Changing Decisions During Drinking: Development of an Alcohol-Related Consequence Intervention for Emerging Adults

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ABSTRACT Consequences caused by alcohol misuse continue to be a public health concern in the United States, especially among emerging adults (EA; individuals aged ~18-24). Previous intervention efforts have shown reductions in alcohol use; however, results have been limited in the reduction of negative consequences, with efforts focused almost solely on college students. Research on alcohol use, attention, and decision-making has indicated alcohol increases the saliences of impelling cues (factors that incite action by drawing attention to benefits of a behavior), and decreases inhibiting cues (factors that prevent behavior by drawing attention to disadvantages). However, there is a lack of research examining cues associated with many alcohol-related consequences EA experience. Importantly, these cues may consist of a number of internal and external factors from mood/affect to specific locations or people. Understanding cues that precede consequences may provide an important avenue for intervention to impact in-the-moment decisions made while drinking. This project proposes three phases of research to provide insight on cues associated with consequences and develop an intervention designed from the relapse prevention framework that trains EA to become aware of these cues and choose safe behaviors by managing situations when then arise. Phase 1 will be a detailed collection of data (both qualitative and quantitative) on cues surrounding decisions made while drinking that influence alcohol related consequences. Phase 1 will include both sober interviews and an alcohol administration paradigm that will assess how level of intoxication may impact attention and perceived importance of cues. Phase 2 will utilize research from Phase 1 to develop a web- and text message-based intervention and Phase 3 will be a pilot feasibility test of the developed intervention. This research is coupled with a detailed training program for the applicant that focuses on expanding knowledge the key components of empirically-supported treatments and adapting them to brief interventions, building methodological and analytical skills in alcohol administration and qualitative research, and integrating user-centered design and technology into brief interventions.