and alcohol-related communication with their student. Targeting these misperceptions through normative feedback could help promote greater and more in-depth alcohol-related communication. The present study examines the potential efficacy of web-based alcohol-related normative feedback for parents of college …

Hooking Up In The College Context: The Event-Level Effects Of Alcohol Use And Partner Familiarity On Hookup Behaviors And Contentment, Joseph W. Labrie, Justin F. Hummer, Tehniat M. Ghaidarov, Andrew Lac, Shannon R. Kenney

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The current study examined hooking up experiences through event-level analyses, including the connections involving alcohol use, the extent of physical contact, and postevaluations of the hookup event. Participants were 828 college students (67.0% female). Of students who reported hooking up sometime within the past year (54.8%), chi-square analyses revealed that they were more likely to have been drinking when they met their partners the night of the hookup. Females who were drinking beforehand and females who met their partners that night were more likely to feel discontent with their hookup decisions. Among participants who consumed alcohol prior to their last …

Impulsivity And Alcohol-Related Risk Among College Students: Examining Urgency, Sensation Seeking And The Moderating Influence Of Beliefs About Alcohol's Role In The College Experience, Joseph W. Labrie, Shannon R. Kenney, Lucy E. Napper, Kevin Miller

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The personality trait of impulsivity is predictive of heavy drinking and consequences among college students. The current study examined how impulsivity—measured via positive urgency, negative urgency, and sensation seeking—and a person's beliefs about the role alcohol plays in the college experience relate to drinking and consequences in a sample of 470 college students (mean age = 19 years, 61.3% female, 59.8% white). In support of hypotheses, sensation seeking independently predicted greater drinking, and both positive and negative urgency predicted greater experience of alcohol-related negative consequences after controlling for consumption level. Moreover, alcohol beliefs moderated the relationship between impulsivity types and …

Use Of Protective Behavioral Strategies And Reduced Alcohol Risk: Examining The Moderating Effects Of Mental Health, Gender And Race, Shannon R. Kenney, Joseph W. Labrie

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Recent research indicates that protective behavioral strategies (PBS)—previously established as effective self-regulating tools for reducing alcohol risk among college students—may be especially useful for students with poor mental health, who are shown to be at heightened risk for alcohol-related harm. The current study examined the moderating influence of mental health (depression and anxiety severity), gender, and race (White, Asian) in the relationship between PBS use and alcohol-related negative consequences. Participants were 1,782 undergraduate students from two West Coast universities who reported past month incidence of heavy episodic drinking. Students reported on their drinking, experience of alcohol-related consequences, use of PBS, …

Rct Of Web-Based Personalized Normative Feedback For College Drinking Prevention: Are Typical Student Norms Good Enough?, Joseph W. Labrie, Melissa A. Lewis, David C. Atkins, Clayton Neighbors, Cheng Zheng, Shannon R. Kenney, Lucy E. Napper, Theresa Walter, Jason R. Kilmer, Justin F. Hummer, Joel Grossbard, Tehniat M. Ghaidarov, Sruti Desai, Christine M. Lee, Mary E. Larimer

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Objectives

Personalized normative feedback (PNF) interventions are generally effective at correcting normative misperceptions and reducing risky alcohol consumption among college students. However, research has yet to establish what level of reference group specificity is most efficacious in delivering PNF. This study compared the efficacy of a web-based PNF intervention employing eight increasingly-specific reference groups against a Web-BASICS intervention and a repeated-assessment control in reducing risky drinking and associated consequences.

Method

Participants were 1663 heavy drinking Caucasian and Asian undergraduates at two universities. The referent for web-based PNF was either the typical same-campus student, or a same-campus student at one (either …

Are They All The Same? An Exploratory, Categorical Analysis Of Drinking Game Types, Joseph W. Labrie, Phillip J. Ehret, Justin F. Hummer

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Drinking games have become a ubiquitous part of the college student drinking culture and are associated with drinking to intoxication and increased alcohol consequences. Contemporary research commonly considers drinking games holistically, with little to no consideration to the different drinking game types. The current study describes the creation of a novel DG categorization scheme and reports differences between DG categories. Participants were 3421 college students (58% female) who completed online surveys. Based on participant responses, 100 distinct drinking games were identified and defined. Two student focus groups were conducted in which drinking game definitions and rules were verified by students. …

Can You Say No? Examining The Relationship Between Drinking Refusal Self-Efficacy And Protective Behavioral Strategy Use On Alcohol Outcomes, Phillip J. Ehret, Tehniat M. Ghaidarov, Joseph W. Labrie

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Preliminary research has demonstrated reductions in alcohol-related harm associated with increased use of protective behavioral strategies (PBS) and higher levels of drinking refusal self-efficacy (DRSE). To extend research that has evaluated these protective factors independently of one another, the present study examined the interactive effects of PBS use and DRSE in predicting alcohol outcomes. Participants were 1084 college students (63% female) who completed online surveys. Two hierarchical linear regression models revealed that both DRSE and PBS use predicted alcohol use and consequences. Additionally, DRSE moderated the relationship between PBS use and both typical weekly drinking and negative alcohol-related consequences, such …

Event-Specific Risk And Ecological Factors Associated With Prepartying Among Heavier Drinking College Students, Justin F. Hummer, Lucy Napper, Phillip E. Ehret, Joseph W. Labrie

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Using event-specific data, the present study sought to identify relevant risk factors and risky drinking patterns associated with prepartying. Analyses focused on drinking outcomes as a function of drinking game playing and the social context on occasions where prepartying did and did not occur. This research utilized a representative two-site sample of prepartiers who also reported a heavy episodic drinking event in the past month (n = 988). Results revealed that during a preparty event, participants drank significantly more, reached higher blood alcohol levels (BALs), and experienced significantly more negative consequences compared to the last occasion that they drank but …

Injunctive Peer Misperceptions And The Mediation Of Self-Approval On Risk For Driving After Drinking Among College Students, Shannon R. Kenney, Joseph W. Labrie, Andrew Lac

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Of the alcohol-related risks faced by college students, it is arguable that none presents a greater public health hazard than driving after drinking (DAD). The present study examined the extent to which students’ injunctive misperceptions toward DAD predicted the likelihood to engage in DAD and how this relation was mediated by self-approval of DAD. Participants were 2,848 college students (59.1% female, 64.6% Caucasian) from two U.S. West Coast universities who completed confidential web-based surveys assessing DAD beliefs and behaviors. Results revealed that respondents tended to overestimate their peers’ approval toward DAD. Moreover, the subgroups likely to engage in DAD—men, 21+ …

I Can Play All Night: Examining The Relationship Between Perceived Tolerance And Drinking Game Alcohol Consumption, Phillip J. Ehret, Joseph W. Labrie, Justin F. Hummer

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The present study examined the impact of perceived tolerance to alcohol on maximum alcohol consumption while playing drinking games. Participants were student drinkers (N=3,546) from two west coast universities. Among these students, 69.2% (n=2,290) reported playing a drinking game in the past month. Analyses demonstrated game players had higher perceived tolerances, and consumed more alcohol than non-game players. A regression model revealed that higher levels of perceived tolerance were related to increased maximal alcohol consumption while playing drinking games. Study limitations and implications for future research are discussed.

Predicting Driving After Drinking Over Time Among College Students: The Emerging Role Of Injunctive Normative Perceptions, Joseph W. Labrie, Lucy E. Napper, Tehniat M. Ghaidarov

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Objective:

Despite prevention efforts, driving after drinking (DAD) is a prevalent high-risk behavior among college students and is a leading cause of death and injury. Examination of factors predicting future DAD behavior is necessary to develop efficacious targeted interventions to reduce this behavior among college students. The current study evaluated demographic, social cognitive, and behavioral predictors of DAD using longitudinal data.

Method:

Participants were 655 nonabstaining college students (67.2% female; 60.3% White; Mage = 19.3 years) who completed online surveys at two time points 12 months apart.

Results:

Results revealed that participants consistently overestimated their peers’ approval (injunctive norms) …

Measuring College Students’ Motives Behind Prepartying Drinking: Development And Validation Of The Prepartying Motivations Inventory, Joseph W. Labrie, Justin F. Hummer, Eric R. Pedersen, Andrew Lac, Taona Chithambo

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Drinking motives are vital in identifying risk factors and better understanding alcohol-related outcomes. However, context-specific motivations could provide greater motivational perspective on high-risk context-specific alcohol use behaviors such as prepartying (consuming alcohol prior to attending one’s intended destination) than general alcohol motivations. In the current study, students’ open-ended responses to reasons for prepartying were collected from a large diverse sample (n = 2497), and the most commonly offered reasons were used to create a prepartying motivations inventory (PMI) that was then administered to a different sample (n = 1085). A split-half validation procedure was used for the purpose …

Prevalence, Social Contexts, And Risks For Prepartying Among Ethnically Diverse College Students, Andrew P. Paves, Joseph W. Labrie, Eric R. Pedersen, Justin F. Hummer, Joseph W. Labrie

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Prepartying, also known as pre-gaming, has emerged as a high-risk drinking event among U.S. college students. Research on factors related to prepartying behavior is in its relative infancy. The present study provides prevalence rates for prepartying across ethnic groups and examines how social context (whether prepartying took place with primarily male, female, or coed groups) and demographic factors may influence prepartying behavior. Participants were students from two West Coast universities (N = 2,546) whom identified as White, Asian and Pacific Islander American (APIA), Hispanic/Latino(a), or African American. The percentage of students who reported prepartying at least once in the …

Estimates And Influences Of Reflective Opposite-Sex Norms On Alcohol Use Among A High-Risk Sample Of College Students: Exploring Greek-Affiliation And Gender Effects, Justin F. Hummer, Joseph W. Labrie, Andrew Lac, Ashley Sessoms, Jessica Cail

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Reflective opposite sex norms are behavior that an individual believes the opposite sex prefers them to do. The current study extends research on this recently introduced construct by examining estimates and influences of reflective norms on drinking in a large high-risk heterosexual sample of male and female college students from two universities. Both gender and Greek-affiliation served as potential statistical moderators of the reflective norms and drinking relationship. All participants (N = 1790; 57% female) answered questions regarding the amount of alcohol they believe members of the opposite sex would like their opposite sex friends, dates, and sexual partners …

Global Sleep Quality As A Moderator Of Alcohol Consumption And Consequences In College Students, Shannon R. Kenney, Joseph W. Labrie, Justin F. Hummer, Andy T. Pham

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The authors examined the relationship between global sleep quality and alcohol risk, including the extent to which global sleep quality moderated the relationship between alcohol use and drinking-related consequences. Global sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) and alcohol-related consequences were assessed using the Rutgers Alcohol Problem Index (RAPI). The sample consisted of 261 college students (61.3% female, 58.2% Caucasian) who completed online surveys. Using a four-step hierarchical multiple regression model, global sleep quality was found to predict alcohol consequences, over and above assessed covariates (demographics and weekly drinking). Further, global sleep quality emerged as a …