Social Norms & Skills Training: Motivating Campus Change

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This supplement in response to the ADVANCE NOSI seeks to extend our parent RCT designed to reduce alcohol use and related consequences among college students through evaluating sequential vs simultaneous presentation of personalized feedback intervention (PFI) modules, with or without text message boosters to address 5 high-risk drinking events (HRDE). The parent RCT sample (N=1000) includes significant diversity, but was not designed to address unique health disparities related to alcohol use and response to preventive interventions among students with minoritized sexual or gender identities (SGM). SGM YA are at risk for alcohol-related health disparities and understudied in prevention trials. The current supplement seeks to increase inclusion of SGM students in our prevention trial to elucidate factors impacting efficacy of the parent PFI for SGM students and enhance relevance, generalizability, and fit of our PFI materials for SGM students. We will utilize mixed methods and existing and new data to determine what adaptations of existing PFI materials may be needed to address unique needs of SGM students, informed by our prior experiences and guidelines for intervention adaptation. We will then replicate aspects of the parent RCT with a new sample of SGM students, addressing both shared (spring break) and tailored (Pride events) HRDE to enable comparison of adapted to standard PFI and potential extensions to SGM-specific HRDE. Supplemental aims include: 1) Expand assessment of key variables to better characterize and understand experiences of SGM students in the parent RCT sample. We will add broader assessment of sexual and gender diversity (e.g., identity, attraction, behavior, gender expression) for existing participants in our RCT as well as expand assessment of alcohol norm salience and HRDE to better capture experiences relevant to SGM students. 2) Conduct secondary analyses of moderators of PFI efficacy for SGM students. Using existing data, analyses will focus on individual and contextual moderators of PFI efficacy for SGM students in the parent RCT, with particular attention to aspects of comorbidity, social context, and personal characteristics related to SGM identity. 3) Collect new quantitative and qualitative data to further explore and address adaptation to enhance PFI for SGM students. We will utilize online and community outreach strategies to recruit 300 SGM students for a survey of demographics, alcohol use/consequences, perceived norms, other socio-cognitive and contextual influences, and HRDE. A purposive sample of existing and newly recruited SGM (N~25) will complete rapid prototyping interviews (RPI) to inform any necessary adaptations of PFI components. 4) Extend the parent RCT to further evaluate efficacy of PFI for SGM students. Drawing from the Aim 3 survey sample, we will recruit and randomly assign SGD students to the sequential + text condition (n=150) or the AOC condition (n=100), and will test booster messages for spring break (overlapping) and Pride (unique) HRDE. Analyses will address intervention efficacy for SGM students, and compare adapted to unadapted PFI.