Development of a behavioral economic intervention with personalized resource allocation feedback to reduce young adult alcohol misuse

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ABSTRACT Alcohol use across the life course peaks for most individuals in young adulthood, and use during this developmental period is associated with numerous consequences and societal costs. Personalized feedback interventions (PFIs) are among the most effective interventions for reducing young adult alcohol misuse, however questions remain regarding the magnitude and duration of effects and the extent to which PFIs are of interest to young adults (YAs). Previous studies have demonstrated YA preferences for feedback on practical information including financial expenditures on alcohol. Behavioral economic models posit that alcohol misuse is indexed by an excessive valuation of alcohol and resources allocated to alcohol (i.e., money and time spent on alcohol), and considerable research supports these models. Although some PFIs include information on alcohol-related resource allocation, they are often not the primary focus of feedback, are not personalized to YAs’ reported personal interests or financial goals, are often very brief and limited in scope, and provide feedback in reference to broad timeframes. This proposed research aims to develop a comprehensive web- based Resource Allocation PFI (RA-PFI) that summarizes YAs’ daily finances and time allocated to alcohol- related activities with weekly personalized information tailored to an individual’s own personal financial and time allocation goals. The RA-PFI will be developed to specifically target behavioral economic risk factors shown to be associated with alcohol misuse, including alcohol demand (e.g., feedback regarding overall and peak financial expenditures on alcohol), delay discounting (e.g., feedback regarding expenditures on immediate rewards [alcohol] vs. delayed rewards [savings]) and time allocation (e.g., feedback on time spent in alcohol vs. alcohol-free activities). To do so, Phase 1 will include formative research on the development of the RA-PFI, including qualitative work assessing young adult preference for specific RA feedback components. Phase 2 will be a pilot study where 150 young adult drinkers (ages 21-29) will be randomized to an RA-PFI intervention (n=75) or an assessment only control (n=75) condition and will complete an online baseline assessment, 3-weeks of daily assessments on resource allocation and weekly personalized feedback, and 1- and 3-month follow-up online assessments. Those in the RA-PFI will receive weekly personalized feedback on behavioral economic indices of alcohol use including spending patterns, expenditures, time allocation, and progress working towards financial goals. We will test the feasibility and acceptability of the RA-PFI and examine intervention effects on alcohol use, related consequences, and behavioral economic indices of alcohol misuse. Findings have important public health implications as we will develop, refine, and test an intervention with high potential for dissemination and interest to YAs by targeting theoretically and empirically supported behavioral economic risk factors to reduce young adult alcohol misuse.