TY - JOUR
T1 - Main outcomes of M-bridge
T2 - A sequential multiple assignment randomized trial (SMART) for developing an adaptive preventive intervention for college drinking.
AU - Patrick, Megan E.
AU - Lyden, Grace R.
AU - Morrell, Nicole
AU - Mehus, Christopher J.
AU - Gunlicks-Stoessel, Meredith
AU - Lee, Christine M.
AU - King, Cheryl A.
AU - Bonar, Erin E.
AU - Nahum-Shani, Inbal
AU - Almirall, Daniel
AU - Larimer, Mary E.
AU - Vock, David M.
N1 - Publisher Copyright:
© 2021 American Psychological Association American Psychological Association
PY - 2021
Y1 - 2021
N2 - Objective: The goal was to develop a universal and resource-efficient adaptive preventive intervention (API) for incoming first-year students as a bridge to indicated interventions to address alcohol-related risks. The aims were to examine: (a) API versus assessment-only control, (b) the different APIs (i.e., 4 intervention sequences) embedded in the study design, and (c) moderators of intervention effects on binge drinking. Method: A sequential multiple assignment randomized trial (SMART) included two randomizations: timing (summer before vs. first semester) of universal personalized normative feedback and biweekly self-monitoring and, for heavy drinkers, bridging strategy (resource email vs. health coaching invitation). Participants (N = 891, 62.4% female, 76.8% White) were surveyed at the end of first and second semesters. The primary outcome was binge drinking frequency (4+/5+ drinks for females/males); secondary outcomes were alcohol consequences and health services utilization. Results: API (vs. control) was not significantly associated with outcomes. There were no differences between embedded APIs. Among heavy drinkers, the resource email (vs. health coach invitation) led to greater health services utilization. Moderator analyses suggested students intending to pledge into Greek life benefited more from any API (vs. control; 42% smaller increase from precollege in binge drinking frequency). Conclusions: Although overall effects were not significant, students at high risk (i.e., entering fraternities/sororities) did benefit more from the intervention. Furthermore, the resource email was effective for heavier drinkers. A technology-based strategy to deliver targeted resource-light interventions for heavy drinkers may be effective for reducing binge drinking during the transition to college. (PsycInfo Database Record (c) 2021 APA, all rights reserved) What is the public health significance of this article?—The study examined the effect of adaptive preventive interventions (APIs), which are interventions tailored over time to better meet the needs of individuals, on college student drinking. In this case, the APIs did not have overall effects for the student population of incoming first-year college students, but the APIs did reduce binge drinking for students intending to pledge into fraternities or sororities. For heavy-drinking students, a resource email providing a link to an online intervention (i.e., Web-BASICS) was more effective in increasing health services utilization than an invitation to chat with an online health coach. Such technology-based strategies to deliver targeted interventions require minimal resources and may be effective for supporting health for high-risk students during the transition to college.
AB - Objective: The goal was to develop a universal and resource-efficient adaptive preventive intervention (API) for incoming first-year students as a bridge to indicated interventions to address alcohol-related risks. The aims were to examine: (a) API versus assessment-only control, (b) the different APIs (i.e., 4 intervention sequences) embedded in the study design, and (c) moderators of intervention effects on binge drinking. Method: A sequential multiple assignment randomized trial (SMART) included two randomizations: timing (summer before vs. first semester) of universal personalized normative feedback and biweekly self-monitoring and, for heavy drinkers, bridging strategy (resource email vs. health coaching invitation). Participants (N = 891, 62.4% female, 76.8% White) were surveyed at the end of first and second semesters. The primary outcome was binge drinking frequency (4+/5+ drinks for females/males); secondary outcomes were alcohol consequences and health services utilization. Results: API (vs. control) was not significantly associated with outcomes. There were no differences between embedded APIs. Among heavy drinkers, the resource email (vs. health coach invitation) led to greater health services utilization. Moderator analyses suggested students intending to pledge into Greek life benefited more from any API (vs. control; 42% smaller increase from precollege in binge drinking frequency). Conclusions: Although overall effects were not significant, students at high risk (i.e., entering fraternities/sororities) did benefit more from the intervention. Furthermore, the resource email was effective for heavier drinkers. A technology-based strategy to deliver targeted resource-light interventions for heavy drinkers may be effective for reducing binge drinking during the transition to college. (PsycInfo Database Record (c) 2021 APA, all rights reserved) What is the public health significance of this article?—The study examined the effect of adaptive preventive interventions (APIs), which are interventions tailored over time to better meet the needs of individuals, on college student drinking. In this case, the APIs did not have overall effects for the student population of incoming first-year college students, but the APIs did reduce binge drinking for students intending to pledge into fraternities or sororities. For heavy-drinking students, a resource email providing a link to an online intervention (i.e., Web-BASICS) was more effective in increasing health services utilization than an invitation to chat with an online health coach. Such technology-based strategies to deliver targeted interventions require minimal resources and may be effective for supporting health for high-risk students during the transition to college.
KW - adaptive preventive intervention
KW - alcohol use
KW - college
KW - health services utilization
UR - http://www.scopus.com/inward/record.url?scp=85114111249&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85114111249&partnerID=8YFLogxK
U2 - 10.1037/ccp0000663
DO - 10.1037/ccp0000663
M3 - Article
C2 - 34383533
AN - SCOPUS:85114111249
SN - 0022-006X
VL - 89
SP - 601
EP - 614
JO - Journal of consulting and clinical psychology
JF - Journal of consulting and clinical psychology
IS - 7
ER -