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Integrating Social Media Inspired Features into a Personalized Normative Feedback Intervention Combats Social Media-Based Alcohol Influence
Abstract
BACKROUND
Research suggests that the social media platforms popular on college campuses may reflect, reinforce, and even exacerbate heavy drinking practices among students. The present study was designed to directly examine: (1) whether exposure to alcohol-related content on social media diminishes the efficacy of a traditional web-based personalized normative feedback (PNF) alcohol intervention among first-year drinkers; and (2) if social media inspired features and digital game mechanics can be integrated into a PNF intervention to combat social media-based alcohol influence and increase efficacy.
METHOD
Alcohol experienced first-year college students (N = 223) completed a pre-survey that assessed exposure to alcohol-related content and social media and were randomized to 1 of 3 web-based alcohol PNF conditions (traditional, gamified only, or social media inspired gamified). One month later, participants’ alcohol consumption was reassessed.
RESULTS
Among participants who received traditional PNF, social media-based alcohol exposure interacted with pre-intervention drinking such that traditional PNF was less effective in reducing drinking among heavier drinkers reporting greater exposure to alcohol-related social media content. Further, when regression models compared the efficacy of all three conditions, the social media inspired gamified PNF condition was significantly more effective in reducing drinking than was traditional PNF among moderate and heavy drinkers reporting greater exposure to alcohol on social media.
CONCLUSION
Although additional research is needed, these findings suggest that representing the population of students on whom normative statistics are based with social media-like user avatars and profiles may enhance the degree to which alcohol PNF is relatable and believable among high-risk students.
... It is common to assess general exposure to alcohol-related content without specifying who is sharing the content (43.3% of the articles included in this review, e.g., see Geusens & Beullens, 2021;Vranken et al., 2020). However, exposure from several specific sources have been examined including friends (43.3% of articles included, e.g., see Brunelle & Hopley, 2017;Pegg et al., 2018;Roberson et al., 2018) and peers (13.3% of articles included, e.g., see Boyle et al., 2016Boyle et al., , 2021Cook et al., 2013;Davis et al., 2019;Hendriks et al., 2021). Although relationships between exposure to alcohol-related content and alcohol use persist even when a reference group is specified, oftentimes only one source is included so it hard to determine if social influences from peers or friends are having a greater impact on individual drinking behavior. ...
... For example, among female students, only enhancement drinking motives and pro-alcohol beliefs (but not typical student peak drinking norms) significantly mediated associations between exposure and alcohol consumption whereas all three mediators were significant among male students (Boyle et al., 2016). Exposure to alcohol-related social media content was also found to be a significant mediator of the relationship between having both public and Finsta (i.e., private pseudoanonymous Instagram account) social media accounts and weekly drinking 9 months later for males but not females (LaBrie, Boyle, Baez, et al., 2021). Among individuals who did not interact with alcohol-related social media content, the relationship between own posting of alcohol content and alcohol consumption is significantly mediated by close friend descriptive drinking norms (Alhabash, Mundel, et al., 2021). ...
Peer social influence is a robust predictor of problematic drinking among young adults and adolescents; it is typically assessed by collecting nonspecific social network information (i.e., behaviors of peers globally) or specific social network information (i.e., behaviors of named friends). Socialization happens both in-person and online through social media. Exposure to alcohol-related social media content is consistently related to alcohol consumption in cross-sectional and longitudinal studies alike. Previous research has often not focused on who specifically is sharing the alcohol-related social media content with most examining effects of exposure to content posted by nonspecific network members (e.g., peers, friends) and individual alcohol consumption. The purpose of the current critical review is to describe how exposure to alcohol-related social media content is commonly measured and how including a specific social network assessment may explain more variance in alcohol use. The review found inconsistencies in the reference groups used when assessing frequency of exposure and found that specific modalities of content exposure were often not assessed. Of the 30 published studies reviewed, 15 used cross-sectional designs, which is regrettable considering that the composition of adolescent and young adult peer groups have been found to change over time possibly affecting the content viewed. Understanding factors which affect the relationship between exposure to alcohol-related social media content and individual alcohol use has implications for tailoring drinking interventions to address the unique social influence of social media content. Gaps in the literature are summarized and future directions for research are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
... The current findings suggest that the peer drinking norms corrected in these interventions may be inflated/reinflated as a function of ARIC and encourage the development of novel strategies to address this issue. Suggestive of one potential avenue, pilot studies have revealed that the integration of social media-inspired copresence features (avatars and personal profiles) into PNF interventions may bolster norms correction among heavy drinking college students (LaBrie et al., 2019) and combat SMS-based alcohol influence (Boyle et al., 2021). In contrast to traditional PNF interventions that derive actual norms from existing university-specific or national datasets, these novel interventions are packaged as social media-inspired games with participating students digitally represented by avatars and personal profiles. ...
... Actual norms for alcohol use and other behaviors presented in PNF are then transparently derived in real-time from the answers of visible classmates. Pilot findings suggest that such social media-inspired PNF formats reduce alcohol use more effectively in the short-term than traditional PNF among heavy drinkers self-reporting greater exposure to alcohol-related content across SMSs (Boyle et al., 2021). Thus, findings from this study specifically encourage longer-term trials that examine both objective and subjective ARIC exposure as potential moderators of social media-inspired PNF intervention efficacy among first-year students. ...
Previous research suggests that exposure to alcohol-related content on social media sites (SMSs) may inflate perceptions of drinking norms, thereby increasing drinking among college students and potentially undermining popular social norms-based alcohol interventions. However, prior research on exposure has used subjective measures of alcohol exposure and has focused mostly on Facebook. The current study focused on Instagram, a popular SMS among college students, and utilized objective time tracking and newsfeed sampling methods to rigorously examine the prospective relationship between exposure to alcohol-related Instagram content (ARIC), alcohol cognitions, and drinking. Participants were 309 matriculating college students (Mage=18.1, SD=0.26; 62.1% female; 46.9% White/Caucasian; 17.5% Hispanic) who had their Instagram use tracked and newsfeeds sampled via a macro several times during the transition into college (August & September), and completed a baseline survey and two follow-up surveys. A sequential mediation model examined theoretically derived pathways between objective ARIC exposure and alcohol use. Results revealed that objective ARIC exposure during the transition to college was positively associated with drinking at the end of the first year of college, and subjective frequency of ARIC exposure mediated this relationship between objective ARIC exposure and later drinking. Subjective frequency of ARIC exposure also mediated the association between objective ARIC exposure and perceptions of descriptive norms, which, in turn, predicted later drinking. These findings illustrate that greater objective ARIC exposure during the transition into college may increase risky drinking over the first year via increased subjective frequency of ARIC and elevated perceptions of drinking norms. Priority directions for future research are discussed and several novel ways in which social norms-based interventions for first-year students may be enhanced to better combat ARIC-related influences are introduced.
... For example, adolescents exposed to the highest quartile of movie alcohol exposure were at increased risk for every drinking milestone, including sipping (7% increased risk for every extra hour of movie alcohol exposure), initiation (risk increased by 49% to 53% over 2 years), consuming a full alcoholic beverage (increased risk by 6% for each hour of movie alcohol exposure), weekly drinking (2.4 times more likely), heavy episodic drinking (8% additional risk per hour of movie alcohol exposure), and binge drinking (1.7 times more likely; Bigman et al., 2020;Jackson et al., 2018;Waylen et al., 2015). Complementing this, exposure to alcohol in popular media can limit the effectiveness of alcohol interventions (Boyle et al., 2021). ...
Reducing alcohol use is challenging due to the volume of alcohol shown in media and the relationship between exposure and use. It is unclear to what degree people are aware of and able to estimate alcohol exposure in the media, such as in movies. In this study, 609 Australian adults estimated the amount of alcohol exposure in up to 10 of 102 popular movies they remembered best. They reported when they last saw each movie, their alcohol use, age, and gender. Participants underestimated the amount of alcohol in movies by an average of 35.39 times. Movies classified as featuring adult content (PG-13 or R) and movies with the greatest amount of alcohol were particularly underestimated. Individual’s age, gender, alcohol use, or when the movie was last viewed had no effect on underestimation. In conclusion, due to the severe underestimation, alcohol exposure should be more seriously reviewed by governmental and medial organizations.
... et al. (2022), with the highest risk profiles in each study reporting the greatest use of Snapchat. More importantly, the current findings extend Russell and colleagues' (2022) work by incorporating alcohol-related SM behaviors into the latent profiles and by demonstrating that the profiles can longitudinally predict perceived peer drinking norms, a mechanism that can be used to combat SM-related risk in interventions (Boyle et al., 2021), and alcohol use and consequences during the transition to college, a period linked to the development of risky drinking trajectories (e.g., Riordan & Carey, 2019). Consistent with the Facebook Influence Model's predictions that alcohol-related posting and exposure to alcohol-related content can lead to escalations in drinking over time, the HGU + HAP group reported increases in perceived peer drinking norms and alcohol use and greater consequences at follow-up than did the HGU + LAP group. ...
Previous research has shown a reliable association between social media (SM) use and drinking among college students. However, most studies have investigated SM behaviors (e.g., time spent on a platform, posting frequency) in isolation and on a single site. While some have studied multiple SM behaviors across platforms using person-centered approaches (e.g., latent profile analysis [LPA]), these studies have failed to take alcohol-related SM behaviors into account. This longitudinal study addressed this gap in the literature by using LPA to identify subpopulations of SM users during the college transition (N=319; 62.1% female) using general (frequency of checking, time spent on, and frequency of posting to Instagram/Facebook/Snapchat; Finstagram ownership) and alcohol-related SM behaviors (posting alcohol, partying, and marijuana content). LPA results revealed three SM user profiles at baseline: low general use with low alcohol-related posting (LGU+LAP), high general use with low alcohol-related posting (HGU+LAP), and high general use with high alcohol-related posting (HGU+HAP). Prospective analyses revealed that HGU+HAP membership was associated with greater descriptive peer drinking norms, alcohol use, and consequences relative to HGU+LAP and LGU+LAP membership. Results suggest that there are distinct patterns of general and alcohol-related SM use during the college transition associated with risky drinking that can inform interventions combating SM-related alcohol risks. These findings illustrate the importance of investigating SM use holistically and suggests studying alcohol-related SM behaviors may reveal differences in individuals’ alcohol risk that general SM behaviors might not capture.
Excessive alcohol use among college students is associated with a host of deleterious physical, mental, and academic outcomes. Social Networking Sites (SNS) are thought to influence norms around alcohol consumption, leading to increased college student drinking. We utilized a sample of 330 college students to investigate the effects of Facebook, Instagram, Twitter, and Snapchat on college student drinking behavior. Only Snapchat use was associated with college student drinking even while controlling for confounders such as the amount of time spent on SNS. Interventions attempting to lower college student drinking should focus on Snapchat to have the most effective platform.
Background:
The consumption of alcohol and drugs, particularly in adolescents and young adults, has increased worldwide in the last several years, representing a significant public health challenge. Serious games have the potential to support preventive and treatment interventions for substance use, facilitating the acquisition of relevant knowledge and the motivation for changes in attitudes and behaviors regarding substance consumption.
Objective:
This scoping review aims to analyze a set of 7 relevant characteristics of current serious games designed to support the prevention and treatment of alcohol and drug consumption in adolescents and young adults-the substance addressed, the type of intervention, the theoretical basis, the computational techniques used, the mechanism for data security and privacy, the evaluation procedure followed, and the main results obtained.
Methods:
The review was performed by following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Data were retrieved from January 2010 to May 2022, using PubMed, Scopus (Elsevier), IEEE Xplore, and ACM Digital as data sources. The eligibility criteria included studies that described serious games designed to support the prevention or treatment of alcohol and drug consumption, targeted a population aged between 12 and 30 years, and included an evaluation procedure. Authors (JMM and IEEC) individually screened the titles and abstracts, and then full articles were reviewed for a final inclusion decision.
Results:
A total of 629 records were obtained, and 29 (4.6%) fulfilled the inclusion criteria. Most of the serious games (14/29, 48%) were focused on the prevention or treatment of alcohol use. The type of intervention that was the most supported was prevention (18/29, 62%), and most studies mentioned the theory, theoretical construct, or therapeutic technique used as a foundation (22/29, 76%). Most of the studies only provided information about the platform for execution (23/29, 79%), and few described the use of computational techniques, such as virtual reality or motion-based interaction (5/29, 17%). A small set of studies (10/29, 34%) explicitly mentioned how data security and privacy were addressed. Most of the reported evaluation protocols were pilot studies (11/29, 38%), followed by randomized controlled trials (10/29, 34%), and the reported results were positive in terms of acceptability, usability, and efficacy. However, more research is needed to assess long-term effects.
Conclusions:
Given the increasing interest in the use of serious games as digital interventions to support the prevention or treatment of substance use, knowing their main features is highly important. This review highlights whether and how current serious games incorporate 7 key features that are useful to consider for the further development of the area.
Many ethical questions have been raised regarding the use of social media and the internet, mainly related to the protection of young people in the digital environment. In order to critically address the research question "who is responsible for ethically protecting minors in the digital environment?", this paper will review the main literature available to understand the role of parents, the government, and companies in protecting young people within the digital environment. We employed a holistic process that covers a state-of-the-art review and desk research. The article is divided into four sessions; (1) Government Policies from the European Union (EU) Perspective; (2) Parental Control; (3) An Overview of Companies and the Private and Self-Regulation Sectors; and (4) the Ethical Dilemma. Throughout, we reviewed specific topics regarding the potentially harmful content for young people within the digital environment, questioned how ethical concerns shape content and interactions online and discussed how internet parenting styles impact risks and opportunities for young people in the digital world. Finally, we analysed the research question contrasting it with the main findings in this review and offered recommendations.
Background
Sexual minority women are more likely to drink alcohol, engage in heavy drinking, and experience alcohol-related problems than heterosexual women. However, culturally tailored interventions for this population have been slow to emerge.
Objective
This type 1 effectiveness-implementation trial examines the feasibility and efficacy of a gamified, culturally tailored, personalized normative feedback (PNF) alcohol intervention for sexual minority women who psychologically identify as lesbian, bisexual, or queer (LBQ).
Methods
The core components of a PNF intervention were delivered within LezParlay, a fun, social media–inspired, digital competition designed to challenge negative stereotypes about LBQ women and increase visibility. The competition was advertised on the web through social media platforms and collaboration with LBQ community organizations. After 2 rounds of play by a large cohort of LBQ women, a subsample of 500 drinkers already taking part in the competition were invited to participate in the evaluation study. Study participants were randomized to receive 1 of 3 unique sequences of PNF (ie, alcohol and stigma coping, alcohol and control, or control topics only) over 2 intervention rounds. Randomization was fully automated by the web app, and both researchers and participants were blinded.
ResultsAnalyses will evaluate whether PNF on alcohol use reduces participants’ drinking and negative consequences at 2 and 4 months postintervention; examine whether providing PNF on stigma-coping behaviors, in addition to alcohol use, further reduces alcohol use and consequences beyond PNF on alcohol alone; identify mediators and moderators of intervention efficacy; and examine broader LezParlay app engagement, acceptability, and perceived benefits.
Conclusions
This incognito intervention approach is uniquely oriented toward engaging and preventing alcohol-related risks among community populations of LBQ women who may view their heavy drinking as normative and not in need of change because of the visibility of alcohol use in sexual minority community spaces. Thus, this intervention strategy diverges from, and is intended to complement, more intensive programs being developed to meet the needs of LBQ women already motivated to reduce their consumption.
Trial RegistrationClinicalTrials.gov NCT03884478; https://clinicaltrials.gov/ct2/show/NCT03884478
International Registered Report Identifier (IRRID)DERR1-10.2196/24647
The popularity of online learning is growing exponentially. Accordingly, it is critical to understand how we can facilitate the learning experience for users in these unique online environments. Past research consistently finds that one important antecedent of online learning outcomes is social presence. However, there is limited research related to how to foster social presence perceptions among users. Further, research has yet to understand whether there are boundary conditions for the positive effects of social presence perceptions on user outcomes (e.g., perceived learning, satisfaction). The current work describes two studies to address these questions. The first study uses an experimental design to investigate how the perception of social presence can be increased in the online learning context. In the second study, we investigate the degree to which social presence perceptions are more beneficial for some individuals versus others. Specifically, we consider two personality traits (i.e., conscientiousness, extraversion) as moderators of the relationships between social presence perceptions and two outcomes – perceived learning and satisfaction. Overall, the results of these two studies provide important insights into how to enhance user outcomes in online learning and training environments.
The research explored explanatory mechanisms of change for a personalized normative feedback (PNF) intervention, through an adapted application of the Articulated Thoughts in Simulated Situation (ATSS) cognitive think-aloud paradigm. A sample of 70 (51% female) U.S. adjudicated students were randomly assigned to one of three conditions: a PNF-ATSS condition, a PNF-Only condition (without ATSS), and an active Control+ATSS condition which received psychoeducation about alcohol use. Students in both the PNF-Only and PNF-ATSS conditions reported significant reductions in their misperceived peer drinking norms and alcohol-related consequences at the 30-day follow-up, relative to students in the control condition. Participants in the PNF-ATSS condition drank significantly fewer drinks per week at follow-up than participants in the PNF-Only condition, but not less than participants in the control condition. Significant indirect effects were found for the ATSS codes of participants’ neutrality and believability toward PNF content. This study presents a proof of concept for an adapted ATSS think-aloud methodology as a clinical science intervention tool to specify the cognitive-affective processes of change linked to complex intervention for particular problems, persons, and contexts.
Adolescents and young adults in the United States are constantly exposed to substance-related media and advertising content. The current study seeks to explore, developmentally, how exposure to substance-related media content influences both normative beliefs about peer alcohol use and individual alcohol use. Youth (N = 4‚840; 50.6% female) were followed for ten years from age 12 to 22. Auto-regressive latent trajectory with structured residual (ALT-SR) models were used to explore within-person reciprocal associations between substance-related media content, descriptive norms, and alcohol use. Results indicated that‚ across adolescence and young adulthood, exposure to substance-related media content was associated with increased alcohol use via perceived alcohol norms. The pathway from media exposure to alcohol use was mediated by increased perceived norms for adolescents only. With screen time increasing over the last decade, it is important to invest resources into real-time interventions that address substance-related social media content as it relates to misperceived norms and to begin these interventions in early adolescence.
Social networking sites (SNSs) now serve as a primary form of communication among adolescents. Consequently, drug prevention campaigns delivered through SNSs have the potential to reach a wide network of adolescents if teens are willing to engage in the message diffusion process by commenting on, “liking,” following, creating, or sharing prevention messages with their networked peers. However, little is known about the psychosocial factors that influence adolescents’ willingness to participate in drug prevention social media campaigns. We use qualitative methods to explore reasons why adolescents may or may not want to engage in the message diffusion process. We conducted four semi-structured focus groups with a total of 33 high school students from various school- and community-based youth programs in Rhode Island. Focus groups were followed by a brief self-administered questionnaire collecting information about participants’ social media use to augment qualitative findings. Overall, findings reveal that engaging teens in the message diffusion process can be advantageous but difficult to accomplish due to multiple factors. Most notably, asking adolescents to participate in drug prevention campaigns delivered through SNSs means also asking youth to violate online norms that promote drug use, which could in turn subject them to peer reprisal. We conclude that future studies should begin to investigate strategies addressing the various challenges we identified. Meanwhile, prevention specialists should consider alternative or supplemental evidence-based approaches to drug prevention rather than invest resources into activities that may offer little return on investment.
As the popularity and diversity of social media platforms increases so does their utility for health research. Using social media for recruitment into clinical studies and/or delivering health behavior interventions may increase reach to a broader audience. However, evidence supporting the efficacy of these approaches is limited, and key questions remain with respect to optimal benchmarks, intervention development and methodology, participant engagement, informed consent, privacy, and data management. Little methodological guidance is available to researchers interested in using social media for health research. In this Tutorial, we summarize the content of the 2017 Society for Behavioral Medicine Pre-Conference Course entitled ‘Using Social Media for Research,’ at which the authors presented their experiences with methodological and ethical issues relating to social media-enabled research recruitment and intervention delivery. We identify common pitfalls and provide recommendations for recruitment and intervention via social media. We also discuss the ethical and responsible conduct of research using social media for each of these purposes.
This article aims to investigate whether alcohol-related disclosure and exposure on social media can predict later alcohol use, and to identify covariates in these relationships. Data were collected by online surveys (two waves) among students in Bergen, Norway. The first survey was administered in fall 2015. The follow-up took place during fall 2016. A total of 5,217 students participated in both waves. The surveys included questions about demographics, personality, alcohol use, alcohol-related cognitions (e.g., attitudes and norms), social media use, and disclosure and exposure of alcohol on social media. Bivariate comparisons were conducted to assess differences in alcohol use between the frequent (i.e., monthly or more often) disclosure and exposure groups and low-frequent disclosure and exposure groups. Crude and adjusted linear regressions were employed to investigate if disclosure and exposure of alcohol could predict later alcohol use, when controlling for a range of covariates. Compared to the low-frequent disclosure and exposure groups, participants which frequently disclosed or were frequently exposed to alcohol-related content had higher alcohol use at baseline and 1 year later (p < 0.001), when no covariates were controlled for. Frequent disclosure of content reflecting positive aspects of alcohol predicted stable or slightly increased alcohol use at Time 2 (p < 0.01), even when all covariates (i.e., demographics, personality, alcohol use, alcohol-related cognitions, and social media use) were controlled for. In conclusion, frequent disclosure and/or exposure to alcohol-related content predicted alcohol use over time. Alcohol disclosure/exposure on social media could for the most part not predict later alcohol use when baseline alcohol use was controlled for. High alcohol use and alcohol disclosure/exposure on social media appear to be strongly intertwined, which hampers identification of directionality between alcohol use and disclosure/exposure. Disclosing content reflecting positive aspects of alcohol was the only independent variable that could predict further alcohol use when other factors, like baseline alcohol use, were held constant. This finding suggests that disclosure of alcohol content reflecting positive aspects of alcohol might have a self-enhancing effect on the sharers' further alcohol consumption, or that disclosing such content could indicate lenient alcohol-related cognitions not detected by the current measurements.
Research suggests that people around the world spend anywhere from an hour to as much as ten hours daily on their smartphones. However, the vast majority of this research has used self-reported data, which is widely considered unreliable. The present research is among the first to capture actual smartphone use and to examine its relationship with individual and relational well-being. Results reveal that, although smartphone use is generally negatively associated with well-being, this is not always so. Deeper analyses show that certain categories of apps are positively associated with well-being, thus revealing a more nuanced relationship between smartphone use and individual well-being. Research which suggests a negative association between smartphone use and well-being may represent an oversimplified perspective of a complex relationship.
The use of Social Networking Sites (SNSs) has become an integral part of daily life, particularly for adolescents. The chapter examines the negative impact of social networking sites and how they may expose alcohol-related consumption and behavior to young adults, especially college students. In particular, the focus is on the use of two specific social networking sites, Facebook and Twitter, and their association with alcohol use. The review of existing literature reveals that the depiction of alcohol use on social networking sites has a deleterious effect on alcohol use through the creation of positive social norms toward use and abuse. Further, the chapter looks at the Theory of Differential Association to explain the use of SNS as a pivot to increased alcohol use by adolescents and young adults.
The objective of this study was to describe the feasibility of using Facebook as a platform to recruit and retain young adult veteran drinkers into an online-alcohol use intervention study. Facebook’s wide accessibility and popularity among the age group that comprises the majority of veterans from the conflicts in Iraq and Afghanistan make it a compelling resource through which research can extend its reach to this otherwise hard-to-reach group. We developed a series of Facebook advertisement campaigns to reach veteran drinkers not specifically searching for alcohol treatment. In doing so, we recruited 793 valid veteran participants in approximately two weeks for an advertising cost of $4.53 per obtained participant. The study sample consisted primarily of male veterans, between 19 and 34 years of age, who were drinking at moderate to heavy levels. Although about half of the sample reported mental health comorbidity, few had received any mental health or substance use treatment in the past year. Facebook appears to be a valuable mechanism through which to recruit young veterans with unmet behavioral health needs, although more specific efforts may be needed to engage certain types of veterans after initial study enrollment.
Patients are increasingly using online social networks (ie, social media) to connect with other patients and health care professionals-a trend called peer-to-peer health care. Because online social networks provide a means for health care professionals to communicate with patients, and for patients to communicate with each other, an opportunity exists to use social media as a modality to deliver behavioral interventions. Social media-delivered behavioral interventions have the potential to reduce the expense of behavioral interventions by eliminating visits, as well as increase our access to patients by becoming embedded in their social media feeds. Trials of online social network-delivered behavioral interventions have shown promise, but much is unknown about intervention development and methodology. In this paper, we discuss the process by which investigators can translate behavioral interventions for social media delivery. We present a model that describes the steps and decision points in this process, including the necessary training and reporting requirements. We also discuss issues pertinent to social media-delivered interventions, including cost, scalability, and privacy. Finally, we identify areas of research that are needed to optimize this emerging behavioral intervention modality.
Despite speculation that peers’ alcohol-related content on social media sites (SMS) may influence the alcohol use behaviors of SMS frequenting college students, this relationship has not been investigated longitudinally. The current prospective study assesses the relationship between exposure to peers’ alcohol-related SMS content and later-drinking among first-year college students. Among 408 first-year students, total exposure to peers’ alcohol-related content on Facebook, Instagram, and Snapchat during the initial 6 weeks of college predicted alcohol consumption 6 months later. The rather robust relationship persisted even after students’ and close friends drinking were accounted for, indicating that alcohol references on SMS do not simply reflect alcohol use behaviors that would otherwise be observed in the absence of SMS and be predictive of later alcohol use. Findings also illuminate important gender differences in the degree to which peers’ alcohol-related SMS content influenced later drinking behavior as well as psychological mediators of this relationship. Among females, enhancement drinking motives and beliefs about the role of alcohol in the college experience fully mediated the relationship between SMS alcohol exposure and later drinking. Males, however, evidenced a much stronger predictive relationship between SMS alcohol exposure and second semester drinking, with this relationship only partially explained by perceptions of drinking norms, enhancement drinking motives, and beliefs about the role of alcohol in the college experience. Implications of these findings for college drinking prevention efforts and directions for future research are discussed.
The use of Social Networking Sites (SNSs) has become an integral part of daily life, particularly for adolescents. The chapter examines the negative impact of social networking sites and how they may expose alcohol-related consumption and behavior to young adults, especially college students. In particular, the focus is on the use of two specific social networking sites, Facebook and Twitter, and their association with alcohol use. The review of existing literature reveals that the depiction of alcohol use on social networking sites has a deleterious effect on alcohol use through the creation of positive social norms toward use and abuse. Further, the chapter looks at the Theory of Differential Association to explain the use of SNS as a pivot to increased alcohol use by adolescents and young adults.
Alcohol-related content is common on social media and may both reflect and influence offline drinking behavior. Posting alcohol-related content has been linked to alcohol outcomes, including higher rates of alcohol consumption, cravings, alcohol-related problems, and clinical alcohol use disorders. Exposure to alcohol-related content on social media has likewise been associated with adverse alcohol outcomes. In this paper, we review research on the relationship between social media and alcohol use, and explore the ways that online identity and social influence can account for this relationship. Finally, we call for further research on the use of social media as a platform for prevention and intervention efforts.
Background
Norms clarification has been identified as an effective component of college student drinking interventions, prompting research on norms clarification as a single-component intervention known as Personalized Normative Feedback (PNF). Previous reviews have examined PNF in combination with other components but not as a stand-alone intervention.
Objectives
To investigate the degree to which computer-delivered stand-alone personalized normative feedback interventions reduce alcohol consumption and alcohol-related harms among college students and to compare gender-neutral and gender-specific PNF.
Data Sources
Electronic databases were searched systematically through November 2014. Reference lists were reviewed manually and forward and backward searches were conducted.
Selection Criteria
Outcome studies that compared computer-delivered, stand-alone PNF intervention with an assessment only, attention-matched, or active treatment control and reported alcohol use and harms among college students.
Methods
Between-group effect sizes were calculated as the standardized mean difference in change scores between treatment and control groups divided by pooled standard deviation. Within-group effect sizes were calculated as the raw mean difference between baseline and follow-up divided by pooled within-groups standard deviation.
Results
Eight studies (13 interventions) with a total of 2,050 participants were included. Compared to control participants, students who received gender-neutral (dbetween = 0.291, 95% CI [0.159, 0.423]) and gender-specific PNF (dbetween = 0.284, 95% CI [0.117, 0.451]) reported greater reductions in drinking from baseline to follow-up. Students who received gender-neutral PNF reported 3.027 (95% CI [2.171, 3.882]) fewer drinks per week at first follow-up and gender-specific PNF reported 3.089 (95% CI [0.992, 5.186]) fewer drinks. Intervention effects were small for harms (dbetween = 0.157, 95% CI [0.037, 0.278]).
Conclusions
Computer-delivered PNF is an effective stand-alone approach for reducing college student drinking and has a small impact on alcohol-related harms. Effects are small but clinically relevant when considered from a public health perspective. Additional research is needed to examine computer-delivered, stand-alone PNF as a population-level prevention program.
Both heavy drinking and related risky sexual behavior among college students are common and are often associated with a number of negative consequences. A previously reported randomized controlled trial showed that a brief personalized normative feedback (PNF) intervention reduced the alcohol consumption and alcohol-related risky sexual behavior of heavy drinking, sexually active college students (Lewis et al., 2014). For the present study, we examined what activities students were engaged in when viewing the feedback, as well as who they were with and where they were when receiving the intervention. Furthermore, we conducted supplemental analyses with perceived attentiveness as a hypothesized predictor of change using the same sample (N = 480). Findings indicated that most students were engaged in activities when viewing the feedback and that most students viewed the feedback alone and at home. Furthermore, results revealed PNF to be most effective in reducing drinks per week among participants who reported greater attention. Clinical implications and suggestions for additional research examining how attentiveness can be increased during Web-based interventions are discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
The present study examined the impact of socially based descriptive norms on willingness to drink alcohol, drinker prototype favorability, affective alcohol attitudes, and perceived vulnerability for alcohol-related consequences within the Prototype Willingness model. Descriptive norms were manipulated by having 189 young adolescents view experimenter-created profile pages from the social networking site Facebook, which either showed older peers drinking or not. The results provided evidence that descriptive norms for alcohol use, as portrayed by Facebook profiles, significantly impact willingness to use, prototypes, attitudes toward use, and perceived vulnerability. A multiple mediation analysis indicated that prototypes, attitudes, and perceptions of use mediated the relationship between the content of the Facebook profile and willingness. These results indicate that adolescents who perceive that alcohol use is normative, as evidenced by Facebook profiles, are at higher risk for cognitions shown to predict alcohol use than adolescents who do not see alcohol use portrayed as frequently on Facebook.
Perceived peer alcohol use is a predictor of consumption in college males; frequent references to alcohol on Facebook may encourage alcohol consumption. Content analysis of college males' Facebook profiles identified references to alcohol. The average age of 225 identified profiles was 19.9 years. Alcohol references were present on 85.3% of the profiles; the prevalence of alcohol was similar across each undergraduate grade. The average number of alcohol references per profile was 8.5 but increased with undergraduate year (p = .003; confidence interval = 1.5, 7.5). Students who were of legal drinking age referenced alcohol 4.5 times more than underage students, and an increase in number of Facebook friends was associated with an increase in displayed alcohol references (p < .001; confidence interval = 0.009, 0.02). Facebook is widely used in the college population; widespread alcohol displays on Facebook may influence social norms and cause increases in male college students' alcohol use.
Human beings can be proactive and engaged or, alternatively, passive and alienated, largely as a function of the social conditions in which they develop and function. Accordingly, research guided by self-determination theory has focused on the social-contextual conditions that facilitate versus forestall the natural processes of self-motivation and healthy psychological development. Specifically, factors have been examined that enhance versus undermine intrinsic motivation, self-regulation, and well-being. The findings have led to the postulate of three innate psychological needs--competence, autonomy, and relatedness--which when satisfied yield enhanced self-motivation and mental health and when thwarted lead to diminished motivation and well-being. Also considered is the significance of these psychological needs and processes within domains such as health care, education, work, sport, religion, and psychotherapy.
Previous research suggests that exposure to alcohol-related content on social media sites (SMSs) may inflate perceptions of drinking norms, thereby increasing drinking among college students and potentially undermining popular social norms-based alcohol interventions. However, prior research on exposure has used subjective measures of alcohol exposure and has focused mostly on Facebook. The current study focused on Instagram, a popular SMS among college students, and utilized objective time tracking and newsfeed sampling methods to rigorously examine the prospective relationship between exposure to alcohol-related Instagram content (ARIC), alcohol cognitions, and drinking. Participants were 309 matriculating college students (Mage=18.1, SD=0.26; 62.1% female; 46.9% White/Caucasian; 17.5% Hispanic) who had their Instagram use tracked and newsfeeds sampled via a macro several times during the transition into college (August & September), and completed a baseline survey and two follow-up surveys. A sequential mediation model examined theoretically derived pathways between objective ARIC exposure and alcohol use. Results revealed that objective ARIC exposure during the transition to college was positively associated with drinking at the end of the first year of college, and subjective frequency of ARIC exposure mediated this relationship between objective ARIC exposure and later drinking. Subjective frequency of ARIC exposure also mediated the association between objective ARIC exposure and perceptions of descriptive norms, which, in turn, predicted later drinking. These findings illustrate that greater objective ARIC exposure during the transition into college may increase risky drinking over the first year via increased subjective frequency of ARIC and elevated perceptions of drinking norms. Priority directions for future research are discussed and several novel ways in which social norms-based interventions for first-year students may be enhanced to better combat ARIC-related influences are introduced.
Virtual copresence, or the sense of being with others in an online space, is a feeling induced on many apps and websites through user avatars and browsable profile pages. Despite the small/modest effect sizes observed in popular web-based personalized normative feedback (PNF) alcohol interventions for college students, previous research has yet to consider how copresence might boost efficacy. This study builds on previous PNF gamification work to investigate whether specific copresence features (visual and text-based information about peers) increase PNF's ability to reduce alcohol use relative to a standard PNF condition and a gamified PNF condition. Copresence and perceptions of drinking norms (average drinks, peak drinks, and binge episodes) were assessed during a 3-week period following random assignment of college students (N = 235) to 1 of the 4 web-based PNF conditions (Standard PNF, Gamified PNF Only, Gamified PNF + Visual Copresence, and Gamified PNF + Maximum Copresence). These conditions asked the same questions about drinking and delivered identical PNF on alcohol use, but differed in the level of visual and text-based information about peers. Overall, only the gamified condition that featured maximum copresence significantly reduced drinking outcomes relative to standard PNF. However, conditional effects were moderated by pre-intervention drinking. Among heavier pre-intervention drinkers, both gamified conditions that featured copresence significantly improved upon Standard PNF in reducing alcohol use at follow-up. Findings suggest that including social media-like copresence features to visually represent and provide basic information about the peers contributing to the norms can enhance the efficacy of gamified PNF interventions, especially among high-risk heavy drinkers.
Social media are advocated as a prime channel through which to reach college students with health-related information. However, how well are colleges and universities utilizing social media as it was intended-a means to be truly social and not just promotional? Social media can only be effective if students actually follow, interact, and share the content being produced. The following study completed a census of student health center Facebook accounts in the United States as well as investigated students' motivations to follow, interact with, and share health-related content. Facebook pages were found for about 20% of student health centers, and about two thirds posted content within the past 14 days. However, their median number of "likes" was between 191 and 496 despite being in existence for an average of 6 years. Additionally, the majority of these centers' most recent posts were promotional, instead of trying to socially engage with their followers. Students indicated that they would be likely to follow, interact, or share social media content from college health accounts if they were incentivized to do so, if they thought the content could be relevant to them, or if they simply knew that the account existed. Unless more attention is given to growing their followings, resources used by student health organizations to consistently post content might be better placed elsewhere. Recommendations for increasing engagement with students are discussed.
Background
Personalized normative feedback (PNF) interventions have been repeatedly found to reduce drinking among undergraduates. However, effects tend to be small, potentially due to inattention to and inadequate processing of the information. Adding a writing component to PNF interventions may allow for greater cognitive processing of the feedback, thereby boosting intervention efficacy. Additionally, expressive writing (EW) has been shown to reduce drinking intentions; however, studies have not examined whether it can reduce drinking behavior. The present experiment evaluated whether including a writing task would improve the efficacy of PNF and whether EW alone can be used to reduce drinking and alcohol‐related problems.
Method
Heavy drinking undergraduates (N=250) were randomized to receive either: 1) PNF about their alcohol use; 2) EW about a negative, heavy drinking occasion; 3) PNF plus writing about the norms feedback; or 4) attention control feedback about their technology use in an online brief intervention. Participants (N=169) then completed a one‐month follow‐up survey about their past month alcohol use and alcohol‐related problems online.
Results
PNF plus writing reduced alcohol‐related problems compared to all other conditions. No significant reductions were found for EW. Both PNF and PNF plus writing reduced perceived norms and perceived norms mediated intervention effects for both feedback conditions.
Conclusions
The current findings suggest that adding a writing component to traditional norms‐based feedback approaches might be an efficacious strategy, particularly for reducing alcohol‐related consequences.
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Objective:
College students' reliance on social media is both a risk factor for alcohol-related problems and a possible avenue for intervention. Greater understanding of students' social media habits in relation to drinking may lead to more effective prevention efforts. This study examined the use of alcohol and social media in Hispanic and non-Hispanic college students with and without a history of binge drinking.
Method:
Participants (N = 424; age 18-25; 84% female) completed online surveys of alcohol use, intensity of use for Snapchat, Instagram, Facebook, and Twitter, social media addiction, and retrospective frequency of social media use while drinking and after intoxication.
Results:
Historical binge drinkers had greater intensity scores for Snapchat, Instagram, and Twitter, and were more likely to report using social media and alcohol concurrently, even while intoxicated (ps < .05). Compared with Hispanics, non-Hispanics exhibited greater intensity of use for Instagram (ps = .001). Quantity and frequency of alcohol use was positively correlated with intensity scores for Snapchat, Instagram and Twitter (ps < .001), as well as social media addiction (p < .001), and use of social media while drinking and after intoxication (ps < .001). Age at first alcohol use and first intoxication were negatively correlated with use of social media while drinking and after intoxication (ps < .001).
Conclusions:
The results of this study may inform intervention efforts aimed at curbing hazardous college drinking by highlighting a context in which students could be exposed to harm-reduction messages presented through social media.
Objective:
Despite its prominence in the health communication literature, psychological reactance has rarely been considered as a factor that may undermine web-based Personalized Normative Feedback (PNF) alcohol interventions for college students. This study built on recent gamification work to examine how chance-based uncertainty, a popular game mechanic associated with motivation and attention in digital games for learning, might be leveraged to reduce the psychological reactance experienced by heavy drinking students receiving alcohol PNF, thereby leading to larger reductions in their alcohol consumption.
Method:
Psychological reactance, perceptions of norms, and drinking behaviors were assessed during a 3-week period following random assignment of binge drinking students (N = 141, 51% female) into one of four web-based PNF conditions. These conditions asked the same questions about drinking and delivered identical PNF on alcohol use but differed in whether animated slot-machine spinners appeared to select participants' question and feedback topics as well as the number of additional topics (beyond alcohol) on which questions were asked and PNF was delivered.
Results:
All conditions similarly reduced drinking norms but differed in the degree to which they aroused cognitive reactance and reduced drinking. Relative to a no-spinner alcohol-only condition, increasing chance-based uncertainty by giving question and feedback topics the appearance of being selected by gamelike spinners substantially reduced cognitive reactance, which, in turn, reduced drinking 20 days later. Overall, participants experienced the least cognitive reactance when spinners first selected three question topics and later selected two of these topics to deliver feedback on.
Conclusions:
Findings suggest that introducing chance-based uncertainty through gamelike spinners, asking questions about multiple topics, and delivering feedback on additional topics unrelated to alcohol together work to reduce the degree to which the task feels like an alcohol intervention overtly aimed at reducing consumption, thereby making the alcohol PNF more effective among heavy drinking students.
Objective:
Examine 1) whether observed social reinforcements (i.e., "likes") received by peers' alcohol-related social media posts are related to first-year college students' perceptions of peer approval for risky drinking behaviors; and 2) whether associations are moderated by students' alcohol use status.
Participants:
First-year university students (N = 296) completed an online survey in September, 2014.
Method:
Participants reported their own alcohol use, friends' alcohol use, perceptions of the typical student's approval for risky drinking, and ranked 10 types of social media posts in terms of the relative numbers of "likes" received when posted by peers.
Results:
Observed social reinforcement (i.e., "likes") for peers' alcohol-related posts predicted perceptions of peer approval for risky drinking behaviors among non-drinking students, but not drinking students.
Conclusions:
For first-year college students who have not yet initiated drinking, observing peers' alcohol-related posts to receive abundant "likes" may increase perceptions of peer approval for risky drinking.
Our recent work (Boyle, Earle, LaBrie, & Smith, 2017) showed that the efficacy of personalized normative feedback-based (PNF) college alcohol interventions can be improved through the addition of gamified elements including points, chance, competition, and personal avatars. However, participants in that study were compensated with subject pool credit. In the current study, we piloted an upgraded, smartphone-based version of the game, which was designed to be truly self-sustaining (i.e., engaging enough that students play voluntarily without the presence of external motivators). First-year students were invited to play the game weekly for six rounds, with participants submitting and voting on their own questions each week and receiving a novel type of feedback in addition to standard descriptive PNF: opposite peers' judgments of participants' self-reported drinking behavior, or reflective norms. With no play-based incentives, 222 first-year college students voluntarily played the game, CampusGANDR. ANCOVA models revealed that, relative to participants randomized to receive feedback on control topics during the three intervention rounds, those who received both descriptive and reflective feedback on peer alcohol use had significantly reduced normative perceptions and reduced alcohol use two months post intervention. This was especially true among heavy drinkers. The results suggest that our gamified “GANDR” approach shows promise as a self-sustaining intervention approach and, further, that high-risk drinkers may benefit disproportionately from this methodology. Thus, self-sustaining interventions represent an encouraging avenue for future research and development and may hold the potential to impact risky college drinking on a large scale.
Keywords
Normative feedback; Gamified; College students; Social norms; Alcohol use
Aim:
To examine students' exposure to user-generated alcohol content on social media, and identify characteristics (i.e. demographics, personality traits, alcohol use, alcohol-related cognitions, and social media factors) associated with monthly or more frequent exposure.
Method:
College/university students (N=11,236) in Bergen, Norway, completed a web-survey measuring exposure to alcohol on social media - both frequency and interpretations of alcohol content. The survey included questions regarding demographics, personality, alcohol-related cognitions, and general use of social media and alcohol. Binary logistic regressions were run to identify characteristics associated with monthly or more frequent exposure to alcohol-related posts on social media.
Results:
A total of 96.7% had been exposed to alcohol-related posts, exposure to posts with a positive valence of alcohol were more frequently reported than exposure to content with a negative valence of alcohol. Reports of monthly or more frequent exposure to alcohol on social media were associated with a range of characteristics, among these younger age, being native Norwegian, lower extroversion and higher agreeableness and self-monitoring scores, higher alcohol use, stronger descriptive norms for alcohol use among online-friends, and more frequent logins to social media.
Conclusions:
Students' potential inflated alcohol norms (originating from social media) should be addressed. The results suggest that exposure may be determined by high alcohol use and membership in demographical groups associated with high alcohol use, an increased attentiveness towards others' behavior, and excessive social media use. Future studies investigating the relationship between alcohol exposure on social media and later alcohol use should control for such factors.
Gamification is defined in the Oxford English Dictionary as “The application of typical elements of game playing (e.g. point scoring, competition with others, rule of play) to other areas of activity, typically as an online marketing technique to encourage engagement with a product or service.”¹ Increasingly, as highlighted in the new study by Patel and colleagues,² it is being used in medicine and public health to motivate behavior change.
This study draws on belongingness theory to explore the impact of social presence on addiction to social networking sites (SNSs). A conceptual framework was developed and empirically tested based on data collected from 278 SNS users in China. The results demonstrate that social presence is positively related to sense of belonging and enjoyment. Sense of belonging has a positive effect on enjoyment, including escapism, pleasure and arousal, but has no effect on SNS addiction. Escapism and pleasure can result in SNS addiction, but arousal has no significant influence. Drawing on a new perspective of belongingness theory, this study makes theoretical contributions related to social presence and SNS addiction, and the findings have managerial implications for SNS providers and users.
Objective:
This article estimates percentages of U.S. emerging adults ages 18-24 engaging in past-month heavy episodic drinking and past-year alcohol-impaired driving, and numbers experiencing alcohol-related unintentional injury deaths and overdose hospitalizations between 1998 and 2014.
Method:
We analyzed national injury mortality data from coroner, census, and college enrollment statistics, the National Survey on Drug Use and Health, and the Nationwide Inpatient Sample.
Results:
From 1999 to 2005, percentages of emerging adults ages 18-24 reporting past-month heavy episodic drinking rose from 37.1% to 43.1% and then declined to 38.8% in 2014. Alcohol-impaired driving rose from 24% to 25.5% and then declined to 16.0%. Alcohol-related unintentional injury deaths increased from 4,807 in 1998 to 5,531 in 2005 and then declined to 4,105 in 2014, a reduction of 29% per 100,000 since 1998. Alcohol-related traffic deaths increased from 3,783 in 1998 to 4,114 in 2005 and then declined to 2,614 in 2014, down 43% per 100,000 since 1998. Alcohol-related overdose deaths increased from 207 in 1998 to 891 in 2014, a 254% increase per 100,000. Other types of nontraffic unintentional injury deaths declined. Alcohol-overdose hospitalizations rose 26% per 100,000 from 1998 to 2014, especially from increases in alcohol/other drug overdoses, up 61% (alcohol/opioid overdoses up 197%).
Conclusions:
Among emerging adults, a trend toward increased alcohol-related unintentional injury deaths, heavy episodic drinking, and alcohol-impaired driving between 1998 and 2005 was reversed by 2014. Persistent high levels of heavy episodic drinking and related problems among emerging adults underscore a need to expand individually oriented interventions, college/community collaborative programs, and evidence-supported policies to reduce their drinking and related problems.
Significance
The dissemination of unverified content (e.g., “fake” news) is a societal problem with influence that can acquire tremendous reach when propagated through social networks. This article examines how evaluating information in a social context affects fact-checking behavior. Across eight experiments, people fact-checked less often when they evaluated claims in a collective (e.g., group or social media) compared with an individual setting. Inducing momentary vigilance increased the rate of fact-checking. These findings advance our understanding of whether and when people scrutinize information in social environments. In an era of rapid information diffusion, identifying the conditions under which people are less likely to verify the content that they consume is both conceptually important and practically relevant.
Background:
Alcohol-related blackouts are a common consequence of heavy drinking, and these blackouts pose risk for injury and other adverse health outcomes.
Objective:
To examine the prevalence and correlates of blackouts among underage drinkers.
Methods:
Youth (ages 14-20) presenting to a suburban Emergency Department (ED) completed screening surveys. Among those reporting past-year alcohol consumption, we examined past 3-month blackouts in relation to: background characteristics (e.g., demographics, fraternity/sorority involvement), substance use, sexual risk behaviors and incapacitated sexual assault (unaware/unable to consent due to alcohol/drugs), forced sexual assault, positive depression screening, and reason for ED visit (injury vs. medical).
Results:
In total, 2,300 past-year drinkers participated: 58% female, 75% Caucasian, and mean age = 18.4. Regarding past 3-month blackouts, 72.7% reported none, 19.3% reported monthly or less, and 8% reported monthly or more. Multivariate cumulative logit regression indicated that blackout frequency was positively associated with: college involvement in Greek life, alcohol use severity, prescription drug misuse, marijuana, screening positive for depression, incapacitated sexual assault, and a gender by alcohol use severity interaction.
Conclusion:
With one-quarter of this clinical sample reporting recent blackouts, as well as the association between blackout frequency and health risk behaviors and other outcomes, findings underscore the need for programs focusing on substance use, depression, and preventing sexual assault. Interventions should also address poly-substance use and drinking motives. Although findings highlight how college students in Greek life may be at high risk for blackouts, many participants not in college also reported blackouts, suggesting that interventions in other settings are also needed.
Gamified interventions exploit the motivational characteristics of a game in order to provide prevention information and promote behavior change. Despite the modest effect sizes observed in increasingly popular web-based personalized normative feedback (PNF) alcohol interventions for college students, previous research has yet to consider how gamification might be used to enhance efficacy. This study examines whether a novel, gamified PNF intervention format, which includes a point-based reward system, the element of chance, and personal icons to visually represent users, is more effective in reducing short-term alcohol use than the standard web-based style of PNF currently used on college campuses. Two-hundred and thirty-seven college students were randomly assigned to receive either a standard brief, web-based PNF alcohol intervention or the same alcohol intervention components delivered within a Facebook-connected social game called CampusGANDR (Gamified Alcohol Norm Discovery and Readjustment). In both study conditions participants answered identical questions about their perceptions of peer drinking norms and own drinking and then received the same PNF slides. Two weeks following PNF delivery, participants again reported their perceptions of peers' alcohol use and own drinking. Students in the CampusGANDR condition reported significantly reduced peer drinking norms and alcohol use at the two-week follow-up relative to students who received identical PNF delivered by standard online survey. Further, a mediation model demonstrated that this effect was driven by larger reductions in perceived drinking norms among participants assigned to receive CampusGANDR, relative to control. As web-based PNF is becoming an increasingly universal prevention strategy, findings from this study suggest gamification may represent one method by which intervention efficacy could be substantially improved. The potential methodological and economic benefits associated with gamified PNF interventions are emphasized and directions for future research are discussed.
Studies examining representations of college drinking on social media have almost exclusively focused on Facebook. However, recent research suggests college students may be more influenced by peers' alcohol-related posts on Instagram and Snapchat, two image-based platforms popular among this demographic. One potential explanation for this differential influence is that qualitative distinctions in the types of alcohol-related content posted by students on these three platforms may exist. Informed by undergraduate focus groups, this study examined the hypothesis that, of the three platforms, students tend to use Instagram most often for photos glamourizing drinking and Snapchat for incriminating photos of alcohol misuse and negative consequences. Undergraduate research assistants aided investigators in developing hypothetical vignettes and photographic examples of posts both glamorizing and depicting negative consequences associated with college drinking. In an online survey, vignette and photo stimuli were followed by counterbalanced paired comparisons that presented each possible pair of social media platforms. Undergraduates (N = 196) selected the platform from each pair on which they would be more likely to see each post. Generalized Bradley-Terry models examined the probabilities of platform selections. As predicted, Instagram was seen as the most probable destination (and Facebook least probable) for photos depicting alcohol use as attractive and glamorous. Conversely, Snapchat was selected as the most probable destination (and Facebook least probable) for items depicting negative consequences associated with heavy drinking. Results suggest researchers aiming to mitigate the potential influences associated with college students' glamorous and consequential alcohol-related photos posted social media posts should shift their focus from Facebook to Instagram and Snapchat.
The spread of smartphones triggers the universal use of smartphone-based social networking services (SNS) by satisfying users' needs for maintaining seamless, constant connection and developing intimate relationships with others, such as family, friends, and acquaintances. Under the circumstances, this study examines the consequences of ubiquitous connectivity, considering that it is a typical characteristic of mobile technologies. More specifically, this study addresses both sides of ubiquitous connectivity due to smartphone-based SNS namely, social presence and privacy concern. Furthermore, the study verifies the role of enjoyment which has been argued as a key determinant of the continued use of hedonic IS. The results show that first, ubiquitous connectivity increases social presence and privacy concern simultaneously. Second, enjoyment derives from not only ubiquitous connectivity but also social presence and privacy concern. Finally, smartphone-based SNS continuance intention is determined by enjoyment, social presence, and privacy concern. Discussion and implications on the results are presented.
Background:
Personalized normative feedback (PNF) interventions are designed to reduce misperceived drinking norms by delivering feedback regarding the actual drinking behavior of college students, thereby leading to subsequent reductions in one's own drinking.
Objective:
We examined the roles of data source credibility and reference group proximity in the effectiveness of a laboratory-based PNF intervention to reduce perceived drinking norms and thereby decrease intentions to drink.
Method:
Following completion of an online preintervention survey and using a 2 (highly credible data source/low credible data source) × 2 (proximal reference group/distal reference group) between-subjects factorial design, 104 college student drinkers were randomly assigned to condition. Participants then completed a postintervention questionnaire to assess for changes in various aspects of drinking.
Results:
Highly credible feedback was associated with greater reductions in perceived weekly drinking by American college students compared to feedback with low credibility. Similarly, more proximal than distal reference group feedback led to greater reductions in perceived weekly drinking by a same-gender/same-class year students at one's university. No condition effects emerged for intended drinks per week.
Conclusions:
PNF interventions may benefit from considering data source credibility and reference group proximity to reduce misperceptions of college student drinking, depending on the goals and resources of practitioners implementing such programs. Even the use of such a distal reference group as American college students can indeed lead to a reduction of normative perceptions provided there is an emphasis on the credibility of the data source.
Objectives:
Web-based interventions enable organisations to deliver personalised individually tailored brief feedback to individuals without the need of a third party. Web-based interventions are effective in reducing alcohol consumption among university students. There is a paucity of evidence to indicate those who access web-based personalised feedback interventions respond in a way consistent with hypothesised active ingredients. This research uses the think-aloud technique to explore how students respond to instant web-based personalised normative feedback.
Methods:
Between-subjects experimental design employing qualitative methods. Twenty-one UK university students generated think-aloud transcripts while completing a web-based intervention (Unitcheck). This was followed by a semi-structured interview. One coding frame was developed to classify all utterances.
Results:
Narrative synthesis revealed five meta-themes: active thinking about alcohol use; comparisons with others; beliefs and knowledge about alcohol consumption; inter-relationship between personal codes and context; and engagement with Unitcheck.
Conclusions:
Students willingly engaged with the online assessment and personalised feedback. Students consciously engaged with the intervention and this engagement prompted students to actively consider their own behaviour, knowledge, perceptions, and to reflect on future behaviour. The ability of web-based personalised feedback interventions to effect change in individual's behaviours is likely related to their ability to encourage cognitive engagement and active processing of the information provided.
Objective:
Given widespread alcohol misuse among college students, numerous intervention programs have been developed, including personalized normative feedback (PNF). Most research evaluating PNF assumes that presenting one's own perceived norms is necessary to correct normative misperceptions and thereby reduce drinking. Alternatively, simply providing social comparison information showing that one drinks more than others may be sufficient. The present study evaluated the efficacy of full PNF (one's own drinking, campus drinking rates, and perceived norms) and a partial personalized social comparison feedback (PSCF; one's own drinking and campus drinking rates) in a randomized trial among heavy-drinking college students.
Method:
Participants included 623 heavy-drinking students from 3 universities. Assessments occurred at baseline and 3- and 6-months postbaseline.
Results:
Primary analyses examined differences across 4 drinking outcomes (drinks per week, total drinks past month, frequency of past month drinking, and negative alcohol-related consequences) at 3- and 6-month follow-ups controlling for the baseline variable. Results revealed significant reductions across all alcohol consumption outcomes at 3 months in both intervention conditions compared to attention-control. Mediation analyses demonstrated significant indirect effects of the intervention on 6-month drinking through changes in perceived norms at 3 months. Moreover, evidence emerged for changes in drinking at 3 months as a mediator of the association between PSCF and 6-month perceived norms.
Conclusions:
The present research suggests PNF may not require explicit consideration of one's perceived norms to be effective and that direct social comparison provides an alternative theoretical mechanism for PNF efficacy. (PsycINFO Database Record
The use of social media to address college drinking is only in its infancy, with this the first review of developments in this area. Given nearly all college students use Facebook, most research has focused on this social networking site. Evidence suggests a disproportionate amount of alcohol content is posted by students on Facebook, influencing peer drinking norms. Portraying oneself as ‘a drinker’ is an important and socially desirable component of online identity for many students, and a study of alcohol content can be used to identify at-risk students. Early findings suggest Facebook can also be used to deliver a personalised normative feedback intervention, resulting in clinically significant reductions in alcohol consumption. There are unprecedented opportunities to build on these findings by utilizing untested peer-to-peer sharing and geo-locating aspects of social media.
Social media and mobile applications (apps) are popular among and frequently used by adolescents and young adults. These digital platforms allow access to content that is influential regarding substance use. Previous research on social media sites such as Facebook and Twitter have described best practices in social media research, documented the prevalence and types of substance use displayed on social media, determined associations between displayed content and offline behaviors, and highlighted potential for interventions. Research on substance use apps has been more limited and can be framed considering both the risk-protectiveness and connectedness of the app.
Introduction. This study explores college students' use of social networking sites for health and wellness information and their perceptions of this use. Method. Thirty-eight college students were interviewed. Analysis. The interview transcripts were analysed using the qualitative content analysis method. Results. Those who had experience using social networking sites for health information used the platform mainly to check health updates of a loved one, find lifestyle information and ask about treatments for mild conditions. Overall, participants were sceptical about the quality of information, concerned about the lack of medical knowledge of their friends or peers and wary about possible social risks and invasion of privacy. Based on the results, a model of users' acceptance of social networking sites for health and wellness information was proposed and implications for designing social platforms to better support health inquiries were discussed. Conclusions. Using social networking sites for health and wellness information is not a popular behaviour among college students in this study and social networking sites seem not to be a well-perceived platform for health and wellness information.
Facebook has become an important tool for recruiting research participants and for program delivery. Given the wide use of Facebook, there is much potential for the site to help with recruitment efforts in both physical and behavioral health care arenas; reaching groups typically difficult to recruit and providing outreach to individuals that may not have received services elsewhere. Health studies using Facebook have generally reported success, including cost-effectiveness, recruitment of samples in brief periods of time, and ability to locate participants for follow-up research. Still, the use of Facebook for research and program delivery is a relatively new area that warrants more research attention and guidance around issues like validity of data, representativeness of samples, and protections of human subjects.
Providing people with information about the behavior and attitudes of their peers is a strategy commonly employed by those seeking to reduce behavior deemed harmful either to individuals (e.g., high alcohol consumption) or the collective (e.g., high energy consumption). We review norm-based interventions, detailing the logic behind them and the various forms they can take. We give special attention to interventions designed to decrease college students' drinking and increase environment-friendly behaviors. We identify the conditions under which norm information has the highest likelihood of changing the targeted behavior and discuss why this is the case. Expected final online publication date for the Annual Review of Psychology Volume 67 is January 03, 2016. Please see http://www.annualreviews.org/catalog/pubdates.aspx for revised estimates.
For over 2 decades, brief motivational interventions (BMIs) have been implemented on college campuses to reduce heavy drinking and related negative consequences. Such interventions include in-person motivational interviews (MIs), often incorporating personalized feedback (PF), and stand-alone PF interventions delivered via mail, computer, or the Web. Both narrative and meta-analytic reviews using aggregate data from published studies suggest at least short-term efficacy of BMIs, although overall effect sizes have been small.
Research has consistently documented that college students tend to overestimate drinking norms, thus contributing to alcohol-related problems on college campuses. The current study aimed to assess whether alcohol-related content posted on online social networking sites can impact perceived drinking norms of college students. A total of 57 college students from a university in Midwestern United States participated in the fall semester of 2010. A between-subjects experimental design was used in which participants viewed a fictitious Facebook profile with or without alcohol-related content and then reported their perceptions of college student drinking norms. Participants who viewed alcohol-related content on Facebook estimated higher college drinking norms than those who did not. Findings are discussed in the context of the importance and challenge of researching online social networking content. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
University students usually overestimate peer alcohol use, resulting in them 'drinking up' to perceived norms. Social norms theory suggests correcting these inflated perceptions can reduce alcohol consumption. Recent findings by the current authors show portraying oneself as 'a drinker' is considered by many students to be a socially desirable component of their Facebook identity, perpetuating an online culture that normalises binge drinking. However, social networking sites have yet to be utilised in social norms interventions.
Actual and perceived descriptive and injunctive drinking norms were collected from 244 university students. Ninety-five students screened positive for hazardous drinking and were randomly allocated to a control group or intervention group that received social norms feedback via personalised Facebook private messages over three sessions.
At 1 month post-intervention, the quantity and frequency of alcohol consumed by intervention group during the previous month had significantly reduced compared with baseline and controls. Reductions were maintained 3 months post-intervention. Intervention group perceived drinking norms were significantly more accurate post-intervention.
This is the first study to test the feasibility of using Facebook to deliver social norms interventions. Correcting misperceptions of peer drinking norms resulted in clinically significant reductions in alcohol use. Facebook has many advantages over traditional social norms delivery, providing an innovative method for tackling problem drinking at university. These results have implications for the use of Facebook to deliver positive messages about safe alcohol use to students, which may counter the negative messages regarding alcohol normally seen on Facebook. [Ridout B, Campbell A. Using Facebook to deliver a social norm intervention to reduce problem drinking at university. Drug Alcohol Rev 2014].
Alcohol is a key component of identity exploration for many young people, yet few studies have investigated identity construction in relation to problematic drinking. Increases in youth alcohol consumption have coincided with expanding use of communications technologies, particularly social networking sites (SNS), which have altered traditional conditions of identity construction. It has been found young people often engage with alcohol in the SNS environment by portraying themselves as binge drinkers. The current study applied an innovative approach to identity construction (the photographic essay) to provide insight into the portrayal of ‘alcohol-identity’ on Facebook.
One hundred and fifty-eight university students completed a range of alcohol measures before providing access for researchers to view their Facebook profiles to operationalise their alcohol-identity according to autophotographic methodology.
Participants utilised a variety of photographic and textual material to present alcohol as a component of their identity on Facebook, with over half having selected an alcohol-related profile image. Alcohol-identity predicted alcohol consumption and problematic alcohol-related behaviours as measured by questionnaires used to reliably identify alcohol-related problems in university students. Almost 60% reported potentially problematic alcohol use according to the Alcohol Use Disorders Identification Test.
Findings suggest that portraying oneself as a drinker is considered by many young people to be a socially desirable component of identity in the SNS environment, perpetuating an online culture that normalises binge drinking. Ready-made Facebook photo essays provide an alternate method of accessing problematic alcohol use, supplementing self-report measures.