Enhancing the Efficacy and Duration of a Brief Alcohol Intervention Using Self-Affirmation

项目总结/摘要 大量饮酒和相关的不良后果对美国大学和 大学;饮酒行为往往导致学生因违反校园酒精政策而受到制裁。 鉴于对这些学生广泛使用强制性酒精干预措施， 并且持续时间可以大大减轻酒精的不良后果。自我肯定代表着 有希望的辅助短暂的酒精干预，特别是那些通过计算机提供的流行，但 往往会产生较小的影响。基础研究表明，当自我肯定练习在收到 健康信息，他们减少防御和抵抗威胁健康信息，并增加 接受和处理健康信息。此外，自我肯定的促进作用是 在高风险人群中最强。因为许多强制学生表现出防御性和高 饮酒严重程度，使用自我肯定来增强信息处理并减少防御反应 可以优化积极酒精干预在这一高危亚群中的疗效。我们建议使用 两组随机设计，以调查在经验性自我肯定之前进行自我肯定练习的效果。 支持简短的酒精干预，包括计算机提供的个性化规范反馈（PNF）。 在学术与学生事务合作的广泛历史基础上，我们将招募450名 来自一所大型公立大学的学生在5个学期的课程。我们的主要目的是检查 在接受PNF（SA + PNF）之前，初始自我肯定（SA）操作相对于 对照组+ PNF对酒精使用和后果的影响。这项研究通过评估 自我肯定练习，以补充积极的酒精干预（而不仅仅是健康信息），以及 在更长的随访期（12个月）内跟踪对酒精使用的影响。次要目标包括（a） 测试理论推导的中介序列，解释SA + PNF对酒精使用和酒精的影响 后果，包括与自我肯定和短暂饮酒相关的行动机制 干预，和（B）SA + PNF对酒精使用的影响的理论调节剂的检查， 酒精的后果我们将使用潜在增长曲线模型分析， 干预对酒精使用的影响和（干预前）基线评估的后果轨迹 在1个月、3个月、6个月、9个月和12个月随访期间。这项研究的公共卫生目标是减少急性和 通过提高低强度短暂酒精干预的有效性来改善酒精滥用的慢性影响。的 本研究的结果具有实际和理论意义。证明了一个 非常简短的自我肯定练习可以提高现有计算机的效率和影响， 为强制学生提供干预措施;它也可能扩大自我肯定理论的范围， 适应自我肯定用于其他接受短暂酒精干预的高危人群。

PROJECT SUMMARY/ABSTRACT High volume drinking and related adverse consequences pose significant health concerns at US colleges and universities; drinking behavior often leads to students being sanctioned for violations of campus alcohol policy. Given the widespread use of mandated alcohol interventions for these students, optimizing their initial effects and their duration could substantially mitigate adverse alcohol outcomes. Self-affirmation represents a promising adjunct to brief alcohol interventions, particularly those delivered via computer that are popular but tend to have smaller effects. Basic research shows that when self-affirmation exercises precede the receipt of health information, they decrease defensiveness and resistance to threatening health information and increase acceptance and processing of health messages. Furthermore, the facilitative effects of self-affirmation are strongest among those at higher risk. Because many mandated students display both defensiveness and high drinking severity, use of self-affirmation to enhance information processing and reduce defensive responding could optimize the efficacy of an active alcohol intervention in this at-risk subpopulation. We propose to use a two-group randomized design to investigate the effect of a self-affirmation exercise prior to an empirically supported brief alcohol intervention consisting of computer-delivered personalized normative feedback (PNF). Building on an extensive history of academic-student affairs collaborations, we will recruit 450 mandated students from a large public university over the course of 5 semesters. Our primary aim is to examine the additive effects of an initial self-affirmation (SA) manipulation prior to receiving PNF (SA + PNF) relative to Control + PNF on alcohol use and consequences. This study extends prior work by evaluating the ability of self-affirmation exercises to supplement active alcohol interventions (rather than just health messages), and tracking the impact on alcohol use over a longer (12-month) follow-up period. Secondary aims include (a) testing theoretically-derived mediation sequences that explain the SA + PNF effects on alcohol use and alcohol consequences, incorporating mechanisms of action associated with both self-affirmation and brief alcohol interventions, and (b) the examination of theoretical moderators of the effects of SA + PNF on alcohol use and alcohol consequences. We will use latent growth curve modeling analyses to examine direct and indirect intervention effects on alcohol use and consequence trajectories from (pre-intervention) baseline assessment across 1-, 3-, 6-, 9- and 12-month follow-ups. The public health goal of this research is to reduce the acute and chronic effects of alcohol misuse by improving the efficacy of a low intensity brief alcohol intervention. The findings of this study have both practical and theoretical implications. Demonstration of the additive utility of a very brief self-affirmation exercise could improve the efficacy and impact of currently available computer- delivered interventions for mandated students; it may also expand the reach of self-affirmation theory, leading to adaptation of self-affirmation for use with other at-risk populations receiving brief alcohol interventions.