Using Counter Attitudinal Advocacy to Change Drinking Behavior

项目摘要/摘要 在大学里的年轻人中，危险饮酒的持续存在要求继续努力预防伤害 与酒精有关。目前的预防干预措施取得了一些成功，但其中大多数 干预依赖于单一的变革机制：纠正夸大的饮酒规范。我们建议 测试针对另一种改变机制的新的预防策略：创造态度-行为 不和谐。到目前为止，与酒精有关的态度的改变以及由此产生的态度-行为差异已经 没有被用作预防酗酒的行为改变策略。由广泛的 文献表明酒精态度和饮酒行为之间存在强烈而一致的联系，我们 调整了简短的反态度倡导(CAA)操作，以适应酒精预防的背景。的目标 建议的研究是为了证明(A)CAA在改变高饮酒量和相关的 结果，(B)态度改变和态度-行为不协调在CAA操纵中起中介作用 效果，以及(C)CAA导致的风险降低不逊于基于以下方面的既定干预 个性化规范反馈(PNF)。为了实现这些目标，我们提出了两项实施的研究 跨越两个站点。首先，我们进行一项初步调查，以记录同伴行为和规范认知(N= 每个站点500个)，以提供准确、特定于园区的PNF。接下来，我们对2个人进行RCT 实验条件(CAA和PNF)和第三个仅评估控制条件，以确定影响 关于酒精结果的CAA。对于RCT，我们将招募总共600名酗酒学生，他们支持&gt；2 与酒精相关的负面后果。在试点工作的基础上，我们设计了一种激发反态度的提示 支持适度饮酒的声明。从大学干预文献中，我们还将使用 作为对照的标准PNF条件。我们将在1个月、3个月和6个月的随访中收集酒精结果。 我们将检验假设，相对于仅评估控制，CAA操纵将(A)增加 积极的适度饮酒态度，(B)减少积极的重度饮酒态度，(C)增加态度-- 行为不协调，以及(D)减少每天饮酒量、暴饮暴食频率、BAC峰值和酒精含量 后果，并增加PBS。我们还将测试CAA条件不会降低的假设 在减少每天饮酒量、暴饮暴食频率、 BAC峰值和酒精后果。此外，我们还将测试有关参与者特征的假设 (饮酒者身份，对一致性的偏好)，这可能会缓和CAA操纵对 饮酒行为。这项研究将证明态度改变理论和CAA的普适性 酒精预防背景下的方法，以及它们在不同人口统计学上的普适性 设置。对公共健康的影响包括建立一种新的方法的有效性，以减少高 从事高风险饮酒的年轻人的饮酒量及其相关后果。

PROJECT SUMMARY/ABSTRACT The persistence of risky drinking among young adults in college calls for continued efforts to prevent harms related to alcohol. Current prevention interventions have achieved some success, but the majority of those interventions rely on a single mechanism of change: correcting exaggerated drinking norms. We propose to test a novel prevention strategy targeting another mechanism of change: creating attitude-behavior dissonance. To date, changing alcohol-related attitudes and the resulting attitude-behavior discrepancy have not been harnessed as a behavior change strategy for alcohol abuse prevention. Informed by an extensive literature showing strong and consistent associations between alcohol attitudes and drinking behavior, we adapted a brief counter-attitudinal advocacy (CAA) manipulation to the alcohol prevention context. The goals of the proposed research are to demonstrate (a) the utility of CAA to change high volume drinking and related consequences, (b) that attitude change and attitude-behavior dissonance mediates the CAA manipulation effect, and (c) that CAA-induced risk reduction is not inferior to an established intervention based on Personalized Normative Feedback (PNF). To achieve these goals, we propose a pair of studies implemented across two sites. First we conduct an initial survey to document peer behaviors and normative perceptions (N = 500 at each site), required to deliver accurate, campus-specific PNF. Next we conduct an RCT with 2 experimental conditions (CAA and PNF) and a 3rd assessment only control condition to determine the impact of CAA on alcohol outcomes. For the RCT, we will recruit a total of 600 heavy drinking students who endorse >2 alcohol-related negative consequence. Based on pilot work, we designed a prompt to elicit counter-attitudinal statements in favor of moderate drinking. Drawing from the college intervention literature, we will also use a standard PNF condition as a comparison. We will collect alcohol outcomes at 1-, 3-, and 6-month follow-ups. We will test hypotheses that, relative to assessment only control, the CAA manipulation will (a) increase positive moderate drinking attitudes, (b) decrease positive heavy drinking attitudes, (c) increase attitude- behavior dissonance, and (d) decrease drinks per drinking day, binge frequency, peak BAC, and alcohol consequences, and increase PBS. We will also test the hypothesis that CAA condition will be no less efficacious than (i.e., not inferior to) the PNF condition in reducing drinks per drinking day, binge frequency, peak BAC, and alcohol consequences. In addition, we will test hypotheses about participant characteristics (drinker identity, preference for consistency) that might moderate the influence of the CAA manipulations on drinking behaviors. This study will demonstrate the generalizability of attitude change theory and CAA methods to the alcohol prevention context, as well as their generalizability across demographically different settings. Implications for the public health include establishing the efficacy of a new approach for reducing high volume drinking and related consequences among young adults engaging in at-risk drinking.