mHealth Intervention to Reduce At-Risk Alcohol Use in College Students: Protective Behavioral Strategies and Motivation

Leah Barnes, Rahi Patel, and Sage Schaefer

Authors:  Leah Barnes, Rahi Patel, and Sage Schaefer

Faculty Mentor:  Robert Leeman

College: College of Health and Human Performance

Abstract

Background:
Indirect protective behavioral strategies (PBS) are precautions taken to reduce negative alcohol consequences, while direct PBS involve reducing consumption. Baseline indirect PBS may act as a moderator, while changes in motivation to reduce drinking may be a mediator between the intervention and its effects on negative consequences.

Methods:
Undergraduate students at sporting events are surveyed on their alcohol use and sexual activity using a smartphone during the game, the day after, and two weeks later. Randomly selected participants will complete a brief intervention or control condition with one-, three-, and six-month follow-ups.

Expected Results:
The intervention is expected to decrease alcohol consumption and negative consequences. Motivation to change (MTC) is expected to act as a mediator, increasing following intervention, thus decreasing alcohol consumption and negative consequences. We cannot currently hypothesize on directionality of baseline indirect PBS as a moderator.

Conclusion:
The impact of MTC on alcohol consumption and related outcomes reveals the importance of personalized feedback in mobile interventions. The unknown relationship between baseline indirect PBS use and the intervention indicates the importance of future research into its role as a moderator. This is especially important on college campuses which experience a high frequency of alcohol-related consequences.

Poster Pitch

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Poster

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Dr. Donnelly
Dr. Donnelly (@guest_232)
1 year ago

Interesting and valuable project. Were you able to collect any data before the shut down?

Leah Barnes
Leah Barnes (@guest_582)
Reply to  Dr. Donnelly
1 year ago

Hi Dr. Donnelly! Thanks for reviewing our poster! We were able to gather participants from a couple basketball games before all sporting events were cancelled, so we have responses from those participants. Unfortunately, we did not gather as large of a sample as we would have liked, though this study will be more long-term (over a span of a few years); we will definitely be collecting more data when we can.

TRÂN
TRÂN (@guest_4772)
Reply to  Dr. Donnelly
1 year ago

I can see here that you’ve collected this data from basketball games. How do you think this data would’ve been different if you observed a football game instead?

Sage Schaefer
Sage Schaefer (@guest_5750)
Reply to  TRÂN
1 year ago

Hi Tran! When looking at the role of sporting games, it is definitely important to note how intertwined they are with drinking culture on college campuses. I think football games are the greatest example of that. I think we would likely find greater alcohol consumption on football game days than basketball game days, due to tailgating and overall greater popularity.

Rahi Patel
Rahi Patel (@guest_6256)
Reply to  TRÂN
1 year ago

Hi Tran, thank you for viewing our presentation! We do plan on collecting data at football games as well. This study will span over a few years, and as we started collecting data after football season was over, we have only been able to collect data from basketball games. As football games are highly associated with pre-gaming, tailgating, and have more of a drinking culture around them, we may see some differences in data, though, we cannot currently posit a definite answer.

Leah Barnes
Leah Barnes (@guest_546)
1 year ago

Hi Dr. Donnelly! Thanks for reviewing our poster! We were able to gather participants from a couple basketball games before all sporting events were cancelled, so we have responses from those participants. Unfortunately, we did not gather as large of a sample as we would have liked, though this study will be more long-term (over a span of a few years); we will definitely be collecting more data when we can.

Dr. Donnelly
Dr. Donnelly (@guest_594)
1 year ago

Great!

Robert Leeman
Robert Leeman (@guest_740)
1 year ago

Great answer, Leah!

Heather Gibson
Heather Gibson (@guest_986)
1 year ago

Thanks for an interesting study!

To what extent do you think surveying at different types of sport will impact your results? For example we know that large crowds at sports such as football and basketball can have a disinhibition effect whereas, individual sports such as tennis or swimming have not been shown to have the same “group think” crowd characteristics.

Leah Barnes
Leah Barnes (@guest_2056)
Reply to  Heather Gibson
1 year ago

Hello Dr. Gibson! We appreciate you viewing our presentation. Our focus is mainly on the difference between drinking on game days in general and on non-game-days (specifically because alcohol has recently been permitted to be sold at basketball games), along with the effect of our intervention on alcohol consumption and the negative consequences. The effect of crowd characteristics based on type of sport, however, is an interesting variable that easily lends itself to consideration in future research. Thank you for your interest in our study!

Robert Leeman
Robert Leeman (@guest_1678)
1 year ago

Interesting question, Dr. Gibson!

Robert Leeman
Robert Leeman (@guest_3636)
Reply to  Robert Leeman
1 year ago

Dr. Gibson, Our plan when we resume this work is to collect data at a variety of games (basketball, baseball, football and hopefully others as well) so we should be able to address this question by the end of the study.

Justine Tryon
Justine Tryon (@guest_1700)
1 year ago

Hi! I love your poster, but I was curious if you all had suggestions or further studies to increase the knowledge, for example including more schools. I also wanted to know if the surveys included information such as if the students were athletes on other teams, participated in greek life, or even a collection of majors?

Leah Barnes
Leah Barnes (@guest_2606)
Reply to  Justine Tryon
1 year ago

Hi! Thank you! We have chosen to keep our study within the University of Florida so we could collect data more quickly and easily. If our intervention essentially “works” as we anticipate (i.e, is effective in decreasing alcohol consumption and negative consequences) or even if it doesn’t, we can then share this knowledge with others in the field of alcohol prevention. Our surveys currently do not include if the participants are athletes or major, though these are great potential factors to look into further. Another group within this Alcohol Prevention research is currently looking into the effect of housing (including Greek life), so please check out their poster: CURE – Alcohol Prevention – Lantzy, Weber, and Weinsier.

Alexandra Rubin
Alexandra Rubin (@guest_2092)
1 year ago

Hello!

Great poster and presentation! I was curious if you went out during these games and took the data. I would be interested to see how many college students would voluntarily agree to an alcohol intervention.

Leah Barnes
Leah Barnes (@guest_2830)
Reply to  Alexandra Rubin
1 year ago

Hello! Yes, we did! As you may know, students often line up outside the Gate to the O’Connell Center before basketball games. Our study team approached these people in line. With the promise of confidentiality and compensation, you might be surprised at how many participants agreed!

Robert Leeman
Robert Leeman (@guest_3778)
1 year ago

Rahi, protective behavioral strategies are presented in a standard manner in this intervention, but what do you think about the possibility of tailoring presentation of strategies to participants in some way?

Rahi Patel
Rahi Patel (@guest_4238)
Reply to  Robert Leeman
1 year ago

Hello! I think that tailoring the presentation of protective behavioral strategies could definitely increase the efficacy of the intervention. While PBS that have been presented in a standard manner have been effective in past studies, I think that if a study was able to tailor the presentation of PBS to the participants, participants would be more likely to act with PBS in the future. This would be a really interesting topic for further research.

Robert Leeman
Robert Leeman (@guest_4628)
Reply to  Rahi Patel
1 year ago

Thanks Rahi. Any idea how you might go about tailoring presentation of PBS in an intervention?

Rahi Patel
Rahi Patel (@guest_5950)
Reply to  Robert Leeman
1 year ago

An intervention can tailor the presentation of PBS by having the feedback given be reflective of what the participant is and is not already doing. Having an intervention present PBS that the participant is already acting with is redundant and may be ineffective, thus an intervention can be tailored to the participant’s actions . For example, if the participant drinks heavily but has less negative associated consequences, the intervention can present direct PBS, like switching between alcoholic and non-alcoholic drinks. If the participant is experiencing many negative consequences, then the intervention feedback focusing on indirect PBS could me more effective.

Rahi Patel
Rahi Patel (@guest_6018)
Reply to  Robert Leeman
1 year ago

An intervention can tailor the presentation of PBS by having the feedback given be reflective of what the participant is and is not already doing. Having an intervention present PBS that the participant is already acting with is redundant and may be ineffective, thus an intervention can be tailored to the participant’s actions . For example, if the participant drinks heavily but has less negative associated consequences, the intervention can present direct PBS, like switching between alcoholic and non-alcoholic drinks. If the participant is experiencing many negative consequences, then the intervention feedback focusing on indirect PBS could me more effective.

Robert Leeman
Robert Leeman (@guest_6624)
Reply to  Rahi Patel
1 year ago

Thanks Rahi. Good thoughts!

Robert Leeman
Robert Leeman (@guest_3888)
1 year ago

Sage, college students and other young adult drinkers are typically viewed as having relatively low motivation to change their drinking behavior. Why might this intervention have a positive effect on motivation to change in this population?

Brinda Bhut
Brinda Bhut (@guest_4526)
1 year ago

Interesting project! From the data that has been collected has there been any patterns seen in the ages of the participants?

Rahi Patel
Rahi Patel (@guest_4782)
Reply to  Brinda Bhut
1 year ago

Hi Brinda, thank you for viewing our presentation! Our research is focusing on undergraduate students, thus one of the requirements to participate in the study is being 18-25. Alcohol misuse is a really big problem in young adults, so we wanted to target this group in our study.

Sage Schaefer
Sage Schaefer (@guest_5414)
Reply to  Brinda Bhut
1 year ago

Hi Brinda! To elaborate more on what Rahi said, our study was focused on this age group as heavy drinking has been identified as a major health concern within this age range, especially for college students. However, our study is focused primarily on the role of protective behavior strategy use and motivation to reduce drinking on intervention effects. However, once we have collected more data, there is certainly potential to study the role of age on drinking behaviors and intervention effects!

Sage Schaefer
Sage Schaefer (@guest_4618)
1 year ago

Hi Dr. Leeman, good question! Our intervention may have a positive effect on college students’ motivation to change and reduce their drinking as it provides normative feedback. Research has shown that college students often hold false normative beliefs regarding alcohol consumption and related behaviors, such as believing peers are drinking much more than they really are. By comparing participants’ responses to that of the average of their peers, they may see that they are drinking much more heavily than most of their peers and feel encouraged to change their behavior.

Robert Leeman
Robert Leeman (@guest_4662)
Reply to  Sage Schaefer
1 year ago

Great answer, Sage!