The effectiveness of intervention studies to decrease alcohol use in college undergraduate students: an integrative analysis.
OBJECTIVE
This analysis was performed to critique intervention studies targeted at decreasing alcohol use in college students for the purpose of (1) synthesizing the various types of interventions and outcomes used, (2) evaluating the effectiveness of the interventions, and (3) identifying the strengths and limitations of prior studies to make recommendations for evidence-based clinical practice and future research.


METHODS
An exhaustive literature search was performed for experimental studies conducted in the past 10 years.


RESULTS
Analysis using 15 identified studies indicated the following strengths: (1) use of random assignment in many of the studies, (2) use of theoretical frameworks to guide the interventions, (3) replication of previous studies, and (4) inclusion of outcome measures of alcohol use, quantity, and frequency. Limitations included: (1) small convenience samples; (2) use of multiple tools to elicit outcomes, making it difficult to compare results across studies; (3) lack of long-term follow-up to assess sustainability of the interventions; (4) use of only self-report outcome measures, which rely on subject's recall memory; (5) lack of manipulation checks to assure that subjects actually processed the interventions; and (6) a paucity of stress and coping interventions.


CONCLUSIONS
Extensive research to address the problem of college alcohol use indicates that while education is an integral part of the approach for this problem, it is ineffective when used alone as an intervention strategy. However, some empirical support exists for the use of brief motivational interventions to reduce alcohol use and harm. A personalized approach addressing expectancies and normative use employing a motivational interviewing style may produce desired outcomes. In addition, theory-based manualized approaches using stress and coping intervention strategies need to be developed and tested. In the design of future studies, careful attention also should be given to methodological issues such as sampling, measurement issues, and inclusion of more long-term follow-up measures.
Hunter Fager
Judith
J
Center for High-Risk Children and Youth, University of Rochester School of Nursing, NY 14642, USA. Judith.Fager@urmc.rochester.edu
Mazurek Melnyk
Bernadette
B
D000428:Alcohol Drinking / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D001294:Attitude to Health; D002986:Clinical Trials as Topic; D003073:Cognitive Dissonance; D003376:Counseling; D019317:Evidence-Based Medicine / Q000458:organization & administration*; D005500:Follow-Up Studies; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D008403:Mass Screening; D015403:Nursing Evaluation Research / Q000458:organization & administration; D009742:Nursing Theory; D017063:Outcome Assessment, Health Care; D011614:Psychotherapy, Brief; D012107:Research Design; D012307:Risk Factors; D013333:Student Health Services; D013334:Students / Q000523:psychology / Q000706:statistics & numerical data; D014495:Universities