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A Randomized Controlled Trial of the eCHECKUP to GO for High School Seniors across the Academic Year
Abstract
Background
Among high school students, seniors report the highest levels of alcohol use and hazardous drinking. Technology-based interventions are a promising approach for reducing alcohol use among this age group. Objectives: This randomized controlled trial investigated the efficacy of the eCHECKUP TO GO, an online personalized feedback intervention, on reducing alcohol use among high school seniors across the academic year (ClinicalTrials.gov Identifier NCT03613818). Drinker risk status, with students classified as high- or low-risk drinkers based on baseline reports binge drinking, was examined as a moderator of intervention effects. Method: Participants (N = 311) were recruited from two high schools. Class periods were randomized to the intervention condition or an assessment-only control condition. Participants completed online surveys at baseline, 30-day, and 6-month assessments. Results: Intervention effects were moderated by drinker risk status. Among high-risk drinkers, those in the intervention condition reported a significant reduction in weekly drinking quantity and estimated blood alcohol concentration (eBAC) at the 30-day follow-up relative to students in the control condition. By 6 months, reductions in alcohol outcomes among high-risk students in the intervention condition were sustained, but high-risk students in the control condition also reported reductions in weekly drinking. In contrast, for eBAC, intervention effects were significantly greater among students in the intervention condition relative to the control condition at 6 months. Conclusions: Results support the efficacy of the eCHECKUP TO GO for decreasing short-term alcohol use among seniors who are high-risk drinkers and provide preliminary evidence that reductions are sustained across the academic year.
... In total, 18 records met all the inclusion criteria, describing a total of 14 different interventions. We found five records with the same main author describing the same intervention (The eCHECKUP TO GO) [24][25][26][27][28], so prevent duplicate studies that might lead to biased results, we assessed the time of recruitment, the sample size, and the time of follow-up [29]. The decision was to include in the narrative synthesis the work of Doumas, D. M. et al., (2021) since it had the best combination of the longest time of follow-up (6 months) with the greatest sample size (n = 311) [28]. ...
... We found five records with the same main author describing the same intervention (The eCHECKUP TO GO) [24][25][26][27][28], so prevent duplicate studies that might lead to biased results, we assessed the time of recruitment, the sample size, and the time of follow-up [29]. The decision was to include in the narrative synthesis the work of Doumas, D. M. et al., (2021) since it had the best combination of the longest time of follow-up (6 months) with the greatest sample size (n = 311) [28]. ...
... From among the 14 included studies, 6 were conducted in the United States of America (42.9%) [28,[30][31][32][33][34], 3 in European countries (21.4%) [35][36][37], 3 in Asian countries (21.4%) [38][39][40] and 2 in Mexico (14.3%) [41,42]. Of those, 10 were implemented in an educational setting (71.4%) [28,30,32,33,[37][38][39][40][41][42]. ...
Although web-based interventions are attractive to researchers and users, the evidence about their effectiveness in the promotion of health behaviour change is still limited. Our aim was to review the effectiveness of web-based interventions used in health behavioural change in adolescents regarding physical activity, eating habits, tobacco and alcohol use, sexual behaviour, and quality of sleep. Studies published from 2016 till the search was run (May-to-June 2021) were included if they were experimental or quasi-experimental studies, pre-post-test studies, clinical trials, or randomized controlled trials evaluating the effectiveness of web-based intervention in promoting behaviour change in adolescents regarding those health behaviours. The risk of bias assessment was performed by using the Effective Public Health Practice Project (EPHPP)—Quality Assessment Tool for Quantitative Studies. Fourteen studies were included. Most were in a school setting, non-probabilistic and relatively small samples. All had a short length of follow-up and were theory driven. Thirteen showed significant positive findings to support web-based interventions’ effectiveness in promoting health behaviour change among adolescents but were classified as low evidence quality. Although this review shows that web-based interventions may contribute to health behaviour change among adolescents, these findings rely on low-quality evidence, so it is urgent to test these interventions in larger controlled trials with long-term maintenance.
Despite the widespread use of personalization of eHealth technologies, there is a lack of comprehensive understanding regarding its application. This systematic review aims to bridge this gap by identifying and clustering different personalization approaches based on the type of variables used for user segmentation and the adaptations to the eHealth technology and examining the role of computational methods in the literature. From the 412 included reports, we identified 13 clusters of personalization approaches, such as behavior + channeling and environment + recommendations. Within these clusters, 10 computational methods were utilized to match segments with technology adaptations, such as classification-based methods and reinforcement learning. Several gaps were identified in the literature, such as the limited exploration of technology-related variables, the limited focus on user interaction reminders, and a frequent reliance on a single type of variable for personalization. Future research should explore leveraging technology-specific features to attain individualistic segmentation approaches.
Background
Previous research has shown that a majority of adolescents in the United States initiate and drink alcohol prior to graduating high school and nearly twenty percent of high school seniors engage in heavy episodic drinking. Despite anecdotal evidence and media portrayals of alcohol use during high school events (e.g., prom), little is understood about alcohol use surrounding specific events that may be identified as “high-risk” events and addressed in specific interventions. Similarly, normative perceptions exert powerful influence on behaviors but little is understood about normative perceptions of alcohol use at high school events. Objectives: The purpose of the present study was to understand whether high school alcohol use is associated with specific events by describing behaviors and normative perceptions
Methods
Participants were 386 U.S. college students age 18 to 19 (60.4% female, mean age = 18.4) who provided retrospective accounts of their alcohol use surrounding senior year high school events (either before, which is relevant to pregaming addressed in this special issue, during, or after).
Results
Most students did not drink surrounding high school events but nearly all reported that they perceived that the typical high school senior did. Those who did drink alcohol tended to drink heavily, particularly during prom. Alcohol use was associated with other high school events ranging from the beginning of senior year (e.g., Homecoming) though the end (e.g., graduation parties)
Conclusions
Results indicate the importance of future research efforts tailoring intervention efforts around specific events and the applicability of personalized normative feedback approaches.
Preventive interventions for adolescents are an important priority within school systems. Several interventions have been developed, but the effectiveness of such interventions varies considerably between studies. The purpose of this study was to assess the effectiveness of universal school-based prevention programs on alcohol use among adolescents by using meta-analytic techniques.
A systematic literature search in the databases, PubMed (Medline), PsycINFO (Ovid), EMBASE (Ovid) and WEB of Science (ISI) was conducted to search for empirical articles published in the period January 1990 to August 2014.
In total, 28 randomized controlled studies with 39,289 participants at baseline were included. Of these 28 articles, 12 studies (N = 16279) reported continuous outcomes (frequency of alcohol use and quantity of alcohol use), and 16 studies (N = 23010) reported categorical data (proportion of students who drank alcohol). The results of the random effects analyses showed that the overall effect size among studies reporting continuous outcomes was small and demonstrated a favorable effect from the preventive interventions (Hedges' g = 0.22, p < .01). The effect size among studies reporting categorical outcomes was not significant (OR = 0.94, p = .25). The level of heterogeneity between studies was found to be significant in most analyses. Moderator analyses conducted to explore the heterogeneity showed neither significant difference between the different school levels (junior high schools and high schools), nor between the varied program intensities (low, medium and high intensity programs). The meta-regression analyses examining continuous moderators showed no significant effects for age or gender.
The findings from this meta-analysis showed that, overall, the effects of school-based preventive alcohol interventions on adolescent alcohol use were small but positive among studies reporting the continuous measures, whereas no effect was found among studies reporting the categorical outcomes. Possible population health outcomes, with recommendations for policy and practice, are discussed further in this paper.
This randomized controlled trial evaluated the efficacy of a brief intervention designed to reduce the harmful consequences of heavy drinking among high-risk college students. Students screened for risk while in their senior year of high school (188 women and 160 men) were randomly assigned to receive an individualized motivational brief intervention in their freshman year of college or to a no-treatment control condition. A normative group selected from the entire screening pool provided a natural history comparison. Follow-up assessments over a 2-year period showed significant reductions in both drinking rates and harmful consequences, favoring students receiving the intervention. Although high-risk students continued to experience more alcohol problems than the natural history comparison group over the 2-year period, most showed a decline in problems over time, suggesting a developmental maturational effect. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
No systematic review has focused on parental consenting procedures used in adolescent substance abuse treatment outcomes research. To address this gap, we examined parental consenting procedures in adolescent outcome studies (n = 34) published between 1980 and 2007. Although parental consent was required in 89% of adolescent treatment outcome studies we reviewed, consenting procedures were not routinely reported. We argue that parental consenting procedures should be routinely reported as a methodological feature of adolescent treatment outcome studies and, given concerns about sample bias in adolescent risk behavior research when parental consent is required, encourage outcomes researchers in this area to prospectively study the impact of consenting procedures on both the study participation rates and substance use reporting.
Two studies were conducted to assess variables related to the social determinants of alcohol consumption. In Study 1, moderate- and heavy-drinking male undergraduates were paired with confederates who behaved in a sociable or unsociable manner while modeling either light or heavy consumption. Modeling occurred in the sociable conditions but not in the unsociable conditions, where subjects tended to drink heavily. In Study 2, a similar group of subjects was exposed to one of three social status conditions crossed with light versus heavy consumption. The results indicated a modeling effect in all social status conditions. These studies provide further support for the existence of a modeling effect that can be disrupted by a lack of rapport between drinking partners. This latter finding has implications for the etiology of problem drinking because it suggests that increased alcohol consumption may serve as a strategy for coping with aversive social interactions.
Schools offer a convenient setting for research on adolescents. However, obtaining active written parental consent is difficult. In a 6th-grade smoking study, students were recruited with two consent procedures: active consent (parents must provide written consent for their children to participate) and implied consent (children may participate unless their parents provide written refusal). Of 4,427 invited students, 3,358 (76%) provided active parental consent, 420 (9%) provided active parental refusal, and 649 (15%) provided implied consent (parental nonresponse). The implied consent procedure recruited more boys, African Americans, students with poor grades, and smokers. This dual-consent procedure is useful for collecting some limited data from students who do not provide active consent or refusal.
III-timed and excessive use of alcohol is associated with multiple and irreversible disabilities. The relationship between perinatal alcohol use and developmental disabilities, including fetal alcohol syndrome, is well documented. Empirical evidence also links alcohol use to a host of other developmental and physical problems among the offspring of drinkers and among drinkers themselves. Toward advancing the science of how to reduce alcohol abuse risks, this study developed and tested family and computer-based approaches for preventing alcohol use among a community sample of inner-city minority youth. Original findings from 4-year follow-up data obtained from over 90% of the study sample document continued positive program outcomes and shed light on cognitive problem solving, peer, and family mediators of alcohol use risk and protective factors among target youth.
https://deepblue.lib.umich.edu/bitstream/2027.42/150621/1/Overview 2018 FINAL print 2-25.pdf
Background
Few computer-delivered brief intervention (CDBI) studies have evaluated participant satisfaction with individual elements of the intervention, or whether participant satisfaction impacts intervention outcomes. Purpose: This factorial trial examined whether subjective reactions to a CDBI for heavy drinking (1) varied depending on the presence versus absence of an animated narrator, a spoken voice, empathic reflections, and motivational interviewing (MI) strategies and (2) were associated with drinking outcomes at 3-month follow-up. Methods: Participants were 352 heavy drinking university students. All participants were randomly assigned to one of 16 versions of a CDBI. After finishing the CDBI, participants completed measures of intervention likability and perceived empathy. Alcohol use outcomes were assessed at 3-month follow-up. Results: CDBI characteristics had minimal effects on participant ratings of likeability and perceived empathy. However, higher likeability ratings were associated with decreases in alcohol use outcomes over the 3-month assessment period. Conclusions: Results indicate that subjective reactions to CDBIs can have important effects on alcohol use outcomes.
Despite the escalation of alcohol use through high school, the majority of research on school‐based alcohol interventions has been conducted with junior high students or first and second‐year high school students. Preliminary research indicates a brief, web‐based personalized feedback intervention developed for college students (eCHECKUP TO GO) may be a promising program for high school seniors. Although these studies demonstrate positive intervention effects, there is some evidence for greater program efficacy for females in this age group. The current study investigates sex differences in program acceptability of the eCHECKUP TO GO and its relationship to short‐term alcohol outcomes among high school seniors (N = 135). Overall, the majority of students reported they found the program to be acceptable (i.e., user‐friendly and useful). However, contrary to our hypothesis, results indicated that male students reported significantly higher perceptions of program acceptability than females. Although we did not find sex differences in alcohol outcomes, program user‐friendliness was related to reductions in alcohol use for males. The results of this study add to the literature supporting the eCHECKUP TO GO for high school seniors and highlight the importance of program user‐friendliness for males. Implications for implementing the program as a school‐based intervention are discussed.
This randomized controlled study evaluated the efficacy of a web‐based program alone and in combination with a parent campaign among 9th‐grade students (N = 205). Results indicate lower drinking rates in both programs compared with traditional education for female students.
Objective:
The purpose of this randomized controlled study was to examine the efficacy of a brief, web-based personalized feedback intervention (the eCHECKUP TO GO) on alcohol use and alcohol-related consequences among high school seniors.
Method:
Participants (n = 221) were high school seniors randomized by class period to either a brief, web-based personalized feedback intervention (the eCHECKUP TO GO) or an assessment-only control group. Participants completed online surveys at baseline and at a 6-week follow-up.
Results:
Students participating in the eCHECKUP TO GO intervention reported a significant reduction in weekly drinking quantity, peak drinking quantity, and frequency of drinking to intoxication relative to those in the control group. Intervention effects were moderated by high-risk status (one or more episodes of heavy episodic drinking in the past 2 weeks reported at baseline) such that intervention effects were significant for high-risk students only. Results for alcohol-related consequences were not significant.
Conclusions:
Providing a brief, web-based personalized feedback intervention in the school setting is a promising approach for reducing problem alcohol use among high school seniors who report recent heavy episodic drinking.
This new edition to the classic book by ggplot2 creator Hadley Wickham highlights compatibility with knitr and RStudio. ggplot2 is a data visualization package for R that helps users create data graphics, including those that are multi-layered, with ease. With ggplot2, it's easy to:
• produce handsome, publication-quality plots with automatic legends created from the plot specification
• superimpose multiple layers (points, lines, maps, tiles, box plots) from different data sources with automatically adjusted common scales
• add customizable smoothers that use powerful modeling capabilities of R, such as loess, linear models, generalized additive models, and robust regression
• save any ggplot2 plot (or part thereof) for later modification or reuse
• create custom themes that capture in-house or journal style requirements and that can easily be applied to multiple plots
• approach a graph from a visual perspective, thinking about how each component of the data is represented on the final plot
This book will be useful to everyone who has struggled with displaying data in an informative and attractive way. Some basic knowledge of R is necessary (e.g., importing data into R). ggplot2 is a mini-language specifically tailored for producing graphics, and you'll learn everything you need in the book. After reading this book you'll be able to produce graphics customized precisely for your problems, and you'll find it easy to get graphics out of your head and on to the screen or page. New to this edition:<
• Brings the book up-to-date with ggplot2 1.0, including major updates to the theme system
• New scales, stats and geoms added throughout
• Additional practice exercises
• A revised introduction that focuses on ggplot() instead of qplot()
• Updated chapters on data and modeling using tidyr, dplyr and broom
The eCHECKUP TO GO is identified as a highly effective, low-cost individually-focused alcohol intervention by the NIAAA CollegeAIM guide. The research on the eCHECKUP TO GO for High School is less consistent, suggesting that the program content, originally designed for college students, may need modification for this age group. This randomized controlled study examined the effectiveness of the eCHECKUP TO GO for High School on shifting risk and protective factors for alcohol use targeted by the program at a 4–6 week follow-up. Female high school students in the intervention group reported a reduction in perceptions of peer drinking, beliefs about alcohol, and positive alcohol expectancies, compared to students in the control group. There were no group differences in risk factors for males or in protective behavioral strategies for either males or females. Results indicate the eCHECKUP TO GO for High School may be more effective for females and that program content targeting protective behavioral strategies may need modification for this age group.
The transition from high school to college has been characterized as a potentially vulnerable period because of decreased parental supervision and increased autonomy. This transition can increase risk for participation in high-risk behaviors such as drinking games (DGs), which are a social drinking activity that encourages intoxication and are associated with negative alcohol-related consequences. To date, there has not been a narrative review of DG research that examines this activity among high schoolers and incoming college students specifically, and thus, the current review bridges this gap. Findings indicate that DG participation is consistently linked to negative consequences (e.g., passing out, becoming sick) and other high-risk behaviors, such as prepartying (drinking before going to a social event). In addition, DG participation is linked to demographic (e.g., age, gender), psychological (e.g., personality, alcohol cognitions), and contextual/cultural factors (e.g., the college drinking culture). These findings have implications for current prevention and intervention efforts and suggest promising directions for future research.
Model building and data analysis in the biological sciences somewhat presupposes that the person has some advanced education in the quantitative sciences, and statistics in particular. This requirement also implies that a person has substantial knowledge of statistical hypothesis-testing approaches. Such people, including ourselves over the past several years, often find it difficult to understand the information-theoretic approach, only because it is conceptually so very different from the testing approach that is so familiar. Relatively speaking, the concepts and practical use of the information-theoretic approach are much simpler than those of statistical hypothesis testing, and very much simpler than some of the various Bayesian approaches to data analysis (e.g., Laud and Ibrahim 1995 and Carlin and Chib 1995).
Adolescent drinking represents a significant problem in the United States. Although high school juniors and seniors are particularly vulnerable to the negative consequences associated with alcohol use, evidence-based interventions for this age group are limited. The purpose of this article is to introduce a Web-based alcohol intervention with promising evidence as a best practice for a school-based program.
This study evaluated the effectiveness of a web-based personalized normative feedback program, electronic Check-Up to Go (e-CHUG), in decreasing heavy drinking among 1st-year university students. Results indicated high-risk students receiving the e-CHUG program during 1st-year orientation activities reported significantly greater reductions in heavy drinking and alcohol-related consequences than did students in an assessment-only control group at a 3-month follow-up. Recommendations for integrating e-CHUG into orientation activities are discussed.
A growing line of research has highlighted the promising role that interactive web and mobile technologies may play in improving the effectiveness, cost-effectiveness, and reach of efforts to assess, prevent, treat, and support the recovery management of substance use disorders and other risk behavior. Manuscripts in this special issue of the Journal of Substance Abuse Treatment focus on the application of technology to the delivery of interventions for the treatment and recovery management of substance use disorders. These manuscripts are intended to highlight the diversity and current state of the science of empirically-supported innovations in this area of intervention delivery. The included manuscripts range from experimental evaluations of a variety of types of technology-based interventions (brief interventions, behavior therapy, medication adherence tools, and HIV prevention interventions) and technology platforms (mobile, Web, videoconferencing, and telephone-based interactive voice response), for an array of populations (adults, adolescents, criminal justice populations, and post-partum women), in a number of different settings (addiction specialty treatment programs, schools, emergency rooms, and criminal justice settings). They additionally reflect a variety of experimental research designs, including those focused on the design, development, and clinical evaluation of these technology-based therapeutic tools, as well as research focused on models for their successful implementation and sustained use.
The efficacy of a Web-based personalized feedback program--electronic CHECKUP TO GO (e-CHUG), aimed at reducing heavy drinking in 1st-year university students--is evaluated. Results indicated that high-risk students in the e-CHUG group reported significantly greater reductions in weekly drinking quantity, frequency of drinking to intoxication, and occurrence of alcohol-related problems. Recommendations for integrating Web-based alcohol programs into a comprehensive prevention program are discussed. (Contains 1 figure and 1 table.)
Issues:
The use of alcohol and drugs amongst young people is a serious concern and the need for effective prevention is clear. This paper identifies and describes current school-based alcohol and other drug prevention programs facilitated by computers or the Internet.
Approach:
The Cochrane Library, PsycINFO and PubMed databases were searched in March 2012. Additional materials were obtained from reference lists of papers. Studies were included if they described an Internet- or computer-based prevention program for alcohol or other drugs delivered in schools.
Key findings:
Twelve trials of 10 programs were identified. Seven trials evaluated Internet-based programs and five delivered an intervention via CD-ROM. The interventions targeted alcohol, cannabis and tobacco. Data to calculate effect size and odds ratios were unavailable for three programs. Of the seven programs with available data, six achieved reductions in alcohol, cannabis or tobacco use at post intervention and/or follow up. Two interventions were associated with decreased intentions to use tobacco, and two significantly increased alcohol and drug-related knowledge.
Conclusion:
This is the first study to review the efficacy of school-based drug and alcohol prevention programs delivered online or via computers. Findings indicate that existing computer- and Internet-based prevention programs in schools have the potential to reduce alcohol and other drug use as well as intentions to use substances in the future. These findings, together with the implementation advantages and high fidelity associated with new technology, suggest that programs facilitated by computers and the Internet offer a promising delivery method for school-based prevention.
One in four youths aged 12 to 17 years and more than half of young adults aged 18 to 25 years in the United States have used an illicit drug in their lifetime. A significant number progress to problematic use, and only 1 in 10 young people who meet criteria for dependence or abuse receive some form of treatment. Despite advances in the field, effectively intervening along the continuum of drug use involvement remains a challenge. In this article, we review the current epidemiology of illicit drug use by young people; describe recent advances in assessment, intervention and treatment; and highlight how technology can help overcome barriers to effective management of drug use among young people.
This meta-analysis evaluates the efficacy of computer-delivered interventions (CDIs) to reduce alcohol use among college students.
We included 35 manuscripts with 43 separate interventions, and calculated both between-group and within-group effect sizes for alcohol consumption and alcohol-related problems. Effects sizes were calculated for short-term (< or =5 weeks) and long-term (> or =6 weeks) intervals. All studies were coded for study descriptors, participant characteristics and intervention components.
The effects of CDIs depended on the nature of the comparison condition: CDIs reduced quantity and frequency measures relative to assessment-only controls, but rarely differed from comparison conditions that included alcohol-relevant content. Small-to-medium within-group effect sizes can be expected for CDIs at short- and long-term follow-ups; these changes are less than or equivalent to the within-group effect sizes observed for more intensive interventions.
CDIs reduce the quantity and frequency of drinking among college students. CDIs are generally equivalent to alternative alcohol-related comparison interventions.
Blood alcohol concentrations (BACs) in children after consumption of different numbers of standard drinks of alcohol have not been estimated previously. The goal was to determine the number of drinks at each age that led to a BAC of > or =80 mg/dL, the National Institute on Alcohol Abuse and Alcoholism criterion for binge drinking.
The updated Widmark equation to estimate BAC was modified to take account of the differing body composition (total body water) and accelerated rates of ethanol elimination of children. The modified formula was used with 1999-2002 National Health and Nutrition Examination Survey data to estimate BACs for >4700 children and adolescents from 9 through 17 years of age, for intake levels of 1 to 5 standard drinks.
The estimated BACs for children after consumption of just 3 standard drinks within a 2-hour period were between 80 and 139 mg/dL for boys 9 to 13 years of age and for girls 9 to 17 years of age, indicating substantial potential alcohol impairment. With 5 drinks within 2 hours (the level used to define binge drinking among college students), children 9 to 13 years of age were estimated to have BACs 2 to 3 times the adult legal limit for intoxication of 80 mg/dL.
Binge drinking should be defined as > or =3 drinks for 9- to 13-year-old children, as > or =4 drinks for boys and > or =3 drinks for girls 14 or 15 years of age, and as > or =5 drinks for boys and > or =3 drinks for girls 16 or 17 years of age.
There is a paucity of test-retest reliability data for adolescent self-reports of a wide range of risk behaviours. Grade 8 and 11 students (N = 358) completed a questionnaire on two occasions between 10 and 14 days apart. It included items about use of various substances, violent behaviour, suicidality, and sexuality. Cohen's kappa was almost perfect for 1 item (kappa = 85.4%); in the substantial range (61-80%) for 4 items; and in the moderate range (41-60%) for 3 items. For the remaining 7 items, the percentage agreement was higher than 92.0%. The questionnaire thus demonstrates adequate test-retest reliability.
To study the reliability of adolescents' self-reported drinking and perceived drunkenness in surveys.
The data from two cross-sectional school-based questionnaire surveys with representative cluster samples (the European School Survey Project on Alcohol and Other Drugs, ESPAD) in Finland were used; there were 2161 (1995) and 3109 (1999) 15-year-old respondents. The response rates were 94% and 90% respectively. The measurements analysed were an open-ended and a set of closed-category questions concerning the latest drinking occasion.
The set of three closed questions used in 1995 yielded mean amounts of 6.6 (girls) and 8.7 (boys) centilitres of pure alcohol whereas the figures obtained from the open question were 8.5 (girls) and 11.8 (boys) centilitres. With the closed set extended in 1999 into five questions, the two figures among girls were 7.7 (closed) and 7.7 (open) centilitres; the corresponding figures among boys were 11.3 (closed) and 11.7 (open) centilitres. Individual level correlations between the two measures among girls were 0.69 in 1995 and 0.69 in 1999; and 0.69 (1995) and 0.65 (1999) among boys. The numbers of students reporting specific beverage type use were higher when using closed questions compared with an open question. Drunkenness self-reports related logically to amounts of alcohol drunk.
The adolescent drinking amount self-reports seem reasonably reliable and valid both on a population and individual level. A set of closed questions may capture the amount drunk even better than an open question.
Alcohol consumption has been a growing concern at U.S. colleges, particularly among first-year students, who are at increased risk for problems. This study tested the efficacy of the "electronic Check-Up to Go" (e-CHUG), a commercially-available internet program, at reducing drinking among a group of at-risk college freshman.
The design was a randomized controlled trial: 106 freshmen students who reported heavy episodic drinking were randomly assigned to receive feedback or to assessment only. Assessment measures were completed at baseline, 8 weeks, and 16 weeks.
At 8 weeks, the feedback group showed a significant decrease in drinks per week and peak BAC over control. By 16 weeks, the control group also declined to a point where there were no differences between groups. Changes in normative drinking estimates mediated the effect of the intervention. An additional 245 abstainers and light drinkers who were also randomized to condition did not show any intervention effect.
This study provides preliminary support for the efficacy of this intervention at reducing short-term drinking among at-risk students.
The epidemiological features of underage drinking and evidence of its social, health, and economic consequences suggest compelling reasons for the development and dissemination of effective preventive interventions. To clarify the nature and extent of the current evidence base on preventive interventions addressing underage drinking, a review of the literature was conducted through extensive searches of the research literature on outcome evaluations, existing reviews of this body of outcome research (N = 25), and summary reports of evidence on specific interventions. More than 400 interventions were identified and screened, and the evidence for 127 was reviewed. Criteria for the evaluation of evidence were established for intervention studies with alcohol-specific outcome measures for 3 developmental periods (< 10, 10-15, and 16 to > or = 20 years of age). Ultimately, 12 interventions met criteria for "most promising" evidence and 29 met criteria for "mixed or emerging" evidence. Conducting this review revealed clear advances in the number of evidence-based interventions available and the quality of outcome research; however, much work remains to achieve greater public health impact through evidence-based interventions. This work should consider (1) the great need for intervention research related to understudied developmental phases, intervention domains (eg, family, school, community, and media), and populations (eg, early tweens, late teens, young adults not attending college, and nonmajority populations); (2) the critical importance of addressing key issues in research design and methods (eg, limited longitudinal studies, replication studies, and dissemination research); and (3) the need for improved consistency in application of evidence and reporting standards. Finally, we recommend the application of emerging consumer-oriented and community-participatory models for intervention development and research, designed to increase the likelihood of "real-world" public health impact through improved translation of intervention science into practice.
Using multivariate statistics
- B G Tabachnick
- L S Fidell
Programming with ggplot2
- H Wickham
Principles and applications of medicolegal alcohol determination (Die theoretischen Grundlagen und die praktische Verwendbarkeit der gerichtlich-medizinischen Alkoholbestimmung- German)
- E M P Widmark
Drinking game participation among high school and incoming college students
- B L Zamboanga
- C C Tomaso
- R M Cloutier
- H Blumenthal
- S R Kenney
- B Borsari
Brief Alcohol Screening and Intervention for College Students (BASICS): A harm reduction approach
- L A Dimeff
- J S Baer
- D R Kivlahan
- G A Marlatt
A sharper Bonferroni procedure for multiple significance testing
- Y Hochberg