Brief alcohol interventions by counselor and computer

描述（由申请人提供）：有害的酗酒经常发生在大学校园，破坏学生的学业成绩，社会关系，身心健康。虽然研究文件表明，辅导员提供的，简短的动机干预（BMI）可靠地减少饮酒和相关问题，BMI产生的影响往往是小到中等的大小，这些影响并不总是保持，特别是在违反校园酒精政策的学生中。因此，为了促进学生的健康和安全，需要改进BMI，以提高观察到的影响的程度，并保持降低风险的收益。此外，为了推进健康行为改变的科学，研究需要提高对简短干预发挥其有益影响的机制的理解。这项研究将通过开发一种理论指导的、低成本的电子邮件助推器（e-booster）来放大和维持BMI的影响，从而改善BMI引发的变化。将在BMI后4至12周（当有益效果开始衰减时）使用现有的分发技术递送电子助推器，并将针对假设的变化机制;即，电子助推器消息将加强和扩展BMI的规范反馈成分，并促进关于规范数据的同行讨论。拟议的研究将分两部分完成。第一阶段将涉及形成性研究，以开发和完善电子助推器和健康行为控制信息与200名学生饮酒者。第二阶段将涉及一项随机对照试验（RCT），其中596名学生因违反校园酒精相关政策而被转介。在这项随机对照试验中，所有被推荐的学生都将获得BMI，然后他们将被随机分配到两种结构等效的助推器条件之一：a）带有纠正规范信息的电子助推器或B）健康促进电子邮件的对照系列。这两种情况下的学生将接受基线评估，接受BMI，并在BMI后1，3，5，8和12个月返回进行随访评估。主要结果将是酒精消费和酒精相关的问题，假设的中介变量将包括描述性和强制性规范以及同行交流。拟议的设计将允许进行以下分析：a）记录初始BMI引起的变化; B）确定电子助推器是否随时间推移增强或维持风险降低;以及c）测试假设的中介机制。这项研究将通过为预防酒精滥用提供更有力的干预措施来促进公共卫生，并将通过确定简短干预改变饮酒行为的社会认知机制来推进预防科学。 公共卫生相关性：短暂的酒精干预措施减少了高危大学饮酒者的饮酒和酒精后果。这项研究的目的是加强这些干预措施的结果与电子邮件传递助推器（电子助推器）组成的一系列简短的消息，旨在纠正夸大的饮酒规范。需要更有效的干预措施来减少大学年轻人不必要的酒精相关伤害。

DESCRIPTION (provided by applicant): Harmful binge drinking occurs frequently on college campuses, undermining students' academic performance, social relationships, and somatic and mental health. Although research documents that counselor-delivered, brief motivational interventions (BMIs) reliably reduce drinking and related problems, the effects produced by BMIs tend to be small-to-medium in size and these effects are not always maintained, especially among students who have violated campus alcohol policies. Thus, to promote student health and safety, BMIs need to be improved to enhance the magnitude of the observed effects and maintain risk-reduction gains. In addition, to advance the science of health behavior change, research needs to improve understanding of the mechanisms by which brief interventions exert their beneficial impact. The proposed research will improve BMI-initiated change by developing a theoretically-guided, low-cost, e-mail booster (e-booster) to magnify and sustain the effects of BMI. The e-booster will be delivered using existing distribution technology between four to twelve weeks after the BMI (when beneficial effects begin to decay) and will target the hypothesized mechanisms of change; that is, e- booster messages will reinforce and expand upon the normative feedback component of the BMI and prompt peer discussion regarding normative data. The proposed research will be completed in two parts. Phase I will involve formative research to develop and refine e-booster and health behavior control messages with 200 student drinkers. Phase II will involve a randomized controlled trial (RCT) with 596 students referred for violating alcohol-related policy on campus. In this RCT, all referred students will receive a BMI, and then they will be randomized to one of two structurally-equivalent booster conditions: a) e-booster with corrective norms messages or b) a control series of health promotion e-mails. Students in both conditions will undergo a baseline assessment, receive a BMI, and return for follow-up assessments at 1, 3, 5, 8, and 12 months post-BMI. Key outcomes will be alcohol consumption and alcohol-related problems; hypothesized mediating variables will include descriptive and injunctive norms as well as peer communication. The proposed design will permit analyses that a) document initial BMI-induced changes; b) determine whether the e-booster enhances or maintains risk reduction over time; and c) test the hypothesized mediational mechanisms. This research will advance public health by providing a more powerful intervention for alcohol abuse prevention, and will advance prevention science by identifying social-cognitive mechanisms by which brief interventions change drinking behavior. PUBLIC HEALTH RELEVANCE: Brief alcohol interventions reduce drinking and alcohol consequences among at-risk college drinkers. This research aims to strengthen outcomes of these interventions with an e-mail- delivered booster (e-booster) consisting of a series of brief messages designed to correct exaggerated drinking norms. More effective interventions are needed to reduce unnecessary alcohol-related harms among young adults in college.