Downloaded from http://ebn.bmj.com/ on November 16, 2015 - Published by group.bmj.com
Health promotion through changes in normative perceptions of alcohol use and alcohol-related RSB.
Randomised controlled trial
Web-delivered personalised normative feedback for college students on alcohol consumption and sexual situations reduces alcohol-related risky sexual behaviour 10.1136/eb-2014-101942
Overall, all PNF-based interventions had a stronger effect on drinking outcomes than on alcohol-related RSB. Interventions that included specific alcohol PNF significantly reduced alcohol consumption, whereas the alcohol-related RSB PNF alone did not. The effects of the intervention on drinking outcomes remained significant at 6-month follow-up. Alcohol-related RSB PNF and combined PNF significantly reduced the frequency of alcohol-related RSB. The combined intervention resulted in a significant reduction in alcohol outcomes and RSB. Reductions in normative perceptions of drinking and RSB mediated the effect of the interventions.
Commentary
Robert Patton, Kim Donoghue Department of Addictions, King’s College London, London, UK Correspondence to: Dr Robert Patton, Department of Addictions, King’s College London, 4 Windsor Walk, London SE5 8BB, UK; [email protected]
Commentary on: Lewis MA, Patrick ME, Litt DM, et al. Randomized controlled trial of a web-delivered personalized normative feedback intervention to reduce alcohol-related risky sexual behaviour among college students. J Consult Clin Psychol 2014;82:429–40.
Implications for practice and research ▪ Alcohol-focused personalised normative feedback (PNF) reduces alcohol consumption, while PNF targeted at risky sexual behaviour (RSB) is also effective. ▪ Combined PNF reduces alcohol consumption and alcohol-related RSB. ▪ Web-based situation–behaviour–impact (SBI) tools reach large numbers of potential users who may benefit from help and advice relating to alcohol use and alcohol-related RSB. ▪ Research that explores the longer term impact of PNF on RSB on a diverse population is needed.
This study demonstrates that web-delivered screening and PNF-based interventions reach large numbers of students. This method of SBI has considerable cost savings and comparable levels of effectiveness compared with traditional face-to-face methods.1 2 The PNF interventions were superior to the control condition at reducing alcohol outcomes, remaining significant up to 6 months following delivery of the intervention. Combining PNF for alcohol and alcoholrelated RSB proved effective. In line with other published evidence it would be interesting to see if these effects were preserved at 1 year.2 The consumption of alcohol has been linked to RSB in student populations, therefore reductions in alcohol could lead to a reduction in RSB.3 However, the study findings suggest that specific content about alcohol in relation to RSB is necessary to reduce alcohol-related RSB; information about alcohol alone is not sufficient. Students’ perceptions of the prevalence of peers engaging in RSB and alcohol-related RSB is positively associated with their engaging in these behaviours.4 This study found evidence that reducing these perceived norms can mediate the efficacy of the intervention, increasing positive outcomes in terms of reduced frequency and quantity of drinking and bringing about a weaker but still significant impact on reducing alcohol-related RSB. As the study sampled students from a single university in the USA, its findings may not be generalisable to a wider student population. Male college students who have sex with men are twice more likely to use alcohol prior to engaging in RSB than their heterosexual counterparts.5 As study participation was restricted to students declaring typical engagement in sexual activity with a partner of the opposite sex, further generalisation of the results is limited. Competing interests None.
Context Alcohol use is associated with an increase in RSB among young adults. University students who engage in these activities overestimate the prevalence of RSB and alcohol use among their peers. PNF is an effective intervention known to reduce alcohol consumption and consequences, and may also reduce RSB. While there is evidence that web-based PNF for alcohol is effective, there is a need to test its impact on RSB.
Methods In total, 480 of 3224 students (randomly selected from one US university) screened positive for excessive drinking and RSB, and completed baseline measures. Participants were randomised to one of four conditions: alcohol-only PNF, alcohol-related RSB PNF, combined alcohol and alcohol-related RSB PNF, or a control condition. Follow-up at 3 and 6 months explored drinking behaviour, alcohol-related RSB, and normative perceptions of alcohol consumption and sexual behaviour. All outcomes produced count data, therefore count regression models were used to investigate the efficacy of the interventions. Mediation analysis was used to explore whether the efficacy of the intervention was mediated
84
Findings
References 1. Patton R, Deluca P, Kaner E, et al. Alcohol screening and brief intervention for adolescents: the how, what and where of reducing alcohol consumption and related harm among young people. Alcohol Alcohol 2014;49:207–12. 2. Donoghue K, Patton R, Phillips T, et al. The effectiveness of electronic screening and brief intervention for reducing levels of alcohol consumption: a systematic review and meta-analysis. J Med Internet Res 2014;16:e142. 3. Patrick M, Maggs J. Does drinking lead to sex? Daily alcohol–sex behaviors and expectancies among college students. Psychol Addict Behav 2009;23:472–81. 4. Lewis M, Litt D, Cronce J, et al. Underestimating protection and overestimating risk: examining descriptive normative perceptions and their association with drinking and sexual behaviors. J Sex Res 2012;51:86–96. 5. Blake S, Ledsky R, Lehman T, et al. Preventing sexual risk behaviors among gay, lesbian, and bisexual adolescents: the benefits of gay-sensitive HIV instruction in schools. Am J Public Health 2001;91:940–6.
Evid Based Nurs July 2015 | volume 18 | number 3 |
Downloaded from http://ebn.bmj.com/ on November 16, 2015 - Published by group.bmj.com
Web-delivered personalised normative feedback for college students on alcohol consumption and sexual situations reduces alcohol-related risky sexual behaviour Robert Patton and Kim Donoghue Evid Based Nurs 2015 18: 84 originally published online September 15, 2014
doi: 10.1136/eb-2014-101942 Updated information and services can be found at: http://ebn.bmj.com/content/18/3/84
These include:
References Email alerting service
Topic Collections
This article cites 6 articles, 1 of which you can access for free at: http://ebn.bmj.com/content/18/3/84#BIBL Receive free email alerts when new articles cite this article. Sign up in the box at the top right corner of the online article.
Articles on similar topics can be found in the following collections Health promotion (19) Alcohol (30) Health education (333) Screening (public health) (188)
Notes
To request permissions go to: http://group.bmj.com/group/rights-licensing/permissions To order reprints go to: http://journals.bmj.com/cgi/reprintform To subscribe to BMJ go to: http://group.bmj.com/subscribe/
Health promotion through changes in normative perceptions of alcohol use and alcohol-related RSB.
Randomised controlled trial
Web-delivered personalised normative feedback for college students on alcohol consumption and sexual situations reduces alcohol-related risky sexual behaviour 10.1136/eb-2014-101942
Overall, all PNF-based interventions had a stronger effect on drinking outcomes than on alcohol-related RSB. Interventions that included specific alcohol PNF significantly reduced alcohol consumption, whereas the alcohol-related RSB PNF alone did not. The effects of the intervention on drinking outcomes remained significant at 6-month follow-up. Alcohol-related RSB PNF and combined PNF significantly reduced the frequency of alcohol-related RSB. The combined intervention resulted in a significant reduction in alcohol outcomes and RSB. Reductions in normative perceptions of drinking and RSB mediated the effect of the interventions.
Commentary
Robert Patton, Kim Donoghue Department of Addictions, King’s College London, London, UK Correspondence to: Dr Robert Patton, Department of Addictions, King’s College London, 4 Windsor Walk, London SE5 8BB, UK; [email protected]
Commentary on: Lewis MA, Patrick ME, Litt DM, et al. Randomized controlled trial of a web-delivered personalized normative feedback intervention to reduce alcohol-related risky sexual behaviour among college students. J Consult Clin Psychol 2014;82:429–40.
Implications for practice and research ▪ Alcohol-focused personalised normative feedback (PNF) reduces alcohol consumption, while PNF targeted at risky sexual behaviour (RSB) is also effective. ▪ Combined PNF reduces alcohol consumption and alcohol-related RSB. ▪ Web-based situation–behaviour–impact (SBI) tools reach large numbers of potential users who may benefit from help and advice relating to alcohol use and alcohol-related RSB. ▪ Research that explores the longer term impact of PNF on RSB on a diverse population is needed.
This study demonstrates that web-delivered screening and PNF-based interventions reach large numbers of students. This method of SBI has considerable cost savings and comparable levels of effectiveness compared with traditional face-to-face methods.1 2 The PNF interventions were superior to the control condition at reducing alcohol outcomes, remaining significant up to 6 months following delivery of the intervention. Combining PNF for alcohol and alcoholrelated RSB proved effective. In line with other published evidence it would be interesting to see if these effects were preserved at 1 year.2 The consumption of alcohol has been linked to RSB in student populations, therefore reductions in alcohol could lead to a reduction in RSB.3 However, the study findings suggest that specific content about alcohol in relation to RSB is necessary to reduce alcohol-related RSB; information about alcohol alone is not sufficient. Students’ perceptions of the prevalence of peers engaging in RSB and alcohol-related RSB is positively associated with their engaging in these behaviours.4 This study found evidence that reducing these perceived norms can mediate the efficacy of the intervention, increasing positive outcomes in terms of reduced frequency and quantity of drinking and bringing about a weaker but still significant impact on reducing alcohol-related RSB. As the study sampled students from a single university in the USA, its findings may not be generalisable to a wider student population. Male college students who have sex with men are twice more likely to use alcohol prior to engaging in RSB than their heterosexual counterparts.5 As study participation was restricted to students declaring typical engagement in sexual activity with a partner of the opposite sex, further generalisation of the results is limited. Competing interests None.
Context Alcohol use is associated with an increase in RSB among young adults. University students who engage in these activities overestimate the prevalence of RSB and alcohol use among their peers. PNF is an effective intervention known to reduce alcohol consumption and consequences, and may also reduce RSB. While there is evidence that web-based PNF for alcohol is effective, there is a need to test its impact on RSB.
Methods In total, 480 of 3224 students (randomly selected from one US university) screened positive for excessive drinking and RSB, and completed baseline measures. Participants were randomised to one of four conditions: alcohol-only PNF, alcohol-related RSB PNF, combined alcohol and alcohol-related RSB PNF, or a control condition. Follow-up at 3 and 6 months explored drinking behaviour, alcohol-related RSB, and normative perceptions of alcohol consumption and sexual behaviour. All outcomes produced count data, therefore count regression models were used to investigate the efficacy of the interventions. Mediation analysis was used to explore whether the efficacy of the intervention was mediated
84
Findings
References 1. Patton R, Deluca P, Kaner E, et al. Alcohol screening and brief intervention for adolescents: the how, what and where of reducing alcohol consumption and related harm among young people. Alcohol Alcohol 2014;49:207–12. 2. Donoghue K, Patton R, Phillips T, et al. The effectiveness of electronic screening and brief intervention for reducing levels of alcohol consumption: a systematic review and meta-analysis. J Med Internet Res 2014;16:e142. 3. Patrick M, Maggs J. Does drinking lead to sex? Daily alcohol–sex behaviors and expectancies among college students. Psychol Addict Behav 2009;23:472–81. 4. Lewis M, Litt D, Cronce J, et al. Underestimating protection and overestimating risk: examining descriptive normative perceptions and their association with drinking and sexual behaviors. J Sex Res 2012;51:86–96. 5. Blake S, Ledsky R, Lehman T, et al. Preventing sexual risk behaviors among gay, lesbian, and bisexual adolescents: the benefits of gay-sensitive HIV instruction in schools. Am J Public Health 2001;91:940–6.
Evid Based Nurs July 2015 | volume 18 | number 3 |
Downloaded from http://ebn.bmj.com/ on November 16, 2015 - Published by group.bmj.com
Web-delivered personalised normative feedback for college students on alcohol consumption and sexual situations reduces alcohol-related risky sexual behaviour Robert Patton and Kim Donoghue Evid Based Nurs 2015 18: 84 originally published online September 15, 2014
doi: 10.1136/eb-2014-101942 Updated information and services can be found at: http://ebn.bmj.com/content/18/3/84
These include:
References Email alerting service
Topic Collections
This article cites 6 articles, 1 of which you can access for free at: http://ebn.bmj.com/content/18/3/84#BIBL Receive free email alerts when new articles cite this article. Sign up in the box at the top right corner of the online article.
Articles on similar topics can be found in the following collections Health promotion (19) Alcohol (30) Health education (333) Screening (public health) (188)
Notes
To request permissions go to: http://group.bmj.com/group/rights-licensing/permissions To order reprints go to: http://journals.bmj.com/cgi/reprintform To subscribe to BMJ go to: http://group.bmj.com/subscribe/
