Melissa A. Lewis

The University of Texas at Arlington | UTA · School of Social Work

Background: Drinking prototypes (i.e., images of the type of individual who engages in specific alcohol use behaviors) are associated with alcohol use, with self-identified similarity to the prototype possibly driving this connection more than one's favorability of the prototype. Alcohol-related content (ARC; posts featuring alcohol or drinking) po...

Compared to other age groups, 18- to 25-year olds (young adults) are more likely to engage in heavy alcohol use and inconsistent contraceptive use, increasing their susceptibility to sexually transmitted infections (STIs) and unintended pregnancy. The Studying Alcohol and Related Risks (STARR) intervention was efficacious in reducing young adult al...

Objective: There is considerable variability in how young adults (YAs) perceive drinking-related consequences, and some researcher-identified "negative" consequences are viewed by YAs as neutral or even somewhat positive. Little is known about individual difference factors that may influence subjective evaluations of alcohol consequences. Method:...

Introduction Women experiencing homelessness are at higher risk of unintended pregnancy than women who are stably housed and may have unique reasons for not engaging in postpartum pregnancy prevention. This sequential explanatory mixed‐methods study aimed to examine reasons women experiencing homelessness may not engage in pregnancy prevention duri...

Objective: Despite protective behavioral strategies (PBS) being an important part of alcohol prevention programs, utilization of PBS is sub-optimal, and research is needed to determine factors associated with use and non-use of PBS. The present study examined daily-level associations between situational familiarity (i.e., familiarity with location...

Background and Objectives Strategic recruitment is necessary to reach recruiting goals when conducting research with vulnerable and transient populations, such as postpartum women experiencing homelessness. The current study evaluated the recruitment process for a qualitative study using the Plan-Do-Study-Act (PDSA) method. Methods In a study cond...

Objectives Women experiencing homelessness have higher rates of unintended pregnancy than stably housed women and may benefit from reproductive interconception care. How reproductive interconception care differs between women who did and did not experience perinatal homelessness is not known. We estimated prevalence ratios of reproductive interconc...

Reproductive interconception care provided at maternal postpartum visits may help reduce unintended pregnancies and elongate birth intervals for women experiencing homelessness. To improve interconception care uptake, this qualitative study aimed to identify barriers and facilitators to reproductive interconception care from the perspectives of wom...

Objective: Although there is growing evidence that alcohol use at the daily level is associated with positive but not negative affect, results are mixed when examining marijuana use and simultaneous alcohol and marijuana (SAM) use (i.e., use with overlapping effects). In addition, less is known about these daily level associations among diverse sam...

Objective: Experimental research has demonstrated that when alcohol-related content is viewed on social media, adolescents and young adults tend to have favorable attitudes toward alcohol use. However, limited research focuses on social media norms for abstaining from alcohol use. The current study examined the role of descriptive and injunctive a...

Social media posts represent a major route by which youth share their substance use cognitions and experiences with others. Extant research has primarily examined relations between alcohol-related posts and posters' own alcohol use, yet little is known about the role of social media in the use of less socially accepted substances, namely tobacco an...

Introduction: Female community college students who use alcohol may be an at-risk group for cannabis use, especially in US states with nonmedical cannabis legalization. This study examined cannabis use among this population. We tested differences in current cannabis use across a state with versus a state without (Washington vs Wisconsin, respectiv...

Background: Research supports the notion that adolescents and young adults communicate about alcohol via text messages and that this form of communication is associated with alcohol use. However, little is known about how this compares to social media content sharing or about the timing of sending and receiving alcohol-related text messages and ass...

Background: Alcohol-induced blackouts are periods of impaired memory in which an individual is unable to recount events that occurred while they were intoxicated and are associated with heavier drinking episodes. Objectives: The present study examined age and Fear of Missing Out (FoMO) as moderators of the association between peak number of drinks...

Background: Adolescence is an important developmental period in which to understand the cognitive underpinnings of risky alcohol use. Normative perceptions, such as descriptive and injunctive norms, are one of the strongest and most consistent predictors in adolescent drinking research. Thus, it is essential to examine which drinking cognitions (e...

Background: Underage drinking and related risky sexual behavior (RSB) are major public health concerns on United States college campuses. Although technology-delivered personalized feedback interventions are considered a best practice for individual-level campus alcohol prevention, there is room for improving the effectiveness of this approach wit...

Objective: Single-component personalized normative feedback (PNF) interventions and multicomponent personalized feedback interventions (PFI) have been shown to reduce alcohol consumption among college students. The present study compared the efficacy of PNF interventions targeting descriptive norms alone (descriptive PNF), injunctive norms alone (...

This study aimed to compare negative alcohol-related sexual experiences among individuals who used (1) alcohol only, (2) alcohol plus marijuana, and (3) alcohol plus marijuana and stimulants. Participants in the analytic sample (N=1,015; Mean age=19.16 (SD=0.79); 45.42% male) completed an online baseline survey as part of an intervention study. A h...

BACKGROUND Underage drinking and related risky sexual behavior (RSB) are major public health concerns on United States college campuses. Although technology-delivered personalized feedback interventions (PFIs) are considered a best practice for individual-level campus alcohol prevention, there is room for improving the effectiveness of this approac...

The present study examined occasion-level associations between cognitions (willingness to drink, descriptive norms, and injunctive norms) and situational factors (familiarity with people and locations) with playing drinking games (DGs) among adolescents and young adults. Further, this study tested the associations between playing DGs, the number of...

Objective: The present study examined young adults' completion of the Web-based intervention content in a randomized trial that tested two Personalized Feedback Interventions (PFIs) for alcohol use and risky sex behavior (RSB). Method: Data are from a study that evaluated efficacy of two Web-delivered PFIs (combined PFI and integrated PFI) among...

This study examined three-way interactions between baseline levels of willingness to engage in alcohol- related sexual behaviors, facets of impulsivity (i.e., urgency, lack of premeditation, and sensation seeking) and biological sex on alcohol-related sexual behaviors 6 months later. Participants were a sample of high- risk 18–25 year olds (N = 321...

Research demonstrates associations between alcohol consumption and posting alcohol-related content on social networking sites (SNS); less is known regarding motivations behind deleting alcohol content on SNS and differences by age. The present study examined the associations of anticipated regret with posting and deleting alcohol-related content; a...

Background The prevalence of adolescent alcohol use continues to be a public health concern. Although adolescents spend an increasing amount of time with their friends, parents remain an important source of support and continue to play a key role in the lives of their adolescents. Extensive research in this area has resulted in parent-based interve...

Background: The vast majority of adolescents and young adults are active on social networking sites (SNSs). SNSs are influential, risk-conducive environments for alcohol use among adolescents and young adults. Specifically, posting or sharing alcohol-related content (ARC) is associated with higher levels of alcohol use. However, it is unknown if sh...

BACKGROUND The prevalence of adolescent alcohol use continues to be a public health concern. Although adolescents spend an increasing amount of time with their friends, parents remain an important source of support and continue to play a key role in the lives of their adolescents. The extensive work in this area has resulted in parent-based interve...

Background: Concurrent use of alcohol and marijuana (i.e., CAM use) is the most common poly-drug use pattern among adolescents and young adults and is associated with negative outcomes. Research indicates that Prototype Willingness Model (PWM) drinking cognitions are associated with alcohol use. This secondary analysis was conducted to explore cro...

Objective: It is critical to gain further understanding of etiologic factors, such as descriptive normative perceptions and behavioral willingness, that are associated with prescription stimulant misuse (PSM) among young adults. Our primary hypotheses were that descriptive normative perceptions for PSM (i.e., perceptions of how much and how often o...

Aims: Marijuana is a popular drug among U.S. college students. In Sweden, the prevalence of marijuana use has been relatively low but is increasing. Brief, personalized interventions have been efficacious in reducing substance use, including marijuana, among college students in the U.S. However, prior to implementation of U.S. interventions in Swed...

Objective: Alcohol use among college students during 21st birthday celebrations constitutes a well-known example of event-specific drinking when alcohol use is both pervasive and heavy. Less is known about how 21st birthday alcohol use compares to other birthday celebrations during young adulthood, whether similar increases occur for cannabis use...

Although there is a robust literature examining normative discrepancies for drinking, less is known related to normative discrepancies related to alcohol-posting behavior on social networking sites (SNS). Given that SNS are posited to be an important risk factor for adolescent and young adult alcohol use, the aims of the present study were to: (1)...

Background Young adulthood is characterized by transitions into and out of social roles in multiple domains. Consistent with self‐medication models of alcohol use, the Transitions Overload Model (J Stud Alcohol Suppl, 14, 2002, 54) hypothesizes that one cause of increased alcohol use during young adulthood may be the stress of navigating simultaneo...

Objective Limited research has examined how alcohol use and related consequences affect drinking-related cognitions, which is important as these cognitions may contribute to future drinking. The current study examines daily associations between alcohol use and alcohol-related negative consequences with next-day Prototype Willingness Model (PWM) soc...

Objective: Alcohol-related sexual consequences are common among young adults, yet there is no standard measure to comprehensively assess this construct. To fill this gap, the current study evaluated a 41-item measure of alcohol-related sexual consequences in a sample of at-risk young adults. Method: A subsample (n = 318; 54% female; 71% White; m...

Objective: The Brief Alcohol Screening and Intervention for College Students (BASICS; Dimeff et al., 1999) is an evidence-based approach to reduce high-risk drinking and associated harms; however, implementation may present challenges for community colleges (CCs) that have limited budgets and mostly non-residential students. We examined feasibility...

Hooking up, which refers to a sexual encounter (ranging from kissing to penetrative sex) between individuals who are not in a committed relationship, is an increasingly normative form of sexual exploration among emerging adults. Past research has focused on hookups within a heteronormative context, and some of this work has examined hookups as a wa...

Objective: The current study expands the literature on alcohol-related protective behavioral strategies (PBS) that individuals may use to reduce risk of intoxication and/or consequences. This study used daily data collected prospectively to test (a) the extent to which college students’ plans for using different types of PBS on a given day were ass...

Young adult drinkers engage in a range of drinking patterns from abstaining to heavy drinking in both the United States and Sweden. Heavy drinking during young adulthood in both countries is associated with a variety of negative consequences. Personalized feedback interventions have been identified as effective prevention strategies to prevent or r...

Introduction This study examined the associations between alcohol-related cognitions within the social reaction pathway of the Prototype Willingness Model and concurrent (use of two or more substances within a specified time period) use of 1) alcohol and marijuana and 2) alcohol and prescription stimulant misuse. Methods A convenience sample of 1,...

Objective In the United States, guidelines indicate all pregnant women should be screened for and counseled on alcohol use to prevent adverse perinatal outcomes due to alcohol consumption. The objective of this study was to describe sociodemographic factors associated with receipt of prenatal alcohol counseling and perinatal alcohol use among US wo...

This study assessed alcohol and sex-related cognitions and behaviors, including alcohol-related sexual expectancies, descriptive norms, and protective behavioral strategies, associated with women's risk for an alcohol-exposed pregnancy. A national sample of young adults ages 18-20 years was subset to women who were capable of pregnancy and sexually...

One of the most pervasive forms of regret, often connected to alcohol use, is sexual regret. Lifetime rates of regretted sexual experiences (RSE) for college students is between 29%-71.9%, with 31.8% endorsing past year RSE and 31.7% stating alcohol negatively influenced decision making. While past research has focused on psychological symptoms fol...

The primary goal of this chapter on health correlates and consequences of social comparison is to highlight the major contributions that social comparison theory has made to health psychology. To achieve this aim, this chapter will provide a brief overview of social comparison theory, highlight specific scientific developments related to health beh...

The purpose of this study was to examine sex cognitions and behavioral strategy correlates for chlamydia, gonorrhea, and HIV testing among a national sample of young adults ages 18–20. Young adults (18–20 years) were recruited nationally (n = 1144). The sample was restricted (n = 817) based on inclusion/exclusion criteria for analysis. The outcome...

Sexual minority women (SMW), including lesbian and bisexual women, are at greater risk for heavy drinking and sexual victimization than heterosexual women. Risk factors for alcohol-related sexual victimization, such as incapacitated rape (IR), include frequent heavy drinking and hookups among heterosexual women, but it is less clear whether these r...

Although young men or young adults with mental health disorders are at higher risk to engage in problematic drinking, they typically evince stronger associations between protective behavioral strategies (PBS) and fewer alcohol outcomes. This study aimed to contribute to this line of research by examining the moderating effect of depression, bipolar...

Introduction The current study examines the norms-behavior link by investigating a novel cognition for protective behavioral strategies (PBS)—descriptive and injunctive norms for close friends’ reasons to use PBS (e.g., limit drinking, reduce consequences)—in relation to one’s own perception of usefulness and personal use of PBS. Further, we tested...

Young adults experience social role transitions across multiple life domains, and a deeper understanding of the ways in which these simultaneous transition experiences are associated with substance use and mental health will inform targeted interventions for this population. Data from the current study include24 repeated monthly assessments of youn...

Underage alcohol use is a public health concern as it remains prevalent and problematic. Protective behavioral strategies (PBS) may prevent or reduce alcohol-related consequences, yet daily-level findings show they instead might be associated with increased drinking and consequences. While parents are a possible source of influence to their child’s...

Sexual activity, including hooking up, increases college women’s vulnerability to sexual victimization. Reducing hookups may reduce rates of sexual victimization among this vulnerable population. Because college students overestimate how frequently their peers hook up, correcting their misperceptions may lead to more accurate perceived social norms...

Alcohol expectancies are consistently associated with alcohol use in cross-sectional and longitudinal studies. However, little research has examined whether alcohol expectancies on specific drinking occasions are associated with reported consequences on those days, particularly when controlling for the amount of alcohol consumed, thus differentiati...

The present study is the first ecologically valid, daily level test of the prototype willingness model (PWM), a model previously tested with hypothetical scenarios to investigate the social reaction and reasoned pathways toward engaging in health-risk behavior. The purpose of the present study is to examine whether days with elevated alcohol-favora...

Introduction: The purpose of this study is to assess risk factors, including other substance use, for nonmedical prescription opioid use among U.S. adolescents. Methods: A secondary data analysis of the 2017 Youth Risk Behavior Survey was conducted (n=10,175) in 2018. The outcome was nonmedical prescription opioid use. Predictor variables includ...

Hookups are uncommitted sexual encounters that range from kissing to intercourse and occur between individuals in whom there is no current dating relationship and no expressed or acknowledged expectations of a relationship following the hookup. Research over the last decade has begun to focus on hooking up among adolescents and young adults with si...

Today's college students have grown up with legalized gambling and access to a variety of gambling venues. Compared to the general adult population, rates of disordered gambling among college students are nearly double. Previous research suggests that the desire to win money is a strong motivator to gamble (Neighbors et al. in J Gambl Stud 18:361-3...

Objective The Protective Behavioral Strategies Scale (PBSS‐20) is one of the most commonly used measures of engagement in protective behavioral strategies (PBS). This research aimed to examine the psychometric properties of a French and German version of the PBSS‐20 in a large sample of young males in Switzerland. Method The sample included 5,017...

The study examines how young adult transitions into and out of social roles (i.e., starting or ending a job, a romantic relationship, school) are associated with drinking motives (coping, enhancement, social, and conformity) and alcohol use in a given month. A community sample of young adult drinkers (N = 767; 56.3% female; 59.3% White; Ages 18–23)...

Deviance Regulation Theory (DRT) proposes that individuals regulate their behavior to be in line with the behaviors of others. Specifically, individuals desire to stand out in positive way and not stand out in a negative way. DRT has been successfully applied to encourage other health behaviors and offers a unique method to utilize both injunctive...

Purpose: Despite the importance of social networking sites on young adult alcohol use, few studies have examined Twitter as a conduit for sharing drinking behavior. However, this work generally uses random samples of tweets and thus cannot determine the extent to which Tweets correspond with self-reported drinking cognitions or behaviors. The prim...

Research has indicated that individuals high in social comparison orientation (SCO) are more influenced by the behavior and perceived norms of others. However, despite research indicating that behavior is more closely influenced by and modeled on more socially proximal reference groups, most social comparison research to date has utilized global me...

Prototypes are defined as the image a person holds of the typical person who engages in risk behavior and are comprised of favorability toward the prototype and similarity to the prototype. Despite both being posited as important prototype dimensions, the findings regarding their predictive utility are mixed, and most research has focused on alcoho...

Objectives The aim of this study is to evaluate how community college students with hazardous drinking perceived the usefulness of alcohol protective behavioral strategy text messages (TM-PBS). Methods Community college students with past hazardous single occasion or weekly drinking (N = 48; 60% female) were randomized to receive 2 TM-PBS on 3 typi...

Whereas past research among young adults has established that the use of protective behavioral strategies (PBS) is negatively related to alcohol outcomes, fewer studies have examined constructs related to PBS use. This study aimed to examine longitudinally the associations of attitudes toward PBS with PBS use and alcohol outcomes, as well as betwee...

The purpose of this study was to evaluate personalized feedback intervention (PFI) framing with two web-delivered PFIs aimed to reduce young adult alcohol-related risky sexual behavior (RSB). Combined PFIs typically use an additive approach whereby independent components on drinking and components on RSB are presented without the discussion of the...

Introduction: Few studies have examined associations between using alcohol only and using both alcohol and marijuana with sexual behavior on specific occasions. The current study examined alcohol and marijuana use during the most recent sexual experience in association with relationship characteristics, psychological issues, and condom use. Metho...

Objective: Hooking up is common in college, and has been linked to heavy drinking. Hookups have positive as well as negative consequences, and thus the motivations for hooking up are complex. Yet, little research has focused on these motivations. The present study examined the role that gender and drinking patterns play in the relationship between...

Drinking protective behavioral strategies (PBS) have been associated with reductions in alcohol use and alcohol-related consequences in young adults. PBS subscales, Limiting/Stopping (LS), Manner of Drinking (MOD), and Serious Harm Reduction (SHR), have been examined in the literature; LS, MOD, and SHR have mixed support as protective factors. Unde...

Introduction: With many young adults pursuing post-secondary education and many working, understanding the importance of education and work roles on alcohol use are of developmental and clinical importance. Utilizing a sample of 18-20year-olds transitioning from adolescence to young adulthood, the current study examined how social role statuses in...

Although there is a growing literature on men's condom use resistance (CUR) tactics (e.g., direct requests, deception), little research exists on women's CUR tactics. This study investigated young women's (ages 18 to 21) self-reported use of CUR tactics since age 14 and related individual difference factors. Participants included 235 sexually activ...

Alcohol expectancies are a central construct in understanding college student typical alcohol use. However, to our knowledge, there is no research addressing how alcohol expectancies for specific events (i.e. 21st birthday) are different from expectancies regarding typical drinking. We examine the extent to which 21st birthday alcohol expectancies...

Personalized normative feedback (PNF) interventions have been shown to be efficacious at reducing college student drinking. Because descriptive norms have been shown to mediate PNF efficacy, the current study focused on examining additional prototype willingness model social reaction cognitions, namely, prototypes and willingness, as mediators of i...

Objective: There has been ample research on college student risks and consequences related to 21st Birthday Drinking. To date, no studies we are aware of have examined how 21st birthday drinking impacts subsequent drinking and related consequences. This study evaluates the effect of a single night of drinking on peak drinking, heavy drinking, and...

Objective Adolescent alcohol use predicts a myriad of negative mental and physical health outcomes including fatality (Midanik, 2004). Research in parental influence on alcohol consumption finds parental monitoring (PM), or knowing where/whom your child is with, is associated with lower levels of alcohol use in adolescents (e.g., Arria et al., 2008...

U.S. universities are increasingly racially/ethnically diverse. Simultaneously, undergraduate graduation rates and alcohol use remain important concerns. Understanding factors that contribute to success and well-being among students in these diverse college settings is critical to informing educational policy and programming. Polyculturalism is the...

Objective: Personalized normative feedback (PNF) interventions have received empirical support, are presumed to work by reducing normative misperceptions, and have been found to be particularly efficacious for those who drink for social reasons. However, PNF interventions also offer direct comparisons between one's own drinking and normative drink...

A key component of the Prototype Willingness Model is willingness, which reflects an openness to opportunity to perform a behavior in situations that are conducive to that behavior. Willingness has traditionally been tested using global, hypothetical assessments, and has not been examined at the daily level. We expected to find within-person variab...

Background: Injunctive norms have been found to be important predictors of behaviors in many disciplines with the exception of alcohol research. This exception is likely due to a misconceptualization of injunctive norms for alcohol consumption. To address this, we outline and test a new conceptualization of injunctive norms and personal approval f...

Sexual assault protective behavioral strategies (PBS) may be negatively associated with sexual assault victimization. However, no studies to date have prospectively examined whether the use of sexual assault PBS is negatively associated with subsequent sexual assault experiences. The current study examined the association between the use of sexual...

Drinking identity is a component of identity that is associated with heavier drinking and more negative alcohol-related consequences. Social identity is displayed through social networking sites, which are being used on a daily basis by millions of young adults. The current research provides insight into understanding for whom social network sites...

Causal mediation analysis is an important statistical method in social and medical studies, as it can provide insights about why an intervention works and inform the development of future interventions. Currently, most causal mediation methods focus on mediation effects defined on a mean scale. However, in health-risk studies, such as alcohol or ri...