The malleability of injunctive norms among college students. Confidence Limits for the Indirect Effect: Distribution of the Product and Resampling Methods Personalized mailed feedback for college drinking prevention: a randomized clinical trial. Conceptual and design essentials for evaluating mechanisms of change. Self-affirmation, intentions and alcohol consumption in students: a randomized exploratory trial. An examination of college student activities and attentiveness during a web-delivered personalized normative feedback intervention. Correcting injunctive norm misperceptions motivates behavior change: a randomized controlled sun protection intervention. Challenging implicit and explicit alcohol-related cognitions in young heavy drinkers. Mailed personalized normative feedback as a brief intervention for at-risk college drinkers. Evaluation of a single-session expectancy challenge intervention to reduce alcohol use among college students. A randomized clinical trial comparing the efficacy of two active conditions of a brief intervention for heavy college drinkers. Preventing College Women’s Sexual Victimization Through Parent Based Intervention: A Randomized Controlled Trial Perceived Norms Mediate Effects of a Brief Motivational Intervention for Sanctioned College Drinkers. The efficacy of a targeted personalized drinking feedback intervention among intercollegiate athletes: a randomized controlled trial. What makes group MET work? A randomized controlled trial of college student drinkers in mandated alcohol diversion. Dismantling motivational interviewing and feedback for college drinkers: a randomized clinical trial. Comparison of participatively set and assigned goals in the reduction of alcohol use. Effects of a brief motivational intervention with college student drinkers. A randomized controlled trial of a behavioral economic supplement to brief motivational interventions for college drinking. Efficacy of web-based personalized normative feedback: a two-year randomized controlled trial. Heavy drinking across the transition to college: predicting first-semester heavy drinking from precollege variables. Brief motivational intervention and alcohol expectancy challenge with heavy drinking college students: a randomized factorial study. The efficacy of single-component brief motivational interventions among at-risk college drinkers. Improving the effectiveness of computer-delivered personalized drinking feedback interventions for college students. Brief motivational and parent interventions for college students: a randomized factorial study. Internet-based personalized feedback to reduce 21st-birthday drinking: a randomized controlled trial of an event-specific prevention intervention. Optimizing personalized normative feedback: the use of gender-specific referents. Distribution of the product confidence limits for the indirect effect: Program PRODCLIN A randomized clinical trial evaluating a combined alcohol intervention for high-risk college students. Brief intervention for heavy-drinking college students: 4-year follow-up and natural history. Motivational interventions for heavy drinking college students: examining the role of discrepancy-related psychological processes. Efficacy of counselor vs. computer-delivered intervention with mandated college students. Computerized versus motivational interviewing alcohol interventions: impact on discrepancy, motivation, and drinking. Brief motivational interventions for heavy college drinkers: A randomized controlled trial. Readiness to change in brief motivational interventions: a requisite condition for drinking reductions? Readiness to change as a mediator of the effect of a brief motivational intervention on posttreatment alcohol-related consequences of injured emergency department hazardous drinkers.
Alcohol use among college students has been associated with injunctive norms , which refer to the perceived acceptability of excessive drinking , and descriptive norms , which refer to perceptions of actual drinking . The purpose of this study was to examine the effect of a brief injunctive norms manipulation on both injunctive and descriptive norms about drinking alcohol and to explore differences in the malleability of norms across referent groups , sex , and gender role . Participants were 265 undergraduates ( 43 % male , 70 % freshmen ) who completed a web-based survey for course credit . A r and omly selected half was exposed to a page of information-based feedback about typical student injunctive norms . Relative to the control condition , the manipulation produced lower injunctive and descriptive norms related to typical students ' drinking but no change in either type of norm related to close friends . Femininity was associated with less permissive normative beliefs about the acceptability of excessive drinking whereas masculinity was associated with elevated perceptions of peer drinking , but neither sex nor gender role moderated the manipulation effect . We conclude that perceptions of peer approval of drinking are malleable with a very brief information-based manipulation The most commonly used method to test an indirect effect is to divide the estimate of the indirect effect by its st and ard error and compare the result ing z statistic with a critical value from the st and ard normal distribution . Confidence limits for the indirect effect are also typically based on critical values from the st and ard normal distribution . This article uses a simulation study to demonstrate that confidence limits are imbalanced because the distribution of the indirect effect is normal only in special cases . Two alternatives for improving the performance of confidence limits for the indirect effect are evaluated : ( a ) a method based on the distribution of the product of two normal r and om variables , and ( b ) resampling methods . In Study 1 , confidence limits based on the distribution of the product are more accurate than methods based on an assumed normal distribution but confidence limits are still imbalanced . Study 2 demonstrates that more accurate confidence limits are obtained using resampling methods , with the bias-corrected bootstrap the best method overall The current study was design ed to evaluate the efficacy of a mailed feedback and tips intervention as a universal prevention strategy for college drinking . Participants ( N = 1,488 ) were r and omly assigned to feedback or assessment -only control conditions . Results indicated that the mailed feedback intervention had a preventive effect on drinking rates overall , with participants in the feedback condition consuming less alcohol at follow-up in comparison with controls . In addition , abstainers in the feedback condition were twice as likely to remain abstinent from alcohol at follow-up in comparison with control participants ( odds ratio = 2.02 ) , and feedback participants were significantly more likely to refrain from heavy episodic drinking ( odds ratio = 1.43 ) . Neither gender nor severity of baseline drinking moderated the efficacy of the intervention in these analyses , but more conservative analyses utilizing last-observation carryforward suggested women and abstainers benefited more from this prevention approach . Protective behaviors mediated intervention efficacy , with participants who received the intervention being more likely to use strategies such as setting limits and alternating alcohol with nonalcoholic beverages . Implication s of these findings for universal prevention of  college  drinking are discussed BACKGROUND Considerable progress has been made toward the development of evidence -based treatments for a wide range of psychological disorders ; however , little is known about the mechanisms through which these treatments actually lead to clinical change . Although the use of traditional r and omized controlled treatment design s and tests of statistical mediation have significantly advanced underst and ing of psychological treatments , they are insufficient to test mechanisms of change . METHOD This article outlines the conceptual and method ological requirements for evaluating mechanisms of change , highlights the importance of such a focus , and offers specific recommendations for research aim ed at elucidating change mechanisms . RESULTS AND CONCLUSIONS Conceptualizing and conducting studies that test mechanisms of change requires substantial modifications to traditional research design s , but doing so will significantly enhance scientific underst and ing as well as the efficiency and effectiveness of clinical interventions AIMS This study tests whether enhancing alcohol risk messages with self-affirmation , the process of focusing on cherished aspects of oneself , increases intentions to reduce alcohol consumption and reduces actual alcohol consumption . It was also examined whether these effects differed by risk status as indicated by st and ard drinks consumed in an average week . METHODS Participants ( n = 121 ) were r and omly allocated to a self-affirmation or matched control condition before viewing emotive graphic alcohol warning posters in a question naire-based study . RESULTS There were significant increases in intentions to reduce alcohol consumption in self-affirmed participants , and these effects were stronger in participants with higher behavioural risk . Intentions in turn significantly predicted a reduction in self-reported alcohol consumption . CONCLUSIONS These findings support the use of self-affirmation to enhance alcohol awareness campaigns , particularly in individuals with high behavioural risk Both heavy drinking and related risky sexual behavior among college students are common and are often associated with a number of negative consequences . A previously reported r and omized controlled trial showed that a brief personalized normative feedback ( PNF ) intervention reduced the alcohol consumption and alcohol-related risky sexual behavior of heavy drinking , sexually active college students ( Lewis et al. , 2014 ) . For the present study , we examined what activities students were engaged in when viewing the feedback , as well as who they were with and where they were when receiving the intervention . Furthermore , we conducted supplemental analyses with perceived attentiveness as a hypothesized predictor of change using the same sample ( N = 480 ) . Findings indicated that most students were engaged in activities when viewing the feedback and that most students viewed the feedback alone and at home . Furthermore , results revealed PNF to be most effective in reducing drinks per week among participants who reported greater attention . Clinical implication s and suggestions for additional research examining how attentiveness can be increased during Web-based interventions are discussed OBJECTIVE Despite long-st and ing social psychological research supporting the influence of injunctive norms ( i.e. , what is commonly approved or disapproved ) on behavior , support for this influence on health behaviors is limited . We examined the utility of correcting misperceptions of injunctive norms for improving sun protection and whether changes in attitudes mediated the injunctive norm-intention relationship . METHOD At baseline 263 community residing primarily White women , aged 37 to 77 years , reported their beliefs about sun protection and tanning and their perceptions of " typical women 's " approval of sun protection versus tanning . Women underestimated approval of sun protection and overestimated approval of tanning . In a r and omized trial , 189 of these women received either information about sun protection or information plus personalized normative feedback ( PNF ) . PNF compared each woman 's own perceptions of typical women 's approval of tanning and sun protection with actual normative values , both measured at baseline . PNF communicated that most women approve of others who sun protect . RESULTS PNF led to more positive sun protection injunctive norms , attitudes , and intentions at immediate posttest and more positive intentions and self-reported behavior at 4-week follow-up . Baseline discrepancy between a woman 's beliefs and actual normative values related negatively to changes in sun protection in the control condition but positively in the PNF condition . As hypothesized , changes in attitudes partially mediated the influence of PNF on changes in intentions . CONCLUSIONS The present research demonstrates the utility of correcting injunctive norm misperceptions for promoting healthy behaviors . That attitudes changed in response to PNF and mediated the norm-intention relationship suggests a method for influencing attitudes that may limit reactance AIMS To test whether an expectancy challenge ( EC ) changes implicit and explicit alcohol-related cognitions and binge drinking in young heavy drinkers . This is important for theoretical and practical reasons : the EC presents a critical test for the hypothesized mediational role of alcohol cognitions and the EC has been presented as a promising intervention to counter alcohol problems in heavy drinking youth . SETTING , PARTICIPANTS AND INTERVENTION : Ninety-two heavy drinking college and university students ( half women ) were assigned r and omly to the EC or control condition ( a sham alcohol experiment in the same bar-laboratory ) . MEASUREMENTS Explicit alcohol cognitions and alcohol use were assessed with paper- and -pencil measures . Alcohol use was assessed prior to the experiment and during a 1-month follow-up . Implicit alcohol-related cognitions were assessed with two versions of the  Implicit Association Test  ( IAT ) , adapted to assess implicit valence and arousal associations with alcohol . FINDINGS AND CONCLUSIONS The EC result ed in decreased explicit positive arousal expectancies in men and women alike . There was some evidence for a differential reduction in implicit arousal associations , but findings depended on the version of the IAT and on the scoring-algorithm used . In men ( but not in women ) there was a short-lived differential reduction in prospect i ve alcohol use ( significant in week 3 of the follow-up ) , and this reduction was partially mediated by the decrease in explicit positive arousal expectancies . These findings suggest that an EC successfully changes explicit alcohol cognitions and that this may have short-lived beneficial effects in heavy drinking young men OBJECTIVE The current study examined the efficacy of mailed personalized normative feedback ( PNF ) as a brief alcohol intervention for at-risk college drinkers , and investigated discrepancy as a possible mediator of the intervention effect . METHOD Participants consisted of 100 at-risk college drinkers who completed an alcohol-use assessment at baseline , 6-week posttest and 6-month follow-up . Measures included number of drinks consumed per heaviest drinking week , frequency of heavy-drinking episodes , peak blood alcohol concentration and number of alcohol-related problems , all for the last month . Participants were r and omly assigned to either a mailed brief intervention ( MBI ; n = 49 ) or attention-control ( C ; n = 51 ) group . The MBI group received mailed PNF that was based on baseline responses to the drinking measures ; the C group received a psychoeducational brochure about alcohol . RESULTS Mixed-model , repeated measures ANOVAs were used to examine the effects of time , group and gender on discrepancy and the drinking variables . Following the intervention , the MBI group reported significantly higher perceived discrepancy between self and others ' drinking than the C group . The MBI group reported consuming significantly fewer drinks per heaviest drinking week and engaging in heavy episodic drinking less frequently than the C group at the 6-week posttest ; however , these differences were no longer evident at the 6-month follow-up . Hierarchical regression analyses did not provide evidence for the hypothesized mediating effect of discrepancy . CONCLUSIONS Mailed PNF may be a cost- and time-efficient means of developing discrepancy and temporarily reducing heavy alcohol consumption among at-risk college drinkers In this study , the authors developed and evaluated a single-session experiential expectancy challenge ( EC ) intervention , seeking to reduce alcohol use by changing key positive expectancies among moderate to heavy drinking male and female college students . Participants ( N=217 ) were r and omly assigned to attend a 90- to 120-min EC session , CD-ROM alcohol education , or assessment only . Participants were assessed at pretest , posttest , and 1-month follow-up . Exposure to the EC intervention led to significant decreases in alcohol expectancies and subsequent alcohol consumption in both genders at follow-up . No significant changes were evident in either control condition . This study is the first to effectively decrease expectancies and drinking in college students  with a single-session EC intervention . Further , although several studies have demonstrated the utility of the intervention with men , it is the first to do so with women . This study represents a critical step in the process of translating an innovative , theory-based intervention into a more practical format that makes it more accessible to those who seek effective drinking-reduction strategies for college campuses Brief interventions for college heavy drinkers have shown promise in reducing drinking and alcohol-related negative consequences . However , intervention duration , content , method of delivery , and follow-up length vary across studies . It therefore remains unclear whether intervention length significantly influences the interventions ' efficacy . The present study is a r and omized clinical trial systematic ally evaluating the efficacy of two brief interventions aim ed at reducing alcohol use and alcohol-related negative consequences among college student drinkers . Treatment mediators were also evaluated . Participants ( N=278 ) were , on average , 20.1 years old ( SD=2.4 ) , mostly Caucasian ( 87 % ) and female ( 71 % ) . They were r and omly assigned to a 10-minute brief intervention , a 50-minute brief intervention , or an attention-control group . Both active interventions were provided by clinical graduate students trained in Brief Alcohol Screening and Intervention for College Students ( BASICS ) . As hypothesized , participants in both active conditions significantly reduced their alcohol consumption , as compared to the control group participants F(2,264)=9.84 , p=.00 , η(2)=.07 . There were no significant differences in alcohol-related negative consequences F(2,264)=3.08 , p=.06 , η(2)=.02 . The hypothesized mediators , alcohol drinking norms and coping behavioral strategies , explained significant variance in intervention efficacy , but neither self-efficacy nor alcohol expectancies were significant mediators . Given the preliminary nature of our investigation , more research is warranted to determine parameters of the critical mechanisms of change within brief alcohol interventions with college student drinkers A r and omized controlled trial , using parent-based intervention ( PBI ) was design ed to reduce the incidence of alcohol-involved sexual victimization among first-year college students . The PBI , adapted from Turrisi et al. ( 2001 ) , was design ed to increase alcohol-specific and general communication between mother and daughter . Female graduating high school seniors and their mothers were recruited from the community and r and omly assigned to one of four conditions : Alcohol PBI ( n = 305 ) , Enhanced Alcohol + Sex PBI ( n = 218 ) , Control ( n = 288 ) or Unmeasured Control ( n = 167 ) . Mothers in the intervention conditions were provided an informational h and book and encouraged to discuss its contents with their daughters prior to college matriculation . Consistent with hypotheses , PBI , either st and ard or enhanced , was associated with lower incidence of incapacitated rape in the first year of college relative to controls . Path analysis revealed support for a hypothesized indirect effects model , by which intervention increased mother-daughter communication , which predicted lower frequency of first semester heavy episodic drinking , result ing in lower rates of alcohol-involved sexual victimization in the first year of college The present study is a secondary analysis of a r and omized trial of brief motivational interventions ( BMI s ) for 198 college students sanctioned for alcohol-related violations of school policy ( Carey , Henson , Carey , & Maisto , 2009 ) . Using multivariate latent growth curve models , we evaluated theoretically-derived mediators of the observed BMI effect : motivation to change ( readiness-to-change , costs and benefits of drinking ) , and drinking norms ( injunctive norms for peers , and descriptive norms for friends , local peers , and national peers ) . Results provided partial support for mediation by changes in perceptions of descriptive but not injunctive norms , a pattern that varied by gender and norm type . We found no evidence of a mediating role for any of the motivational variables College athletes are an at-risk population for excessive alcohol use and subsequent alcohol-related harms . The purpose of this study was to test the efficacy of an electronically delivered personalized drinking feedback ( PDF ) intervention targeted specifically to college athletes , both in comparison with a st and ard ( i.e. , nontargeted ) PDF intervention and an education-only ( EO ) condition that also included targeted information . Data were collected on 263 intercollegiate athletes from three colleges ( 76 % women , 86 % White ) who were r and omly assigned to one of the conditions . Results provided partial support for the efficacy of the targeted PDF intervention . Students in the targeted PDF condition reported a lower peak blood alcohol concentration ( BAC ) at the 6-month follow-up than those in the other conditions . Heavy drinking students in the targeted PDF condition reported a lower peak BAC than those in the other conditions at the 1-month follow-up and a lower peak BAC than those in the EO condition at the 6-month follow-up . Finally , in-season athletes in the targeted PDF condition reported fewer drinks per week than those in the PDF-st and ard condition at the 1-month follow-up . These findings provide preliminary support for the use of targeted PDF interventions with at-risk alcohol users , such as college athletes Nationally , college drinkers exhibit the highest rates of alcohol consumption and represent the largest percentage of problem drinkers . Group motivational enhancement therapy ( GMET ) has been found to catalyze problem drinking reductions among college student sample s. Although research supporting the use of single-session GMET in college sample s ( general and m and ated ) is emergent , no studies have evaluated a comprehensive model of the potential active ingredients of this group intervention . College students ( N = 206 ; 88 % White ; 63 % men ; M age = 18.6 ) m and ated to a university alcohol diversion program were r and omly assigned to 1 of 3 conditions : the st and ard-of-care 2-session " Focus on Alcohol Concerns " education group ( FAC ) , a single GMET , or a single alcohol information-only control group ( AI ) to evaluate the role of 5 putative mediators : readiness to change , self-efficacy , perceived risk , norm estimates , and positive drinking expectancies . At 3- and 6-month follow-ups , GMET students demonstrated greater reductions in problem drinking outcomes ( drinks per drinking day , hazardous drinking symptoms , and alcohol-related problems ) . Of the 5 mediators proposed , only self-efficacy emerged as a significant mediator Motivational interviewing ( MI ) is a counseling style that has been shown to reduce heavy drinking among college students . To date , all studies of MI among college students have used a format that includes a feedback profile delivered in an MI style . This study was a dismantling trial of MI and feedback among heavy-drinking college students . After an initial screen , 279 heavy-drinking students were r and omized to ( a ) Web feedback only , ( b ) a single MI session without feedback , ( c ) a single MI session with feedback , or ( d ) assessment only . At 6 months , MI with feedback  significantly reduced drinking , as compared with assessment only ( effect size = .54 ) , MI without feedback ( effect size = .63 ) , and feedback alone ( effect size = .48 ) . Neither MI alone nor feedback alone differed from  assessment  only . Neither sex , race or ethnicity , nor baseline severity of drinking moderated the effect of the intervention . Norm perceptions mediated the effect of the intervention on drinking . MI with feedback appears to be a robust intervention for reducing drinking and may be mediated by changes in normative perceptions The effects of setting goals on goal commitment , self-efficacy for goal achievement , and goal achievement in the context of an alcohol use intervention were examined using an experimental design in which  participants were r and omized to participatively set goals , assigned goals , and no goal conditions .  One hundred and twenty-six heavy-drinking college students received a single cognitive-behavioral assessment /intervention session and completed measures of goal commitment , self-efficacy for goal achievement , and alcohol use . Results were consistent with , and exp and ed upon , previous research by demonstrating that having a goal for limiting alcohol consumption was predictive of lower quantity and frequency of alcohol use relative to not having a goal . Participation in goal setting yielded greater goal commitment and self-efficacy for goal achievement than assigned goals , but did not result in significantly greater reductions in alcohol use relative to assigned goals . Goal commitment and self-efficacy explained unique variance in the prediction of alcohol use at follow-up . Findings support the importance of goal setting in alcohol interventions and suggest areas for further research This study consisted of a r and omized controlled trial of a 1-session motivational intervention for college student binge drinkers . Sixty students who reported binge drinking 2 or more times in the past 30 days were r and omly assigned to either a no-treatment control or a brief intervention group . The intervention provided students with feedback regarding personal consumption , perceived drinking norms , alcohol-related problems , situations associated with heavy drinking , and alcohol expectancies . At 6-week follow-up , the brief intervention group exhibited significant reductions on number of drinks consumed per week , number of times drinking alcohol in the past month , and frequency of binge drinking in the past month . Estimates of typical student drinking mediated these reductions . This study replicates earlier research on the efficacy of brief interventions with college students and extends previous work regarding potential mechanisms of change OBJECTIVE Behavioral economic theory suggests that a reduction in substance use is most likely when there is an increase in rewarding substance-free activities . The goal of this r and omized controlled clinical trial was to evaluate the incremental efficacy of a novel behavioral economic supplement ( Substance-Free Activity Session [ SFAS ] ) to a st and ard alcohol brief motivational interviewing ( BMI ) session for heavy-drinking college students . METHOD Participants were 82 first-year college students ( 50 % female ; 81.7 % White/European American ; M age = 18.5 years , SD = 0.71 ) who reported 2 or more past-month heavy drinking episodes . After completing a baseline assessment and an individual alcohol-focused BMI , participants were r and omized to either the SFAS or to a Relaxation Training ( RT ) control session . The SFAS was delivered in an MI style and attempted to increase the salience of delayed academic and career rewards and the patterns of behavior leading to those rewards . RESULTS The combination of an alcohol BMI plus the SFAS was associated with significantly greater reductions in alcohol problems compared with an alcohol BMI plus RT at the 1-month and 6-month follow-up assessment s ( p = .015 , ηp² = .07 ) , an effect that was partially mediated by increases in protective behavioral strategies . BMI + SFAS was also associated with greater reductions in heavy drinking among participants who at baseline reported low levels of substance-free reinforcement or symptoms of depression . CONCLUSION These results are consistent with behavioral economic theory and suggest that a single session focused on increasing engagement in alternatives to drinking can enhance the effects of brief alcohol interventions OBJECTIVE Web-based brief alcohol interventions have the potential to reach a large number of individuals at low cost ; however , few controlled evaluations have been conducted to date . The present study was design ed to evaluate the efficacy of gender-specific versus gender-nonspecific personalized normative feedback ( PNF ) with single versus biannual administration in a 2-year r and omized controlled trial targeting a large sample of heavy-drinking college students . METHOD Participants included 818 freshmen ( 57.6 % women ; 42 % non-Caucasian ) who reported 1 or more heavy-drinking episodes in the previous month at baseline . Participants were r and omly assigned in a 2 ( gender-specific vs. gender-nonspecific PNF ) × 2 ( single vs. biannual administration of PNF ) + 1 ( attention control ) design . Assessment s occurred every 6 months for a 2-year period . RESULTS Results from hierarchical generalized linear models provided modest effects on weekly drinking and alcohol-related problems but not on heavy episodic drinking . Relative to control , gender-specific biannual PNF was associated with reductions over time in weekly drinking ( d = -0.16 , 95 % CI [ -0.02 , -0.31 ] ) , and this effect was partially mediated by changes in perceived norms . For women , but not men , gender-specific biannual PNF was associated with reductions over time in alcohol-related problems relative to control ( d = -0.29 , 95 % CI [ -0.15 , -0.58 ] ) . Few other effects were evident . CONCLUSIONS The present research provides modest support for the use of biannually administered web-based gender-specific PNF as an alternative to more costly indicated prevention strategies Parents , public health officials , college personnel , and society at-large continue to be concerned about the increase in heavy drinking that occurs across the transition to college , prompting alcohol research ers to continue the search for effective interventions . In this report we use data from a large ( N=3720 ) prospect i ve study to ( 1 ) estimate how predictable heavy drinking in the first semester of college is on the basis of information obtained prior to college and ( 2 ) identify precollege variables that are important predictors of heavy drinking in the first semester . We found that first-semester heavy drinking is highly predictable , primarily because of continuity from precollege heavy drinking , but also from precollege peer drinking norms , precollege other substance use ( esp . tobacco use ) , and precollege party motivation for attending college . These findings have implication s for both the timing and targets of interventions . Interventions timed to occur prior to college and /or in the early months of college may disrupt the momentum of previously established drinking behavior . Furthermore , interventions may be most effective if they target conjoint alcohol and tobacco use , college party motivation , and self- selection into heavy-drinking social environments This study is the first reported test of the unique and combined effects of Brief Motivational Intervention ( BMI ) and Alcohol Expectancy Challenge ( AEC ) with heavy drinking college students . Three hundred and thirty-five participants were r and omly assigned in a 2x2 factorial design to either : BMI , AEC , BMI and AEC , and assessment only conditions . Follow-ups occurred at 1 , 3 , and 6 months . Unconditional latent curve analyses suggested that alcohol use ( Q-F ) , heavy episodic drinking , and alcohol problems were best modeled as quadratic effects . BMI produced significant decreases in Q-F , heavy drinking , and problems , while AEC produced significant decreases in Q-F and heavy drinking . There was no evidence of an additive effect of combining the interventions . Intervention effects decayed somewhat for BMI and completely for AEC over 6 months . Multi-group analyses suggested similar intervention effects for men and women . BMI effects on alcohol problems were mediated by perceived norms . These findings extend previous research with BMI and AEC but do not support their utility as a combined preventive intervention to reduce collegiate alcohol abuse OBJECTIVE College students are an at-risk population for heavy drinking and negative alcohol-related outcomes . Research has established that brief , multicomponent motivational interviewing-based interventions can be effective at reducing alcohol use or related problems , but less is known about the efficacy of individual components within these interventions . The purpose of this study was to test the efficacy of 2 single-component , in-person , brief ( 15 - 20 min ) alcohol interventions : personalized normative feedback ( PNF ) and protective behavioral strategies feedback ( PBSF ) . METHOD Data were collected on 365 undergraduate students from a large Midwestern university ( 65 % women ; 89 % White ) who were r and omly assigned to 1 of 3 conditions : PNF , PBSF , or alcohol education ( AE ) . Participants completed measures of alcohol use , alcohol-related problems , social norms , and protective behavioral strategies . RESULTS Results indicated that the PNF intervention was efficacious relative to the other conditions at reducing alcohol use and that its effects at 6-month follow-up were mediated by changes in perceived norms at the 1-month follow-up . The PBSF intervention was not efficacious at reducing alcohol use or alcohol-related problems . CONCLUSIONS These findings provide support for the efficacy of an in-person PNF intervention and theoretical support for the hypothesized mechanisms of change in the intervention . Implication s for research ers and clinicians are discussed This study evaluated methods of enhancing college students ' retention of information provided to them in a computer-delivered personalized drinking feedback intervention and whether enhanced retention reduced alcohol consumption during the two-week period following the intervention . Participants were 98 college students who reported at least one heavy drinking episode in the past two weeks . After participating in an online , personalized drinking feedback intervention , students were r and omly assigned to one of three experimental conditions : 1 ) typical , in which they were simply sent home , 2 ) reading , in which they were asked to spend the next 20 minutes re-reading the feedback , and 3 ) recall , in which they were asked to spend the next 20 minutes writing down as much of the information from the feedback as they could remember . Two weeks following the intervention , participants completed a recall test and provided information on their alcohol use during the previous two weeks . Results indicated that participants in the reading and recall conditions retained more of the feedback information than did participants in the typical condition . In addition , participants in the reading and recall conditions reported reduced alcohol consumption in the two-week period following the intervention , compared to those in the typical condition . Information retention partially mediated the effects of the reading and recall conditions on drinking outcomes OBJECTIVE Using a r and omized factorial design , we examined the efficacy of a brief motivational intervention ( BMI ) and a parent-based intervention ( PBI ) as universal preventive interventions to reduce alcohol use among incoming college students . METHOD Participants ( N = 1,014 ) were assessed prior to matriculation and at 10 months and 22 months postbaseline . Two-part latent growth modeling was used to simultaneously examine initiation and growth in heavy episodic drinking and alcohol-related consequences . RESULTS This study retained 90.8 % ( n = 921 ) of r and omized students at the 10-month follow-up and 84.0 % ( n = 852 ) of r and omized students at the 22-month follow-up . BMI participants were significantly less likely than non- BMI participants to initiate heavy episodic drinking and to begin experiencing alcohol-related consequences . Effect sizes were minimal at 10 months ( Cohen 's h ranged from 0.02 to 0.07 ) and were small at 22 months ( hs ranged from 0.15 to 0.22 ) . A significant BMI x PBI interaction revealed that students receiving both the BMI and the PBI were significantly less likely to report the onset of consequences beyond the sum of the individual intervention effects ( h = 0.08 at 10 months , and h = 0.21 at 22 months ) . Hypothesized direct BMI effects for reductions in heavy episodic drinking and consequences were not observed . Significant mediated effects via changes in descriptive norms were present for both growth and initiation of heavy episodic drinking and consequences . CONCLUSIONS To our knowledge , the current study is the first to provide support for BMI as a universal preventive intervention for incoming college students . Although hypothesized PBI main effects were not found , mediation analyses suggest future refinements could enhance PBI effectiveness This article presents an initial r and omized controlled trial of an event-specific prevention intervention .  Participants included 295 college students ( 41.69 % male , 58.31 % female ) who intended to consume 2 or more drinks on their 21st birthday . Participants completed a screening/baseline assessment approximately 1 week before they turned 21 and were r and omly assigned to receive Web-based personalized feedback or assessment only . Feedback included normative information , protective behaviors , and personalized blood alcohol concentration information . A follow-up assessment was completed approximately 1 week after a student 's birthday . Results indicated a significant intervention effect in reducing estimated blood alcohol concentration ( d = 0.33 ) . The intervention effect was moderated by 21st-birthday drinking intentions , and the intervention was primarily effective among those who intended to reach higher levels of intoxication . Results provide some support for normative information as a mediator of intervention efficacy . Overall results provide support for Web-based personalized feedback as an intervention approach for specific events associated with extreme drinking OBJECTIVE Many brief interventions include personalized normative feedback ( PNF ) using gender-specific or gender-neutral referents . Several theories suggest that information pertaining to more socially proximal referents should have greater influence on one 's behavior compared with more socially distal referents . The current research evaluated whether gender specificity of the normative referent employed in PNF related to intervention efficacy . METHOD Following baseline assessment , 185 college students ( 45.2 % women ) were r and omly assigned to one of three intervention conditions : gender-specific feedback , gender-neutral feedback , or assessment -only control . Immediately after completing measures of perceived norms , alcohol consumption , and gender identity , participants in the gender-neutral and gender-specific intervention conditions were provided with computerized information detailing their own drinking behavior , their perceptions of student drinking , and actual student drinking . RESULTS After a 1-month follow-up , the results indicated that normative feedback was effective in changing perceived norms and reducing alcohol consumption for both intervention groups for women and men . The results provide support , however , for changes in perceived gender-specific norms as a mediator of the effects of normative feedback on reduced drinking behavior for women only . Additionally , gender-specific feedback was found to be more effective for women higher in gender identity , relative to the gender-neutral feedback . A post- assessment follow-up telephone survey administered to assess potential dem and characteristics corroborated the intervention effects . CONCLUSIONS Results extend previous research documenting efficacy of computer delivered PNF . Gender specificity and gender identity appear to be important elements to consider for PNF intervention efficacy for women This article describes a program , PRODCLIN ( distribution of the PRODuct Confidence Limits for INdirect effects )  , written for SAS , SPSS , and R , that computes confidence limits for the product of two normal r and om variables . The program is important because it can be used to obtain more accurate confidence limits for the indirect effect , as demonstrated in several recent articles ( MacKinnon , Lockwood , & Williams , 2004 ; Pituch , Whittaker , & Stapleton , 2005 ) . Tests of the significance of and confidence limits for indirect effects based on the distribution of the product method have more accurate Type I error rates and more power than other , more commonly used tests . Values for the two paths involved in the indirect effect and their st and ard errors are entered in the PRODCLIN program , and distribution of the product confidence limits are computed . Several examples are used to illustrate the PRODCLIN program . The PRODCLIN programs in rich text format may be downloaded from www.psychonomic.org/archive OBJECTIVE The current study is a multisite r and omized alcohol prevention trial to evaluate the efficacy of both a parenting h and book intervention and the Brief Alcohol Screening and Intervention for College Students ( BASICS ) intervention , alone and in combination , in reducing alcohol use and consequences among a high-risk population of matriculating college students ( i.e. , former high school athletes ) . METHOD Students ( n = 1,275 ) completed a series of Web-administered measures at baseline ( in the summer before starting college ) and follow-up ( after 10 months ) . Students were r and omized to one of four conditions : parent intervention only , BASICS only , combined ( parent and BASICS ) , and assessment -only control . Intervention efficacy was tested on a number of outcome measures , including peak blood alcohol concentration , weekly and weekend drinking , and negative consequences . Hypothesized mediators and moderators of intervention effect were tested . RESULTS The overall results revealed that the combined-intervention group had significantly lower alcohol consumption , high-risk drinking , and consequences at 10-month follow-up , compared with the control group , with changes in descriptive and injunctive peer norms mediating intervention effects . CONCLUSIONS The findings of the present study suggest that the parent intervention delivered to students before they begin college serves to enhance the efficacy of the BASICS intervention , potentially priming students to respond to the subsequent BASICS session OBJECTIVES This study examined long-term response to an individual preventive intervention for high-risk college drinkers relative to the natural history of college drinking . METHODS A single-session , individualized preventive intervention was evaluated within a r and omized controlled trial with college freshmen who reported drinking heavily while in high school . An additional group r and omly selected from the entire screening pool provided a normative comparison . Participant self-report was assessed annually for 4 years . RESULTS High-risk controls showed secular trends for reduced drinking quantity and negative consequences without changes in drinking frequency . Those receiving the brief preventive intervention reported significant additional reductions , particularly with respect to negative consequences . Categorical individual change analyses show that remission is normative , and they suggest that participants receiving the brief intervention are more likely to improve and less likely to worsen regarding negative drinking consequences . CONCLUSIONS Brief individual preventive interventions for high-risk college drinkers can achieve long-term benefits even in the context of maturational trends The authors examined the effects of a brief motivational intervention for heavy , episodic alcohol use on discrepancy-related psychological processes . Heavy-drinking college students ( N=73 ) were r and omly assigned to a motivationally based intervention ( MBI ) or an assessment -only control ( AC ) condition . Cognitive ( actual-ideal discrepancy ) and affective ( 2 forms of cognitive dissonance ) discrepancy processes were assessed at baseline and immediately following the experimental manipulation . At 6-week follow-up , MBI participants demonstrated significantly greater reductions in problematic drinking than AC participants . Moreover , actual-ideal discrepancy and negative , self-focused dissonance were significantly increased following the intervention ( discomfort-related dissonance was not ) and were correlated with outcome alcohol involvement . These discrepancy processes did not , however , mediate the relationship between condition and outcome . The findings lend some support to the role of discrepancy enhancement in drinking-related behavior change among college students The purpose of this study was to evaluate the efficacy of two brief interventions and the inclusion of a 1-month booster session with college students who were referred to attend alcohol education following an alcohol-related incident . Participants ( N=225 ; 48.9 % male ) were r and omly assigned to receive one session of a Brief Motivational Interview ( BMI ) or computer-delivered intervention ( CDI ) with the Alcohol 101 CD-ROM . Participants were also r and omly assigned to booster/no booster . At 3-month follow up , participants in BMI reported greater help seeking and use of behavioral strategies to moderate drinking . At 12-month follow up , BMI participants were drinking more frequently and CDI participants were consuming a greater number of drinks per occasion than at baseline . Mediation analyses showed that the use of specific behavioral strategies mediated the effect of the BMI condition on drinking volume . There was no intervention effect on alcohol problems , and the booster condition did not significantly affect outcomes . Promoting specific behaviors in the context of in-person brief interventions may be a promising approach to reducing drinking volume among identified at-risk students The authors conducted two r and omized clinical trials with ethnically diverse sample s of college student drinkers in order to determine ( a ) the relative efficacy of two popular computerized interventions versus a more comprehensive motivational interview approach ( BASICS ) and ( b ) the mechanisms of change associated with these interventions . In Study 1 , heavy drinking participants recruited from a student health center ( N = 74 , 59 % women , 23 % African American ) were r and omly assigned to receive BASICS or the Alcohol 101 CD-ROM program . BASICS was associated with greater post-session motivation to change and self-ideal and normative discrepancy relative to Alcohol 101 , but there were no group differences in the primary drinking outcomes at 1-month follow-up . Pre to post session increases in motivation predicted lower follow-up drinking across both conditions . In Study 2 , heavy drinking freshman recruited from a core university course ( N = 133 , 50 % women , 30 % African American ) were r and omly assigned to BASICS , a web-based feedback program ( e-CHUG ) , or assessment -only . BASICS was associated with greater post-session self-ideal discrepancy than e-CHUG , but there were no differences in motivation or normative discrepancy . There was a significant treatment effect on typical weekly and heavy drinking , with participants in BASICS reporting significantly lower follow-up drinking relative to assessment only participants . In Study 2 , change in the motivation or discrepancy did not predict drinking outcomes . Across both studies , African American students assigned to BASICS reported medium effect size reductions in drinking whereas African American students assigned to Alcohol 101 , e-CHUG , or assessment did not reduce their drinking In this r and omized controlled trial , the authors evaluated brief motivational interventions ( BMI s ) for at-risk college drinkers . Heavy drinking students ( N = 509 ; 65 % women , 35 % men ) were r and omized into 1 of 6 intervention conditions formed by crossing the baseline Timeline Followback ( TLFB ) interview ( present versus absent ) and intervention type ( basic BMI , BMI enhanced with a decisional balance module , or none ) . Assessment s completed at baseline , 1 , 6 , and 12 months measured typical and risky drinking as well as drinking-related problems . Relative to controls , the TLFB interview  reduced consumption but not problems at 1 month . The basic BMI improved all drinking outcomes beyond the effects of the TLFB interview at 1 month , whereas the enhanced BMI did not . Risk reduction achieved by brief interventions maintained throughout the follow-up year Brief motivational interventions ( BMI s ) have been found to be efficacious for reducing alcohol use and consequences among college student drinkers . Despite the putative emphasis on motivation , surprisingly little is known about the role of motivation in BMI -facilitated changes . Using data from three published r and omized trials implementing BMI s , we examined  motivation or readiness to change ( RTC ) as a potential mechanism of behavior change . Two of the three studies indicated that BMI were associated with increases in motivation to change alcohol use that are apparent immediately after BMI sessions and persist up to 6-months post-intervention . However , RTC does not appear to be a mechanism of behavior change , as it did not mediate reductions in alcohol use or problems in any of the studies . Issues regarding the conceptualization and measurement of RTC are discussed , as well as promising directions for future research Brief motivational interventions ( BMI s ) are usually effective for reducing alcohol use and consequences in primary care setting s. We examined readiness to change drinking as a mediator of the effects of BMI on alcohol-related consequences .  Participants were r and omized into three conditions : ( a ) st and ard care plus assessment ( SC ) , ( b ) SC plus BMI ( BI ) , and ( c ) BI plus a booster session ( BIB ) . At 12-month follow-up BIB patients had significantly reduced alcohol consequences more than had SC patients . Patients receiving BI or BIB maintained higher readiness scores 3 months after treatment than did patients receiving SC . However , readiness mediated treatment effects only for those highly motivated to change prior to the intervention but not for those with low pre-intervention motivation . BI and BIB for these patients decreased alcohol consequences in part because they enhanced and maintained readiness for those highly motivated prior to the intervention , but not for those with low motivation . Results are opposite of what would be expected from MI theory . An alternative explanation is offered as to why this finding occurred with this opportunistically recruited Emergency Department patient population
Interventions to reduce college student drinking , although efficacious , generally yield only small effects on behavior change .
Examining mechanisms of change may help to improve the magnitude of intervention effects by identifying effective and ineffective active ingredients .
Informed by guidelines for establishing mechanisms of change , we conducted a systematic review of alcohol interventions for college students to identify ( a ) which constructs have been examined and received support as mediators , ( b ) circumstances that enhance the likelihood of detecting mediation , and ( c ) the extent of evidence for mechanisms of change .