Dynamic Personalized Feedback for Young Adults with a History of Alcohol-Induced Blackout

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PROJECT SUMMARY / ABSTRACT Approximately 50% of young adults who drink alcohol experience alcohol-induced “blackouts,” defined as permanent (en bloc) or temporary (fragmentary) memory loss for events that occurred while they are drinking. This experience of alcohol-induced blackout is associated prospectively with alcohol-related harm, including emergency room visits and sexual coercion, with medical care costs exceeding $469,000 per year. While young adults who have recently experienced a blackout report less favorable evaluations of drinking events and increased motivation to decrease their drinking, they do not actually change their drinking behavior as a result of the blackout alone. Collectively, these data suggest that blackouts may serve as an opportunity for intervention, after which young adults are more likely to respond to alcohol feedback. This R34 aims to develop an intervention tailored to individuals who experience blackouts. The research team developed a dynamic personalized feedback intervention for young adults with a history of blackout. In the first phase of this research (Aim 1 user testing), 15-20 young adults with a history of blackout will provide their perspectives on the proposed content, layout, and language of the intervention. In the second phase of the project (Aim 1 pilot testing), 15 young adults with a history of blackout will pilot the intervention and then provide feedback on their experience with and reactions to delivery. In the final phase (Aim 2 preliminary efficacy testing), 162 young adults (50% female, ≥50% non-college) who report a history of blackout will be randomly assigned to receive the intervention (n=81) or assessment only (n=81). Outcomes will be assessed immediately post-intervention and at 3-month follow-up. Primary outcomes include feasibility (recruitment/retention) and acceptability of the intervention, frequency of high-intensity drinking, peak blood alcohol concentration (BAC), frequency of blackouts, and alcohol-related consequences. Secondary outcomes include incidence of sexual coercion or emergency room visits, perceived likelihood and aversiveness of blackouts, cost/benefits of alcohol use, and self-efficacy of avoid blackouts. Results will inform an R01 randomized trial examining the efficacy and mediators/moderators of the intervention in a larger sample of heavy-drinking young adults. This study will provide initial evidence that blackouts are a feasible and motivating target for brief alcohol interventions.