Enhancing the Efficacy and Duration of a Brief Alcohol Intervention Using Self-Affirmation

项目摘要/摘要 大量饮酒和相关的不良后果在美国大学和 大学；饮酒行为经常导致学生因违反校园酒精政策而受到制裁。 考虑到对这些学生普遍使用强制酒精干预，优化他们的初始效果 而且他们的持续时间可以大大减轻酒精的不良后果。自我肯定代表着一种 有希望的辅助工具来介绍酒精干预，特别是那些通过计算机提供的干预，这些虽然很受欢迎，但 往往会产生较小的影响。基础研究表明，当自我肯定练习在收到 健康信息，它们降低了对威胁健康信息的防御性和抵抗力，并增加了 接受和处理健康消息。此外，自我肯定的促进作用是 在风险较高的人群中最强。因为许多强制要求的学生既表现出防御性，又表现出高度的 饮酒严重，使用自我肯定来加强信息处理，减少防御反应 可以优化在这一高危亚群中进行积极酒精干预的效果。我们建议使用 两组随机设计，以调查在经验性测试前自我肯定练习的效果 支持短暂的酒精干预，包括计算机提供的个性化规范反馈(PNF)。 在学术和学生事务合作的广泛历史基础上，我们将招募450名强制 来自一所大型公立大学的学生在5个学期的课程中。我们的主要目标是研究 在接受PNF(SA+PNF)之前的初始自我肯定(SA)操作的相加效应相对于 关于酒精使用和后果的控制+PNF。这项研究扩展了先前的工作，评估了 自我肯定练习，以补充积极的酒精干预(而不仅仅是健康信息)，以及 在更长的(12个月)随访期内跟踪酒精使用的影响。次要目标包括(A) 测试解释SA+PNF对酒精使用和酒精影响的理论推导的中介序列 后果，纳入与自我肯定和短暂酒精有关的行动机制 干预措施，以及(B)SA+PNF对酒精使用的影响的理论调节因子的检查 酗酒的后果。我们将使用潜在增长曲线模型分析来检验直接和间接 干预对酒精使用的影响和(干预前)基线评估的结果轨迹 分别进行1、3、6、9和12个月的随访。这项研究的公共卫生目标是减少急性和 通过提高酒精滥用的慢性效应，对低强度的酒精进行短暂干预。这个 本研究的发现具有实际意义和理论意义。的加法效用的演示 非常简短的自我肯定练习可以提高目前可用的计算机的效率和影响- 为强制要求的学生提供干预；它还可能扩大自我肯定理论的影响范围，领导 适应自我肯定，以供接受短暂酒精干预的其他高危人群使用。

PROJECT SUMMARY/ABSTRACT High volume drinking and related adverse consequences pose significant health concerns at US colleges and universities; drinking behavior often leads to students being sanctioned for violations of campus alcohol policy. Given the widespread use of mandated alcohol interventions for these students, optimizing their initial effects and their duration could substantially mitigate adverse alcohol outcomes. Self-affirmation represents a promising adjunct to brief alcohol interventions, particularly those delivered via computer that are popular but tend to have smaller effects. Basic research shows that when self-affirmation exercises precede the receipt of health information, they decrease defensiveness and resistance to threatening health information and increase acceptance and processing of health messages. Furthermore, the facilitative effects of self-affirmation are strongest among those at higher risk. Because many mandated students display both defensiveness and high drinking severity, use of self-affirmation to enhance information processing and reduce defensive responding could optimize the efficacy of an active alcohol intervention in this at-risk subpopulation. We propose to use a two-group randomized design to investigate the effect of a self-affirmation exercise prior to an empirically supported brief alcohol intervention consisting of computer-delivered personalized normative feedback (PNF). Building on an extensive history of academic-student affairs collaborations, we will recruit 450 mandated students from a large public university over the course of 5 semesters. Our primary aim is to examine the additive effects of an initial self-affirmation (SA) manipulation prior to receiving PNF (SA + PNF) relative to Control + PNF on alcohol use and consequences. This study extends prior work by evaluating the ability of self-affirmation exercises to supplement active alcohol interventions (rather than just health messages), and tracking the impact on alcohol use over a longer (12-month) follow-up period. Secondary aims include (a) testing theoretically-derived mediation sequences that explain the SA + PNF effects on alcohol use and alcohol consequences, incorporating mechanisms of action associated with both self-affirmation and brief alcohol interventions, and (b) the examination of theoretical moderators of the effects of SA + PNF on alcohol use and alcohol consequences. We will use latent growth curve modeling analyses to examine direct and indirect intervention effects on alcohol use and consequence trajectories from (pre-intervention) baseline assessment across 1-, 3-, 6-, 9- and 12-month follow-ups. The public health goal of this research is to reduce the acute and chronic effects of alcohol misuse by improving the efficacy of a low intensity brief alcohol intervention. The findings of this study have both practical and theoretical implications. Demonstration of the additive utility of a very brief self-affirmation exercise could improve the efficacy and impact of currently available computer- delivered interventions for mandated students; it may also expand the reach of self-affirmation theory, leading to adaptation of self-affirmation for use with other at-risk populations receiving brief alcohol interventions.