title: Providing web-based feedback and social norms information to reduce student alcohol intake: a multisite investigation.
abstract: BACKGROUND
  Unhealthy alcohol use among university students is cause for concern, yet the level of help seeking behavior for alcohol use is low within the student population. Electronic brief interventions delivered via the Internet present an alternative to traditional treatments and could enable the delivery of interventions on a population basis. Further evidence is needed of the effectiveness of Internet-delivered interventions and of their generalizability across educational institutions.
  
  
  OBJECTIVE
  Our objective was to evaluate the effectiveness across 4 UK universities of a Web-based intervention for student alcohol use.
  
  
  METHODS
  In total, 1112 participants took part. Participants were stratified by educational institution, gender, age group, year of study, and self-reported weekly consumption of alcohol and randomly assigned to either the control arm or to the immediate or delayed intervention arms. Intervention participants gained access to the intervention between weeks 1 to 7 or weeks 8 to 15, respectively. The intervention provided electronic personalized feedback and social norms information on drinking behavior accessed by logging on to a website. Participants registered interest by completing a brief screening questionnaire and were then asked to complete 4 further assessments across the 24 weeks of the study. Assessments included a retrospective weekly drinking diary, the Alcohol Use Disorders Identification Test (AUDIT), and a readiness-to-change algorithm. The outcome variable was the number of units of alcohol consumed in the last week. The effect of treatment arm and time on units consumed last week and average units consumed per drinking occasion were investigated using repeated measures multivariate analysis of covariance (MANCOVA). In addition, the data were modeled using a longitudinal regression with time points clustered within students.
  
  
  RESULTS
  MANCOVA revealed a main effect of time on units of alcohol consumed over the last week. A longitudinal regression model showed an effect of assessment across time predicting that participants who completed at least 2 assessments reduced their drinking. The model predicted an additional effect of being assigned to an intervention arm, an effect that increased across time. Regression analysis predicted that being male or being assigned to an intervention arm increased the odds of not completing all assessments. The number of units of alcohol consumed over the last week at registration, age, university educational institution, and readiness to change were not predictive of completion.
  
  
  CONCLUSIONS
  Delivering an electronic personalized feedback intervention to students via the Internet can be effective in reducing weekly alcohol consumption. The effect does not appear to differ by educational institution. Our model suggested that monitoring alone is likely to reduce weekly consumption over 24 weeks but that consumption could be further reduced by providing access to a Web-based intervention. Further research is needed to understand the apparent therapeutic effect of monitoring and how this can be utilized to enhance the effectiveness of brief Web-based interventions.
authors.affiliation: Academic Unit of Psychiatry and Behavioural Sciences, Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom. B.M.Bewick@leeds.ac.uk
authors.forename: Bridgette M
authors.initials: BM
authors.lastname: Bewick
authors.forename: Robert
authors.initials: R
authors.lastname: West
authors.forename: Jan
authors.initials: J
authors.lastname: Gill
authors.forename: Fiona
authors.initials: F
authors.lastname: O'May
authors.forename: Brendan
authors.initials: B
authors.lastname: Mulhern
authors.forename: Michael
authors.initials: M
authors.lastname: Barkham
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Hill
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D019973:Alcohol-Related Disorders / Q000517:prevention & control / Q000523:psychology; D003194:Computer-Assisted Instruction / Q000706:statistics & numerical data; D030141:Feedback, Psychological; D005260:Female; D015438:Health Behavior; D006266:Health Education / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D010349:Patient Compliance / Q000706:statistics & numerical data; D015397:Program Evaluation; D012657:Self-Help Groups; D012938:Social Perception; D013334:Students / Q000523:psychology / Q000706:statistics & numerical data*; D013813:Therapy, Computer-Assisted / Q000379:methods / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D006113:United Kingdom; D055815:Young Adult