Responding to excessive alcohol consumption in third-level (REACT): a study protocol

Reducing drug-use harms among higher education students: MyUSE contextual-behaviour change digital intervention development using the Behaviour Change Wheel

BACKGROUND

Digital harm-reduction interventions typically focus on people with severe drug-use problems, yet these interventions have moderate effectiveness on drug-users with lower levels of risk of harm. The difference in effectiveness may be explained by differences in behavioural patterns between the two groupings. Harnessing behavioural theories to understand what is at the core of drug-use behaviours and mapping the content of new interventions, may improve upon the effectiveness of interventions for lower-risk drug-users. To the best of our knowledge, this is the first study to systematically apply the Behaviour Change Wheel (BCW) approach to understand the components, influencing capabilities, opportunities, and motivations (COM-B) of higher education students to change their drug-use behaviors. It is also the first study which identifies specific patterns of behaviours that are more responsive to harm reduction practices through the use of the Theoretical Domain Framework (TDF).

METHODS

We employed an explanatory sequential mix-method design. We first conducted an on-line survey and a Delphi exercise to understand the factors influencing COM-B components of higher education students to change their drug-use. Subsequently, we mapped all evidence onto the COM-B components and the TDF domains to identify clusters of behaviours to target for change, using a pattern-based discourse analysis. Finally, a series of multidisciplinary group meetings identified the intervention functions-the means by which the intervention change targeted behaviours and the Behavioural Change Techniques (BCTs) involved using the behaviour change technique taxonomy (v.1).

RESULTS

Twenty-nine BCTs relevant to harm-reduction practices were identified and mapped across five intervention functions (education, modelling, persuasion, incentivization, and training) and five policy categories (communication/marketing, guidelines, regulation, service provision, and environmental/social planning). These BCTs were distributed across eight identified saturated clusters of behaviours MyUSE intervention attempts to change.

CONCLUSIONS

The BCTs, identified, will inform the development of a digitally delivered behaviour change intervention that focuses on increasing mindful decision-making with respect to drug-use and promotes alternatives to drug-use activities. The findings can also inform implementation scientists in applying context-specific harm-reduction practices in higher education. We present examples of how the eight identified clusters of target behaviours are mapped across the COM-B components and the TDF, along with suggestions of implementation practices for harm reduction at student population level.

College students’ perspectives on an alcohol prevention programme and student drinking – A focus group study

Aim:

While there is considerable research on the efficacy of interventions designed to reduce alcohol consumption and related harms among college students, there is limited research on students’ own perspectives on such interventions. This qualitative study aimed to address this gap by examining college students’ perspectives in the context of an alcohol prevention programme for college students in Ireland.

Methods:

Focus groups were used as the means of data collection, and participants were selected using purposive sampling based on two criteria – type/location of college and category of student. A total of eight focus groups were conducted at two institutions taking part in the programme. Participants comprised four categories of student: undergraduates, mature students, international students and students who were members of clubs or societies. Results were analysed through the lens of a social-ecological framework.

Results:

The study findings indicated that students perceived alcohol as being endemic to college life and wider society. As a result, many of the students were sceptical or ambivalent regarding the potential efficacy of alcohol prevention programmes. Despite the perceived pervasiveness of alcohol, the study pointed to heterogeneity in drinking practices among the participants. Moreover, the study participants expressed divergent views when asked whose responsibility it was to control student alcohol consumption.

Conclusions:

Viewing the findings through a social-ecological lens, students seemed to collectively acknowledge the different layers of influence on student drinking, acknowledging the complex nature of this issue. Providing a greater variety of leisure spaces, including alcohol-free environments, was viewed particularly favourably by the student participants in terms of solutions proposed.

Responding to excessive alcohol consumption in third-level (REACT): a study protocol

BACKGROUND

Problem alcohol use is an ongoing, worldwide phenomenon of considerable concern. Throughout the past 20 years, national policies have noted the importance of students when tackling alcohol consumption. Considering alcohol is a multifaceted issue, a multi-component response is required to combat its excessive use. This protocol sets out the approach used for developing, implementing and evaluating the REACT (Responding to Excessive Alcohol Consumption in Third-level) Programme.

METHODS/DESIGN

This evaluation will provide the evidence base for programme development, implementation and improvement. Stage one involved defining the multi-component intervention. This was developed following a systematic review of existing literature and a Delphi-consensus workshop involving university students, staff and relevant stakeholders. Following this, the programme is being implemented across the Higher Education sector in Ireland. A number of Higher Education Institutes have declined the invitation to participate in the programme. These institutions will act as control sites. Each intervention site will have a steering committee whose membership will include a mix of students and academic and student service staff. This steering committee will report to the REACT research team on the implementation of mandatory and optional action points at local sites. An online cross-sectional study at baseline and two-years post intervention will be utilised to determine the impact of the REACT programme. The impact assessment will focus on (1) whether the intervention has reduced alcohol consumption among third-level students (2); whether the programme altered students attitudes toward alcohol and (3) whether the programme has decreased the second-hand effects associated with excessive consumption. Finally, qualitative research will focus on factors influencing the take-up and implementation of this programme as well as students' views on the initiative.

DISCUSSION

Alcohol consumption has remained on the policy agenda at both national and international level over recent decades. Students are regularly among the highest alcohol consumers, yet university management and public policymakers struggle to tackle this burgeoning issue. The REACT Programme provides a structure to translate policy into practice for those seeking to reduce hazardous alcohol consumption and related harms among third-level students.