Personalized feedback tempers weekend increases in alcohol use among nonstudent emerging adult drinkers

A common pattern of problematic alcohol consumption among emerging adults consists of little to no drinking during the week, with heavy drinking episodes on the weekend. However, little is known about whether brief alcohol interventions exert impact on decreasing weekend drinking escalations or simply overall consumption throughout the week. A recent randomized controlled trial of heavy drinking emerging adult nonstudents (N = 164) demonstrated the efficacy of a personalized feedback intervention (PFI). Specifically, the PFI was associated with reduced overall alcohol consumption relative to assessment-only controls. However, it is not clear if patterns of weekend drinking escalation may have been disrupted by the intervention. The current study was a follow-up analysis of the parent trial. Using retrospective daily drinking data provided at each timepoint (up to 9-months), data were coded to reflect condition, time (coded to capture initial changes post-intervention as well as long-term maintenance), and day of the week (coded to capture weekend versus weekday). A multilevel negative binomial hurdle analysis was conducted, yielding two sets of results: 1) predicting the probability of a non-drinking day, and 2) predicting number of drinks consumed. Although the three-way interaction was not significant, 2 two-way interactions indicated that weekend increases in drinking were less steep over time for both groups, and less steep for PFI participants. In addition, the higher weekend likelihood of drinking was decreased over time for both groups. Steep weekend increases in drinking were disrupted over time, particularly among PFI recipients. Personalized feedback may be effective at helping nonstudent emerging adults avoid high risk drinking situations.

Mediators and Moderators of a Personalized Feedback Alcohol Intervention for Nonstudent Emerging Adult Drinkers

BACKGROUND

The main objective of this study was to test proposed mediators and moderators of a personalized feedback alcohol intervention (PFI) on alcohol use. Data for the current investigation came from an earlier randomized controlled trial of a PFI targeted for nonstudent heavy drinkers between 18 and 25 years.

METHODS

Participants were 164 (65.9% men) drinkers recruited from the community. They were randomly assigned to either a single-session PFI or an assessment-only (AO) control group. Follow-up assessments at 1 and 3 months were included for analysis.

RESULTS

Perceived drinking norms mediated the intervention effect on quantity, frequency, and peak drinking; 2 dimensions of protective behavioral strategies (PBS) mediated the intervention effect on peak drinking; and drinking to cope motives did not mediate any drinking outcomes. Of the moderating factors examined (i.e., norms, PBS, drink to cope motives, age, gender), only PBS related to serious harm reduction moderated intervention impact. Specifically, for those high in serious harm reduction PBS at baseline, postintervention reductions in drinking were stronger for the PFI group compared to AO.

CONCLUSIONS

Overall, findings highlight the importance of correcting misperceived drinking norms and addressing the use of specific PBS in brief interventions. The knowledge gained from this study represents an important step toward minimizing drinking-related harms that are disproportionately experienced by those with lower educational attainment.

A Randomized Trial of a Personalized Feedback Intervention for Nonstudent Emerging Adult At-Risk Drinkers

BACKGROUND

Emerging adulthood is a period of heightened vulnerability for problematic alcohol use. Considerable research has been devoted to reducing alcohol risks in college student populations, although far less effort has focused on their noncollege-attending peers. Research targeting nonstudent emerging adults is critical as this group is at risk of experiencing alcohol-related harms. Consequently, the main objective of the present randomized study was to examine the preliminary efficacy of a brief personalized feedback intervention (PFI) tailored for nonstudent at-risk drinkers. We also examined the influence of gender on intervention outcomes. Finally, we explored participant acceptability of the intervention.

METHODS

Participants were 164 (65.9% men) emerging adults (M age = 21.98, SD = 2.02) recruited from the community. They were randomly assigned to either a 50-minute, in-person PFI or an assessment-only control group and were assessed over 9 months postintervention.

RESULTS

Results showed that for short-term change (1 month), the PFI condition reduced drinking significantly more than controls. For longer-term change (1 to 9 months), both conditions continued to show gradual decline in consumption. The groups did not differ in alcohol-related problems, and the intervention was equally effective for both women and men. Regarding acceptability, participants were extremely satisfied with the intervention, perceived the information to be personally relevant, and thought it provided them a new way of looking at their own drinking.

CONCLUSIONS

Overall, the present research advanced knowledge regarding an understudied and at-risk group of drinkers. This is among one of the first randomized studies to evaluate a brief intervention tailored to the needs of nonstudent emerging adults based on prior formative research with this group. Our data support PFI as a promising intervention approach for nonstudent drinkers in the community. Ultimately, this line of research aims to reduce alcohol-related health disparities associated with inequities in education.

Motivations and Consequences of Alcohol Use among Heavy Drinking Nonstudent Emerging Adults

Research suggests that nonstudent emerging adults may be at elevated risk for alcohol-related problems in adulthood. The present study utilized a qualitative approach to broaden our understanding of the drinking-related perceptions and experiences of heavy drinking nonstudents, with the ultimate goal of generating meaningful knowledge that could aid intervention planning. Research aims were to identify nonstudent (1) drinking motivations and (2) drinking consequences. Eleven focus groups were conducted (n = 64 participants). Data analytic techniques were used to code transcripts and generate themes emerging from the group data. Analyses revealed three main themes emerged regarding nonstudent reasons for drinking (i.e., emotional, social, enhanced experiences). Four prominent themes were identified for drinking consequences (i.e., physical health, psychological health, risk-taking, life functioning). Our findings underscore several considerations related to intervening with this at-risk and understudied population.

A latent profile analysis of drinking patterns among nonstudent emerging adults

Research indicates that nonstudent emerging adults, as compared to their college-attending peers, are at higher risk for experiencing alcohol-related problems, including alcohol use disorders. The present study sought to extend the limited research on nonstudent drinking by (1) identifying sub-groups of nonstudent drinkers based on their drinking patterns and (2) determining the extent to which social-cognitive between-person factors related to drinking (i.e., social expectancies, perceived drinking norms, social drinking motivations) distinguish these sub-groups. Participants were 195 (65.1% men) nonstudent emerging adult heavy episodic drinkers recruited from the community. Mean age was 21.88 (SD=2.08) years and 45.4% were unemployed. Latent profile analysis identified two classes based on drinking across 30days. The "moderate drinkers" group (n=143; 73.3%) reported consuming 10-11 drinks weekly and drinking two to three times per week, on average. The "heavy drinkers" class (n=52; 26.7%) reported consuming 42-43 drinks weekly and drinking six to seven days per week. Both groups exhibited a cyclic pattern of drinking whereby weekday drinking was lower, with increases on the weekend; the heavy drinkers class had stronger weekend increases starting earlier. Heavy drinkers reported greater volume, frequency, and problematic drinking behaviors, as compared to the moderate drinkers. The heavy drinkers class also endorsed stronger social motives and perceived their peers to drink more. The present study offered unique insights into nonstudent emerging adult drinking patterns by identifying sub-populations of drinkers based on their past 30-day use. Knowledge gained from this study could aide in tailoring existing alcohol interventions to nonstudents to reduce alcohol-related harms.